Science.gov

Sample records for communicable disease update

  1. ISS Update: High Rate Communications System

    NASA Image and Video Library

    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. Nutrimetabolomics: An Update on Analytical Approaches to Investigate the Role of Plant-Based Foods and Their Bioactive Compounds in Non-Communicable Chronic Diseases

    PubMed Central

    Rangel-Huerta, Oscar Daniel; Gil, Angel

    2016-01-01

    Metabolomics is the study of low-weight molecules present in biological samples such as biofluids, tissue/cellular extracts, and culture media. Metabolomics research is increasing, and at the moment, it has several applications in the food science and nutrition fields. In the present review, we provide an update about the most frequently used methodologies and metabolomic platforms in these areas. Also, we discuss different metabolomic strategies regarding the discovery of new bioactive compounds (BACs) in plant-based foods. Furthermore, we review the existing literature related to the use of metabolomics to investigate the potential protective role of BACs in the prevention and treatment of non-communicable chronic diseases, namely cardiovascular disease, diabetes, and cancer. PMID:27941699

  3. Nutrimetabolomics: An Update on Analytical Approaches to Investigate the Role of Plant-Based Foods and Their Bioactive Compounds in Non-Communicable Chronic Diseases.

    PubMed

    Rangel-Huerta, Oscar Daniel; Gil, Angel

    2016-12-09

    Metabolomics is the study of low-weight molecules present in biological samples such as biofluids, tissue/cellular extracts, and culture media. Metabolomics research is increasing, and at the moment, it has several applications in the food science and nutrition fields. In the present review, we provide an update about the most frequently used methodologies and metabolomic platforms in these areas. Also, we discuss different metabolomic strategies regarding the discovery of new bioactive compounds (BACs) in plant-based foods. Furthermore, we review the existing literature related to the use of metabolomics to investigate the potential protective role of BACs in the prevention and treatment of non-communicable chronic diseases, namely cardiovascular disease, diabetes, and cancer.

  4. Update on medical management of Peyronie's disease.

    PubMed

    Tan, Ronny B W; Sangkum, Premsant; Mitchell, Gregory C; Hellstrom, Wayne J G

    2014-06-01

    The treatment of Peyronie's disease (PD) is a challenge for the clinician. In the quest to straighten the penis, alleviate pain, prevent further shortening, and restore erectile function, many non-surgical treatments have been offered in lieu of an operative approach, which is still considered the gold standard for definitive treatment. This communication is an update on the different approaches used in the minimally invasive management of this frustrating and yet intriguing condition.

  5. Alzheimer disease update.

    PubMed

    Matthews, Brandy R

    2010-04-01

    Alzheimer disease (AD) is a progressive neurodegenerative disorder affecting more than 37 million people worldwide and increasing in incidence based on its primary risk factor, advancing age. A growing body of knowledge regarding amyloid and tau neuropathology, genetic and environmental risk modifiers, early and atypical clinical presentations, and the use of symptom-modifying medical and psychosocial therapies is available to aid in the diagnosis and management of patients with AD. Exciting recent advances in neurobiology render the areas of genetic susceptibility, biomarkers for early disease detection and assessment of disease progression, and novel therapeutic strategies to modify the natural history of the disease compelling, but in need of further study before implementation into routine clinical practice is feasible.

  6. Parkinson disease: an update.

    PubMed

    Gazewood, John D; Richards, D Roxanne; Clebak, Karl

    2013-02-15

    Parkinson disease is a progressive neurologic disorder afflicting approximately 1 percent of Americans older than 60 years. The cardinal features of Parkinson disease are bradykinesia, rigidity, tremor, and postural instability. There are a number of neurologic conditions that mimic the disease, making it difficult to diagnose in its early stages. Physicians who rarely diagnose Parkinson disease should refer patients suspected of having it to physicians with more experience in making the diagnosis, and should periodically reevaluate the accuracy of the diagnosis. Treatment is effective in reducing motor impairment and disability, and should be started when a patient begins to experience functional impairment. The combination of carbidopa and levodopa is the most effective treatment, but dopamine agonists and monoamine oxidase-B inhibitors are also effective, and are less likely to cause dyskinesias. For patients taking carbidopa/levodopa who have motor complications, adjunctive therapy with a dopamine agonist, a monoamine oxidase-B inhibitor, or a catechol O-methyltransferase inhibitor will improve motor symptoms and functional status, but with an increase in dyskinesias. Deep brain stimulation is effective in patients who have poorly controlled symptoms despite optimal medical therapy. Occupational, physical, and speech therapy improve patient function. Fatigue, sleep disturbances, dementia, and depression are common in patients with Parkinson disease. Although these conditions are associated with significantly lower quality of life, they may improve with treatment.

  7. [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.

  8. Parkinson Disease Psychosis: Update

    PubMed Central

    Friedman, J. H.

    2013-01-01

    Psychotic symptoms are common in drug treated patients with Parkinson's disease (PD). Visual hallucinations occur in about 30% and delusions, typically paranoid in nature, occur in about 5%. These problems, particularly the delusions, cause great distress for patient and caregivers, and are among the most important precipitants for nursing home placement. Psychotic symptoms carry a poor prognosis. They often herald dementia, and are associated with increased mortality. These symptoms often abate with medication reductions, but this may not be tolerated due to worsened motor function. Only clozapine has level A evidence to support its use in PD patients with psychosis (PDP), whether demented or not. While quetiapine has been recommended by the American Academy of Neurology for “consideration,” double blind placebo controlled trials have demonstrated safety but not efficacy. Other antipsychotic drugs have been reported to worsen motor function and data on the effectiveness of cholinesterase inhibitors is limited. PDP remains a serious problem with limited treatment options. PMID:23242358

  9. Update on Wilson disease.

    PubMed

    Aggarwal, Annu; Bhatt, Mohit

    2013-01-01

    Wilson disease (WD) is an inherited disorder of chronic copper toxicosis characterized by excessive copper deposition in the body, primarily in the liver and the brain. It is a progressive disease and fatal if untreated. Excessive copper accumulation results from the inability of liver to excrete copper in bile. Copper is an essential trace metal and has a crucial role in many metabolic processes. Almost all of the body copper is protein bound. In WD, the slow but relentless copper accumulation overwhelms the copper chaperones (copper-binding proteins), resulting in high levels of free copper and copper-induced tissue injury. Liver is the central organ for copper metabolism, and copper is initially accumulated in the liver but over time spills to other tissues. WD has protean clinical manifestations mainly attributable to liver, brain, and osseomuscular impairment. Diagnosis of WD is challenging and based on combination of clinical features and laboratory tests. Identification of various high-frequency mutations identified in different population studies across the world has revived interest in developing DNA chips for rapid genetic diagnosis of WD. All symptomatic and all presymptomatic patients require lifelong decoppering with careful clinical tracking. Decoppering ensures that presymptomatic individuals remain symptom free. With judicious decoppering, given time, even patients with severe neurological disability improve and can return to normal life and resume school or work at par with their peers. Treatment regimens and tracking patients using the WD-specific Global Assessment Scale for WD (GAS for WD) are discussed. © 2013 Elsevier Inc. All rights reserved.

  10. An Update on Autoinflammatory Diseases

    PubMed Central

    Ciccarelli, F.; Martinis, M. De; Ginaldi, L.

    2013-01-01

    Autoinflammatory diseases area group of clinical conditions other than autoimmune diseases, characterized by recurrent inflammatory episodes. From apathogenetic point of view they are determined by a dys regulation of innate immunity, without involvement of specific immunity (auto reactive T cells and auto antibodies). Recently, the increased knowledge in the field of auto inflammation highlighted shared immune mechanisms in the pathogenesis of both classical monogenetic and multifactorial auto inflammatory diseases and a broad spectrum of chronic age-related inflammatory pathologies. The current increase in the prevalence of chronic inflammatory diseases makes this subject of topical interest. In the light of these considerations, we propose an update of auto inflammatory diseases and a new interpretation of auto inflammation with both theoretical and clinical implications. PMID:24164192

  11. Update in Infectious Diseases 2017.

    PubMed

    Candel, F J; Peñuelas, M; Lejárraga, C; Emilov, T; Rico, C; Díaz, I; Lázaro, C; Viñuela-Prieto, J M; Matesanz, M

    2017-09-01

    Antimicrobial resistance in complex models of continuous infection is a current issue. The update 2017 course addresses about microbiological, epidemiological and clinical aspects useful for a current approach to infectious disease. During the last year, nosocomial pneumonia approach guides, recommendations for management of yeast and filamentous fungal infections, review papers on the empirical approach to peritonitis and extensive guidelines on stewardship have been published. HIV infection is being treated before and more intensively. The implementation of molecular biology, spectrometry and inmunology to traditional techniques of staining and culture achieve a better and faster microbiological diagnosis. Finally, the infection is increasingly integrated, assessing non-antibiotic aspects in the treatment.

  12. Tumorous diseases of turkeys - an update

    USDA-ARS?s Scientific Manuscript database

    This update is primarily focused on addressing various aspects of virus-induced tumorous diseases of turkeys including review of current methods for diagnosis and control of these diseases of turkeys. Virus-induced tumorous diseases of turkeys are caused primarily by retroviruses, namely reticuloend...

  13. Clinical update: communication issues and advance care planning.

    PubMed

    Moore, Crystal Dea; Reynolds, Ashley M

    2013-11-01

    To provide a clinical update on practical strategies to enhance the quality of communication in the palliative and end-of-life medical care settings. Published articles, textbooks, reports, and clinical experience. The components of effective and compassionate care throughout the advanced illness trajectory require thoughtful and strategic communication with patients, families, and members of the health care team. Unfortunately, few health care professionals are formally trained in communication skills. Nurses who possess self-awareness and are skilled in effective communication practices are integral to the provision of high-quality palliative care for patients and families coping with advanced malignancies. Copyright © 2013 Elsevier Inc. All rights reserved.

  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. Chagas Heart Disease: An Update.

    PubMed

    Malik, Lindsey H; Singh, Gagan D; Amsterdam, Ezra A

    2015-11-01

    Chagas disease, also known as American trypanosomiasis, results from infection by the protozoan Trypanosoma cruzi, and is a major cause of cardiac disease worldwide. Until recently, Chagas disease was confined to those areas of South and Central America where Trypanosoma cruzi is endemic. With the migration of infected individuals, however, the disease has spread, and it is estimated that 6-7 million people worldwide are infected. In the US alone, more than 7 million people from Trypanosoma cruzi-endemic countries became legal US residents by the turn of the century, resulting in a surge of Chagas disease in this country. According to preliminary estimates, the US now ranks seventh in the Western Hemisphere in number of individuals infected with Trypanosoma cruzi, and the disease has become a major public health concern due to limited awareness in the medical community. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Update on diseases of chinchillas.

    PubMed

    Mans, Christoph; Donnelly, Thomas M

    2013-05-01

    Chinchillas have been successfully maintained in captivity for almost a century. They have only recently been recognized as excellent, long-lived, and robust pets. Most of the literature on diseases of chinchillas comes from farmed chinchillas, whereas reports of pet chinchilla diseases continue to be sparse. This review aims to provide information on current, poorly reported disorders of pet chinchillas, such as penile problems, urolithiasis, periodontal disease, otitis media, cardiac disease, pseudomonadal infections, and giardiasis. This review is intended to serve as a complement to current veterinary literature while providing valuable and clinically relevant information for veterinarians treating chinchillas.

  17. Disease mapping in veterinary parasitology: an update.

    PubMed

    Rinaldi, L; Musella, V; Cringoli, G

    2006-06-01

    The development of methods for disease mapping has progressed considerably in recent years. Geographical Information Systems (GIS) and Remote Sensing (RS) represent new tools for the study of epidemiology, and their application to veterinary medicine, and in particular to veterinary parasitology, has become more and more advanced to study the spatial and temporal patterns of diseases. The present paper reports an update regarding the use of these technologies in veterinary parasitology.

  18. Update in Diffuse Parenchymal Lung Disease 2013

    PubMed Central

    Kaminski, Naftali

    2015-01-01

    The period covered by this update can be considered as the most exciting period in idiopathic pulmonary fibrosis (IPF) research. It started with the identification of genetic variants that are associated with IPF in the majority of patients and continued with discovery of molecular and genetic biomarkers that predict distinct clinical presentations of patients with IPF and potential new biological mechanisms. More importantly, the period ends with the publication of two groundbreaking studies that confirmed that two drugs, pirfenidone and nintedanib, slowed disease progression, leading to a historic approval by the FDA. In this update, we describe these key advances, their scientific and significant clinical implications, and future directions. PMID:25635490

  19. 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.

  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. Video Image Communication And Retrieval - Updated

    NASA Technical Reports Server (NTRS)

    Wall, Ray J.; Jepsen, Paul L.; Andersen, Kurt K.; Bartholomew, Paul D.; Deen, Robert G.; Girard, Michael A.; Greer, Thomas C.; Hodges, David R.; Jentoft-Nilsen, Merit; Lewicki, Scott A.; hide

    1991-01-01

    Video Image Communication and Retrieval (VICAR) package of computer programs is general-purpose image-processing software system. Intended for processing data from Jet Propulsion Laboratory's unmanned planetary spacecraft, now used in variety of other applications, including processing of biomedical images, cartography, studies of Earth resources, and geological exploration. Development of newest version of VICAR emphasizes standardized, easily-understood user interface, shield between user and host operating system, and comprehensive array of image-processing capabilities.

  2. Desmosomes and disease: an update.

    PubMed

    Chidgey, M

    2002-10-01

    Desmosomes play a critical role in the maintenance of normal tissue architecture. Skin blistering can occur when desmosomal adhesion is compromised by antibodies in autoimmune diseases such as pemphigus. Inherited mutations in genes encoding desmosomal constituents can adversely affect the skin, and result in heart abnormalities. Desmosomes may have a tumour suppressor function: expression of desmosomal components is reduced in some human cancers, and desmosomal cadherins have the capacity to suppress the invasiveness of cells in culture. Transgenic animal research has provided important insights into the role of these junctions in normal epithelial morphogenesis and disease.

  3. 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

  4. [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. Copyright © 2013 Elsevier España, S.L. and AEEH y AEG. All rights reserved.

  5. Hodgkin's disease: update of findings.

    PubMed

    Pileri, S; Sabattini, E; Tazzari, P L; Gherlinzoni, F; Zucchini, L; Bigerna, B; Leoncini, L; Rosso, R; Stein, H; Falini, B

    1991-01-01

    The authors critically review the problem of Hodgkin's disease (HD) in the light of new morphological, immunohistochemical, kinetic, genotypic, and virological findings. These support the lymphoid origin of neoplastic Hodgkin's and Reed-Sternberg cells, because of regular expression of the CD30 lymphoid activation antigen and frequent detection of B- or T-cell phenotypic and/or genotypic markers. It is possible to hypothesize the release of cytokines by tumoral elements as well as the presence of specific cytokine receptors on their surface. This might explain some clinical and pathological features, such as fever, loss of weight, eosinophilia and attraction of reactive elements that make up the composite cellular milieu of typical HD. Integration of monoclonal EBV in the genoma of neoplastic elements has repeatedly been shown, and this might play an essential role in the pathogenesis of the disease. On the basis of present concepts, the borderlines between HD and some categories of non-Hodgkin's lymphomas--especially the anaplastic large cell forms--have become somewhat blurred. Additional research work in the field of HD is desirable and might pave the way for new and more effective therapeutic approaches, designed on the basis of the natural history of the neoplasm.

  6. Updated Deep Space Communications Complex VLBI Processor

    NASA Astrophysics Data System (ADS)

    Navarro, R.; Rogstad, S.; Goodhart, C. E.; Sigman, E.; Soriano, M.; Wang, D.; White, Leslie A.; Jacobs, Christopher S.

    JPL VLBI Data Acquisition Modernization Program has two Current Purposes with two different recording systems. One for Radio Reference Frame and Time & Earth Motion Observations - Uses MarkIV formatters and Mark5A recorders. One for Double Differential One Way Ranging for spacecraft tracking - Uses Wideband VLBI Science Receiver. We are currently working on a new modernized system to merge functions into one new hardware platform. It will replace the current MarkIV, PCFS and Mark5-A equipment. The new system will be called the JPL Deep Space Communications Complex VLBI Processor (DVP) It is based on hardware development at JPL, NRAO and Haystack. It uses a JPL designed digitizer and the CASPER ROACH board to perform digital backend processing: sampling, channelization, formatting. It uses Mark5C disk units to record data. It aims for compatibility with other VLBI centers recording equipment while conforming to JPL DSN system interface requirements.

  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. Estrogen and thyroid diseases: an update.

    PubMed

    Lu, Yihan; Li, Jian; Li, Jing

    2016-08-01

    Most of thyroid diseases show female predilection, especially autoimmune thyroid diseases (AITD) and thyroid cancer (TC). We give an updated brief review here, focusing on estrogen, estrogen receptor (ER) and AITD as well as TC. Estrogen can regulate the functions of nearly all immunocyte subsets, which may contribute to the development of AITD. However, there was still lack of direct studies on ER subtype-specific effects on AITD. Recently, the local expression of ER subtypes and their individual mediated actions in the pathogenesis of TC have already received much attention. ERα activation seems to exacerbate the development of TC, while wild-type ERβ (ERβ1) plays a protective role against TC.

  9. Update on pathology of ocular parasitic disease

    PubMed Central

    Das, Dipankar; Ramachandra, Varsha; Islam, Saidul; Bhattacharjee, Harsha; Biswas, Jyotirmay; Koul, Akanksha; Deka, Panna; Deka, Apurba

    2016-01-01

    Parasites are a group of eukaryotic organisms that may be free-living or form a symbiotic or parasitic relationship with the hosts. Consisting of over 800,000 recognized species, parasites may be unicellular (Protozoa) or multicellular (helminths and arthropods). The association of parasites with human population started long before the emergence of civilization. Parasitic zoonotic diseases are prevalent worldwide including India. Appropriate epidemiological data are lacking on existing zoonotic parasitic diseases, and newer diseases are emerging in our scenario. Systemic diseases such as cysticercosis, paragonimiasis, hydatidosis, and toxoplasmosis are fairly common. Acquired Toxoplasma infections are rising in immune-deficient individuals. Amongst the ocular parasitic diseases, various protozoas such as Cystoidea, trematodes, tissue flagellates, sporozoas etc. affect humans in general and eyes in particular, in different parts of the world. These zoonoses seem to be a real health related problem globally. Recent intensification of research throughout the world has led to specialization in biological fields, creating a conducive situation for researchers interested in this subject. The basics of parasitology lie in morphology, pathology, and with recent updates in molecular parasitology, the scope has extended further. The current review is to address the recent update in ophthalmic parasites with special reference to pathology and give a glimpse of further research in this field. PMID:27958200

  10. [Sexually transmitted diseases--an update].

    PubMed

    Davidovitch, Nadav; Shohat, Tami; Dan, Michael

    2005-04-01

    Sexually transmitted infections represent an worldwide challenge for the public health. According to WHO estimates, approximately 330 million people are infected annually by curable sexually transmitted infections (AIDS excluded). and their incidence has been increasing, particularly in high-risk populations. Like in other developed countries, the occurrence of venereal diseases in Israel has been increasing recently. In addition, a sharp rise has been observed in the resistance rate of gonococci to fluoroquinolones. The purpose of the present review is to update the information on the epidemiology, diagnosis, therapy and prevention of sexually transmitted diseases (STDs) in Israel. In response to the reemergence of these diseases in Israel, it was decided in the Ministry of Health to open for the first time ever STD clinics in the two cities with the highest disease burden, namely Tel Aviv and Haifa. These clinics are staffed with a multidisciplinary group of specialists, including gynecologists, dermatologists, epidemiologists, nurses and social workers.

  11. An update on risk communication in the Arctic.

    PubMed

    Krümmel, Eva-Maria; Gilman, Andrew

    2016-01-01

    Background Arctic residents can be exposed to a wide range of contaminants through consumption of traditional (country) foods (i.e. food from wild animals and plants that are hunted, caught or collected locally in the Arctic). Yet these foods provide excellent nutrition, promote social cohesion, meet some spiritual needs for connectedness to the land and water, reinforce cultural ties, are economically important and promote overall good health for many. The risk and benefit balance associated with the consumption of traditional Arctic foods is complicated to communicate and has been referred to as the "Arctic Dilemma". This article gives an update on health risk communication in the Arctic region. It briefly summarizes some research on risk communication methodologies as well as approaches to an evaluation of the outcomes of risk communication initiatives. It provides information on specific initiatives in several Arctic countries, and particularly those that were directed at Indigenous populations. This article also summarizes some international versus local risk communication activities and the complexity of developing and delivering messages designed for different audiences. Finally, the potential application of social media for risk communication and a summary of "best practices" based on published literature and a survey of Inuit in a few Arctic countries are described. Conclusion Several of the risk communication initiatives portrayed in this article indicate that there is only limited awareness of the outcome of risk communication messages. In some cases, risk communication efforts appear to have been successful, at least when effectiveness is measured in an indirect way, for example, by lower contaminant levels. However, due to missing effectiveness evaluation studies, uncertainty remains as to whether a specific risk communication method was successful and could be clearly linked to behavioural changes that resulted in decreased contaminant exposure.

  12. An update on risk communication in the Arctic.

    PubMed

    Krümmel, Eva-Maria; Gilman, Andrew

    2016-01-01

    Arctic residents can be exposed to a wide range of contaminants through consumption of traditional (country) foods (i.e. food from wild animals and plants that are hunted, caught or collected locally in the Arctic). Yet these foods provide excellent nutrition, promote social cohesion, meet some spiritual needs for connectedness to the land and water, reinforce cultural ties, are economically important and promote overall good health for many. The risk and benefit balance associated with the consumption of traditional Arctic foods is complicated to communicate and has been referred to as the "Arctic Dilemma". This article gives an update on health risk communication in the Arctic region. It briefly summarizes some research on risk communication methodologies as well as approaches to an evaluation of the outcomes of risk communication initiatives. It provides information on specific initiatives in several Arctic countries, and particularly those that were directed at Indigenous populations. This article also summarizes some international versus local risk communication activities and the complexity of developing and delivering messages designed for different audiences. Finally, the potential application of social media for risk communication and a summary of "best practices" based on published literature and a survey of Inuit in a few Arctic countries are described. Several of the risk communication initiatives portrayed in this article indicate that there is only limited awareness of the outcome of risk communication messages. In some cases, risk communication efforts appear to have been successful, at least when effectiveness is measured in an indirect way, for example, by lower contaminant levels. However, due to missing effectiveness evaluation studies, uncertainty remains as to whether a specific risk communication method was successful and could be clearly linked to behavioural changes that resulted in decreased contaminant exposure.

  13. An update on risk communication in the Arctic

    PubMed Central

    Krümmel, Eva-Maria; Gilman, Andrew

    2016-01-01

    Background Arctic residents can be exposed to a wide range of contaminants through consumption of traditional (country) foods (i.e. food from wild animals and plants that are hunted, caught or collected locally in the Arctic). Yet these foods provide excellent nutrition, promote social cohesion, meet some spiritual needs for connectedness to the land and water, reinforce cultural ties, are economically important and promote overall good health for many. The risk and benefit balance associated with the consumption of traditional Arctic foods is complicated to communicate and has been referred to as the “Arctic Dilemma”. This article gives an update on health risk communication in the Arctic region. It briefly summarizes some research on risk communication methodologies as well as approaches to an evaluation of the outcomes of risk communication initiatives. It provides information on specific initiatives in several Arctic countries, and particularly those that were directed at Indigenous populations. This article also summarizes some international versus local risk communication activities and the complexity of developing and delivering messages designed for different audiences. Finally, the potential application of social media for risk communication and a summary of “best practices” based on published literature and a survey of Inuit in a few Arctic countries are described. Conclusion Several of the risk communication initiatives portrayed in this article indicate that there is only limited awareness of the outcome of risk communication messages. In some cases, risk communication efforts appear to have been successful, at least when effectiveness is measured in an indirect way, for example, by lower contaminant levels. However, due to missing effectiveness evaluation studies, uncertainty remains as to whether a specific risk communication method was successful and could be clearly linked to behavioural changes that resulted in decreased contaminant

  14. Update on Charcot-Marie-Tooth disease.

    PubMed

    Gutmann, Laurie; Shy, Michael

    2015-10-01

    Charcot-Marie-Tooth disease (CMT) is the common terminology used to describe the hereditary neuropathies. This update reviews advances in the past year in our understanding of these diseases, including some important earlier references. In the past year, advances in next-generation sequencing continued to increase the number of genes associated with CMT. The connection between genotype and phenotype has become more complicated. New insights into the pathogenesis of the diseases are reviewed. Treatment and clinical trial updates coming from these new insights, as well as use of high-throughput screening to match potential treatments with targets, are moving the field forward. There is a discussion of potential next steps, including the use of patient-derived induced pluripotent stem cells, to enhance our understanding of individual genotypes and phenotypes. The use of high-throughput screens, and techniques such as RNAi and induced pluripotent stem cell continue to push forward other therapies for specific genetic forms of CMT and are potentially more generalizable to peripheral neuropathies. These developments, along with the development of improved outcome measures and longitudinal natural history data, advance CMT, making the future for finding treatments and/or cures closer than it has ever been.

  15. Communication Partner Training in Aphasia: An Updated Systematic Review.

    PubMed

    Simmons-Mackie, Nina; Raymer, Anastasia; Cherney, Leora R

    2016-12-01

    To update a previous systematic review describing the effect of communication partner training on individuals with aphasia and their communication partners, with clinical questions addressing effects of partner training on language, communication activity/participation, psychosocial adjustment, and quality of life. Twelve electronic databases were searched using 23 search terms. References from relevant articles were hand searched. Three reviewers independently reviewed abstracts, excluding those that failed to meet inclusion criteria. Thirty-two full text articles were reviewed by 2 independent reviewers. Articles not meeting inclusion criteria were eliminated, resulting in a corpus of 25 articles for full review. For the 25 articles, 1 reviewer extracted descriptive data regarding participants, intervention, outcome measures, and results. A second reviewer verified the accuracy of the extracted data. The 3-member review team classified studies using the American Academy of Neurology levels of evidence. Two independent reviewers evaluated each article using design-specific tools to assess research quality. All 25 of the current review articles reported positive changes from partner training. Therefore, to date, 56 studies across 2 systematic reviews have reported positive outcomes from communication partner training in aphasia. The results of the current review are consistent with the previous review and necessitate no change to the earlier recommendations, suggesting that communication partner training should be conducted to improve partner skill in facilitating the communication of people with chronic aphasia. Additional high-quality research is needed to strengthen the original 2010 recommendations and expand recommendations to individuals with acute aphasia. High-quality clinical trials are also needed to demonstrate implementation of communication partner training in complex environments (eg, health care). Copyright © 2016 American Congress of

  16. 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

  17. Update on epigenetics in allergic disease.

    PubMed

    Harb, Hani; Renz, Harald

    2015-01-01

    Chronic inflammatory diseases, including allergies and asthma, are the result of complex gene-environment interactions. One of the most challenging questions in this regard relates to the biochemical mechanism of how exogenous environmental trigger factors modulate and modify gene expression, subsequently leading to the development of chronic inflammatory conditions. Epigenetics comprises the umbrella of biochemical reactions and mechanisms, such as DNA methylation and chromatin modifications on histones and other structures. Recently, several lifestyle and environmental factors have been investigated in terms of such biochemical interactions with the gene expression-regulating machinery: allergens; microbes and microbial compounds; dietary factors, including vitamin B12, folic acid, and fish oil; obesity; and stress. This article aims to update recent developments in this context with an emphasis on allergy and asthma research.

  18. 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.

  19. 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

  20. Communicable disease control in Afghanistan.

    PubMed

    Ikram, Mohammad S; Powell, Clydette L; Bano, Rashida A; Quddus, Arshad D; Shah, Syad K; Ogden, Ellyn L; Butt, Waqar R; Moideen, Mohd Arshil

    2014-01-01

    Among public health challenges in Afghanistan, communicable diseases still predominate because the epidemiologic transition to chronic disease has not yet occurred. Afghanistan's 10-year journey to improve its response to communicable disease is reflected in varying degrees of progress and innovation, all while long-standing conflict and geographic inaccessibility limit outreach and effective service delivery to vulnerable populations. Although Afghanistan is close to achieving polio elimination, other reportable communicable diseases are only slowly achieving their goals and objectives through targeted, sustained programmatic efforts. The introduction of disease early warning systems has allowed for identification and investigation of outbreaks within 48 hours. Tuberculosis case detection has risen over the last 10 years, and treatment success rates have been sustained at World Health Organization targets over the last 5 years at 85%. These successes are in large part due to increased government commitment, Global Fund support, training of community health workers and improved laboratory capabilities. Malaria cases dropped between 2002 and 2010. HIV/AIDS has been kept at low levels except in only certain sub-sectors of the population. In order to build on these achievements, Afghanistan will need a comprehensive strategy for all communicable diseases, with better human and infrastructure development, better multi-sectoral development and international collaboration.

  1. 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.

  2. Updated management of chronic kidney disease in patients with diabetes.

    PubMed

    Hass, Virginia McCoy

    2014-06-01

    Chronic diseases, including chronic kidney disease (CKD), are the primary threat to global public health in the 21st century. Recently updated guidelines from the National Kidney Foundation's Kidney Disease Outcomes Quality Initiative provide patient care benchmarks that physician assistants can use when caring for patients with diabetes and CKD and developing clinical performance improvement plans.

  3. An update on clinical immunology, immune mechanisms and deficiency diseases.

    PubMed

    Hill, Harry R

    2012-11-01

    29th Annual Jackson Hole, Wyoming, Update in Clinical Immunology, Microbiology and Infectious Diseases Salt Lake city, UT, USA, 9-13 July 2012 The 29th Annual Jackson Hole, Wyoming, Update in Clinical Immunology, Microbiology and Infectious Diseases was held from 9 to 13 July 2012. This postgraduate, continuing medical education course of the University of Utah's Department of Pathology (UT, USA) is designed for laboratorians, clinical pathologists, pathologists, clinicians, clinical immunology and infectious disease specialists and medical technologists, as well as residents and fellows training in immunology, microbiology or infectious diseases.

  4. ISS Update: Alvin Drew Talks about Delayed Communications

    NASA Image and Video Library

    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...

  5. Diagnosis and Updates in Celiac Disease.

    PubMed

    Shannahan, Sarah; Leffler, Daniel A

    2017-01-01

    Celiac disease is an autoimmune disorder induced by gluten in genetically susceptible individuals. It can result in intraintestinal and extraintestinal manifestations of disease including diarrhea, weight loss, anemia, osteoporosis, or lymphoma. Diagnosis of celiac disease is made through initial serologic testing and then confirmed by histopathologic examination of duodenal biopsies. Generally celiac disease is a benign disorder with a good prognosis in those who adhere to a gluten-free diet. However, in refractory disease, complications may develop that warrant additional testing with more advanced radiologic and endoscopic methods. This article reviews the current strategy to diagnose celiac disease and the newer modalities to assess for associated complications. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Alzheimer disease: update on basic mechanisms.

    PubMed

    Bi, Xiaoning

    2010-09-01

    Alzheimer disease is the most common form of dementia in the aged population. Pathologically, Alzheimer disease is characterized by progressive synaptic and neuronal loss and the presence of diagnostic amyloid plaques, consisting of fibril b-amyloid peptide aggregates and neurofibrillary tangles containing hyperphosphorylated tau protein filaments. Although plaques and tangles were originally considered the mediators of neurotoxicity in Alzheimer disease, recent research has underscored the roles of soluble β-amyloid oligomers and tau molecules. Furthermore, new evidence has re-emphasized the important roles of endocytic, autophagic, and lysosomal pathways in Alzheimer disease pathogenesis-including the finding that deficiency or mutations in the gene that encodes presenilin 1 (the most common cause for early-onset familial Alzheimer disease) impairs the maturation of the lysosomal proton pump. The author discusses recent developments in the perspective of Alzheimer disease pathogenesis and potential therapeutic interventions.

  7. UPDATE ON SWINE DISEASE AND GENOMICS RESEARCH

    USDA-ARS?s Scientific Manuscript database

    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...

  8. Military Infectious Diseases Update on Vaccine Development

    DTIC Science & Technology

    2011-01-24

    Research Program (MIDRP) Insect Vector ControlDiagnostics Prevention Treatment Infectious diseases adversely impact military operations. Vaccines...appropriate treatment and aids commanders in the field. Most militarily relevant infectious diseases are transmitted by biting insects and other...based Insect Repellent (1946) Vaccines Protectants Antiparasitic Drugs Research Effort Advanced Development Fielded Products Malaria Rapid

  9. Celiac disease. CME update for family physicians.

    PubMed Central

    Devlin, Shane M.; Andrews, Christopher N.; Beck, Paul L.

    2004-01-01

    OBJECTIVE: To review current understanding of the epidemiology, pathophysiology, diagnosis, and management of celiac disease. QUALITY OF EVIDENCE: Few recent randomized controlled trials (level I evidence) have studied treatments for celiac disease. There are recent comparative studies (level II evidence) and there is well established consensus (level III evidence) on diagnosis and treatment of celiac disease. MAIN MESSAGE: Celiac disease is an immune-mediated small bowel enteropathy caused by exposure to wheat gluten protein. The disease can be insidious and often presents with only subtle extraintestinal manifestations in a variety of organ systems. Recent epidemiologic surveys suggest celiac disease is much more common in North America than previously thought. Advances in immunology and screening have made diagnosis more reliable than in the past. Removing gluten from the diet is effective in most cases. CONCLUSION: Celiac disease manifests subtly and is an easy diagnosis to miss. Good laboratory screening tests and effective treatment are available. Family practitioners should consider celiac disease in patients who present with confounding symptoms. PMID:15171674

  10. Liver Disease in Cystic Fibrosis: an Update

    PubMed Central

    Parisi, Giuseppe Fabio; Di Dio, Giovanna; Franzonello, Chiara; Gennaro, Alessia; Rotolo, Novella; Lionetti, Elena; Leonardi, Salvatore

    2013-01-01

    Context Cystic fibrosis (CF) is the most widespread autosomal recessive genetic disorder that limits life expectation amongst the Caucasian population. As the median survival has increased related to early multidisciplinary intervention, other manifestations of CF have emergedespecially for the broad spectrum of hepatobiliary involvement. The present study reviews the existing literature on liver disease in cystic fibrosis and describes the key issues for an adequate clinical evaluation and management of patients, with a focus on the pathogenetic, clinical and diagnostic-therapeutic aspects of liver disease in CF. Evidence Acquisition A literature search of electronic databases was undertaken for relevant studies published from 1990 about liver disease in cystic fibrosis. The databases searched were: EMBASE, PubMed and Cochrane Library. Results CF is due to mutations in the gene on chromosome 7 that encodes an amino acidic polypeptide named CFTR (cystic fibrosis transmembrane regulator). The hepatic manifestations include particular changes referring to the basic CFTR defect, iatrogenic lesions or consequences of the multisystem disease. Even though hepatobiliary disease is the most common non-pulmonary cause ofmortalityin CF (the third after pulmonary disease and transplant complications), only about the 33%ofCF patients presents clinically significant hepatobiliary disease. Conclusions Liver disease will have a growing impact on survival and quality of life of cystic fibrosis patients because a longer life expectancy and for this it is important its early recognition and a correct clinical management aimed atdelaying the onset of complications. This review could represent an opportunity to encourage researchers to better investigate genotype-phenotype correlation associated with the development of cystic fibrosis liver disease, especially for non-CFTR genetic polymorphisms, and detect predisposed individuals. Therapeutic trials are needed to find strategies of

  11. [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. © Georg Thieme Verlag KG Stuttgart · New York.

  12. Endemic Poultry Viral Diseases 2016 Research Update

    USDA-ARS?s Scientific Manuscript database

    Viral infections of the avian gastrointestinal tract negatively impact poultry production; however, determining the complex etiologies of the viral enteric diseases in poultry has been difficult. Project scientists are continuing to investigate the species specificity, molecular phylogenetics, and p...

  13. Update on Diffuse Lung Disease in Children.

    PubMed

    Vece, Timothy J; Young, Lisa R

    2016-03-01

    Diffuse lung diseases in children, also called children's interstitial lung disease, are a diverse group of rare disorders that cause disturbances of gas exchange in the lungs. Although individually rare, there are many different forms of diffuse lung disease in children, and collectively these disorders are associated with significant morbidity and mortality, as well as health-care resource utilization. Over the past several years, there have been many significant advances in the field, including genetic discoveries and the development of clinical practice guidelines. This review summarizes recent advances in the understanding, diagnosis, and treatment of diffuse lung diseases in children. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  14. 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.

  15. Sickle Cell Disease: A Brief Update.

    PubMed

    Azar, Sharl; Wong, Trisha E

    2017-03-01

    Sickle cell disease (SCD) is an inherited monogenic disease characterized by misshapen red blood cells that causes vaso-occlusive disease, vasculopathy, and systemic inflammation. Approximately 300,000 infants are born per year with SCD globally. Acute, chronic, and acute-on-chronic complications contribute to end-organ damage and adversely affect quantity and quality of life. Hematopoietic stem cell transplantation is the only cure available today, but is not feasible for the vast majority of people suffering from SCD. Fortunately, new therapies are in late clinical trials and more are in the pipeline, offering hope for this unfortunate disease, which has increasing global burden. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Thromboangiitis obliterans. An update on Buerger's disease.

    PubMed Central

    Szuba, A; Cooke, J P

    1998-01-01

    Buerger's disease (thromboangiitis obliterans) is a nonnecrotizing vasculitis affecting small and medium-sized arteries, typically in young male smokers. The diagnosis can often be made on the basis of a careful history and physical examination, together with ancillary laboratory studies. Occasionally arteriography is warranted to confirm the diagnosis. The pathological findings are distinctive and distinguish this disorder from other arterial occlusive diseases. Successful therapy is possible only with absolute abstinence from tobacco. Images Figure 1. Figure 2. Figure 3. PMID:9584663

  17. 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.

  18. ISS Update: Communication Delays During Deep Space Missions

    NASA Image and Video Library

    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...

  19. 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.

  20. Inflammation in neurodegenerative diseases--an update.

    PubMed

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

    2014-06-01

    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.

  1. Charcot-Marie-Tooth disease: an update.

    PubMed

    Shy, Michael E

    2004-10-01

    The purpose of this review is to assist neurologists, neuroscientists and other interested readers in following the expanding volume of information relating to the inherited peripheral neuropathies collectively referred to as Charcot-Marie-Tooth disease. Currently, mutations in multiple different genes expressed in Schwann cells and neurons cause a variety of overlapping clinical phenotypes. Recent articles clarify molecular pathways involved in the pathogenesis of these disorders, and for the first time provide rational treatment strategies for the most common form of Charcot-Marie-Tooth disease. The identification of many new genes associated with neuropathy demonstrate the role of axonal transport and abnormal protein trafficking in causing various forms of Charcot-Marie-Tooth. They also further define the role of axonal signaling and the molecular architecture of both Schwann cells and neurons in maintaining normal peripheral nervous system function. Finally, recent reports have shown that progesterone antagonists and ascorbic acid can successfully treat rodent models of Charcot-Marie-Tooth disease type 1A. Taken together, results from these articles support the concept that genetic causes of Charcot-Marie-Tooth disease serve as a living microarray system to identify molecules necessary for normal peripheral nervous system function. When we can make sense of these microarrays we are likely to understand the pathogenesis and develop rational therapies for many neurodegenerative diseases including Charcot-Marie-Tooth.

  2. 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.

  3. Communication Efforts against AIDS in Latin America: An Updated Report.

    ERIC Educational Resources Information Center

    Simmons, Robert E.; And Others

    This paper presents recent information on the use of mass communication to combat the acquired immunodeficiency syndrome (AIDS) epidemic in Latin America. The paper takes up the following topics: (1) communication as anti-AIDS weapon; (2) the information effort lag; (3) targeting AIDS information; (4) delivering the message to health…

  4. Nonsurgical interventions for Peyronie disease: 2011 update.

    PubMed

    Schaeffer, Anthony J; Burnett, Arthur L

    2012-01-01

    Peyronie disease (PD) arises from the deposition of collagen and fibrin that creates a plaque in the tunica albuginea of the penis. The resulting induration and curvature of the penis leads to sexual dysfunction in many men. Despite the prevalence of the disease and natural history studies that suggest progression, men might not seek therapeutic intervention due to a lack of general knowledge about the disease, its pathophysiology, and treatments aimed at ameliorating its symptoms. Medical therapy using oral, topical, or intralesionally delivered drug is pursued in all but the most severe cases. This review of the literature in the last 4 years attempts to identify new trials of therapies and treatment modalities aimed at altering the PD process. Specifically, we will address clinical trials evaluating oral pharmacotherapies; topical, intralesional, and shockwave therapies; and penile traction devices. We will discuss the level of evidence and support for each of the new clinical trials.

  5. Update on cardiovascular disease in lupus.

    PubMed

    Lewandowski, Laura B; Kaplan, Mariana J

    2016-09-01

    Atherosclerotic cardiovascular disease confers significant morbidity and mortality in patients with systemic lupus erythematosus (SLE) and cannot be fully explained by traditional cardiovascular risk factors. Recent immunologic discoveries have outlined putative pathways in SLE that may also accelerate the development of atherosclerosis. Aberrant innate and adaptive immune responses implicated in lupus pathogenesis may also contribute to the development of accelerated atherosclerosis in these patients. Defective apoptosis, abnormal lipoprotein function, autoantibodies, aberrant neutrophil responses, and a dysregulated type I interferon pathway likely contribute to endothelial dysfunction. SLE macrophages have an inflammatory phenotype that may drive progression of plaque. Recent discoveries have placed increased emphasis on the immunology of atherosclerotic cardiovascular disease. Understanding the factors that drive the increased risk for cardiovascular disease in SLE patients may provide selective therapeutic targets for reducing inflammation and improving outcomes in atherosclerosis.

  6. Lyme disease update for the general dermatologist.

    PubMed

    Godar, Desiree A; Laniosz, Valerie; Wetter, David A

    2015-02-01

    Lyme disease is an Ixodes tick-borne illness that may arise from different species of the Borrelia spirochete and may be propagated in various hosts. Humans are considered dead-end hosts in this propagation cycle but may have a range of Lyme disease characteristics as a result of borrelial infection. Lyme disease has varied cutaneous manifestations, and the approach to diagnosis and treatment is based on the patient, the region, and suspected coinfection with another tick-borne illness. An understanding of the distribution of the Ixodes tick, its vectors, and the most likely dermatologic presentation based on these factors allows the dermatologist to make appropriate testing and treatment recommendations. Our aim is to simplify this approach for the treating practitioner.

  7. Novel therapeutics for Alzheimer's disease: an update.

    PubMed

    Bonda, David J; Lee, Hyun-Pil; Lee, Hyoung-gon; Friedlich, Avi L; Perry, George; Zhu, Xiongwei; Smith, Mark A

    2010-03-01

    As the most prevalent form of dementia worldwide, Alzheimer's disease (AD) continues to be a burden for patients and their families. In addition, with the global population of aged individuals increasing exponentially, AD represents a significant economic burden to society. The development of an effective approach for the treatment of AD is thus of major importance, as current treatment strategies are limited to agents that attenuate disease symptomatology without addressing the causes of disease. A considerable need exists for the development of an effective therapy to prevent, or at least delay, the progression of AD. Current hypotheses for the pathogenesis of AD are discussed in this review, with a particular emphasis on the implications of these hypotheses with respect to treatment strategies and preventive measures.

  8. Perioperative anticoagulation and renal disease: an update.

    PubMed

    Dutta, Suparna; Jaffer, Amir K; Slawski, Barbara A; Pfeifer, Kurt J; Smetana, Gerald W; Cohn, Steven L

    2014-12-01

    As our surgical population becomes older and increasingly medically complex, knowledge of the most recent perioperative literature can provide guidance for physicians across multiple specialties caring for the surgical patient. Common issues many clinicians encounter in the perioperative period relate to anticoagulation and renal disease. This article identifies gaps in knowledge for the fields of perioperative anticoagulation, acute kidney injury, and chronic kidney disease and highlights recently published studies on these topics that attempt to fill these gaps and help clinicians provide excellent care for their patients.

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

    USDA-ARS?s Scientific Manuscript database

    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...

  10. [Update in family medicine: Periodontal disease].

    PubMed

    López Silva, M C; Diz-Iglesias, P; Seoane-Romero, J M; Quintas, V; Méndez-Brea, F; Varela-Centelles, P

    2017-03-01

    About 85-94% of the Spanish adults older than 35 experience gum problems, and about 15-30% suffer from periodontitis, being severe in up to 5-11% of them. Unlike other inflammatory conditions, periodontal disease rarely causes discomfort, or limits life or causes functional limitations until its advanced stages, when clinical signs and symptoms arise (gingival recession, pathological teeth migration, or mobility). Lack of knowledge about the disease, together with the idea that tooth loss is linked to ageing, frequently results in a late diagnosis, requiring extensive treatments with a worse prognosis. At Primary Care level, there is series of drugs have been related to periodontal disease (anticonvulsants, immunosuppressive drugs, and calcium channel blockers) as secondary effects, which vary as regards their frequency and severity depending of the amount of accumulated plaque. Stress and depression have also been reported to alter the immune response and to increase the inflammatory response as well as periodontal susceptibility. Certain systemic conditions, such as diabetes mellitus, cardiovascular disorders, respiratory diseases, as well as low-weight pre-term birth, have also been linked to periodontitis. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  11. [Pramipexole and Parkinson's disease, an update].

    PubMed

    Martínez-Corral, M; Kulisevsky, J

    Pramipexole is a non-ergotic D2/D3 dopaminergic agonist that can be used to treat the symptoms of Parkinson's disease safely and effectively both as monotherapy in the early stages and in the advanced phases in association with levodopa, which improves the motor fluctuations and dyskinesias. Furthermore, in laboratory studies pramipexole has proved to exert neuroprotector effects and its use in clinical practice from the early stages of the disease has been related to a delay in the appearance of motor complications (fluctuations and dyskinesias). It has recently been shown that it is especially valuable in the treatment of tremors and is also effective in improving certain non-motor symptoms such as depression. Pramipexole is free of the severe side effects (fibrosis and valve disease) linked with ergotic dopaminergic agonists and causes fewer digestive and dysautonomic alterations. Other undesirable side effects of treatment with non-ergotic agonists, such as hallucinations, the appearance of oedemas and drowsiness, can be minimised by carefully selecting the patients. Further studies need to be conducted to help define the long-term effects of dopaminergic agonists on the progress of the disease and also to show the differences between non-ergotic agonists in clinical practice.

  12. Pheochromocytoma – update on disease management

    PubMed Central

    Lenders, Jacques W.M.; Hofbauer, Lorenz C.; Naumann, Bernd; Bornstein, Stefan R.; Eisenhofer, Graeme

    2012-01-01

    Pheochromocytomas are rare endocrine tumors that can present insidiously and remain undiagnosed until death or onset of clear manifestations of catecholamine excess. They are often referred to as one of the ‘great mimics’ in medicine. These tumors can no longer be regarded as a uniform disease entity, but rather as a highly heterogeneous group of chromaffin cell neoplasms with different ages of onset, secretory profiles, locations, and potential for malignancy according to underlying genetic mutations. These aspects all have to be considered when the tumor is encountered, thereby enabling optimal management for the patient. Referral to a center of specialized expertise for the disease should be considered wherever possible. This is not only important for surgical management of patients, but also for post-surgical follow up and screening of disease in patients with a hereditary predisposition to the tumor. While preoperative management has changed little over the last 20 years, surgical procedures have evolved so that laparoscopic resection is the standard of care and partial adrenalectomy should be considered in all patients with a hereditary condition. Follow-up testing is essential and should be recommended and ensured on a yearly basis. Managing such patients must now also take into account possible underlying mutations and the appropriate selection of genes for testing according to disease presentation. Patients and family members with identified mutations then require an individualized approach to management. This includes consideration of distinct patterns of biochemical test results during screening and the appropriate choice of imaging studies for tumor localization according to the mutation and associated differences in predisposition to adrenal, extra-adrenal and metastatic disease. PMID:23148191

  13. 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

  14. Molecular Pathogenesis of Alzheimer's Disease: An Update

    PubMed Central

    Sanabria-Castro, Alfredo; Alvarado-Echeverría, Ileana; Monge-Bonilla, Cecilia

    2017-01-01

    Dementia is a chronic or progressive syndrome, characterized by impaired cognitive capacity beyond what could be considered a consequence of normal aging. It affects the memory, thinking process, orientation, comprehension, calculation, learning ability, language, and judgment; although awareness is usually unaffected. Alzheimer's disease (AD) is the most common form of dementia; symptoms include memory loss, difficulty solving problems, disorientation in time and space, among others. The disease was first described in 1906 at a conference in Tubingen, Germany by Alois Alzheimer. One hundred and ten years since its first documentation, many aspects of the pathophysiology of AD have been discovered and understood, however gaps of knowledge continue to exist. This literature review summarizes the main underlying neurobiological mechanisms in AD, including the theory with emphasis on amyloid peptide, cholinergic hypothesis, glutamatergic neurotransmission, the role of tau protein, and the involvement of oxidative stress and calcium. PMID:28588356

  15. Asbestos-induced lung diseases: an update

    PubMed Central

    KAMP, DAVID W.

    2009-01-01

    Asbestos causes asbestosis (pulmonary fibrosis caused by asbestos inhalation) and malignancies (bronchogenic carcinoma and mesothelioma) by mechanisms that are not fully elucidated. Despite a dramatic reduction in asbestos use worldwide, asbestos-induced lung diseases remain a substantial health concern primarily because of the vast amounts of fibers that have been mined, processed, and used during the 20th century combined with the long latency period of up to 40 years between exposure and disease presentation. This review summarizes the important new epidemiologic and pathogenic information that has emerged over the past several years. Whereas the development of asbestosis is directly associated with the magnitude and duration of asbestos exposure, the development of a malignant clone of cells can occur in the setting of low-level asbestos exposure. Emphasis is placed on the recent epidemiologic investigations that explore the malignancy risk that occurs from nonoccupational, environmental asbestos exposure. Accumulating studies are shedding light on novel mechanistic pathways by which asbestos damages the lung. Attention is focused on the importance of alveolar epithelial cell (AEC) injury and repair, the role of iron-derived reactive oxygen species (ROS), and apoptosis by the p53- and mitochondria-regulated death pathways. Furthermore, recent evidence underscores crucial roles for specific cellular signaling pathways that regulate the production of cytokines and growth factors. An evolving role for epithelial-mesenchymal transition (EMT) is also reviewed. The translational significance of these studies is evident in providing the molecular basis for developing novel therapeutic strategies for asbestos-related lung diseases and, importantly, other pulmonary diseases, such as interstitial pulmonary fibrosis and lung cancer. PMID:19304273

  16. Control of communicable diseases: foreign; scope and definitions. Direct final rule and request for comments.

    PubMed

    2012-12-26

    Through this Direct Final Rule, the Centers for Disease Control and Prevention (CDC), located within the Department of Health and Human Services (HHS) is updating and reorganizing the Scope and Definitions for foreign quarantine regulations and add a new section to contain definitions for Importations. This Direct Final Rule (DFR) will update the scope and definitions to reflect modern terminology and plain language used globally by industry and public health partners. As part of the update, we are updating five existing definitions; adding thirteen new definitions to help clarify existing provisions; creating a new scope and definitions section for Importations under a new section by reorganizing existing definitions into this new section; and updating regulations to reflect the language used by the most recent Executive Order regarding quarantinable communicable diseases.

  17. Biomarkers in Alzheimer's Disease-Recent Update.

    PubMed

    Sharma, Sushil; Lipincott, Walter

    2017-02-20

    Alzheimer disease (AD) is an age-related neurodegenerative disorder, characterized by loss of memory and cognitive function. It is the common cause of dementia in elderly and is a global health concern as the population of people aged 85 and older, is growing alarmingly. Although pharmacotherapy for the treatment of AD has improved, lot of work remains to treat this devastating disease. AD pathology begins even before the onset of clinical symptoms. Because therapies could be more effective if implemented early in the disease progression, it is highly prudent to discover reliable biomarkers, to detect its exact pathophysiology during pre-symptomatic stage. Biomarker(s) with high sensitivity and specificity would facilitate AD diagnosis at early stages. Currently, CSF amyloid β 1-42, total tau, and phosphorylated tau181 are used as AD biomarkers. This report describes conventional and potential in-vitro and in-vivo biomarkers of AD. Particularly, in-vitro transcriptomic, proteomic, lipidomic, and metabolomic; body fluid biomarkers (C-reactive proteins, homocysteine, α-sunuclein index, and dehydroepiandrosterone sulphate) from blood, serum, plasma, CSF, and saliva; and neuronal, platelets, and lymphocyte microRNA, mtDNA, and Charnoly body are detected. In-vivo physiological and neurobehavioral biomarkers are evaluated by analyzing computerized EEG, event-related potentials, circadian rhythm, and multimodality fusion imaging including: CT, MRI, SPECT, and PET. More specifically, PET imaging biomarkers representing reduced fronto-temporal 18FdG uptake, increased 11C or 18F-PIB uptake, 11C-PBR28 to measure 18 kDa translocator protein (TSPO), a biomarker for inflammation; and 3-D MRI (ventriculomegaly)/MRS are performed for early and effective clinical management of AD.

  18. [Update on the pathophysiology of Parkinson' disease].

    PubMed

    Duyckaerts, Charles; Sazdovitch, Véronique; Seilhean, Danielle

    2010-10-01

    Changes in the substantia nigra of patients with Parkinson's disease were suspected by Brissaud in the late 19th century. They were subsequently confirmed by Tretiakoff but neglected by Lewy, who described the inclusion bodies that bear his name. The experimental Parkinsonian syndrome caused by reserpine led Carlsson to discover the neuromediatory role of dopamine, a finding at the origin of L-DOPA therapy. Identification of a mutation of the alpha-synuclein gene in cases of familial Parkinson's disease with autosomal dominant transmission was followed by the detection of the protein product in Lewy bodies and neurites. Alpha-synuclein is now recognized as being the main constituent of Lewy bodies. Alpha-synuclein immunohistochemistry has revealed that lesions can extend from the autonomous nervous system to the cortex (in Lewy body dementia). The Lewy body itself does not appear to be the direct cause of symptoms, which correlate better with neuronal death. Neuronal death could be due to metabolic disturbances related to alpha-synuclein accumulation, ubiquitin-proteasome system dysfunction, or oxidative stress. Non-autonomous cell death, caused by neuro-inflammation or gliosis, has also been incriminated.

  19. 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.

  20. Genetics of Cushing's disease: an update.

    PubMed

    Perez-Rivas, L G; Reincke, M

    2016-01-01

    Cushing's disease (CD) results from uncontrolled hypercortisolism induced by ACTH-secreting corticotroph adenomas; accordingly, patients diagnosed with CD usually present several comorbidities and an increased risk of mortality. Hypothesis-driven screenings have led to identification of rare alterations in a low number of patients, although the genetic basis underlying CD has remained unclear until recently. Using whole-exome sequencing, recurrent mutations have been reported in the gene coding for the ubiquitin-specific protease 8 (USP8), a protein with deubiquitinase (DUB) activity that modulates the lysosomal turnover of the EGF receptor (EGFR) and other membrane proteins. In this review, we summarize the recent genetic findings and discuss the clinical and pathological implications of USP8 deregulation in corticotroph adenomas. Mutations in USP8 have been identified in 35-62 % of functional sporadic corticotroph adenomas causing Cushing's disease, but not in any other type of pituitary tumor. These mutations are found mostly in adult female patients and lead to an aberrant DUB activation by impairing the regulation of USP8 by members of the 14-3-3 family of proteins. The consequence of this hyperactivation is a longer retention of EGFR at the plasma membrane which promotes an enhanced production of ACTH.

  1. 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. © 2014 Society for Endocrinology.

  2. Nuclear Command, Control, and Communications: Update on DOD’s Modernization

    DTIC Science & Technology

    2015-06-15

    Page 1 GAO-15-584R NC3 Modernization Review 441 G St. N.W. Washington, DC 20548 June 15, 2015 Congressional Committees Nuclear Command...Control, and Communications: Update on DOD’s Modernization Nuclear command, control, and communications (NC3) is a large and complex system...support both nuclear and conventional missions. The Department of Defense (DOD) is executing several acquisition efforts to modernize elements of NC3

  3. [DGRW-Update: musculo-skeletal diseases].

    PubMed

    Greitemann, B; Dibbelt, S; Fröhlich, S; Niemeyer, C

    2012-12-01

    Orthopedic rehabilitation is a major entity in rehabilitation. Due to coming demographic changes and its challenges concerning mobility of elderly patients it will increase. The criticism on orthopedic rehabilitation in Germany focuses on its missing evidence in therapeutic eff ectiveness especially in chronic low back pain. This overall-criticism is actually no more valid as there are a number of studies showing eff ectiveness of orthopedic treatment in rehabilitation if psychosocial comorbidities are respected and treatment is focussed on occupational training and eintegration. This overview describes the actual situation in orthopedic rehabilitation and its research. The need for orthopedic rehabilitation will increase over the next years due to demographic changes. Important fi elds in orthopedic rehabilitation research are chronic low back pain, new rehabilitation models with focus on occupational reintegration, rehabilitation in elderly and following joint surgery as well as the analysis of health-care-system changes due to disease related groups. © Georg Thieme Verlag KG Stuttgart · New York.

  4. Rotavirus: disease and vaccine update, 2007.

    PubMed

    Stebbins, Samuel

    2007-02-01

    Rotavirus infection is a ubiquitous illness, infecting the vast majority of children worldwide in the first 5 years of life. Rotavirus is one of the major causes of severe diarrhea in infants and young children throughout the developing and developed world. An estimated 500,000 deaths per year occur, with the burden of morbidity and mortality highest in the poorest nations. Two new oral, live, attenuated vaccines have recently shown efficacy and safety in clinical trials, and one of these, RotaTeq, was approved by the US Food and Drug Administration on February 3, 2006. RotaTeq is recommended for general use by the Centers for Disease Control and Prevention, American Academy of Family Practice, and American Academy of Pediatrics.

  5. 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. Written permission from the American Academy of Family Physicians is required for reproduction of this material in whole or in part in any form or medium.

  6. Functional role of apoptosis in oral diseases: An update

    PubMed Central

    Misra, Akansha; Rai, Shalu; Misra, Deepankar

    2016-01-01

    Cell death appears to be a basic biological phenomenon which is maintained by the human body. The term apoptosis, also known as programmed cell death, is characterized by several unique morphological and biochemical features. Apoptosis and its different forms are essential for tissue homeostasis. Alteration in molecular mechanisms involved in apoptotic signaling contributes to a vast range of oral diseases. An understanding of the regulation of apoptosis has led to the development of many therapeutic approaches and better management of oral diseases. The review updates us the correlation between apoptosis in normal oral tissues and oral diseases. PMID:27721616

  7. 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. Written permission from the American Academy of Family Physicians is required for reproduction of this material in whole or in part in any form or medium.

  8. Effective doctor-patient communication: an updated examination.

    PubMed

    Matusitz, Jonathan; Spear, Jennifer

    2014-01-01

    This article examines, in detail, the quality of doctor-patient interaction. Doctor-patient communication is such a powerful indicator of health care quality that it can determine patients' self-management behavior and health outcomes. The medical visit (i.e., the medical encounter) plays a pivotal role in the health care process. In fact, doctor-patient communication is one of the most essential dynamics in health care, affecting the course of patient care and patient compliance with recommendations for care. Unlike many other analyses (that often look at only one or two specific aspects of doctor-patient relationships), this analysis is more encompassing; it looks at doctor-patient communication from multiple perspectives.

  9. 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

  10. Update on medical treatment for Cushing's disease.

    PubMed

    Cuevas-Ramos, Daniel; Lim, Dawn Shao Ting; Fleseriu, Maria

    2016-01-01

    Cushing's disease (CD) is the most common cause of endogenous Cushing's syndrome (CS). The goal of treatment is to rapidly control cortisol excess and achieve long-term remission, to reverse the clinical features and reduce long-term complications associated with increased mortality. While pituitary surgery remains first line therapy, pituitary radiotherapy and bilateral adrenalectomy have traditionally been seen as second-line therapies for persistent hypercortisolism. Medical therapy is now recognized to play a key role in the control of cortisol excess. In this review, all currently available medical therapies are summarized, and novel medical therapies in phase 3 clinical trials, such as osilodrostat and levoketoconazole are discussed, with an emphasis on indications, efficacy and safety. Emerging data suggests increased efficacy and better tolerability with these novel therapies and combination treatment strategies, and potentially increases the therapeutic options for treatment of CD. New insights into the pathophysiology of CD are highlighted, along with potential therapeutic applications. Future treatments on the horizon such as R-roscovitine, retinoic acid, epidermal growth factor receptor inhibitors and somatostatin-dopamine chimeric compounds are also described, with a focus on potential clinical utility.

  11. Alzheimer's disease public-private partnerships: update 2014.

    PubMed

    Snyder, Heather M; Kim, Hye; Bain, Lisa J; Egge, Robert; Carrillo, Maria C

    2014-11-01

    The National Plan to Address Alzheimer's Disease highlights the need for coordinated public-private partnerships. In recent years, the number of collaborations and consortia have expanded and grown in Alzheimer's research. The Alzheimer's Association compiles this annually updated compendium to centralize this inventory of partnerships in an effort to synergize these activities. This manuscript reflects the 2014 landscape of non-profit organizations who engage in public-private partnerships to promote and support dementia research.

  12. 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…

  13. 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…

  14. 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

  15. Alzheimer disease and cerebrovascular pathology: an update.

    PubMed

    Jellinger, K A

    2002-05-01

    Recent epidemiological and clinico-pathologic data suggest overlaps between Alzheimer disease (AD) and cerebrovascular lesions that may magnify the effect of mild AD pathology and promote progression of cognitive decline or even may precede neuronal damage and dementia. Vascular pathology in the aging brain and in AD includes: 1. cerebral amyloid angiopathy (CAA) with an incidence of 82-98% often associated with ApoE epsilon 2 and causing a) cerebral mass hemorrhages (around 70%, mainly in the frontal and parietal lobes), b) multiple or recurrent microhemorrhages (15%), and c) ischemic (micro-)infarcts or lacunes (around 20%). The frequency of these lesions increases with the severity of CAA and shows no correlation with that of senile amyloid plaques. CAA, significantly more frequent in patients with cerebral hemorrhages or infarcts than in aged controls, is an important risk factor for cerebrovascular lesions in AD. 2. Microvascular changes with decreased density and structural abnormalities causing regional metabolic and blood-brain barrier dysfunctions with ensuing neuronal damage. In large autopsy series of demented aged subjects, around 80% show Alzheimer type pathology, 20-40% with additional, often minor vascular lesions, 7-10% "pure" vascular dementia, and 3-5% "mixed" dementia (combination of AD and vascular encephalopathy). AD cases with additional minor cerebrovascular lesions have significantly more frequent histories of hypertension or infarcts than "pure" AD patients. Vascular lesions in AD include cortical microinfarcts, subcortical lacunes, white matter lesions / leukoencephalopathy, small hemorrhages and corticosubcortical infarcts, while in mixed type dementia multiple larger or hemispheral infarcts are more frequent. Small infarcts in AD patients have no essential impact on global cognitive decline which mainly depends on the severity of Alzheimer pathology, but in early stage of AD they may influence and promote the development of dementia

  16. 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.

  17. Supporting communication for patients with neurodegenerative disease.

    PubMed

    Fried-Oken, Melanie; Mooney, Aimee; Peters, Betts

    2015-01-01

    Communication supports, referred to as augmentative and alternative communication (AAC), are an integral part of medical speech-language pathology practice, yet many providers remain unfamiliar with assessment and intervention principles. For patients with complex communication impairments secondary to neurodegenerative disease, AAC services differ depending on whether their condition primarily affects speech and motor skills (ALS), language (primary progressive aphasia) or cognition (Alzheimer's disease). This review discusses symptom management for these three conditions, identifying behavioral strategies, low- and high-tech solutions for implementation during the natural course of disease. These AAC principles apply to all neurodegenerative diseases in which common symptoms appear. To present AAC interventions for patients with neurodegenerative diseases affecting speech, motor, language and cognitive domains. Three themes emerge: (1) timing of intervention: early referral, regular re-evaluations and continual treatment are essential; (2) communication partners must be included from the onset to establish AAC acceptance and use; and (3) strategies will change over time and use multiple modalities to capitalize on patients' strengths. AAC should be standard practice for adults with neurodegenerative disease. Patients can maintain effective, functional communication with AAC supports. Individualized communication systems can be implemented ensuring patients remain active participants in daily activities.

  18. Commentary: Emerging and other communicable diseases.

    PubMed Central

    Heymann, D.; Dzenowagis, J.

    1998-01-01

    There is an increasing need for integrated, sustainable; and cost-effective approaches to the management of infectious diseases. For example, an emerging disease in one country may already be endemic in another country but nearing elimination in a third. A coordinated approach by WHO towards infectious diseases is therefore needed that will facilitate more effective support of on-going efforts for the prevention and control of endemic diseases, intensify efforts against those diseases targeted for eradication and elimination, and result in better preparedness and response to new and re-emerging diseases. In order to meet these challenges, WHO has created a new Programme on Communicable Diseases (CDS), which will replace the former Division of Emerging and other Communicable Diseases (EMC). The new Programme will better integrate surveillance, prevention, control, and research over the whole spectrum of communicable diseases. CDS will function as focal point for global data and information exchange on infectious diseases, and inter alia, will reinforce laboratory-based surveillance of bacterial, viral, and zoonotic diseases to ensure early detection of threats to international public health. Changes in susceptibility to infectious disease, increased opportunities for infection, and the ability of microbes to adapt rapidly will continue to challenge WHO to improve prevention and control of infectious diseases in the future by establishing strong partnerships with both the private and public sectors. PMID:10191549

  19. Laser Communications Relay Demonstration (LCRD) Update and the Path Towards Optical Relay Operations

    NASA Technical Reports Server (NTRS)

    Israel, David J.; Edwards, Bernard L.; Staren, John W.

    2017-01-01

    This paper provides a concept for an evolution of NASA's optical communications near Earth relay architecture. NASA's Laser Communications Relay Demonstration (LCRD), a joint project between NASA's Goddard Space Flight Center (GSFC), the Jet Propulsion Laboratory - California Institute of Technology (JPL), and the Massachusetts Institute of Technology Lincoln Laboratory (MIT LL). LCRD will provide a minimum of two years of high data rate optical communications service experiments in geosynchronous orbit (GEO), following launch in 2019. This paper will provide an update of the LCRD mission status and planned capabilities and experiments, followed by a discussion of the path from LCRD to operational network capabilities.

  20. Laser Communications Relay Demonstration (LCRD) Update and the Path Towards Optical Relay Operations

    NASA Technical Reports Server (NTRS)

    Israel, David J.; Edwards, Bernard L.; Staren, John W.

    2017-01-01

    This Presentation provides a concept for an evolution of NASAs optical communications near Earth relay architecture. NASA's Laser Communications Relay Demonstration (LCRD), a joint project between NASAs Goddard Space Flight Center (GSFC), the Jet Propulsion Laboratory - California Institute of Technology (JPL), and the Massachusetts Institute of Technology Lincoln Laboratory (MIT LL). LCRD will provide a minimum of two years of high data rate optical communications service experiments in geosynchronous orbit (GEO), following launch in 2019. This paper will provide an update of the LCRD mission status and planned capabilities and experiments, followed by a discussion of the path from LCRD to operational network capabilities.

  1. 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.

  2. Asbestos disease in sheet metal workers: proportional mortality update

    SciTech Connect

    Michaels, D.; Zoloth, S.

    1988-01-01

    This paper, updating the findings of an earlier study, provides additional evidence that sheet metal workers in the construction trades are at increased risk for asbestos-related disease. A proportional analysis of cause of death among 331 New York sheet metal workers found a significantly elevated PMR for lung cancer (PMR = 186). In addition, there were six deaths attributable to mesothelioma (three classified as lung cancer deaths) and three death certificates mentioned asbestosis or pulmonary fibrosis, although none of these three deaths were attributed to these diseases.

  3. Enhancing Disease Surveillance Event Communication Among Jurisdictions.

    PubMed

    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.

  4. 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.

  5. The global burden of foodborne parasitic diseases: an update.

    PubMed

    Torgerson, Paul R; de Silva, Nilanthi R; Fèvre, Eric M; Kasuga, Fumiko; Rokni, Mohammad B; Zhou, Xiao-Nong; Sripa, Banchob; Gargouri, Neyla; Willingham, Arve Lee; Stein, Claudia

    2014-01-01

    Foodborne diseases (FBDs) are a major cause of morbidity and mortality in the human population. Accurate information on the burden of FBDs is needed to inform policy makers and allocate appropriate resources for food safety control and intervention. Consequently, in 2006 the WHO launched an initiative to estimate the global burden of FBDs in terms of Disability Adjusted Life Years (DALYs). This review gives an update of the progress on evaluating the burden of foodborne parasitic diseases that has been generated by this study. Results to date indicate that parasitic diseases that can be transmitted through food make a substantial contribution to the global burden of disease. Copyright © 2013 Elsevier Ltd. All rights reserved.

  6. Updated TDP-43 in Alzheimer's disease staging scheme.

    PubMed

    Josephs, Keith A; Murray, Melissa E; Whitwell, Jennifer L; Tosakulwong, Nirubol; Weigand, Stephen D; Petrucelli, Leonard; Liesinger, Amanda M; Petersen, Ronald C; Parisi, Joseph E; Dickson, Dennis W

    2016-04-01

    In this study, we update the TDP-43 in Alzheimer's disease staging scheme by assessing the topography of TDP-43 in 193 cases of Alzheimer's disease, in 14 different brain regions (eight previously described plus six newly reported) and use conditional probability to model the spread of TDP-43 across the 14 brain regions. We show that in addition to the eight original regions we previously reported [amygdala, entorhinal cortex, subiculum, dentate gyrus of the hippocampus, occipitotemporal cortex, inferior temporal cortex, middle frontal cortex and basal ganglia (putamen/globus pallidum)] that TDP-43 is also deposited in the insular cortex, ventral striatum, basal forebrain, substantia nigra, midbrain tectum, and the inferior olive of the medulla oblongata, in Alzheimer's disease. The conditional probability analysis produced six significantly different stages (P < 0.01), and suggests that TDP-43 deposition begins in the amygdala (stage 1), then moves to entorhinal cortex and subiculum (stage 2); to the dentate gyrus of the hippocampus and occipitotemporal cortex (stage 3); insular cortex, ventral striatum, basal forebrain and inferior temporal cortex (stage 4); substantia nigra, inferior olive and midbrain tectum (stage 5); and finally to basal ganglia and middle frontal cortex (stage 6). This updated staging scheme is superior to our previous staging scheme, classifying 100% of the cases (versus 94% in the old scheme), based on criteria provided, and shows clinical significance with some regions and with increasing stage. We discuss the relevance of the updated staging scheme, as well as its impact on the prion-like hypothesis of protein spread in neurodegenerative disease. We also address the issue of whether frontotemporal lobar degeneration with TDP-43 could be the primary pathology in stage 6.

  7. Patients with nontuberculous mycobacteria: comparison of updated and previous diagnostic criteria for lung disease.

    PubMed

    Epson, Erin; Cassidy, Maureen; Marshall-Olson, Angela; Hedberg, Katrina; Winthrop, Kevin L

    2012-09-01

    We classified patients with respiratory nontuberculous mycobacteria (NTM) isolates using updated (2007) and previous (1997) American Thoracic Society/Infectious Diseases Society of America criteria for NTM lung disease. We found that a greater proportion of such patients have disease using updated criteria due to improved sensitivity of the microbiologic component of the disease definition.

  8. [Inhaled in chronic obstructive pulmonary disease therapy update].

    PubMed

    Viejo-Casas, A; Bonnardeaux-Chadburn, C; Ginel-Mendoza, L; Quintano-Jimenez, J A

    2016-10-01

    Knowledge of chronic obstructive pulmonary disease has increased significantly in recent years, and today we have a more comprehensive concept of the disease. Additionally, drug development allows having a wide range of therapeutic options. The inhaled route is the choice, as it allows drugs to act directly on the bronchial tree. In the past few months, new molecules and devices have been developed that increases our options when treating, but also our doubts when choosing one or the other, so an update of inhaled medications for chronic obstructive pulmonary disease is necessary. The different types of inhalers currently available are reviewed in this article, as well as the advantages and disadvantages of each of them, in order to determine how to choose the right device. Copyright © 2015 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  9. An update on treatment and prevention strategies for Alzheimer's disease.

    PubMed

    Neugroschl, Judith; Sano, Mary

    2009-09-01

    With the aging of the population, the incidence and prevalence of Alzheimer's disease will grow, increasing the burden on individuals and society. While ameliorating symptoms, the currently available treatments approved by the US Food and Drug Administration do not halt progression or cure the illness. This article discusses recent data on treatment strategies targeting amyloid and tau pathology. Novel therapeutic strategies such as inhibitors of receptors for advanced glycation end products (RAGE), potential mitochondrial modification with Dimebon, anti-inflammatory approaches, and cholesterol-lowering agents are also reviewed. An update on results from pharmacologic and nonpharmacologic prevention trials is provided.

  10. 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.

  11. Central venous disease in hemodialysis patients: an update.

    PubMed

    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.

  12. Update: Ebola virus disease outbreak--West Africa, October 2014.

    PubMed

    2014-10-31

    CDC is assisting ministries of health and working with other organizations to control and end the ongoing outbreak of Ebola virus disease (Ebola) in West Africa. The updated data in this report were compiled from situation reports from the Guinea Interministerial Committee for Response Against the Ebola Virus and the World Health Organization, the Liberia Ministry of Health and Social Welfare, and the Sierra Leone Ministry of Health and Sanitation. Total case counts include all suspected, probable, and confirmed cases as defined by each country. These data reflect reported cases, which make up an unknown proportion of all actual cases and reporting delays that vary from country to country.

  13. 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

  14. Digital communication support and Alzheimer's disease.

    PubMed

    Ekström, Anna; Ferm, Ulrika; Samuelsson, Christina

    2015-12-06

    Communication is one of the areas where people with dementia and their caregivers experience most challenges. The purpose of this study is to contribute to the understanding of possibilities and pitfalls of using personalized communication applications installed on tablet computers to support communication for people with dementia and their conversational partners. The study is based on video recordings of a woman, 52 years old, with Alzheimer's disease interacting with her husband in their home. The couple was recorded interacting with and without a tablet computer including a personalized communication application. The results from the present study reveal both significant possibilities and potential difficulties in introducing a digital communication device to people with dementia and their conversational partners. For the woman in the present study, the amount of interactive actions and the number of communicative actions seem to increase with the use of the communication application. The results also indicate that problems associated with dementia are foregrounded in interaction where the tablet computer is used.

  15. Aspirin dosing in cardiovascular disease prevention and management: an update.

    PubMed

    Ganjehei, Leila; Becker, Richard C

    2015-11-01

    Aspirin has been in use for prevention and management of cardiovascular diseases for several decades. Clinical and epidemiological literature suggests that while net benefits of aspirin in primary prevention of CVDs are less clear, the benefits of aspirin in acute scenarios and secondary prevention settings are well established. However, its optimum dosing requirements have been up for debate especially in various settings of acute coronary syndrome and stable ischemic heart disease. The role of clinician in stratifying individual risk score to achieve net clinical benefit is an important determinant of initiating aspirin therapy. The purpose of this article is to review association of aspirin and CVD in general, and to review its dosing regimens in acute settings as well as primary and secondary prevention as suggested by various established guidelines. We also aim to provide the readers an update on recent changes and current evidence based practice trends.

  16. Vitamin D and Graves' disease: a meta-analysis update.

    PubMed

    Xu, Mei-Yan; Cao, Bing; Yin, Jian; Wang, Dong-Fang; Chen, Kai-Li; Lu, Qing-Bin

    2015-05-21

    The association between vitamin D levels and Graves' disease is not well studied. This update review aims to further analyze the relationship in order to provide an actual view of estimating the risk. We searched for the publications on vitamin D and Graves' disease in English or Chinese on PubMed, EMBASE, Chinese National Knowledge Infrastructure, China Biology Medical and Wanfang databases. The standardized mean difference (SMD) and 95% confidence interval (CI) were calculated for the vitamin D levels. Pooled odds ratio (OR) and 95% CI were calculated for vitamin D deficiency. We also performed sensitivity analysis and meta-regression. Combining effect sizes from 26 studies for Graves' disease as an outcome found a pooled effect of SMD = -0.77 (95% CI: -1.12, -0.42; p < 0.001) favoring the low vitamin D level by the random effect analysis. The meta-regression found assay method had the definite influence on heterogeneity (p = 0.048). The patients with Graves' disease were more likely to be deficient in vitamin D compared to the controls (OR = 2.24, 95% CI: 1.31, 3.81) with a high heterogeneity (I2 = 84.1%, p < 0.001). We further confirmed that low vitamin D status may increase the risk of Graves' disease.

  17. Vitamin D and Graves’ Disease: A Meta-Analysis Update

    PubMed Central

    Xu, Mei-Yan; Cao, Bing; Yin, Jian; Wang, Dong-Fang; Chen, Kai-Li; Lu, Qing-Bin

    2015-01-01

    The association between vitamin D levels and Graves’ disease is not well studied. This update review aims to further analyze the relationship in order to provide an actual view of estimating the risk. We searched for the publications on vitamin D and Graves’ disease in English or Chinese on PubMed, EMBASE, Chinese National Knowledge Infrastructure, China Biology Medical and Wanfang databases. The standardized mean difference (SMD) and 95% confidence interval (CI) were calculated for the vitamin D levels. Pooled odds ratio (OR) and 95% CI were calculated for vitamin D deficiency. We also performed sensitivity analysis and meta-regression. Combining effect sizes from 26 studies for Graves’ disease as an outcome found a pooled effect of SMD = −0.77 (95% CI: −1.12, −0.42; p < 0.001) favoring the low vitamin D level by the random effect analysis. The meta-regression found assay method had the definite influence on heterogeneity (p = 0.048). The patients with Graves’ disease were more likely to be deficient in vitamin D compared to the controls (OR = 2.24, 95% CI: 1.31, 3.81) with a high heterogeneity (I2 = 84.1%, p < 0.001). We further confirmed that low vitamin D status may increase the risk of Graves’ disease. PMID:26007334

  18. Arsenic Exposure and Cardiovascular Disease: An Updated Systematic Review

    PubMed Central

    Moon, Katherine; Guallar, Eliseo; Navas–Acien, Ana

    2012-01-01

    In epidemiologic studies, high-chronic arsenic exposure has been associated with cardiovascular disease, despite methodological limitations. At low-moderate arsenic levels, the evidence was inconclusive. Here, we update a previous systematic review (Am J Epidemiol 2005;162: 1037–49) examining the association between arsenic exposure and cardiovascular disease. Eighteen studies published since 2005 were combined with 13 studies from the previous review. We calculated pooled relative risks by comparing the highest versus the lowest exposure category across studies. For high exposure (arsenic in drinking water > 50 μg/L), the pooled relative risks (95 % confidence interval) for cardiovascular disease, coronary heart disease, stroke, and peripheral arterial disease were 1.32 (95 % CI: 1.05–1.67), 1.89 (95 % CI: 1.33–2.69), 1.08 (95 % CI: 0.98–1.19), and 2.17 (95 % CI: 1.47–3.20), respectively. At low-moderate arsenic levels, the evidence was inconclusive. Our review strengthens the evidence for a causal association between high-chronic arsenic exposure and clinical cardiovascular endpoints. Additional high quality studies are needed at low-moderate arsenic levels. PMID:22968315

  19. Bacteria without borders: communicable disease politics in Europe.

    PubMed

    Greer, Scott L; Mätzke, Margitta

    2012-12-01

    Communicable disease control might be one of the oldest and most important functions of the modern state, but it receives very little attention today. This article introduces a special issue on the Europeanization of communicable disease control politics in Europe. The Europeanization of communicable disease control is a case of both European integration and communicable disease politics. We first analyze the problems and tensions in communicable disease control as a problem of overlapping interprofessional, interorganizational, intergovernmental, and international tensions. We then present the European Union, a new and understudied actor in communicable disease politics, sketching the theoretical background for Europeanization of the field and introducing the articles in the special issue.

  20. Microbial Immuno-Communication in Neurodegenerative Diseases

    PubMed Central

    Main, Bevan S.; Minter, Myles R.

    2017-01-01

    Neuro-inflammation is a critical process by which the brain coordinates chemokine-regulated cellular recruitment, cytokine release, and cell-mediated removal of pathogenic material to protect against infection or brain injury. Dysregulation of this immune response is involved in multiple neurodegenerative disorders, however the precise contribution of neuro-inflammation to the exacerbation and progression of these diseases remains unclear. Evidence now suggests that commensal micro-organisms populating the host and their metabolites, collectively termed the microbiome, regulate innate immunity by influencing peripheral immune cell populations, and modulating microglial phenotype. Recent preclinical studies now demonstrate that perturbations in the host microbiome can induce alterations in pathological phenotypes associated with numerous neurodegenerative diseases. How perturbations in the host microbiome and subsequently altered peripheral immune status are communicated to the brain to influence neuro-inflammatory processes in these neurodegenerative disease settings is far from understood. This review provides insight into the regulation of neuro-inflammatory processes by the host microbiome in the context of neurodegenerative disease and highlights the potential importance of the blood-brain barrier and blood-cerebrospinal fluid-brain barrier, functioning as “immune barriers,” to communicate host immune status to the brain. Understanding the mechanisms by which the commensal microbiome communicates with the brain to influence neuro-inflammatory processes will be critical in the development of microbially-targeted therapeutics in the potential treatment of neurodegenerative disorders. PMID:28386215

  1. 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.

  2. Updates in the management of stable chronic obstructive pulmonary disease.

    PubMed

    Narsingam, Saiprasad; Bozarth, Andrew L; Abdeljalil, Asem

    2015-01-01

    Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease state characterized by persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory process. It is increasingly recognized as a major public health problem, affecting more than 20 million adults in the US. It is also recognized as a leading cause of hospitalizations and is the fourth leading cause of death in the US. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) operates to promote evidence-based management of COPD, increase awareness and encourage research. In 2011, GOLD published a consensus report detailing evidence-based management strategies for COPD, which were last updated in 2015. In recent years, newer strategies and a growing number of new pharmacologic agents to treat symptoms of COPD have also been introduced and show promise in improving the management of COPD. We aim to provide an evidence-based review of the available and upcoming pharmacologic and non-pharmacologic treatment options for stable COPD, with continued emphasis on evidence-based management.

  3. Tuberculosis Comorbidity with Communicable and Noncommunicable Diseases.

    PubMed

    Bates, Matthew; Marais, Ben J; Zumla, Alimuddin

    2015-02-06

    The 18th WHO Global Tuberculosis Annual Report indicates that there were an estimated 8.6 million incident cases of tuberculosis (TB) in 2012, which included 2.9 million women and 530,000 children. TB caused 1.3 million deaths including 320,000 human immunodeficiency virus (HIV)-infected people; three-quarters of deaths occurred in Africa and Southeast Asia. With one-third of the world's population latently infected with Mycobacterium tuberculosis (Mtb), active TB disease is primarily associated with a break down in immune surveillance. This explains the strong link between active TB disease and other communicable diseases (CDs) or noncommunicable diseases (NCDs) that exert a toll on the immune system. Comorbid NCD risk factors include diabetes, smoking, malnutrition, and chronic lung disease, all of which have increased relentlessly over the past decade in developing countries. The huge overlap between killer infections such as TB, HIV, malaria, and severe viral infections with NCDs, results in a "double burden of disease" in developing countries. The current focus on vertical disease programs fails to recognize comorbidities or to encourage joint management approaches. This review highlights major disease overlaps and discusses the rationale for better integration of tuberculosis care with services for NCDs and other infectious diseases to enhance the overall efficiency of the public health responses. Copyright © 2015 Cold Spring Harbor Laboratory Press; all rights reserved.

  4. 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

    2014-10-22

    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.

  5. 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...

  6. 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...

  7. 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...

  8. 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...

  9. 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...

  10. Advances in pleural disease management including updated procedural coding.

    PubMed

    Haas, Andrew R; Sterman, Daniel H

    2014-08-01

    Over 1.5 million pleural effusions occur in the United States every year as a consequence of a variety of inflammatory, infectious, and malignant conditions. Although rarely fatal in isolation, pleural effusions are often a marker of a serious underlying medical condition and contribute to significant patient morbidity, quality-of-life reduction, and mortality. Pleural effusion management centers on pleural fluid drainage to relieve symptoms and to investigate pleural fluid accumulation etiology. Many recent studies have demonstrated important advances in pleural disease management approaches for a variety of pleural fluid etiologies, including malignant pleural effusion, complicated parapneumonic effusion and empyema, and chest tube size. The last decade has seen greater implementation of real-time imaging assistance for pleural effusion management and increasing use of smaller bore percutaneous chest tubes. This article will briefly review recent pleural effusion management literature and update the latest changes in common procedural terminology billing codes as reflected in the changing landscape of imaging use and percutaneous approaches to pleural disease management.

  11. 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

  12. [Non-verbal communication in Alzheimer's disease].

    PubMed

    Schiaratura, Loris Tamara

    2008-09-01

    This review underlines the importance of non-verbal communication in Alzheimer's disease. A social psychological perspective of communication is privileged. Non-verbal behaviors such as looks, head nods, hand gestures, body posture or facial expression provide a lot of information about interpersonal attitudes, behavioral intentions, and emotional experiences. Therefore they play an important role in the regulation of interaction between individuals. Non-verbal communication is effective in Alzheimer's disease even in the late stages. Patients still produce non-verbal signals and are responsive to others. Nevertheless, few studies have been devoted to the social factors influencing the non-verbal exchange. Misidentification and misinterpretation of behaviors may have negative consequences for the patients. Thus, improving the comprehension of and the response to non-verbal behavior would increase first the quality of the interaction, then the physical and psychological well-being of patients and that of caregivers. The role of non-verbal behavior in social interactions should be approached from an integrative and functional point of view.

  13. Acoustic communication in insect disease vectors.

    PubMed

    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.

  14. 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

  15. Development safety update reports and proposals for effective and efficient risk communication.

    PubMed

    Urushihara, Hisashi; Kawakami, Koji

    2010-05-01

    The periodic safety reporting to regulatory authorities is globally harmonized for postmarketing medicinal products by the International Conference on Harmonisation (ICH) guidelines, and is being extended for investigational drugs. To facilitate effective safety risk communication regarding investigational drugs, and to reduce duplicate periodic reporting to the US and EU by sponsors during development programmes, standardized Development Safety Update Reports (DSURs) are to be implemented in the near future. In this current opinion article, after extensively reviewing the relevant report from the CIOMS VII Working Group and the ICH draft guideline regarding DSURs, we discuss an effective and efficient approach to its application. To ensure effective risk communication, we recommend that DSURs be made available to all the ethics committees and participating investigators around the world for the purpose of continuing review during ongoing clinical trials. Furthermore, in order to maintain the consistency and integrity of safety information throughout the life-cycle of a drug, we believe it would be substantially more prudent and efficient to start a single, integrated, life-cycle periodic safety report covering both development and postmarketing, as proposed by the CIOMS VII Working Group, rather than maintain separate DSURs and Periodic Safety Update Reports, which can overlap considerably in content. To this end, we believe that the international regulatory community should undertake the new initiative for integrated periodic reporting immediately.

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

    PubMed Central

    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.

    2017-01-01

    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

  17. Animal models of Parkinson's disease: An updated overview.

    PubMed

    Gubellini, P; Kachidian, P

    2015-11-01

    Parkinson's disease (PD) is a progressive neurodegenerative disorder whose etiology, besides a minority of genetic cases, is still largely unknown. Animal models have contributed to elucidate PD etiology and pathogenesis, as well as its cellular and molecular mechanisms, leading to the general hypothesis that this neurological disorder is due to complex interactions between environmental and genetic factors. However, the full understanding of PD is still very far from being achieved, and new potential treatments need to be tested to further improve patients' quality of life and, possibly, slow down the neurodegenerative process. In this context, animal models of PD are required to address all these issues. "Classic" models are based on neurotoxins that selectively target catecholaminergic neurons (such as 6-hydroxydopamine, 1-methyl-1,2,3,6-tetrahydropiridine, agricultural pesticides, etc.), while more recent models employ genetic manipulations that either introduce mutations similar to those find in familial cases of PD (α-synuclein, DJ-1, PINK1, Parkin, etc.) or selectively disrupt nigrostriatal neurons (MitoPark, Pitx3, Nurr1, etc.). Each one of these models has its own advantages and limitations, thus some are better suited for studying PD pathogenesis, while others are more pertinent to test therapeutic treatments. Here, we provide a critical and updated review of the most used PD models.

  18. Update on pharmacologic therapy for chronic obstructive pulmonary disease.

    PubMed

    Ferguson, G T

    2000-12-01

    As described throughout this article, significant improvements continue to occur in the pharmacologic management of COPD. These improvements range from improved medication targeting to better understanding of mechanisms of action, to better delivery of medications, to lower side effects. New areas of pharmacologic intervention, if not ready for use today, hold great promise for the not-too-distant future. In addition to the many agents described here, multiple mediator antagonists and anti-inflammatory agents are also under investigation for use in COPD. Interestingly, repair of alveolar tissue may be possible. Indeed, preliminary animal studies suggest that retinoic acid may be able to induce regeneration of lung alveoli. Overall, more effort is needed to broaden awareness and provide for the appropriate diagnosis of COPD, better explain pharmacologic therapies for COPD, simplify and disseminate guidelines, and highlight key differences between asthma and COPD, including their treatment strategies. As interest in COPD continues to grow, future updates on COPD management will continue to add new pharmacologic options for this devastating and preventable disease.

  19. Survey of Communicable Diseases Surveillance System in Hospitals of Iran: A Qualitative Approach.

    PubMed

    Fadaei Dehcheshmeh, Nayeb; Arab, Mohammad; Rahimi Fouroshani, Abbas; Farzianpour, Fereshteh

    2016-09-01

    updating of surveillance systems can play a significant role in its efficiency and effectiveness. In the meantime, policy makers' and senior managers' support in development and implementation of communicable disease surveillance' plans and their reporting plays a key and core role.

  20. Subclinical thyroid dysfunction and cardiovascular diseases: 2016 update.

    PubMed

    Floriani, Carmen; Gencer, Baris; Collet, Tinh-Hai; Rodondi, Nicolas

    2017-02-27

    Subclinical thyroid dysfunction comprises subclinical hypothyroidism (SHypo), defined as elevated thyroid-stimulating hormone (TSH) by normal free thyroxine (FT4), and subclinical hyperthyroidism (SHyper) with decreased or undetectable TSH and normal FT4. Up to 10% of the elderly have SHypo, which is usually asymptomatic. Individual participant data (IPD) analyses of prospective cohort studies from the international Thyroid Studies Collaboration show that SHypo is associated with increased coronary heart disease (CHD) mortality [hazard ratio (HR) 1,58 for TSH ≥ 10 mIU/L, 95% CI 1.10-2.27), as well as increased risk of stroke, and heart failure (HF) for both higher and lower TSH. Small studies found that SHypo affects carotid intima media thickness (CIMT), diastolic function, peripheral vascular resistance, endothelial function, and lipid profile. SHyper is associated with increased risk of atrial fibrillation (AF) (HR 1.68, 95% CI 1.16-2.43) and CHD events (HR 1.21, 95% CI 0.99-1.46). The TSH threshold for initiating treatment is unclear. In the absence of large randomized controlled trials, the best evidence suggests SHypo therapy should be started at TSH ≥ 10 mIU/L, and SHyper therapy at TSH < 0.1 mIU/L. Recommendations on screening are discordant, but most guidelines advocate that thyroid function should be checked in those at risk for hypothyroidism, those over 60, and those with known CHD and HF. This review updates current evidence on the association between thyroid dysfunction and cardiovascular disease, as well as on screening and treatment of subclinical thyroid dysfunction.

  1. Survey of Communicable Diseases Surveillance System in Hospitals of Iran: A Qualitative Approach

    PubMed Central

    Dehcheshmeh, Nayeb Fadaei; Arab, Mohammad; Foroushani, Abbas Rahimi; Farzianpour, Fereshteh

    2016-01-01

    , improving, monitoring and continuous updating of surveillance systems can play a significant role in its efficiency and effectiveness. In the meantime, policy makers’ and senior managers’ support in development and implementation of communicable disease surveillance’ plans and their reporting plays a key and core role. PMID:27157154

  2. Keys to Heart Disease Care: Communication and Trust

    MedlinePlus

    ... fullstory_164421.html Keys to Heart Disease Care: Communication and Trust These factors linked to patients' greater ... trusted the medical profession. It's no secret that communication and trust are important in any doctor-patient ...

  3. 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.

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

    DOE PAGES

    Kibbe, Warren A.; Arze, Cesar; Felix, Victor; ...

    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

  5. 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.

  6. 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.

  7. 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

  8. 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... QUARANTINE, INSPECTION, LICENSING INTERSTATE QUARANTINE § 70.5 Certain communicable diseases; special... disease, is in the incubation period thereof: (a) Requirements relating to travelers. (1) No such...

  9. 42 CFR 70.5 - Certain communicable diseases; special requirements.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Certain communicable diseases; special requirements... QUARANTINE, INSPECTION, LICENSING INTERSTATE QUARANTINE § 70.5 Certain communicable diseases; special... disease, is in the incubation period thereof: (a) Requirements relating to travelers. (1) No such...

  10. 42 CFR 70.5 - Certain communicable diseases; special requirements.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Certain communicable diseases; special requirements... QUARANTINE, INSPECTION, LICENSING INTERSTATE QUARANTINE § 70.5 Certain communicable diseases; special... disease, is in the incubation period thereof: (a) Requirements relating to travelers. (1) No such...

  11. 42 CFR 70.5 - Certain communicable diseases; special requirements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Certain communicable diseases; special requirements... QUARANTINE, INSPECTION, LICENSING INTERSTATE QUARANTINE § 70.5 Certain communicable diseases; special... disease, is in the incubation period thereof: (a) Requirements relating to travelers. (1) No such...

  12. Crosscultural communication in those with airway diseases.

    PubMed

    Car, J; Partridge, M R

    2004-01-01

    Transcultural consultations are becoming commonplace. Such consultations arise because patients from ethnic groups consult doctors, but also because patients consult doctors from other ethnic backgrounds. Such consultations require a cultural awareness and sensitivity which may be particularly necessary when concerning those with respiratory illnesses which are often long-term and about which there may be considerable stigma. The prevalence of respiratory disease can vary between ethnic groups, most noticeably in tuberculosis and smoking; and in diseases such as asthma, health service usage and treatment can vary significantly with ethnicity. Some of this may represent cultural, rather than disease specific differences. Good communication is essential throughout medical practice, but in transcultural consultations it is especially important that the doctor pays appropriate attention to likely patient beliefs and approaches to shared decision making. Usual negotiation regarding goals and outcomes first requires the clinician to understand how a patient's understanding of illness may vary from a traditional western scientific approach. Special attention needs to be paid to the optimal way of using interpreters and more time is often needed for crosscultural consultations. Specific training is necessary for health practitioners to enable them to acquire the skills for crosscultural care and this involves learning about other cultures and an appreciation of how a change in attitude often needs to be incorporated into the clinical approach. Acquiring these skills and understandings to facilitate optimal transcultural consultation enables transfer of these skills to other similar clinical scenarios such as the approach to those with disability. The global burden of long-term respiratory disease, both infectious and noncommunicable, coupled with increased migration and geographical mobility means that a successful crosscultural approach is now a priority area for

  13. Financing national non-communicable disease responses.

    PubMed

    Allen, Luke Nelson

    2017-01-01

    Non-communicable diseases (NCDs) (also known as socially transmitted diseases) were conspicuously absent from the Millennium Development Goals and seemed to miss out on the 'golden years' of health funding despite causing more death and disability than any other disease group worldwide. The share of 'development assistance for health' dedicated to NCDs has remained at 1-2% of the total since 2000. This level of funding is insufficient to attain the nine targets in the World Health Organization (WHO) Global Action Plan on NCDs. In 2015 the Sustainable Development Goals - which include the target of reducing premature NCD mortality by a third - were endorsed by 193 countries. Whilst this commitment is welcome, the same text stresses the primacy of domestic financing, which is currently dominated by out-of-pocket payments in low- and middle-income countries (LMICs). This paper presents the findings of the WHO Global Coordination Mechanism on NCDs financing working group. The group was convened to explore NCD financing options with an emphasis on LMICs. The main sources of available finance include taxation, loans, engagement with the private sector, impact investment and innovative financing mechanisms. There is a role for development assistance to increase in the interim as raising additional revenue from these sources will take time. In the medium term it may be appropriate for international NCD funding to remain low where LMICs successfully assume financial responsibility for preventing and controlling NCDs. Countries will have to manage blends of innovative and traditional funding sources, whilst finding ways to boost tax revenue for NCDs.

  14. Financing national non-communicable disease responses

    PubMed Central

    Allen, Luke Nelson

    2017-01-01

    ABSTRACT Non-communicable diseases (NCDs) (also known as socially transmitted diseases) were conspicuously absent from the Millennium Development Goals and seemed to miss out on the ‘golden years’ of health funding despite causing more death and disability than any other disease group worldwide. The share of ‘development assistance for health’ dedicated to NCDs has remained at 1–2% of the total since 2000. This level of funding is insufficient to attain the nine targets in the World Health Organization (WHO) Global Action Plan on NCDs. In 2015 the Sustainable Development Goals – which include the target of reducing premature NCD mortality by a third – were endorsed by 193 countries. Whilst this commitment is welcome, the same text stresses the primacy of domestic financing, which is currently dominated by out-of-pocket payments in low- and middle-income countries (LMICs). This paper presents the findings of the WHO Global Coordination Mechanism on NCDs financing working group. The group was convened to explore NCD financing options with an emphasis on LMICs. The main sources of available finance include taxation, loans, engagement with the private sector, impact investment and innovative financing mechanisms. There is a role for development assistance to increase in the interim as raising additional revenue from these sources will take time. In the medium term it may be appropriate for international NCD funding to remain low where LMICs successfully assume financial responsibility for preventing and controlling NCDs. Countries will have to manage blends of innovative and traditional funding sources, whilst finding ways to boost tax revenue for NCDs. PMID:28604238

  15. Augmentative and alternative communication for people with progressive neuromuscular disease.

    PubMed

    Ball, Laura J; Fager, Susan; Fried-Oken, Melanie

    2012-08-01

    Individuals with progressive neuromuscular disease often experience complex communication needs and consequently find that interaction using their natural speech may not sufficiently meet their daily needs. Increasingly, assistive technology advances provide accommodations for and/or access to communication. Assistive technology related to communication is referred to as augmentative and alternative communication (AAC). The nature of communication challenges in progressive neuromuscular diseases can be as varied as the AAC options currently available. AAC systems continue to be designed and implemented to provide targeted assistance based on an individual's changing needs.

  16. 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…

  17. 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…

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

    USDA-ARS?s Scientific Manuscript database

    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...

  19. Tuberculosis comorbidity with communicable and non-communicable diseases: integrating health services and control efforts.

    PubMed

    Marais, Ben J; Lönnroth, Knut; Lawn, Stephen D; Migliori, Giovanni Battista; Mwaba, Peter; Glaziou, Philippe; Bates, Matthew; Colagiuri, Ruth; Zijenah, Lynn; Swaminathan, Soumya; Memish, Ziad A; Pletschette, Michel; Hoelscher, Michael; Abubakar, Ibrahim; Hasan, Rumina; Zafar, Afia; Pantaleo, Guiseppe; Craig, Gill; Kim, Peter; Maeurer, Markus; Schito, Marco; Zumla, Alimuddin

    2013-05-01

    Recent data for the global burden of disease reflect major demographic and lifestyle changes, leading to a rise in non-communicable diseases. Most countries with high levels of tuberculosis face a large comorbidity burden from both non-communicable and communicable diseases. Traditional disease-specific approaches typically fail to recognise common features and potential synergies in integration of care, management, and control of non-communicable and communicable diseases. In resource-limited countries, the need to tackle a broader range of overlapping comorbid diseases is growing. Tuberculosis and HIV/AIDS persist as global emergencies. The lethal interaction between tuberculosis and HIV coinfection in adults, children, and pregnant women in sub-Saharan Africa exemplifies the need for well integrated approaches to disease management and control. Furthermore, links between diabetes mellitus, smoking, alcoholism, chronic lung diseases, cancer, immunosuppressive treatment, malnutrition, and tuberculosis are well recognised. Here, we focus on interactions, synergies, and challenges of integration of tuberculosis care with management strategies for non-communicable and communicable diseases without eroding the functionality of existing national programmes for tuberculosis. The need for sustained and increased funding for these initiatives is greater than ever and requires increased political and funder commitment. Copyright © 2013 World Health Organization. Published by Elsevier Ltd/Inc/BV. All rights reserved. Published by Elsevier Ltd. All rights reserved.

  20. Global foot-and-mouth disease research update and gap analysis: 7 - pathogenesis and molecular biology

    USDA-ARS?s Scientific Manuscript database

    In 2014, the GFRA (Global Foot-and-mouth disease Research Alliance) conducted a gap analysis of FMD (Foot-and-Mouth Disease) research. This work has been updated and reported in a series of papers, in this article we report findings in the fields of 1) pathogenesis and 2) molecular biology. The arti...

  1. 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

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

    USDA-ARS?s Scientific Manuscript database

    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 ...

  3. Perception of Communicative and Non-Communicative Motion-Defined Gestures in Parkinson’s Disease

    PubMed Central

    Jaywant, Abhishek; Wasserman, Victor; Kemppainen, Maaria; Neargarder, Sandy; Cronin-Golomb, Alice

    2017-01-01

    Objective Parkinson's disease (PD) is associated with deficits in social cognition and visual perception, but little is known about how the disease affects perception of socially complex biological motion, specifically motion-defined communicative and non-communicative gestures. We predicted that individuals with PD would perform more poorly than normal control (NC) participants in discriminating between communicative and non-communicative gestures, and in describing communicative gestures. We related the results to the participants’ gender, as there are gender differences in social cognition in PD. Method The study included 23 individuals with PD (10 men) and 24 NC participants (10 men) matched for age and education level. Participants viewed point-light human figures that conveyed communicative and non-communicative gestures and were asked to describe each gesture while discriminating between the two gesture types. Results PD as a group were less accurate than NC in describing non-communicative but not communicative gestures. Men with PD were impaired in describing and discriminating between communicative as well as non-communicative gestures. Conclusion The present study demonstrated PD-related impairments in perceiving and inferring the meaning of biological motion gestures. Men with PD may have particular difficulty in understanding the communicative gestures of others in interpersonal exchanges. PMID:27055646

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

    PubMed

    Janati, Ali; Hosseiny, Mozhgan; Gouya, Mohammad Mehdi; Moradi, Ghobad; Ghaderi, Ebrahim

    2015-11-01

    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. 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. 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. 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.

  5. Prevention of communicable diseases after disaster: A review

    PubMed Central

    Jafari, Najmeh; Shahsanai, Armindokht; Memarzadeh, Mehrdad; Loghmani, Amir

    2011-01-01

    Natural disasters are tragic incidents originating from atmospheric, geologic and hydrologic changes. In recent decades, millions of people have been killed by natural disasters, resulting in economic damages. Natural and complex disasters dramatically increase the mortality and morbidity due to communicable diseases. The major causes of communicable disease in disasters are categorized into four sections: Infections due to contaminated food and water, respiratory infections, vector and insect-borne diseases, and infections due to wounds and injuries. With appropriate intervention, high morbidity and mortality resulting from communicable diseases can be avoided to a great deal. This review article tries to provide the best recommendations for planning and preparing to prevent communicable disease after disaster in two phases: before disaster and after disaster. PMID:22279466

  6. [An update on the pharmacological treatment of Alzheimer disease].

    PubMed

    Fuentes, Patricio; Slachevsky, Andrea

    2005-02-01

    Dementia in general, especially Alzheimer disease and vascular dementia, are diseases of high prevalence with severe socio-economic consequences in all countries. In recent years, due to the obtention of new pharmaceutical products acting on different brain neurotransmitters, there has been important changes in the therapy of these diseases. Although these drugs do not stop disease progression, there is consistent evidence of their usefulness in cognitive, behavioral and functional domains and of their pharmaco-economical justification. This article reviews the main drugs available for Alzheimer disease and some future therapeutic perspectives.

  7. Matrix metalloproteinases as biomarkers of disease: updates and new insights.

    PubMed

    Galliera, Emanuela; Tacchini, Lorenza; Corsi Romanelli, Massimiliano M

    2015-02-01

    Matrix metalloproteinases (MMPs) play a pivotal role in remodeling the extracellular matrix (ECM) and are therefore of interest for new diagnostic tools for the clinical management of diseases involving ECM disruption. This setting ranges from the classical areas of MMP studies, such as vascular disease, cancer progression or bone disorders, to new emerging fields of application, such as neurodegenerative disease or sepsis. Increasing the knowledge about the role of MMPs in the pathogenesis of diseases where a clear diagnostic panel is still lacking could provide new insight and improve the identification and the clinical treatment of these human diseases. This review focuses on the latest descriptions of the clinical use of MMP as biomarkers in the diagnosis, prognosis and monitoring of different diseases, such as diabetes, cardiovascular diseases, cancer and metastasis, neurodegenerative disorders and sepsis.

  8. 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

  9. 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.

  10. Celiac disease and overweight in children: an update.

    PubMed

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

    2014-01-02

    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.

  11. The prevalence of cardiovascular disease in non-communicating hydrocephalus.

    PubMed

    Eide, Per Kristian; Pripp, Are Hugo

    2016-10-01

    Hydrocephalus (HC) caused by blockade of ventricular cerebrospinal fluid (CSF) pathways is denoted non-communicating HC. One issue not previously addressed is how the prevalence of cardiovascular disease compares between patients with non-communicating HC and the general population. We examined whether the prevalence of cardiovascular disease (arterial hypertension, angina pectoris, cardiac infarction, and diabetes) differed between cases with non-communicating HC and a general control population, represented by participants of the North-Trøndelag Health 3 Survey (The HUNT3 Survey). A second control group consisted of patients with communicating hydrocephalus (idiopathic normal pressure hydrocephalus, iNPH). The study included 50 cases with non-communicating HC (53.4+10.5years), and two control cohorts: 35,413 participants of the HUNT3 Survey (52.8+9.6years), and 176 iNPH patients (61.2+8.3years). All individuals were aged 35-70 years. Among the non-communicating HC patients, the results showed increased prevalence for arterial hypertension (males), cardiac infarction (females), and diabetes (females), as compared with the HUNT3 control group with significant odds ratio estimates. However, the prevalence of cardiovascular disease did not significantly differ between patients with non-communicating HC or iNPH. In patients with either non-communicating HC or iNPH and elevated pulsatile intracranial pressure (ICP) during overnight monitoring, the prevalence of diabetes was increased. This study showed significantly increased prevalence of cardiovascular disease in non-communicating HC, indicating an association between cardiovascular disease and the development of non-communicating HC. Further, diabetes was associated with abnormal pulsatile ICP in both non-communicating HC and iNPH patients. Copyright © 2016 Elsevier B.V. All rights reserved.

  12. DiseaseMeth version 2.0: a major expansion and update of the human disease methylation database.

    PubMed

    Xiong, Yichun; Wei, Yanjun; Gu, Yue; Zhang, Shumei; Lyu, Jie; Zhang, Bin; Chen, Chuangeng; Zhu, Jiang; Wang, Yihan; Liu, Hongbo; Zhang, Yan

    2017-01-04

    The human disease methylation database (DiseaseMeth, http://bioinfo.hrbmu.edu.cn/diseasemeth/) is an interactive database that aims to present the most complete collection and annotation of aberrant DNA methylation in human diseases, especially various cancers. Recently, the high-throughput microarray and sequencing technologies have promoted the production of methylome data that contain comprehensive knowledge of human diseases. In this DiseaseMeth update, we have increased the number of samples from 3610 to 32 701, the number of diseases from 72 to 88 and the disease-gene associations from 216 201 to 679 602. DiseaseMeth version 2.0 provides an expanded comprehensive list of disease-gene associations based on manual curation from experimental studies and computational identification from high-throughput methylome data. Besides the data expansion, we also updated the search engine and visualization tools. In particular, we enhanced the differential analysis tools, which now enable online automated identification of DNA methylation abnormalities in human disease in a case-control or disease-disease manner. To facilitate further mining of the disease methylome, three new web tools were developed for cluster analysis, functional annotation and survival analysis. DiseaseMeth version 2.0 should be a useful resource platform for further understanding the molecular mechanisms of human diseases. © The Author(s) 2016. Published by Oxford University Press on behalf of Nucleic Acids Research.

  13. Association between periodontal disease and non-communicable diseases

    PubMed Central

    Lee, Jae-Hong; Oh, Jin-Young; Youk, Tae-Mi; Jeong, Seong-Nyum; Kim, Young-Taek; Choi, Seong-Ho

    2017-01-01

    Abstract The National Health Insurance Service–Health Examinee Cohort during 2002 to 2013 was used to investigate the associations between periodontal disease (PD) and the following non-communicable diseases (NCDs): hypertension, diabetes mellitus, osteoporosis, cerebral infarction, angina pectoris, myocardial infarction, and obesity. Univariate and multivariate logistic regression analyses adjusting for potential confounders during the follow-up period—including age, sex, household income, insurance status, residence area, health status, and comorbidities—were used to estimated odds ratios (ORs) with 95% confidence intervals (CIs) in order to assess the associations between PD and NCDs. We enrolled 200,026 patients with PD and 154,824 subjects with a healthy oral status. Statistically, significant associations were found between PD and the investigated NCDs except for cerebral and myocardial infarction after adjusting for sociodemographic and comorbidity factors (P < .05). In particular, obesity (OR = 1.30, 95% CI = 1.04–1.63, P = .022), osteoporosis (OR = 1.22, 95% CI = 1.18–1.27, P < .001), and angina pectoris (OR = 1.22, 95% CI = 1.17–1.27, P < .001) were significantly and positively associated with PD. This longitudinal cohort study has provided evidence that patients with PD are at increased risk of NCDs. Further studies are required to confirm the reliability of this association and elucidate the role of the inflammatory pathway in periodontitis pathogenesis as a triggering and mediating mechanism. PMID:28658175

  14. 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. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  15. Updates in the medical management of Parkinson disease.

    PubMed

    Fernandez, Hubert H

    2012-01-01

    Most, if not all, currently available drugs for Parkinson disease address dopaminergic loss and relieve symptoms. However, their adverse effects can be limiting and they do not address disease progression. Moreover, nonmotor features of Parkinson disease such as depression, dementia, and psychosis are now recognized as important and disabling. A cure remains elusive. However, promising interventions and agents are emerging. As an example, people who exercise regularly are less likely to develop Parkinson disease, and if they develop it, they tend to have slower progression.

  16. 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

  17. Update on etio and immunopathogenesis of Kawasaki disease.

    PubMed

    Takahashi, Kei; Oharaseki, Toshiaki; Yokouchi, Yuki

    2014-01-01

    This review first discusses the pathogenesis of Kawasaki disease based on the results of recently performed studies aimed at identifying Kawasaki disease-susceptibility genes and the results of analyses of the immune system. Following that, we discuss the findings generated using a murine Kawasaki disease arteritis model and speculate regarding the mechanism of Kawasaki disease onset based on immune function aberrations seen in that model. Recent advances in gene analysis studies of Kawasaki disease are contributing not only to prediction of disease susceptibility but also to improving our understanding of the pathogenesis of Kawasaki disease and development of new improved therapies. In addition, Th17/Treg imbalance is observed in patients with acute-phase Kawasaki disease. Th17/Treg imbalance may be an important factor causing disturbed immunological function. IL-17 induced by Th17 cells have proinflammatory properties and act on inflammatory cells, thereby inducing expression of cytokines and chemokines and resulting in tissue inflammation. Kawasaki disease vasculitis may be triggered by aberrant activation of inflammatory cytokines mediated by IL-17 that is produced by Th17 cells that have been activated by some infectious agent(s).

  18. 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.

  19. 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

  20. Salivary gland disease in pediatric HIV patients: an update.

    PubMed

    Pinto, Andres; De Rossi, Scott S

    2004-01-01

    Oral manifestations are one of the earliest clinical indicators of HIV infection and progression in children. Prompt recognition of these signs and symptoms by dental providers can help in the diagnosis and intervention of delaying the progression of HIV disease to AIDS. Salivary gland disease is a common manifestation of HIV infection in pediatric patients, presenting either as gland enlargement and/or xerostomia. The parotid glands by far are most frequently affected, though the other major glands are commonly involved. Diseases of the salivary glands and the corresponding quantitative changes in saliva affect the homeostasis of the oral cavity and account for significant morbidity during the progression of HIV disease. This paper summarizes the research on HIV-related salivary gland disease and outlines treatment and management considerations.

  1. Update on the therapy of Behçet disease.

    PubMed

    Saleh, Zeinab; Arayssi, Thurayya

    2014-05-01

    Behçet disease is a chronic inflammatory systemic disorder, characterized by a relapsing and remitting course. It manifests with oral and genital ulcerations, skin lesions, uveitis, and vascular, central nervous system and gastrointestinal involvement. The main histopathological finding is a widespread vasculitis of the arteries and veins of any size. The cause of this disease is presumed to be multifactorial involving infectious triggers, genetic predisposition, and dysregulation of the immune system. As the clinical expression of Behçet disease is heterogeneous, pharmacological therapy is variable and depends largely on the severity of the disease and organ involvement. Treatment of Behçet disease continues to be based largely on anecdotal case reports, case series, and a few randomized clinical trials.

  2. 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.

  3. Hepatobiliary diseases during pregnancy and their management: An update

    PubMed Central

    Lata, Indu

    2013-01-01

    Liver diseases in pregnancy although rare but they can seriously affect mother and fetus. Signs and symptoms are often not specific and consist of jaundice, nausea, vomiting, and abdominal pain. Although any type of liver disease can develop during pregnancy or pregnancy may occur in a patient already having chronic liver disease. All liver diseases with pregnancy can lead to increased maternal and fetal morbidity and mortality. It is difficult to identify features of liver disease in pregnant women because of physiological changes. Physiological changes of normal pregnancy can be confounding with that of sign and symptoms of liver diseases. Telangiectasia or spider angiomas, palmar erythema, increased alkaline phosphatase due to placental secretion, hypoalbuminemia due to hemodilution. These normal alterations mimic physiological changes in patients with decompensated chronic liver disease. Besides all these pathological changes however, blood flow to the liver remains constant and the liver usually remains impalpable during pregnancy. The diagnosis of liver disease in pregnancy is challenging and relies on laboratory investigations. The underlying disorder can have a significant effect on morbidity and mortality in both mother and fetus, and a diagnostic workup should be initiated promptly. If we see the spectrum of liver disease in pregnancy, in mild form there occur increase in liver enzymes to severe form, where liver failure affecting the entire system or maternal mortality and morbidity. It can not only complicate mother's life but also poses burden of life of fetus to growth restriction. Most of the times termination is only answer to save life of mother but sometimes early detection of diseases, preventive measures and available active treatment is helpful for both of the life. Extreme vigilance in recognizing physical and laboratory abnormalities in pregnancy is a prerequisite for an accurate diagnosis. This could lead to a timely intervention and

  4. Chagas disease (American trypanosomiasis) in Mexico: an update.

    PubMed

    Carabarin-Lima, Alejandro; González-Vázquez, María Cristina; Rodríguez-Morales, Olivia; Baylón-Pacheco, Lidia; Rosales-Encina, José Luis; Reyes-López, Pedro Antonio; Arce-Fonseca, Minerva

    2013-08-01

    Chagas disease is a parasitic infection caused by the protozoan Trypanosoma cruzi, a flagellated organism that is transmitted mainly to humans through the infected feces of triatomine kissing bugs (vector transmission in endemic areas) or by transfusion of infected blood, donations of infected organ, or transmission from an infected mother to her child at birth. Chagas disease was first described in 1909 by the Brazilian physician Carlos Chagas, and due to the parasite's distribution throughout North, Central and South America, the disease is commonly known as American trypanosomiasis. However, this disease is now present in non-endemic countries such as Canada, the United States of America, and several countries in Europe (principally Spain). Moreover, Chagas disease was recently designated by the World Health Organization as one of the main neglected tropical diseases. The aim of this review is to summarize the research efforts recently described in studies conducted in Mexico on Chagas disease. In this country, there are no existing vector control programs. In addition, there is no consensus on the diagnostic methods for acute and chronic Chagas disease in maternity wards and blood banks, and trypanocidal therapy is not administered to chronic patients. The actual prevalence of the disease is unknown because no official reporting of cases is performed. Therefore, the number of people infected by different routes of transmission (vector, congenital, blood transfusion, organ transplantation, or oral) is unknown. We believe that by promoting education about Chagas disease in schools starting at the basic elementary level and including reinforcement at higher education levels will ensure that the Mexican population would be aware of this health problem and that the control measures adopted will have more acceptance and success. We hope that this review sensitizes the relevant authorities and that the appropriate measures to reduce the risk of infection by T. cruzi

  5. Update on persistent symptoms associated with Lyme disease.

    PubMed

    Oliveira, Carlos R; Shapiro, Eugene D

    2015-02-01

    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. 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. 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.

  6. Contraception for women with heart disease: an update.

    PubMed

    Bonassi Machado, Rogério; Gandolpho, Ana C; Santana, Narayana; Bocardo, Rogerio C; Palandri, Nathalia; Morassutti Machado, Renato

    2017-06-01

    It is estimated that by the year 2013, 303.000 women worldwide died as a result of pregnancy-related conditions. The risk of pregnancy complications in women with heart disease depends on the specific disease and on the individual conditions of each patient. A bibliographic research was carried out on PubMed using the descriptors "heart disease" AND "contraceptive" OR "pregnancy" AND "thrombosis" OR "angina" OR "cardiopathy". A total of 1456 articles were found. Classification of heart disease in pregnancy according to the severity of the condition include high, intermediate or low-risk cardiac patients. Tubal ligation is indicated for women with high-risk heart disease. Reversible methods are possible for intermediate or low-risk cardiac patient, but formal contraindications for estrogens are present in large percentage of clinical conditions and progestogen-only formulations are generally considered. Contraindications to the use of an intrauterine device disease should be considered. According to the different forms of heart disease, different contraceptive methods are recommended.

  7. A Recent Update of Clinical and Research Topics Concerning Adult Moyamoya Disease

    PubMed Central

    Jeon, Jin Pyeong

    2016-01-01

    A better understanding of moyamoya disease (MMD), such as natural clinical course, surgical outcomes and research, has been obtained. This review article focuses on an giving an update for adult MMD in the Korean population. In this paper, we mainly discuss the results of our domestic investigations including meta-analysis, and related subjects from other countries. PMID:27847564

  8. Global foot-and-mouth disease research update and gap analysis: 4 - diagnostics

    USDA-ARS?s Scientific Manuscript database

    In 2014, the Global Foot-And-Mouth Disease Research Alliance (GFRA) conducted a gap analysis of FMD research. Published as a series of seven papers, in this paper, we report updated findings in the field of diagnostics. The paper consists of the following four sections: 1. Research priorities identi...

  9. Global foot-and-mouth disease research update and gap analysis: 5 - biotherapeutics and disinfectants

    USDA-ARS?s Scientific Manuscript database

    In 2014, the Global Foot-and-mouth disease Research Alliance(GFRA)conducted a gap analysis of FMD research. This work has been updated and reported in a series of papers with the focus of this article being (i) biotherapeutics and (ii) disinfectants, including environmental contamination. The paper ...

  10. Global foot-and-mouth disease research update and gap analysis: 6 - immunology

    USDA-ARS?s Scientific Manuscript database

    In 2014, the Global Foot-and-mouth disease Research Alliance (GFRA) conducted a gap analysis of FMD research. This has been updated with findings reported in a series of papers. Here we present findings for FMD immunology research. The paper consists of the following four sections: 1. Research prior...

  11. Global foot-and-mouth disease research update and gap analysis: 3 - vaccines

    USDA-ARS?s Scientific Manuscript database

    In 2014, the Global Foot-and-mouth disease Research Alliance (GFRA) conducted a gap analysis of FMD research. In this paper, we report updated findings in the field of FMD vaccine research. This paper consists of the following four sections: 1) Research priorities identified in the 2010 GFRA gap ana...

  12. [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.

  13. 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

  14. Update in diagnosis and management of interstitial lung disease.

    PubMed

    Mikolasch, Theresia A; Garthwaite, Helen S; Porter, Joanna C

    2016-12-01

    The field of interstitial lung disease (ILD) has undergone significant evolution in recent years, with an increasing incidence and more complex, ever expanding disease classification. In their most severe forms, these diseases lead to progressive loss of lung function, respiratory failure and eventually death. Despite notable advances, progress has been challenged by a poor understanding of pathological mechanisms and patient heterogeneity, including variable progression. The diagnostic pathway is thus being continually refined, with the introduction of tools such as transbronchial cryo lung biopsy and a move towards genetically aided, precision medicine. In this review, we focus on how to approach a patient with ILD and the diagnostic process.

  15. Update on Janus Kinase Antagonists in Inflammatory Bowel Disease

    PubMed Central

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

    2014-01-01

    Janus kinase (JAK) inhibitors have emerged as a novel orally administered small molecule therapy for the treatment of ulcerative colitis and possibly Crohn’s disease. These molecules are designed to selectively target the activity of specific JAKs and 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

  16. 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

  17. 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.

  18. [An update on viral diseases of the dog and cat].

    PubMed

    Bodewes, R; Egberink, H F

    2009-04-15

    In this review, recent developments in the field of viral diseases of the dog and the cat are discussed. In the dog, infection with the coronavirus type 2 is associated with respiratory signs, while infection of a highly pathogenic strain of the coronavirus type 1 has been identified as the cause of mortality in puppies. A new strain of the canine parvovirus is identified, from which the pathogenicity is not yet completely clarified. Infection with West Nile virus is associated with progressive neurological disease and subclinical infections in dogs. Infection with equine influenza A (H3N8) or a highly related influenza virus can cause severe respiratory disease and mortality in greyhounds and other dogs. Infection with avian influenza A (H5N1) can cause disease and mortality in cats and is mostly subclinical in dogs. A number of outbreaks of highly virulent strains of the calicivirus in cats have been described.

  19. Statins in nonalcoholic fatty liver disease and steatohepatitis: updated review.

    PubMed

    Nseir, William; Mahamid, Mahmud

    2013-03-01

    Non-alcoholic fatty liver disease (NAFLD) is a chronic liver disease that refers to the presence of hepatic steatosis without significant intake of alcohol. NAFLD is an asymptomatic disease that can progress to nonalcoholic steatohepatitis (NASH), fibrosis, cirrhosis, and hepatocellular carcinoma. The most common cause of mortality in patients with NAFLD or NASH is cardiovascular disease (CVD). Currently, the treatment of NAFLD focuses on gradual weight loss and life style modifications. However, multifactorial treatment of NAFLD or NASH risk factors may be needed to reduce the likelihood of these patients developing CVD. This review discusses the mechanisms that link hyperlipidemia and NAFLD. In addition, the review focuses on the safety and efficacy of statins in patients with NAFLD or NASH, and their effect on the extent of hepatic steatosis and fibrosis based on human studies.

  20. A Century in the Life of the Control of Communicable Diseases Manual: 1917 to 2017.

    PubMed

    Marr, John S; Cathey, John T

    2016-01-01

    The Control of Communicable Diseases Manual, a premier publication of the American Public Health Association, celebrates its centennial in 2017. The Control of Communicable Diseases Manual has evolved in format and content through 20 separate editions. This article is a follow-up to an earlier article, titled "Evolution of the Control of Communicable Disease Manual: 1917 to 2000," that appeared in the Journal of Public Health Management & Practice in 2001. Our update focuses on the period since the 17th edition, which is characterized by dramatic changes. The 20th edition (2014) added a few arboviral diseases (Banna, Cache Valley, Eyach, Heartland, severe fever with thrombocytopenia syndrome virus, Iquitos, and Me Tri), but mostly contracted, leaving 65 arboviral entries. Other categories of pathogens also declined in the most recent editions, indicating an apparent trend to make the manual less encyclopedic. We attempt to explain these and other changes and ask the reader to comment whether they are aware of other related facts or history based on personal experience.

  1. 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

  2. Treatment of inflammatory bowel disease in the elderly: an update.

    PubMed

    Pardi, Darrell S; Loftus, Edward V; Camilleri, Michael

    2002-01-01

    Inflammatory bowel disease (IBD) is most common in young adults, but it can also present in the elderly. Furthermore, with the aging of the population, the number of elderly patients with IBD is expected to grow. Other conditions, such as diverticulitis and ischaemic colitis, may be more common in the elderly and need to be considered in the differential diagnosis. Management of elderly patients with IBD follows the same principles as in younger patients, with a few exceptions. For patients with mild-to-moderate colitis, a 5-aminosalicylate drug is often used (sulfasalazine, olsalazine, mesalazine, balsalazide). Topical therapy may be sufficient for those with distal colitis, whereas an oral preparation is used for more extensive disease. In those with more severe or refractory symptoms, corticosteroids are used, although the elderly appear to be at increased risk for corticosteroid-associated complications. For patients with corticosteroid-dependent or corticosteroid-refractory disease, immunosuppression with azathioprine or mercaptopurine may help avoid surgery. In patients with Crohn's disease, a similar approach is followed, with the additional consideration that the formulation of drug used must ensure delivery of drug to the site of inflammation. In fistulising Crohn's disease, antibacterials, immunosuppressive drugs, infliximab and surgery are often used in combination. Controlled trials and clinical experience have shown that infliximab is a significant addition to the therapeutic armamentarium for patients with Crohn's disease.

  3. Updated clinical diagnostic criteria for sporadic Creutzfeldt-Jakob disease

    PubMed Central

    Kallenberg, K.; Summers, D. M.; Romero, C.; Taratuto, A.; Heinemann, U.; Breithaupt, M.; Varges, D.; Meissner, B.; Ladogana, A.; Schuur, M.; Haik, S.; Collins, S. J.; Jansen, Gerard H.; Stokin, G. B.; Pimentel, J.; Hewer, E.; Collie, D.; Smith, P.; Roberts, H.; Brandel, J. P.; van Duijn, C.; Pocchiari, M.; Begue, C.; Cras, P.; Will, R. G.; Sanchez-Juan, P.

    2009-01-01

    Several molecular subtypes of sporadic Creutzfeldt–Jakob disease have been identified and electroencephalogram and cerebrospinal fluid biomarkers have been reported to support clinical diagnosis but with variable utility according to subtype. In recent years, a series of publications have demonstrated a potentially important role for magnetic resonance imaging in the pre-mortem diagnosis of sporadic Creutzfeldt–Jakob disease. Magnetic resonance imaging signal alterations correlate with distinct sporadic Creutzfeldt–Jakob disease molecular subtypes and thus might contribute to the earlier identification of the whole spectrum of sporadic Creutzfeldt–Jakob disease cases. This multi-centre international study aimed to provide a rationale for the amendment of the clinical diagnostic criteria for sporadic Creutzfeldt–Jakob disease. Patients with sporadic Creutzfeldt–Jakob disease and fluid attenuated inversion recovery or diffusion-weight imaging were recruited from 12 countries. Patients referred as ‘suspected sporadic Creutzfeldt–Jakob disease’ but with an alternative diagnosis after thorough follow up, were analysed as controls. All magnetic resonance imaging scans were assessed for signal changes according to a standard protocol encompassing seven cortical regions, basal ganglia, thalamus and cerebellum. Magnetic resonance imaging scans were evaluated in 436 sporadic Creutzfeldt–Jakob disease patients and 141 controls. The pattern of high signal intensity with the best sensitivity and specificity in the differential diagnosis of sporadic Creutzfeldt–Jakob disease was identified. The optimum diagnostic accuracy in the differential diagnosis of rapid progressive dementia was obtained when either at least two cortical regions (temporal, parietal or occipital) or both caudate nucleus and putamen displayed a high signal in fluid attenuated inversion recovery or diffusion-weight imaging magnetic resonance imaging. Based on our analyses, magnetic

  4. DiseaseMeth version 2.0: a major expansion and update of the human disease methylation database

    PubMed Central

    Xiong, Yichun; Wei, Yanjun; Gu, Yue; Zhang, Shumei; Lyu, Jie; Zhang, Bin; Chen, Chuangeng; Zhu, Jiang; Wang, Yihan; Liu, Hongbo; Zhang, Yan

    2017-01-01

    The human disease methylation database (DiseaseMeth, http://bioinfo.hrbmu.edu.cn/diseasemeth/) is an interactive database that aims to present the most complete collection and annotation of aberrant DNA methylation in human diseases, especially various cancers. Recently, the high-throughput microarray and sequencing technologies have promoted the production of methylome data that contain comprehensive knowledge of human diseases. In this DiseaseMeth update, we have increased the number of samples from 3610 to 32 701, the number of diseases from 72 to 88 and the disease–gene associations from 216 201 to 679 602. DiseaseMeth version 2.0 provides an expanded comprehensive list of disease–gene associations based on manual curation from experimental studies and computational identification from high-throughput methylome data. Besides the data expansion, we also updated the search engine and visualization tools. In particular, we enhanced the differential analysis tools, which now enable online automated identification of DNA methylation abnormalities in human disease in a case-control or disease–disease manner. To facilitate further mining of the disease methylome, three new web tools were developed for cluster analysis, functional annotation and survival analysis. DiseaseMeth version 2.0 should be a useful resource platform for further understanding the molecular mechanisms of human diseases. PMID:27899673

  5. 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

  6. 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

  7. An update on the epigenetics of psychotic diseases and autism.

    PubMed

    Abdolmaleky, Hamid Mostafavi; Zhou, Jin-Rong; Thiagalingam, Sam

    2015-01-01

    The examination of potential roles of epigenetic alterations in the pathogenesis of psychotic diseases have become an essential alternative in recent years as genetic studies alone are yet to uncover major gene(s) for psychosis. Here, we describe the current state of knowledge from the gene-specific and genome-wide studies of postmortem brain and blood cells indicating that aberrant DNA methylation, histone modifications and dysregulation of micro-RNAs are linked to the pathogenesis of mental diseases. There is also strong evidence supporting that all classes of psychiatric drugs modulate diverse features of the epigenome. While comprehensive environmental and genetic/epigenetic studies are uncovering the origins, and the key genes/pathways affected in psychotic diseases, characterizing the epigenetic effects of psychiatric drugs may help to design novel therapies in psychiatry.

  8. Pharmacotherapy in the treatment of Alzheimer's disease: an update

    PubMed Central

    Leonard, Brian E

    2004-01-01

    This review summarises the pharmacological properties of the main classes of drugs in current use for the symptomatic treatment of Alzheimer's disease. These may be divided into two major groups: those enhancing cholinergic function which has been shown to be defective in the disease, and those which either directly or indirectly reduce free radical/inflammatory processes in the brain. To date, none of the drugs available has been shown to reverse the pathological changes associated with the disease. However, a number of drugs are in development which are designed to block the neurotoxic action of amyloid beta peptide and thereby reverse the underlying pathological processes. These include the gamma secretase inhibitors and vaccines against amyloid beta peptide. The limitations of these novel approaches are discussed. PMID:16633462

  9. Biomarkers of lipid peroxidation in Alzheimer disease (AD): an update.

    PubMed

    Bradley-Whitman, Melissa A; Lovell, Mark A

    2015-07-01

    Increasing evidence suggests that free radical-mediated oxidation of biological substrates is a key feature of Alzheimer's disease (AD) pathogenesis. While it has long been established that biomarkers of lipid peroxidation (LPO) are elevated in AD brain as well as ventricular CSF postmortem, more recent studies have demonstrated increased LPO biomarkers in postmortem brain from subjects with mild cognitive impairment, the earliest clinically detectable phase of dementia and preclinical AD, the earliest detectable pathological phase. Furthermore, multiple LPO biomarkers are elevated in readily accessible biological fluids throughout disease progression. Collectively, these studies demonstrate that LPO is an early feature during disease progression and may be considered a key pathway for targeted therapeutics as well as an enhancer of diagnostic accuracy for early detection of subjects during the prodromal phase.

  10. Biomarkers of lipid peroxidation in Alzheimer disease (AD): an update

    PubMed Central

    Bradley-Whitman, Melissa A.; Lovell, Mark A.

    2015-01-01

    Increasing evidence suggests free radical mediated oxidation of biological substrates is a key feature of Alzheimer’s disease (AD) pathogenesis. While it has long been established that biomarkers of lipid peroxidation (LPO) are elevated in AD brain as well as ventricular CSF postmortem, more recent studies have demonstrated increased LPO biomarkers in postmortem brain from subjects with mild cognitive impairment (MCI), the earliest clinically detectable phase of dementia and preclinical AD (PCAD), the earliest detectable pathological phase. Furthermore, multiple LPO biomarkers are elevated in readily accessible biological fluids throughout disease progression. Collectively these studies demonstrate that LPO is an early feature during disease progression and may be considered a key pathway for targeted therapeutics as well as an enhancer of diagnostic accuracy for early detection of subjects during the prodromal phase. PMID:25895140

  11. Update on Legionnaires' disease: pathogenesis, epidemiology, detection and control.

    PubMed

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

    2010-04-01

    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 seventh 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.

  12. Endovascular treatment of iliac occlusive disease: review and update.

    PubMed

    Mousa, Albeir Y; Beauford, Robert B; Flores, Lucio; Faries, Peter L; Patel, Prem; Fogler, Richard

    2007-01-01

    Use of endovascular interventions for arterial occlusive lesions continues to increase. With the evolution of the technology supporting these therapeutic measures, the results of these interventions continue to improve. In general, a comparison of techniques for revascularization of iliac occlusive diseases shows similar initial technical success rates for open versus percutaneous transluminal angioplasty. Angioplasty is often associated with lower periprocedural morbidity and mortality rates. Conversely, surgery frequently provides greater long-term patency, although late failure of percutaneous therapies may occur but still can be treated successfully with reintervention. The perpetual buildup of experience with angioplasty and stenting will eventually characterize its role in the management of occlusive disease. This review outlines the current consensus and applicability of endovascular management of iliac occlusive diseases.

  13. 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

  14. 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.

  15. Chagas’ disease: an update on immune mechanisms and therapeutic strategies

    PubMed Central

    Boscardin, Silvia Beatriz; Torrecilhas, Ana Claudia Troccoli; Manarin, Romina; Revelli, Silvia; Rey, Elena Gonzalez; Tonelli, Renata Rosito; Silber, Ariel Mariano

    2010-01-01

    Abstract The final decade of the 20th century was marked by an alarming resurgence in infectious diseases caused by tropical parasites belonging to the kinetoplastid protozoan order. Among the pathogenic trypanosomatids, some species are of particular interest due to their medical importance. These species include the agent responsible for Chagas’ disease, Trypanosoma cruzi. Approximately 8 to 10 million people are infected in the Americas, and approximately 40 million are at risk. In the present review, we discuss in detail the immune mechanisms elicited during infection by T. cruzi and the effects of chemotherapy in controlling parasite proliferation and on the host immune system. PMID:20070438

  16. Portuguese recommendations for the use of methotrexate in rheumatic diseases - 2016 update.

    PubMed

    Duarte, Ana Catarina; Santos-Faria, Daniela; Gonçalves, Maria João; Sepriano, Alexandre; Mourão, Ana Filipa; Duarte, Cátia; Neves, Joana Sousa; Águeda, Ana Filipa; Ribeiro, Pedro Avila; Daniel, Alexandra; Neto, Adriano; Cordeiro, Ana; Rodrigues, Ana; Barcelos, Anabela; Silva, Cândida; Ponte, Cristina; Vieira-Sousa, Elsa; Teixeira, Filipa; Oliveira-Ramos, Filipa; Araújo, Filipe; Barcelos, Filipe; Canhão, Helena; Santos, Helena; Ramos, João; Polido-Pereira, Joaquim; Tavares-Costa, José; Melo Gomes, José António; Cunha-Miranda, Luís; Costa, Lúcia; Cerqueira, Marcos; Cruz, Margarida; Santos, Maria José; Bernardes, Miguel; Oliveira, Paula; Abreu, Pedro; Figueira, Ricardo; Barros, Rita; Falcão, Sandra; Pinto, Patrícia; Pimenta, Sofia; Capela, Susana; Teixeira, Vitor; Fonseca, João Eurico

    2017-01-01

    Methotrexate (MTX) is the first-line drug in the treatment of rheumatoid arthritis (RA) and the most commonly prescribed disease modifying anti-rheumatic drug. Moreover, it is also used as an adjuvant drug in patients under biologic therapies, enhancing the efficacy of biologic agents. To review the literature and update the Portuguese recommendations for the use of MTX in rheumatic diseases first published in 2009. The first Portuguese guidelines for the use of MTX in rheumatic diseases were published in 2009 and were integrated in the multinational 3E Initiative (Evidence Expertise Exchange) project. The Portuguese rheumatologists based on literature evidence and consensus opinion formulated 13 recommendations. At a national meeting, the recommendations included in this document were further discussed and updated. The document resulting from this meeting circulated to all Portuguese rheumatologists, who anonymously voted online on the level of agreement with the updated recommendations. Results presented in this article are mainly in accordance with previous guidelines, with some new information regarding hepatitis B infection during MTX treatment, pulmonary toxicity monitoring, hepatotoxicity management, association with hematologic neoplasms, combination therapy and tuberculosis screening during treatment. The present recommendations combine scientific evidence with expert opinion and attained desirable agreement among Portuguese rheumatologists. The regular update of these recommendations is essential in order to keep them a valid and useful tool in daily practice.

  17. 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.

  18. Update on ischemic heart disease and critical care cardiology.

    PubMed

    Marín, Francisco; Díaz-Castro, Oscar; Ruiz-Nodar, Juan Miguel; García de la Villa, Bernardo; Sionis, Alessandro; López, Javier; Fernández-Ortiz, Antonio; Martínez-Sellés, Manuel

    2014-02-01

    This article summarizes the main developments reported in 2013 on ischemic heart disease, together with the most important innovations in the management of acute cardiac patients. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  19. Update on ischemic heart disease and intensive cardiac care.

    PubMed

    Sionis, Alessandro; Ruiz-Nodar, Juan Miguel; Fernández-Ortiz, Antonio; Marín, Francisco; Abu-Assi, Emad; Díaz-Castro, Oscar; Nuñez-Gil, Ivan J; Lidón, Rosa-Maria

    2015-03-01

    This article summarizes the main developments reported in 2014 on ischemic heart disease, together with the most important innovations in intensive cardiac care. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

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

    USDA-ARS?s Scientific Manuscript database

    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...

  1. UPDATE ON FIBROBLAST GROWTH FACTOR 23 IN CHRONIC KIDNEY DISEASE

    PubMed Central

    Wolf, Myles

    2012-01-01

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

  2. [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.

  3. Celiac disease and endocrine autoimmune disorders in children: an update.

    PubMed

    Diamanti, Antonella; Capriati, Teresa; Bizzarri, Carla; Panetta, Fabio; Ferretti, Francesca; Ancinelli, Monica; Romano, Francesca; Locatelli, Mattia

    2013-12-01

    Celiac disease (CD) is a life-long inflammatory condition of the gut that occurs in genetically susceptible individuals. Several autoimmune diseases (AI) are associated with CD. To date, no conclusive evidence is available that proves if the relationship between CD and AI is mediated by gluten exposure, or if CD and AI could co-occur due to other causes, in particular the loss of the intestinal barrier function and the common genetic background. Furthermore, it is not clear yet if CD needs a regular screening program for AI. This review will cover the key studies on both the pathogenetic and clinical evidence explaining this association. We will review the reports including patients aged <18 years with CD and endocrine AI.

  4. Estrogens, episodic memory, and Alzheimer's disease: a critical update.

    PubMed

    Henderson, Victor W

    2009-05-01

    Estrogen-containing hormone therapy initiated during late postmenopause does not improve episodic memory (an important early symptom of Alzheimer's disease), and it increases dementia risk. Cognitive consequences of exogenous estrogen exposures during midlife are less certain. Observational evidence implies that use of hormone therapy at a younger age close to the time of menopause may reduce risk of Alzheimer's disease later in life. However, there are concerns that observational findings may be systematically biased. Partial insight on this critical issue may be gleaned from results of ongoing clinical trials involving midlife postmenopausal women (Early versus Late Intervention Trial with Estrogen; Kronos Early Estrogen Prevention Study). The effects of exogenous midlife estrogen exposures and Alzheimer risk can also be approached through better animal models, through carefully designed cohort studies, and through use of surrogate outcomes in randomized controlled trials in midlife women. Selective estrogen receptor modulators have the potential to affect cognitive outcomes and also merit additional study.

  5. 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

  6. 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

  7. Motor neurone disease: a practical update on diagnosis and management.

    PubMed

    Wood-Allum, Clare; Shaw, Pamela J

    2010-06-01

    Motor neurone disease (MND) is an adult-onset neurodegenerative disease which leads inexorably via weakness of limb, bulbar and respiratory muscles to death from respiratory failure three to five years later. Most MND is sporadic but approximately 10% is inherited. In exciting recent breakthroughs two new MND genes have been identified. Diagnosis is clinical and sometimes difficult--treatable mimics must be excluded before the diagnosis is ascribed. Riluzole prolongs life by only three to four months and is only available for the amyotrophic lateral sclerosis (ALS) form of MND. Management therefore properly focuses on symptom relief and the preservation of independence and quality of life. Malnutrition is a poor prognostic factor. In appropriate patients enteral feeding is recommended although its use has yet to be shown to improve survival. In ALS patients with respiratory failure and good or only moderately impaired bulbar function non-invasive positive pressure ventilation prolongs life and improves quality of life.

  8. Update on the Diagnosis and Management of Refractory Coeliac Disease

    PubMed Central

    Nijeboer, Petula; van Wanrooij, Roy L. J.; Tack, Greetje J.; Mulder, Chris J. J.; Bouma, Gerd

    2013-01-01

    A small subset of coeliac disease (CD) patients experiences persisting or recurring symptoms despite strict adherence to a gluten-free diet (GFD). When other causes of villous atrophy have been excluded, these patients are referred to as refractory celiac disease (RCD) patients. RCD can be divided in two types based on the absence (type I) or presence (type II) of an, usually clonal, intraepithelial lymphocyte population with aberrant phenotype. RCDI usually runs a benign course and may be difficult to be differentiated from uncomplicated, slow responding CD. In contrast, RCDII can be defined as low-grade intraepithelial lymphoma and frequently transforms into an aggressive enteropathy associated T-cell lymphoma with dismal prognosis. This paper describes the clinical characteristics of RCDI and RCDII, diagnostic approach, and the latest insights in treatment options. PMID:23762036

  9. An update on type 2B von Willebrand disease.

    PubMed

    Mikhail, Sameh; Aldin, Ehab Saad; Streiff, Michael; Zeidan, Amer

    2014-04-01

    Type 2B von Willebrand disease (VWD) accounts for fewer than 5% of all VWD patients. In this disease, mutations in the A1 domain result in increased von Willebrand factor (VWF) binding to platelet GPIbα receptors, causing increased platelet clearance and preferential loss of high molecular weight VWF multimers. Diagnosis is complicated because of significant clinical variations even among patients with identical mutations. Platelet transfusion often provides suboptimal results since transfused platelets may be aggregated by the patients' abnormal VWF. Desmopressin may cause a transient decrease in platelet count that could lead to an increased risk of bleeding. Replacement therapy with factor VIII/VWF concentrates is the most effective approach to prevention and treatment of bleeding in type 2B VWD.

  10. 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. Copyright © 2015 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

  11. Update on Mineral and Bone Disorders in Chronic Kidney Disease.

    PubMed

    Foster, Jonathan D

    2016-11-01

    The inappropriate phosphorus retention observed in chronic kidney disease is central to the pathophysiology of mineral and bone disorders observed in these patients. Subsequent derangements in serum fibroblast growth factor 23, parathyroid hormone, and calcitriol concentrations play contributory roles. Therapeutic intervention involves dietary phosphorus restriction and intestinal phosphate binders in order to correct phosphorus retention and maintain normocalcemia. Additional therapies may be considered to normalize serum fibroblast growth factor 23 and parathyroid hormone. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Update on radiation therapy in patients with Cushing's disease.

    PubMed

    Tritos, Nicholas A; Biller, Beverly M K

    2015-04-01

    Radiation therapy is an important therapy for patients with Cushing's disease who are not in remission or relapse after transsphenoidal pituitary surgery and are not considered surgical candidates. The development of stereotactic radiation therapy, using gamma knife, linear accelerators or proton beam based methods, has enabled selective radiation delivery to the target while minimizing exposure of healthy tissues. In patients whose tumors are sufficiently distant from the optic apparatus, stereotactic radiation therapy can be delivered in a single session, a procedure termed radiosurgery, which significantly improves patient convenience. Original articles on radiation therapy in Cushing's disease, published during the past 12 months (2013-2014), were identified and pertinent data extracted. Recent studies have reported on the outcomes of patients with Cushing's disease who received mostly stereotactic radiation therapy. While tumor control has been excellent, biochemical remission was less consistently achieved. Some studies suggested that stereotactic radiation may lead to biochemical remission faster than conventional radiation therapy. In addition, retrospective data have suggested that withdrawing medical therapy around the time stereotactic radiation therapy is administered might lead to a faster biochemical response. Regardless of the radiation therapy method, biochemical recurrences may develop and these patients are at long-term risk of developing anterior hypopituitarism and require lifelong periodic endocrine follow-up. Other, less frequent complications may include cranial neuropathies, secondary tumor formation or temporal lobe necrosis. It is plausible that complications may be less frequent after stereotactic radiation therapy, but this requires confirmation. Radiation therapy is an effective second line therapy in patients with Cushing's disease. Ongoing refinements in delivery of radiation therapy are anticipated to lead to improved patient

  13. [Update on fracture risk in life style-related diseases].

    PubMed

    Yamaguchi, Toru; Sugimoto, Toshitsugu

    2014-03-01

    Accumulating evidence shows that type 2 diabetes and chronic kidney disease (CKD) enhance fracture risk mainly by deteriorating bone quality. Vertebral fracture on X-ray films and hip fracture in past history in subjects of 50 years old or more are hallmarks to start medication for osteoporosis. Patients with diabetes or CKD who have no fracture could undergo drug treatments if their bone mineral density is osteopenic, considering the established link between these disorders and fracture risk.

  14. Updates on chikungunya epidemiology, clinical disease, and diagnostics.

    PubMed

    Sam, I-Ching; Kümmerer, Beate M; Chan, Yoke-Fun; Roques, Pierre; Drosten, Christian; AbuBakar, Sazaly

    2015-04-01

    Chikungunya virus (CHIKV) is an Aedes-borne alphavirus, historically found in Africa and Asia, where it caused sporadic outbreaks. In 2004, CHIKV reemerged in East Africa and spread globally to cause epidemics, including, for the first time, autochthonous transmission in Europe, the Middle East, and Oceania. The epidemic strains were of the East/Central/South African genotype. Strains of the Asian genotype of CHIKV continued to cause outbreaks in Asia and spread to Oceania and, in 2013, to the Americas. Acute disease, mainly comprising fever, rash, and arthralgia, was previously regarded as self-limiting; however, there is growing evidence of severe but rare manifestations, such as neurological disease. Furthermore, CHIKV appears to cause a significant burden of long-term morbidity due to persistent arthralgia. Diagnostic assays have advanced greatly in recent years, although there remains a need for simple, accurate, and affordable tests for the developing countries where CHIKV is most prevalent. This review focuses on recent important work on the epidemiology, clinical disease and diagnostics of CHIKV.

  15. Pulmonary hypertension in connective tissue diseases: an update.

    PubMed

    Aithala, Ramya; Alex, Anoop G; Danda, Debashish

    2017-02-16

    Pulmonary hypertension (PH) is a relatively commoner complication of systemic sclerosis (SSc) with estimated prevalence ranging between 8% and 12% as compared to much lower figures in other connective tissue diseases (CTD). It is a major cause of morbidity and mortality in CTDs. PH is classified into five major groups. CTD-associated PH belongs to group 1 PH, also known as pulmonary arterial hypertension (PAH). Around 30% of scleroderma-related deaths are due to PAH. Underlying pathogenesis is related to pulmonary vasculopathy involving small vessels. The Evidence-based Detection of Pulmonary Arterial Hypertension in Systemic sclerosis (DETECT) algorithm outperforms the current European Society of Cardiology/European Respiratory Society guidelines as a screening tool in SSc-PAH; it can, therefore, suggest when to refer a patient for right heart catheterization. CTD-PAH patients constitute at least 20% of patients included in all major trials of PH-specific therapy and the results are comparable to those of idiopathic PAH. The role of anticoagulation in CTD-PAH is associated with a high risk-benefit ratio with the caveat of its potential role in those with severe disease. There appears to be no role of immunosuppression in scleroderma-PAH; however, immunosuppressive agents, namely the combination of glucocorticoids and pulse cyclophosphamide / possibly mycophenolate, may result in clinical improvement in a subset of patients with systemic lupus erythematosus and mixed connective tissue disease-related PAH.

  16. Clostridium difficile disease: Diagnosis, pathogenesis, and treatment update.

    PubMed

    Napolitano, Lena M; Edmiston, Charles E

    2017-03-03

    Clostridium difficile infections are the leading cause of health care-associated infectious diarrhea, posing a significant risk for both medical and surgical patients. Because of the significant morbidity and mortality associated with C difficile infections, knowledge of the epidemiology of C difficile in combination with a high index of suspicion and susceptible patient populations (including surgical, postcolectomy, and inflammatory bowel disease patients) is warranted. C difficile infections present with a wide spectrum of disease, ranging from mild diarrhea to fulminant colitis or small bowel enteritis and recurrent C difficile infections. Early implementation of medical and operative treatment strategies for C difficile infections is imperative for optimal patient outcomes. National and international guidelines recommend early operative consultation and total abdominal colectomy with end ileostomy and preservation of rectum. Diverting loop ileostomy and colonic lavage followed by intravenous metronidazole and intracolonic vancomycin administered via the efferent limb of the ileostomy should be considered as an alternative to total colectomy in selected patients. New and emerging strategies for C difficile infection treatment include monoclonal antibodies, vaccines, probiotics, biotherapeutics, and new antibiotics. A successful C difficile prevention and eradication program requires a multidisciplinary approach that includes early disease recognition, implementation of guidelines for monitoring adherence to environmental control, judicious hand hygiene, evidence-based treatment and management strategies, and a focused antibiotic stewardship program. Surgeons are an important part of the clinical team in the management of C difficile infection prevention and treatment.

  17. Update on the clinical management of Wilson’s disease

    PubMed Central

    Hedera, Peter

    2017-01-01

    Wilson’s disease (WD), albeit relatively rare, is an important genetic metabolic disease because of highly effective therapies that can be lifesaving. It is a great imitator and requires a high index of suspicion for correct and timely diagnosis. Neurologic, psychiatric and hepatologic problems in WD are very nonspecific, and we discuss the most common clinical phenotypes. The diagnosis remains laboratory based, and here we review the most important challenges and pitfalls in laboratory evaluation of WD, including the emerging role of genetic testing in WD diagnosis. WD is a monogenic disorder but has very high allelic heterogeneity with >500 disease-causing mutations identified, and new insights into phenotype–genotype correlations are also reviewed. The gold standard of therapy is chelation of excessive copper, but many unmet needs exist because of possible clinical deterioration in treated patients and potential adverse effects associated with currently available chelating medications. We also review the most promising novel therapeutic approaches, including chelators targeting specific cell types, cell transplantation and gene therapy. PMID:28144156

  18. 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

  19. 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

  20. Gastroesophageal reflux disease: Update on inflammation and symptom perception.

    PubMed

    Altomare, Annamaria; Guarino, Michele Pier Luca; Cocca, Silvia; Emerenziani, Sara; Cicala, Michele

    2013-10-21

    Although gastroesophageal reflux disease (GERD) is a common disorder in Western countries, with a significant impact on quality of life and healthcare costs, the mechanisms involved in the pathogenesis of symptoms remain to be fully elucidated. GERD symptoms and complications may result from a multifactorial mechanism, in which acid and acid-pepsin are the important noxious factors involved. Prolonged contact of the esophageal mucosa with the refluxed content, probably caused by a defective anti-reflux barrier and luminal clearance mechanisms, would appear to be responsible for macroscopically detectable injury to the esophageal squamous epithelium. Receptors on acid-sensitive nerve endings may play a role in nociception and esophageal sensitivity, as suggested in animal models of chronic acid exposure. Meanwhile, specific cytokine and chemokine profiles would appear to underlie the various esophageal phenotypes of GERD, explaining, in part, the genesis of esophagitis in a subset of patients. Despite these findings, which show a significant production of inflammatory mediators and neurotransmitters in the pathogenesis of GERD, the relationship between the hypersensitivity and esophageal inflammation is not clear. Moreover, the large majority of GERD patients (up to 70%) do not develop esophageal erosions, a variant of the condition called non-erosive reflux disease. This summary aims to explore the inflammatory pathway involved in GERD pathogenesis, to better understand the possible distinction between erosive and non-erosive reflux disease patients and to provide new therapeutic approaches.

  1. Systematic review with meta-analysis: early infant feeding and coeliac disease--update 2015.

    PubMed

    Szajewska, H; Shamir, R; Chmielewska, A; Pieścik-Lech, M; Auricchio, R; Ivarsson, A; Kolacek, S; Koletzko, S; Korponay-Szabo, I; Mearin, M L; Ribes-Koninckx, C; Troncone, R

    2015-06-01

    New evidence emerged on early feeding practices and the risk of coeliac disease. To systematically update evidence on these practices to find out whether there is a need to revise current recommendations. MEDLINE, EMBASE and the Cochrane Library were searched from July 2012 (end of last search) to February 2015 for studies of any design that assessed the effect of gluten consumption and breastfeeding on the development of coeliac disease and/or coeliac disease-related autoimmunity. We identified 21 publications, including two, new, large, randomised controlled trials performed in high-risk infants. Exclusive or any breastfeeding, as well as breastfeeding at the time of gluten introduction, did not reduce the risk of developing coeliac disease during childhood. For infants at high risk of developing coeliac disease, gluten introduction at 4 months of age in very small amounts, or at 6 or 12 months of age, resulted in similar rates of coeliac disease diagnosis in early childhood. Later gluten introduction was associated with later development of coeliac specific autoimmunity and coeliac disease during childhood, but not total risk reduction. Observational studies indicate that consumption of a higher amount of gluten at weaning may increase the risk for coeliac disease development. Infant feeding practices (breastfeeding, time of gluten introduction) have no effect on the risk of developing coeliac disease during childhood (at least at specific timeframes evaluated in the included studies), necessitating an update of current European recommendations. © 2015 John Wiley & Sons Ltd.

  2. 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

  3. Zoonotic diseases associated with reptiles and amphibians: an update.

    PubMed

    Mitchell, Mark A

    2011-09-01

    Reptiles and amphibians are popular as pets. There are increased concerns among public health officials because of the zoonotic potential associated with these animals. Encounters with reptiles and amphibians are also on the rise in the laboratory setting and with wild animals; in both of these practices, there is also an increased likelihood for exposure to zoonotic pathogens. It is important that veterinarians remain current with the literature as it relates to emerging and reemerging zoonotic diseases attributed to reptiles and amphibians so that they can protect themselves, their staff, and their clients from potential problems.

  4. Coronary artery calcification in chronic kidney disease: An update

    PubMed Central

    Stompór, Tomasz

    2014-01-01

    Arterial calcification is a well-recognized complication of advanced atherosclerosis. Chronic kidney disease (CKD) is characterized by significantly more pronounced, disseminated and fast-progressing calcification of the vascular system, including the coronary arteries. New computed tomography-based imaging techniques allow for the noninvasive assessment and monitoring of calcification in different vascular sites. Coronary artery calcification (CAC) develops early in the course of CKD and is tightly associated with mineral and bone disorders, which include but are not limited to secondary hyperparathyroidism. In this review, recent data on the pathogenesis of CAC development and progression are discussed, with a special emphasis on fibroblast growth factor 23 and its co-receptor, klotho. The prevalence, progression and prognostic significance of CAC are reviewed separately for patients with end-stage renal disease treated with dialysis, kidney transplant recipients and patients with earlier stages of CKD. In the last section, therapeutic considerations are discussed, with special attention paid to the importance of treatment that addresses mineral and bone disorders of CKD. PMID:24772252

  5. Climate change, air pollution, and allergic respiratory diseases: an update.

    PubMed

    D'Amato, Gennaro; Vitale, Carolina; Lanza, Maurizia; Molino, Antonio; D'Amato, Maria

    2016-10-01

    The rising trend in prevalence of allergic respiratory disease and bronchial asthma, observed over the last decades, can be explained by changes occurring in the environment, with increasing presence of biologic, such as allergens, and chemical atmospheric trigger factors able to stimulate the sensitization and symptoms of these diseases. Many studies have shown changes in production, dispersion, and allergen content of pollen and spores because of climate change with an increasing effect of aeroallergens on allergic patients. Over the last 50 years, global earth's temperature has markedly risen likely because of growing emission of anthropogenic greenhouse gas concentrations. Major changes involving the atmosphere and the climate, including global warming induced by human activity, have a major impact on the biosphere and human environment.Urbanization and high levels of vehicle emissions are correlated to an increase in the frequency of pollen-induced respiratory allergy prevalent in people who live in urban areas compared with those who live in rural areas. Measures of mitigation need to be applied for reducing future impacts of climate change on our planet, but until global emissions continue to rise, adaptation to the impacts of future climate variability will also be required.

  6. Probiotics and their Effects on Metabolic Diseases: An Update

    PubMed Central

    Aggarwal, Juhi; Swami, Gaurav; Kumar, Mayur

    2013-01-01

    Probiotics are lactic acid bacteria which are used extensively in therapeutic preparations and added to foods. There are many studies which have demonstrated the effects of probiotics on metabolic diseases. One study has shown the effect of fermented dairy products on the serum cholesterol, especially with selected strains of lactic acid bacteria. It has been found that a minute quantity of the dry culture of Lactobacillus fermentum KC4b, for example, can remove 14.8 mg of cholesterol from the culture medium. Lactobacilli also play an important role in deconjugating the bile salts in the intestine to form bile acids and thereby inhibiting the micelle formation. Probiotics reduce the lipid peroxidation and improve the lipid metabolism in vivo. The addition of probiotics to the diet for weeks improved the immune response without the release of inflammatory cytokines, thereby reducing the onset of systemic inflammatory induced diabetes. There are evidences that the differences in the composition of the gut microbiota may precede the development of obesity in children. This review has illustrated the potential of probiotics in mediating metabolic diseases via the positive modulation of several different physiological systems, apart from its conventional benefits for the gastrointestinal health. PMID:23449881

  7. Inflammation in Alzheimer's Disease and Molecular Genetics: Recent Update.

    PubMed

    Zhang, Zhi-Gang; Li, Yan; Ng, Cheung Toa; Song, You-Qiang

    2015-10-01

    Alzheimer's disease (AD) is a complex age-related neurodegenerative disorder of the central nervous system. Since the first description of AD in 1907, many hypotheses have been established to explain its causes. The inflammation theory is one of them. Pathological and biochemical studies of brains from AD individuals have provided solid evidence of the activation of inflammatory pathways. Furthermore, people with long-term medication of anti-inflammatory drugs have shown a reduced risk to develop the disease. After three decades of genetic study in AD, dozens of loci harboring genetic variants influencing inflammatory pathways in AD patients has been identified through genome-wide association studies (GWAS). The most well-known GWAS risk factor that is responsible for immune response and inflammation in AD development should be APOE ε4 allele. However, a growing number of other GWAS risk AD candidate genes in inflammation have recently been discovered. In the present study, we try to review the inflammation in AD and immunity-associated GWAS risk genes like HLA-DRB5/DRB1, INPP5D, MEF2C, CR1, CLU and TREM2.

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

    PubMed

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

    2015-11-14

    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.

  9. Update on the medical management of stone disease.

    PubMed

    Tracy, Chad R; Pearle, Margaret S

    2009-03-01

    Recurrent nephrolithiasis is a burden to the individual patient as well as the healthcare system. A lack of new medications for treatment of stone disease and continued poor compliance with drug therapy has led to a growing interest in dietary manipulation and novel therapies aimed at preventing recurrent stone formation. Despite initial enthusiasm for lemonade therapy, recent metabolic studies suggest that beverages with a high potassium citrate content, rather than citric acid, may be more effective in reducing stone risk because of the alkali load and citraturic response. In addition, there is increasing epidemiologic and metabolic evidence that obesity and dietary excess, including fructose-rich and purine-rich foods, are associated with increased stone risk. Finally, alternative measures for reducing urinary risk factors, such as probiotics, show promise in reducing urinary oxalate and may be effective in the treatment of primary and enteric hyperoxaluria or even idiopathic calcium oxalate nephrolithiasis. Although changes in urinary stone risk factors may reduce the need for surgical treatment of stone disease, the best management for recurrent nephrolithiasis is likely a combination of surgical and medical therapy. Dietary measures and novel probiotic therapy are promising adjuncts for preventing recurrent nephrolithiasis.

  10. Exercise, vascular wall and cardiovascular diseases: an update (part 2).

    PubMed

    Yung, Lai Ming; Laher, Ismail; Yao, Xiaoqiang; Chen, Zhen Yu; Huang, Yu; Leung, Fung Ping

    2009-01-01

    There is much evidence extolling the virtues of physical activity on cardiovascular disease (CVD). The evidence derives from different population groups where leisure time physical activity reduced the risk of coronary heart disease and cardiovascular mortality in both men and women. Recent meta-analyses have shown that large risk reductions for both ischaemic and haemorrhagic stroke can be achieved by moderate or intense physical activity. There are many data from human and animal studies confirming a beneficial role for exercise in the prevention and treatment of CVD. Physical inactivity and obesity/overweight are not only associated with a number of health-related risk factors, but are considered to be independent risk factors for CVD, type 2 diabetes mellitus and hypertension. Clinical trials confirm that lifestyle interventions (dietary modification and increased physical activity) reduce the risk of progressing from impaired glucose tolerance to type 2 diabetes. Moreover, epidemiological studies indicate that the risk of hypertension increases by being overweight. Modest increases in exercise intensity and frequency have hypotensive effects in sedentary hypertensive patients. Long-term training improves endothelium-dependent dilatation in the aorta and resistance arteries of the heart, whereas short-term training increases endothelial function in coronary conduit arteries. Overall, more scientific evidence will undoubtedly encourage the widespread advocacy of the clinical benefits of exercise therapy in the prevention and treatment of CVD.

  11. [Therapy of lysosomal storage diseases: update and perspectives].

    PubMed

    Lara-Aguilar, Ricardo Alejandro; Juárez-Vázquez, Clara Ibet; Medina-Lozano, Claudina

    2011-01-01

    Lysosomal storage diseases (LSD) are caused by monogenic mutations in genes coding for multiple aberrant proteins involved in the catabolism of complex lipids, glycosaminoglycans, oligosaccharides, or nucleic acids. The pathophysiology of the LSD is due to abnormal accumulation of non-hydrolyzed substrate in the lysosomes, affecting the architecture and function of cells, tissues and organs. Due to their genic and allelic heterogeneity the LSD present a wide clinical spectrum in severity of symptoms, evolution and age of onset. The therapeutic strategy has two goals: 1) Palliative management of symptoms (splenectomy, surgery to improve or restore joints or bones, drugs for CNS symptoms, etc.), and 2) The correction of activity of the mutant protein, the former has two approaches: A) Replacing deficient protein (bone marrow transplantation, hematopoietic stem cells or umbilical cord blood cells; replacement with recombinant enzyme and gene therapy) and B) Activate or enhanced the functionality of the mutant enzyme with therapeutic small molecules. Neither of the known treatments is able to address all aspects of these multisystemic disorders, nor cure the patients. Currently, the combination of corrective therapy (CT) with paliative therapy (PT) is the most promising strategy to solve most of the multisystem manifestations. The multidisciplinary medical care is fundamental for diagnosis, treatment and control of disease. Nanotechnology opens a promising new era in the treatment of LSD. Finally, the LSD that has CT must be included in newborn screening programs in order to implement timely treatment and prevent irreversible damage.

  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. Synaptic activity and Alzheimer's disease: a critical update

    PubMed Central

    Tampellini, Davide

    2015-01-01

    Synapses have been known for many years to be the crucial target of pathology in different forms of dementia, in particular Alzheimer's disease (AD). Synapses and their appropriate activation or inhibition are fundamental for the proper brain function. Alterations in synaptic/neuronal activity and brain metabolism are considered among the earliest symptoms linked to the progression of AD, and lead to a central question in AD research: what is the role played by synaptic activity in AD pathogenesis? Intriguingly, in the last decade, important studies demonstrated that the state of activation of synapses affects the homeostasis of beta-amyloid (Aβ) and tau, both of which aggregate and accumulate during AD, and are involved in neuronal dysfunction. In this review we aim to summarize the up-to-date data linking synaptic/neuronal activity with Aβ and tau; moreover, we also intend to provide a critical overview on brain activity alterations in AD, and their role in the disease's pathophysiology. PMID:26582973

  14. IgG4-related kidney disease – an update

    PubMed Central

    Kawano, Mitsuhiro; Saeki, Takako

    2015-01-01

    Purpose of review IgG4-related disease (IgG4-RD) is a recently recognized systemic inflammatory disorder that can affect most organs/tissues such as sarcoidosis. The kidney is a frequently affected organ with tubulointerstitial nephritis (TIN), the representative lesion of IgG4-RD. This review focuses on the latest knowledge of IgG4-related kidney disease (IgG4-RKD). Recent findings A wide range of renal manifestations of IgG4-RD, that is TIN, membranous glomerulonephritis (MGN) and other glomerular lesions, and pyelitis, are collectively referred to as IgG4-RKD. Clinically, decreased renal function, or characteristic imaging findings such as multiple low-density lesions on contrast-enhanced computed tomography or diffuse thickening of the renal pelvic wall, are typical presenting features. Although a rapid response to corticosteroid therapy is a very important feature of IgG4-TIN, in cases in which renal function is moderately to severely decreased before therapy, only partial recovery of renal function is obtained. Summary TIN with characteristic imaging findings is a typical manifestation of IgG4-RKD in the interstitium, while MGN is a representative manifestation of the glomerular lesions. Although IgG4 is a central feature of IgG4-RD, the recent discovery of IgG4-negative IgG4-RD raises questions about the causative role of the IgG4 molecule in this context. PMID:25594543

  15. 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.

  16. Exercise, vascular wall and cardiovascular diseases: an update (Part 1).

    PubMed

    Leung, Fung Ping; Yung, Lai Ming; Laher, Ismail; Yao, Xiaoqiang; Chen, Zhen Yu; Huang, Yu

    2008-01-01

    Cardiovascular disease (CVD) remains the leading cause of morbidity and premature mortality in both women and men in most industrialized countries, and has for some time also established a prominent role in developing nations. In fact, obesity, diabetes mellitus and hypertension are now commonplace even in children and youths. Regular exercise is rapidly gaining widespread advocacy as a preventative measure in schools, medical circles and in the popular media. There is overwhelming evidence garnered from a number of sources, including epidemiological, prospective cohort and intervention studies, suggesting that CVD is largely a disease associated with physical inactivity. A rapidly advancing body of human and animal data confirms an important beneficial role for exercise in the prevention and treatment of CVD. In Part 1 of this review we discuss the impact of exercise on CVD, and we highlight the effects of exercise on (i) endothelial function by regulation of endothelial genes mediating oxidative metabolism, inflammation, apoptosis, cellular growth and proliferation, increased superoxide dismutase (SOD)-1, down-regulation of p67phox, changes in intracellular calcium level, increased vascular endothelial nitric oxide synthase (eNOS), expression and eNOS Ser-1177 phosphorylation; (ii) vascular smooth muscle function by either an increased affinity of the Ca2+ extrusion mechanism or an augmented Ca2+ buffering system by the superficial sarcoplasmic reticulum to increase Ca2+ sequestration, increase in K+ channel activity and/or expression, and increase in L-type Ca2+ current density; (iii) antioxidant systems by elevation of Mn-SOD, Cu/Zn-SOD and catalase, increases in glutathione peroxidase activity and activation of vascular nicotinamide adenine dinucleotide phosphate [(NAD(P)H] oxidase and p22phox expression; (iv) heat shock protein (HSP) expression by stimulating HSP70 expression in myocardium, skeletal muscle and even in human leucocytes, probably through heat

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

    PubMed Central

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

    1999-01-01

    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

  18. 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

  19. Progress update: Pharmacological treatment of Alzheimer’s disease

    PubMed Central

    Hogan, David B

    2007-01-01

    A number of drugs have been approved for the treatment of Alzheimer’s disease (AD) and a larger number are being studied as possible therapies. The current mainstays of the pharmacotherapy of AD are the cholinesterase inhibitors (donepezil, galantamine, rivastigmine) and memantine. They collectively have acceptable tolerability and proven but modest efficacy. The agents being studied include dietary supplements (eg, vitamin E), herbal preparations (eg, Ginkgo biloba), medications approved for other indications (eg, HMG-CoA reductase enzyme inhibitors) and research drugs. In this review we discuss in detail the approved agents and review a number of the unapproved therapies that are currently available to the practitioner. While our era offers much more in the way of therapeutics for AD, it is clear that more work still needs to be done. PMID:19300586

  20. Updated Mechanisms of Sickle Cell Disease-Associated Chronic pain

    PubMed Central

    Lutz, Brianna; Meiler, Steffen E.; Bekker, Alex; Tao, Yuan-Xiang

    2015-01-01

    Sickle cell disease (SCD), a hemoglobinopathy, causes sickling of red blood cells, resulting in vessel blockage, stroke, anemia, inflammation, and extreme pain. A vast majority of SCD patients experience pain on a chronic basis, and many turn to opioids to provide limited relief. The side effects that come with chronic opioid use push for research into understanding the specific mechanisms of SCD-associated chronic pain. Current advances in SCD-associated pain have focused on alterations in the pain pathway including nociceptor sensitization and endogenous pain inducers. This article reviews the underlying pathophysiology of SCD, potential pain mechanisms, current treatments and their mechanism of action, and future directions of SCD-associated pain management. The information provided could help propel research in SCD-associated chronic pain and uncover novel treatment options for clinicians. PMID:26301256

  1. 2017 update on pain management in patients with chronic kidney disease.

    PubMed

    Pham, Phuong Chi; Khaing, Kathy; Sievers, Theodore M; Pham, Phuong Mai; Miller, Jeffrey M; Pham, Son V; Pham, Phuong Anh; Pham, Phuong Thu

    2017-10-01

    The prevalence of pain has been reported to be >60-70% among patients with advanced and end-stage kidney disease. Although the underlying etiologies of pain may vary, pain per se has been linked to lower quality of life and depression. The latter is of great concern given its known association with reduced survival among patients with end-stage kidney disease. We herein discuss and update the management of pain in patients with chronic kidney disease with and without requirement for renal replacement therapy with the focus on optimizing pain control while minimizing therapy-induced complications.

  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. Troponin in Cardiovascular Disease Prevention: Updates and Future Direction.

    PubMed

    Hoff, Jason; Wehner, William; Nambi, Vijay

    2016-03-01

    Cardiac troponin has been well described as the preferred biomarker for diagnosis of myocardial infarction due to the high sensitivity and specificity for myocardial injury. Numerous other conditions apart from acute coronary syndrome can also lead to small elevations in troponin levels. However, the use of cTn as prognostic biomarker for the primary assessment of cardiovascular risk in asymptomatic patient has only recently been described. And with the development of newer generations of high-sensitivity cardiac troponin assays that can detect 10-fold lower concentrations of troponin, the potential value cTn in the prevention and management of asymptomatic cardiovascular disease has come to the fore. This review provides an overview of the transition of cardiac troponin as a marker of acute myocardial injury to one that detects sub-clinical injury. Evidence continues to show that high-sensitivity troponin is emerging as one of the most powerful prognostic biomarkers for the assessment of cardiovascular risk in the general population.

  5. 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

  6. Extrathyroidal manifestations of Graves' disease: a 2014 update.

    PubMed

    Bartalena, Luigi; Fatourechi, Vahab

    2014-08-01

    Graves' orbitopathy (GO), thyroid dermopathy (also called pretibial myxedema) and acropachy are the extrathyroidal manifestations of Graves' disease. They occur in 25, 1.5, and 0.3 % of Graves' patients, respectively. Thus, GO is the main and most common extrathyroidal manifestation. Dermopathy is usually present if the patient is also affected with GO. The very rare acropachy occurs only in patients who also have dermopathy. GO and dermopathy have an autoimmune origin and are probably triggered by autoimmunity to the TSH receptor and, likely, the IGF-1 receptor. Both GO and dermopathy may be mild to severe. Mild GO usually does not require any treatment except for local measures and preventive actions (especially refraining from smoking). Currently, moderate-to-severe and active GO is best treated by systemic glucocorticoids, but response to treatment is not optimal in many instances, and retreatments and use of other modalities (glucocorticoids, orbital radiotherapy, cyclosporine) and, in the end, rehabilitative surgery are often needed. Dermopathy is usually managed by local glucocorticoid treatment. No specific treatment is available for acropachy. Novel treatments are presently being investigated for GO, and particular attention is paid to the use of rituximab. It is unknown whether novel treatments for GO might be useful for the other extrathyroidal manifestations. Future novel therapies shown to be beneficial for GO in randomized studies may be empirically used for dermopathy and acropachy.

  7. 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

  8. Gut microbiota and inflammatory bowel disease: an update.

    PubMed

    Holleran, Grainne; Lopetuso, Loris R; Ianiro, Gianluca; Pecere, Silvia; Pizzoferrato, Marco; Petito, Valentina; Graziani, Cristina; Mc Namara, Deirdre; Gasbarrini, Antonio; Scaldaferri, Franco

    2017-03-14

    Major advances have occurred in the knowledge of the pathogenesis of Inflammatory Bowel Disease (IBD) over the last decade, and perhaps the most major, and clinically advantageous of these advances has been the discovery of the microbiome as a key multifaceted component of inflammation. The Gut microbiome is the largest known group of cells in the body, and is now recognised as an organ in its own right. Initial studies looking at a possible role of bacterial manipulation of the immune system in IBD, looked at identifying a specific bacterial species, and were not representative of a feasible model of inflammation in IBD overall. More recently there has been a shift towards the concept of dysbiosis, and the acceptance that a number of bacterial factors interact with the immune system in order for inflammation to occur. In the present review we will focus on past perspective of the role of microbiota in IBD, current evidences about dysbiosis in IBD and also the main therapeutic modalities to affect IBD by affecting gut microbiota: probiotics, prebiotics, faecal Microbiota Transplantation and emerging dietary intervention.

  9. Inflammatory Bowel Disease: Updates on Molecular Targets for Biologics.

    PubMed

    Katsanos, Konstantinos H; Papadakis, Konstantinos A

    2017-07-15

    Therapy for inflammatory bowel disease (IBD) has changed, with several new agents being evaluated. The era of anti-tumor necrosis factor (anti-TNF) antibody therapy saw remarkable progress in IBD therapy. Some patients, however, do not respond to anti-TNF treatment, or their response decreases over time. This phenomenon highlights the need to identify new molecular targets for therapy in IBD. The targets of new therapeutic molecules in IBD must aim to restore immune dysregulation by the inhibition of proinflammatory cytokines (TNF-α, interleukin [IL]-6, IL-13, IL-17, IL-18, and IL-21) and augmentation of the effect of anti-inflammatory cytokines (IL-10, IL-11, and transforming growth factor β) and to pursue new anti-inflammatory targets, such as regulatory T-cell therapy, Smad7 antisense, Janus-activated kinase inhibition, Toll-like receptor stimulation, leukocyte adhesion, and blockade of T-cell homing via integrins and mucosal addressin cellular adhesion molecule-1. In addition, potential molecular targets could restore mucosal barrier function and stimulate mucosal healing. Despite these potential targets, the value and clinical significance of most new molecules remain unclear, and clinical efficacy and safety must be better defined before their implementation in clinical practice. This article aims to review the promising and emerging molecular targets that could be clinically meaningful for novel therapeutic approaches.

  10. Inflammatory Bowel Disease: Updates on Molecular Targets for Biologics

    PubMed Central

    Katsanos, Konstantinos H.; Papadakis, Konstantinos A.

    2017-01-01

    Therapy for inflammatory bowel disease (IBD) has changed, with several new agents being evaluated. The era of anti-tumor necrosis factor (anti-TNF) antibody therapy saw remarkable progress in IBD therapy. Some patients, however, do not respond to anti-TNF treatment, or their response decreases over time. This phenomenon highlights the need to identify new molecular targets for therapy in IBD. The targets of new therapeutic molecules in IBD must aim to restore immune dysregulation by the inhibition of proinflammatory cytokines (TNF-α, interleukin [IL]-6, IL-13, IL-17, IL-18, and IL-21) and augmentation of the effect of anti-inflammatory cytokines (IL-10, IL-11, and transforming growth factor β) and to pursue new anti-inflammatory targets, such as regulatory T-cell therapy, Smad7 antisense, Janus-activated kinase inhibition, Toll-like receptor stimulation, leukocyte adhesion, and blockade of T-cell homing via integrins and mucosal addressin cellular adhesion molecule-1. In addition, potential molecular targets could restore mucosal barrier function and stimulate mucosal healing. Despite these potential targets, the value and clinical significance of most new molecules remain unclear, and clinical efficacy and safety must be better defined before their implementation in clinical practice. This article aims to review the promising and emerging molecular targets that could be clinically meaningful for novel therapeutic approaches. PMID:28486793

  11. [Charcot-Marie-Tooth (CMT) disease: an update].

    PubMed

    Vallat, Jean-Michel; Funalot, Benoît

    2010-10-01

    Charcot-Marie-Tooth (CMT) <disease> is the generic name given to a group of genetic disorders characterized by a relatively isolated dysfunction of peripheral nerves, with combined motor and sensory impairment. These CMT syndromes are the most frequent genetically-determined peripheral neuropathies, with a global prevalence between 4.7 and 36/100,000. Their clinical phenotype is predominantly motor, with a grossly symmetrical distal amyotrophy involving both lower and upper limbs. Mode of inheritance is variable: autosomal dominant, autosomal recessive or X-linked. Apparently sporadic forms can be a difficult diagnosis and they must be considered in all patients with a chronic polyneuropathy which is not clearly of acquired origin. During the last two decades, the identification of more than 25 genes mutated in CMT syndromes has complicated the classification of these disorders. Knowledge of the function of some of these genes has improved our understanding of the pathogenesis of myelinic or axonal dysfunction in CMT, but for some others their function remains elusive or unknown.

  12. Urology and nephrology update: anemia of chronic kidney disease.

    PubMed

    Fiore, David C; Fox, Cara-Louise

    2014-01-01

    Anemia is associated with chronic kidney disease (CKD) at all stages, and it is nearly universal among patients with stage 5 CKD. Nonetheless, anemia of CKD is a diagnosis of exclusion. When anemia is detected in a patient with CKD, etiologies other than CKD must be considered and ruled out. Iron deficiency also is common among patients with CKD, and iron replenishment improves the anemia and the response to erythropoiesis-stimulating agents. Current guidelines for managing anemia of CKD recommend a hemoglobin goal of 11 to 12 g/dL, but lower hemoglobin may be acceptable for asymptomatic patients. Some patients do not benefit from erythropoiesis-stimulating agents, or they lose their responsiveness to treatment and transfusions must be considered. Other agents are being investigated as management for anemia of CKD, with vitamin C (ascorbic acid) showing some promise. Written permission from the American Academy of Family Physicians is required for reproduction of this material in whole or in part in any form or medium.

  13. Nonsurgical treatment options in Peyronie’s Disease: 2016 update

    PubMed Central

    Talib, Raidh A.; Ibrahim, Mohammed Abdulkareem; Cangüven, Önder

    2016-01-01

    Peyronie’s disease (PD) is an inflammatory condition of penile tunica albuginea which commonly ends with penile curvature and difficulty in vaginal penetration. Unfortunately, the pathophysiology of PD has not been completely understood. In this paper, we will review what is known about the pathophysiology of PD and the nonsurgical medical treatment options that have been trialed as a result. In the last 5 years, commonly used oral medications left their places to intralesional therapies. Clostridium collagenase, which is the only Food and Drug Administration (FDA) approved treatment for PD, is now the most prescribed intralesional therapy in the last years. Clostridium collagenase is advised for patients whose penile curvature is > 30° and < 90°. Because of its side effects, patients should be counseled before intralesional Clostridium collagenase treatment. Until finding best treatment solution for PD, more investigations in regards to the basic science of PD need to be carried out in order to elucidate the exact mechanisms of the fibrosis. PMID:27909612

  14. [Risk perception and communication: from diabetes to cardiovascular diseases].

    PubMed

    Gianinazzi, F; Bodenmann, P; Izzo, F; Voeffray Favre, A C; Rossi, I; Ruiz, J

    2010-06-09

    Evidence-based medicine has enabled to approach disease in a more rational and scientific way. Clinical research has identified behaviours and risk factors that could cause disease often "silent" at the beginning, such as diabetes. Despite the clear impact of these evidences on public health, it seems that the individual risk perception level remains weak. To mention as well, the health professionals very often have a different views, which makes it difficult to communicate the risk with patients. In this article we describe the principles of risk perception, the diabetes related risk perception concerning cardiovascular complications, and suggest some practical strategies and tools which could improve risk communication in the everyday practice.

  15. [Program to combat communicable diseases in children].

    PubMed

    Ntilivamunda, A

    1985-08-01

    The project for the struggle against childhood diseases began in Rwanda in 1984. Lack of birth spacing, malnutrition, unhealthy environments and infectious diseases sicken and kill children in all of Africa, and many may be alleviated by simple measures. The project focuses on diarrhea and malaria, attempting to reduce mortality by 25%, administering chloroquine to children with fever and pregnant mothers for malaria, and oral rehydration therapy (ORT) for diarrhea. Goals are breastfeeding and gradual weaning being as universal as possible, and proper alimentation for sufferers of infant diarrhea. ORT is expected to be administered by the mother herself, and should reduce the 60% to 70% of diarrhea deaths caused by dehydration. Measles, whooping cough, neonatal tetanus, polio, diphtheria, and tuberculosis among children will be the targets of innoculation campaigns. All of the diseases are major child killers in Africa; measles are responsible for an estimated 31.3% of child deaths from 1 to 4, 10.3% in the 1st year of life. Community oriented primary care of the type necessary to execute these programs is not presently a priority among medical personnel; it should become an important component of medical education. Education to counter ignorance and the designation of the family as the primary instrument of good health will assure child survival and eliminate the need for multiple births to maintain the family.

  16. Pathophysiology and Management of Alcoholic Liver Disease: Update 2016

    PubMed Central

    Stickel, Felix; Datz, Christian; Hampe, Jochen; Bataller, Ramon

    2017-01-01

    Alcoholic liver disease (ALD) is a leading cause of cirrhosis, liver cancer, and acute and chronic liver failure and as such causes significant morbidity and mortality. While alcohol consumption is slightly decreasing in several European countries, it is rising in others and remains high in many countries around the world. The pathophysiology of ALD is still incompletely understood but relates largely to the direct toxic effects of alcohol and its main intermediate, acetaldehyde. Recently, novel putative mechanisms have been identified in systematic scans covering the entire human genome and raise new hypotheses on previously unknown pathways. The latter also identify host genetic risk factors for significant liver injury, which may help design prognostic risk scores. The diagnosis of ALD is relatively easy with a panel of well-evaluated tests and only rarely requires a liver biopsy. Treatment of ALD is difficult and grounded in abstinence as the pivotal therapeutic goal; once cirrhosis is established, treatment largely resembles that of other etiologies of advanced liver damage. Liver transplantation is a sound option for carefully selected patients with cirrhosis and alcoholic hepatitis because relapse rates are low and prognosis is comparable to other etiologies. Still, many countries are restrictive in allocating donor livers for ALD patients. Overall, few therapeutic options exist for severe ALD. However, there is good evidence of benefit for only corticosteroids in severe alcoholic hepatitis, while most other efforts are of limited efficacy. Considering the immense burden of ALD worldwide, efforts of medical professionals and industry partners to develop targeted therapies in ALF has been disappointingly low. PMID:28274107

  17. Creutzfeldt-Jakob disease surveillance in Australia: update to December 2015.

    PubMed

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

    2016-09-30

    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 delineation of new disease subtypes, improvements in diagnostic capabilities and the overall heightened awareness of prion diseases in the health care setting. In 2015, 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 2015, and retrospectively to 1970.

  18. Creutzfeldt-Jakob disease surveillance in Australia, update to December 2013.

    PubMed

    Klug, Genevieve M; Boyd, Alison; Sarros, Shannon; Stehmann, Christiane; Simpson, Marion; McLean, Catriona A; Masters, Collin L; Collins, Stephen J

    2014-12-31

    Nation-wide surveillance of transmissible spongiform encephalopathies including Creutzfeldt-Jakob disease, is performed by the Australian National Creutzfeldt-Jakob Disease Registry, based at the University of Melbourne. Surveillance has been undertaken since 1993. Over this dynamic period in transmissible spongiform encephalopathy research and understanding, the unit has evolved and adapted to changes in surveillance practices and requirements, the emergence of new disease subtypes, improvements in diagnostic capabilities and the overall heightened awareness and understanding of Creutzfeldt-Jakob disease and other transmissible spongiform encephalopathies in the health care setting. In 2013, routine surveillance continued and this brief report provides an update of the surveillance data collected by the Australian National Creutzfeldt-Jakob Disease Registry prospectively from 1993 to December 2013, and retrospectively to 1970. The report highlights the recent multi-national collaborative study published that has verified the correlation between surveillance intensity and reported disease incidence.

  19. 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

    2016-06-30

    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.

  20. Cardiovascular Disease in CKD in Children: Update on Risk Factors, Risk Assessment, and Management

    PubMed Central

    Wilson, Amy C; Mitsnefes, Mark M

    2009-01-01

    In young adults with onset of chronic kidney disease in childhood, cardiovascular disease is the most common cause of death. The likely reason for increased cardiovascular disease in these patients is high prevalence of traditional and uremia-related cardiovascular disease risk factors during childhood chronic kidney disease. Early markers of cardiomyopathy, such as left ventricular hypertrophy and left ventricular dysfunction and early markers of atherosclerosis, such as increased carotid artery intima-media thickness, carotid arterial wall stiffness and coronary artery calcification are frequently found in this patient population. The purpose of this review is to provide an update of recent advances in the understanding and management of cardiovascular disease risks in this population. PMID:19619845

  1. Communicable disease control: an introductory course for MPH students.

    PubMed

    Slater, Paul E; Anis, Emilia; Leventhal, Alex

    2002-01-01

    Persons preparing for careers in public health practice need a solid academic grounding in the principles of communicable disease control before arriving on the job. We have developed an introductory course in infectious disease control for the Master of Public Health program in Jerusalem, which includes instruction in the following broad areas: How do micro-organisms spread and cause disease? How do we investigate and control an outbreak? What are the basics of primary prevention by immunization and what can mass immunization accomplish? What is the importance of routine ongoing communicable disease surveillance? What are the essentials of Travel Medicine? How can public health officials provide useful information to a concerned citizenry by intelligent cooperation with the media? How can immunization programs and other programs for infectious disease control be kept current with the help of expert advisory committees? What are the best resources available to the public health practitioner in the area of infectious disease control? Armed with the essentials, the practitioner will have the tools to approach communicable disease problems in an orderly and rational way even in an atmosphere of public and professional ignorance and apprehension.

  2. Communicable diseases in complex emergencies: impact and challenges.

    PubMed

    Connolly, Máire A; Gayer, Michelle; Ryan, Michael J; Salama, Peter; Spiegel, Paul; Heymann, David L

    Communicable diseases, alone or in combination with malnutrition, account for most deaths in complex emergencies. Factors promoting disease transmission interact synergistically leading to high incidence rates of diarrhoea, respiratory infection, malaria, and measles. This excess morbidity and mortality is avoidable as effective interventions are available. Adequate shelter, water, food, and sanitation linked to effective case management, immunisation, health education, and disease surveillance are crucial. However, delivery mechanisms are often compromised by loss of health staff, damage to infrastructure, insecurity, and poor co-ordination. Although progress has been made in the control of specific communicable diseases in camp settings, complex emergencies affecting large geographical areas or entire countries pose a greater challenge. Available interventions need to be implemented more systematically in complex emergencies with higher levels of coordination between governments, UN agencies, and non-governmental organisations. In addition, further research is needed to adapt and simplify interventions, and to explore novel diagnostics, vaccines, and therapies.

  3. Disability-Adjusted Life Years for Communicable Disease in the Korean Burden of Disease Study 2012.

    PubMed

    Lee, Ye Rin; Moon, Kanghee; Kim, Young Ae; Park, So Youn; Oh, Chang Mo; Lee, Kyung Suk; Oh, In Hwan

    2016-11-01

    Globally, the incidence of communicable diseases has decreased compared to non-communicable diseases. However, chronic communicable diseases such as HIV/AIDS and tuberculosis persist worldwide. Furthermore, emerging new infections such as H1N1 influenza pose a new threat to public health. However, most studies have focused on non-communicable diseases because of their increasing incidence, with fewer studies investigating communicable diseases. Therefore, we estimated the burden of communicable diseases in Korea using national representative 2012 data. To estimate the disability-adjusted life years (DALY), we used cause of death data from the Statistics Korea to estimate the years of life lost (YLL), applied the Korean garbage code algorithm, and used national claims data from the National Health Insurance Service (NHIS) to estimate years lived with disability (YLD). In 2012, the total DALYs of communicable disease were 445 per 100,000, with 129 YLLs per 100,000 and 316 YLDs per 100,000. The total DALYs in men were 468 per 100,000, greater than the 422 per 100,000 DALYs seen in women. The DALYs of lower respiratory infections were the highest value among communicable diseases at 143/100,000 DALYs followed by tuberculosis and upper respiratory infections. The 40-49 years old age group had the largest number of total DALYs. In contrast, the over 80 years old age group had the largest number of total DALYs per 100,000 followed by the 70-79 and 0-9 years old age groups. These results enable the prioritization of interventions related to communicable diseases and can be used for evidence-based public health policies.

  4. Non-communicable diseases and injuries in Pakistan: strategic priorities.

    PubMed

    Jafar, Tazeen H; Haaland, Benjamin A; Rahman, Atif; Razzak, Junaid A; Bilger, Marcel; Naghavi, Mohsen; Mokdad, Ali H; Hyder, Adnan A

    2013-06-29

    Non-communicable diseases, including cardiovascular diseases, cancers, respiratory diseases, diabetes, and mental disorders, and injuries have become the major causes of morbidity and mortality in Pakistan. Tobacco use and hypertension are the leading attributable risk factors for deaths due to cardiovascular diseases, cancers, and respiratory diseases. Pakistan has the sixth highest number of people in the world with diabetes; every fourth adult is overweight or obese; cigarettes are cheap; antismoking and road safety laws are poorly enforced; and a mixed public-private health-care system provides suboptimum care. Furthermore, almost three decades of exposure to sociopolitical instability, economic uncertainty, violence, regional conflict, and dislocation have contributed to a high prevalence of mental health disorders. Projection models based on the Global Burden of Disease 2010 data suggest that there will be about 3·87 million premature deaths by 2025 from cardiovascular diseases, cancers, and chronic respiratory diseases in people aged 30-69 years in Pakistan, with serious economic consequences. Modelling of risk factor reductions also indicate that Pakistan could achieve at least a 20% reduction in the number of these deaths by 2025 by targeting of the major risk factors. We call for policy and legislative changes, and health-system interventions to target readily preventable non-communicable diseases in Pakistan.

  5. 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…

  6. 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…

  7. Communitarianism and the ethics of communicable disease: some preliminary thoughts.

    PubMed

    Cheyette, Cara M

    2011-01-01

    Communicable diseases, especially those that are highly contagious, are on the rise and each of us, no matter who we are or where we live, is equally at risk of transmitting contagious diseases to others as we are of contracting such diseases from others. Because contagious diseases are as readily passed state-to-state as person-to-person, we all have a stake in every country's ability to enact effective infectious disease control policies, while policies grounded in shared values are more likely to gain widespread acceptance and thereby prove most effective. This paper suggests that principlism proved invaluable as an ethical framework for resolving hard medical cases and setting health care policy because it nicely "fits" dilemmas that arise in the context of the special relationship between doctors and patients or within family units. It then argues that communitarianism provides the better foundation for crafting infectious diseases control policies because contagious diseases, which often pass between perfect strangers, raise questions about the moral obligations we owe to (or are entitled to demand of) people with whom we share no "special" relationship. Accordingly, a socially embedded framework such as communitarianism may be a better fit for the more socially embedded ethical dilemmas of communicable diseases. © 2011 American Society of Law, Medicine & Ethics, Inc.

  8. 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

  9. 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

    2016-07-14

    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.

  10. Notification: CTS Asheville Superfund Site Update: Sampling, Monitoring, Communication and Opportunities for Cleanup Efficiencies

    EPA Pesticide Factsheets

    Project #OPE-FY14-0044, July 22, 2014. The EPA OIG plans to begin preliminary research of the EPA's sampling, monitoring, communication and opportunities for cleanup efficiencies for the CTS Asheville Superfund Site, North Carolina.

  11. Estimating the risk of communicable diseases aboard cargo ships.

    PubMed

    Schlaich, Clara C; Oldenburg, Marcus; Lamshöft, Maike M

    2009-01-01

    International travel and trade are known to be associated with the risk of spreading communicable diseases across borders. No international surveillance system for infectious diseases on ships exists. Outbreak reports and systematic studies mainly focus on disease activity on cruise ships. The study aims to assess the relevance of communicable disease occurrence on cargo ships. Retrospective analysis of all documented entries to 49 medical log books from seagoing cargo ships under German flag between 2000 and 2008. Incidence rates were calculated per 100 person-years at sea. Case series of acute respiratory illness, influenza-like illness, and infectious gastrointestinal illness affecting more than two persons within 1 successive week were classified as an outbreak. Attack rates were calculated based on number of entries to the medical log book in comparison to the average shipboard population during outbreak periods. During more than 1.5 million person-days of observation, 21% of the visits to the ship's infirmary were due to presumably communicable diseases (45.8 consultations per 100 person-years). As many as 33.9 patients per 100 person-years sought medical attention for acute respiratory symptoms. Of the 68 outbreaks that met predefined criteria, 66 were caused by acute respiratory illness with a subset of 12 outbreaks caused by influenza-like illness. Attack rates ranged between 3 and 10 affected seafarers per ship (12.5&-41.6% of the crew). Two outbreaks of gastrointestinal illness were detected. Respiratory illness is the most common cause of presumably communicable diseases aboard cargo ships and may cause outbreaks of considerable morbidity. Although the validity of the data is limited due to the use of nonprofessional diagnoses, missing or illegible entries, and restriction of the study population to German ships, the results provide guidance to ship owners and to Port Health Authorities to allocate resources and build capacities under International

  12. Update on role of agalsidase alfa in management of Fabry disease

    PubMed Central

    Ramaswami, Uma

    2011-01-01

    Fabry disease (FD) is an X-linked lysosomal storage disorder that affects both men and women. The manifestations of this heterogeneous disease are multisystemic and progressive. Prior to the development of enzyme replacement therapy, the management and treatment for Fabry disease was largely nonspecific and supportive. Because enzyme replacement therapy became commercially available in 2001, a variety of clinical benefits in Fabry patients have been consistently reported, including improved renal pathology and cardiac function, and reduced severity of neuropathic pain and improved pain-related quality of life. This update focuses on published data on the efficacy and tolerability of enzyme replacement therapy with agalsidase alfa, and gives a brief overview on some of the outstanding management issues in the treatment of this complex disease. PMID:21552486

  13. 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. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. Performance Assessment of a Communicable Disease Surveillance System in Response to the Twin Earthquakes of East Azerbaijan.

    PubMed

    Babaie, Javad; Ardalan, Ali; Vatandoost, Hasan; Goya, Mohammad Mehdi; Akbari Sari, Ali

    2015-08-01

    Following the twin earthquakes on August 11, 2012, in the East Azerbaijan province of Iran, the provincial health center set up a surveillance system to monitor communicable diseases. This study aimed to assess the performance of this surveillance system. In this quantitative-qualitative study, performance of the communicable diseases surveillance system was assessed by using the updated guidelines of the Centers for Disease Control and Prevention (CDC). Qualitative data were collected through interviews with the surveillance system participants, and quantitative data were obtained from the surveillance system. The surveillance system was useful, simple, representative, timely, and flexible. The data quality, acceptability, and stability of the surveillance system were 65.6%, 10.63%, and 100%, respectively. The sensitivity and positive predictive value were not calculated owing to the absence of a gold standard. The surveillance system satisfactorily met the goals expected for its setup. The data obtained led to the control of communicable diseases in the affected areas. Required interventions based on the incidence of communicable disease were designed and implemented. The results also reassured health authorities and the public. However, data quality and acceptability should be taken into consideration and reviewed for implementation in future disasters.

  15. [Chronic non-communicable diseases in Brazil: priorities for disease management and research].

    PubMed

    Duncan, Bruce Bartholow; Chor, Dóra; Aquino, Estela M L; Bensenor, Isabela M; Mill, José Geraldo; Schmidt, Maria Inês; Lotufo, Paulo Andrade; Vigo, Alvaro; Barreto, Sandhi Maria

    2012-12-01

    Chronic Non-Communicable Diseases are the main source of disease burden in Brazil. In 2011, the Brazilian Ministry of Health launched the Strategic Plan of Action for Management of Chronic Non-Communicable Diseases focusing on population-based interventions to manage cardiovascular diseases, diabetes, cancer, and chronic respiratory diseases mainly through fighting tobacco use, unhealthy diets, physical inactivity and the harmful use of alcohol. Although a significant number of scientific studies on chronic diseases and their risk factors have been undertaken in Brazil, few are of cohort design. In this context, the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), a cohort study of 15,105 Brazilian public servants reflects the reality of high prevalences of diabetes, hypertension and the main chronic diseases risk factors. The diversity of information that the Study will produce can provide important input to better understand the causes of chronic diseases and to support public policies for fighting them.

  16. Mapping communicable disease control in the European union.

    PubMed

    Elliott, Heather A; Jones, David K; Greer, Scott L

    2012-12-01

    Understanding both the current performance of communicable disease control in Europe and the scale of the differences among systems is crucial to understanding its present performance and possible Europeanization. We attempt to identify the structure of authority in communicable disease control in each European Union (EU) member state. The primary sources of information were the competent bodies list posted on the European Centre for Disease Prevention and Control website and the Health in Transition reports produced by the European Observatory on Health Systems and Policies. Three key patterns emerge to answer the question of who does what. First, the landscape is full and crowded, with many actors involved. Second, the landscape is highly fragmented, with many organizations performing overlapping functions in each country. Third, regional patterns describe which types of organizations are assigned which functions. These full, fragmented, and regionally disparate systems show no signs of constituting a shared model. As a result, if there is an EU model of communicable disease control today, it is at most an aspiration.

  17. A new perspective on John Snow's communicable disease theory.

    PubMed

    Winkelstein, W

    1995-11-01

    When John Snow undertook the studies of the cholera epidemic of 1854 in London, he was testing his theory of communicable disease, which had been enunciated in an oration delivered at the 80th anniversary of the Medical Society of London. Snow had been elected orator of the year for 1853 and, according to his biographer, had spent the better part of a year in preparation. The oration was titled, "On Continuous Molecular Changes, More Particularly in Their Relation to Epidemic Diseases." Although the text of this oration is readily available in the 1936 Commonwealth Fund facsimile reprint of Snow's more famous cholera studies, few modern epidemiologists are familiar with the work. In it, Snow lays out a theory which includes recognition that for each communicable disease there is a distinct and specific cause, that the causal agent is a living organism which is stable over many generations of propagation, that infection is necessary for communication to occur, and that the quantity of infectious material transmitted is increased by multiplication after infection to produce disease manifestations. Although Snow's theory is similar to Jacob Henle's formulations of a decade earlier, it is more precise, more comprehensive, and more explicit. On the basis of this work alone, Snow deserves broader recognition than he has received.

  18. [The wanderings of the communication on the Ebola virus disease].

    PubMed

    Seytre, B

    2016-10-01

    For two reasons, communication is one of the major tools in the fight against any Ebola epidemics. Firstly, because Ebola is one of the most easily preventable of all infectious diseases and the thorough application of health-protection measures by the community of the sick persons is the best tool to fight any Ebola epidemic. Secondly, because during the two dozens of known Ebola epidemics health care workers have often met with people's skepticism, or even hostility. However, our review of Ebola communication, as defined by WHO since 2013, shows that it has been marked by a series of errors, as well from a strategic perspective as in its concrete deployment. The same communication messages and tools have been used in non-epidemic and epidemic countries. A general ban on hunting has been promoted, while only 2% of sub-Saharan Africans live in areas inhabited by the bats that are the reservoir of the Ebola virus and while it is not proven that hunting is a major risk of infection. Erroneous or inappropriate messages have contributed to doubts and created anxiety. To be effective, Ebola communication should be based on education about the disease, meaning explanation of its cause, its transmission and its prevention.

  19. 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.

  20. 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…

  1. Exploring family communication about sickle cell disease in adolescence.

    PubMed

    Graff, J Carolyn; Hankins, Jane; Graves, Rebecca J; Robitaille, Kimberly Y; Roberts, Ruth; Cejda, Katherine; Hardy, Belinda T; Johnson, Margery; Porter, Jerlym S

    2012-01-01

    Sickle cell disease (SCD) is a lifelong disorder that involves progressive organ damage and requires ongoing medical attention to prevent and treat episodic acute complications. Children with SCD need ongoing monitoring and extra attention that may be stressful to family members. Communication within families can help resolve family stress and may be associated with medical follow-up and management of SCD. Focus groups were conducted with 12 African American families to explore the communication that occurred within and outside of the family from the perspectives of adolescents with SCD, siblings, and parents. Factors that influence family communication were explored. The extended family was an important social network and resource to adolescents, siblings, and parents. Family member knowledge of SCD was an important factor that influenced communication about SCD; adolescents and parents communicated more easily than siblings and also reported having more knowledge of SCD than siblings. Future research focusing on the knowledge of immediate and extended family members and their recognition of their contribution to the child with SCD is recommended.

  2. 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

  3. Surveillance for Creutzfeldt-Jakob disease in Australia: update to December 2012.

    PubMed

    Klug, Genevieve M; Boyd, Alison; Zhao, Teresa; Stehmann, Christiane; Simpson, Marion; McLean, Catriona A; Masters, Colin L; Collins, Steven J

    2013-06-30

    Nation-wide surveillance for transmissible spongiform encephalopathies including Creutzfeldt-Jakob disease (CJD) is undertaken by the Australian National Creutzfeldt-Jakob disease Registry (ANCJDR), based at the University of Melbourne. Surveillance has been undertaken since 1993. During this period the unit has evolved and adapted to changes in surveillance practices and requirements, the emergence of new disease subtypes, improvements in diagnostic capabilities and the overall heightened awareness and understanding of CJD and other transmissible spongiform encephalopathies in the health care setting. In 2012, routine surveillance continued. This brief report provides an update on the surveillance data collected by the ANCJDR prospectively from 1993 to December 2012, and retrospectively to 1970. It also highlights the recent release of the revised Australian CJD Infection Control Guidelines.

  4. Update on the Management of Chronic Total Occlusions in Coronary Artery Disease.

    PubMed

    Kearney, Kathleen; Hira, Ravi S; Riley, Robert F; Kalyanasundaram, Arun; Lombardi, William L

    2017-04-01

    Chronic total occlusions (CTOs) are found in about a third of patients with coronary artery disease (CAD) and can pose a significant challenge during percutaneous revascularization. However, advances in CTO percutaneous coronary intervention (PCI) strategies, devices, and algorithms have led to significant improvements in successful treatment of CTOs. This review summarizes current management of CTOs in the context of modern PCI techniques and current evidence. The hybrid algorithm now provides a standardized, teachable approach to CTO PCI, and success rates are approximately 90% in experienced hands. The first randomized controlled trial in patients with CTOs recently reported that patients with ST elevation myocardial infarction (STEMI) and a CTO in the non-culprit vessel showed an improvement in ejection fraction in patients undergoing CTO PCI of the LAD, but not other vessels. Updated data from the SYNTAX trial showed a benefit with complete revascularization in patients with coronary artery disease (CAD). Incomplete revascularization of CTOs in the PCI group may explain some of the benefit seen with CABG over PCI in patients with complex coronary disease. Contemporary CTO registries have reported success rates of approximately 90%, and the OPEN-CTO registry updates our understanding of CTO PCI complication rates and outcomes. The available evidence highlights the potential benefits of CTO PCI in patients with an indication for revascularization. Technological advancements have paved the way for success rates approaching 90% at high-volume centers, but further studies evaluating outcomes following CTO PCI are needed, with several currently underway.

  5. Climate Change, Migration, and Allergic Respiratory Diseases: An Update for the Allergist

    PubMed Central

    Rottem, Menachem; Dahl, Ronald; Blaiss, Michael; Ridolo, Erminia; Cecchi, Lorenzo; Rosario, Nelson; Motala, Cassim; Ansotegui, Ignacio; Annesi-Maesano, Isabella

    2011-01-01

    Abstract Local climate changes can impact on a number of factors, including air pollution, that have been shown to influence both the development and attacks of allergic respiratory diseases, and thus, they represent an important consideration for the allergist. Migration involves exposure to a new set of pollutants and allergens as well as changes in housing conditions, diet, and accessibility to medical services, all of which are likely to affect migrants' health. This review provides an update on climate change, migration, and allergy and discusses factors for consideration when making recommendations for local allergy service provision and for assessing an individual patient's environmental exposures. PMID:23268459

  6. The Centre for Communicative and Cognitive Disabilities at the University of Western Ontario: An Update.

    ERIC Educational Resources Information Center

    Harper, Frank, B. W.; Sitko, Merrill

    1991-01-01

    The Centre for Communicative and Cognitive Disabilities at the University of Western Ontario provides support services for students with hearing impairment, visual impairment, physical impairment, and learning disabilities. Centre activities have included policy development, student organization, interpreter services, technology development, and…

  7. 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…

  8. 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,…

  9. 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,…

  10. The heart-liver metabolic axis: defective communication exacerbates disease

    PubMed Central

    Baskin, Kedryn K; Bookout, Angie L; Olson, Eric N

    2014-01-01

    The heart has been recognized as an endocrine organ for over 30 years (de Bold, 2011); however, little is known about how the heart communicates with other organs in the body, and even less is known about this process in the diseased heart. In this issue of EMBO Molecular Medicine, Magida and Leinwand (2014) introduce the concept that a primary genetic defect in the heart results in aberrant hepatic lipid metabolism, which consequently exacerbates hypertrophic cardiomyopathy (HCM). This study provides evidence in support of the hypothesis that crosstalk occurs between the heart and liver, and that this becomes disrupted in the diseased state. PMID:24623378

  11. 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.

  12. Communicable disease control in England; recommendations from an American.

    PubMed

    Detels, R

    1994-12-01

    The problems associated with the Wakefield salmonella and the Stafford Legionnaires' disease outbreaks and the recommendations of the Acheson Committee formed in response led to the creation of the position of Consultant in Communicable Disease Control (CCDC) within the District Health Authorities. The reality of the position as implemented differs from that envisaged by the Acheson Committee and has resulted in ambiguities about the role of the CsCDC, the source of their support, and the range of their responsibilities. This paper, by an American invited to review the position, outlines the history of the position, the current status of CsCDC, and the barriers to effective performance of the position. It ends with a series of recommendations for improving disease control within England by solidifying the position, establishing its role in disease control within the National Health Service and recommending an educational/training pathway to attract and prepare physicians for the position.

  13. Update on POCIT portable optical communicators: VideoBeam and EtherBeam

    NASA Astrophysics Data System (ADS)

    Mecherle, G. Stephen; Holcomb, Terry L.

    2000-05-01

    LDSC is developing the POCITTM (Portable Optical Communication Integrated Transceiver) family of products which includes VideoBeamTM and the latest addition, EtherBeamTM. Each is a full duplex portable laser communicator: VideoBeamTM providing near-broadcast- quality analog video and stereo audio, and EtherBeamTM providing standard Ethernet connectivity. Each POCITTM transceiver consists of a 3.5-pound unit with a binocular- type form factor, which can be manually pointed, tripod- mounted or gyro-stabilized. Both units have an operational range of over two miles (clear air) with excellent jam- resistance and low probability of interception characteristics. The transmission wavelength of 1550 nm enables Class 1 eyesafe operation (ANSI, IEC). The POCITTM units are ideally suited for numerous military scenarios, surveillance/espionage, industrial precious mineral exploration, and campus video teleconferencing applications. VideoBeam will be available second quarter 2000, followed by EtherBeam in third quarter 2000.

  14. Receiver Operating Characteristic (ROC) Curve-based Prediction Model for Periodontal Disease Updated With the Calibrated Community Periodontal Index.

    PubMed

    Su, Chiu-Wen; Ming-Fang Yen, Amy; Lai, Hongmin; Chen, Hsiu-Hsi; Chen, Sam Li-Sheng

    2017-07-28

    Background The accuracy of a prediction model for periodontal disease using the community periodontal index (CPI) has been undertaken by using an area receiver operating characteristics (AUROC) curve, but how the uncalibrated CPI, as measured by general dentists trained by periodontists in a large epidemiological study, required for constructing a prediction model that affects its performance has not been researched yet. Methods We conducted a two-stage design by first proposing a validation study to calibrate the CPI between a senior periodontal specialist and trained general dentists who measured CPIs in the main study of a nationwide survey. A Bayesian hierarchical logistic regression model was applied to estimate the non-updated and updated clinical weights used for building up risk scores. How the calibrated CPI affected the performance of the updated prediction model was quantified by comparing the AUROC curves between the original and the updated model. Results The estimates regarding the calibration of CPI obtained from the validation study were 66% and 85% for sensitivity and specificity, respectively. After updating, the clinical weights of each predictor were inflated, and the risk score for the highest risk category was elevated from 434 to 630. Such an update improved the AUROC performance of the two corresponding prediction models from 62.6% (95% CI: 61.7%-63.6%) for the non-updated model to 68.9% (95% CI: 68.0%-69.6%) for the updated one, reaching a statistically significant difference (P < 0.05). Conclusions We demonstrated an improvement in the updated prediction model for periodontal disease as measured by the calibrated CPI derived from a large epidemiological survey.

  15. Calibration of the Pooled Cohort Equations for Atherosclerotic Cardiovascular Disease: An Update.

    PubMed

    Cook, Nancy R; Ridker, Paul M

    2016-12-06

    The latest guidelines from the American College of Cardiology and American Heart Association, released in fall 2013, provide a long-anticipated update to the recommendations of the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). The guidelines incorporate a new risk score for atherosclerotic cardiovascular disease that includes stroke as well as coronary heart disease. After publication, the new pooled cohort equations (PCEs) were evaluated in 15 studies from the United States and Europe, most of which used cohorts that were more contemporary than those used in developing the guidelines. In almost all of these external validation cohorts, the PCEs overestimated the observed risk. This narrative review provides an update of the published reports, an overview of the strengths and weaknesses of these validation efforts, and a discussion of possible reasons for the discrepancies. These issues may be useful in a recalibration process designed to better match predicted and observed risks relevant for current clinical practice.

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

    PubMed

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

    2012-12-31

    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). 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). 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). 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.

  17. 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

  18. 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. © 2013 Society of Chemical Industry.

  19. Saturated Fat Consumption and Risk of Coronary Heart Disease and Ischemic Stroke: A Science Update

    PubMed Central

    Nettleton, Joyce A.; Brouwer, Ingeborg A.; Geleijnse, Johanna M.; Hornstra, Gerard

    2017-01-01

    At a workshop to update the science linking saturated fatty acid (SAFA) consumption with the risk of coronary heart disease (CHD) and ischemic stroke, invited participants presented data on the consumption and bioavailability of SAFA and their functions in the body and food technology. Epidemiological methods and outcomes were related to the association between SAFA consumption and disease events and mortality. Participants reviewed the effects of SAFA on CHD, causal risk factors, and surrogate risk markers. Higher intakes of SAFA were not associated with higher risks of CHD or stroke apparently, but studies did not take macronutrient replacement into account. Replacing SAFA by cis-polyunsaturated fatty acids was associated with significant CHD risk reduction, which was confirmed by randomized controlled trials. SAFA reduction had little direct effect on stroke risk. Cohort studies suggest that the food matrix and source of SAFA have important health effects. PMID:28125802

  20. Recommendations to standardize preanalytical confounding factors in Alzheimer's and Parkinson's disease cerebrospinal fluid biomarkers: an update.

    PubMed

    del Campo, Marta; Mollenhauer, Brit; Bertolotto, Antonio; Engelborghs, Sebastiaan; Hampel, Harald; Simonsen, Anja Hviid; Kapaki, Elisabeth; Kruse, Niels; Le Bastard, Nathalie; Lehmann, Sylvain; Molinuevo, Jose L; Parnetti, Lucilla; Perret-Liaudet, Armand; Sáez-Valero, Javier; Saka, Esen; Urbani, Andrea; Vanmechelen, Eugeen; Verbeek, Marcel; Visser, Pieter Jelle; Teunissen, Charlotte

    2012-08-01

    Early diagnosis of neurodegenerative disorders such as Alzheimer's (AD) or Parkinson's disease (PD) is needed to slow down or halt the disease at the earliest stage. Cerebrospinal fluid (CSF) biomarkers can be a good tool for early diagnosis. However, their use in clinical practice is challenging due to the high variability found between centers in the concentrations of both AD CSF biomarkers (Aβ42, total tau and phosphorylated tau) and PD CSF biomarker (α-synuclein). Such a variability has been partially attributed to different preanalytical procedures between laboratories, thus highlighting the need to establish standardized operating procedures. Here, we merge two previous consensus guidelines for preanalytical confounding factors in order to achieve one exhaustive guideline updated with new evidence for Aβ42, total tau and phosphorylated tau, and α-synuclein. The proposed standardized operating procedures are applicable not only to novel CSF biomarkers in AD and PD, but also to biomarkers for other neurodegenerative disorders.

  1. An update on diagnostic and prognostic biomarkers in inflammatory bowel disease.

    PubMed

    Day, Andrew S; Leach, Steven T; Lemberg, Daniel A

    2017-09-01

    Diagnosis of the chronic inflammatory bowel diseases relies upon initial recognition of an inflammatory condition, followed by definitive endoscopic, histological and radiological investigations. Various biomarkers are available to assist with initial elucidation of an inflammatory process: these also have important roles after diagnosis in monitoring and ongoing assessment of progress. Areas covered: Various inflammatory markers, serological tests and genetic analyses may be helpful in predicting the course of disease in the coming months. This review provides an update on the current understanding and knowledge about these markers. It also highlights key gaps and identifies aspects that require further study. Expert commentary: Our current approach to the application of non-invasive biomarkers is rudimentary. Further work is required to elucidate the roles of the various markers.

  2. A scientific update on biosimilar infliximab (CT-P13) in rheumatic diseases.

    PubMed

    Taylor, Peter

    2015-01-01

    The development of biologic drugs has undoubtedly enhanced the spectrum of treatments available for immune-mediated inflammatory rheumatic diseases such as rheumatoid arthritis. However, despite their clear clinical benifits, use of biologics is often hindered by their high costs. The manufacture and subsequent approval of more cost-effective 'biosimilar' versions of these drugs may address this issue and improve patient access. CT-P13 (Remsima(®), Inflectra(®)), a biosimilar of infliximab (Remicade(®)), has shown comparable efficacy, safety and pharmacokinetics to its originator drug in clinical studies. The articles in this supplement present a scientific update on the development and use of biosimilars in rheumatic disorders, with specific focus on CT-P13. The information discussed highlights the predicted positive clinical and economic impact of biosimilars on the management of rheumatic diseases.

  3. Saturated Fat Consumption and Risk of Coronary Heart Disease and Ischemic Stroke: A Science Update.

    PubMed

    Nettleton, Joyce A; Brouwer, Ingeborg A; Geleijnse, Johanna M; Hornstra, Gerard

    2017-01-27

    At a workshop to update the science linking saturated fatty acid (SAFA) consumption with the risk of coronary heart disease (CHD) and ischemic stroke, invited participants presented data on the consumption and bioavailability of SAFA and their functions in the body and food technology. Epidemiological methods and outcomes were related to the association between SAFA consumption and disease events and mortality. Participants reviewed the effects of SAFA on CHD, causal risk factors, and surrogate risk markers. Higher intakes of SAFA were not associated with higher risks of CHD or stroke apparently, but studies did not take macronutrient replacement into account. Replacing SAFA by cis-polyunsaturated fatty acids was associated with significant CHD risk reduction, which was confirmed by randomized controlled trials. SAFA reduction had little direct effect on stroke risk. Cohort studies suggest that the food matrix and source of SAFA have important health effects.

  4. Reputation, relationships, risk communication, and the role of trust in the prevention and control of communicable disease: a review.

    PubMed

    Cairns, Georgina; de Andrade, Marisa; MacDonald, Laura

    2013-01-01

    Population-level compliance with health protective behavioral advice to prevent and control communicable disease is essential to optimal effectiveness. Multiple factors affect perceptions of trustworthiness, and trust in advice providers is a significant predeterminant of compliance. While competency in assessment and management of communicable disease risks is critical, communications competency may be equally important. Organizational reputation, quality of stakeholder relationships and risk information provision strategies are trust moderating factors, whose impact is strongly influenced by the content, timing and coordination of communications. This article synthesizes the findings of 2 literature reviews on trust moderating communications and communicable disease prevention and control. We find a substantial evidence base on risk communication, but limited research on other trust building communications. We note that awareness of good practice historically has been limited although interest and the availability of supporting resources is growing. Good practice and policy elements are identified: recognition that crisis and risk communications require different strategies; preemptive dialogue and planning; evidence-based approaches to media relations and messaging; and building credibility for information sources. Priority areas for future research include process and cost-effectiveness evaluation and the development of frameworks that integrate communication and biomedical disease control and prevention functions, conceptually and at scale.

  5. The relationship between different dimensions of alcohol use and the burden of disease-an update.

    PubMed

    Rehm, Jürgen; Gmel, Gerhard E; Gmel, Gerrit; Hasan, Omer S M; Imtiaz, Sameer; Popova, Svetlana; Probst, Charlotte; Roerecke, Michael; Room, Robin; Samokhvalov, Andriy V; Shield, Kevin D; Shuper, Paul A

    2017-06-01

    Alcohol use is a major contributor to injuries, mortality and the burden of disease. This review updates knowledge on risk relations between dimensions of alcohol use and health outcomes to be used in global and national Comparative Risk Assessments (CRAs). Systematic review of reviews and meta-analyses on alcohol consumption and health outcomes attributable to alcohol use. For dimensions of exposure: volume of alcohol use, blood alcohol concentration and patterns of drinking, in particular heavy drinking occasions were studied. For liver cirrhosis, quality of alcohol was additionally considered. For all outcomes (mortality and/or morbidity): cause of death and disease/injury categories based on International Classification of Diseases (ICD) codes used in global CRAs; harm to others. In total, 255 reviews and meta-analyses were identified. Alcohol use was found to be linked causally to many disease and injury categories, with more than 40 ICD-10 three-digit categories being fully attributable to alcohol. Most partially attributable disease categories showed monotonic relationships with volume of alcohol use: the more alcohol consumed, the higher the risk of disease or death. Exceptions were ischaemic diseases and diabetes, with curvilinear relationships, and with beneficial effects of light to moderate drinking in people without heavy irregular drinking occasions. Biological pathways suggest an impact of heavy drinking occasions on additional diseases; however, the lack of medical epidemiological studies measuring this dimension of alcohol use precluded an in-depth analysis. For injuries, except suicide, blood alcohol concentration was the most important dimension of alcohol use. Alcohol use caused marked harm to others, which has not yet been researched sufficiently. Research since 2010 confirms the importance of alcohol use as a risk factor for disease and injuries; for some health outcomes, more than one dimension of use needs to be considered. Epidemiological

  6. Infantile Pompe disease on ERT: update on clinical presentation, musculoskeletal management, and exercise considerations.

    PubMed

    Case, Laura E; Beckemeyer, Alexandra A; Kishnani, Priya S

    2012-02-15

    Enzyme replacement therapy (ERT) with alglucosidase alpha, approved by the FDA in 2006, has expanded possibilities for individuals with Pompe disease (glycogen storage disease type II, GSDII, or acid maltase deficiency). Children with infantile Pompe disease are surviving beyond infancy, some achieving independent walking and functional levels never before possible. Individuals with late-onset Pompe disease are experiencing motor and respiratory improvement and/or stabilization with slower progression of impairments. A new phenotype is emerging for those with infantile Pompe disease treated with ERT. This new phenotype appears to be distinct from the late-onset phenotype rather than a shift from infantile to late-onset phenotype that might be expected from a simple diminution of symptoms with ERT. Questions arise regarding the etiology of the distinct distribution of weakness in this new phenotype, with increasing questions regarding exercise and musculoskeletal management. Answers require an increased understanding of the muscle pathology in Pompe disease, how that muscle pathology may be impacted by ERT, and the potential impact of, and need for, other clinical interventions. This article reviews the current state of knowledge regarding the pathology of muscle involvement in Pompe disease and the potential change in muscle pathology with ERT; the newly emerging musculoskeletal and gross motor phenotype of infantile Pompe disease treated with ERT; updated recommendations regarding musculoskeletal management in Pompe disease, particularly in children now surviving longer with residual weakness impacting development and integrity of the musculoskeletal system; and the potential impact and role of exercise in infantile Pompe survivors treated with ERT. Copyright © 2012 Wiley Periodicals, Inc.

  7. [Updates on Lifestyle-Related Diseases and Bone Metabolism. Bisphosphonates for lifestyle-related disease].

    PubMed

    Okada, Yosuke; Tanaka, Yoshiya

    2014-11-01

    A lifestyle-related disease and osteoporosis are diseases to increase with aging and a lifestyle-related disease has an influence on the bone metabolism. Because the number of patients with lifestyle-related disease is getting larger, it is necessary to prevent fracture in those. Unfortunately, substantial randomized control studies are yet to be done in patients with lifestyle-related disease to clarify if anti-osteoporotic drugs are effective to prevent fractures. It is suggested by the subanalysis in the existing clinical study with usefulness of bisphosphonates with evidence as an osteoporotic therapeutic drug in life-related disease. Here I will review about the effective and problem with bisphosphonate for the lifestyle-related disease with arteriosclerosis.

  8. 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. © The Author (2014). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  9. 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.

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

    PubMed

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

    2014-09-01

    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. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  11. 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.

  12. Paraoxonases, mitochondrial dysfunction and non-communicable diseases.

    PubMed

    Camps, Jordi; García-Heredia, Anabel; Hernández-Aguilera, Anna; Joven, Jorge

    2016-11-25

    The most common non-communicable diseases (NCD) are obesity, cardiovascular disease, diabetes, cancer, chronic respiratory diseases, and neurological diseases. Together, they constitute the commonest cause of death and disability worldwide. Mitochondrial alterations, oxidative stress and inflammation underpin NCD and are molecular mechanisms playing major roles in the disease onset and natural history. Interrelations between the mechanisms of oxidative stress, inflammation and metabolism are, in the broadest sense of energy transformations, being increasingly recognized as part of the problem in NCD. Whether or not oxidative stress and inflammation are the causes or the consequences of cellular disturbances, they do significantly contribute to NCD. Paraoxonases are associated with mitochondria and mitochondria-associated membranes. They modulate mitochondria-dependent superoxide production, and prevent apoptosis. Their overexpression protects mitochondria from endoplasmic reticulum stress and subsequent mitochondrial dysfunction; highlighting that the anti-inflammatory effects of paraoxonases may be mediated, at least in part, by their protective role in mitochondria and associated organelle function. Since oxidative stress is implicated in the development of NCD (as a result of mitochondrial dysfunction), these data suggest that understanding the role and the molecular targets of paraoxonases may provide novel strategies of intervention in the treatment of these important diseases.

  13. 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

  14. Trends in urological stone disease: a 5-year update of hospital episode statistics.

    PubMed

    Heers, Hendrik; Turney, Benjamin W

    2016-11-01

    To provide a 5-year follow-on update on the changes in prevalence and treatment of upper urinary tract (UUT) stone disease in England. Data from the Hospital Episode Statistics (HES) website (http://www.hesonline.nhs.uk) were extracted, summarised, analysed, and presented. The total number of UUT stone hospital episodes increased slightly from 83 050 in 2009-2010 to 86 742 in 2014-2015 (4.4% increase). The use of shockwave lithotripsy (SWL) for treating all UUT stones remained stable over the 5-year study period following a significant increase in previous years. There was a 49.6% increase in the number of ureteroscopic stone treatments from 12 062 in 2009-2010 to 18 055 in 2014-2015. Increase in ureterorenoscopy (flexible ureteroscopy) showed the most rapid increase from 3 267 to 6 631 cases in the 5-year study period (103% increase). The gap between the total number of ureteroscopies and SWL treatments continues to narrow. Open stone surgery continued to decline with only 30 reported cases in 2014-2015. Due to the continued rapid increase in the number of ureteroscopies performed, treatment for stone disease has continued to increase significantly in comparison to other urological activity. This study provides an update on the changing landscape of the management of UUT stones in England. It shows a sustained high prevalence of stone disease commensurate with levels in other developed countries. This study reveals a trend in the last 5 years to surgically intervene on a higher proportion of patients with stones. As in other countries, there is a significant increase in the use of ureteroscopy (particularly intrarenal flexible ureteroscopy) in England. These data have important implications for work-force planning, training, service delivery, and research in the field of urolithiasis. © 2016 The Authors BJU International © 2016 BJU International Published by John Wiley & Sons Ltd.

  15. Complexity theory in the management of communicable diseases.

    PubMed

    Simmons, Mike

    2003-06-01

    In nature, apparently complex behavioural patterns are the result of repetitive simple rules. Complexity science studies the application of these rules and looks for applications in society. Complexity management opportunities have developed from this science and are providing a revolutionary approach in the constantly changing workplace. This article discusses how complexity management techniques have already been applied to communicable disease management in Wales and suggests further developments. A similar approach is recommended to others in the field, while complexity management probably has wider applications in the NHS, not least in relation to the developing managed clinical networks.

  16. NASA Update

    NASA Image and Video Library

    2011-02-15

    NASA Deputy Associate Administrator for the Office of Communications Bob Jacobs moderates the NASA Update program, Tuesday, Feb. 15, 2011 at NASA Headquarters in Washington. NASA's 12th Administrator Charles Bolden and Deputy Administrator Lori Garver took the time discuss the agency’s fiscal year 2012 budget request and to take questions from employees. Photo Credit: (NASA/Bill Ingalls)

  17. Reproductive Health and Women With Congenital Heart Disease: A Practice Update.

    PubMed

    Osteen, Kathryn A; Beal, Claudia C

    2016-01-01

    The purpose of this article was to examine reproductive health issues for women with congenital structural abnormalities of the heart. Because of surgical advances and innovations in healthcare, infants with congenital heart disease often live now into adulthood. Women with congenital heart disease have reported the desire to have children but expressed concern about fertility and the health consequences of pregnancy. Although many women with congenital heart disease are able to give birth without adverse outcomes, life-threatening complications can occur. Best practices for the care of women with congenital heart disease are grounded in an understanding of how cardiac defects may affect pregnancy and in communicating the implications of cardiac defects for reproductive health to support informed decision making.

  18. 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…

  19. 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…

  20. Clinical Update in Aspects of the Management of Autoimmune Thyroid Diseases

    PubMed Central

    2016-01-01

    Aspects of autoimmune thyroid disease updated in this review include: immunoglobulin G4 (IgG4)-related thyroid disease (Riedel's thyroiditis, fibrosing variant of Hashimoto's thyroiditis, IgG4-related Hashimoto's thyroiditis, and Graves' disease with elevated IgG4 levels); recent epidemiological studies from China and Denmark indicating that excess iodine increases the incidence of Hashimoto's thyroiditis and hypothyroidism; immunomodulatory agents (ipilimumab, pembrolizumab, nivolumab) activate immune response by inhibiting T-cell surface receptors which down-regulate immune response, i.e., cytotoxic T-lymphocyte antigen 4 and programmed cell death protein 1 pathways; alemtuzumab is a humanised monoclonal antibody to CD52 which causes immune depletion and thyroid autoimmune disease especially Graves' hyperthyroidism; small molecule ligand (SML) agonists which activate receptors, SML neutral antagonists, which inhibit receptor activation by agonists, and SML inverse agonists which inhibit receptor activation by agonists and inhibit constitutive agonist independent signaling have been identified. SML antagonism of thyroid-stimulating hormone-receptor stimulatory antibody could treat Graves' hyperthyroidism and Graves' ophthalmopathy; and thyroxine treatment of subclinical hypothyroidism can produce iatrogenic subclinical hyperthyroidism with the risk of atrial fibrillation and osteoporosis. The increased risk of harm from subclinical hyperthyroidism may be stronger than the potential benefit from treatment of subclinical hypothyroidism. PMID:28029020

  1. 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. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. 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

  3. Communicable disease epidemiology following migration: studies from the African famine.

    PubMed

    Shears, P; Lusty, T

    1987-01-01

    Few epidemiological studies have been undertaken of morbidity and mortality due to communicable disease in mass migration. This article reviews data from refugee displacement areas in north-east Africa. Risk factors to increase morbidity and mortality include 1) breakdown of health services, 2) movement to new ecological zones, 3) malnutrition, and 4) crowding and poor sanitation in relief camps. Highest mortalities are recorded in children under 5 years old, principal causes being measles, gastro-enteritis, chest infections, and malaria. The greatest morbidity and mortality occurs after arrival in relief camps, and could be reduced by epidemiologically based, selective health programs. This article stresses the importance of regional level coordination between relief agencies and the need for an effective disease surveillance system.

  4. Advancing digital methods in the fight against communicable diseases.

    PubMed

    Chabot-Couture, Guillaume; Seaman, Vincent Y; Wenger, Jay; Moonen, Bruno; Magill, Alan

    2015-03-01

    Important advances are being made in the fight against communicable diseases by using new digital tools. While they can be a challenge to deploy at-scale, GPS-enabled smartphones, electronic dashboards and computer models have multiple benefits. They can facilitate program operations, lead to new insights about the disease transmission and support strategic planning. Today, tools such as these are used to vaccinate more children against polio in Nigeria, reduce the malaria burden in Zambia and help predict the spread of the Ebola epidemic in West Africa. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  5. Event communication in a regional disease surveillance system.

    PubMed

    Loschen, Wayne; Coberly, Jacqueline; Sniegoski, Carol; Holtry, Rekha; Sikes, Marvin; Happel Lewis, Sheryl

    2007-10-11

    When real-time disease surveillance is practiced in neighboring states within a region, public health users may benefit from easily sharing their concerns and findings regarding potential health threats. To better understand the need for this capability, an event communications component (ECC) was added to the National Capital Region Disease Surveillance System, an operational biosurveillance system employed in the District of Columbia and in surrounding Maryland and Virginia counties. Through usage analysis and user survey methods, we assessed the value of the enhanced system in daily operational use and during two simulated exercises. Results suggest that the system has utility for regular users of the system as well as suggesting several refinements for future implementations.

  6. Agricultural policy, food policy, and communicable disease policy.

    PubMed

    Grant, Wyn

    2012-12-01

    Food and agricultural policy is an essential element of a communicable disease policy. The European Union has developed a more systematic and broadly based interest in questions of food safety and animal health and welfare linked to modernization of the Common Agricultural Policy, reflected in a new treaty obligation on animal welfare. Following the bovine spongiform encephalopathy crisis, moves were made to create a European competency, but implementation and enforcement resources reside with the member states. The European Animal Health Strategy is meant to lead to an EU animal health law, but this has already been constrained by fiscal austerity. The development of such a law may lead to a lowest common denominator formula that does little to enhance consumer protection or improve animal welfare. This is an inherent risk with top-down forms of Europeanization; more attention should be paid to lessons to be learned from bottom-up initiatives of the type used to counteract the bovine diarrhea virus. There will always be a tension among what is good policy for reducing the incidence of communicable disease, policy that is popular with EU citizens, and policy that is acceptable to member states.

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

    PubMed

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

    2016-06-01

    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. 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. 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. 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.

  8. Bad bugs, no drugs: no ESKAPE! An update from the Infectious Diseases Society of America.

    PubMed

    Boucher, Helen W; Talbot, George H; Bradley, John S; Edwards, John E; Gilbert, David; Rice, Louis B; Scheld, Michael; Spellberg, Brad; Bartlett, John

    2009-01-01

    The Infectious Diseases Society of America (IDSA) continues to view with concern the lean pipeline for novel therapeutics to treat drug-resistant infections, especially those caused by gram-negative pathogens. Infections now occur that are resistant to all current antibacterial options. Although the IDSA is encouraged by the prospect of success for some agents currently in preclinical development, there is an urgent, immediate need for new agents with activity against these panresistant organisms. There is no evidence that this need will be met in the foreseeable future. Furthermore, we remain concerned that the infrastructure for discovering and developing new antibacterials continues to stagnate, thereby risking the future pipeline of antibacterial drugs. The IDSA proposed solutions in its 2004 policy report, "Bad Bugs, No Drugs: As Antibiotic R&D Stagnates, a Public Health Crisis Brews," and recently issued a "Call to Action" to provide an update on the scope of the problem and the proposed solutions. A primary objective of these periodic reports is to encourage a community and legislative response to establish greater financial parity between the antimicrobial development and the development of other drugs. Although recent actions of the Food and Drug Administration and the 110th US Congress present a glimmer of hope, significant uncertainly remains. Now, more than ever, it is essential to create a robust and sustainable antibacterial research and development infrastructure--one that can respond to current antibacterial resistance now and anticipate evolving resistance. This challenge requires that industry, academia, the National Institutes of Health, the Food and Drug Administration, the Centers for Disease Control and Prevention, the US Department of Defense, and the new Biomedical Advanced Research and Development Authority at the Department of Health and Human Services work productively together. This report provides an update on potentially effective

  9. 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....

  10. 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....

  11. 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....

  12. [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

  13. [Tobacco control, a strategy to reduce non-communicable diseases].

    PubMed

    Reynales-Shigematsu, Luz Myriam

    2012-06-01

    Nearly two-thirds of all deaths globally are caused by noncommunicable diseases (cardiovascular diseases, cancer, respiratory diseases and diabetes). The UN General Assembly approved Political Declaration of the High-Level Meeting on the Prevention and Control of non communicable diseases and recommending five priority interventions: 1. Tobacco control (the most urgent and immediate), 2. Salt reduction, 3. Improved diet and physical activity, 4 Reduction of hazardous alcohol intake, 5. Access to essential drugs and technologies. The Assembly recognizes the fundamental conflict of interest between tobacco industry and public health and recommends the implementation of WHO Framework Convention on Tobacco Control (FCTC) and MPOWER strategies. The full implementation of FCTC could prevent 5.5 Million of death in the next 10 years in low and middle income countries. All these recommendations are feasible to implement considering the willingness of Governments, the infrastructure available, the capacity building existing and the participation of all sectors, including civil society and the community as a whole.

  14. Molecular pathology of cancer: how to communicate with disease

    PubMed Central

    Birner, Peter; Prager, Gerald; Streubel, Berthold

    2016-01-01

    Recent technical advances have brought insights into the biology of cancer in human, establishing it as a disease driven by genetic mutations. Beside inherited family tumour syndromes caused by germline mutations, somatic genetic alterations occur early in tumourigenesis, which accumulate during the progression of the disease and its treatment. Based on these observations, medical oncology has started to enter an era of stratified medicine, where treatment selection is becoming tailored to drugable molecular pathways. As a pre-requisite of an individualised treatment concept, molecular and genetic characterisation of the individual tumour has to be performed to align the most appropriate therapies according to the patient's disease. Reading the individual molecular tumour profile and responding by a tailored treatment concept is the ‘communication’ required to fight this deadly disease. This way to communicate is currently changing the field of oncology dramatically, and fundamentally involves the discipline of molecular pathology. This review highlights the role of genetic characterisation of human malignancies by giving an overview on the basic methods of molecular pathology, the challenge of the instable tumour genome and its clinical consequences. Trial registration number EK1541/2012. PMID:27933213

  15. [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.

  16. An update for the controversies and hypotheses of regulating nonthyroidal illness syndrome in chronic kidney diseases.

    PubMed

    Xu, Gaosi; Yan, Wenjun; Li, Jingzhen

    2014-12-01

    Nonthyroidal illness syndrome (NTIS) is widely found in the patients with chronic kidney disease (CKD) or critical illness. However, the exact pathogenesis and reasonable treatment remain unclear. To identify suitable studies for inclusion in present review, a search for articles using PubMed search engine with combined terms: (thyroid OR hypothyroidism OR hyperthyroidism OR triiodothyronine) AND (glomerulonephritis OR chronic kidney disease OR chronic renal failure OR end stage renal disease OR hemodialysis OR peritoneal dialysis OR kidney transplantation OR renal transplantation) was performed. The bibliographies of relevant articles were also hand searched. The search was updated on November 8, 2013. Mechanisms for the alternations of thyroid hormone concentrations in NTIS are complicated. Inflammatory cytokines and oxidative stress may play pivotal roles in the pathogenesis of NTIS in patients with CKD. It was controversial whether CKD patients with NTIS should be treated with thyroid hormone replacement. N-Acetyl cysteine or sodium bicarbonate may negatively regulate the progress of micro-inflammation in CKD. Large-scale, multi-centered randomized controlled trials should be conducted to verify the NTIS hypothesis in CKD patients.

  17. The minimal important difference for measures of urticaria disease activity: Updated findings.

    PubMed

    Mathias, Susan D; Crosby, Ross D; Rosén, Karin E; Zazzali, James L

    2015-01-01

    The Urticaria Patient Daily Diary (UPDD) is a validated patient-reported outcome that captures key measures of urticaria disease activity. To update estimates of the minimal important difference (MID) for urticaria disease activity measures in the UPDD, including the weekly itch severity score, weekly number of hives score, weekly average size of largest hive score, and the composite measure of itch severity and number of hives over 7 days, or urticaria activity score 7 (UAS7). A total of 975 subjects with chronic idiopathic urticaria from three randomized, double-blind, placebo-controlled studies completed the UPDD and other patient-reported outcome assessments (the Dermatology Life Quality Index, Medical Outcomes Study Sleep Scale, the Chronic Urticaria Quality-of-Life Questionnaire, the EuroQoL-5 Dimension Questionnaire) multiple times. MIDs were estimated through a combination of distribution- and anchor-based methods. MID estimates ranged from 4.5 to 5.0 for the weekly itch severity score, 5.0 to 5.5 for weekly hives count score, 9.5 to 10.5 for the UAS7, and 4.0 to 4.5 for the weekly size of the largest hive score. This analysis provided confirmation of the previous MID estimates for the urticaria disease activity measures in the UPDD.

  18. An updated meta-analysis of amantadine for treating dyskinesia in Parkinson's disease

    PubMed Central

    Ren, Chao; Yu, Ling; Dong, Shengjie; Yu, Guoping; Liang, Hui

    2017-01-01

    In recent years, a few of randomized controlled trials (RCTs) about amantadine for treating dyskinesia in Parkinson's disease (PD) were completed. Here, we conducted a systematic literature review about the clinical research to provide the updated evidence for treating dyskinesia. Electronic search of Medline, PubMed, Cochrane Library, and other databases up to May 2016 for relevant studies was performed. We selected the Unified Parkinson's Disease Rating Scale IV (UPDRS IV) and Dyskinesia Rating Scales (DRS) as efficacy outcomes of amantadine on dyskinesia. Pooled data from included studies was then used to carry out meta-analysis. A total of eleven eligible RCTs that involved 356 PD patients with existing dyskinesia were included in the present study. The results of meta-analysis showed that amantadine significantly improved UPDRS IV (P < 0.0001) and DRS (P < 0.00001). Meanwhile, there was a mild reduction in Unified Parkinson's Disease Rating Scale III after amantadine treatment in advanced PD patients with dyskinesia (P = 0.01) compared with placebo. High dosage of amantadine obviously improved existing dyskinesia in PD, yet at the expense of the increased adverse events. It was necessary to detect the optimal therapeutic efficacy to balance the incidence of adverse events when we used amantadine to treat existing dyskinesia in PD patients. PMID:28915672

  19. Non-communicable diseases in South Asia: contemporary perspectives

    PubMed Central

    Siegel, Karen R.; Patel, Shivani A.; Ali, Mohammed K.

    2014-01-01

    Introduction Non-communicable diseases (NCDs) such as metabolic, cardiovascular, cancers, injuries and mental health disorders are increasingly contributing to the disease burden in South Asia, in light of demographic and epidemiologic transitions in the region. Home to one-quarter of the world's population, the region is also an important priority area for meeting global health targets. In this review, we describe the current burden of and trends in four common NCDs (cardiovascular disease, diabetes, cancer and chronic obstructive pulmonary disease) in South Asia. Sources of data The 2010 Global Burden of Disease Study supplemented with the peer-reviewed literature and reports by international agencies and national governments. Areas of agreement The burden of NCDs in South Asia is rising at a rate that exceeds global increases in these conditions. Shifts in leading risk factors—particularly dietary habits, tobacco use and high blood pressure—are thought to underlie the mounting burden of death and disability due to NCDs. Improvements in life expectancy, increasing socioeconomic development and urbanization in South Asia are expected to lead to further escalation of NCDs. Areas of controversy Although NCD burdens are currently largest among affluent groups in South Asia, many adverse risk factors are concentrated among the poor, portending a future increase in disease burden among lower income individuals. Growing points There continues to be a notable lack of national surveillance data to document the distribution and trends in NCDs in the region. Similarly, economic studies and policy initiatives addressing NCD burdens are still in their infancy. Areas timely for developing research Opportunities for innovative structural and behavioral interventions that promote maintenance of healthy lifestyles—such as moderate caloric intake, adequate physical activity and avoidance of tobacco—in the context of socioeconomic development are abundant. Testing of health

  20. Placing a Health Equity Lens on Non-communicable Diseases in sub-Saharan Africa.

    PubMed

    Dagadu, Helena E; Patterson, Evelyn J

    2015-08-01

    Deaths from non-communicable diseases are increasing worldwide. Low and middle-income countries, particularly those in sub-Saharan Africa (SSA), are projected to see the most rapid increase over the next two decades. While non-communicable diseases such as diabetes and cardiovascular disease increasingly contribute to mortality in SSA, communicable diseases such as malaria and HIV/AIDS remain major causes of death in this region, leading to a double burden of disease. In this paper, we use World Health Organization data and life table techniques to: (1) delineate the magnitude and toll of the double burden of disease in four SSA countries: Ghana, Gabon, Botswana, and Kenya, and (2) scrutinize assumptions linking changes in disease patterns to economic development and modernization. Our findings suggest that non-communicable and communicable diseases warrant equal research attention and financial commitment in pursuit of health equity.

  1. 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…

  2. Priority actions for the non-communicable disease crisis.

    PubMed

    Beaglehole, Robert; Bonita, Ruth; Horton, Richard; Adams, Cary; Alleyne, George; Asaria, Perviz; Baugh, Vanessa; Bekedam, Henk; Billo, Nils; Casswell, Sally; Cecchini, Michele; Colagiuri, Ruth; Colagiuri, Stephen; Collins, Tea; Ebrahim, Shah; Engelgau, Michael; Galea, Gauden; Gaziano, Thomas; Geneau, Robert; Haines, Andy; Hospedales, James; Jha, Prabhat; Keeling, Ann; Leeder, Stephen; Lincoln, Paul; McKee, Martin; Mackay, Judith; Magnusson, Roger; Moodie, Rob; Mwatsama, Modi; Nishtar, Sania; Norrving, Bo; Patterson, David; Piot, Peter; Ralston, Johanna; Rani, Manju; Reddy, K Srinath; Sassi, Franco; Sheron, Nick; Stuckler, David; Suh, Il; Torode, Julie; Varghese, Cherian; Watt, Judith

    2011-04-23

    The UN High-Level Meeting on Non-Communicable Diseases (NCDs) in September, 2011, is an unprecedented opportunity to create a sustained global movement against premature death and preventable morbidity and disability from NCDs, mainly heart disease, stroke, cancer, diabetes, and chronic respiratory disease. The increasing global crisis in NCDs is a barrier to development goals including poverty reduction, health equity, economic stability, and human security. The Lancet NCD Action Group and the NCD Alliance propose five overarching priority actions for the response to the crisis--leadership, prevention, treatment, international cooperation, and monitoring and accountability--and the delivery of five priority interventions--tobacco control, salt reduction, improved diets and physical activity, reduction in hazardous alcohol intake, and essential drugs and technologies. The priority interventions were chosen for their health effects, cost-effectiveness, low costs of implementation, and political and financial feasibility. The most urgent and immediate priority is tobacco control. We propose as a goal for 2040, a world essentially free from tobacco where less than 5% of people use tobacco. Implementation of the priority interventions, at an estimated global commitment of about US$9 billion per year, will bring enormous benefits to social and economic development and to the health sector. If widely adopted, these interventions will achieve the global goal of reducing NCD death rates by 2% per year, averting tens of millions of premature deaths in this decade. Copyright © 2011 Elsevier Ltd. All rights reserved.

  3. 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

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

    PubMed Central

    Sawyer, Richard T.; Maier, Lisa A.

    2011-01-01

    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

  5. Traffic-related air pollution and allergic disease: an update in the context of global urbanization.

    PubMed

    Carlsten, Christopher; Rider, Christopher F

    2017-04-01

    The review aims to give an update on the literature around traffic-related air pollution (TRAP) and allergic disease in the context of global urbanization, as the most populous countries in the world face severe TRAP exposure challenges. As research continues to show that gene-environment interactions and epigenetics contribute to the TRAP-allergy link, evidence around the links to climate change grows. Greenspace may provide a buffer to adverse effects of traffic on health, overall, but pose risks in terms of allergic disease. The link between traffic-related pollution and allergy continues to strengthen, in terms of supportive observational findings and mechanistic studies. Levels of TRAP across the world, particularly in Asia, continue to dramatically exceed acceptable levels, suggesting that the related adverse health consequences will accelerate. This could be counterbalanced by primary emission control and urban planning. Attention to combined effects of TRAP and allergen exposure is critical to avoiding misleading inferences drawn though examination only of isolated factors.

  6. [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.

  7. 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

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

    PubMed

    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

    2011-07-12

    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.

  9. 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.

  10. 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,…

  11. State of non-communicable diseases in Nepal

    PubMed Central

    2014-01-01

    Background The prevalence of Non Communicable Diseases (NCDs) is still unknown in Nepal. The Ministry of Health and Population, Government of Nepal has not yet formulated policy regarding NCDs in the absence of evidence based finding. The study aims to find out the hospital based prevalence of NCDs in Nepal, thus directing the concerned authorities at policy level. Methods A cross sectional study was conducted to identify the hospital based prevalence of 4 NCDs (cancer, cardiovascular disease, diabetes mellitus and chronic obstructive pulmonary disease), wherein 400 indoor patients admitted during 2009 were randomly selected from each of the 31 selected health institutions which included all non-specialist tertiary level hospitals outside the Kathmandu valley (n = 25), all specialist tertiary level hospitals in the country (n = 3) and 3 non-specialist tertiary level hospitals inside the Kathmandu valley. In case of Kathmandu valley, 3 non-specialist health institutions- one central hospital, one medical college and one private hospital were randomly selected. The main analyses are based on the 28 non-specialist hospitals. Univariate (frequency and percentage) and bivariate (cross-tabulation) analysis were used. Results In non-specialist institutions, the hospital based NCD prevalence was 31%. Chronic obstructive pulmonary disease (43%) was the most common NCD followed by cardiovascular disease (40%), diabetes mellitus (12%) and cancer (5%). Ovarian (14%), stomach (14%) and lung cancer (10%) were the main cancers accounting for 38% of distribution. Majority of CVD cases were hypertension (47%) followed by cerebrovascular accident (16%), congestive cardiac failure (11%), ischemic heart disease (7%), rheumatic heart disease (5%) and myocardial infarction (2%). CVD was common in younger age groups while COPD in older age groups. Majority among males (42%) and females (45%) were suffering from COPD. Conclusions The study was able to reveal that Nepal is also

  12. 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

  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. 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…

  15. A mixed treatment meta-analysis of antibiotic treatment options for bovine respiratory disease - An update.

    PubMed

    O'Connor, A M; Yuan, C; Cullen, J N; Coetzee, J F; da Silva, N; Wang, C

    2016-09-15

    Bovine respiratory disease is the most economically important disease of feedlot cattle in North America. Choice of antibiotic is a critical factor for producers and veterinarians. We previously published a mixed-treatment comparison meta-analysis that combined evidence from published trials and published estimates of comparative efficacy for 12 antibiotics registered for use in the USA. Some of the comparative efficacy estimates were based only on indirect evidence. Since the original review was published, new studies that provide direct evidence of comparative efficacy have been published. We updated the original review to include the current evidence. We also compared the results from the indirect estimates from the prior model with the observed results from randomized control trials. We repeated the original search and found that five of the new studies met the criteria for inclusion in the updated review. Four of these studies provided new data on direct comparisons of active drugs. The results from one study (performed in 2002) that compared ceftiofur pinna and enrofloxacin were inconsistent with the network and were excluded from the analysis. Three new direct comparison studies examined gamithromycin compared with tulathromycin, florfenicol, and tilmicosin. The results of our analysis suggested that the indirect estimates from the prior model provided reasonable estimates of the risk ratios revealed by the primary studies. For example, for the comparison of gamithromycin (referent) with tulathromycin, the original model predicted a risk ratio of re-treatment of 0.54 (95% credible interval 0.27-0.87). The subsequent randomized controlled trial revealed that the observed risk ratio of re-treatment was 0.59 (95% confidence interval 0.45-0.78). The results of other comparisons were also similar. For the gamithromycin (referent) to florfenicol comparison, the observed randomized trial RR was 1.17 (95% confidence interval 0.83-1.64) and the indirect estimate of

  16. 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

  17. 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

  18. 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

  19. 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.

  20. 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.

  1. Inequalities in non-communicable diseases and effective responses.

    PubMed

    Di Cesare, Mariachiara; Khang, Young-Ho; Asaria, Perviz; Blakely, Tony; Cowan, Melanie J; Farzadfar, Farshad; Guerrero, Ramiro; Ikeda, Nayu; Kyobutungi, Catherine; Msyamboza, Kelias P; Oum, Sophal; Lynch, John W; Marmot, Michael G; Ezzati, Majid

    2013-02-16

    In most countries, people who have a low socioeconomic status and those who live in poor or marginalised communities have a higher risk of dying from non-communicable diseases (NCDs) than do more advantaged groups and communities. Smoking rates, blood pressure, and several other NCD risk factors are often higher in groups with low socioeconomic status than in those with high socioeconomic status; the social gradient also depends on the country's stage of economic development, cultural factors, and social and health policies. Social inequalities in risk factors account for more than half of inequalities in major NCDs, especially for cardiovascular diseases and lung cancer. People in low-income countries and those with low socioeconomic status also have worse access to health care for timely diagnosis and treatment of NCDs than do those in high-income countries or those with higher socioeconomic status. Reduction of NCDs in disadvantaged groups is necessary to achieve substantial decreases in the total NCD burden, making them mutually reinforcing priorities. Effective actions to reduce NCD inequalities include equitable early childhood development programmes and education; removal of barriers to secure employment in disadvantaged groups; comprehensive strategies for tobacco and alcohol control and for dietary salt reduction that target low socioeconomic status groups; universal, financially and physically accessible, high-quality primary care for delivery of preventive interventions and for early detection and treatment of NCDs; and universal insurance and other mechanisms to remove financial barriers to health care.

  2. Non-Communicable Disease Preventive Screening by HIV Care Model

    PubMed Central

    Rhodes, Corinne M.; Chang, Yuchiao; Regan, Susan; Triant, Virginia A.

    2017-01-01

    Importance The Human Immunodeficiency Virus (HIV) epidemic has evolved, with an increasing non-communicable disease (NCD) burden emerging and need for long-term management, yet there are limited data to help delineate the optimal care model to screen for NCDs for this patient population. Objective The primary aim was to compare rates of NCD preventive screening in persons living with HIV/AIDS (PLWHA) by type of HIV care model, focusing on metabolic/cardiovascular disease (CVD) and cancer screening. We hypothesized that primary care models that included generalists would have higher preventive screening rates. Design Prospective observational cohort study. Setting Partners HealthCare System (PHS) encompassing Brigham & Women’s Hospital, Massachusetts General Hospital, and affiliated community health centers. Participants PLWHA age >18 engaged in active primary care at PHS. Exposure HIV care model categorized as infectious disease (ID) providers only, generalist providers only, or ID plus generalist providers. Main Outcome(s) and Measures(s) Odds of screening for metabolic/CVD outcomes including hypertension (HTN), obesity, hyperlipidemia (HL), and diabetes (DM) and cancer including colorectal cancer (CRC), cervical cancer, and breast cancer. Results In a cohort of 1565 PLWHA, distribution by HIV care model was 875 ID (56%), 90 generalists (6%), and 600 ID plus generalists (38%). Patients in the generalist group had lower odds of viral suppression but similar CD4 counts and ART exposure as compared with ID and ID plus generalist groups. In analyses adjusting for sociodemographic and clinical covariates and clustering within provider, there were no significant differences in metabolic/CVD or cancer screening rates among the three HIV care models. Conclusions There were no notable differences in metabolic/CVD or cancer screening rates by HIV care model after adjusting for sociodemographic and clinical factors. These findings suggest that HIV patients receive similar

  3. Non-Communicable Disease Preventive Screening by HIV Care Model.

    PubMed

    Rhodes, Corinne M; Chang, Yuchiao; Regan, Susan; Triant, Virginia A

    2017-01-01

    The Human Immunodeficiency Virus (HIV) epidemic has evolved, with an increasing non-communicable disease (NCD) burden emerging and need for long-term management, yet there are limited data to help delineate the optimal care model to screen for NCDs for this patient population. The primary aim was to compare rates of NCD preventive screening in persons living with HIV/AIDS (PLWHA) by type of HIV care model, focusing on metabolic/cardiovascular disease (CVD) and cancer screening. We hypothesized that primary care models that included generalists would have higher preventive screening rates. Prospective observational cohort study. Partners HealthCare System (PHS) encompassing Brigham & Women's Hospital, Massachusetts General Hospital, and affiliated community health centers. PLWHA age >18 engaged in active primary care at PHS. HIV care model categorized as infectious disease (ID) providers only, generalist providers only, or ID plus generalist providers. Odds of screening for metabolic/CVD outcomes including hypertension (HTN), obesity, hyperlipidemia (HL), and diabetes (DM) and cancer including colorectal cancer (CRC), cervical cancer, and breast cancer. In a cohort of 1565 PLWHA, distribution by HIV care model was 875 ID (56%), 90 generalists (6%), and 600 ID plus generalists (38%). Patients in the generalist group had lower odds of viral suppression but similar CD4 counts and ART exposure as compared with ID and ID plus generalist groups. In analyses adjusting for sociodemographic and clinical covariates and clustering within provider, there were no significant differences in metabolic/CVD or cancer screening rates among the three HIV care models. There were no notable differences in metabolic/CVD or cancer screening rates by HIV care model after adjusting for sociodemographic and clinical factors. These findings suggest that HIV patients receive similar preventive health care for NCDs independent of HIV care model.

  4. Minamata disease revisited: an update on the acute and chronic manifestations of methyl mercury poisoning.

    PubMed

    Ekino, Shigeo; Susa, Mari; Ninomiya, Tadashi; Imamura, Keiko; Kitamura, Toshinori

    2007-11-15

    The first well-documented outbreak of acute methyl mercury (MeHg) poisoning by consumption of contaminated fish occurred in Minamata, Japan, in 1953. The clinical picture was officially recognized and called Minamata disease (MD) in 1956. However, 50 years later there are still arguments about the definition of MD in terms of clinical symptoms and extent of lesions. We provide a historical review of this epidemic and an update of the problem of MeHg toxicity. Since MeHg dispersed from Minamata to the Shiranui Sea, residents living around the sea were exposed to low-dose MeHg through fish consumption for about 20 years (at least from 1950 to 1968). These patients with chronic MeHg poisoning continue to complain of distal paresthesias of the extremities and the lips even 30 years after cessation of exposure to MeHg. Based on findings in these patients the symptoms and lesions in MeHg poisoning are reappraised. The persisting somatosensory disorders after discontinuation of exposure to MeHg were induced by diffuse damage to the somatosensory cortex, but not by damage to the peripheral nervous system, as previously believed.

  5. 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

  6. 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.

  7. 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.

  8. 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

  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. Updated French guidelines for diagnosis and management of pelvic inflammatory disease.

    PubMed

    Brun, Jean-Luc; Graesslin, Olivier; Fauconnier, Arnaud; Verdon, Renaud; Agostini, Aubert; Bourret, Antoine; Derniaux, Emilie; Garbin, Olivier; Huchon, Cyrille; Lamy, Catherine; Quentin, Roland; Judlin, Philippe

    2016-08-01

    Pelvic inflammatory disease (PID) is commonly encountered in clinical practice. To provide up-to-date guidelines on management of PID. An initial search of the Cochrane database, PubMed, and Embase was performed using keywords related to PID to identify reports in any language published between January 1990 and January 2012, with an update in May 2015. All identified reports relevant to the areas of focus were included. A level of evidence based on the quality of the data available was applied for each area of focus and used for the guidelines. PID must be suspected when spontaneous pelvic pain is associated with induced adnexal or uterine pain (grade C). Pelvic ultrasonography is necessary to exclude tubo-ovarian abscess (grade B). Microbiological diagnosis requires vaginal and endocervical sampling for molecular and bacteriological analysis (grade B). First-line treatment for uncomplicated PID combines ofloxacin and metronidazole for 14days (grade B). Treatment of tubo-ovarian abscess is based on drainage if the collection measures more than 3cm (grade B), with combined ceftriaxone, metronidazole, and doxycycline for 14-21days. Current management of PID requires easily reproducible investigations and treatment, and thus can be applied worldwide. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  11. Optimal ECG Electrode Sites and Criteria for Detection of Asymptomatic Coronary Artery Disease - Update 1990. Multilead ECG Changes at Rest, with Exercise, and with Coronary Angioplasty

    DTIC Science & Technology

    1992-02-01

    AD-A248 613 OPTIMAL ECG ELECTRODE SITES AND CRITERIA CORONARY ARTERY DISEASE -UPDATE 1990 MULILEAD ECG CHANGES AT REST, WITH A EXERCISE, AND WITH...5. FUNDING NUMBERS Optimal ECG Electrode Sites and Criteria for Detection of Asymptomatic C - F33615-87-D-0609/0023 Coronary Artery Disease --Update...improve the detection of asymptomatic coronary disease . Three ECG recording systems with signal processing of 30 simultaneous leads (30SL) have been

  12. National disease management plans for key chronic non-communicable diseases in Singapore.

    PubMed

    Tan, C C

    2002-07-01

    In Singapore, chronic, non-communicable diseases, namely coronary heart disease, stroke and cancer, account for more than 60% of all deaths and a high burden of disability and healthcare expenditure. The burden of these diseases is likely to rise with our rapidly ageing population and changing lifestyles, and will present profound challenges to our healthcare delivery and financing systems over the next 20 to 30 years. The containment and optimal management of these conditions require a strong emphasis on patient education and the development of integrated models of healthcare delivery in place of the present uncoordinated, compartmentalised way of delivering healthcare. To meet these challenges, the Ministry of Health's major thrusts are disease control measures which focus mainly on primary prevention; and disease management, which coordinates the national effort to reduce the incidence of these key diseases and their predisposing factors and to ameliorate their long-term impact by optimising control to reduce mortality, morbidity and complications, and improving functional status through rehabilitation. The key initiatives include restructuring of the public sector healthcare institutions into two clusters, each comprising a network of primary health care polyclinics, regional hospitals and tertiary institutions. The functional integration of these healthcare elements within each cluster under a common senior administrative and professional management, and the development of common clinical IT systems will greatly facilitate the implementation of disease management programmes. Secondly, the Ministry is establishing National Disease Registries in coronary heart disease, cancer, stroke, myopia and kidney failure, which will be valuable sources of clinical and outcomes data. Thirdly, in partnership with expert groups, national committees and professional agencies, the Ministry will produce clinical practice guidelines which will assist doctors and healthcare

  13. Communicative strategies used by spouses of individuals with communication disorders related to stroke-induced aphasia and Parkinson's disease.

    PubMed

    Carlsson, Emilia; Hartelius, Lena; Saldert, Charlotta

    2014-11-01

    A communicative disability interferes with the affected person's ability to take active part in social interaction, but non-disabled communication partners may use different strategies to support communication. However, it is not known whether similar strategies can be used to compensate for different types of communicative disabilities, nor what factors contribute to the development of a particular approach by communication partners. To develop a set of categories to describe the strategies used by communication partners of adults who have problems expressing themselves due to neurogenic communicative disabilities. The reliability of assessment was a particular focus. The material explored consisted of 21 video-recorded everyday conversations involving seven couples where one spouse had a communicative disability. Three of the dyads included a person with dysarthria and anomia related to later stages of Parkinson's disease, while four of them included a person with stroke-induced aphasia involving anomia. First a qualitative interaction analysis was performed to explore the strategies used by the communication partners when their spouses had problems expressing themselves. The strategies were then categorized, the reliability of the categorizations was explored and the relative frequency of the various strategies was examined. The analysis of the conversational interactions resulted in a set of nine different strategies used by the communication partners without a communicative disability. Each of these categories belonged to one of three overall themes: No participation in repair; Request for clarification or modification; and Providing candidate solutions. The reliability of the categorization was satisfactory. There were no statistically significant differences between diagnoses in the frequency of use of strategies, but the spouses of the persons with Parkinson's disease tended to use open-class initiations of repair more often than the spouses of the persons

  14. German guideline on the diagnosis and treatment of peripheral artery disease - a comprehensive update 2016.

    PubMed

    Lawall, Holger; Huppert, Peter; Espinola-Klein, Christine; Zemmrich, Claudia Silke; Ruemenapf, Gerhard

    2017-03-01

    The prevalence of peripheral artery disease (PAD) is increasing worldwide and is strongly age-related, affecting about 20 % of Germans over 70 years of age. Recent advances in endovascular and surgical techniques as well as clinical study results on comparative treatment methods strengthened the need for a comprehensive review of the published evidence for diagnosis, management, and prevention of PAD. The interdisciplinary guideline exclusively covers distal aorta and atherosclerotic lower extremity artery disease. A systematic literature review and formal consensus finding process, including delegated members of 22 medical societies and two patient self-support organisations were conducted and supervised by the Association of Scientific Medical Societies in Germany, AWMF. Three levels of recommendation were defined, A = "is recommended/indicated", B = "should be considered", C = "may be considered", means agreement of expert opinions due to lack of evidence. Altogether 294 articles, including 34 systematic reviews and 98 RCTs have been analysed. The key diagnostic tools and treatment basics have been defined. In patients with intermittent claudication endovascular and/or surgical techniques are treatment options depending on appropriate individual morphology and patient preference. In critical limb ischaemia, revascularisation without delay by means of the most appropriate technique is key. If possible and reasonable, endovascular procedures should be applied first. The TASC classification is no longer recommended as the base of therapeutic decision process due to advances in endovascular techniques and new crural therapeutic options. Limited new data on rehabilitation and follow-up therapies have been integrated. The article summarises major new aspects of PAD treatment from the updated German Guidelines for Diagnosis and Treatment of PAD. Limited scientific evidence still calls for randomised clinical trials to close the present gap of evidence.

  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.

  16. Mortality from cardiovascular and cerebrovascular diseases in Europe and other areas of the world: an update.

    PubMed

    Levi, Fabio; Chatenoud, Liliane; Bertuccio, Paola; Lucchini, Francesca; Negri, Eva; La Vecchia, Carlo

    2009-06-01

    To update trends in mortality from coronary heart diseases (CHD) and cerebrovascular diseases (CVD) over the period 1981-2004 in Europe, the USA, Latin America, Japan and other selected areas of the world. Age-standardized mortality rates were derived from the World Health Organization database. Joinpoint analysis was used to identify significant changes in trends. In the European Union (27 countries), CHD mortality in men declined from 139/100,000 in 1985-1989 to 93/100,000 in 2000-2004 (-33%). In women, the fall was from 61/100,000 to 44/100,000 (-27%). In this area, a decline by over 30% was also registered in CVD mortality for both sexes. In the Russian Federation and other countries of the former Soviet Union, CHD rates in 2000-2004 were exceedingly high, around 380/100,000 men and 170/100,000 women in Russia, 430 for men and 240 for women in Ukraine, 420 and 200 in Belarus. For CVD, a similar situation was registered, with mortality rates of 226/100,000 for men and 159/100,000 for women in 2004 in the Russian Federation, and more than 24% increase since the late 1980s for men and 15% for women. CHD and CVD mortality continued to decline in most Latin American countries, Australia and other areas considered, including Asia (even if with marked differences). Although mortality from CHD and CVD continues to decline in several areas of the world including most countries of Europe and of the America providing data and Australia, unfavourable trends were still observed in the Russian Federation and other countries of the former Soviet Union, whose recent rates remain exceedingly high.

  17. 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

  18. 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. © 2016 Blackwell Verlag GmbH.

  19. [Bone and calcium update; diagnosis and therapy of bone metabolism disease update. Molecular mechanism in cardiac valve calcification].

    PubMed

    Furukawa, Ken-Ichi; Motomura, Shigeru

    2011-12-01

    When cardiac valve stenosis is accompanied by calcification, symptoms and prognosis become much worse and may cause sudden cardiac death. The prevalence of this disease has increased with the rapidly aging in Japanese society. It has recently been revealed that several genes which relate to physiological ossification and calcification play important roles in this process. To find a suitable target for medical treatment, the molecular mechanism for calcification of cardiac valves should be elucidated in detail. In this review, we summarize the current knowledge on the pathology and molecular mechanism for ectopic calcification of the cardiac valve.

  20. 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

  1. 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…

  2. 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…

  3. 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…

  4. Guideline for the management of chronic obstructive pulmonary disease--2011 update.

    PubMed

    Abdool-Gaffar, M S; Ambaram, A; Ainslie, G M; Bolliger, C T; Feldman, C; Geffen, L; Irusen, E M; Joubert, J; Lalloo, U G; Mabaso, T T; Nyamande, K; O'Brien, J; Otto, W; Raine, R; Richards, G; Smith, C; Stickells, D; Venter, A; Visser, S; Wong, M

    2011-01-01

    To revise the South African Guideline for the Management of Chronic Obstructive Pulmonary Disease (COPD) based on emerging research that has informed updated recommendations. (1) Smoking is the major cause of COPD, but exposure to biomass fuels and tuberculosis are important additional factors. (2) Spirometry is essential for the diagnosis and staging of COPD. (3) COPD is either undiagnosed or diagnosed too late, so limiting the benefit of therapeutic interventions; performing spirometry in at-risk individuals will help to establish an early diagnosis. (4) Oral corticosteroids are no longer recommended for maintenance treatment of COPD. (5) A therapeutic trial of oral corticosteroids to distinguish corticosteroid responders from non-responders is no longer recommended. (6) Primary and secondary prevention are the most cost-effective strategies in COPD. Smoking cessation as well as avoidance of other forms of pollution can prevent disease in susceptible individuals and ameliorate progression. Bronchodilators are the mainstay of pharmacotherapy, relieving dyspnoea and improving quality of life. (7) Inhaled corticosteroids are recommended in patients with frequent exacerbations and have a synergistic effect with bronchodilators in improving lung function, quality of life and exacerbation frequency. (8) Acute exacerbations of COPD significantly affect morbidity, health care units and mortality. (9) Antibiotics are only indicated for purulent exacerbations of chronic bronchitis. (10) COPD patients should be encouraged to engage in an active lifestyle and participate in rehabilitation programmes. Treatment recommendations are based on the following: annual updates of the Global Obstructive Lung Disease (GOLD), initiative, that provide an evidence-based comprehensive review of management; independent evaluation of the level of evidence in support of some of the new treatment trends; and consideration of factors that influence COPD management in South Africa, including

  5. Preventing non-communicable disease in Oman, a legislative review.

    PubMed

    Al-Bahlani, Sabah; Mabry, Ruth

    2014-06-01

    The burden of non-communicable disease (NCD) is a major global concern and is projected to increase by 15% over the next 10 years. NCD is the leading cause of mortality in Oman and other countries of the Gulf Cooperation Council (GCC). Some of the most successful interventions to address NCD include legislations like banning smoking in public places. A desk review of available policies and legislations related to the behavioural risk factors of NCD from the GCC and from Oman was conducted with a focus on policies and legislations related to food, physical activity and tobacco. The review identified numerous documents; most were policies and resolutions related to tobacco control. Although only a few documents were laws, a majority were issued by non-health sectors. This policy review is the first effort in the GCC to consolidate information on the regulatory framework for the three key risk behaviours in the region, tobacco use, unhealthy diet and physical inactivity. Further work is needed to strengthen the regulatory framework, at both the national and regional levels, to strengthen tobacco control as well as to improve dietary patterns and physical activity levels. Given that a bulk of laws, regulations and policies are beyond the scope of the health sector, significant advocacy efforts are required to generate a multisectoral response.

  6. 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

  7. Glycogen storage diseases: a brief review and update on clinical features, genetic abnormalities, pathologic features, and treatment.

    PubMed

    Hicks, John; Wartchow, Eric; Mierau, Gary

    2011-10-01

    Glycogen storage diseases (GSD) affect primarily the liver, skeletal muscle, heart, and sometimes the central nervous system and the kidneys. These unique diseases are quite varied in age of onset of symptoms, morbidity, and mortality. Glycogen storage diseases are classified according to their individual enzyme deficiency. Each of these enzymes regulates synthesis or degradation of glycogen. Interestingly, there is great phenotypic variation and variable clinical courses even when a specific enzyme is altered by mutation. Depending on the specific mutation in an enzyme, a GSD patient may have a favorable or unfavorable prognosis. With neonatal or infantile forms, some GSDs lead to death within the first year of life, whereas other glycogen storage diseases are relatively asymptomatic or may cause only exercise intolerance. The paper provides a brief review and update of glycogen storage diseases, with respect to clinical features, genetic abnormalities, pathologic features, and treatment.

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

    PubMed

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

    2016-08-15

    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. 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. 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. 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. avaliar a relação entre as faltas em consultas agendadas e o número de doenças crônicas não transmissíveis e averiguar a relação entre distribuição espacial dessas doenças e vulnerabilidade social, utilizando-se o geoprocessamento. estudo quantitativo, de abordagem mista sequencial, sendo analisados 158 prontuários de usuários do sexo masculino para se relacionar as faltas e 1250 prontuários para o geoprocessamento. quanto maior o número de faltas nas consultas médicas agendadas, menores foram a quantidade de doenças crônicas não transmissíveis e as listadas na Classificação Internacional de

  9. National mortality burden due to communicable, non-communicable, and other diseases in Ethiopia, 1990-2015: findings from the Global Burden of Disease Study 2015.

    PubMed

    Misganaw, Awoke; Haregu, Tilahun N; Deribe, Kebede; Tessema, Gizachew Assefa; Deribew, Amare; Melaku, Yohannes Adama; Amare, Azmeraw T; Abera, Semaw Ferede; Gedefaw, Molla; Dessalegn, Muluken; Lakew, Yihunie; Bekele, Tolesa; Mohammed, Mesoud; Yirsaw, Biruck Desalegn; Damtew, Solomon Abrha; Krohn, Kristopher J; Achoki, Tom; Blore, Jed; Assefa, Yibeltal; Naghavi, Mohsen

    2017-01-01

    Ethiopia lacks a complete vital registration system that would assist in measuring disease burden and risk factors. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015) estimates to describe the mortality burden from communicable, non-communicable, and other diseases in Ethiopia over the last 25 years. GBD 2015 mainly used cause of death ensemble modeling to measure causes of death by age, sex, and year for 195 countries. We report numbers of deaths and rates of years of life lost (YLL) for communicable, maternal, neonatal, and nutritional (CMNN) disorders, non-communicable diseases (NCDs), and injuries with 95% uncertainty intervals (UI) for Ethiopia from 1990 to 2015. CMNN causes of death have declined by 65% in the last two-and-a-half decades. Injury-related causes of death have also decreased by 70%. Deaths due to NCDs declined by 37% during the same period. Ethiopia showed a faster decline in the burden of four out of the five leading causes of age-standardized premature mortality rates when compared to the overall sub-Saharan African region and the Eastern sub-Saharan African region: lower respiratory infections, tuberculosis, HIV/AIDS, and diarrheal diseases; however, the same could not be said for ischemic heart disease and other NCDs. Non-communicable diseases, together, were the leading causes of age-standardized mortality rates, whereas CMNN diseases were leading causes of premature mortality in 2015. Although lower respiratory infections, tuberculosis, and diarrheal disease were the leading causes of age-standardized death rates, they showed major declines from 1990 to 2015. Neonatal encephalopathy, iron-deficiency anemia, protein-energy malnutrition, and preterm birth complications also showed more than a 50% reduction in burden. HIV/AIDS-related deaths have also decreased by 70% since 2005. Ischemic heart disease, hemorrhagic stroke, and ischemic stroke were among the top causes of premature mortality and age

  10. National mortality burden due to communicable, non-communicable, and other diseases in Ethiopia, 1990-2015: findings from the Global Burden of Disease Study 2015.

    PubMed

    Misganaw, Awoke; Haregu, Tilahun N; Deribe, Kebede; Tessema, Gizachew Assefa; Deribew, Amare; Melaku, Yohannes Adama; Amare, Azmeraw T; Abera, Semaw Ferede; Gedefaw, Molla; Dessalegn, Muluken; Lakew, Yihunie; Bekele, Tolesa; Mohammed, Mesoud; Yirsaw, Biruck Desalegn; Damtew, Solomon Abrha; Krohn, Kristopher J; Achoki, Tom; Blore, Jed; Assefa, Yibeltal; Naghavi, Mohsen

    2017-07-21

    Ethiopia lacks a complete vital registration system that would assist in measuring disease burden and risk factors. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015) estimates to describe the mortality burden from communicable, non-communicable, and other diseases in Ethiopia over the last 25 years. GBD 2015 mainly used cause of death ensemble modeling to measure causes of death by age, sex, and year for 195 countries. We report numbers of deaths and rates of years of life lost (YLL) for communicable, maternal, neonatal, and nutritional (CMNN) disorders, non-communicable diseases (NCDs), and injuries with 95% uncertainty intervals (UI) for Ethiopia from 1990 to 2015. CMNN causes of death have declined by 65% in the last two-and-a-half decades. Injury-related causes of death have also decreased by 70%. Deaths due to NCDs declined by 37% during the same period. Ethiopia showed a faster decline in the burden of four out of the five leading causes of age-standardized premature mortality rates when compared to the overall sub-Saharan African region and the Eastern sub-Saharan African region: lower respiratory infections, tuberculosis, HIV/AIDS, and diarrheal diseases; however, the same could not be said for ischemic heart disease and other NCDs. Non-communicable diseases, together, were the leading causes of age-standardized mortality rates, whereas CMNN diseases were leading causes of premature mortality in 2015. Although lower respiratory infections, tuberculosis, and diarrheal disease were the leading causes of age-standardized death rates, they showed major declines from 1990 to 2015. Neonatal encephalopathy, iron-deficiency anemia, protein-energy malnutrition, and preterm birth complications also showed more than a 50% reduction in burden. HIV/AIDS-related deaths have also decreased by 70% since 2005. Ischemic heart disease, hemorrhagic stroke, and ischemic stroke were among the top causes of premature mortality and age

  11. Communications Technology and Motor Neuron Disease: An Australian Survey of People With Motor Neuron Disease.

    PubMed

    Mackenzie, Lynette; Bhuta, Prarthna; Rusten, Kim; Devine, Janet; Love, Anna; Waterson, Penny

    2016-01-25

    People with Motor Neuron Disease (MND), of which amyotrophic lateral sclerosis (ALS) is the most common form in adults, typically experience difficulties with communication and disabilities associated with movement. Assistive technology is essential to facilitate everyday activities, promote social support and enhance quality of life. This study aimed to explore the types of mainstream and commonly available communication technology used by people with MND including software and hardware, to identify the levels of confidence and skill that people with MND reported in using technology, to determine perceived barriers to the use of technology for communication, and to investigate the willingness of people with MND to adopt alternative modes of communication. An on-line survey was distributed to members of the New South Wales Motor Neuron Disease Association (MND NSW). Descriptive techniques were used to summarize frequencies of responses and cross tabulate data. Free-text responses to survey items and verbal comments from participants who chose to undertake the survey by telephone were analyzed using thematic analysis. Responses from 79 MND NSW members indicated that 15-21% had difficulty with speaking, writing and/or using a keyboard. Commonly used devices were desktop computers, laptops, tablets and mobile phones. Most participants (84%) were connected to the Internet and used it for email (91%), to find out more about MND (59%), to follow the news (50%) or for on-line shopping (46%). A third of respondents used Skype or its equivalent, but few used this to interact with health professionals. People with MND need greater awareness of technology options to access the most appropriate solutions. The timing for people with MND to make decisions about technology is critical. Health professionals need skills and knowledge about the application of technology to be able to work with people with MND to select the best communication technology options as early as possible

  12. Communications Technology and Motor Neuron Disease: An Australian Survey of People With Motor Neuron Disease

    PubMed Central

    2016-01-01

    Background People with Motor Neuron Disease (MND), of which amyotrophic lateral sclerosis (ALS) is the most common form in adults, typically experience difficulties with communication and disabilities associated with movement. Assistive technology is essential to facilitate everyday activities, promote social support and enhance quality of life. Objective This study aimed to explore the types of mainstream and commonly available communication technology used by people with MND including software and hardware, to identify the levels of confidence and skill that people with MND reported in using technology, to determine perceived barriers to the use of technology for communication, and to investigate the willingness of people with MND to adopt alternative modes of communication. Methods An on-line survey was distributed to members of the New South Wales Motor Neuron Disease Association (MND NSW). Descriptive techniques were used to summarize frequencies of responses and cross tabulate data. Free-text responses to survey items and verbal comments from participants who chose to undertake the survey by telephone were analyzed using thematic analysis. Results Responses from 79 MND NSW members indicated that 15-21% had difficulty with speaking, writing and/or using a keyboard. Commonly used devices were desktop computers, laptops, tablets and mobile phones. Most participants (84%) were connected to the Internet and used it for email (91%), to find out more about MND (59%), to follow the news (50%) or for on-line shopping (46%). A third of respondents used Skype or its equivalent, but few used this to interact with health professionals. Conclusions People with MND need greater awareness of technology options to access the most appropriate solutions. The timing for people with MND to make decisions about technology is critical. Health professionals need skills and knowledge about the application of technology to be able to work with people with MND to select the best

  13. Communicable disease policy development in response to changing European political frontiers in Finland, Norway and Sweden.

    PubMed

    Bernitz, Brita Kaltenbrunner

    2008-11-01

    The European Union (EU) enlargement of 2004 brings both opportunities and challenges for public health. It is believed that further integration will bring direct health benefits, mainly through improved socioeconomic conditions, but there are also risks associated with the EU expansion, in particular cross-border health risks, such as the impact of the internal EU market policy of free movement and migration on communicable disease patterns. Against this background, this article examines communicable disease policy development in Finland, Norway and Sweden in response to changing European political frontiers, in particular the EU accession of the Baltic States. The emphasis is on HIV/AIDS and tuberculosis. The study is based on a qualitative and quantitative approach, using two complementary methods: documentary analysis and stakeholder analysis. The article identifies a distinct pattern in communicable disease policy development between 1990 and 2005. The turn of the new millennium saw a sharp increase in national attention and the priority assigned to communicable diseases in Finland, Norway and Sweden. The article argues that this development is likely to be related to the rising national, regional and European awareness of the public health challenges associated with communicable diseases in today's borderless Europe. It also shows that the Baltic health situation is a particular concern for Finland. Although there is increasing national and regional activity within the communicable disease area, there is a need for a more effective European approach to tackle the future communicable disease challenges that may follow in an increasingly interdependent and integrated Europe.

  14. [Spanish Society of Clinical Microbiology and Infectious Diseases (SEIMC) guidelines for the diagnosis of invasive fungal infections. 2010 update].

    PubMed

    Ayats, Josefina; Martín-Mazuelos, Estrella; Pemán, Javier; Quindós, Guillermo; Sánchez, Fernando; García-Rodríguez, Julio; Guarro, Josep; Guinea, Jesús; Linares, María J; Pontón, José; Rodríguez-Tudela, Juan L; Cuenca-Estrella, Manuel

    2011-01-01

    These guidelines are an update of recommendations for the diagnosis of invasive fungal infections by the Spanish Society of Clinical Microbiology and Infectious Diseases (SEIMC) published in 2004 (Enferm Infecc Microbiol Clin. 2004, 22:32-9). In this updated version of the guidelines, a comprehensive review of the most recent diagnostic innovations and levels of evidence to recommend those diagnostic procedures are included. We first analyse conventional diagnostic methods, microscopic examination and culture, underlining their limitations which have led to the development of alternative methods, such as fungal antigen and DNA quantification. Those alternative methods of diagnosis are analysed by fungal infection. We also briefly review the methods for molecular identification of fungal species and recommendations for carrying out susceptibility tests for antifungal drugs, including reference procedures, commercial techniques and their indications.

  15. Designing a Biocontainment Unit to Care for Patients with Serious Communicable Diseases: A Consensus Statement

    DTIC Science & Technology

    2006-08-29

    emerging infectious diseases , such as multidrug-resistant tuberculosis, SARS, monkey- pox, hemorrhagic fever virus infection, avian influenza, and vancomycin...infectious agents who were working under BSL-4 conditions.10 The death of a Russian lab worker in 200426 after an Ebola virus expo- sure demonstrates that...for Disease Control and Prevention. Update: outbreak of Ebola viral hemorrhagic fever—Zaire, 1995. MMWR Morb Mortal Wkly Rep 1995;44(25):468–469, 475

  16. 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

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

    2012-05-01

    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.

  17. 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

  18. [Structural requirements for the management of patients with highly contagious life-threatening infectious diseases: update 2015].

    PubMed

    Grünewald, Thomas

    2015-07-01

    The care of highly contagious life-threatening infectious diseases (HLID) requires specialized treatment facilities that are capable of strict isolation measures and appropriate medical treatment. The German approach to the management of these diseases, which is maintained by the Permanent Working Group of Medical Competence and Treatment Centers for Highly Contagious and Life-Threatening Diseases (STAKOB) is adjusted in the present publication with regards to recent experiences and upcoming needs. Clear synergies in using infrastructures and bundling of resources have led to similar efforts at the European level. The German concept, therefore, has a pioneering role. This update is intended to improve professional patient care and also minimize the risk of disease spread and transmission.

  19. 76 FR 20249 - Update Station License Expiration Dates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-12

    ... From the Federal Register Online via the Government Publishing Office FEDERAL COMMUNICATIONS COMMISSION 47 CFR Part 73 Update Station License Expiration Dates AGENCY: Federal Communications Commission. ACTION: Final rule. SUMMARY: In this document the Federal Communications Commission updates its rules...

  20. 77 FR 75880 - Control of Communicable Diseases: Interstate; Scope and Definitions

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-26

    ... HUMAN SERVICES 42 CFR Part 70 RIN 0920-AA22 Control of Communicable Diseases: Interstate; Scope and Definitions AGENCY: Centers for Disease Control and Prevention (HHS/CDC), Department of Health and Human... Centers for Disease Control and Prevention (CDC), located within the Department of Health and...

  1. 78 FR 12702 - Control of Communicable Diseases: Interstate; Scope and Definitions

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-25

    ... HUMAN SERVICES 42 CFR Part 70 RIN 0920-AA22 Control of Communicable Diseases: Interstate; Scope and Definitions AGENCY: Centers for Disease Control and Prevention (HHS/CDC), Department of Health and Human Services (HHS). ACTION: Notice of proposed rulemaking; withdrawal. SUMMARY: The Centers for Disease...

  2. 78 FR 12622 - Control of Communicable Diseases: Foreign; Scope and Definitions

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-25

    ... HUMAN SERVICES 42 CFR Part 71 RIN 0920-AA12 Control of Communicable Diseases: Foreign; Scope and Definitions AGENCY: Centers for Disease Control and Prevention (HHS/CDC), Department of Health and Human... Disease Control and Prevention (CDC) within the Department of Health and Human Services (HHS)...

  3. 78 FR 12621 - Control of Communicable Diseases: Interstate; Scope and Definitions

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-25

    ... HUMAN SERVICES 42 CFR Part 70 RIN 0920-AA22 Control of Communicable Diseases: Interstate; Scope and Definitions AGENCY: Centers for Disease Control and Prevention (HHS/CDC), Department of Health and Human... Disease Control and Prevention (CDC) within the Department of Health and Human Services (HHS)...

  4. 77 FR 75936 - Control of Communicable Diseases: Interstate; Scope and Definitions

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-26

    ... HUMAN SERVICES 42 CFR Part 70 RIN 0920-AA22 Control of Communicable Diseases: Interstate; Scope and Definitions AGENCY: Centers for Disease Control and Prevention (HHS/CDC), Department of Health and Human... Proposed Rulemaking (NPRM), the Centers for Disease Control and Prevention (CDC), located within...

  5. 77 FR 75885 - Control of Communicable Diseases: Foreign; Scope and Definitions

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-26

    ... HUMAN SERVICES 42 CFR Part 71 RIN 0920-AA12 Control of Communicable Diseases: Foreign; Scope and Definitions AGENCY: Centers for Disease Control and Prevention (HHS/CDC), Department of Health and Human..., the Centers for Disease Control and Prevention (CDC), located within the Department of Health...

  6. 77 FR 75939 - Control of Communicable Diseases: Foreign; Scope and Definitions

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-26

    ... HUMAN SERVICES 42 CFR Part 71 RIN 0920-AA12 Control of Communicable Diseases: Foreign; Scope and Definitions AGENCY: Centers for Disease Control and Prevention (HHS/CDC), Department of Health and Human... Notice of Proposed Rulemaking (NPRM), the Centers for Disease Control and Prevention (CDC),...

  7. 78 FR 12702 - Control of Communicable Diseases: Foreign; Scope and Definitions

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-25

    ... HUMAN SERVICES 42 CFR Part 71 RIN 0920-AA12 Control of Communicable Diseases: Foreign; Scope and Definitions AGENCY: Centers for Disease Control and Prevention (HHS/CDC), Department of Health and Human Services (HHS). ACTION: Notice of proposed rulemaking; withdrawal. SUMMARY: The Centers for Disease...

  8. Extralinguistic Communication Compensates for the Loss of Verbal Fluency: A Case Study of Alzheimer's Disease.

    ERIC Educational Resources Information Center

    Sabat, Steven R.; Cagigas, Xavier E.

    1997-01-01

    The case study of an older woman with Alzheimer's disease shows that while her command of words and syntax had deteriorated, her ability to use other forms of communication had not. Her alternative forms of communication included use of gesture, facial expression, posture, and tone of voice. (MSE)

  9. Multifaceted Communication Problems in Everyday Conversations Involving People with Parkinson's Disease.

    PubMed

    Saldert, Charlotta; Bauer, Malin

    2017-09-25

    It is known that Parkinson's disease is often accompanied by a motor speech disorder, which results in impaired communication. However, people with Parkinson's disease may also have impaired word retrieval (anomia) and other communicative problems, which have a negative impact on their ability to participate in conversations with family as well as healthcare staff. The aim of the present study was to explore effects of impaired speech and language on communication and how this is managed by people with Parkinson's disease and their spouses. Using a qualitative method based on Conversation Analysis, in-depth analyses were performed on natural conversational interaction in five dyads including elderly men who were at different stages of Parkinson's disease. The findings showed that the motor speech disorder in combination with word retrieval difficulties and adaptations, such as using communication strategies, may result in atypical utterances that are difficult for communication partners to understand. The coexistence of several communication problems compounds the difficulties faced in conversations and individuals with Parkinson's disease are often dependent on cooperation with their communication partner to make themselves understood.

  10. Aspects of communication in Alzheimer's disease: clinical features and treatment options.

    PubMed

    Woodward, Michael

    2013-06-01

    During the course of Alzheimer's disease (AD), cognitive processes, including language and communication, become increasingly impaired. The aim of this review was to highlight the impact of communication deficits in AD, and discuss the need for effective treatments. PubMed was searched for studies relating to language and communication in AD. The publications identified were used as a basis for the commentary in this paper. Studies relating to the clinical effectiveness of pharmacological treatment for language and communication issues were identified systematically. Communication deficits are common in AD. From the earliest disease stage, the patient's capacity for communication declines as problems develop with the use of language and all aspects of functional communication. There is a loss of the ability to communicate thoughts and needs, and it becomes increasingly difficult to interact socially and sustain personal relationships with caregivers, family, and friends. It is unsurprising that patients become frustrated at their loss of self-expression, and studies have demonstrated that impaired communication is strongly linked with the development of significant behavioral concerns. Overall, poor communication contributes to caregiver strain, and adds notably to the burden of disease. Clinical data and post-hoc analyses provide preliminary indications that anti-AD therapies (memantine and the cholinesterase inhibitors, ChEIs) and non-pharmacological cognitive-linguistic stimulation techniques may be helpful in addressing communication difficulties. The capacity to treat or slow the progression of communication deficits in AD would prolong patient independence, and have a profound impact on the quality of life of patients and caregivers. The use of pharmacological (anti-AD therapies) and non-pharmacological (cognitive-linguistic stimulation) treatments may be useful management methods and warrant further investigation.

  11. Treatment of canine atopic dermatitis: 2015 updated guidelines from the International Committee on Allergic Diseases of Animals (ICADA).

    PubMed

    Olivry, Thierry; DeBoer, Douglas J; Favrot, Claude; Jackson, Hilary A; Mueller, Ralf S; Nuttall, Tim; Prélaud, Pascal

    2015-08-16

    In 2010, the International Task Force on Canine Atopic Dermatitis (now International Committee on Allergic Diseases of Animals, ICADA) published the first consensus guidelines for the treatment of atopic dermatitis (AD) in dogs. This is the first 5-year minor update of this document. The treatment of acute flares of AD should involve the search for, and then elimination of, the cause of the flares, bathing with mild shampoos, and controlling pruritus and skin lesions with interventions that include topical and/or oral glucocorticoids or oclacitinib. For chronic canine AD, the first steps in management are the identification and avoidance of flare factors, as well as ensuring that there is adequate skin and coat hygiene and care; this might include more frequent bathing and possibly increasing essential fatty acid intake. The medications currently most effective in reducing chronic pruritus and skin lesions are topical and oral glucocorticoids, oral ciclosporin, oral oclacitinib, and, where available, injectable recombinant interferons. Allergen-specific immunotherapy and proactive intermittent topical glucocorticoid applications are the only interventions likely to prevent or delay the recurrence of flares of AD. This first 5-year minor update of the international consensus guidelines for treatment of AD in dogs further establishes that the treatment of this disease is multifaceted, and that interventions should be combined for a proven (or likely) optimal benefit. Importantly, treatment plans are likely to vary between dogs and, for the same dog, between times when the disease is at different stages.

  12. 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.

  13. Communication.

    ERIC Educational Resources Information Center

    Hancock, Alan

    An informal introduction to the study of communication deals with the major topics in the field. It presents basic theories of communication and language, reviews how language takes on meaning, explains the stimulus-response and Piaget theories of learning, and presents major theories dealing with communications and society. These theories include…

  14. Communication.

    ERIC Educational Resources Information Center

    Hancock, Alan

    An informal introduction to the study of communication deals with the major topics in the field. It presents basic theories of communication and language, reviews how language takes on meaning, explains the stimulus-response and Piaget theories of learning, and presents major theories dealing with communications and society. These theories include…

  15. 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.

  16. 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…

  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. Pellagra: a non-communicable disease of poverty.

    PubMed

    Frank, Gerard-Peter G M; Voorend, Daniëlle M; Chamdula, Andrew; van Oosterhout, Joep J; Koop, Klaas

    2012-07-01

    Pellagra is a disease of poverty that is treatable but easily overlooked. The disease is caused by a deficiency of niacin and is clinically characterized by the triad of dermatitis, diarrhoea and dementia. We describe two cases of pellagra in a Malawian district hospital and discuss the pathogenesis, clinical manifestations and treatment of the disease.

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

    PubMed

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

    2014-03-01

    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. 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. 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. 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 review identified several promising

  1. 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

  2. [Epidemic trend on notifiable communicable diseases from 2010 to 2015 in Beijing].

    PubMed

    Gao, J H; Huang, R G

    2016-06-01

    To analyze the trends and epidemiological characteristics of notifiable communicable diseases from 2010 to 2015 in Beijing so as to provide reliable reference data. Data on the epidemiological characteristics was gathered and analyzed through the monitoring programs on notifiable diseases, reported by the China Information System for Disease Control and Prevention, from 2010 to 2015. A total of 764 290 cases of notifiable communicable diseases were reported from 2010 to 2015 in Beijing. The annual reported incidence on notifiable communicable diseases showed an annual downward (χ(2)=1.25×10(4), P<0.01), with rates between 498.95/100 000 and 828.45/100 000. The annual reported incidence rates of intestinal infectious diseases and respiratory infectious diseases also showed an annual downward (χ(2)=1.25×10(4), P<0.01; χ(2)=4.97×10(2), P<0.01), which accounted for 39.72% and 33.01% among the total classes A and B reported cases, respectively. The average annual reported incidence rates in males were higher than that in females. The average annual incidence of children under 7 years old appeared higher than that of the other age groups that accounted for 47.79% of the total reported cases. High incidence mainly appeared in children that living scattering around which accounted for 31.64% of the total reported cases. The first three leading incidence rates seen in other infectious diseases were infectious diarrhea, hand-foot-and-mouth disease and dysentery for the last consecutive 6 years. The laboratory diagnosed rate on notifiable disease was 16.67%, but with a trend of annual increase. Intestinal infective diseases kept the highest incidence among all the notifiable communicable diseases, suggesting the necessity of improving the prevention and control programs on notifiable communicable diseases in preschool, especially in those children with their houses scattered around. Programs on laboratory diagnosis also need to be strengthened.

  3. The road to the United Nations High Level Meeting on chronic non-communicable diseases.

    PubMed

    Hassell, T; Hennis, A

    2011-07-01

    The United Nations High Level Meeting (UNHLM) on non-communicable diseases (NCDs) will take place in New York on September 19 and 20, 2011. This historic event will focus world attention on the chronic non-communicable diseases (CNCDs) for the first time. In 2008, CNCDs, principally cardiovascular disease, cancer; chronic lung diseases and diabetes, accounted for 63% (or 36 million) of the 57 million deaths occurring worldwide. Many of these deaths may be considered premature (involving 9.1 million persons aged less than 60 years), and around 80% of overall deaths occurred in low and middle income countries. Chronic non-communicable diseases are therefore a major cause of premature death, with resulting enormous negative impact on national economies and global development, while continuing to increase at worrying rates particularly in the developing world. Without successful interventions, NCD-related deaths are projected to reach 52 million by 2030.

  4. Detection of antinuclear antibodies by the Inno-Lia ANA update test in canine systemic rheumatic disease.

    PubMed

    Hansson-Hamlin, Helene; Rönnelid, Johan

    2010-06-01

    Certain systemic autoimmune diseases in dogs are characterized by high titers of circulating antinuclear antibodies (ANA), which can be demonstrated by indirect immunofluorescence (IIF). In an earlier study of IIF-ANA-positive dogs, the Ouchterlony double immunodiffusion (DID) test was used to identify specific autoantibodies. The DID test has largely been replaced with line blot tests in human diagnostic settings. The objective of this study was to investigate whether the line blot assay Inno-Lia ANA update test is a useful tool in demonstrating ANA specificities in canine patients with previously diagnosed IIF-ANA-positive rheumatic disorders. Serum samples from 3 clinically healthy control dogs and 20 canine patients with clinical signs of systemic rheumatic disease and documented positive results for IIF-ANA and DID tests were included in the study. The Inno-Lia ANA update assay was performed with an anti-canine detection antibody. Six serum samples that had DID positivity with anti-spliceosomal small nuclear ribonucleoproteins (snRNP) reactivity showed reactivity to multiple snRNP proteins in the Inno-Lia test. Samples from 2 dogs that had other types of DID positivity also had clear SmB reactivity and 1 had weak reactivity to RNP-70K. The other serum samples, including controls, were negative. Using the Inno-Lia ANA update test, multiple snRNP specificities were demonstrated in some canine patients with autoimmune rheumatic disorders. Other canine autoantibodies may exist that are not detected by this test. Further studies are necessary to characterize the target antigen(s) of these remaining autoantibodies in canine sera.

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

    PubMed

    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

    2013-02-01

    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.

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

    PubMed

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

    2016-03-18

    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.

  7. Xanthine oxidase inhibition for the treatment of cardiovascular disease: an updated systematic review and meta‐analysis

    PubMed Central

    Dierckx, Riet; Mohee, Kevin; Clark, Andrew L.; Cleland, John G.

    2016-01-01

    Abstract Background Previous studies have shown that xanthine oxidase inhibitors (XOI) might improve outcome for patients with cardiovascular disease. However, more evidence is required. Methods and results We published a meta‐analysis of trials conducted before 2014 examining the effects of XOI on mortality in patients with cardiovascular disease. At least two further trials (N = 323 patients) have since been published. Accordingly, we repeated our analysis after a further search for randomized controlled trials of XOI in PubMed/MEDLINE, EMBASE, and Cochrane Databases. We identified eight relevant trials with 1031 patients. The average age of the patients was 61 years and 68% were men (one study did not report gender). There were 57 deaths in these eight trials, 26 in those assigned to XOI, and 31 in those assigned to the control. The updated meta‐analysis could not confirm a reduction in mortality for patients assigned to XOI compared with placebo (odds ratio 0.84) but 95% confidence intervals were wide (0.48–1.47). Conclusions This updated meta‐analysis does not suggest that XOI exert a large reduction in mortality but also cannot exclude the possibility of substantial harm or benefit. PMID:28217311

  8. 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.

  9. Non-communicable diseases in emergencies: a call to action.

    PubMed

    Demaio, Alessandro; Jamieson, Jennifer; Horn, Rebecca; de Courten, Maximilian; Tellier, Siri

    2013-09-06

    Recent years have demonstrated the devastating health consequences of complex emergencies and natural disasters and thereby highlighted the importance of comprehensive and collaborative approaches to humanitarian responses and risk reduction. Simultaneously, noncommunicable diseases are now recognised as a real and growing threat to population health and development; a threat that is magnified by and during emergencies. Noncommunicable diseases, however, continue to receive little attention from humanitarian organisations in the acute phase of disaster and emergency response. This paper calls on all sectors to recognise and address the specific health challenges posed by noncommunicable diseases in emergencies and disaster situations. This publication aims to highlight the need for: • Increased research on morbidity and mortality patterns due to noncommunicable diseases during and following emergencies; • Raised awareness through greater advocacy for the issue and challenges of noncommunicable diseases during and following emergencies; • Incorporation of noncommunicable diseases into existing emergency-related policies, standards, and resources; • Development of technical guidelines on the clinical management of noncommunicable diseases in emergencies; • Greater integration and coordination in health service provision during and following emergencies; • Integrating noncommunicable diseases into practical and academic training of emergency workers and emergency-response coordinators.

  10. Non-Communicable Diseases in Emergencies: A Call to Action

    PubMed Central

    Demaio, Alessandro; Jamieson, Jennifer; Horn, Rebecca; de Courten, Maximilian; Tellier, Siri

    2013-01-01

    Recent years have demonstrated the devastating health consequences of complex emergencies and natural disasters and thereby highlighted the importance of comprehensive and collaborative approaches to humanitarian responses and risk reduction. Simultaneously, noncommunicable diseases are now recognised as a real and growing threat to population health and development; a threat that is magnified by and during emergencies. Noncommunicable diseases, however, continue to receive little attention from humanitarian organisations in the acute phase of disaster and emergency response. This paper calls on all sectors to recognise and address the specific health challenges posed by noncommunicable diseases in emergencies and disaster situations. This publication aims to highlight the need for: • Increased research on morbidity and mortality patterns due to noncommunicable diseases during and following emergencies; • Raised awareness through greater advocacy for the issue and challenges of noncommunicable diseases during and following emergencies; • Incorporation of noncommunicable diseases into existing emergency-related policies, standards, and resources; • Development of technical guidelines on the clinical management of noncommunicable diseases in emergencies; • Greater integration and coordination in health service provision during and following emergencies; • Integrating noncommunicable diseases into practical and academic training of emergency workers and emergency-response coordinators. PMID:24056956

  11. Shelters for Battered Women and Their Children: An Under-Recognized Source of Communicable Disease Transmission.

    ERIC Educational Resources Information Center

    Gross, Thomas P.; Rosenberg, Mark L.

    1987-01-01

    Reports on a study of various aspects of communicable disease occurrence (focusing on diarrheal illness) in shelters for battered women and their children, the extent and methods of screening for disease, training of staff in health care principles, resources available for health care needs, and the health regulations governing these shelters. (PS)

  12. Understanding chronic non-communicable diseases in Latin America: towards an equity-based research agenda.

    PubMed

    De Maio, Fernando G

    2011-10-07

    Although chronic non-communicable diseases are traditionally depicted as diseases of affluence, growing evidence suggests they strike along the fault lines of social inequality. The challenge of understanding how these conditions shape patterns of population health in Latin America requires an inter-disciplinary lens. This paper reviews the burden of chronic non-communicable diseases in the region and examines key myths surrounding their prevalence and distribution. It argues that a social justice approach rooted in the idea of health inequity needs to be at the core of research in this area, and concludes with discussion of a new approach to guide empirical research, the 'average/deprivation/inequality' framework.

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

    PubMed

    Glenn, Adriana D

    2015-01-01

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

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

    USDA-ARS?s Scientific Manuscript database

    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...

  15. Rising Health Expenditure Due to Non-Communicable Diseases in India: An Outlook.

    PubMed

    Barik, Debasis; Arokiasamy, Perianayagam

    2016-01-01

    With ongoing demographic transition, epidemiological transition has been emerged as a growing concern in India. The share of non-communicable disease in total disease burden has increased from 31% in 1990 to 45% in 2010. This paper seeks to explore the health scenario of India in the wake of the growing pace of non-communicable diseases such as diabetes and hypertension among Indian population using data from health and morbidity survey of the National Sample Survey Organisation (2004) and notifies about the resource needed to tackle this growing health risk. Given the share of private players (70%) in Indian health system, results indicate a higher private expenditure, mostly out-of-pocket expense, on account of non-communicable diseases. A timely look into the matter may tackle a more dreadful situation in near future.

  16. Rising Health Expenditure Due to Non-Communicable Diseases in India: An Outlook

    PubMed Central

    Barik, Debasis; Arokiasamy, Perianayagam

    2016-01-01

    With ongoing demographic transition, epidemiological transition has been emerged as a growing concern in India. The share of non-communicable disease in total disease burden has increased from 31% in 1990 to 45% in 2010. This paper seeks to explore the health scenario of India in the wake of the growing pace of non-communicable diseases such as diabetes and hypertension among Indian population using data from health and morbidity survey of the National Sample Survey Organisation (2004) and notifies about the resource needed to tackle this growing health risk. Given the share of private players (70%) in Indian health system, results indicate a higher private expenditure, mostly out-of-pocket expense, on account of non-communicable diseases. A timely look into the matter may tackle a more dreadful situation in near future. PMID:27965952

  17. Impact of information and communication technology on interprofessional collaboration for chronic disease management: a systematic review.

    PubMed

    Barr, Neil; Vania, Diana; Randall, Glen; Mulvale, Gillian

    2017-01-01

    Objectives Information and communication technology is often lauded as the key to enhancing communication among health care providers. However, its impact on interprofessional collaboration is unclear. The objective of this study was to determine the extent to which it improves communication and, subsequently, enhances interprofessional collaboration in chronic disease management. Methods A systematic review of academic literature using two electronic platforms: HealthSTAR and Web of Science (core collection and MEDLINE). To be eligible for inclusion in the review, articles needed to be peer-reviewed; accessible in English and focused on how technology supports, or might support, collaboration (through enhanced communication) in chronic disease management. Studies were assessed for quality and a narrative synthesis conducted. Results The searches identified 289 articles of which six were included in the final analysis (three used qualitative methods, two were descriptive and one used mixed methods). Various forms of information and communication technology were described including electronic health records, online communities/learning resources and telehealth/telecare. Three themes emerged from the studies that may provide insights into how communication that facilitates collaboration in chronic disease management might be enhanced: professional conflict, collective engagement and continuous learning. Conclusions The success of technology in enhancing collaboration for chronic disease management depends upon supporting the social relationships and organization in which the technology will be placed. Decision-makers should take into account and work toward balancing the impact of technology together with the professional and cultural characteristics of health care teams.

  18. 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

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

    PubMed

    Rolfhamre, Per; Grabowska, Katarzyna; Ekdahl, Karl

    2004-06-10

    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. 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. 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). 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).

  20. Communicable and non-communicable diseases in the Solomon Islands villages during recovery from a massive earthquake in April 2007.

    PubMed

    Furusawa, Takuro; Furusawa, Hana; Eddie, Ricky; Tuni, Makiva; Pitakaka, Freda; Aswani, Shankar

    2011-04-29

    The major causes of mortality and morbidity have changed from infectious diseases and malnutrition conditions to non-communicable diseases (NCDs) in Melanesian societies. However, a massive earthquake and its related changes might have disturbed the patterns. This study aimed to explore which health problems were likely to be prevalent during the recovery process from the 2 April 2007 earthquake in the Solomon Islands. Participants were recruited in Titiana, a severely damaged village located near a town; Tapurai, a severely damaged remote village; Mondo, a severely damaged, medium urban village; and Olive, a control village. Health indicators measured were classified into communicable and nutritional conditions (malaria, malnutrition, infection status and child growth) and NCDs (overweight/obesity, hypertension and diabetes). Titiana residents were more at risk of infectious conditions (C-reactive protein greater than and equal to 1 mg/dL) and obesity (BMI greater than and equal to 30 kg/m²). Tapurai and Mondo residents were at risks of infectious conditions and becoming overweight (BMI greater than and equal to 25 kg/m²), respectively. Titiana and Mondo residents complained about insufficient subsistence production. The urban communities were found to be at risks of both communicable and NCDs. Controlling the urbanisation as well as providing continuous support against infectious conditions during the recovery process would be beneficial.

  1. 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

  2. Communication partner training of enrolled nurses working in nursing homes with people with communication disorders caused by stroke or Parkinson's disease.

    PubMed

    Eriksson, Karin; Forsgren, Emma; Hartelius, Lena; Saldert, Charlotta

    2016-01-01

    To evaluate the effect of a communication partner training programme directed to enrolled nurses working with people with communication disorders in nursing homes, using an individualised approach. Five dyads consisting of a person with stroke-induced aphasia (n = 4) or Parkinson's disease (PD) (n = 1) living in different nursing homes and his/her enrolled nurse participated in the study, which had a replicated single-subject design with multiple baselines across individuals. The main element of the intervention was supervised analysis of video-recorded natural interaction in everyday nursing situations and the formulation of individual goals to change particular communicative strategies. Outcome was measured via blinded assessments of filmed natural interaction obtained at baseline, intervention and follow-up and showed an increased use of the target communicative strategies. Subjective measures of goal attainment by the enrolled nurses were consistent with these results. Measures of perceived functional communication on behalf of the persons with communication disorders were mostly positive; four of five participants with communication disorders and two of five enrolled nurses reported improved functional communication after intervention. The use of an individualised communication partner training programme led to significant changes in natural interaction, which contributes importantly to a growing body of knowledge regarding communication partner training. Communication partner training can improve the communicative environment of people with communication disorders. For people with communication disorders who live in institutions, the main conversation partner is likely to be a professional caretaker. An individualised approach for communication partner training that focussed on specific communication patterns was successful in increasing the use of supportive strategies that enrolled nurses used in natural interaction with persons with communication disorders

  3. Communicate!

    ERIC Educational Resources Information Center

    Chase, Stuart

    This ten chapter book is designed to provide high school students with an understanding of basic communication processes. The first five chapters include discussions of language development, function, and acquisition in relation to both human and non-human communication. The sixth chapter contains specimen linguistic analyses of speech and…

  4. Communicable disease surveillance and control in the context of conflict and mass displacement in Syria.

    PubMed

    Ismail, Sharif A; Abbara, Aula; Collin, Simon M; Orcutt, Miriam; Coutts, Adam P; Maziak, Wasim; Sahloul, Zaher; Dar, Osman; Corrah, Tumena; Fouad, Fouad M

    2016-06-01

    To describe trends in major communicable diseases in Syria during the ongoing conflict, and the challenges to communicable disease surveillance and control in the context of dynamic, large-scale population displacement, unplanned mass gatherings, and disruption to critical infrastructure. A rapid review of the peer-reviewed and non-peer-reviewed literature from 2005 to 2015 was performed, augmented by secondary analysis of monitoring data from two disease early warning systems currently operational in Syria, focusing mainly on three diseases: tuberculosis (TB), measles, and polio. Trend data show discrepancies in case report numbers between government and non-government controlled areas, especially for TB, but interpretation is hampered by uncertainties over sentinel surveillance coverage and base population numbers. Communicable disease control has been undermined by a combination of governance fragmentation, direct and indirect damage to facilities and systems, and health worker flight. Five years into the crisis, some progress has been made in disease surveillance, but governance and coordination problems, variable immunization coverage, and the dynamic and indiscriminate nature of the conflict continue to pose a serious threat to population health in Syria and surrounding countries. The risk of major cross-border communicable disease outbreaks is high, and challenges for health in a post-conflict Syria are formidable. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  5. 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.

  6. 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

  7. Particulate matter air pollution and cardiovascular disease: An update to the scientific statement from the American Heart Association.

    PubMed

    Brook, Robert D; Rajagopalan, Sanjay; Pope, C Arden; Brook, Jeffrey R; Bhatnagar, Aruni; Diez-Roux, Ana V; Holguin, Fernando; Hong, Yuling; Luepker, Russell V; Mittleman, Murray A; Peters, Annette; Siscovick, David; Smith, Sidney C; Whitsel, Laurie; Kaufman, Joel D

    2010-06-01

    In 2004, the first American Heart Association scientific statement on "Air Pollution and Cardiovascular Disease" concluded that exposure to particulate matter (PM) air pollution contributes to cardiovascular morbidity and mortality. In the interim, numerous studies have expanded our understanding of this association and further elucidated the physiological and molecular mechanisms involved. The main objective of this updated American Heart Association scientific statement is to provide a comprehensive review of the new evidence linking PM exposure with cardiovascular disease, with a specific focus on highlighting the clinical implications for researchers and healthcare providers. The writing group also sought to provide expert consensus opinions on many aspects of the current state of science and updated suggestions for areas of future research. On the basis of the findings of this review, several new conclusions were reached, including the following: Exposure to PM <2.5 microm in diameter (PM(2.5)) over a few hours to weeks can trigger cardiovascular disease-related mortality and nonfatal events; longer-term exposure (eg, a few years) increases the risk for cardiovascular mortality to an even greater extent than exposures over a few days and reduces life expectancy within more highly exposed segments of the population by several months to a few years; reductions in PM levels are associated with decreases in cardiovascular mortality within a time frame as short as a few years; and many credible pathological mechanisms have been elucidated that lend biological plausibility to these findings. It is the opinion of the writing group that the overall evidence is consistent with a causal relationship between PM(2.5) exposure and cardiovascular morbidity and mortality. This body of evidence has grown and been strengthened substantially since the first American Heart Association scientific statement was published. Finally, PM(2.5) exposure is deemed a modifiable factor

  8. LincSNP 2.0: an updated database for linking disease-associated SNPs to human long non-coding RNAs and their TFBSs.

    PubMed

    Ning, Shangwei; Yue, Ming; Wang, Peng; Liu, Yue; Zhi, Hui; Zhang, Yan; Zhang, Jizhou; Gao, Yue; Guo, Maoni; Zhou, Dianshuang; Li, Xin; Li, Xia

    2017-01-04

    We describe LincSNP 2.0 (http://bioinfo.hrbmu.edu.cn/LincSNP), an updated database that is used specifically to store and annotate disease-associated single nucleotide polymorphisms (SNPs) in human long non-coding RNAs (lncRNAs) and their transcription factor binding sites (TFBSs). In LincSNP 2.0, we have updated the database with more data and several new features, including (i) expanding disease-associated SNPs in human lncRNAs; (ii) identifying disease-associated SNPs in lncRNA TFBSs; (iii) updating LD-SNPs from the 1000 Genomes Project; and (iv) collecting more experimentally supported SNP-lncRNA-disease associations. Furthermore, we developed three flexible online tools to retrieve and analyze the data. Linc-Mart is a convenient way for users to customize their own data. Linc-Browse is a tool for all data visualization. Linc-Score predicts the associations between lncRNA and disease. In addition, we provided users a newly designed, user-friendly interface to search and download all the data in LincSNP 2.0 and we also provided an interface to submit novel data into the database. LincSNP 2.0 is a continually updated database and will serve as an important resource for investigating the functions and mechanisms of lncRNAs in human diseases. © The Author(s) 2016. Published by Oxford University Press on behalf of Nucleic Acids Research.

  9. LincSNP 2.0: an updated database for linking disease-associated SNPs to human long non-coding RNAs and their TFBSs

    PubMed Central

    Ning, Shangwei; Yue, Ming; Wang, Peng; Liu, Yue; Zhi, Hui; Zhang, Yan; Zhang, Jizhou; Gao, Yue; Guo, Maoni; Zhou, Dianshuang; Li, Xin; Li, Xia

    2017-01-01

    We describe LincSNP 2.0 (http://bioinfo.hrbmu.edu.cn/LincSNP), an updated database that is used specifically to store and annotate disease-associated single nucleotide polymorphisms (SNPs) in human long non-coding RNAs (lncRNAs) and their transcription factor binding sites (TFBSs). In LincSNP 2.0, we have updated the database with more data and several new features, including (i) expanding disease-associated SNPs in human lncRNAs; (ii) identifying disease-associated SNPs in lncRNA TFBSs; (iii) updating LD-SNPs from the 1000 Genomes Project; and (iv) collecting more experimentally supported SNP-lncRNA-disease associations. Furthermore, we developed three flexible online tools to retrieve and analyze the data. Linc-Mart is a convenient way for users to customize their own data. Linc-Browse is a tool for all data visualization. Linc-Score predicts the associations between lncRNA and disease. In addition, we provided users a newly designed, user-friendly interface to search and download all the data in LincSNP 2.0 and we also provided an interface to submit novel data into the database. LincSNP 2.0 is a continually updated database and will serve as an important resource for investigating the functions and mechanisms of lncRNAs in human diseases. PMID:27924020

  10. Communicating cardiovascular disease risk: an interview study of General Practitioners' use of absolute risk within tailored communication strategies.

    PubMed

    Bonner, Carissa; Jansen, Jesse; McKinn, Shannon; Irwig, Les; Doust, Jenny; Glasziou, Paul; McCaffery, Kirsten

    2014-05-29

    Cardiovascular disease (CVD) prevention guidelines encourage assessment of absolute CVD risk - the probability of a CVD event within a fixed time period, based on the most predictive risk factors. However, few General Practitioners (GPs) use absolute CVD risk consistently, and communication difficulties have been identified as a barrier to changing practice. This study aimed to explore GPs' descriptions of their CVD risk communication strategies, including the role of absolute risk. Semi-structured interviews were conducted with a purposive sample of 25 GPs in New South Wales, Australia. Transcribed audio-recordings were thematically coded, using the Framework Analysis method to ensure rigour. GPs used absolute CVD risk within three different communication strategies: 'positive', 'scare tactic', and 'indirect'. A 'positive' strategy, which aimed to reassure and motivate, was used for patients with low risk, determination to change lifestyle, and some concern about CVD risk. Absolute risk was used to show how they could reduce risk. A 'scare tactic' strategy was used for patients with high risk, lack of motivation, and a dismissive attitude. Absolute risk was used to 'scare' them into taking action. An 'indirect' strategy, where CVD risk was not the main focus, was used for patients with low risk but some lifestyle risk factors, high anxiety, high resistance to change, or difficulty understanding probabilities. Non-quantitative absolute risk formats were found to be helpful in these situations. This study demonstrated how GPs use three different communication strategies to address the issue of CVD risk, depending on their perception of patient risk, motivation and anxiety. Absolute risk played a different role within each strategy. Providing GPs with alternative ways of explaining absolute risk, in order to achieve different communication aims, may improve their use of absolute CVD risk assessment in practice.

  11. Updated assessment of the prevalence, spectrum and case definition of autoimmune disease.

    PubMed

    Hayter, Scott M; Cook, Matthew C

    2012-08-01

    Autoimmune diseases are heterogeneous with regard to prevalence, manifestations, and pathogenesis. The classification of autoimmune diseases has varied over time. Here, we have compiled a comprehensive up-to-date list of the autoimmune diseases, and have reviewed published literature to estimate their prevalence. We identified 81 autoimmune diseases. The overall estimated prevalence is 4.5%, with 2.7% for males and 6.4% for females. For specific diseases, prevalence ranges from 1% to <1/10(6). Considering all diseases in the class, the most common mean age-of-onset was 40-50 years. This list of autoimmune diseases has also yielded information about autoantigens. Forty-five autoimmune diseases have been associated with well-defined autoantigens. Of the diseases with known autoantigens, 33.3% had highly repetitive sequences, 35.6% had coiled-coil arrangements and 57.8% were associated with cellular membranes, which means that based on these structural motifs alone, autoantigens do not appear to be a random sample of the human proteome. Finally, we identified 19 autoimmune diseases that phenocopy diseases arising from germline mutations in the corresponding autoantigen. Collectively, our findings lead to a tentative proposal for criteria for assigning autoimmune pathogenesis to a particular disease.

  12. European Society of Clinical Microbiology and Infectious Diseases: update of the diagnostic guidance document for Clostridium difficile infection.

    PubMed

    Crobach, M J T; Planche, T; Eckert, C; Barbut, F; Terveer, E M; Dekkers, O M; Wilcox, M H; Kuijper, E J

    2016-08-01

    In 2009 the first European Society of Clinical Microbiology and Infectious Diseases (ESCMID) guideline for diagnosing Clostridium difficile infection (CDI) was launched. Since then newer tests for diagnosing CDI have become available, especially nucleic acid amplification tests. The main objectives of this update of the guidance document are to summarize the currently available evidence concerning laboratory diagnosis of CDI and to formulate and revise recommendations to optimize CDI testing. This update is essential to improve the diagnosis of CDI and to improve uniformity in CDI diagnosis for surveillance purposes among Europe. An electronic search for literature concerning the laboratory diagnosis of CDI was performed. Studies evaluating a commercial laboratory test compared to a reference test were also included in a meta-analysis. The commercial tests that were evaluated included enzyme immunoassays (EIAs) detecting glutamate dehydrogenase, EIAs detecting toxins A and B and nucleic acid amplification tests. Recommendations were formulated by an executive committee, and the strength of recommendations and quality of evidence were graded using the Grades of Recommendation Assessment, Development and Evaluation (GRADE) system. No single commercial test can be used as a stand-alone test for diagnosing CDI as a result of inadequate positive predictive values at low CDI prevalence. Therefore, the use of a two-step algorithm is recommended. Samples without free toxin detected by toxins A and B EIA but with positive glutamate dehydrogenase EIA, nucleic acid amplification test or toxigenic culture results need clinical evaluation to discern CDI from asymptomatic carriage.

  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.

  14. An unequal burden: poor patient-provider communication and sickle cell disease.

    PubMed

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

    2014-08-01

    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. 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. 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. 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. 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. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  15. Expansion of the prognostic assessment of patients with chronic obstructive pulmonary disease: the updated BODE index and the ADO index.

    PubMed

    Puhan, Milo A; Garcia-Aymerich, Judith; Frey, Martin; ter Riet, Gerben; Antó, Josep M; Agustí, Alvar G; Gómez, Federico P; Rodríguez-Roisín, Roberto; Moons, Karel G M; Kessels, Alphons G; Held, Ulrike

    2009-08-29

    The BODE index (including body-mass index, airflow obstruction, dyspnoea, and exercise capacity) was an important contribution to the prognostic assessment of patients with chronic obstructive pulmonary disease (COPD). However, no study has assessed whether the risk of mortality predicted by the BODE index matches the observed mortality in different populations. We assessed the calibration of the BODE index, updated it to improve its calibration, and developed and validated a simplified index for use in primary-care settings. We included 232 patients from the Swiss Barmelweid cohort with longstanding and severe COPD and 342 patients from the Spanish Phenotype and Course of COPD cohort study who had had their first hospital admission due to moderate-to-severe COPD. In both cohorts we compared the observed 3-year risk of all-cause mortality with the risk predicted by the BODE index. We then updated the BODE index and developed a simplified ADO index (including age, dyspnoea, and airflow obstruction) from the Swiss cohort, and validated both in the Spanish cohort. Calibration of the BODE index was poor, with relative underprediction of 3-year risk of mortality by 36% in the Swiss cohort (median predicted risk 21.7% [IQR 12.7-31.7] vs 34.1% observed risk; p=0.013) and relative overprediction by 39% in the Spanish cohort (16.7% [12.7-31.7] vs 12.0%; p=0.035). The 3-year risk of mortality predicted by both the updated BODE (median 10.7% [8.1-13.8]) and ADO indices (11.8% [9.1-14.3]) matched the observed mortality in the Spanish cohort well (p=0.99 and p=0.98, respectively). Both the updated BODE and ADO indices could lend support to the prognostic assessment of patients with COPD in specialised and primary-care settings. Such assessment enhances the targeting of treatments to individual patients. Swiss National Science Foundation; Klinik Barmelweid; Fondo de Investigación Sanitaria Ministry of Health, Spain; Agència d'Avaluació de Tecnologia i Recerca M

  16. Dynamic network communication as a unifying neural basis for cognition, development, aging, and disease.

    PubMed

    Voytek, Bradley; Knight, Robert T

    2015-06-15

    Perception, cognition, and social interaction depend upon coordinated neural activity. This coordination operates within noisy, overlapping, and distributed neural networks operating at multiple timescales. These networks are built upon a structural scaffolding with intrinsic neuroplasticity that changes with development, aging, disease, and personal experience. In this article, we begin from the perspective that successful interregional communication relies upon the transient synchronization between distinct low-frequency (<80 Hz) oscillations, allowing for brief windows of communication via phase-coordinated local neuronal spiking. From this, we construct a theoretical framework for dynamic network communication, arguing that these networks reflect a balance between oscillatory coupling and local population spiking activity and that these two levels of activity interact. We theorize that when oscillatory coupling is too strong, spike timing within the local neuronal population becomes too synchronous; when oscillatory coupling is too weak, spike timing is too disorganized. Each results in specific disruptions to neural communication. These alterations in communication dynamics may underlie cognitive changes associated with healthy development and aging, in addition to neurological and psychiatric disorders. A number of neurological and psychiatric disorders-including Parkinson's disease, autism, depression, schizophrenia, and anxiety-are associated with abnormalities in oscillatory activity. Although aging, psychiatric and neurological disease, and experience differ in the biological changes to structural gray or white matter, neurotransmission, and gene expression, our framework suggests that any resultant cognitive and behavioral changes in normal or disordered states or their treatment are a product of how these physical processes affect dynamic network communication.

  17. The environment-pathogen-host axis in communicable and non-communicable diseases: recent advances in experimental and clinical research.

    PubMed

    Gilles, Stefanie; Traidl-Hoffmann, Claudia

    2014-05-01

    Allergies and autoimmune diseases are spreading worldwide. Control of infections, on the other hand, remains an issue, even in the post-antibiotic era. Chronic or poorly controlled infections occur in immune compromised individuals such as HIV patients, hospitalized patients exposed to multi-resistant bacteria, or patients on immunosuppressive treatment. They may become an even more emerging issue in an ageing population. At the same time, profound environmental changes such as global warming, urbanization, increasing environmental pollution and novel food engineering technologies may alter the abundance or aggressiveness of allergens/allergen carriers in our environment. Likewise, changes in dietary habits - and possibly also use of antibiotics - have an impact on the composition of our natural microbial flora in the gut, airways and skin, which may alter susceptibility for common diseases, among them allergies, asthma and atopic eczema. At the recently founded Institute of Environmental Medicine of the Technische Universität Munich, located in Augsburg at the UNIKA-T, experimental, clinical and translational research is focused on the complex interactions of environment, pathogen and host in expression or control of communicable and non-communicable diseases. We present our research concept and recent findings in environment - host interactions.

  18. An update on Lyme disease and other tick-borne illnesses.

    PubMed

    Fell, E

    2000-10-01

    Lyme disease, the most common vector-borne illness in North America, is a multisystem, multistage infectious disease caused by the tick-transmitted spirochete Borrelia burgdorferi. Although Lyme disease is not fatal, it can cause musculoskeletal, neurological, and cardiovascular manifestations that may be difficult to treat. Clinicians must also be aware of other potentially fatal tick-borne diseases such as babesiosis, ehrlichiosis, and Rocky Mountain spotted fever. Early identification and treatment of tick-borne diseases are crucial to preventing devastating sequelae.

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

    PubMed Central

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

    2014-01-01

    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

  20. Updates on cardiovascular comorbidities associated with psoriatic diseases: epidemiology and mechanisms.

    PubMed

    Yim, Kaitlyn M; Armstrong, April W

    2017-01-01

    Psoriasis and psoriatic arthritis are associated with a significantly increased risk of cardiovascular risk factors and major adverse cardiovascular events (MACE). Active research is ongoing to elucidate this relationship between psoriatic diseases and cardiovascular comorbidities, as well as their shared pathogenic mechanisms. This review focuses on (1) the epidemiologic association between psoriasis and cardiovascular risk factors, (2) the epidemiologic association between psoriasis and MACE, (3) the epidemiologic association between psoriatic arthritis, cardiovascular risk factors, and MACE, and (4) proposed mechanisms for the contribution of psoriatic diseases to cardiovascular diseases. The proposed mechanisms for shared pathogenesis between psoriatic diseases and cardiovascular diseases are inflammation, insulin resistance, dyslipidemia, angiogenesis, oxidative stress, and endothelial dysfunction. There is complex interplay and overlap among these mechanisms and their contributions to shared pathogenesis. Future translational research is necessary to elucidate the link between psoriatic diseases and cardiovascular diseases. Such findings may be applied clinically to improve the lives of psoriasis patients.

  1. 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.

  2. Asia-Pacific consensus on the management of gastro-oesophageal reflux disease: an update focusing on refractory reflux disease and Barrett's oesophagus.

    PubMed

    Fock, Kwong Ming; Talley, Nicholas; Goh, Khean Lee; Sugano, Kentaro; Katelaris, Peter; Holtmann, Gerald; Pandolfino, John E; Sharma, Prateek; Ang, Tiing Leong; Hongo, Michio; Wu, Justin; Chen, Minhu; Choi, Myung-Gyu; Law, Ngai Moh; Sheu, Bor-Shyang; Zhang, Jun; Ho, Khek Yu; Sollano, Jose; Rani, Abdul Aziz; Kositchaiwat, Chomsri; Bhatia, Shobna

    2016-09-01

    Since the publication of the Asia-Pacific consensus on gastro-oesophageal reflux disease in 2008, there has been further scientific advancement in this field. This updated consensus focuses on proton pump inhibitor-refractory reflux disease and Barrett's oesophagus. A steering committee identified three areas to address: (1) burden of disease and diagnosis of reflux disease; (2) proton pump inhibitor-refractory reflux disease; (3) Barrett's oesophagus. Three working groups formulated draft statements with supporting evidence. Discussions were done via email before a final face-to-face discussion. We used a Delphi consensus process, with a 70% agreement threshold, using Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria to categorise the quality of evidence and strength of recommendations. A total of 32 statements were proposed and 31 were accepted by consensus. A rise in the prevalence rates of gastro-oesophageal reflux disease in Asia was noted, with the majority being non-erosive reflux disease. Overweight and obesity contributed to the rise. Proton pump inhibitor-refractory reflux disease was recognised to be common. A distinction was made between refractory symptoms and refractory reflux disease, with clarification of the roles of endoscopy and functional testing summarised in two algorithms. The definition of Barrett's oesophagus was revised such that a minimum length of 1 cm was required and the presence of intestinal metaplasia no longer necessary. We recommended the use of standardised endoscopic reporting and advocated endoscopic therapy for confirmed dysplasia and early cancer. These guidelines standardise the management of patients with refractory gastro-oesophageal reflux disease and Barrett's oesophagus in the Asia-Pacific region. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  3. 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.

  4. Regional development and seasonality of communicable diseases in rural Andhra Pradesh, India.

    PubMed

    Bhardwaj, S M; Rao, M N

    1988-01-01

    This paper explores the seasonality of morbidity due to communicable diseases in Guntur district in Andhra Pradesh, India. The district has been divided into development regions using cluster analysis. Seasonality of selected communicable diseases is then compared with the levels of development. It is shown that seasonality is most pronounced in the least developed region of the district. In the most developed region, seasonality of morbidity is low. The paper supports the general hypothesis that there is a decreased seasonality of illness as development takes place.

  5. Castleman disease: an update on classification and the spectrum of associated lesions.

    PubMed

    Cronin, Danielle M P; Warnke, Roger A

    2009-07-01

    Since its initial description, researchers have expanded the spectrum of Castleman disease to include not only the classic and well-recognized hyaline-vascular type, but also the plasma cell type and multicentric types of broader histologic range, including human herpes virus-8-associated Castleman disease. These less common subtypes of Castleman disease are less familiar, and may be under-recognized. Also of practical importance, current authors are restructuring the classification of multicentric Castleman disease to accommodate the emerging pathogenic role of human herpes virus-8 and its association with the recently described plasmablastic variant. In addition to an increased risk of lymphoma, patients with Castleman disease also are at increased risk for other related neoplasms, including Kaposi sarcoma and follicular dendritic cell tumors, which are of prognostic and therapeutic relevance. This review focuses on the histologic diagnosis of Castleman disease, current and emerging concepts in its pathogenesis and classification, and associated histopathologic entities.

  6. 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

  7. 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

  8. A review on Alzheimer's disease pathophysiology and its management: an update.

    PubMed

    Kumar, Anil; Singh, Arti; Ekavali

    2015-04-01

    Alzheimer's disease acknowledged as progressive multifarious neurodegenerative disorder, is the leading cause of dementia in late adult life. Pathologically it is characterized by intracellular neurofibrillary tangles and extracellular amyloidal protein deposits contributing to senile plaques. Over the last two decades, advances in the field of pathogenesis have inspired the researchers for the investigation of novel pharmacological therapeutics centered more towards the pathophysiological events of the disease. Currently available treatments i.e. acetylcholinesterase inhibitors (rivastigmine, galantamine, donepezil) and N-methyl d-aspartate receptor antagonist (memantine) contribute minimal impact on the disease and target late aspects of the disease. These drugs decelerate the progression of the disease, provide symptomatic relief but fail to achieve a definite cure. While the neuropathological features of Alzheimer's disease are recognized but the intricacies of the mechanism have not been clearly defined. This lack of understanding regarding the pathogenic process may be the likely reason for the non-availability of effective treatment which can prevent onset and progression of the disease. Owing to the important progress in the field of pathophysiology in the last couple of years, new therapeutic targets are available that should render the underlying disease process to be tackled directly. In this review, authors will discusses the different aspects of pathophysiological mechanisms behind Alzheimer's disease and its management through conventional drug therapy, including modern investigational therapeutic strategies, recently completed and ongoing. Copyright © 2014 Institute of Pharmacology, Polish Academy of Sciences. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  9. 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

  10. Update on the diagnosis and management of Behçet’s disease

    PubMed Central

    Rokutanda, Ryo; Kishimoto, Mitsumasa; Okada, Masato

    2015-01-01

    Behçet’s disease is a multi-organ disorder that is more common in countries around the Silk Road, and manifests as mucosal ulcers and skin lesions, and with ocular involvement. As a systemic disease, it can also involve gastrointestinal organs and the central nervous or cardiovascular systems. Although the etiology of Behçet’s disease is not clearly identified, the pathogenesis of the disease is most commonly hypothesized as a profound inflammatory response triggered by an infectious agent in a genetically susceptible host. As there are no single specific manifestations or specific diagnostic tests, various diagnostic criteria have been proposed around the world, and, among them, the International Study Group criteria have been most commonly used. As the clinical expression of Behçet’s disease is heterogeneous, the treatment should be individualized based on involved organs, severity of the disease, and patient’s background. The choice of therapeutic agents is limited by lack of clinical trials and is based largely on case reports, case series, and several open-label clinical trials. Corticosteroids, colchicine, and traditional immunosuppressive agents, including azathioprine and cyclosporine, have been used for the treatment of Behçet’s disease. Recently, tumor necrosis factor (TNF) inhibitors have become available for several rheumatic diseases, and considerable published data suggest that TNF inhibitors represent an important therapeutic advance for patients with severe and resistant disease, as well as for those with contraindications or intolerance to these treatments. PMID:27790039

  11. Physical activity in primary and secondary prevention of cardiovascular disease: Overview updated

    PubMed Central

    Alves, Alberto J; Viana, João L; Cavalcante, Suiane L; Oliveira, Nórton L; Duarte, José A; Mota, Jorge; Oliveira, José; Ribeiro, Fernando

    2016-01-01

    Although the observed progress in the cardiovascular disease treatment, the incidence of new and recurrent coronary artery disease remains elevated and constitutes the leading cause of death in the developed countries. Three-quarters of deaths due to cardiovascular diseases could be prevented with adequate changes in lifestyle, including increased daily physical activity. New evidence confirms that there is an inverse dose-response relationship between physical activity and cardiovascular disease and mortality risk. However, participation in moderate to vigorous physical activity may not fully attenuate the independent effect of sedentary activities on increased risk for cardiovascular diseases. Physical activity also plays an important role in secondary prevention of cardiovascular diseases by reducing the impact of the disease, slowing its progress and preventing recurrence. Nonetheless, most of eligible cardiovascular patients still do not benefit from secondary prevention/cardiac rehabilitation programs. The present review draws attention to the importance of physical activity in the primary and secondary prevention of cardiovascular diseases. It also addresses the mechanisms by which physical activity and regular exercise can improve cardiovascular health and reduce the burden of the disease. PMID:27847558

  12. Preventing Emerging Infectious Diseases: A Strategy for the 21st Century. Overview of the Updated CDC plan.

    PubMed

    1998-09-11

    Societal, technological, and environmental factors continue to have a dramatic effect on infectious diseases worldwide, facilitating the emergence of new diseases and the reemergence of old ones, sometimes in drug-resistant forms. Modern demographic and ecologic conditions that favor the spread of infectious diseases include rapid population growth; increasing poverty and urban migration; more frequent movement across international boundaries by tourists, workers, immigrants, and refugees; alterations in the habitats of animals and arthropods that transmit disease; increasing numbers of persons with impaired host defenses; and changes in the way that food is processed and distributed. Several recent health events underscore the need for a public health system ready to address whatever disease problems that might arise. For example, in 1997, an avian strain of influenza that had never before infected humans began to kill previously healthy persons in Hong Kong, and strains of Sta phylococcus aureus with diminished susceptibility to the antibiotic vancomycin were reported in Japan and the United States. In addition, researchers recently discovered that a strain of the virus that causes acquired immunodeficiency syndrome (AIDS) had been infecting humans for at least 20 years before AIDS emerged as a worldwide epidemic. Preventing Emerging Infectious Diseases: A Strategy for the 21st Century describes CDC's plan to combat today's infectious diseases and prevent those of tomorrow. It represents the second phase of the effort launched in 1994 with the publication of CDC's Addressing Emerging Infectious Disease Threats: A Prevention Strategy for the United States. This overview of the updated plan outlines specific objectives under four major goals: a) surveillance and response, b) applied research, c) infrastructure and training, and d) prevention and control. Achieving these objectives will enhance understanding of infectious diseases and bolster their detection

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

    USDA-ARS?s Scientific Manuscript database

    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...

  14. 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…

  15. 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…

  16. The periodontal disease classification system of the American Academy of Periodontology--an update.

    PubMed

    Wiebe, C B; Putnins, E E

    2000-12-01

    Until recently, the accepted standard for the classification of periodontal diseases was the one agreed upon at the 1989 World Workshop in Clinical Periodontics. This classification system, however, had its weaknesses. In particular, some criteria for diagnosis were unclear, disease categories overlapped, and patients did not always fit into any one category. Also, too much emphasis was placed on the age of disease onset and rate of progression, which are often difficult to determine. Finally, no classification for diseases limited to the gingiva existed. In 1999, an International Workshop for a Classification of Periodontal Diseases and Conditions was organized by the American Academy of Periodontology to address these concerns and to revise the classification system. The workshop proceedings have been published in the Annals of Periodontology. The major changes to the 1989 proceedings and the rationale for these changes are summarized here. In addition, the potential impact of these changes is discussed.

  17. 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

  18. What We Are Watching-Top Global Infectious Disease Threats, 2013-2016: An Update from CDC's Global Disease Detection Operations Center.

    PubMed

    Christian, Kira A; Iuliano, A Danielle; Uyeki, Timothy M; Mintz, Eric D; Nichol, Stuart T; Rollin, Pierre; Staples, J Erin; Arthur, Ray R

    2017-08-14

    To better track public health events in areas where the public health system is unable or unwilling to report the event to appropriate public health authorities, agencies can conduct event-based surveillance, which is defined as the organized collection, monitoring, assessment, and interpretation of unstructured information regarding public health events that may represent an acute risk to public health. The US Centers for Disease Control and Prevention's (CDC's) Global Disease Detection Operations Center (GDDOC) was created in 2007 to serve as CDC's platform dedicated to conducting worldwide event-based surveillance, which is now highlighted as part of the "detect" element of the Global Health Security Agenda (GHSA). The GHSA works toward making the world more safe and secure from disease threats through building capacity to better "Prevent, Detect, and Respond" to those threats. The GDDOC monitors approximately 30 to 40 public health events each day. In this article, we describe the top threats to public health monitored during 2012 to 2016: avian influenza, cholera, Ebola virus disease, and the vector-borne diseases yellow fever, chikungunya virus, and Zika virus, with updates to the previously described threats from Middle East respiratory syndrome-coronavirus (MERS-CoV) and poliomyelitis.

  19. Communicable disease among displaced Afghans: refuge without shelter.

    PubMed

    Rajabali, Alefiyah; Moin, Omer; Ansari, Amna S; Khanani, Mohammad R; Ali, Syed H

    2009-08-01

    More than 23 years of warfare in Afghanistan has caused over 6 million Afghans to seek asylum in approximately 70 different countries, with most Afghan refugees settling in the developing countries of Pakistan and Iran. In a developing host country, poor sanitation and nutrition, overcrowding and inaccessibility to health care facilities act synergistically to influence morbidity and mortality from infectious disease in the refugee population. In this Science and Society article we discuss the prevalence of transmissible infection, modes of transmission, associated risk factors, and the state of health and health care in the displaced Afghan population.

  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.