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Sample records for extremity disease status

  1. Health status evaluation in extremely premature infants

    Directory of Open Access Journals (Sweden)

    M. Yu. Arkhipova

    2016-01-01

    Full Text Available The health status was analyzed in extremely preterm infants at a postconceptual age of 38–40 weeks and in the first year of life. All the infants in the analyzed group were shown to have respiratory disorders, severe perinatal CNS lesions, and the high incidence of bronchopulmonary dysplasia and infectious and inflammatory diseases. In the first year of life, these children belonged to a group of the frequently ill. Dysfunction of the digestive system and intestinal microflora and residual signs of rickets were detected in the majority of the patients; the manifestations of bronchopulmonary dysplasia persisted in 50%. 40% of the infants had disabling complications.

  2. Extreme weather events and infectious disease outbreaks.

    Science.gov (United States)

    McMichael, Anthony J

    2015-01-01

    Human-driven climatic changes will fundamentally influence patterns of human health, including infectious disease clusters and epidemics following extreme weather events. Extreme weather events are projected to increase further with the advance of human-driven climate change. Both recent and historical experiences indicate that infectious disease outbreaks very often follow extreme weather events, as microbes, vectors and reservoir animal hosts exploit the disrupted social and environmental conditions of extreme weather events. This review article examines infectious disease risks associated with extreme weather events; it draws on recent experiences including Hurricane Katrina in 2005 and the 2010 Pakistan mega-floods, and historical examples from previous centuries of epidemics and 'pestilence' associated with extreme weather disasters and climatic changes. A fuller understanding of climatic change, the precursors and triggers of extreme weather events and health consequences is needed in order to anticipate and respond to the infectious disease risks associated with human-driven climate change. Post-event risks to human health can be constrained, nonetheless, by reducing background rates of persistent infection, preparatory action such as coordinated disease surveillance and vaccination coverage, and strengthened disaster response. In the face of changing climate and weather conditions, it is critically important to think in ecological terms about the determinants of health, disease and death in human populations.

  3. Using Blood Indexes to Predict Overweight Statuses: An Extreme Learning Machine-Based Approach.

    Directory of Open Access Journals (Sweden)

    Huiling Chen

    Full Text Available The number of the overweight people continues to rise across the world. Studies have shown that being overweight can increase health risks, such as high blood pressure, diabetes mellitus, coronary heart disease, and certain forms of cancer. Therefore, identifying the overweight status in people is critical to prevent and decrease health risks. This study explores a new technique that uses blood and biochemical measurements to recognize the overweight condition. A new machine learning technique, an extreme learning machine, was developed to accurately detect the overweight status from a pool of 225 overweight and 251 healthy subjects. The group included 179 males and 297 females. The detection method was rigorously evaluated against the real-life dataset for accuracy, sensitivity, specificity, and AUC (area under the receiver operating characteristic (ROC curve criterion. Additionally, the feature selection was investigated to identify correlating factors for the overweight status. The results demonstrate that there are significant differences in blood and biochemical indexes between healthy and overweight people (p-value < 0.01. According to the feature selection, the most important correlated indexes are creatinine, hemoglobin, hematokrit, uric Acid, red blood cells, high density lipoprotein, alanine transaminase, triglyceride, and γ-glutamyl transpeptidase. These are consistent with the results of Spearman test analysis. The proposed method holds promise as a new, accurate method for identifying the overweight status in subjects.

  4. Is prescribed lower extremity weight-bearing status after geriatric lower extremity trauma associated with increased mortality?

    Science.gov (United States)

    Gitajn, Ida Leah; Connelly, Daniel; Mascarenhas, Daniel; Breazeale, Stephen; Berger, Peter; Schoonover, Carrie; Martin, Brook; O'Toole, Robert V; Pensy, Raymond; Sciadini, Marcus

    2018-02-01

    Evaluate whether mortality after discharge is elevated in geriatric fracture patients whose lower extremity weight-bearing is restricted. Retrospective cohort study SETTING: Urban Level 1 trauma center PATIENTS/PARTICIPANTS: 1746 patients >65 years of age INTERVENTION: Post-operative lower extremity weight-bearing status MAIN OUTCOME MEASURE: Mortality, as determined by the Social Security Death Index RESULTS: Univariate analysis demonstrated that patients who were weight-bearing as tolerated on bilateral lower extremities (BLE) had significantly higher 5-year mortality compared to patients with restricted weight-bearing on one lower extremity and restricted weight-bearing on BLE (30%, 21% and 22% respectively, p bearing as tolerated on BLE, restricted weight-bearing on one lower extremity had a hazard ratio (HR) of 0.97 (95% confidence interval 0.78 to 1.20, p = 0.76) and restricted weight-bearing in BLE had a HR of 0.91 (95% confidence interval 0.60 to 1.36, p = 0.73). In geriatric patients, prescribed weight-bearing status did not have a statistically significant association with mortality after discharge, when controlling for age, sex, body mass index, medical comorbidities, Injury Severity Scale (ISS), mechanism of injury, nonoperative treatment and admission GCS. This remained true in when the analysis was restricted to operative injuries only. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Identification of extreme motor phenotypes in Huntington's disease.

    Science.gov (United States)

    Braisch, Ulrike; Hay, Birgit; Muche, Rainer; Rothenbacher, Dietrich; Landwehrmeyer, G Bernhard; Long, Jeffrey D; Orth, Michael

    2017-04-01

    The manifestation of motor signs in Huntington's disease (HD) has a well-known inverse relationship with HTT CAG repeat length, but the prediction is far from perfect. The probability of finding disease modifiers is enhanced in individuals with extreme HD phenotypes. We aimed to identify extreme HD motor phenotypes conditional on CAG and age, such as patients with very early or very late onset of motor manifestation. Retrospective data were available from 1,218 healthy controls and 9,743 HD participants with CAG repeats ≥40, and a total of about 30,000 visits. Boundaries (2.5% and 97.5% quantiles) for extreme motor phenotypes (UHDRS total motor score (TMS) and motor age-at-onset) were estimated using quantile regression for longitudinal data. More than 15% of HD participants had an extreme TMS phenotype for at least one visit. In contrast, only about 4% of participants were consistent TMS extremes at two or more visits. Data from healthy controls revealed an upper cut-off of 13 for the TMS representing the extreme of motor ratings for a normal aging population. In HD, boundaries of motor age-at-onset based on diagnostic confidence or derived from the TMS data cut-off in controls were similar. In summary, a UHDRS TMS of more than 13 in an individual carrying the HD mutation indicates a high likelihood of motor manifestations of HD irrespective of CAG repeat length or age. The identification of motor phenotype extremes can be useful in the search for disease modifiers, for example, genetic or environmental such as medication. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  6. Extremely thermophilic microorganisms for biomass conversion: status and prospects.

    Science.gov (United States)

    Blumer-Schuette, Sara E; Kataeva, Irina; Westpheling, Janet; Adams, Michael Ww; Kelly, Robert M

    2008-06-01

    Many microorganisms that grow at elevated temperatures are able to utilize a variety of carbohydrates pertinent to the conversion of lignocellulosic biomass to bioenergy. The range of substrates utilized depends on growth temperature optimum and biotope. Hyperthermophilic marine archaea (T(opt)>or=80 degrees C) utilize alpha- and beta-linked glucans, such as starch, barley glucan, laminarin, and chitin, while hyperthermophilic marine bacteria (T(opt)>or=80 degrees C) utilize the same glucans as well as hemicellulose, such as xylans and mannans. However, none of these organisms are able to efficiently utilize crystalline cellulose. Among the thermophiles, this ability is limited to a few terrestrial bacteria with upper temperature limits for growth near 75 degrees C. Deconstruction of crystalline cellulose by these extreme thermophiles is achieved by 'free' primary cellulases, which are distinct from those typically associated with large multi-enzyme complexes known as cellulosomes. These primary cellulases also differ from the endoglucanases (referred to here as 'secondary cellulases') reported from marine hyperthermophiles that show only weak activity toward cellulose. Many extremely thermophilic enzymes implicated in the deconstruction of lignocellulose can be identified in genome sequences, and many more promising biocatalysts probably remain annotated as 'hypothetical proteins'. Characterization of these enzymes will require intensive effort but is likely to generate new opportunities for the use of renewable resources as biofuels.

  7. Progression of disease preceding lower extremity amputation in Denmark

    DEFF Research Database (Denmark)

    Jensen, Pia Søe; Petersen, Janne; Kirketerp-Møller, Klaus

    2017-01-01

    OBJECTIVES: Patients with non-traumatic lower extremity amputation are characterised by high age, multi-morbidity and polypharmacy and long-term complications of atherosclerosis and diabetes. To ensure early identification of patients at risk of amputation, we need to gain knowledge about...... the progression of diseases related to lower extremity amputations during the years preceding the amputation. DESIGN: A retrospective population-based national registry study. SETTING: The study includes data on demographics, diagnoses, surgery, medications and healthcare services from five national registries....... Data were retrieved from 14 years before until 1 year after the amputation. Descriptive statistics were used to describe the progression of diseases and use of medication and healthcare services. PARTICIPANTS: An unselected cohort of patients (≥50 years; n=2883) subjected to a primary non...

  8. Analysis and evaluation of functional status of lower extremity amputee-appliance systems: an integrated approach.

    Science.gov (United States)

    Ganguli, S

    1976-11-01

    This paper introduces an integrated, objective and biomechanically sound approach for the analysis and evaluation of the functional status of lower extremity amputee-appliance systems. The method is demonstrated here in its application to the unilateral lower extremity amputee-axillary crutches system and the unilateral below-knee amputee-PTB prosthesis system, both of which are commonly encountered in day-to-day rehabilitation practice.

  9. Extreme delta brush evolving into status epilepticus in a patient with anti-NMDA encephalitis

    Directory of Open Access Journals (Sweden)

    Aline Herlopian, MD

    2017-01-01

    Full Text Available Extreme delta brush (EDB is an EEG pattern unique to anti-NMDA encephalitis. It is correlated with seizures and status epilepticus in patients who have a prolonged course of illness. The etiology of the underlying association between EDB and seizures is not understood. We present a patient with anti-NMDA encephalitis who developed status epilepticus evolving from the high frequency activity of the extreme delta brush. This case demonstrates that EDB is not only a marker for a greater propensity for seizures but also directly implicated in seizure generation.

  10. Ultrasonographic findings of Kimura's disease presenting in the upper extremities.

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    Shin, Gi Won; Lee, Sun Joo; Choo, Hye Jung; Park, Young Mi; Jeong, Hae Woong; Lee, Sung-Moon; Suh, Jin-Suck; Jung, Soo-Jin

    2014-12-01

    To describe ultrasound findings of Kimura's disease arising in the upper extremities. Five patients with Kimura's disease confirmed by surgical resection were retrospectively reviewed by two musculoskeletal radiologists and a pathologist. All six lesions involved the epitrochlear area and appeared as partially (n = 5) or poorly (n = 1) marginated subcutaneous masses with the presence of curvilinear hyperechoic bands intermingled within the hypoechoic components by US. Moderate (n = 4) to severe (n = 2) vascular signals were observed in some proportion of the hyperechoic bands by color Doppler US. The associated findings were the increased echogenicity of surrounding subcutaneous fat (n = 6) and adjacent lymphadenopathy (n = 4). Microscopic examination showed proliferation of lymphoid follicles with prominent germinal centers and intervening fibrosis. In this study, Kimura's disease arising in the upper extremities showed a partially defined hypoechoic subcutaneous mass with internal hyperechoic bands and moderate-to-severe vascularities, increased echogenicity of the surrounding subcutaneous fat and adjacent lymphadenopathy on US. Thus, when these US features are observed in the typical epitrochlear region of an Asian individual, especially if accompanied by peripheral eosinophilia, Kimura's disease should be considered as a possible diagnosis.

  11. A rare disease in an atypical location - Kimura's Disease of the upper extremity

    Energy Technology Data Exchange (ETDEWEB)

    Lam, Alan Cheuk Si; Lau, Vince Wing Hang [Queen Mary Hospital, Department of Radiology, Hong Kong (China); Au Yeung, Rex Kwok Him [University of Hong Kong, Department of Pathology, Li Ka Shing Faculty of Medicine, Hong Kong (China)

    2015-12-15

    Kimura's disease is a rare chronic inflammatory disorder predominantly affecting young Asian male patients, occurring mainly in the head and neck regions. Kimura's disease of the upper extremity is extremely rare, and previous case reports in the literature show similar imaging characteristics with consistent location at the medial epitrochlear region, predominantly with unilateral involvement. We present the first reported case of Kimura's disease affecting the anterolateral aspect of the upper arm, sparing the medial epitrochlear region, illustrating that with typical MR appearance and serology, the involvement of this rare disease in an atypical location still warrants consideration of this diagnosis. There was also bilateral asymmetrical involvement in our patient, suggesting the possibility of a propensity for Kimura's disease affecting the upper extremities to have bilateral involvement, which may necessitate imaging of the clinically asymptomatic contralateral limb in these patients for early lesion identification and treatment. (orig.)

  12. A rare disease in an atypical location - Kimura's Disease of the upper extremity

    International Nuclear Information System (INIS)

    Lam, Alan Cheuk Si; Lau, Vince Wing Hang; Au Yeung, Rex Kwok Him

    2015-01-01

    Kimura's disease is a rare chronic inflammatory disorder predominantly affecting young Asian male patients, occurring mainly in the head and neck regions. Kimura's disease of the upper extremity is extremely rare, and previous case reports in the literature show similar imaging characteristics with consistent location at the medial epitrochlear region, predominantly with unilateral involvement. We present the first reported case of Kimura's disease affecting the anterolateral aspect of the upper arm, sparing the medial epitrochlear region, illustrating that with typical MR appearance and serology, the involvement of this rare disease in an atypical location still warrants consideration of this diagnosis. There was also bilateral asymmetrical involvement in our patient, suggesting the possibility of a propensity for Kimura's disease affecting the upper extremities to have bilateral involvement, which may necessitate imaging of the clinically asymptomatic contralateral limb in these patients for early lesion identification and treatment. (orig.)

  13. Vitamin K status in chronic kidney disease.

    Science.gov (United States)

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

    2013-11-07

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

  14. Iron status and cardiovascular disease risk in black South African ...

    African Journals Online (AJOL)

    2011-03-29

    Mar 29, 2011 ... Keywords: iron status, cardiovascular disease, African women, PURE study. Iron status and .... sponsored Arlie Conference.20 Body circumferences of participants ...... cardiovascular disease prevention in clinical practice.

  15. The fat and the thin - a survey of nutritional status and disease ...

    African Journals Online (AJOL)

    The nutritional status of and disease patterns in 449 healthy and 803 hospitalized urbanized Blacks in Durban were surveyed. While unemployed males were generally less fat than controls, obesity (i.e. weight 40% over that expected) was extremely common among female factory (33%) and female hospital 'domestic' ...

  16. Effect of poverty reduction program on nutritional status of the extreme poor in Bangladesh.

    Science.gov (United States)

    Jalal, Chowdhury S B; Frongillo, Edward A

    2013-12-01

    Poverty alleviation programs for the extreme poor improve participants' economic status and may impact other important outcomes that are seldom evaluated. A program targeted to the extreme poor by BRAG, a development organization in Bangladesh, has been successful in significantly alleviating extreme poverty. We hypothesized that the program also improved the nutritional status of women and preschool children. A nonequivalent control, pre- and posttest quasi-experimental design that was longitudinal at the village level was used to test the hypotheses. Data were collected from a random sample of 4,131 children and 3,551 women from 3,409 households in 159 villages of 3 northern districts of Bangladesh in 2002 and 2006. Linear mixed random-intercept models accounted for clustering effects and potential confounders. The weight-for-height of children between 24 and 35 months of age from program households was significantly higher (p growth and body-composition indicators in three other age categories of preschool children or in women. These results are important, as this is a large-scale program that has already been extended to more than half the country. The findings will contribute to judging the cost-benefit and cost-effectiveness of the program and in garnering support for the expansion of such programs.

  17. Employment and weight status: The extreme case of body concern in South Korea.

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    Han, Seung-Yong; Brewis, Alexandra A; SturtzSreetharan, Cindi

    2018-05-01

    For an industrialized nation, obesity rates in South Korea are extremely low. Yet, reflecting an extremely fat-averse, thin-positive society, efforts to lose weight are now reportedly very common. Since the 1980s, South Korea has experienced an increasingly flexible and insecure labor market which was exacerbated by the 1997 economic recession. In this social and economic setting, body shape and weight status, as human capital, may have gained significant bargaining power in the labor market. Consequently, we propose that Koreans, particularly those who are employed in "stable" jobs (i.e., non-manual and regular jobs), would increasingly engage in intense weight management and reduction activities even when not technically overweight or obese as a means to job security and upward mobility. Using nationally-representative data from the Korean Nutrition and Health Examination Survey (KNHANES), we identify the changing role of weight concerns versus actual body weight in predicting South Korean efforts to lose weight between 2001 (KNHANES-phase 1) and 2007-2009 (phase 4). The patterns were examined by occupation type (manual and non-manual jobs) and status (regular and non-regular jobs). Oaxaca decomposition analysis supported that people's perception of being "fat," rather than actual weight status, was crucial to explaining accelerated weight management efforts in South Korea over the decade (coef. = 0.062 and p-value < .0001 for male with regular work; coef. = 0.031 and p-value = .002 for female with regular work). Occupation status, rather than employment in itself, mattered. Job stability predicted increased effort; the pattern of change through time suggests efforts to invest high levels of effort in appearance positively impacts both employment opportunity and stability. Copyright © 2018 Elsevier B.V. All rights reserved.

  18. The extremity function index (EFI), a disability severity measure for neuromuscular diseases : psychometric evaluation

    NARCIS (Netherlands)

    Bos, Isaac; Wynia, Klaske; Drost, Gea; Almansa, Josué; Kuks, Joannes

    2017-01-01

    OBJECTIVE: To adapt and to combine the self-report Upper Extremity Functional Index and Lower Extremity Function Scale, for the assessment of disability severity in patients with a neuromuscular disease and to examine its psychometric properties in order to make it suitable for indicating disease

  19. Health status as a risk factor in cardiovascular disease

    DEFF Research Database (Denmark)

    Mommersteeg, Paula M C; Denollet, Johan; Spertus, John A

    2009-01-01

    Patient-perceived health status is receiving increased recognition as a patient-centered outcome in chronic heart failure (CHF) and coronary artery disease (CAD), but poor health status is also associated with adverse prognosis. In this systematic review, we examined current evidence...... on the influence of health status on prognosis in CHF and CAD....

  20. Implementation status of the extreme light infrastructure - nuclear physics (ELI-NP) project

    Energy Technology Data Exchange (ETDEWEB)

    Gales, S., E-mail: sydney.gales@eli-np.ro; Zamfir, N. V., E-mail: sydney.gales@eli-np.ro [ELI-NP, Horia Hulubei National Institute for Physics and Nuclear Engineering, 30 Reactorului Street, RO-077125 Bucharest-Magurele (Romania)

    2015-02-24

    The Project Extreme Light Infrastructure (ELI) is part of the European Strategic Forum for Research Infrastructures (ESFRI) Roadmap. ELI will be built as a network of three complementary pillars at the frontier of laser technologies. The ELI-NP pillar (NP for Nuclear Physics) is under construction near Bucharest (Romania) and will develop a scientific program using two 10 PW lasers and a Compton back-scattering high-brilliance and intense gamma beam, a marriage of laser and accelerator technology at the frontier of knowledge. In the present paper, the technical description of the facility, the present status of the project as well as the science, applications and future perspectives will be discussed.

  1. Lower extremity function in normal cognitive aging, mild cognitive impairment, and Alzheimer’s disease

    NARCIS (Netherlands)

    Eggermont, L.H.P.; Gavett, B.E.; Volkers, K.M.; Blankevoort, C.G.; Scherder, E.J.A.; Jefferson, A.L.; Steinberg, E.; Nair, A.; Green, R.C.; Stern, R.A.

    2010-01-01

    Eggermont LH, Gavett BE, Volkers KM, Blankevoort CG, Scherder EJ, Jefferson AL, Steinberg E, Nair A, Green RC, Stern RA. Lower-extremity function in cognitively healthy aging, mild cognitive impairment, and Alzheimer's disease. Objective: To examine differences in lower-extremity function in

  2. Status of cassava mosaic disease and whitefly population in Zambia ...

    African Journals Online (AJOL)

    Cassava mosaic disease is the most important disease affecting cassava in Zambia. A study was conducted through a survey to determine the status of cassava mosaic disease incidence, severity and whitefly abundance in farmers' fields in six provinces: Lusaka, Northern, North-Western, Luapula, Eastern and Western ...

  3. Superior Lower Extremity Vein Graft Bypass Patency among Married Patients with Peripheral Artery Disease.

    Science.gov (United States)

    Lagergren, Emily; Kempe, Kelly; Craven, Timothy E; Kornegay, Susan T; Hurie, Justin B; Garg, Nitin; Velazquez-Ramirez, Gabriela; Edwards, Matthew S; Corriere, Matthew A

    2017-10-01

    Outcome disparities associated with lower extremity bypass (LEB) for peripheral artery disease (PAD) have been identified but are poorly understood. Marital status may affect outcomes through factors related to health risk behaviors, adherence, and access to care but has not been characterized as a predictor of surgical outcomes and is often omitted from administrative data sets. We evaluated associations between marital status and vein graft patency following LEB using multivariable models adjusting for established risk factors. Consecutive patients undergoing autogenous LEB for PAD were identified and analyzed. Survival analysis and Cox proportional hazards models were used to evaluate patency stratified by marital status (married versus single, divorced, or widow[er]) adjusting for demographic, comorbidity, and anatomic factors in multivariable models. Seventy-three participants who underwent 79 autogenous vein LEB had complete data and were analyzed. Forty-three patients (58.9%) were married, and 30 (41.1%) were unmarried. Compared with unmarried patients, married patients were older at the time of their bypass procedure (67.3 ± 10.8 years vs. 62.2 ± 10.6 years; P = 0.05). Married patients also had a lower prevalence of female gender (11.6% vs. 33.3%; P = 0.02). Diabetes, hypertension, hyperlipidemia, and smoking were common among both married and unmarried patients. Minimum great saphenous vein conduit diameters were larger in married versus unmarried patients (2.82 ± 0.57 mm vs. 2.52 ± 0.65 mm; P = 0.04). Twenty-four-month primary patency was 66% for married versus 38% for unmarried patients. In a multivariable proportional hazards model adjusting for proximal and distal graft inflow/outflow, medications, gender, age, race, smoking, diabetes, and minimum vein graft diameter, married status was associated with superior primary patency (hazard ratio [HR] = 0.33; 95% confidence limits [0.11, 0.99]; P = 0.05); other predictive covariates

  4. Hiccup: An Extremely Rare Presentation of Thyrotoxicosis of Graves’ Disease

    Directory of Open Access Journals (Sweden)

    Irshad Parray

    2011-03-01

    Full Text Available Persistent hiccup is a rare but potentially severe condition that can be symptomatic of a variety of diseases or idiopathic. Most episodes last only a few minutes and are self-limited, but hiccup can get persistent and become a real problem for physician and patient alike. The center of hiccup may be activated by a great variety of stimuli travelling along different nerve pathways and bring different effecter responses. We report a case of persistent hiccup as a presentation of impending thyroid storm of Graves’ disease. Though the condition is rare, clinicians should remain alert to the possibility of this diagnosis.

  5. [Magnetotherapy in obliterating vascular diseases of the lower extremities].

    Science.gov (United States)

    Kirillov, Iu B; Shval'b, P G; Lastushkin, A V; Baranov, V M; Sigaev, A A; Zueva, G V; Karpov, E I

    1992-01-01

    The investigators have developed a polymagnetic system "Avrora-MK-01" employing running impulse magnetic field to treat diseases of the leg vessels by the action on peripheral capillary bed. At a pregangrene stage a positive effect on peripheral capillaries was achieved in 75-82% of the patients treated.

  6. Lower extremity necrotizing fasciitis: A unique initial presentation of Crohn's disease

    Directory of Open Access Journals (Sweden)

    Anna Weiss

    2015-09-01

    Full Text Available Crohn's disease is a disease of the bowel, typically presenting with diarrhea, weight loss, and abdominal pain. Complications such as abscesses, fistulas, and strictures may require surgical intervention. We would like to report a patient with Crohn's disease who presented for the first time with left lower extremity necrotizing fasciitis. There are very few reports of necrotizing fasciitis in Crohn's disease as the initial presentation.

  7. Current status of adrenalectomy for Cushing's disease

    International Nuclear Information System (INIS)

    Brunicardi, F.C.; Rosman, P.M.; Lesser, K.L.; Andersen, D.K.

    1985-01-01

    To evaluate the current use of adrenalectomy in the treatment of Cushing's disease, we reviewed seven consecutive patients who have undergone adrenalectomy for Cushing's disease at this medical center during 1983 to 1984. Seventy-one percent (5/7) had pituitary, or type I, Cushing's disease, while 29% (2/7) had adrenal, or type II, Cushing's disease from either an adenoma or an adrenocortical carcinoma. Presenting signs and symptoms, either initially or at the time of recurrence, were typical of Cushing's syndrome. Four of five patients with type I disease had recurrent disease after transphenoidal hypophysectomy, bilateral adrenalectomy, or unilateral adrenalectomy. In three of five patients, medical therapy of hypercortisolism was abandoned because of adverse side effects. Preoperative evaluation in all patients included cortisol and ACTH levels, dexamethasone suppression tests, and computerized tomography (both abdominal and head). In patients with a prior history of adrenalectomy, radiocholesterol scans were also performed and were useful. Angiographic procedures were not required in these patients. In patients with type I disease, posterior operative approaches were used. In patients with type II disease, an anterolateral approach was used. Posterolateral incisions are preferred over Hugh-Young incisions and provide better exposure with a reduced risk of poor wound healing. Morbidity and mortality included one death and three nonhealing wounds. In the six surviving patients, symptoms resolved with variable frequency. Findings suggestive of Nelson's syndrome (hyperpigmentation) have occurred in two patients; serial computerized tomographic scans fail to reveal evidence of pituitary tumors

  8. The current status of sheep pox disease.

    Science.gov (United States)

    Bhanuprakash, V; Indrani, B K; Hosamani, M; Singh, R K

    2006-01-01

    Sheep are the moving banks of shepherds and their economic contribution in terms of meat, wool and skin/hide is immense. Various infectious diseases jeopardize the optimum productivity; among which sheep pox is more important as the disease restricts the export of sheep and their products besides other economic losses. Although, clinical signs are indicative of the disease but a laboratory confirmation is necessary for unequivocal diagnosis and studying epidemiology. The causative agent, sheep pox virus (SPV), is antigenically and genetically closely related to goat pox virus (GPV) and lumpy skin disease virus (LSDV), the other members of the genus capripox virus. In some countries, SPV and GPV are cross infective to small ruminants posing problem in diagnosis and epidemiology. However, recent studies have showed that the viruses are phylogenetically distinct and can be differentiated by molecular tools. Prophylaxis using attenuated vaccines is the choice of control measure as the immunity is long lasting. Detailed information on isolation, identification, pathology, epidemiology, diagnosis and prophylaxis would not only help in updating the knowledge of scientific fraternity but will be useful to the policy makers in order to formulate appropriate measures for control and eradication of the disease. This synthesis is to present an up-to-date review of the disease and its control to provide the reader with an overview of the problem.

  9. Occupational exposure to extremely low-frequency magnetic fields and risk for central nervous system disease

    DEFF Research Database (Denmark)

    Pedersen, Camilla; Poulsen, Aslak Harbo; Rod, Naja Hulvej

    2017-01-01

    Purpose: Evidence of whether exposure to extremely low-frequency magnetic fields (ELF-MF) is related to central nervous system diseases is inconsistent. This study updates a previous study of the incidence of such diseases in a large cohort of Danish utility workers by almost doubling the period...

  10. Extreme concentrations of endogenous sex hormones, ischemic heart disease, and death in women

    DEFF Research Database (Denmark)

    Benn, Marianne; Voss, Sidsel Skou; Holmegard, Haya N.

    2015-01-01

    OBJECTIVE - : Sex hormones may be critical determinants of ischemic heart disease and death in women, but results from previous studies are conflicting. To clarify this, we tested the hypothesis that extreme plasma concentrations of endogenous estradiol and testosterone are associated with risk...... for ischemic heart disease, 36% (18%-58%) higher for any death, and 38% (15%-65%) higher for death from other causes than cardiovascular disease and cancer. These results were similar for postmenopausal women alone. CONCLUSIONS - : In women, extreme low concentrations of endogenous estradiol were associated...

  11. Coronary arterial Disease associated with arteriosclerosis in lower extremity: Angiographic analysis

    International Nuclear Information System (INIS)

    Kim, Ji Hye; Chung, Jin Wook; Lee, Seon Kyu; Han, Joon Koo; Park, Jae Hyung; Kim, Jae Seung; Han, Man Chung

    1993-01-01

    We performed both peripheral and coronary angiographies in 52 patients with an arteriosclerosis in lower extremities. The severity of arteriosclerotic narrowing of the coronary and peripheral arteries were compared on angiographies. An angiographic vascular score(AVS, 0-5) reflecting the number and the degree of stenosis in 12 lower extremity arteries and three major coronary arteries was assigned to each angiogram and the sun of scores in the lower extremity arteries was compared with the incidence of significant coronary artery disease (more than grade 3) and coronary score. Relation of incidence and severity of vascular stenosis and risk factors (diabetes metallitus, hypertension, smoking, and hypercholesterolemia) was also analyzed. Thirty-four of 52 patients (65%) had an angiographically significant coronary artery disease. Thirteen of these 34 patients (38%) had no clinical symptom and sign of the ischemic heart disease. There was no statistically significant difference in the incidence and severity of coronary artery disease between high (more than 30) and low AVS group in lower extremity (p>0.14). All patients had at least one risk factor and 49 of 52 patients (94%) had multiple risk factors. Coronary angiography was normal in there patients with only one risk factors, and angiographically significant coronary artery disease existed in nine of 16 cases (56.3%) with two risk factors. 13 of 17 case (76.5%) with three risk factors, and 12 of 16 cases (75.0%) with all four risk factors. There were no significant correlations between individual risk factors and incidence, severity of arteriosclerosis in coronary and lower extremity arteries. In conclusion, angiographic evaluation of the coronary artery disease in patients with lower extremity arteriosclerosis is necessary because of the high chance of coronary artery disease and difficulty in the prediction of coronary artery disease with a severity of the peripheral arteriosclerosis, presence of various risk

  12. Sufficient vitamin K status combined with sufficient vitamin D status is associated with better lower extremity function: a prospective analysis of two knee osteoarthritis cohorts.

    Science.gov (United States)

    Shea, M Kyla; Loeser, Richard F; McAlindon, Timothy E; Houston, Denise K; Kritchevsky, Stephen B; Booth, Sarah L

    2017-10-17

    Vitamins K and D are important for the function of vitamin K-dependent proteins in joint tissues. It is unclear if these nutrients are mutually important to functional outcomes related to knee osteoarthritis (OA). We evaluated the association of vitamin K and D sufficiency with lower-extremity function in the Health, Aging Body Composition Knee OA Sub-study (Health ABC) and conducted a replication analysis in an independent cohort, the Osteoarthritis Initiative (OAI). In Health ABC (60% female, 75±3 years) baseline nutrient status was measured using circulating vitamin K and 25(OH)D. Lower-extremity function was assessed using the short physical performance battery (SPPB) and usual 20-meter gait speed. In the OAI (58% female, 61±9 years), baseline nutrient intake was estimated by food frequency questionnaire. Lower-extremity function was assessed using usual 20-meter gait speed and chair stand completion time. Multivariate mixed models were used to evaluate the association of vitamin K and D status and intake with lower-extremity function over 4-5 years. Health ABC participants with sufficient plasma vitamin K (≥1.0 nmol/L) and serum 25(OH)D (≥50 nmol/L) generally had better SPPB scores and faster usual gait speed over follow-up (p≤0.002). In the OAI, sufficient vitamin K and vitamin D intake combined was associated with overall faster usual gait speed and chair stand completion time over follow-up (p≤0.029). Sufficient vitamin K status combined with sufficient vitamin D status was associated with better lower-extremity function in two knee OA cohorts. These findings merit confirmation in vitamin K and D co-supplementation trials. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  13. Endovascular Interventions for Acute and Chronic Lower Extremity Deep Venous Disease: State of the Art.

    Science.gov (United States)

    Sista, Akhilesh K; Vedantham, Suresh; Kaufman, John A; Madoff, David C

    2015-07-01

    The societal and individual burden caused by acute and chronic lower extremity venous disease is considerable. In the past several decades, minimally invasive endovascular interventions have been developed to reduce thrombus burden in the setting of acute deep venous thrombosis to prevent both short- and long-term morbidity and to recanalize chronically occluded or stenosed postthrombotic or nonthrombotic veins in symptomatic patients. This state-of-the-art review provides an overview of the techniques and challenges, rationale, patient selection criteria, complications, postinterventional care, and outcomes data for endovascular intervention in the setting of acute and chronic lower extremity deep venous disease. Online supplemental material is available for this article.

  14. Effects of extreme precipitation to the distribution of infectious diseases in Taiwan, 1994-2008.

    Directory of Open Access Journals (Sweden)

    Mu-Jean Chen

    Full Text Available The incidence of extreme precipitation has increased with the exacerbation of worldwide climate disruption. We hypothesize an association between precipitation and the distribution patterns that would affect the endemic burden of 8 infectious diseases in Taiwan, including water- and vector-borne infectious diseases. A database integrating daily precipitation and temperature, along with the infectious disease case registry for all 352 townships in the main island of Taiwan was analysed for the period from 1994 to 2008. Four precipitation levels, 350 mm, were categorized to represent quantitative differences, and their associations with each specific disease was investigated using the Generalized Additive Mixed Model and afterwards mapped on to the Geographical Information System. Daily precipitation levels were significantly correlated with all 8 mandatory-notified infectious diseases in Taiwan. For water-borne infections, extreme torrential precipitation (>350 mm/day was found to result in the highest relative risk for bacillary dysentery and enterovirus infections when compared to ordinary rain (<130 mm/day. Yet, for vector-borne diseases, the relative risk of dengue fever and Japanese encephalitis increased with greater precipitation only up to 350 mm. Differential lag effects following precipitation were statistically associated with increased risk for contracting individual infectious diseases. This study's findings can help health resource sector management better allocate medical resources and be better prepared to deal with infectious disease outbreaks following future extreme precipitation events.

  15. Weight Status in the First 2 Years of Life and Neurodevelopmental Impairment in Extremely Low Gestational Age Newborns.

    Science.gov (United States)

    Belfort, Mandy B; Kuban, Karl C K; O'Shea, T Michael; Allred, Elizabeth N; Ehrenkranz, Richard A; Engelke, Stephen C; Leviton, Alan

    2016-01-01

    To examine the extent to which weight gain and weight status in the first 2 years of life relate to the risk of neurodevelopmental impairment in extremely preterm infants. In a cohort of 1070 infants born between 23 and 27 weeks' gestation, we examined weight gain from 7-28 days of life (in quartiles) and weight z-score at 12 and 24 months corrected age (in 4 categories: Weight gain in the lowest quartile from 7-28 days was not associated with higher risk of adverse outcomes. Children with a 12-month weight z-score weight z-score weight z-score at 24 months with adverse outcomes were attenuated with exclusion of children with motor impairment. Excluding children who have gross motor impairment appears to eliminate the association of low weight status with neurodevelopmental impairments at 2 years in extremely preterm infants. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Knowledge of HIV and hepatitis B and C status among people living in extreme poverty in France, in 2012.

    Science.gov (United States)

    Chappuis, M; Pauti, M-D; Tomasino, A; Fahet, G; Cayla, F; Corty, J-F

    2015-03-01

    "Médecins du Monde" healthcare centers receive individuals living in extremely precarious conditions for primary health care; 94% of these are foreigners. These medical consultations are an opportunity to discuss their serological status and to offer them screening tests. Two standardized questionnaires were implemented in all healthcare centers in 2000. The medical record covers knowledge of HIV and hepatitis B and C status. 41,033 consultations were given in 2012 in the 20 healthcare centers, for 23,181 patients. Only 29% of the patients knew their hepatitis status and 35% their HIV status. 42% of French patients were unaware of their HIV status compared to 67% of foreign patients. The lack of knowledge of foreign patients' HIV status was more frequent among men and in age classes60 years of age. Patients from non-EU Europe, the Middle East, and Asia were significantly more likely to be unaware of their HIV status compared to people from Sub-Saharan Africa and Oceania/America. The rate of foreigners not having undergone screening remained stable, regardless of the duration of residence in France. These results highlight the need to develop specific prevention projects among immigrant populations in precarious situations. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  17. Regional cerebral blood flow patterns in extremely elderly patients with Alzheimer's disease

    International Nuclear Information System (INIS)

    Hirao, Kentaro; Hanyu, Haruo; Kanetaka, Hidekazu; Shimizu, Soichiro; Sato, Tomohiko; Iwamoto, Toshihiko

    2008-01-01

    Clinical and pathologic features in Alzheimer's disease (AD) patients differ depending on the age of onset. The aim of our study was to compare the regional cerebral blood flow (rCBF) patterns of younger, elderly, and extremely elderly patients with AD with that of controls to characterize the rCBF patterns in extremely elderly patients with AD. Single photon emission CT (SPECT) was performed in 113 patients with probable AD, including 34 younger (<70 years), 41 elderly (70-84 years), and 38 extremely elderly (≥85 years) patients divided according to age at examination. The SPECT data were analyzed using three-dimensional stereotactic surface projection (3D-SSP). No significant differences regarding gender, duration of disease, education, and Mini-Mental State Examination score were found among the groups. As compared with controls, younger and elderly AD demonstrated significant reduction of rCBF in the temporo-parietal areas, posterior cingulate cortices and precunei, which is considered to be a characteristic rCBF pattern in AD. On the other hand, the extremely elderly AD group demonstrated significant reduction of rCBF in the frontal and medial temporal areas, in addition to the temporo-parietal areas, posterior cingulate cortices and precunei, but the reductions were milder than in those in younger and elderly AD groups. The extremely elderly patients with AD showed atypical rCBF patterns in AD compared to younger and elderly patients with AD. Our data suggest that pathological features in extremely elderly AD may be different from those in younger and elderly AD and that diseases different from AD, such as senile dementia of the neurofibrillary tangle type may be clinically diagnosed as extremely elderly AD. (author)

  18. Occupational exposure to electromagnetic fields (Emf) of extremely low frequency and Alzheimer disease

    International Nuclear Information System (INIS)

    Mir, L.

    2008-01-01

    Occupational exposure to extremely low frequency electromagnetic fields (between 3 and 3000 hz) is one potential risk factor for Alzheimer disease. this critical meta-analysis of the published epidemiologic work suggests the existence of an association in a very heterogeneous dataset. It looks for potential sources of error, examines the areas of uncertainty, and calls for the pursuit of further research. (author)

  19. Lower-Extremity Function in Cognitively Healthy Aging, Mild Cognitive Impairment, and Alzheimer's Disease

    NARCIS (Netherlands)

    Eggermont, Laura H.; Gavett, Brandon E.; Volkers, Karin M.; Blankevoort, Christiaan G.; Scherder, Erik J.; Jefferson, Angela L.; Steinberg, Eric; Nair, Anil; Green, Robert C.; Stern, Robert A.

    Eggermont LH, Gavett BE, Volkers KM, Blankevoort CG, Scherder EJ, Jefferson AL, Steinberg E, Nair A, Green RC, Stern RA. Lower-extremity function in cognitively healthy aging, mild cognitive impairment, and Alzheimer's disease. Arch Phys Med Rehabil 2010;91:584-8. Objective: To examine differences

  20. Maternal global methylation status and risk of congenital heart diseases

    NARCIS (Netherlands)

    van Driel, Lydi M. J. W.; de Jonge, Robert; Helbing, Willem A.; van Zelst, Bertrand D.; Ottenkamp, Jaap; Steegers, Eric A. P.; Steegers-Theunissen, Regine P. M.

    2008-01-01

    OBJECTIVE: To investigate whether the association between the maternal methylation status as reflected by low S-adenosylmethionine and high S-adenosylhomocysteine, is detrimental for cardiogenesis and congenital heart disease (CHD) in the offspring. METHODS: As part of a case-control study in the

  1. Socio-economic status, risk factors and coronary heart disease ...

    African Journals Online (AJOL)

    The relationship of socio-economic status (SES) indicators and coronary risk factors (RFs) with coronary heart disease (CHD) prevalence was examined in 5620 subjects aged 20 ... The SES indicators had Iitlle or no independent effect on CHD prevalence in multivariate logistic analyses after, inclusion of the standard RFs.

  2. Partial status epilepticus - rapid genetic diagnosis of Alpers' disease.

    LENUS (Irish Health Repository)

    McCoy, Bláthnaid

    2011-11-01

    We describe four children with a devastating encephalopathy characterised by refractory focal seizures and variable liver dysfunction. We describe their electroencephalographic, radiologic, genetic and pathologic findings. The correct diagnosis was established by rapid gene sequencing. POLG1 based Alpers\\' disease should be considered in any child presenting with partial status epilepticus.

  3. Vitamin D status and periodontal disease among pregnant women.

    Science.gov (United States)

    Boggess, Kim A; Espinola, Janice A; Moss, Kevin; Beck, Jim; Offenbacher, Steven; Camargo, Carlos A

    2011-02-01

    Maternal periodontal disease is found in pregnancy outcomes. Vitamin D deficiency may play a role in periodontal disease and tooth loss, and insufficient vitamin D status is common among pregnant women. The objective of this study is to examine the relationship between maternal vitamin D status and periodontal disease. A case-control study was conducted. Cases were defined as pregnant women with clinical moderate to severe periodontal disease; controls were pregnant women who were periodontally healthy. Maternal data were chart abstracted and serum was collected between 14 and 26 weeks of gestation. Serum 25-hydroxyvitamin D (25[OH]D) levels were measured using liquid chromatography-tandem mass spectrometry. Median serum 25(OH)D levels and prevalence of vitamin D insufficiency (defined as periodontal disease among women with vitamin D insufficiency was calculated using multivariable logistic regression, adjusting for maternal race, season of blood draw, and other potential confounders. A total of 117 cases were compared to 118 controls. Cases had lower median 25(OH)D levels than controls (59 versus 100 nmol/l; P periodontal disease among women with vitamin D insufficiency was 2.1 (0.99 to 4.5). Vitamin D insufficiency (serum 25[OH]D periodontal disease during pregnancy. Vitamin D supplementation represents a potential therapeutic strategy to improve maternal oral health.

  4. Metabolic disorders and nutritional status in autoimmune thyroid diseases

    Directory of Open Access Journals (Sweden)

    Anna Kawicka

    2015-01-01

    Full Text Available In recent years, the authors of epidemiological studies have documented that autoimmune diseases are a major problem of modern society and are classified as diseases of civilization. Autoimmune thyroid diseases (ATDs are caused by an abnormal immune response to autoantigens present in the thyroid gland – they often coexist with other autoimmune diseases. The most common dysfunctions of the thyroid gland are hypothyroidism, Graves-Basedow disease and Hashimoto’s disease. Hashimoto’s thyroiditis can be the main cause of primary hypothyroidism of the thyroid gland. Anthropometric, biochemical and physicochemical parameters are used to assess the nutritional status during the diagnosis and treatment of thyroid diseases. Patients with hypothyroidism are often obese, whereas patients with hyperthyroidism are often afflicted with rapid weight loss. The consequence of obesity is a change of the thyroid hormones’ activity; however, weight reduction leads to their normalization. The activity and metabolic rate of thyroid hormones are modifiable. ATDs are associated with abnormalities of glucose metabolism and thus increased risk of developing diabetes mellitus type 1 and type 2. Celiac disease (CD also increases the risk of developing other autoimmune diseases. Malnutrition or the presence of numerous nutritional deficiencies in a patient’s body can be the cause of thyroid disorders. Coexisting deficiencies of such elements as iodine, iron, selenium and zinc may impair the function of the thyroid gland. Other nutrient deficiencies usually observed in patients suffering from ATD are: protein deficiencies, vitamin deficiencies (A, C, B6, B5, B1 and mineral deficiencies (phosphorus, magnesium, potassium, sodium, chromium. Proper diet helps to reduce the symptoms of the disease, maintains a healthy weight and prevents the occurrence of malnutrition. This article presents an overview of selected documented studies and scientific reports on the

  5. [Metabolic disorders and nutritional status in autoimmune thyroid diseases].

    Science.gov (United States)

    Kawicka, Anna; Regulska-Ilow, Bożena; Regulska-Ilow, Bożena

    2015-01-02

    In recent years, the authors of epidemiological studies have documented that autoimmune diseases are a major problem of modern society and are classified as diseases of civilization. Autoimmune thyroid diseases (ATDs) are caused by an abnormal immune response to autoantigens present in the thyroid gland - they often coexist with other autoimmune diseases. The most common dysfunctions of the thyroid gland are hypothyroidism, Graves-Basedow disease and Hashimoto's disease. Hashimoto's thyroiditis can be the main cause of primary hypothyroidism of the thyroid gland. Anthropometric, biochemical and physicochemical parameters are used to assess the nutritional status during the diagnosis and treatment of thyroid diseases. Patients with hypothyroidism are often obese, whereas patients with hyperthyroidism are often afflicted with rapid weight loss. The consequence of obesity is a change of the thyroid hormones' activity; however, weight reduction leads to their normalization. The activity and metabolic rate of thyroid hormones are modifiable. ATDs are associated with abnormalities of glucose metabolism and thus increased risk of developing diabetes mellitus type 1 and type 2. Celiac disease (CD) also increases the risk of developing other autoimmune diseases. Malnutrition or the presence of numerous nutritional deficiencies in a patient's body can be the cause of thyroid disorders. Coexisting deficiencies of such elements as iodine, iron, selenium and zinc may impair the function of the thyroid gland. Other nutrient deficiencies usually observed in patients suffering from ATD are: protein deficiencies, vitamin deficiencies (A, C, B6, B5, B1) and mineral deficiencies (phosphorus, magnesium, potassium, sodium, chromium). Proper diet helps to reduce the symptoms of the disease, maintains a healthy weight and prevents the occurrence of malnutrition. This article presents an overview of selected documented studies and scientific reports on the relationship of metabolic

  6. Current status and issues of external event PSA for extreme natural hazards after Fukushima accident

    International Nuclear Information System (INIS)

    Choi, In-Kil; Hahm, Daegi; Kim, Min Kyu

    2014-01-01

    Extreme external events is emerged as significant risk contributor to the nuclear power plants after Fukushima Daiichi accident due to the catastrophic earthquake followed by great tsunami greater than a design basis. This accident shows that the extreme external events have the potential to simultaneously affect redundant and diverse safety systems and thereby induce common cause failure or common cause initiators. The probabilistic risk assessment methodology has been used for the risk assessment and safety improvement against the extreme natural hazards. The earthquake and tsunami hazard is an important issue for the nuclear industry in Korea. In this paper, the role and application of probabilistic safety assessment for the post Fukushima action will be introduced. For the evaluation of the extreme natural hazard, probabilistic seismic and tsunami hazard analysis is being performed for the safety enhancement. The research activity on the external event PSA and its interim results will be introduced with the issues to be solved in the future for the reliability enhancement of the risk analysis results. (authors)

  7. Endovascular Interventions for Acute and Chronic Lower Extremity Deep Venous Disease: State of the Art

    Science.gov (United States)

    Sista, Akhilesh K.; Vedantham, Suresh; Kaufman, John A.

    2015-01-01

    The societal and individual burden caused by acute and chronic lower extremity venous disease is considerable. In the past several decades, minimally invasive endovascular interventions have been developed to reduce thrombus burden in the setting of acute deep venous thrombosis to prevent both short- and long-term morbidity and to recanalize chronically occluded or stenosed postthrombotic or nonthrombotic veins in symptomatic patients. This state-of-the-art review provides an overview of the techniques and challenges, rationale, patient selection criteria, complications, postinterventional care, and outcomes data for endovascular intervention in the setting of acute and chronic lower extremity deep venous disease. Online supplemental material is available for this article. © RSNA, 2015 PMID:26101920

  8. Vitamin D status and chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Skaaby, Tea; Husemoen, Lise Lotte Nystrup; Thuesen, Betina Heinsbæk

    2014-01-01

    OBJECTIVES: Vitamin D deficiency is common among persons with chronic obstructive pulmonary disease (COPD). Whether vitamin D affects the development and deterioration of COPD or is a consequence of the disease lacks clarity. We investigated the association between vitamin D status and prevalent...... and incident COPD in the general population. METHODS: We included a total of 12,041 individuals from three general population studies conducted in 1993-94, 1999-2001, and 2006-2008, respectively, with vitamin D measurements. Information on COPD was obtained from the Danish National Patient Register...... and The Danish Registry of Causes of Death. RESULTS: There were 85 prevalent and 463 incident cases of COPD (median follow-up 9.7 years). We found a statistically significant inverse association between vitamin D status and prevalent COPD with odds ratio = 0.89 (95% confidence interval, CI: 0.79, 1...

  9. Assessing nutritional status in children with chronic liver disease.

    Science.gov (United States)

    Taylor, Rachel M; Dhawan, Anil

    2005-12-01

    The metabolic changes compounded by anorexia associated with chronic liver disease adversely affect growth in children. In many cases, this requires the administration of artificial nutritional support. It is important in this group of patients that those who are becoming nutritionally depleted are identified quickly and in those receiving artificial nutritional support, the effectiveness is monitored. The current review is an examination of methods available to assess nutritional status. These include anthropometry, methods available in the laboratory and a selection of less commonly used methods undergoing evaluation at research level. A brief discussion accompanies each technique, outlining the limitations of its use in children with chronic liver disease. The review concludes with an outline of how nutritional status should be assessed in this group of children, and suggests further research.

  10. Change of periodontal disease status during and after pregnancy.

    Science.gov (United States)

    Xie, Yiqiong; Xiong, Xu; Elkind-Hirsch, Karen E; Pridjian, Gabriella; Maney, Pooja; Delarosa, Robert L; Buekens, Pierre

    2013-06-01

    This study explored whether there is any change of periodontal disease status during and after pregnancy. We also examined whether the change is different between females with a history of gestational diabetes mellitus (GDM) and females without GDM during pregnancy. A follow-up study was conducted at Woman's Hospital, Baton Rouge, Louisiana. Thirty-nine females who were previously enrolled in a case-control study during pregnancy were followed an average of 22 months postpartum. Periodontal status was assessed through dental examinations performed both during and after pregnancy. Clinical periodontal parameters included bleeding on probing (BOP), mean probing depth (PD), and mean clinical attachment level (CAL). Periodontitis was defined as the presence of ≥1 sites exhibiting PD ≥4 mm or CAL ≥4 mm. We used generalized estimating equation analysis to examine the change of periodontal status. Mean number and percentage of sites with BOP decreased from 10.7 ± 11.6 (mean ± SD) and 6.5% ± 7.0% during pregnancy to 7.1 ± 8.8 and 4.3% ± 5.3% at 22 months postpartum (P periodontitis decreased from 66.7% to 33.3% (P periodontal status between females with GDM and females without GDM during pregnancy. Pregnancy may be associated with an increased risk of periodontal disease. The association is not different between females with GDM and females without GDM during pregnancy.

  11. Endovascular Management of Deep venous Thrombosis of Lower Extremity in Patients with Malignant Disease

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Su Jin; Kim, Jae Kyu; Jang, Nam Kyu; Han, Seung Min; Kang, Heoung Keun; Choi, Soo Jin Nah [Chonnam National University Hospital, Gwangju (Korea, Republic of)

    2009-07-15

    To evaluate the efficacy of endovascular management of lower extremity deep vein thrombosis (DVT) in patients with malignant disease. Between January 2002 and January 2008, six consecutive patients (5 male and 1 female, mean age-65 years) with lower extremity DVT and malignant disease underwent endovascular management. The duration of symptoms lasted 4-120 days (mean-31 days; 20 days or less in four patients and more than 20 days in two). A catheter-directed thrombolysis was performed via the ipsilateral popliteal vein or common femoral vein, used alone or combined with a percutaneous mechanical thrombectomy. Angioplasty or stent placement was performed in residual stenosis or occlusion of the vein. The follow-up period lasted 1-14 months (mean 7.6 months) and was performed via a color Doppler ultrasonography or computed tomographic venography. Technical success and relief from symptoms was achieved within two days was achieved in five patients. Minor hemorrhagic complications occurred in two cases: hematuria and a hematoma at the puncture site. Upon follow-up, a recurrent DVT occurred in three patients as well as a patent venous flow in two. One patient died within 1 month due to a metastatic mediastinal lymphadenopathy. Endovascular management of the lower extremity DVT is effective for quickly eliminating a thrombus, relieving symptoms, and decreasing hemorrhagic complications in patients with malignant disease.

  12. Endovascular Management of Deep venous Thrombosis of Lower Extremity in Patients with Malignant Disease

    International Nuclear Information System (INIS)

    Jeong, Su Jin; Kim, Jae Kyu; Jang, Nam Kyu; Han, Seung Min; Kang, Heoung Keun; Choi, Soo Jin Nah

    2009-01-01

    To evaluate the efficacy of endovascular management of lower extremity deep vein thrombosis (DVT) in patients with malignant disease. Between January 2002 and January 2008, six consecutive patients (5 male and 1 female, mean age-65 years) with lower extremity DVT and malignant disease underwent endovascular management. The duration of symptoms lasted 4-120 days (mean-31 days; 20 days or less in four patients and more than 20 days in two). A catheter-directed thrombolysis was performed via the ipsilateral popliteal vein or common femoral vein, used alone or combined with a percutaneous mechanical thrombectomy. Angioplasty or stent placement was performed in residual stenosis or occlusion of the vein. The follow-up period lasted 1-14 months (mean 7.6 months) and was performed via a color Doppler ultrasonography or computed tomographic venography. Technical success and relief from symptoms was achieved within two days was achieved in five patients. Minor hemorrhagic complications occurred in two cases: hematuria and a hematoma at the puncture site. Upon follow-up, a recurrent DVT occurred in three patients as well as a patent venous flow in two. One patient died within 1 month due to a metastatic mediastinal lymphadenopathy. Endovascular management of the lower extremity DVT is effective for quickly eliminating a thrombus, relieving symptoms, and decreasing hemorrhagic complications in patients with malignant disease

  13. Heatshield for Extreme Entry Environment Technology (HEEET) Development and Maturation Status

    Science.gov (United States)

    Ellerby, D.; Boghozian, T.; Driver, D.; Chavez-Garcia, J.; Fowler, M.; Gage, P.; Gasch, M.; Gonzales, G.; Kazemba, C.; Kellermann, C.; hide

    2018-01-01

    This poster provides an overview of the requirements, design, development and testing of the 3D (Three Dimensional) Woven TPS (Thermal Protection System) being developed under NASA's Heatshield for Extreme Entry Environment Technology (HEEET) project. Under this current program, NASA is working to develop a TPS capable of surviving entry into Saturn. A primary goal of the project is to build and test an Engineering Test Unit (ETU) to establish a Technical Readiness Level (TRL) of 6 for this technology by 2017.

  14. Heatshield for Extreme Entry Environment Technology (HEEET) Development and Maturation Status for NF Missions

    Science.gov (United States)

    Ellerby, D.; Blosser, M.; Boghozian, T.; Chavez-Garcia, J.; Chinnapongse, R.; Fowler, M.; Gage, P.; Gasch, M.; Gonzales, G.; Hamm, K.; hide

    2016-01-01

    This poster provides an overview of the requirements, design, development and testing of the 3D Woven TPS being developed under NASA's Heatshield for Extreme Entry Environment Technology (HEEET) project. Under this current program, NASA is working to develop a Thermal Protection System (TPS) capable of surviving entry into Saturn. A primary goal of the project is to build and test an Engineering Test Unit (ETU) to establish a Technical Readiness Level (TRL) of 6 for this technology by 2017.

  15. Understanding the Impacts of Climate and Hydrologic Extremes on Diarrheal Diseases in Southwestern Amazon

    Science.gov (United States)

    Fonseca, P. A. M.

    2015-12-01

    Bacterial diarrheal diseases have a high incidence rate during and after flooding episodes. In the Brazilian Amazon, flood extreme events have become more frequent, leading to high incidence rates for infant diarrhea. In this study we aimed to find a statistical association between rainfall, river levels and diarrheal diseases in children under 5, in the river Acre basin, in the State of Acre (Brazil). We also aimed to identify the time-lag and annual season of extreme rainfall and flooding in different cities in the water basin. The results using Tropical Rainfall Measuring Mission (TRMM) Satellite rainfall data show robustness of these estimates against observational stations on-ground. The Pearson coefficient correlation results (highest 0.35) indicate a time-lag, up to 4 days in three of the cities in the water-basin. In addition, a correlation was also tested between monthly accumulated rainfall and the diarrheal incidence during the rainy season (DJF). Correlation results were higher, especially in Acrelândia (0.7) and Brasiléia and Epitaciolândia (0.5). The correlation between water level monthly averages and diarrheal diseases incidence was 0.3 and 0.5 in Brasiléia and Epitaciolândia. The time-lag evidence found in this paper is critical to inform stakeholders, local populations and civil defense authorities about the time available for preventive and adaptation measures between extreme rainfall and flooding events in vulnerable cities. This study was part of a pilot application in the state of Acre of the PULSE-Brazil project (http://www.pulse-brasil.org/tool/), an interface of climate, environmental and health data to support climate adaptation. The next step of this research is to expand the analysis to other climate variables on diarrheal diseases across the whole Brazilian Amazon Basin and estimate the relative risk (RR) of a child getting sick. A statistical model will estimate RR based on the observed values and seasonal forecasts (higher

  16. A Bayesian Spatial Model to Predict Disease Status Using Imaging Data From Various Modalities

    Directory of Open Access Journals (Sweden)

    Wenqiong Xue

    2018-03-01

    Full Text Available Relating disease status to imaging data stands to increase the clinical significance of neuroimaging studies. Many neurological and psychiatric disorders involve complex, systems-level alterations that manifest in functional and structural properties of the brain and possibly other clinical and biologic measures. We propose a Bayesian hierarchical model to predict disease status, which is able to incorporate information from both functional and structural brain imaging scans. We consider a two-stage whole brain parcellation, partitioning the brain into 282 subregions, and our model accounts for correlations between voxels from different brain regions defined by the parcellations. Our approach models the imaging data and uses posterior predictive probabilities to perform prediction. The estimates of our model parameters are based on samples drawn from the joint posterior distribution using Markov Chain Monte Carlo (MCMC methods. We evaluate our method by examining the prediction accuracy rates based on leave-one-out cross validation, and we employ an importance sampling strategy to reduce the computation time. We conduct both whole-brain and voxel-level prediction and identify the brain regions that are highly associated with the disease based on the voxel-level prediction results. We apply our model to multimodal brain imaging data from a study of Parkinson's disease. We achieve extremely high accuracy, in general, and our model identifies key regions contributing to accurate prediction including caudate, putamen, and fusiform gyrus as well as several sensory system regions.

  17. Differential Effects of Temperature Extremes on Hospital Admission Rates for Respiratory Disease between Indigenous and Non-Indigenous Australians in the Northern Territory

    Science.gov (United States)

    Green, Donna; Bambrick, Hilary; Tait, Peter; Goldie, James; Schultz, Rosalie; Webb, Leanne; Alexander, Lisa; Pitman, Andrew

    2015-01-01

    The health gap between Indigenous and non-Indigenous Australians may be exacerbated by climate change if temperature extremes have disproportionate adverse effects on Indigenous people. To explore this issue, we analysed the effect of temperature extremes on hospital admissions for respiratory diseases, stratified by age, Indigenous status and sex, for people living in two different climates zones in the Northern Territory during the period 1993–2011. We examined admissions for both acute and chronic respiratory diagnoses, controlling for day of the week and seasonality variables. Our analysis showed that: (1) overall, Indigenous hospital admission rates far exceeded non-Indigenous admission rates for acute and chronic diagnoses, and Top End climate zone admission rates exceeded Central Australia climate zone admission rates; (2) extreme cold and hot temperatures were associated with inconsistent changes in admission rates for acute respiratory disease in Indigenous and non-Indigenous children and older adults; and (3) no response to cold or hot temperature extremes was found for chronic respiratory diagnoses. These findings support our two hypotheses, that extreme hot and cold temperatures have a different effect on hospitalisations for respiratory disease between Indigenous and non-Indigenous people, and that these health risks vary between the different climate zones. We did not, however, find that there were differing responses to temperature extremes in the two populations, suggesting that any increased vulnerability to climate change in the Indigenous population of the Northern Territory arises from an increased underlying risk to respiratory disease and an already greater existing health burden. PMID:26633456

  18. Differential Effects of Temperature Extremes on Hospital Admission Rates for Respiratory Disease between Indigenous and Non-Indigenous Australians in the Northern Territory

    Directory of Open Access Journals (Sweden)

    Donna Green

    2015-12-01

    Full Text Available The health gap between Indigenous and non-Indigenous Australians may be exacerbated by climate change if temperature extremes have disproportionate adverse effects on Indigenous people. To explore this issue, we analysed the effect of temperature extremes on hospital admissions for respiratory diseases, stratified by age, Indigenous status and sex, for people living in two different climates zones in the Northern Territory during the period 1993–2011. We examined admissions for both acute and chronic respiratory diagnoses, controlling for day of the week and seasonality variables. Our analysis showed that: (1 overall, Indigenous hospital admission rates far exceeded non-Indigenous admission rates for acute and chronic diagnoses, and Top End climate zone admission rates exceeded Central Australia climate zone admission rates; (2 extreme cold and hot temperatures were associated with inconsistent changes in admission rates for acute respiratory disease in Indigenous and non-Indigenous children and older adults; and (3 no response to cold or hot temperature extremes was found for chronic respiratory diagnoses. These findings support our two hypotheses, that extreme hot and cold temperatures have a different effect on hospitalisations for respiratory disease between Indigenous and non-Indigenous people, and that these health risks vary between the different climate zones. We did not, however, find that there were differing responses to temperature extremes in the two populations, suggesting that any increased vulnerability to climate change in the Indigenous population of the Northern Territory arises from an increased underlying risk to respiratory disease and an already greater existing health burden.

  19. Awareness Status of Chronic Disabling Neurological Diseases among Elderly Veterans.

    Science.gov (United States)

    Tan, Ji-Ping; Zhu, Lin-Qi; Zhang, Jun; Zhang, Shi-Min; Lan, Xiao-Yang; Cui, Bo; Deng, Yu-Cheng; Li, Ying-Hao; Ye, Guang-Hua; Wang, Lu-Ning

    2015-05-20

    The awareness, treatment and prevention of chronic diseases are generally poor among the elderly population of China, whereas the prevention and control of chronic diseases in elderly veteran communities have been ongoing for more than 30 years. Therefore, investigating the awareness status of chronic disabling neurological diseases (CDND) and common chronic diseases (CCD) among elderly veterans may provide references for related programs among the elderly in the general population. A cross-sectional survey was conducted among veterans ≥60 years old in veteran communities in Beijing. The awareness of preventive strategies against dementia, Alzheimer's disease (AD), Parkinson's disease (PD), sleep disorders, cerebrovascular disease (CVD) and CCD such as hypertension, and the approaches used to access this information, including media, word of mouth (verbal communication among the elderly) and health care professionals, were investigated via face-to-face interviews. The awareness rates for CCD and CVD were approximately 100%, but that for AD was the lowest at word-of-mouth peer education.

  20. Current status of indications for surgery in peptic ulcer disease.

    Science.gov (United States)

    Jamieson, G G

    2000-03-01

    The eradication of Helicobacter pylori in patients with peptic ulcer disease has greatly diminished the need for antiulcer surgery. However, in societies where such drug therapy is considered too expensive and because occasional patients remain refractory to optimal medical therapy, elective surgery for duodenal ulcer disease is still carried out. If the required expertise is available, it can be undertaken laparoscopically. The advent of endoscopic therapies such as heater probe therapy and injection sclerotherapy has also greatly diminished the need for emergency surgery in bleeding peptic ulcer disease. Once again, however, when such therapy fails surgery is still indicated. Even with perforated peptic ulcer disease the role of surgery has receded somewhat, but here not because of changes in drug therapy. Nonoperative management of perforation is indicated in fit patients if the diagnosis is in doubt, in any patient when surgical facilities are unavailable (e.g., remote geographic areas, on board ship), or when a patient is extremely ill either because of co-morbidity or late presentation of the disease. Operation should be considered in all patients when the perforation is established to be unsealed, particularly after

  1. The identification of plankton tropical status in the Wonokromo, Dadapan and Juanda extreme water estuary

    Science.gov (United States)

    Sari, L. A.; Satyantini, W. H.; Manan, A.; Pursetyo, K. T.; Dewi, N. N.

    2018-04-01

    Wonokromo, Dadapan and Juanda estuaries are extreme waters located around Surabaya environment. This is because of a lot of organic material intake, which provided nutrients for plankton growth. In addition, the waters is also dynamic in reason of physico-chemical, geological and biological processes controlled by the tides and freshwater run-off from the river that empties into it. The objective of this study was to identify the presentation of plankton in extreme waters based on brightness and ammonia level. The study was conducted in January 2017. Three sampling locations were Wonokromo, Dadapan and Juanda estuaries. Each station consists of three points based on distances, which were 400, 700, and 1000 meters from the coastline. The brightness in Wonokromo, Dadapan, and Juanda environment was 60, 40, and 100 cm, respectively. The result of ammonia in Wonokromo, Dadapan, and Juanda estuary was 0.837, 0.626, and 0.396 mg/L, correspondingly. Nine classes of phytoplankton’s were found in three locations (bacillariophyceae, dynophyceae, chlorophyceae, cyanophyceae, crysophyceae, euglenoidea, trebouxlophyceae, mediophyceae, and nitachiaceae) and five classes of zooplanktons (maxillopoda, hexanuplia, copepoda, malacostraca, and oligotrichea). The density of plankton in Wonokromo, Dadapan and Juanda environments, was 37.64, 63.80, and 352.85 cells/L, respectively.

  2. Heat-shield for Extreme Entry Environment Technology (HEEET) Development Status

    Science.gov (United States)

    Venkatapathy, Ethiraj; Ellerby, Don; Gage, Peter

    2016-01-01

    The Heat shield for Extreme Entry Environment Technology (HEEET) Project is a NASA STMD and SMD co-funded effort. The goal is to develop and mission infuse a new ablative Thermal Protection System that can withstand extreme entry. It is targeted to support NASA's high priority missions, as defined in the latest decadal survey, to destinations such as Venus and Saturn in-situ robotic science missions. Entry into these planetary atmospheres results in extreme heating. The entry peak heat-flux and associated pressure are estimated to be between one and two orders of magnitude higher than those experienced by Mars Science Laboratory or Lunar return missions. In the recent New Frontiers community announcement NASA has indicated that it is considering providing an increase to the PI managed mission cost (PIMMC) for investigations utilizing the Heat Shield for Extreme Entry Environment Technology (HEEET) and in addition, NASA is considering limiting the risk assessment to only their accommodation on the spacecraft and the mission environment. The HEEET ablative TPS utilizes 3D weaving technology to manufacture a dual layer material architecture. The 3-D weaving allows for flat panels to be woven. The dual layer consists of a top layer designed to withstand the extreme external environment while the inner or insulating layer by design, is designed to achieve low thermal conductivity, and it keeps the heat from conducting towards the structure underneath. Both arc jet testing combined with material properties have been used to develop thermal response models that allows for comparison of performance with heritage carbon phenolic. A 50% mass efficiency is achieved by the dual layer construct compared to carbon phenolic for a broad range of missions both to Saturn and Venus. The 3-D woven flat preforms are molded to achieve the shape as they are compliant and then resin infusion with curing forms a rigid panels. These panels are then bonded on to the aeroshell structure. Gaps

  3. Lower Extremity Arterial Calcification as a Predictor of Coronary Atherosclerosis in Patients with Peripheral Arterial Disease

    International Nuclear Information System (INIS)

    Shin, Hwa Seon; Jung Park, Mi; Nyeo Jeon, Kyung; Min Cho, Jae; Soo Bae, Kyung; Seob Choi, Dae; Boem Na, Jae; Cheol Choi, Ho; Young Choi, Hye; Eun Kim, Ji; Bueum Cho, Soo; Eun Park, Sung

    2016-01-01

    Until now, there has been no study on the relationship between the calcification of the lower extremity arteries and significant coronary arterial disease (CAD). To evaluate whether lower extremity calcium scores (LECS) are associated with CAD and whether this can predict multivessel-CAD in patients with peripheral arterial disease (PAD). We retrospectively enrolled 103 PAD patients without cardiac symptoms or known CAD. All patients underwent cardiac computed tomography (CT) and lower extremity CT within 1 month and were categorized as nonsignificant CAD, single-CAD, or multivessel-CAD. The coronary calcium scores (CCS) were quantitatively measured according to the Agatston method and LECS were semi-quantitatively measured according to the presence of lower extremity calcification in the segment. The extent of CAD was evaluated according to the presence of ≥ 50% luminal diameter stenosis in the segment of CAD. LECS in multivessel-CAD were significantly higher than those in nonsignificant CAD (10.0 ± 5.8 versus 4.0 ± 3.1, P < 0.001). LECS significantly correlated with CCS (r = 0.831, P < 0.001) and the extent of CAD (r = 0.631, P < 0.001). Multivariate regression analysis demonstrated LECS and log-transformed CCS were independent predictors for multivessel-CAD. In receiver operating characteristic curve analysis, the diagnostic performance of LECS was 0.807 (95% confidence interval = 0.724-0.891, P < 0.001) for predicting multivessel-CAD. Peripheral arterial calcification is significantly correlated with CAD extent in patients with PAD. Peripheral arterial calcification can be a useful marker for predicting multivessel-CAD

  4. Quadriceps strength, inter-extremity difference (IED) and joint status in adult persons with severe haemophilia in different age stages.

    Science.gov (United States)

    Brunner, A; Stäuber, F; Göhler, S; Czepa, D; Krüger, S; Wendel, M; Seuser, A; Hilberg, T

    2013-03-01

    Quadriceps weakness seems to be a hallmark in adult persons with severe haemophilia (PWH). The purpose of this study was to compare PWH and non-haemophilic controls in different age stages with reference to joint status and quadriceps strength. Further aims were to examine the extent of strength-specific inter-extremity-difference (IED) and the prevalence of abnormal IED (AIED). A total of 106 adults with severe haemophilia (H) and 80 controls (C) had undergone an orthopaedic examination for classification of knee and ankle status using the WFH score. Quadriceps strength was evaluated unilaterally as well as bilaterally with a knee extensor device. Each group was divided into four age-related subgroups (HA/CA: 18-29, HB/CB: 30-39, HC/CC: 40-49, HD/CD: 50-70; in years). H presented a worse knee and ankle status than C indicated by higher WFH scores (P age-matched subgroups only HB showed higher knee scores than CB (P age-matched controls (P age in H. We discovered an AIED in 35% of H. These findings highlight the importance for the early implementation of preventive and rehabilitative muscle training programmes in the comprehensive treatment of PWH. © 2012 Blackwell Publishing Ltd.

  5. Recent Weather Extremes and Impacts on Agricultural Production and Vector-Borne Disease Outbreak Patterns

    Science.gov (United States)

    Anyamba, Assaf; Small, Jennifer L.; Britch, Seth C.; Tucker, Compton J.; Pak, Edwin W.; Reynolds, Curt A.; Crutchfield, James; Linthicum, Kenneth J.

    2014-01-01

    We document significant worldwide weather anomalies that affected agriculture and vector-borne disease outbreaks during the 2010-2012 period. We utilized 2000-2012 vegetation index and land surface temperature data from NASA's satellite-based Moderate Resolution Imaging Spectroradiometer (MODIS) to map the magnitude and extent of these anomalies for diverse regions including the continental United States, Russia, East Africa, Southern Africa, and Australia. We demonstrate that shifts in temperature and/or precipitation have significant impacts on vegetation patterns with attendant consequences for agriculture and public health. Weather extremes resulted in excessive rainfall and flooding as well as severe drought, which caused,10 to 80% variation in major agricultural commodity production (including wheat, corn, cotton, sorghum) and created exceptional conditions for extensive mosquito-borne disease outbreaks of dengue, Rift Valley fever, Murray Valley encephalitis, and West Nile virus disease. Analysis of MODIS data provided a standardized method for quantifying the extreme weather anomalies observed during this period. Assessments of land surface conditions from satellite-based systems such as MODIS can be a valuable tool in national, regional, and global weather impact determinations.

  6. Recent weather extremes and impacts on agricultural production and vector-borne disease outbreak patterns.

    Directory of Open Access Journals (Sweden)

    Assaf Anyamba

    Full Text Available We document significant worldwide weather anomalies that affected agriculture and vector-borne disease outbreaks during the 2010-2012 period. We utilized 2000-2012 vegetation index and land surface temperature data from NASA's satellite-based Moderate Resolution Imaging Spectroradiometer (MODIS to map the magnitude and extent of these anomalies for diverse regions including the continental United States, Russia, East Africa, Southern Africa, and Australia. We demonstrate that shifts in temperature and/or precipitation have significant impacts on vegetation patterns with attendant consequences for agriculture and public health. Weather extremes resulted in excessive rainfall and flooding as well as severe drought, which caused ∼10 to 80% variation in major agricultural commodity production (including wheat, corn, cotton, sorghum and created exceptional conditions for extensive mosquito-borne disease outbreaks of dengue, Rift Valley fever, Murray Valley encephalitis, and West Nile virus disease. Analysis of MODIS data provided a standardized method for quantifying the extreme weather anomalies observed during this period. Assessments of land surface conditions from satellite-based systems such as MODIS can be a valuable tool in national, regional, and global weather impact determinations.

  7. Alcohol Consumption Is a Risk Factor for Lower Extremity Arterial Disease in Chinese Patients with T2DM

    Directory of Open Access Journals (Sweden)

    Shanshan Yang

    2017-01-01

    Full Text Available Objective. To investigate the relationship between alcohol consumption and diabetic lower extremity arterial disease (LEAD in hospitalized patients with type 2 diabetes mellitus (T2DM. Methods. We evaluated 138 hospitalized patients with T2DM who consumed alcohol and 833 who did not. We used propensity score matching to reduce the confounding bias between groups. Additionally, a logistic regression analysis was performed with the matched data to evaluate the LEAD risk. Results. In total, 119 pairs of patients who did and did not consume alcohol were matched. According to the logistic regression analysis, patients who consumed >8 U of alcohol/day had a higher risk of LEAD (odds ratio (OR: 6.35, 95% confidence interval (CI: 1.78–22.65 than patients who did not consume alcohol. Additionally, after adjusting for age, gender, region, occupation, smoking status, body mass index, weight change, and duration of diabetes, the OR of peripheral artery disease after >20 years of alcohol consumption was 3.48 (95% CI: 1.09–11.15. Furthermore, we observed a significant dose-response relationship between alcohol consumption and LEAD. Conclusions. Alcohol consumption may be a risk factor of LEAD in patients with T2DM. Patients with T2DM should be advised to stop drinking, to prevent the onset of LEAD.

  8. Marital Status and Outcomes in Patients With Cardiovascular Disease.

    Science.gov (United States)

    Schultz, William M; Hayek, Salim S; Samman Tahhan, Ayman; Ko, Yi-An; Sandesara, Pratik; Awad, Mosaab; Mohammed, Kareem H; Patel, Keyur; Yuan, Michael; Zheng, Shuai; Topel, Matthew L; Hartsfield, Joy; Bhimani, Ravila; Varghese, Tina; Kim, Jonathan H; Shaw, Leslee; Wilson, Peter; Vaccarino, Viola; Quyyumi, Arshed A

    2017-12-20

    Being unmarried is associated with decreased survival in the general population. Whether married, divorced, separated, widowed, or never-married status affects outcomes in patients with cardiovascular disease has not been well characterized. A prospective cohort (inception period 2003-2015) of 6051 patients (mean age 63 years, 64% male, 23% black) undergoing cardiac catheterization for suspected or confirmed coronary artery disease was followed for a median of 3.7 years (interquartile range: 1.7-6.7 years). Marital status was stratified as married (n=4088) versus unmarried (n=1963), which included those who were never married (n=451), divorced or separated (n=842), or widowed (n=670). The relationship between marital status and primary outcome of cardiovascular death and myocardial infarction was examined using Cox regression models adjusted for clinical characteristics. There were 1085 (18%) deaths from all causes, 688 (11%) cardiovascular-related deaths, and 272 (4.5%) incident myocardial infarction events. Compared with married participants, being unmarried was associated with higher risk of all-cause mortality (hazard ratio [HR]: 1.24; 95% confidence interval [CI], 1.06-1.47), cardiovascular death (HR: 1.45; 95% CI, 1.18-1.78), and cardiovascular death or myocardial infarction (HR: 1.52; 95% CI, 1.27-1.83). Compared with married participants, the increase in cardiovascular death or myocardial infarction was similar for the participants who were divorced or separated (HR: 1.41; 95% CI, 1.10-1.81), widowed (HR: 1.71; 95% CI, 1.32-2.20), or never married (HR: 1.40; 95% CI, 0.97-2.03). The findings persisted after adjustment for medications and other socioeconomic factors. Marital status is independently associated with cardiovascular outcomes in patients with or at high risk of cardiovascular disease, with higher mortality in the unmarried population. The mechanisms responsible for this increased risk require further study. © 2017 The Authors. Published on

  9. Health Status Measurement Instruments in Chronic Obstructive Pulmonary Disease

    Directory of Open Access Journals (Sweden)

    Yves Lacasse

    1997-01-01

    Full Text Available Chronic obstructive pulmonary disease (COPD is associated with primary respiratory impairment, disability and handicap, as well as with secondary impairments not necessarily confined to the respiratory system. Because the primary goals of managing patients with COPD include relief of dyspnea and the improvement of health-related quality of life (HRQL, a direct measurement of HRQL is important. Fourteen disease-specific and nine generic questionnaires (four health profiles and five utility measures most commonly used to measure health status in patients with COPD were reviewed. The measures were classified according to their domain of interest, and their measurement properties - specifications, validity, reliability, responsiveness and interpretability - were described. This review suggests several findings. Currently used health status instruments usually refer to the patients’ perception of performance in three major domains of HRQL - somatic sensation, physical and occupational function, and psychological state. The choice of a questionnaire must be related to its purpose, with a clear distinction being made between its evaluative and discriminative function. In their evaluative function, only a few instruments fulfilled the criteria of responsiveness, and the interpretability of most questionnaires is limited. Generic questionnaires should not be used alone in clinical trials as evaluative instruments because of their inability to detect change over time. Further validation and improved interpretability of existing instruments would be of greater benefit to clinicians and scientists than the development of new questionnaires.

  10. Type 2 diabetes risk alleles demonstrate extreme directional differentiation among human populations, compared to other diseases.

    Directory of Open Access Journals (Sweden)

    Rong Chen

    Full Text Available Many disease-susceptible SNPs exhibit significant disparity in ancestral and derived allele frequencies across worldwide populations. While previous studies have examined population differentiation of alleles at specific SNPs, global ethnic patterns of ensembles of disease risk alleles across human diseases are unexamined. To examine these patterns, we manually curated ethnic disease association data from 5,065 papers on human genetic studies representing 1,495 diseases, recording the precise risk alleles and their measured population frequencies and estimated effect sizes. We systematically compared the population frequencies of cross-ethnic risk alleles for each disease across 1,397 individuals from 11 HapMap populations, 1,064 individuals from 53 HGDP populations, and 49 individuals with whole-genome sequences from 10 populations. Type 2 diabetes (T2D demonstrated extreme directional differentiation of risk allele frequencies across human populations, compared with null distributions of European-frequency matched control genomic alleles and risk alleles for other diseases. Most T2D risk alleles share a consistent pattern of decreasing frequencies along human migration into East Asia. Furthermore, we show that these patterns contribute to disparities in predicted genetic risk across 1,397 HapMap individuals, T2D genetic risk being consistently higher for individuals in the African populations and lower in the Asian populations, irrespective of the ethnicity considered in the initial discovery of risk alleles. We observed a similar pattern in the distribution of T2D Genetic Risk Scores, which are associated with an increased risk of developing diabetes in the Diabetes Prevention Program cohort, for the same individuals. This disparity may be attributable to the promotion of energy storage and usage appropriate to environments and inconsistent energy intake. Our results indicate that the differential frequencies of T2D risk alleles may

  11. Fluency in Parkinson?s disease: disease duration, cognitive status and age

    Directory of Open Access Journals (Sweden)

    Natalia Casagrande Brabo

    2014-05-01

    Full Text Available The objective of this study was to determine the frequency of occurrence and to characterize the typology of dysfluencies in individuals with Parkinson’s disease (PD, including the variables age, gender, schooling, disease duration, score on the Hoehn and Yahr scale and cognitive status (score on Mini-Mental State Examination. A cross-sectional study of a sample comprising 60 adults matched for gender, age and schooling was conducted. Group I comprised 30 adults with idiopathic PD, and Group II comprised 30 healthy adults. For assessment of fluency of speech, subjects were asked to utter a narrative based on a sequence of drawings and a transcription of 200 fluent syllables was performed to identify speech dysfluencies. PD patients exhibited a higher overall number of dysfluencies in speech with a large number of atypical dysfluencies. Additionally, results showed an influence of the variables cognitive status, disease duration and age on occurrence of dysfluencies.

  12. To evaluate the differences of risk factors in patients with lower extremity venous disease

    International Nuclear Information System (INIS)

    Sadikoglu, G.; Ozcakir, A.; Ercan, I.; Ozkaya, G.; Sadikoglu, Y.M.

    2007-01-01

    To determine whether there is difference between risk factors in patients diagnosed to have clinically documented lower extremity venous disease after confirming the diagnosis radiologically by ultrasonographic and venographic evaluation. This study was performed from January 2002 to January 2005 in Bursa, the fourth biggest city of Turkey situated in the west of country in the Marmara region. The study center is a private imaging center working in conjunction with the Department of Health, which performs diagnostic and therapeutic vascular protocols in the region. Five hundred and fifty-three cases with clinically and radiologically documented diagnoses were evaluated with Multi-Variate Statistical Package 3.13 for the presence of pre-defined clusters of 14 different variables. Other statistical analyses were performed by the Statistical Package for Social sciences, version 13.0. Three different clusters were defined. The variables used to define the clusters were: age, gender, educational level, presence of smoking, amount of smoking (pack/per year), disease symptoms, presence of heart disease and radiologically documented diagnosis. Chronic venous insufficiency and varicose veins are venous system diseases that are most commonly present in association with more than one concomitant risk factors. (author)

  13. Teenager male with burning pain in extremities--suspect Fabry disease, 2 case reports.

    Science.gov (United States)

    Patil, Rajesh B; Joglekar, V K

    2014-01-01

    We present 2 cases of teenager males presented with burning pain in extremities and turned out to be cases of Fabry disease.The purpose of presenting this case is to highlight the fact that suspicion of Fabry disease in patients presenting with these symptoms will lead to early diagnosis and treatment of this condition before occurrences of complications. A 14-year-old male presented with severe burning pain in both hands and feet since last 4 yrs which persisted despite consumption of painkillers and becoming more disabling and without having any family history for such condition. On general examination patient had small reddish coloured lesions around the umbilicus, appearing like angiokeratomas. Skin biopsy confirmed the lesion. On enzyme assay his alpha galactosidase activity found to be '0' nmol/hr/mg of protein, confirming his diagnosis. Patient's creatinine and 2 D ECHO were normal and urine had 1+ proteinuria. Patient started on carbamazepine tablets for pain and referred to higher centre for genetic diagnosis and enzyme replacement therapy. CASE REPORT 2: An 18-year-old male referred to our hospital by general practitioner for fatigue and pedal oedema with deranged renal function tests. On history taking patient gave history of severe burning pain in both hands and feet since age of 9 yrs. Patient's general examination revealed hypertension with pallor, pedal oedema along with angiokeratomas in bathing suit distribution. Patient's ultrasonography of kidney revealed bilaterally normal sized kidneys with altered echotexture and urine examination showed fine granular foamy cells with sub nephrotic range proteinuria. 2 D ECHO revealed concentric left ventricular hypertrophy. Skin biopsy report supported the diagnosis of Fabry disease. Patient advised to undergo renal biopsy to confirm Fabry nephropathy but patient denied any further diagnostic workup for nephropathy or Fabry disease. Patient started on conservative treatment and carbamazepine in renal dose

  14. Upper Extremity Freezing and Dyscoordination in Parkinson’s Disease: Effects of Amplitude and Cadence Manipulations

    Directory of Open Access Journals (Sweden)

    April J. Williams

    2013-01-01

    Full Text Available Purpose. Motor freezing, the inability to produce effective movement, is associated with decreasing amplitude, hastening of movement, and poor coordination. We investigated how manipulations of movement amplitude and cadence affect upper extremity (UE coordination as measured by the phase coordination index (PCI—only previously measured in gait—and freezing of the upper extremity (FO-UE in people with Parkinson's disease (PD who experience freezing of gait (PD + FOG, do not experience FOG (PD-FOG, and healthy controls. Methods. Twenty-seven participants with PD and 18 healthy older adults made alternating bimanual movements between targets under four conditions: Baseline; Fast; Small; SmallFast. Kinematic data were recorded and analyzed for PCI and FO-UE events. PCI and FO-UE were compared across groups and conditions. Correlations between UE PCI, gait PCI, FO-UE, and Freezing of Gait Questionnaire (FOG-Q were determined. Results. PD + FOG had poorer coordination than healthy old during SmallFast. UE coordination correlated with number of FO-UE episodes in two conditions and FOG-Q score in one. No differences existed between PD−/+FOG in coordination or number of FO-UE episodes. Conclusions. Dyscoordination and FO-UE can be elicited by manipulating cadence and amplitude of an alternating bimanual task. It remains unclear whether FO-UE and FOG share common mechanisms.

  15. Upper Extremity Injured Workers Stratified by Current Work Status: An Examination of Health Characteristics, Work Limitations and Work Instability

    Directory of Open Access Journals (Sweden)

    D Pichora

    2010-06-01

    Full Text Available Background: Upper extremity injured workers are an under-studied population. A descriptive comparison of workers with shoulder, elbow and hand injuries reporting to a Canadian Workplace Safety and Insurance Board (WSIB clinic was undertaken. Objective: To determine if differences existed between injury groups stratified by current work status. Methods: All WSIB claimants reporting to our upper extremity clinic between 2003 and 2008 were approached to participate in this descriptive study. 314 working and 146 non-working WSIB claimants completed the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH; Short Form health survey (SF36; Worker’s Limitations Questionnaire and the Work Instability Scale. Various parametric and non-parametric analyses were used to assess significant differences between groups on demographic, work and health related variables. Results: Hand, followed by the shoulder and elbow were the most common site of injury. Most non-workers listed their current injury as the reason for being off work, and attempted to return to work once since their injury occurrence. Non-workers and a subset of workers at high risk for work loss showed significantly worse mental functioning. Workers identified physical demands as the most frequent injury-related on the job limitation. 60% of current workers were listed as low risk for work loss on the Work Instability Scale. Conclusions: Poorer mental functioning, being female and sustaining a shoulder injury were risk factors for work instability. Our cohort of injured non-workers were unable to return to work due to their current injury, reinforcing the need to advocate for modified duties, shorter hours and a work environment where stress and injury recurrence is reduced. Future studies examining pre-injury depression as a risk factor for prolonged work absences are warranted.

  16. Patients With Diabetic Foot Disease Fear Major Lower-Extremity Amputation More Than Death.

    Science.gov (United States)

    Wukich, Dane K; Raspovic, Katherine M; Suder, Natalie C

    2018-02-01

    The aim of this study was to identify the most-feared complications of diabetes mellitus (DM), comparing those with diabetic foot pathology with those without diabetic foot pathology. We determined the frequency of patients ranking major lower-extremity amputation (LEA) as their greatest fear in comparison to blindness, death, diabetic foot infection (DFI), or end-stage renal disease (ESRD) requiring dialysis. We further categorized the study group patients (N = 207) by their pathology such as diabetic foot ulcer (DFU), Charcot neuroarthropathy, foot infection, or acute neuropathic fractures and dislocations. The control group (N = 254) was comprised of patients with diabetes who presented with common non-diabetes-related foot pathology. A total of 461 patients were enrolled in this study and included 254 patients without diabetic foot complications and 207 patients with diabetic foot problems. When comparing patients with and without diabetic disease, no significant differences were observed with regard to their fear of blindness, DFI, or ESRD requiring dialysis. Patients with diabetic foot disease (61 of 207, 31.9%) were 136% more likely (odds ratio [OR] = 2.36; 95% CI = 1.51-3.70; P = .002] to rank major LEA as their greatest fear when compared with diabetic patients without foot disease (42 of 254, 16.5%) and were 49% less likely (OR = 0.51; 95% CI = 0.34-0.79; P = .002) to rank death as their greatest fear compared with patients without diabetic foot disease. Patients with diabetic foot pathology fear major LEA more than death, foot infection, or ESRD. Variables that were associated with ranking LEA as the greatest fear were the presence of a diabetic-related foot complication, duration of DM ≥10 years, insulin use, and the presence of peripheral neuropathy. Level II: Prospective, Case controlled study.

  17. The role of atherectomy in the treatment of lower extremity peripheral artery disease

    Science.gov (United States)

    2012-01-01

    Background The incidence of lower extremity peripheral artery disease (LE-PAD) continues to increase and associated morbidity remains high. Despite the significant development of percutaneous revascularization strategies, over the past decade, LE-PAD still represents a unique challenge for interventional cardiologists and vascular surgeons. Method Typical features of atherosclerosis that affects peripheral vascular bed (diffuse nature, poor distal runoff, critical limb ischemia, chronic total occlusion) contribute to the disappointing results of traditional percutaneous transluminal angioplasty (PTA). New technologies have been developed in attempt to improve the safety and effectiveness of percutaneous revascularization. Among these, atherectomy, debulking and removing atherosclerotic plaque, offers the potential advantage of eliminating stretch on arterial walls and reducing rates of restenosis. Conclusions This review summarizes the features and the current applications of new debulking devices. PMID:23173800

  18. Extreme hyponatraemia with intact neurological outcome in a young child with Addison’s disease

    Science.gov (United States)

    Smith, John-Paul; Burren, Christine; Cherinet, Yonas

    2011-01-01

    The authors present the case of a 6-year-old boy with a good neurological outcome from extreme hyponatraemia caused by autoimmune hypoadrenalism. He presented with 1 week of reduced appetite, lethargy, vomiting and one episode of diarrhoea. He was described as being slightly unsteady on his feet. Clinically he was alert, although intermittently confused, with dry mucous membranes and sunken eyes. Serum sodium was 96 mmol/l with normal serum potassium and renal function. He was initially treated with 3% saline intravenously, and his serum sodium increased to 128 mmol/l by day 3. He developed slurred speech and ataxia on day 4, although MRI brain showed no evidence of pontine myelinosis, and the symptoms resolved over 1 week. A Synacthen test on day 10 confirmed a diagnosis of Addison’s disease and he was commenced on hydrocortisone and fludrocortisone replacement therapy. At 5 months follow-up there are no obvious neurological or developmental sequelae. PMID:22679234

  19. Endovascular management of deep venous thrombotic diseases of the lower extremity

    International Nuclear Information System (INIS)

    Roh, Byung Suk

    2004-01-01

    Pulmonary embolism and venous ischemia are acute complications of deep vein thrombosis (DVT) of the lower extremities. Delayed complications include a spectrum of debilitating symptoms referred to as postthrombotic syndrome (PST). Because the early symptoms and patient signs are nonspecific for DVT, careful history taking and radiological evaluation of the extent and migration of thrombus should be used to establish an objective diagnosis and the need for treatment. Anticoagulation therapy is recognized as the mainstay treatment in acute DVT. However, there are few data to suggest any major beneficial effect of the early clearing of massive DVT and PTS. Endovascular, catheter-directed, thrombolysis techniques, used alone or in combination with mechanical thrombectomy devices, have been proven to be highly effective in clearing acute DVT, which may allow the preservation of venous valve function and the prevention of subsequent venous occlusive disease. Definitive management of the underlying anatomic occlusive abnormalities should also be undertaken

  20. Endovascular management of deep venous thrombotic diseases of the lower extremity

    Energy Technology Data Exchange (ETDEWEB)

    Roh, Byung Suk [School of Medicine, Wonkwang Univ., Iksan (Korea, Republic of)

    2004-07-01

    Pulmonary embolism and venous ischemia are acute complications of deep vein thrombosis (DVT) of the lower extremities. Delayed complications include a spectrum of debilitating symptoms referred to as postthrombotic syndrome (PST). Because the early symptoms and patient signs are nonspecific for DVT, careful history taking and radiological evaluation of the extent and migration of thrombus should be used to establish an objective diagnosis and the need for treatment. Anticoagulation therapy is recognized as the mainstay treatment in acute DVT. However, there are few data to suggest any major beneficial effect of the early clearing of massive DVT and PTS. Endovascular, catheter-directed, thrombolysis techniques, used alone or in combination with mechanical thrombectomy devices, have been proven to be highly effective in clearing acute DVT, which may allow the preservation of venous valve function and the prevention of subsequent venous occlusive disease. Definitive management of the underlying anatomic occlusive abnormalities should also be undertaken.

  1. Non-specific Inflammatory Disease Showed Abnormal FDG Uptake in Lower Extremities

    International Nuclear Information System (INIS)

    Chun, Kyung Ah; Kong, Eun Jung; Cho, Ihn Ho; Hong, Young Hoon; Lee, Choong Ki

    2008-01-01

    Including malignancy, various disease can show abnormal uptake in bone marrow. 1,2) We report a case of non-specific inflammatory FDG uptake in bone marrow mimicking malignancy. A 35-year old woman with fever of unknown origin (FUO) underwent 18 F-FDG PET/CT to find out fever focus and unknown malignancy. 18 F-FDG was injected and imaged 1hr after injection with Discovery ST (GE, USA). 18 F-FDG PET/CT whole body image showed abnormal uptake in lower extremities. MRI and biopsy was also done in the sites of abnormal uptake. PET and MRI suspect malignancy, but biopsy result was non-specific inflammatory process. The patient was improved her clinical condition after antibiotics therapy

  2. Arterial diseases of lower extremities in diabetic patients: current state and prospects of therapy

    Directory of Open Access Journals (Sweden)

    Gagik Radikovich Galstyan

    2011-03-01

    Full Text Available Peripheral artery diseases (PAD are most serious diabetic complications responsible for the high risk of amputation of lower extremities. The occurrenceof PAD in diabetic patients is much higher than in subjects with undisturbed carbohydrate metabolism. PAD in diabetic patients is frequentlyan asymptomatic condition affecting distal portions of arterial segments and associated with pronounced mediacalcinosis. Standard diagnostic proceduresfor the screening of arterial lesions must be supplemented by non-invasive visualization and measurement of transcutaneous oxygen tensionin patients at risk of PAD and persisting foot ulcers. Of special importance is early diagnosis of critical limb ischemia and prevention of foot lesions.Combined treatment of diabetic foot syndrome in patients with critical limb ischemia includes normalization of foot circulation, surgical interventionand conservative therapy of the wound, monitoring concomitant micro- and macrovascular diabetic complications?

  3. Upper Extremity Functional Status of Female Youth Softball Pitchers Using the Kerlan-Jobe Orthopaedic Clinic Questionnaire.

    Science.gov (United States)

    Holtz, Kaila A; O'Connor, Russell J

    2018-01-01

    Softball is a popular sport with a high incidence of upper extremity injuries. The Kerlan-Jobe Orthopaedic Clinic (KJOC) questionnaire is a validated performance and functional assessment tool used in overhead athletes. Upper extremity pain patterns and baseline KJOC scores have not been reported for active female youth softball pitchers. The purpose of this study was to establish the prevalence of upper extremity pain and its effect in female youth softball pitchers over a competitive season. We hypothesized that participants who missed time due to injury in the past year would have lower KJOC scores. Cross-sectional study; Level of evidence, 3. Fifty-three female softball pitchers aged 12 to 18 years were recruited from softball clinics in Vancouver, British Columbia, Canada. All participants self-identified as a pitcher on a competitive travel team. Participants were administered the KJOC questionnaire before and during the playing season. Missed time due to injury in the past year, current pain patterns, and KJOC scores were primary outcomes. The mean (±SD) preseason KJOC score was 87.2 ± 10.6. In the preseason, 22.6% of pitchers reported playing with arm trouble, and 32.1% missed time due to injury in the past year. The mean KJOC score for pitchers reporting a previous injury (n = 17) was significantly lower compared with those without an injury (n = 36) (79.5 ± 13.8 vs 90.9 ± 6.2, respectively; P = .02). The posterior shoulder was the most commonly reported pain location. For the cohort completing the questionnaire both before and during the playing season (n = 35), mean KJOC scores did not change significantly over the playing season ( P = .64). Lower preseason KJOC scores were significantly related to the in-season injury risk ( P = .016). Pitchers with a preseason score of less than 90 had a 3.5 (95% CI, 1.1-11.2) times greater risk of reporting an in-season injury. Female youth softball pitchers have a high baseline functional status. However, 1 in 3

  4. The course of health status and (health-related) quality of life following fracture of the lower extremity : A 6-month follow-up study

    NARCIS (Netherlands)

    van Son, Marleen; de Vries, J.; Roukema, J.A.; Gosens, T.; Verhofstad, M. H. J.; den Oudsten, B.L.

    2016-01-01

    Purpose The aim of this prospective study was to describe the course of health status (HS), health-related quality of life, and quality of life (QOL) in patients with lower extremity fractures (LEF) up to 6 months post-fracture. Methods Patients (n = 171; age range 18–100 years) completed the World

  5. The course of health status and (health-related) quality of life following fracture of the lower extremity: a 6-month follow-up study

    NARCIS (Netherlands)

    M.A.C. van Son; J. de Vries (Jolanda); J.A. Roukema; T. Gosens; M.H.J. Verhofstad (Michiel); B.L. den Oudsten (Brenda)

    2016-01-01

    textabstractPurpose: The aim of this prospective study was to describe the course of health status (HS), health-related quality of life, and quality of life (QOL) in patients with lower extremity fractures (LEF) up to 6 months post-fracture. Methods: Patients (n = 171; age range 18–100 years)

  6. Mental health status can reflect disease activity in rheumatoid arthritis.

    Science.gov (United States)

    Sokolovic, Sekib; Dervisevic, Vedina; Fisekovic, Saida

    2014-06-01

    A significant number of patients with rheumatoid arthritis (RA) link the start of illness with psychological trauma or severe stress. Impaired mental health (IMH), defined as depression and anxiety with psychoneuroimmunological factors, can play a significant role in RA. The main objective of this research was to investigate the mutual correlation of IMH and RA activity, estimated by the laboratory and clinical parameters in RA patients. An open clinical prospective study that lasted for 6 months was designed. There were 72 patients included, 58 women and 14 men, aged 34 to 80 years and screened for mental health status. The study population was randomized following the Brief Symptoms Inventory (BSI) scale, comprised of 53 questions with a range from 0 (no symptoms) to 4 (severe). This mental test was done only once during the study. Following the results from the BSI scale, RA patients were divided into mentally stable and mentally unstable patients to investigate the influence of RA activity on mental health. The following laboratory and clinical parameters were analyzed: sex, age, erythrocyte sedimentation rate (ESR), rheumatoid factor (RF), C-reactive protein (CRP), anti-cyclic citrullinated peptide (anti-CCP) antibody, and disease activity score (DAS28). All RA patients did not express extra-articular manifestations or Sjögren's syndrome. The chi-square test, ANOVA, Pearson's coefficient, and IBM Statistics - SPSS v19 were used. From a total of 72 RA patients, there were 44 mentally stable and 28 mentally unstable patients. All patients had either moderate or severe active disease. The only significant correlation of IMH and activity of RA was found in CRP and DAS28, but no significance was observed in ESR, RF, and anti-CCP. The DAS28 showed high disease activity with an average of 5.3 and CRP of 20.9 mg/L in patients with unstable mental health compared to stable mental health patients, where RA was associated with a moderate DAS average value of 4.35 and

  7. Stenting for peripheral artery disease of the lower extremities: an evidence-based analysis.

    Science.gov (United States)

    2010-01-01

    In January 2010, the Medical Advisory Secretariat received an application from University Health Network to provide an evidentiary platform on stenting as a treatment management for peripheral artery disease. The purpose of this health technology assessment is to examine the effectiveness of primary stenting as a treatment management for peripheral artery disease of the lower extremities. CONDITION AND TARGET POPULATION Peripheral artery disease (PAD) is a progressive disease occurring as a result of plaque accumulation (atherosclerosis) in the arterial system that carries blood to the extremities (arms and legs) as well as vital organs. The vessels that are most affected by PAD are the arteries of the lower extremities, the aorta, the visceral arterial branches, the carotid arteries and the arteries of the upper limbs. In the lower extremities, PAD affects three major arterial segments i) aortic-iliac, ii) femoro-popliteal (FP) and iii) infra-popliteal (primarily tibial) arteries. The disease is commonly classified clinically as asymptomatic claudication, rest pain and critical ischemia. Although the prevalence of PAD in Canada is not known, it is estimated that 800,000 Canadians have PAD. The 2007 Trans Atlantic Intersociety Consensus (TASC) II Working Group for the Management of Peripheral Disease estimated that the prevalence of PAD in Europe and North America to be 27 million, of whom 88,000 are hospitalizations involving lower extremities. A higher prevalence of PAD among elderly individuals has been reported to range from 12% to 29%. The National Health and Nutrition Examination Survey (NHANES) estimated that the prevalence of PAD is 14.5% among individuals 70 years of age and over. Modifiable and non-modifiable risk factors associated with PAD include advanced age, male gender, family history, smoking, diabetes, hypertension and hyperlipidemia. PAD is a strong predictor of myocardial infarction (MI), stroke and cardiovascular death. Annually, approximately

  8. Does the anatomical localization of lower extremity venous diseases affect the quality of life?

    Science.gov (United States)

    Sadikoglu, Ganime; Ozcakir, Alis; Ercan, Ilker; Yildiz, Caner; Sadikoglu, Yurtkuran

    2006-11-01

    To investigate the effects of venous diseases at different anatomical localizations on the qualities of life of patients with varicose veins. The study included 354 cases, which was referred to a private vascular and interventional radiology center in Bursa, Turkey between January 2005 to January 2006. The cases were diagnosed with visual inspection and were clinically indicative of varicose veins. Color Doppler ultrasonography was used to radiologically examine the varicose veins. All cases were accepted as class II criteria according to the Clinical, Etiologic, Anatomic, Pathophysiologic classification. The generic Short Form Health Survey-36 (SF-36) was used to measure physical and mental quality of life (QOL). High scores indicated good QOL. The Statistical Package for Social Sciences version 13.0 program was used for the statistical evaluation. When the life SF-36 quality parameters of cases with different anatomical localizations of the varicose veins were examined, only the mental health scores were found to differ in different groups (pemotional role scores among the mental state determinants. When females and males with deep vein disease were compared, significant differences were found among both physical and mental health determinants. Anatomical localization of lower extremity varicose veins can be accepted as a predictive factor in determining the life qualities of patients with varicosities in their lower limb, and should be used to regulate their therapy and follow up protocols.

  9. Aortic dissection: natural course of disease? Report of two cases representing the extremes of the condition

    International Nuclear Information System (INIS)

    Tollefsen, Isak; Joergensen, Ingrid K.; Woie, Leik; Fossdal, Jan E.

    2001-01-01

    Objective: In a time when diagnostic methods and above all, surgical as well as interventional radiological treatment for aortic aneurysms and aortic dissections have reached a point nobody could think of a few years back, the present authors feel that it is worth while to remind oneself of the natural course of disease in these conditions. Taking into consideration the high morbidity and mortality rate in surgically treated patients with aortic dissection, and the high complication rate per- and postoperatively, it also seems right to ask if a more expectative and conservative approach to the condition sometimes perhaps may be justified. Methods and material: Two case reports are given. One was a 15-year-old boy with Stanford (Daily) type B dissection who statistically ought to have a good prognosis, but who died within 2 h after onset of symptoms. The other patient, a middle-aged woman with Stanford type A dissection, survived for 25 years without operation. Conclusion: These two cases, though not unique viewed separately, we consider to represent the extremes of the condition and also a natural course of disease, while none of them was operated on

  10. Aortic dissection: natural course of disease? Report of two cases representing the extremes of the condition.

    Science.gov (United States)

    Tollefsen, I; Jørgensen, I K; Woie, L; Fossdal, J E

    2001-10-01

    In a time when diagnostic methods and above all, surgical as well as interventional radiological treatment for aortic aneurysms and aortic dissections have reached a point nobody could think of a few years back, the present authors feel that it is worth while to remind oneself of the natural course of disease in these conditions. Taking into consideration the high morbidity and mortality rate in surgically treated patients with aortic dissection, and the high complication rate per- and postoperatively, it also seems right to ask if a more expectative and conservative approach to the condition sometimes perhaps may be justified. Two case reports are given. One was a 15-year-old boy with Stanford (Daily) type B dissection who statistically ought to have a good prognosis, but who died within 2 h after onset of symptoms. The other patient, a middle-aged woman with Stanford type A dissection, survived for 25 years without operation. These two cases, though not unique viewed separately, we consider to represent the extremes of the condition and also a natural course of disease, while none of them was operated on.

  11. Water-Borne Diseases and Extreme Weather Events in Cambodia: Review of Impacts and Implications of Climate Change

    Directory of Open Access Journals (Sweden)

    Grace I. Davies

    2014-12-01

    Full Text Available Cambodia is prone to extreme weather events, especially floods, droughts and typhoons. Climate change is predicted to increase the frequency and intensity of such events. The Cambodian population is highly vulnerable to the impacts of these events due to poverty; malnutrition; agricultural dependence; settlements in flood-prone areas, and public health, governance and technological limitations. Yet little is known about the health impacts of extreme weather events in Cambodia. Given the extremely low adaptive capacity of the population, this is a crucial knowledge gap. A literature review of the health impacts of floods, droughts and typhoons in Cambodia was conducted, with regional and global information reviewed where Cambodia-specific literature was lacking. Water-borne diseases are of particular concern in Cambodia, in the face of extreme weather events and climate change, due to, inter alia, a high pre-existing burden of diseases such as diarrhoeal illness and a lack of improved sanitation infrastructure in rural areas. A time-series analysis under quasi-Poisson distribution was used to evaluate the association between floods and diarrhoeal disease incidence in Cambodian children between 2001 and 2012 in 16 Cambodian provinces. Floods were significantly associated with increased diarrhoeal disease in two provinces, while the analysis conducted suggested a possible protective effect from toilets and piped water. Addressing the specific, local pre-existing vulnerabilities is vital to promoting population health resilience and strengthening adaptive capacity to extreme weather events and climate change in Cambodia.

  12. Water-borne diseases and extreme weather events in Cambodia: review of impacts and implications of climate change.

    Science.gov (United States)

    Davies, Grace I; McIver, Lachlan; Kim, Yoonhee; Hashizume, Masahiro; Iddings, Steven; Chan, Vibol

    2014-12-23

    Cambodia is prone to extreme weather events, especially floods, droughts and typhoons. Climate change is predicted to increase the frequency and intensity of such events. The Cambodian population is highly vulnerable to the impacts of these events due to poverty; malnutrition; agricultural dependence; settlements in flood-prone areas, and public health, governance and technological limitations. Yet little is known about the health impacts of extreme weather events in Cambodia. Given the extremely low adaptive capacity of the population, this is a crucial knowledge gap. A literature review of the health impacts of floods, droughts and typhoons in Cambodia was conducted, with regional and global information reviewed where Cambodia-specific literature was lacking. Water-borne diseases are of particular concern in Cambodia, in the face of extreme weather events and climate change, due to, inter alia, a high pre-existing burden of diseases such as diarrhoeal illness and a lack of improved sanitation infrastructure in rural areas. A time-series analysis under quasi-Poisson distribution was used to evaluate the association between floods and diarrhoeal disease incidence in Cambodian children between 2001 and 2012 in 16 Cambodian provinces. Floods were significantly associated with increased diarrhoeal disease in two provinces, while the analysis conducted suggested a possible protective effect from toilets and piped water. Addressing the specific, local pre-existing vulnerabilities is vital to promoting population health resilience and strengthening adaptive capacity to extreme weather events and climate change in Cambodia.

  13. Bone mineral density and nutritional status in children with chronic inflammatory bowel disease

    NARCIS (Netherlands)

    A.M. Boot (Annemieke); J. Bouquet (Jan); E.P. Krenning (Eric); S.M.P.F. de Muinck Keizer-Schrama (Sabine)

    1998-01-01

    textabstractBACKGROUND: Osteoporosis has been reported in adult patients with inflammatory bowel disease. AIMS: To evaluate bone mineral density (BMD), nutritional status, and determinants of BMD in children with inflammatory bowel disease. PATIENTS: Fifty five patients

  14. Growth and nutritional status of children with homozygous sickle cell disease

    NARCIS (Netherlands)

    Al-Saqladi, A.-W. M.; Cipolotti, R.; Fijnvandraat, K.; Brabin, B. J.

    2008-01-01

    Background: Poor growth and under-nutrition are common in children with sickle cell disease (SCD). This review summarises evidence of nutritional status in children with SCD in relation to anthropometric status, disease severity, body composition, energy metabolism, micronutrient deficiency and

  15. Do health-status measures play a role in improving treatment in chronic obstructive pulmonary disease?

    NARCIS (Netherlands)

    van der Molen, T; Kocks, JWH

    During the past few decades, health status has become increasingly important in the clinical research of chronic obstructive pulmonary disease. The use of health-status questionnaires in routine practice can enhance understanding about the impact of the disease on the patient, improve

  16. Why do people buy dogs with potential welfare problems related to extreme conformation and inherited disease? A representative study of Danish owners of four small dog breeds

    OpenAIRE

    Sand?e, P.; Kondrup, S. V.; Bennett, P. C.; Forkman, B.; Meyer, I; Proschowsky, H. F.; Serpell, J. A.; Lund, T. B.

    2017-01-01

    number of dog breeds suffer from welfare problems due to extreme phenotypes and high levels of inherited diseases but the popularity of such breeds is not declining. Using a survey of owners of two popular breeds with extreme physical features (French Bulldog and Chihuahua), one with a high load of inherited diseases not directly related to conformation (Cavalier King Charles Spaniel), and one representing the same size range but without extreme conformation and with the same level of disease...

  17. Femoral artery plaque characteristics, lower extremity collaterals, and mobility loss in peripheral artery disease.

    Science.gov (United States)

    McDermott, Mary M; Carroll, Timothy; Carr, James; Yuan, Chun; Ferrucci, Luigi; Guralnik, Jack M; Kibbe, Melina; Criqui, Michael H; Tian, Lu; Polonsky, Tamar; Zhao, Lihui; Gao, Ying; Hippe, Daniel S; Xu, Dongxiang; McCarthy, Walter; Kramer, Christopher M

    2017-12-01

    Little is known about the prognostic significance of specific characteristics of magnetic resonance imaging (MRI) measured plaque in the superficial femoral artery (SFA). Associations of MRI-measured plaque quantity, lumen area, and plaque composition in the SFA with subsequent mobility loss were studied in people with lower extremity peripheral artery disease (PAD). Participants with an ankle-brachial index (ABI) Mobility loss was defined as becoming unable to walk up and down a flight of stairs or walk one-quarter of a mile without assistance among participants without mobility impairment at baseline. Analyses adjusted for age, sex, race, comorbidities, ABI, physical activity, and other confounders. Of 308 PAD participants without baseline mobility impairment, 100 (32.5%) developed mobility loss during follow-up. Compared to the lowest mean plaque area tertile at baseline, participants in the highest (worst) plaque area tertile had a higher rate of mobility loss (hazard ratio (HR) = 2.08, 95% confidence interval (CI) = 1.14-3.79, p = 0.018). Compared to the highest mean lumen area tertile, the smallest (worst) mean lumen area tertile was associated with greater mobility loss (HR = 2.18, 95% CI = 1.20-3.96, p = 0.011). Neither lipid rich necrotic core nor calcium in the SFA were associated with mobility loss. In conclusion, greater plaque quantity and smaller lumen area in the proximal SFA, but not lipid rich necrotic core or calcium, were associated with higher mobility loss in people with PAD.

  18. Prognostic value of biochemical variables for survival after surgery for metastatic bone disease of the extremities.

    Science.gov (United States)

    Sørensen, Michala Skovlund; Hovgaard, Thea Bechman; Hindsø, Klaus; Petersen, Michael Mørk

    2017-03-01

    Prediction of survival in patients having surgery for metastatic bone disease in the extremities (MBDex) has been of interest in more than two decades. Hitherto no consensus on the value of biochemical variables has been achieved. Our purpose was (1) to investigate if standard biochemical variables have independent prognostic value for survival after surgery for MBDex and (2) to identify optimal prognostic cut off values for survival of biochemical variables. In a consecutive cohort of 270 patients having surgery for MBDex, we measured preoperative biochemical variables: hemoglobin, alkaline phosphatase, C-reactive protein and absolute, neutrophil and lymphocyte count. ROC curve analyses were performed to identify optimal cut off levels. Independent prognostic factors for variables were addressed with multiple Cox regression analyses. Optimal cut off levels were identified as: hemoglobin 7.45 mmol/L, absolute lymphocyte count 8.5 × 10 9 /L, neutrophil 5.68 × 10 9 /L, lymphocyte 1.37 × 10 9 /L, C-reactive protein 22.5 mg/L, and alkaline phosphatase 129 U/L. Regression analyses found alkaline phosphatase (HR 2.49) and neutrophil count (HR 2.49) to be independent prognostic factors. We found neutrophil count and alkaline phosphatase to be independent prognostic variables in predicting survival in patients after surgery for MBDex. © 2016 Wiley Periodicals, Inc.

  19. A genome-wide study reveals rare CNVs exclusive to extreme phenotypes of Alzheimer disease.

    Science.gov (United States)

    Rovelet-Lecrux, Anne; Legallic, Solenn; Wallon, David; Flaman, Jean-Michel; Martinaud, Olivier; Bombois, Stéphanie; Rollin-Sillaire, Adeline; Michon, Agnès; Le Ber, Isabelle; Pariente, Jérémie; Puel, Michèle; Paquet, Claire; Croisile, Bernard; Thomas-Antérion, Catherine; Vercelletto, Martine; Lévy, Richard; Frébourg, Thierry; Hannequin, Didier; Campion, Dominique

    2012-06-01

    Studying rare extreme forms of Alzheimer disease (AD) may prove to be a useful strategy in identifying new genes involved in monogenic determinism of AD. Amyloid precursor protein (APP), PSEN1, and PSEN2 mutations account for only 85% of autosomal dominant early-onset AD (ADEOAD) families. We hypothesised that rare copy number variants (CNVs) could be involved in ADEOAD families without mutations in known genes, as well as in rare sporadic young-onset AD cases. Using high-resolution array comparative genomic hybridisation, we assessed the presence of rare CNVs in 21 unrelated ADEOAD cases, having no alteration on known genes, and 12 sporadic AD cases, with an age of onset younger than 55 years. The analysis revealed the presence of 7 singleton CNVs (4 in ADEOAD and 3 in sporadic cases) absent in 1078 controls and 912 late-onset AD cases. Strikingly, 4 out of 7 rearrangements target genes (KLK6, SLC30A3, MEOX2, and FPR2) encoding proteins that are tightly related to amyloid-β peptide metabolism or signalling. Although these variants are individually rare and restricted to particular subgroups of patients, these findings support the causal role, in human pathology, of a set of genes coding for molecules suspected for a long time to modify Aβ metabolism or signalling, and for which animal or cellular models have already been developed.

  20. Spatial extreme learning machines: An application on prediction of disease counts.

    Science.gov (United States)

    Prates, Marcos O

    2018-01-01

    Extreme learning machines have gained a lot of attention by the machine learning community because of its interesting properties and computational advantages. With the increase in collection of information nowadays, many sources of data have missing information making statistical analysis harder or unfeasible. In this paper, we present a new model, coined spatial extreme learning machine, that combine spatial modeling with extreme learning machines keeping the nice properties of both methodologies and making it very flexible and robust. As explained throughout the text, the spatial extreme learning machines have many advantages in comparison with the traditional extreme learning machines. By a simulation study and a real data analysis we present how the spatial extreme learning machine can be used to improve imputation of missing data and uncertainty prediction estimation.

  1. Upper Extremity Functional Status of Female Youth Softball Pitchers Using the Kerlan-Jobe Orthopaedic Clinic Questionnaire

    OpenAIRE

    Holtz, Kaila A.; O’Connor, Russell J.

    2018-01-01

    Background: Softball is a popular sport with a high incidence of upper extremity injuries. The Kerlan-Jobe Orthopaedic Clinic (KJOC) questionnaire is a validated performance and functional assessment tool used in overhead athletes. Upper extremity pain patterns and baseline KJOC scores have not been reported for active female youth softball pitchers. Purpose/Hypothesis: The purpose of this study was to establish the prevalence of upper extremity pain and its effect in female youth softball pi...

  2. Prevalence and Significance of Unrecognized Lower Extremity Peripheral Arterial Disease in General Medicine Practice

    Science.gov (United States)

    McGrae McDermott, Mary; Kerwin, Diana R; Liu, Kiang; Martin, Gary J; O'Brien, Erin; Kaplan, Heather; Greenland, Philip

    2001-01-01

    OBJECTIVE To determine the prevalence of unrecognized lower extremity peripheral arterial disease (PAD) among men and women aged 55 years and older in a general internal medicine (GIM) practice and to identify characteristics and functional performance associated with unrecognized PAD. DESIGN Cross-sectional. SETTING Academic medical center. PARTICIPANTS We identified 143 patients with known PAD from the noninvasive vascular laboratory, and 239 men and women aged 55 and older with no prior PAD history from a GIM practice. Group 1 consisted of patients with PAD consecutively identified from the noninvasive vascular laboratory (n = 143). Group 2 included GIM practice patients found to have an ankle brachial index less than 0.90, consistent with PAD (n = 34). Group 3 consisted of GIM practice patients without PAD (n = 205). MEASUREMENTS AND MAIN RESULTS Leg functioning was assessed with the 6-minute walk, 4-meter walking velocity, and Walking Impairment Questionnaire (WIQ). Of GIM practice patients, 14% had unrecognized PAD. Only 44% of patients in Group 2 had exertional leg symptoms. Distances achieved in the 6-minute walk were 1,130, 1,362, and 1,539 feet for Groups 1, 2, and 3, respectively, adjusting for age, gender, and race (P < .001). The degree of difficulty walking due to leg symptoms as reported on the WIQ was comparable between Groups 2 and 3 and significantly greater in Group 1 than Group 2. In multiple logistic regression analysis including Groups 2 and 3, current cigarette smoking was associated independently with unrecognized PAD (odds ratio [OR], 6.82; 95% confidence interval [95% CI], 1.55 to 29.93). Aspirin therapy was nearly independently associated with absence of PAD (OR, 0.37; 95% CI, 0.12 to 1.12). CONCLUSION Unrecognized PAD is common among men and women aged 55 years and older in GIM practice and is associated with impaired lower extremity functioning. Ankle brachial index screening may be necessary to diagnose unrecognized PAD in a GIM

  3. DIFFERENCES IN THE LEVELS OF LIPID STATUS IN PATIENTS WITH ISACHEMIC HEART DISEASE AND MALIGNANT DISEASE

    Directory of Open Access Journals (Sweden)

    Beretka Atila

    2009-01-01

    Full Text Available Arteriosclerosis is the basis of all cardiovascular diseases. Numerous risk factors lead to the rise of malignant and cardiovascular diseases. Those are: elevated artery blood pressure, raised plasma cholesterol and triglycerides, low level of HDL-cholesterol, smoking, diabetes mellitus, diet, lack of physical exercises, heredity, stress, gender.The aim of the study was to compare the lipid status of patients with cardiovascular disease or malignancy.The database of the biochemical laboratory and oncology counseling unit of the "Ostrog Clinic" was used. The method of random sample was used and patients (n=29 of both genders were selected, who were at the age of 40 to 47, with cardiovascular diseases, and had significant occlusive coronary disease, which required operation or surgical revascularization procedure. The patients were classified in two groups: G1 (n=14 with statin therapy and G2 (n=15 without statin therapy. Both groups were statistically compared with a group of female patients (n=30 with breast cancer, who were between 37 and 69 years of age. Control group comprised 25 healthy subjects. Standard statistical methods were used for processing the lipid status parameters, namely: the arithmetic mean, standard deviation SDn and SDn-1, correlation coefficient, post hock test and a single factor analysis of variance.The results obtained have pointed to the existence of a marked hyperlipoproteinemia type 4 in the group of cardiovascular patients who did not use statin (G2. In G2, higher levels of cholesterol, LDL-cholesterol and plasma triglycerides in comparison with the control and G1, while the value of HDL-cholesterol was within the range of referent values. The obvious suppressing effect of statin on cholesterol and LDL-cholesterol was observed in G1. Group G3 had, in comparison with the control and cardiovascular patients, significantly lower levels of cholesterol and triglycerides in plasma, as well as lower index of atherosclerosis

  4. Hepatic tuberculosis presenting with extreme hyperferritinemia masquerading as adult-onset Still’s disease: a case report

    Directory of Open Access Journals (Sweden)

    Manoj Edirisooriya

    2012-07-01

    Full Text Available Abstract Introduction Isolated hepatic tuberculosis is an uncommon manifestation of one of the most common infections worldwide, caused by Mycobacterium tuberculosis. Extremely high serum ferritin, which is regarded as a marker of adult onset Still’s disease, has not been observed in patients with tuberculosis of the liver. We report a case of hepatic tuberculosis who presented with clinical criteria of adult-onset Still’s disease and extreme hyperferritinemia, which posed a diagnostic confusion. Case presentation Our patient was a 48-year-old Sri Lankan man who presented with fever, polyarthralgia and a generalized skin rash of three months duration. He had marked constitutional symptoms, oral ulcers, hair loss, anemia and hepatomegaly. Laboratory investigations disclosed an inflammatory syndrome, evidence of hepatic dysfunction, bone marrow suppression and a raised serum ferritin level of 34,674 ng/ml. A rapidly deteriorating course of illness prompted treatment based on a presumptive diagnosis of adult-onset Still’s disease until liver histology was available. The patient died of sepsis followed by multi-organ dysfunction. Later, the liver histology revealed tuberculosis. Conclusion Extrapulmonary tuberculosis, although well known to present with peculiar manifestations, has not been reported to be associated with extremely high levels of serum ferritin in immunocompetent individuals. Isolated hepatic tuberculosis presenting with clinical criteria of adult-onset Still’s disease is remarkable. Since tuberculosis remains a potentially curable disease, an awareness of its’ protean manifestations is essential.

  5. Extreme nonfasting remnant cholesterol vs extreme LDL cholesterol as contributors to cardiovascular disease and all-cause mortality in 90000 individuals from the general population

    DEFF Research Database (Denmark)

    Varbo, Anette; Freiberg, Jacob J; Nordestgaard, Børge G

    2015-01-01

    BACKGROUND: Increased nonfasting remnant cholesterol, like increased LDL cholesterol, is causally associated with increased risk for ischemic heart disease (IHD). We tested the hypothesis that extreme concentrations of nonfasting remnant and LDL cholesterol are equal contributors to the risk of IHD......, myocardial infarction (MI), and all-cause mortality. METHODS: We compared stepwise increasing concentrations of nonfasting remnant and LDL cholesterol for association with risk of IHD, MI, and all-cause mortality in approximately 90 000 individuals from the Danish general population. During up to 22 years...... of complete follow-up, 4435 participants developed IHD, 1722 developed MI, and 8121 died. RESULTS: Compared with participants with nonfasting remnant cholesterol cholesterol of 0.5-0.99 mmol/L (19.3-38.2 mg/dL) to 2...

  6. Epidemiology of diabetic foot disease and diabetes-related lower-extremity amputation in Australia: a systematic review protocol.

    Science.gov (United States)

    van Netten, Jaap J; Baba, Mendel; Lazzarini, Peter A

    2017-05-18

    Diabetic foot disease is associated with major morbidity, mortality, costs, and reduction of a person's quality of life. Investigating the epidemiology of diabetic foot disease is the backbone of diabetic foot research and clinical practice, yet the full burden of diabetic foot disease in Australia is unknown. This study aims to describe the protocol for a systematic review of the epidemiology of diabetic foot disease and diabetes-related lower-extremity amputation in Australia. The systematic review will be performed according to the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. PubMed and EMBASE will be searched for publications in any language and without restrictions to date. Two independent investigators will screen publications for eligibility, with publications reporting Australian population-based incidence or prevalence of diabetic foot disease or diabetes-related lower-extremity amputation to be included. Additionally, a forward literature search will be performed in Google Scholar, and a grey literature search will be performed to identify government publications. Quality assessment will be performed using customised checklists. The summary statistic used for each study will be an incidence or prevalence proportion of diabetic foot disease or diabetes-related lower-extremity amputation. The standard error for each proportion will be calculated. A meta-analysis will be performed when three or more publications of adequate quality, reporting on similar outcomes and in similar populations, are identified. The results of this systematic review can be used to adequately inform stakeholders in the field of diabetic foot disease on the extent of the problem in incidence and prevalence of diabetic foot disease in Australia, and to help guide appropriate use of resources to reduce the burden of this disease. PROSPERO CRD42016050740.

  7. Employment status of patients with neuromuscular diseases in relation to personal factors, fatigue and health status : A secondary analysis

    NARCIS (Netherlands)

    Rob Oostendorp; Peter Huijbregts; Marie-Antoinette Minis; Joke Kalkman; Baziel Engelen; Reinier Akkermans; Gijs Bleijenberg; Josephine Engels

    2010-01-01

    To determine the number of employed people in a group of patients with neuromuscular diseases and in 3 separate subgroups (facioscapulo-humeral dystrophy, hereditary motor and sensory neuropathy, and myotonic dystrophy) to investigate any differences in employment status between the patient groups,

  8. Employment status of patients with neuromuscular diseases in relation to personal factors, fatigue and health status: a secondary analysis.

    NARCIS (Netherlands)

    Minis, M.A.H; Kalkman, J.S.; Akkermans, R.P.; Engels, J.A.; Huijbregts, P.A.; Bleijenberg, G.; Oostendorp, R.A.B.; Engelen, B.G.M. van

    2010-01-01

    OBJECTIVE: To determine the number of employed people in a group of patients with neuromuscular diseases and in 3 separate subgroups (facioscapulo-humeral dystrophy, hereditary motor and sensory neuropathy, and myotonic dystrophy) to investigate any differences in employment status between the

  9. Racial differences in functional decline in peripheral artery disease and associations with socioeconomic status and education.

    Science.gov (United States)

    McDermott, Mary M; Polonsky, Tamar S; Kibbe, Melina R; Tian, Lu; Zhao, Lihui; Pearce, William H; Gao, Ying; Guralnik, Jack M

    2017-09-01

    The objective of this study was to determine whether blacks with lower extremity peripheral artery disease (PAD) have faster functional decline than whites with PAD. Participants with ankle-brachial index sex, ankle-brachial index, comorbidities, and other confounders (hazard ratio, 1.45; 95% confidence interval, 1.05-1.99; P = .022). This association was attenuated after adjustment for income and education (P = .229). Among 844 participants without baseline mobility impairment, black participants had a higher rate of mobility loss (64/209 [30.6%] vs 164/635 [25.8%]; log-rank, P = .009). Black race was associated with increased mobility loss, adjusting for potential confounders (hazard ratio, 1.42; 95% confidence interval, 1.04-1.94; P = .028). This association was attenuated after additional adjustment for income and education (P = .392) and physical activity (P = .113). There were no racial differences in average annual declines in 6-minute walk, usual-paced 4-meter walking velocity, or fast-paced 4-meter walking velocity. Black PAD patients have higher rates of mobility loss and becoming unable to walk for 6 minutes continuously. These differences appear related to racial differences in socioeconomic status and physical activity. Copyright © 2017 Society for Vascular Surgery. All rights reserved.

  10. Effects of interactive metronome training on postural stability and upper extremity function in Parkinson’s disease: a case study

    Science.gov (United States)

    Kim, Arim; Lee, Hye-Sun; Song, Chiang-Soon

    2017-01-01

    [Purpose] The purpose of this study was to examine the effects of interactive metronome training on the postural stability and upper extremity function of an individual with Parkinson’s disease. [Subject and Methods] The participant of this case study was a 75-year-old female with Parkinson’s disease diagnosed 7 years prior. This study was a single-subject research with an A-B-A design. She received IM training during the treatment phase (B phase) for 40 minutes per session. She was assessed pretest and posttest using the Berg balance scale and Wolf motor function test, and at baseline and the treatment phase using the measured box-and-block test and a Tetrax system. [Results] After training, the patient’s static and dynamic balance, functional activity, and performance time of the upper extremity improved. Interactive metronome therapy improved the manual dexterity of both hands. Interactive metronome therapy also improved the limit of stability of the Parkinson’s disease. [Conclusion] Though a case study, the results of this study suggest that IM therapy is effective at restoring the postural stability and upper extremity function of patients with Parkinson’s disease. PMID:28210066

  11. Effects of interactive metronome training on postural stability and upper extremity function in Parkinson's disease: a case study.

    Science.gov (United States)

    Kim, Arim; Lee, Hye-Sun; Song, Chiang-Soon

    2017-01-01

    [Purpose] The purpose of this study was to examine the effects of interactive metronome training on the postural stability and upper extremity function of an individual with Parkinson's disease. [Subject and Methods] The participant of this case study was a 75-year-old female with Parkinson's disease diagnosed 7 years prior. This study was a single-subject research with an A-B-A design. She received IM training during the treatment phase (B phase) for 40 minutes per session. She was assessed pretest and posttest using the Berg balance scale and Wolf motor function test, and at baseline and the treatment phase using the measured box-and-block test and a Tetrax system. [Results] After training, the patient's static and dynamic balance, functional activity, and performance time of the upper extremity improved. Interactive metronome therapy improved the manual dexterity of both hands. Interactive metronome therapy also improved the limit of stability of the Parkinson's disease. [Conclusion] Though a case study, the results of this study suggest that IM therapy is effective at restoring the postural stability and upper extremity function of patients with Parkinson's disease.

  12. Type D personality and health status in cardiovascular disease populations

    DEFF Research Database (Denmark)

    Versteeg, Henneke; Spek, Viola; Pedersen, Susanne S.

    2012-01-01

    Background: Knowledge of the factors associated with individual differences in patient-reported outcomes is essential to identify high-risk patients and improve secondary prevention. Design: In this meta-analysis, we examined the association between Type D personality and the individual differences...... in patient-reported physical and mental health status among cardiovascular patients. Methods: A computerized search of the literature through PUBMED and PsychINFO (from 1995 to May 2011) was performed and prospective studies were selected that analysed the association between Type D personality and health...... status in cardiovascular patients. Two separate meta-analyses were performed for the association of Type D personality with physical and mental health status, respectively. Results: Of all identified studies, ten studies met the selection criteria. The meta-analyses showed that Type D was associated...

  13. Community Health Status Indicators (CHSI) to Combat Obesity, Heart Disease and Cancer

    Data.gov (United States)

    U.S. Department of Health & Human Services — Community Health Status Indicators (CHSI) to combat obesity, heart disease, and cancer are major components of the Community Health Data Initiative. This dataset...

  14. Differences in Nutritional Status Between Very Mild Alzheimer's Disease Patients and Healthy Controls

    NARCIS (Netherlands)

    Olde Rikkert, M.G.M.; Verhey, F. R.; Sijben, J.W.C.; Bouwman, F.H.; Dautzenberg, P.L.J.; Lansink, M.; Sipers, W.M.W.; van Asselt, D.Z.B.; van Hees, A.M.J.; Stevens, M.; Vellas, B.; Scheltens, P.

    2014-01-01

    Background: Studies on the systemic availability of nutrients and nutritional status in Alzheimer's disease (AD) are widely available, but the majority included patients in a moderate stage of AD. Objective: This study compares the nutritional status between mild AD outpatients and healthy controls.

  15. Nutritional status and long-term mortality in hospitalised patients with chronic obstructive pulmonary disease (COPD)

    DEFF Research Database (Denmark)

    Hallin, Runa; Gudmundsson, Gunnar; Suppli Ulrik, Charlotte

    2007-01-01

    Patients with chronic obstructive pulmonary disease (COPD) often have difficulties with keeping their weight. The aim of this investigation was to study nutritional status in hospitalised Nordic COPD patients and to investigate the association between nutritional status and long-term mortality in...

  16. a survey of nutritional status and disease patterns among urbanized ...

    African Journals Online (AJOL)

    1983-04-30

    Apr 30, 1983 ... The most common cause of death in males was respiratory disease, and in females ... elevated mortality rates.l-4 The pattern of disease among these people is characterized by the dominance of infective ... total Black (African) population was urbanized in 1911. This figure had risen to 28% by 1960 and is ...

  17. Distinct trajectories of disease-specific health status in heart failure patients undergoing cardiac resynchronization therapy

    DEFF Research Database (Denmark)

    Mastenbroek, Mirjam H.; Pedersen, Susanne S.; Meine, Mathias

    2016-01-01

    of beta-blockers, use of psychotropic medication, anxiety, depression, and type D personality were found to be associated with poorer health status in unadjusted analyses. Interestingly, subgroups of patients (12-20 %) who experienced poor health status at baseline improved to stable good health status....... The timely identification of CRT-D patients who present with poor disease-specific health status (i.e., KCCQ score anxiety, depression, and/or type D personality) is paramount, as they may benefit from cardiac rehabilitation in combination...

  18. a survey of nutritional status and disease patterns among urbanized ...

    African Journals Online (AJOL)

    1983-04-30

    Apr 30, 1983 ... common forms of cardiac disease encountered were congestive cardiac failure due to cardiomyopathy or .... 'domestic' worker group), and hence the habit is going to be very difficult to break. However, it is possible to change ...

  19. Nanomedicines for renal disease: current status and future applications

    DEFF Research Database (Denmark)

    Kamaly, Nazila; He, John C.; Ausiello, Dennis A.

    2016-01-01

    , alongside research efforts in tissue regeneration and organ-on-a-chip investigations, are likely to provide novel solutions to treat kidney diseases. Our understanding of renal anatomy and of how the biological and physico-chemical properties of nanomedicines (the combination of a nanocarrier and a drug......Treatment and management of kidney disease currently presents an enormous global burden, and the application of nanotechnology principles to renal disease therapy, although still at an early stage, has profound transformative potential. The increasing translation of nanomedicines to the clinic......) influence their interactions with renal tissues has improved dramatically. Tailoring of nanomedicines in terms of kidney retention and binding to key membranes and cell populations associated with renal diseases is now possible and greatly enhances their localization, tolerability, and efficacy. This Review...

  20. Current status of gene therapy for motor neuron disease

    Institute of Scientific and Technical Information of China (English)

    Xingkai An; Rong Peng; Shanshan Zhao

    2006-01-01

    OBJECTIVE: Although the etiology and pathogenesis of motor neuron disease is still unknown, there are many hypotheses on motor neuron mitochondrion, cytoskeleton structure and functional injuries. Thus, gene therapy of motor neuron disease has become a hot topic to apply in viral vector, gene delivery and basic gene techniques.DATA SOURCES: The related articles published between January 2000 and October 2006 were searched in Medline database and ISl database by computer using the keywords "motor neuron disease, gene therapy", and the language is limited to English. Meanwhile, the related references of review were also searched by handiwork. STUDY SELECTION: Original articles and referred articles in review were chosen after first hearing, then the full text which had new ideas were found, and when refer to the similar study in the recent years were considered first.DATA EXTRACTION: Among the 92 related articles, 40 ones were accepted, and 52 were excluded because of repetitive study or reviews.DATA SYNTHESIS: The viral vectors of gene therapy for motor neuron disease include adenoviral, adeno-associated viral vectors, herpes simplex virus type 1 vectors and lentiviral vectors. The delivery of them can be achieved by direct injection into the brain, or by remote delivery after injection vectors into muscle or peripheral nerves, or by ex vivo gene transfer. The viral vectors of gene therapy for motor neuron disease have been successfully developed, but the gene delivery of them is hampered by some difficulties. The RNA interference and neuroprotection are the main technologies for gene-based therapy in motor neuron disease. CONCLUSION : The RNA interference for motor neuron disease has succeeded in animal models, and the neuroprotection also does. But, there are still a lot of questions for gene therapy in the clinical treatment of motor neuron disease.

  1. Disease-specific health status as a predictor of mortality in patients with heart failure

    DEFF Research Database (Denmark)

    Mastenbroek, Mirjam H; Versteeg, Henneke; Zijlstra, Wobbe P

    2014-01-01

    AIMS: Some, but not all, studies have shown that patient-reported health status, including symptoms, functioning, and health-related quality of life, provides additional information to traditional clinical factors in predicting prognosis in heart failure patients. To evaluate the overall evidence......, the association of disease-specific health status on mortality in heart failure was examined through a systematic review and meta-analysis. METHODS AND RESULTS: Prospective cohort studies that assessed the independent association of disease-specific health status with mortality in heart failure were selected....... Searching PubMed (until March 2013) resulted in 17 articles in the systematic review and 17 studies in the meta-analysis. About half of the studies reported a significant relationship between disease-specific health status and mortality in heart failure, while the remainder found no association. A larger...

  2. The course of health status and (health-related) quality of life following fracture of the lower extremity: a 6-month follow-up study.

    Science.gov (United States)

    Van Son, M A C; De Vries, J; Roukema, J A; Gosens, T; Verhofstad, M H J; Den Oudsten, B L

    2016-05-01

    The aim of this prospective study was to describe the course of health status (HS), health-related quality of life, and quality of life (QOL) in patients with lower extremity fractures (LEF) up to 6 months post-fracture. Patients (n = 171; age range 18-100 years) completed the World Health Organization Quality of Life assessment instrument-Bref (WHOQOL-Bref) and the Short Musculoskeletal Function Assessment questionnaire (SMFA) at time of diagnosis (i.e., pre-injury status), 1 week, and 6 months post-fracture. Linear mixed modeling was performed. Interaction effects of time with treatment were detected for the WHOQOL-Bref facet Overall QOL and General health (p = .002) and Physical health (p = .003). Patients did not return to their pre-injury Physical health, Psychological health, and Environment 6 months post-fracture (p choice of the questionnaire influences the derived conclusions. LEF did not affect satisfaction with social relationships.

  3. Disease Patterns and Socioeconomic Status Associated with Utilization of Computed Tomography in Taiwan, 1997–2003

    Directory of Open Access Journals (Sweden)

    Pei-Tseng Kung

    2008-02-01

    Conclusion: Neoplasm, diseases of the circulatory system, congenital malformations, and poor socioeconomic status were significantly associated with a higher rate of CT utilization. The distribution of disease patterns varied with gender, age groups, salary levels, and health care region's household income levels. Further study is needed to better understand the nature of the findings.

  4. Sufficient vitamin K status combined with sufficient vitamin D status is associated with better lower extremity function: a prospective analysis of two knee osteoarthritis cohorts

    Science.gov (United States)

    Objective: Vitamins K and D are important for the function of vitamin K-dependent proteins in joint tissues. It is unclear if these nutrients are mutually important to functional outcomes related to knee osteoarthritis (OA). This study aimed to evaluate the association of vitamin K and D status with...

  5. Diseases of the Date Palm: Present Status and Future Prospects

    Directory of Open Access Journals (Sweden)

    M. Djerbi

    1998-01-01

    Full Text Available While date palm is affected by many diseases, bayoud remains the most serious one. It is caused by a soil born pathogen, Fusarium oxyspurum f .sp. albedinis. It has affected practically all Moroccan palm groves as well as those of western and central Algerian sahara, where it has respectively killed more than 12 million in Morocco and three million in Algeria and has accelerated the desertification phenomenon. External and internal symptoms as well as identification methods of F.o. f. sp. albedinis by pathogenicity test, cultural characteristics, and vegetative compatibility were reviewed and discussed. Small distance contamination occurs by root contact between diseased trees and healthy ones, and at large distances through the movement of contaminated planting material (offshoots, symptomless carriers and infested soil and irrigation water. Prophylactic measures as well as chemical, cultural, biological and genetic controls were reviewed. It appears that the most productive mean lies in research into resistant cultivars. Hundreds of genotypes have been selected and introduced for micro-propagation and planted in infested areas to rehabilitate date palm oasis ravaged by bayoud. Among other date palm diseases Khamedj (Mauginiella scaettae, fruit rot (due to numerous fungi, Black scorch (Thielaviopsis paradoxa, Belaat (Phytophtora sp. are of minor importance and of sporadic occurrence. However, they become serious and cause heavy losses under favorable conditions and when proper sanitation is not applied. Two serious and fatal diseases of unknown causes (AI Wijam and the Brittle leaf disease as well as many other diseases and physiological disorders of minor importance were also reviewed.

  6. Impact of chronic kidney disease stage on lower-extremity arthroplasty.

    Science.gov (United States)

    Deegan, Brian F; Richard, Raveesh D; Bowen, Thomas R; Perkins, Robert M; Graham, Jove H; Foltzer, Michael A

    2014-07-01

    End-stage renal disease and dialysis is commonly associated with poor outcomes after joint replacement surgery. The goal of this study was to evaluate postoperative complications in patients with less advanced chronic kidney disease undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA). Patients who underwent THA or TKA between 2004 and 2011 with stage 1, 2, or 3 chronic kidney disease were retrospectively reviewed via an electronic medical record. The authors compared 377 patients who had stage 1 to 2 chronic kidney disease with 402 patients who had stage 3 chronic kidney disease. No significant differences in 90-day readmission or revision rates were found between the stage 1 to 2 and stage 3 patient groups. For patients with stage 3 chronic kidney disease, the overall mortality rate was greater than that in patients with stage 1 to 2 chronic kidney disease. However, when adjusted for comorbid disease, no significant increases were seen in joint infection, readmission, or early revision between patients with stage 1 to 2 chronic kidney disease vs patients with stage 3 chronic kidney disease. The overall incidence of infection was high (3.5%) but far less than reported for patients with end-stage renal disease, dialysis, and kidney transplant. In conclusion, patients with stage 1, 2, or 3 chronic kidney disease may have a higher than expected rate of prosthetic joint infection (3.5%) after total joint arthroplasty. Patients with stage 3 chronic kidney disease are at higher risk for postoperative mortality compared with those with lesser stages of kidney disease. Copyright 2014, SLACK Incorporated.

  7. Current status of radionuclide imaging in valvular heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Boucher, C.A.; Okada, R.D.; Pohost, G.M.

    1980-12-18

    The current state-of-the-art in radionuclide imaging of valvular heart disease is based on different angiographic patterns in three left-sided valve abnormalities: pressure overload, volume overload, and inflow obstruction. In pressure overload, the left ventricle has normal dimensions or is minimally dilated the volume overload involves a left ventricular dilatation with a normal or reduced ejection fraction at rest the left ventricular function in inflow obstruction is normal, but in some cases may be depressed. Radionuclide angiography evaluates the effect of a valve abnormality on cardiac chamber and function thallium-201 imaging diagnoses regional myocardial blood flow and cell integrity and can evaluate the associated coronary artery disease.

  8. Current status of radionuclide imaging in valvular heart disease

    International Nuclear Information System (INIS)

    Boucher, C.A.; Okada, R.D.; Pohost, G.M.

    1980-01-01

    The current state-of-the-art in radionuclide imaging of valvular heart disease is based on different angiographic patterns in three left-sided valve abnormalities: pressure overload, volume overload, and inflow obstruction. In pressure overload, the left ventricle has normal dimensions or is minimally dilated the volume overload involves a left ventricular dilatation with a normal or reduced ejection fraction at rest the left ventricular function in inflow obstruction is normal, but in some cases may be depressed. Radionuclide angiography evaluates the effect of a valve abnormality on cardiac chamber and function thallium-201 imaging diagnoses regional myocardial blood flow and cell integrity and can evaluate the associated coronary artery disease

  9. Current status of viral diseases in Indian shrimp aquaculture.

    Science.gov (United States)

    Tandel, G M; John, K Riji; Rosalind George, M; Prince Jeyaseelan, M J

    The intensification of aquaculture has been unique in showing the overwhelming changes in global food production in the last 100 years. Presently, it is playing a vital role in the economies of several countries. Conversely, it is also to be noted that the progression of aquaculture has been the foundation of anthropogenic alteration of a gigantic hierarchy and hence not astonishingly, it resulted in spread and emergence of an increasing group of new unknown diseases. In India, Penaeus monodon, black tiger shrimp was previously the foremost-cultivated shrimp species. Subsequently in 2008, the American white leg shrimp Litopenaeus vannamei has effectively replaced it. The change in dominant species has affected disease concerns in India as well as in world shrimp aquaculture. White spot syndrome virus (WSSV) is the most deleterious for both species. Hepatopancreatic parvovirus (HPV), Monodon baculovirus (MBV) and Infectious hypodermal and hematopoietic necrosis virus (IHHNV) are the other significant infectious agents of P. monodon and L. vannamei. An emerging disease of loose shell syndrome (LSS) was already reported from India during late 1998. A more recent disease of L. vannamei in India is monodon slow growth syndrome (MSGS), a component of which seems to be Laem-Singh virus (LSNV). Thus, most of the information in this review relates to new emerging pathogens that threaten the cultivation shrimp industry in India.

  10. Current status of gastroesophageal reflux disease : diagnosis and treatment.

    Science.gov (United States)

    Chuang, Tang-Wei; Chen, Shou-Chien; Chen, Kow-Tong

    2017-01-01

    The aim of this study was to explore the recent advances in diagnosis and treatment of gastroesophageal reflux disease (GERD). Previous studies were searched using the terms "gastroesophageal reflux disease" and "diagnosis" or "treatment" in Medline and Pubmed. Articles that were not published in the English language, manuscripts without an abstract, reviews, meta-analysis, and opinion articles were excluded from the review. After a preliminary screening, all of the articles were reviewed and synthesized to provide an overview of the contemporary approaches to GERD. GERD has a variety of symptomatic manifestations, which can be grouped into typical, atypical and extra-esophageal symptoms. Those with the highest specificity for GERD are acid regurgitation and heartburn. In the absence of other alarming symptoms, these symptoms allow one to make a presumptive diagnosis of GERD and initiate empiric therapy. GERD-associated complications include erosive esophagitis, peptic stricture, Barrett's esophagus, esophageal adenocarcinoma and pulmonary disease. Management of GERD may involve lifestyle modifications, medical and surgical therapy. Medical therapy involves acid suppression, which can be achieved with antacids, histamine-receptor antagonists or proton-pump inhibitors. Whereas most patients can be effectively managed with medical therapy, others may go on to require anti-reflux surgery after undergoing a proper pre-operative evaluation. The management of this disease requires a complex approach. Maintenance therapy of GERD after using anti-secretory drugs should be continuously monitored. © Acta Gastro-Enterologica Belgica.

  11. [Current status and prospect of photodynamic therapy in laryngeal diseases].

    Science.gov (United States)

    Zhang, C; Jiang, J Q

    2018-04-07

    Laryngeal diseases are closely related to the swallowing and speech function of the patients.Protecting and restoring laryngeal function, while curing lesions, is vital to patients' quality of life.Photodynamic therapy (PDT) is a minimally invasive method which is widely used in the treatment of tumor, precancerous lesions, and inflammatory diseases.In recent years, it has been shown to have a protective effect on normal structures. This article reviews the clinical outcomes of laryngeal diseases treated with PDT since 1990 in order to evaluate its efficacy and significance. The complete remission rate of early-stage laryngeal tumors and precancerous lesions after PDT is 77.6%(249/321), and a promising effect on recurrent laryngeal papillomatosis has been observed thus far. The prolonged adverse effects of the first-generation photosensitizers have limited the application of PDT. With the improvement of photosensitizers and treatment strategies, PDT promises to be a safe, effective, and minimally invasive treatment method for laryngeal diseases.

  12. Status of cocoa swollen shoot virus disease in Nigeria

    African Journals Online (AJOL)

    SERVER

    African Journal of Biotechnology Vol. 6 (17), pp. 2054-2061, 5 September 2007. Available online at ... Plant Pathology Division, Cocoa Research Institute of Nigeria, P.M.B. 5244, Ibadan, Oyo State, Nigeria. Accepted 9 August, 2007 ... economic importance of the disease in Nigeria. Key words: Cocoa, cocoa swollen shoot ...

  13. nutritional status of children admitted for diarrhoeal diseases in a ...

    African Journals Online (AJOL)

    2013-07-07

    Jul 7, 2013 ... Objectives: To determine the prevalence of malnutrition among children admitted with acute diarrhoea disease at Moi Teaching and Referral Hospital and to establish the effect of malnutrition on duration of hospital stay. Design: Prospective observational study. Setting: Paediatric wards of Moi Teaching and ...

  14. Extremely low frequency electromagnetic field (ELF-EMF) reduces oxidative stress and improves functional and psychological status in ischemic stroke patients.

    Science.gov (United States)

    Cichoń, Natalia; Bijak, Michał; Miller, Elżbieta; Saluk, Joanna

    2017-07-01

    As a result of ischaemia/reperfusion, massive generation of reactive oxygen species occurs, followed by decreased activity of antioxidant enzymes. Extremely low frequency electromagnetic fields (ELF-EMF) can modulate oxidative stress, but there are no clinical antioxidant studies in brain stroke patients. The aim of our study was to investigate the effect of ELF-EMF on clinical and antioxidant status in post-stroke patients. Fifty-seven patients were divided into two groups: ELF-EMF and non-ELF-EMF. Both groups underwent the same 4-week rehabilitation program. Additionally, the ELF-EMF group was exposed to an ELF-EMF field of 40 Hz, 7 mT for 15 min/day for 4 weeks (5 days a week). The activity of catalase and superoxide dismutase was measured in hemolysates, and total antioxidant status (TAS) determined in plasma. Functional status was assessed before and after the series of treatments using Activities of Daily Living (ADL), Mini-Mental State Examination (MMSE), and Geriatric Depression Scale (GDS). Applied ELF-EMF significantly increased enzymatic antioxidant activity; however, TAS levels did not change in either group. Results show that ELF-EMF induced a significant improvement in functional (ADL) and mental (MMSE, GDS) status. Clinical parameters had positive correlation with the level of enzymatic antioxidant protection. Bioelectromagnetics. 38:386-396, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  15. Adult lactose digestion status and effects on disease

    Science.gov (United States)

    Szilagyi, Andrew

    2015-01-01

    BACKGROUND: Adult assimilation of lactose divides humans into dominant lactase-persistent and recessive nonpersistent phenotypes. OBJECTIVES: To review three medical parameters of lactose digestion, namely: the changing concept of lactose intolerance; the possible impact on diseases of microbial adaptation in lactase-nonpersistent populations; and the possibility that the evolution of lactase has influenced some disease pattern distributions. METHODS: A PubMed, Google Scholar and manual review of articles were used to provide a narrative review of the topic. RESULTS: The concept of lactose intolerance is changing and merging with food intolerances. Microbial adaptation to regular lactose consumption in lactase-nonpersistent individuals is supported by limited evidence. There is evidence suggestive of a relationship among geographical distributions of latitude, sunhine exposure and lactase proportional distributions worldwide. DISCUSSION: The definition of lactose intolerance has shifted away from association with lactose maldigestion. Lactose sensitivity is described equally in lactose digesters and maldigesters. The important medical consequence of withholding dairy foods could have a detrimental impact on several diseases; in addition, microbial adaptation in lactase-nonpersistent populations may alter risk for some diseases. There is suggestive evidence that the emergence of lactase persistence, together with human migrations before and after the emergence of lactase persistence, have impacted modern-day diseases. CONCLUSIONS: Lactose maldigestion and lactose intolerance are not synonymous. Withholding dairy foods is a poor method to treat lactose intolerance. Further epidemiological work could shed light on the possible effects of microbial adaptation in lactose maldigesters. The evolutionary impact of lactase may be still ongoing. PMID:25855879

  16. Extremes in vitamin K status of bone are related to bone ultrasound properties in children with juvenile idiopathic arthritis

    NARCIS (Netherlands)

    van Summeren, M. J. H.; Vermeer, C.; Engelbert, R. H. H.; Schurgers, L. J.; Takken, T.; Fischer, K.; Kuis, W.

    2008-01-01

    Osteopenia is a common complication of juvenile idiopathic arthritis (JIA). In adults, low bone density and increased fracture risk are associated with low vitamin K status of bone. The vitamin K-dependent protein osteocalcin plays an important role in bone metabolism. Its activity depends upon

  17. Perceived Health Status and Utilization of Specialty Care: Racial and Ethnic Disparities in Patients with Chronic Diseases

    Science.gov (United States)

    Glover, Saundra; Bellinger, Jessica D.; Bae, Sejong; Rivers, Patrick A.; Singh, Karan P.

    2010-01-01

    Objective: The objective of this study is to determine racial and ethnic variations in specialty care utilization based on (a) perceived health status and (b) chronic disease status. Methods: Variations in specialty care utilization, by perceived health and chronic disease status, were examined using the Commonwealth Fund Health Care Quality…

  18. Extreme nonfasting remnant cholesterol vs extreme LDL cholesterol as contributors to cardiovascular disease and all-cause mortality in 90000 individuals from the general population.

    Science.gov (United States)

    Varbo, Anette; Freiberg, Jacob J; Nordestgaard, Børge G

    2015-03-01

    Increased nonfasting remnant cholesterol, like increased LDL cholesterol, is causally associated with increased risk for ischemic heart disease (IHD). We tested the hypothesis that extreme concentrations of nonfasting remnant and LDL cholesterol are equal contributors to the risk of IHD, myocardial infarction (MI), and all-cause mortality. We compared stepwise increasing concentrations of nonfasting remnant and LDL cholesterol for association with risk of IHD, MI, and all-cause mortality in approximately 90 000 individuals from the Danish general population. During up to 22 years of complete follow-up, 4435 participants developed IHD, 1722 developed MI, and 8121 died. Compared with participants with nonfasting remnant cholesterol cholesterol of 0.5-0.99 mmol/L (19.3-38.2 mg/dL) to 2.4 (1.9-2.9) for remnant cholesterol of ≥1.5 mmol/L (58 mg/dL) (P for trend LDL cholesterol LDL cholesterol of 3-3.99 mmol/L (115.8-154 mg/dL) to 2.3 (1.9-2.8) for LDL cholesterol of ≥5 mmol/L (193 mg/dL) (P cholesterol (P LDL cholesterol (P cholesterol concentrations were associated stepwise with all-cause mortality ranging from hazard ratio 1.0 (0.9-1.1) to 1.6 (1.4-1.9) (P LDL cholesterol concentrations were associated with decreased all-cause mortality risk in a U-shaped pattern, with hazard ratios from 0.8 (0.7-0.8) to 0.9 (0.8-1.0) (P = 0.002). After mutual adjustment, LDL cholesterol best predicted MI, and remnant cholesterol best predicted all-cause mortality. Both lipoproteins were associated equally with risk of IHD and MI; however, only nonfasting remnant cholesterol concentrations were associated stepwise with increased all-cause mortality risk. © 2015 American Association for Clinical Chemistry.

  19. Periodontal Disease Status in an Isolated Greek Adult Population

    Directory of Open Access Journals (Sweden)

    N. A. Chrysanthakopoulos

    2012-01-01

    Full Text Available Objective: The aim of the present study was to examine the periodontal condition of an adult population in three isolated regions in Greece and to determine the association of periodontal disease with several demographic, behavioral and environmental factors.Materials and Methods: The study population consisted of 640 individuals, aged 20to69 years from three isolated regions. The following indices were assessed: Pocket Depth (PD, Clinical Attachment Level (CAL, Dental Plaque, Calculus and Bleeding on Probing (BOP. Statistical analysis was accomplished by multiple linear regression model which was used to assess the association between the mean clinical attachment loss and clinical, demographic and behavioral parameters.Results: The samples of the study showed high levels of dental plaque, dental calculus and BOP. The final multivariate model showed that age (p=0.000, gender (p=0.016 and presence of calculus (p=0.000 were associated with the mean clinical attachment loss. Age (p=0.000, gender (p=0.000 and dental plaque (p=0.027 were associated with gingival recession, while age (p=0.018 and gender (p=0.000 were associated with probing depth. Bleeding on probing, dental plaque, toothbrush frequency, level of education, tobacco consumption and reasons for dental visits were not associated with the mean clinical attachment loss.Conclusion: Periodontal disease consists of a complicated destructive condition of the Periodontal tissue with a.multi-factorial etiology. Oral hygiene instructions and a regular dental follow-up could play a significant role in the prevention of periodontal disease.Key Words: Periodontal Disease; Epidemiology; Risk Factors

  20. Gadolinium-enhanced MR angiography of arterial occlusive disease in lower extremity : comparison with conventional digital subtraction angiography

    International Nuclear Information System (INIS)

    Shin, Sang June; Koh, Young Hwan; Cha, Joo Hee; Kim, Hyu Beom; Chung, Jin Wook; Park, Jae Hyung

    2000-01-01

    To compare the diagnostic value of gadolinium-enhanced MR angiography with that of conventional digital subtraction angiography for the evaluation of lower extremity arterial occlusive diseases. In 26 patients with symptomatic lower extremity arterial occlusive disease, both conventional digital subtraction angiography (DSA) and gadolinium-enhanced MR angiography (CE-MRA) were performed during the same week. MR angiography was performed using three-dimensional gradient-echo acquisition before, and two sequential acquisitions after, the administration of gadolinium (0.2 mmol/kg). In 23 patients, two separate, contiguous areas were scanned using additional doses. In three patients, only one field with a suspicious lesion was scanned. Three radiologists independently analyzed the CE-MRA and DSA findings of each vascular segment (20 segments per arterial tree) for the presence of obstructive lesions; the grade assigned was either mild or none (less than 50%), stenotic (50%-99%), or occlusion (100%). From among a total of 462 segments, DSA detected 99 which were significantly narrowed (stenosis, 33; occlusion, 66). Using MR angiography, 102 segments (stenosis 39; occlusion, 63) were identified, and 94 lesions (stenosis, 32; occlusion, 62) were graded correctly. Seven lesions were overestimated and four were underestimated. For the detection of hemodynamically significant stenosis or occlusions using MR angiography, sensitivity, specificity, and diagnostic accuracy were 95%, 98%, and 98% (G=3D0.995, P less than 0.001), respectively. To prove the absence of lesions, we repeated DSA in two patients with arterial spasm due to puncture. Three occluded segments seen on DSA, which revealed intact segments on MR angiography, suggested slow distal flow after reconstitution. For the evaluation of lower extremity arterial occlusive disease, the diagnostic value of gadolinium-enhanced MR angiography is comparable with that of digital subtraction angiography. The advantages of the

  1. Extreme Bilirubin Levels as a Causal Risk Factor for Symptomatic Gallstone Disease

    DEFF Research Database (Denmark)

    Stender, Stefan; Frikke-Schmidt, Ruth; Nordestgaard, Børge G

    2013-01-01

    In individuals without blockage of their bile ducts, levels of plasma bilirubin likely reflect levels of biliary bilirubin; higher biliary bilirubin levels may increase the risk of gallstone disease.......In individuals without blockage of their bile ducts, levels of plasma bilirubin likely reflect levels of biliary bilirubin; higher biliary bilirubin levels may increase the risk of gallstone disease....

  2. Arterial tortuosity syndrome: An extremely rare disease presenting as a mimic of pulmonary sling

    Directory of Open Access Journals (Sweden)

    Amy Farkas, MD

    2018-02-01

    Full Text Available Pulmonary sling is the anatomic variant defined by the aberrant origin of the left pulmonary artery from the right pulmonary artery. This patient presented with a mimic of pulmonary sling as a result of an extremely rare condition, arterial tortuosity syndrome (ATS. The patient was first diagnosed with pulmonary sling on prenatal echocardiogram performed by cardiology. Computed tomography angiography of the chest obtained at birth to evaluate respiratory depression demonstrated ATS. The early detection of ATS has been demonstrated to improve patient outcome. This case provides an overview of the typical imaging features of ATS to aid radiologists in making this uncommon diagnosis.

  3. Risk of seizures and status epilepticus in older patients with liver disease.

    Science.gov (United States)

    Alkhachroum, Ayham M; Rubinos, Clio; Kummer, Benjamin R; Parikh, Neal S; Chen, Monica; Chatterjee, Abhinaba; Reynolds, Alexandra; Merkler, Alexander E; Claassen, Jan; Kamel, Hooman

    2018-06-06

    Seizures can be provoked by systemic diseases associated with metabolic derangements, but the association between liver disease and seizures remains unclear. We performed a retrospective cohort study using inpatient and outpatient claims between 2008 and 2015 from a nationally representative 5% sample of Medicare beneficiaries. The primary exposure variable was cirrhosis, and the secondary exposure was mild, noncirrhotic liver disease. The primary outcome was seizure, and the secondary outcome was status epilepticus. Diagnoses were ascertained using validated International Classification of Diseases, Ninth Edition, Clinical Modification codes. Survival statistics were used to calculate incidence rates, and Cox proportional hazards models were used to examine the association between exposures and outcomes while adjusting for seizure risk factors. Among 1 782 402 beneficiaries, we identified 10 393 (0.6%) beneficiaries with cirrhosis and 19 557 (1.1%) with mild, noncirrhotic liver disease. Individuals with liver disease were older and had more seizure risk factors than those without liver disease. Over 4.6 ± 2.2 years of follow-up, 49 843 (2.8%) individuals were diagnosed with seizures and 25 patients (0.001%) were diagnosed with status epilepticus. Cirrhosis was not associated with seizures (hazard ratio [HR] = 1.1, 95% confidence interval [CI] = 1.0-1.3), but there was an association with status epilepticus (HR = 1.9, 95% CI = 1.3-2.8). Mild liver disease was not associated with a higher risk of seizures (HR = 0.8, 95% CI = 0.6-0.9) or status epilepticus (HR = 1.1, 95% CI = 0.7-1.5). In a large, population-based cohort, we found an association between cirrhosis and status epilepticus, but no overall association between liver disease and seizures. Wiley Periodicals, Inc. © 2018 International League Against Epilepsy.

  4. The Association of Vitamin D Status with Disease Activity in a Cohort of Crohn’s Disease Patients in Canada

    Directory of Open Access Journals (Sweden)

    Dania Alrefai

    2017-10-01

    Full Text Available We determined the association between vitamin D status as 25hydroxyvitamin D [25(OHD] and disease activity in a cohort of 201 Crohn’s Disease (CD patients in Saskatoon, Canada over three years. The association between high-sensitivity C-reactive protein (hs-CRP and 25(OHD and several disease predictors were evaluated by the generalized estimating equation (GEE over three time-point measurements. A GEE binary logistic regression test was used to evaluate the association between vitamin D status and the Harvey-Bradshaw Index (HBI. The deficient vitamin D group (≤29 nmol/L had significantly higher mean hs-CRP levels compared with the three other categories of vitamin D status (p < 0.05. CRP was significantly lower in all of the other groups compared with the vitamin D-deficient group, which had Coef. = 12.8 units lower (95% CI −19.8, −5.8, Coef. 7.85 units (95% CI −14.9, −0.7, Coef. 9.87 units (95% CI −17.6, −2.0 for the vitamin D insufficient, adequate, and optimal groups, respectively. The vitamin D status was associated with the HBI active disease category. However, the difference in the odds ratio compared with the reference category of deficient vitamin D category was only significant in the insufficient category (odds ratio = 3.45, p = 0.03, 95% CI 1.0, 10.8. Vitamin D status was inversely associated with indicators of disease activity in Crohn’s disease, particularly with the objective measures of inflammation.

  5. Narrative psychological content analysis as a tool for psychological status monitoring of crews in isolated, confined and extreme settings

    Science.gov (United States)

    Ehmann, B.; Balázs, L.; Fülöp, É.; Hargitai, R.; Kabai, P.; Péley, B.; Pólya, T.; Vargha, A.; László, J.

    2011-05-01

    This paper is about a pilot application of narrative psychological content analysis in the psychological status monitoring of Crew 71 of a space analog simulation environment, the Mars Desert Research Station (MDRS). Both the method and its theoretical framework, Scientific Narrative Psychology, are original developments by Hungarian psychologists [5] (László, 2008). The software was NooJ, a multilingual linguistic development environment [11] (Silberztein, 2008). Three measures were conceptualized and assessed: emotional status, team spirit and subjective physical comfort. The results showed the patterns of these three measures on a daily basis at group level, and allowed for detecting individual differences as well. The method is adaptable to languages involved in space psychology, e.g. Russian, French and German in addition to English.

  6. Upper Extremity Motor Learning among Individuals with Parkinson's Disease: A Meta-Analysis Evaluating Movement Time in Simple Tasks

    Directory of Open Access Journals (Sweden)

    K. Felix

    2012-01-01

    Full Text Available Motor learning has been found to occur in the rehabilitation of individuals with Parkinson's disease (PD. Through repetitive structured practice of motor tasks, individuals show improved performance, confirming that motor learning has probably taken place. Although a number of studies have been completed evaluating motor learning in people with PD, the sample sizes were small and the improvements were variable. The purpose of this meta-analysis was to determine the ability of people with PD to learn motor tasks. Studies which measured movement time in upper extremity reaching tasks and met the inclusion criteria were included in the analysis. Results of the meta-analysis indicated that people with PD and neurologically healthy controls both demonstrated motor learning, characterized by a decrease in movement time during upper extremity movements. Movement time improvements were greater in the control group than in individuals with PD. These results support the findings that the practice of upper extremity reaching tasks is beneficial in reducing movement time in persons with PD and has important implications for rehabilitation.

  7. Integrated case management for work-related upper-extremity disorders: impact of patient satisfaction on health and work status.

    Science.gov (United States)

    Feuerstein, Michael; Huang, Grant D; Ortiz, Jose M; Shaw, William S; Miller, Virginia I; Wood, Patricia M

    2003-08-01

    An integrated case management (ICM) approach (ergonomic and problem-solving intervention) to work-related upper-extremity disorders was examined in relation to patient satisfaction, future symptom severity, function, and return to work (RTW). Federal workers with work-related upper-extremity disorder workers' compensation claims (n = 205) were randomly assigned to usual care or ICM intervention. Patient satisfaction was assessed after the 4-month intervention period. Questionnaires on clinical outcomes and ergonomic exposure were administered at baseline and at 6- and 12-months postintervention. Time from intervention to RTW was obtained from an administrative database. ICM group assignment was significantly associated with greater patient satisfaction. Regression analyses found higher patient satisfaction levels predicted decreased symptom severity and functional limitations at 6 months and a shorter RTW. At 12 months, predictors of positive outcomes included male gender, lower distress, lower levels of reported ergonomic exposure, and receipt of ICM. Findings highlight the utility of targeting workplace ergonomic and problem solving skills.

  8. Nutritional status and long-term mortality in hospitalised patients with chronic obstructive pulmonary disease (COPD)

    DEFF Research Database (Denmark)

    Hallin, Runa; Gudmundsson, Gunnar; Suppli Ulrik, Charlotte

    2007-01-01

    Patients with chronic obstructive pulmonary disease (COPD) often have difficulties with keeping their weight. The aim of this investigation was to study nutritional status in hospitalised Nordic COPD patients and to investigate the association between nutritional status and long-term mortality in...... years. Further studies are needed in order to show whether identifying and treating weight loss and depletion of fat-free mass (FFM) is a way forward in improving the prognosis for hospitalised COPD patients. Udgivelsesdato: 2007-Sep...

  9. Nutritional status in chronic obstructive pulmonary disease: role of hypoxia.

    Science.gov (United States)

    Raguso, Comasia A; Luthy, Christophe

    2011-02-01

    In patients with chronic obstructive pulmonary disease (COPD), malnutrition and limited physical activity are very common and contribute to disease prognosis, whereas a balance between caloric intake and exercise allows body weight stability and muscle mass preservation. The goal of this review is to analyze the implications of chronic hypoxia on three key elements involved in energy homeostasis and its role in COPD cachexia. The first one is energy intake. Body weight loss, often observed in patients with COPD, is related to lack of appetite. Inflammatory cytokines are known to be involved in anorexia and to be correlated to arterial partial pressure of oxygen. Recent studies in animals have investigated the role of hypoxia in peptides involved in food consumption such as leptin, ghrelin, and adenosine monophosphate activated protein kinase. The second element is muscle function, which is strongly related to energy use. In COPD, muscle atrophy and muscle fiber shift to the glycolytic type might be an adaptation to chronic hypoxia to preserve the muscle from oxidative stress. Muscle atrophy could be the result of a marked activation of the ubiquitin-proteasome pathway as found in muscle of patients with COPD. Hypoxia, via hypoxia inducible factor-1, is implicated in mitochondrial biogenesis and autophagy. Third, hormonal control of energy balance seems to be affected in patients with COPD. Insulin resistance has been described in this group of patients as well as a sort of "growth hormone resistance." Hypoxia, by hypoxia inducible factor-1, accelerates the degradation of tri-iodothyronine and thyroxine, decreasing cellular oxygen consumption, suggesting an adaptive mechanism rather than a primary cause of COPD cachexia. COPD rehabilitation aimed at maintaining function and quality of life needs to address body weight stabilization and, in particular, muscle mass preservation. Copyright © 2011 Elsevier Inc. All rights reserved.

  10. A clinical study on chronic arterial occlusive diseases of the lower extremities by scintiangiography of the foot

    International Nuclear Information System (INIS)

    Oya, Yoshitaro

    1981-01-01

    Scintiangiography of the foot was performed on 210 limbs with peripheral vascular diseases of the lower extremities in comparison with 12 normal limbs. After an intravenous bolus of 10 to 20 mCi of sup(99m)Tc-human serum albumin, the arrival and distribution of activity in foot during reactive hyperemia were observed and photographed on the monitor scope of the gamma camera and recorded on video tape. The activity curve was obtained for several regions of interest and analysed to obtain the arrival time of activity Ta, the maximum counts time Tmax and the perfusion index. Those results were compared with angiography and the pressure index. The gamma camera image provided approximately the state of the peripheral circulation, and the defect or delay of the image was obtained on 93 per cent of the ischemic extremities. The pattern of the activity curves were classified into three types, I: rapid appearance with high activity peak, II: relatively rapid appearance with low activity peak, III: delayed appearance with the absence of the activity peak. In normal subjects and good run-off patients, the typical pattern of the activity curve was mainly observed being to I type, on the other hand, the pattern was generally being to III type in patients with ulcerated or cyanotic foot. The difference between the arrival time of activity of foot and toe under conditions of reactive hyperemia was longer evidently according to degree of arterial occlusion. The perfusion index was well correlated to the pressure index on foot and toe. In conclusion, scintiangiography of the foot is a simple and harmless procedure to evaluate the hemodynamic state of the lower extremities and is applicable for screening the peripheral vascular diseases and postoperative study. (author)

  11. Association of lower extremity arterial calcification with amputation and mortality in patients with symptomatic peripheral artery disease.

    Directory of Open Access Journals (Sweden)

    Chi-Lun Huang

    Full Text Available OBJECTIVE: The clinical implication of the coronary artery calcium score (CS is well demonstrated. However, little is known about the association between lower extremity arterial calcification and clinical outcomes. METHODS AND RESULTS: Eighty-two patients with symptomatic peripheral artery disease (age 61.0±12.4 years were followed for 21±11 months. CSs, ranging from the common iliac artery bifurcation to the ankle area, were analyzed through noncontrast multidetector computed tomography images retrospectively. The primary endpoints of this study were amputation and mortality. Old age, diabetes, hyperlipidemia, and end-stage renal disease were associated with higher CSs. Patients with more advanced Fontaine stages also tended to have significantly higher CSs (p = 0.03. During the follow-up period (21±11 months, 29 (35% patients underwent amputation, and 24 (29% patients died. Among the patients who underwent amputation, there were no significant differences in CSs between the amputated legs and the non-amputated legs. In the Cox proportional hazard model with CS divided into quartiles, patients with CS in the highest quartile had a 2.88-fold (95% confidence interval [CI] 1.18-12.72, p = 0.03 and a 5.16-fold (95% CI 1.13-21.61, p = 0.04 higher risk for amputation and all-cause mortality, respectively, than those with CS in the lowest quartile. These predictive effects remained after conventional risk factor adjustment. CONCLUSION: Lower extremity arterial CSs are associated with disease severity and outcomes, including amputation and all-cause mortality, in patients with symptomatic peripheral artery disease. However, the independent predictive value needs further investigation in large scale, prospective studies.

  12. Vitamin D status and incident cardiovascular disease and all-cause mortality

    DEFF Research Database (Denmark)

    Skaaby, Tea; Husemoen, Lise Lotte Nystrup; Pisinger, Charlotta

    2013-01-01

    Low vitamin D status has been associated with cardiovascular disease (CVD) and mortality primarily in selected groups, smaller studies, or with self-reported vitamin D intake. We investigated the association of serum vitamin D status with the incidence of a registry-based diagnosis of ischemic...... heart disease (IHD), stroke, and all-cause mortality in a large sample of the general population. A total of 9,146 individuals from the two population-based studies, Monica10 and Inter99, were included. Measurements of serum 25-hydroxyvitamin D at baseline were carried out using the IDS ISYS immunoassay...

  13. Guideline for the management of wounds in patients with lower-extremity venous disease: an executive summary.

    Science.gov (United States)

    Kelechi, Teresa J; Johnson, Jan J

    2012-01-01

    This article provides an executive summary of the lower extremity venous disease (LEVD) evidence-based guideline produced by the WOCN Wound Guidelines Task Force. The target audience for this guideline is health care professionals who specialize in, direct, or provide wound care for patients at risk for or with lower-extremity venous disease. The full guideline opens with an overview of definitions of LEVD, its prevalence, clinical relevance, etiology, related physiology and pathophysiology, and overall management goals for patients at risk for developing venous leg ulcers. A detailed assessment section describes how to conduct a full clinical history and physical examination. Two approaches to interventions are provided: one addresses prevention strategies to reduce the risk of developing LEVD with ulcers. Methods to prevent ulcer recurrence are summarized including compression therapy, adjunctive therapies, medications, and patient education. A second approach presents treatment interventions including wound cleansing, debridement, infection control, antibiotic use, along with management of the periwound skin, nutrition, pain, and edema. This section also discusses limb elevation, surgical options, adjunctive therapies, patient education, and health care provider follow-up. A comprehensive reference list, glossary of terms, and appendices on cellulitis and venous eczema, types of edema, and compression therapy are available at the end of the guideline. This article provides an executive summary of the essential features of the guideline.

  14. Combination pharmacotherapy to prevent cardiovascular disease: present status and challenges.

    Science.gov (United States)

    Yusuf, Salim; Attaran, Amir; Bosch, Jackie; Joseph, Philip; Lonn, Eva; McCready, Tara; Mente, Andrew; Nieuwlaat, Robby; Pais, Prem; Rodgers, Anthony; Schwalm, J-D; Smith, Richard; Teo, Koon; Xavier, Denis

    2014-02-01

    Combination pills containing aspirin, multiple blood pressure (BP) lowering drugs, and a statin have demonstrated safety, substantial risk factor reductions, and improved medication adherence in the prevention of cardiovascular disease (CVD). The individual medications in combination pills are already recommended for use together in secondary CVD prevention. Therefore, current information on their pharmacokinetics, impact on the risk factors, and tolerability should be sufficient to persuade regulators and clinicians to use fixed-dose combination pills in high-risk individuals, such as in secondary prevention. Long-term use of these medicines, in a polypill or otherwise, is expected to reduce CVD risk by at least 50-60% in such groups. This risk reduction needs confirmation in prospective randomized trials for populations for whom concomitant use of the medications is not currently recommended (e.g. primary prevention). Given their additive benefits, the combined estimated relative risk reduction (RRR) in CVD from both lifestyle modification and a combination pill is expected to be 70-80%. The first of several barriers to the widespread use of combination therapy in CVD prevention is physician reluctance to use combination pills. This reluctance may originate from the belief that lifestyle modification should take precedence, and that medications should be introduced one drug at a time, instead of regarding combination pills and lifestyle modification as complementary and additive. Second, widespread availability of combination pills is also impeded by the reluctance of large pharmaceutical companies to invest in development of novel co-formulations of generic (or 'mature') drugs. A business model based on 'mass approaches' to drug production, packaging, marketing, and distribution could make the combination pill available at an affordable price, while at the same time providing a viable profit for the manufacturers. A third barrier is regulatory approval for novel

  15. Stressors, social support, depressive symptoms and general health status of Taiwanese caregivers of persons with stroke or Alzheimer's disease.

    Science.gov (United States)

    Huang, Chiung-Yu; Sousa, Valmi D; Perng, Shao-Jen; Hwang, Mei-Yi; Tsai, Chun-Ching; Huang, Mei-Huang; Yao, Shu-Ying

    2009-02-01

    This study examined the relationships among stressors, social support, depressive symptoms and the general health status of Taiwanese caregivers of individuals with stroke or Alzheimer's disease. Caring for a disabled or cognitively impaired person can be extremely stressful and often has adverse effects on caregivers' health. While research on caregiving in Taiwan has examined caregivers' characteristics, caregivers' need and caregivers' burden in caring for older people in general, little is known about Taiwanese caregivers of individuals with stroke or Alzheimer's disease. Cross-sectional, descriptive correlation design. Data were obtained from a convenience sample of 103 Taiwanese informal caregivers in the South of Taiwan and analysed using descriptive statistics, Pearson's correlations, multiple and hierarchical regressions and t-tests. Caregivers who had lower household incomes and were taking care of individuals with more behaviour problems had more depressive symptoms. In addition, caregivers who were older and were taking care of individuals with more behaviour problems had worse general health. Caregivers who had more emotional support had less depressive symptoms. Caregivers of persons with Alzheimer's disease had more depressive symptoms and worse general health than caregivers of persons with stroke. Only emotional support moderated the relationship between one of the stressors (household income) and depressive symptoms. The findings of this study may be helpful for nurses and other health care professionals in designing effective interventions to minimise the negative impacts of stressors on the psychological and general health of caregivers in Taiwan.

  16. Prognostic value of nutritional status in chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Landbo, C; Prescott, E; Lange, P

    1999-01-01

    The association between low body mass index (BMI) and poor prognosis in patients with chronic obstructive pulmonary disease (COPD) is a common clinical observation. We prospectively examined whether BMI is an independent predictor of mortality in subjects with COPD from the Copenhagen City Heart...... Study. In total, 1,218 men and 914 women, aged 21 to 89 yr, with airway obstruction defined as an FEV(1)-to-FVC ratio of less than 0.7, were included in the analyses. Spirometric values, BMI, smoking habits, and respiratory symptoms were assessed at the time of study enrollment, and mortality from COPD...... with that in subjects of normal weight of 1.64 (95% confidence interval [CI]: 1.20 to 2.23) in men and 1.42 (95% CI: 1.07 to 1.89) in women. However, the association between BMI and survival differed significantly with stage of COPD. In mild and moderate COPD there was a nonsignificant U-shaped relationship...

  17. Current status of endoscopic balloon dilation for Crohn's disease

    Directory of Open Access Journals (Sweden)

    Fumihito Hirai

    2017-04-01

    Full Text Available The therapeutic target in Crohn's disease (CD has been raised to the achievement of mucosal healing. Although effective treatments that target cytokines and other molecules has been widely used for CD, intestinal strictures are still a major cause of surgery. Endoscopic balloon dilation (EBD is known to be an effective and safe intervention for intestinal strictures in CD. Since frequent intestinal resection often results in short bowel syndrome and can decrease the quality of life, EBD can help avoid surgery. EBD with a conventional colonoscope for Crohn's strictures of the colon and ileo-colonic anastomosis has established efficacy and safety. In addition, EBD using balloon-assisted enteroscopy has recently been applied for small bowel Crohn's strictures. Although the evidence is not strong, EBD may become an alternative to surgery in small bowel strictures in CD. EBD and other new methods such as self-expanding stent implantation for Crohn's strictures may be useful and safe; however, it is important to address several issues regarding these interventions and to establish a protocol for combined therapies.

  18. Nutritional status of Vietnamese outpatients with chronic obstructive pulmonary disease.

    Science.gov (United States)

    Hogan, D; Lan, L T T; Diep, D T N; Gallegos, D; Collins, P F

    2017-02-01

    Nutritional screening and assessment is not currently part of routine clinical practice in Vietnam. Therefore, the present study aimed to investigate the utility of the commonly used methods for identifying malnutrition in outpatients with chronic obstructive pulmonary disease (COPD). A cross-sectional pilot study and a larger retrospective study were carried out in outpatients with COPD who were attending a respiratory clinic in Ho Chi Minh City, Vietnam. Routine clinical data were collected [body mass index (BMI), forced expiratory volume in 1 s (FEV 1 )]. Nutritional screening and assessment were performed using the Malnutrition Screening Tool (MST) and Subjective Global Assessment (SGA) as the gold standard to diagnose malnutrition. In total, 393 outpatients had documented BMI and 29 were prospectively assessed using SGA: males, n = 25; females, n = 4; mean (SD) age 69.7 (9.6) years; mean (SD) BMI 21.0 (3.4) kg m -2 ; mean (SD) FEV 1 percentage predicted 57.0% (19.7%). Malnutrition risk was identified in 20.7% (n = 6) of patients using the MST (38% sensitivity; 94% specificity). However, 45% (n = 13) were diagnosed as malnourished using the SGA (31% mild/moderate; 14% severe). All malnourished patients not identified by the MST had evidence of muscle wasting. BMI had a strong negative correlation with muscle wasting as assessed using the SGA (r = -0.857, n = 28; P Vietnamese outpatients with COPD. A BMI threshold of <21 kg m -2 appears to represent a useful and pragmatic cut-off point for identifying outpatients requiring comprehensive nutritional assessment and support. © 2016 The British Dietetic Association Ltd.

  19. Comparing the contributions of well-being and disease status to employee productivity.

    Science.gov (United States)

    Gandy, William M; Coberley, Carter; Pope, James E; Wells, Aaron; Rula, Elizabeth Y

    2014-03-01

    To compare employee overall well-being to chronic disease status, which has a long-established relationship to productivity, as relative contributors to on-the-job productivity. Data from two annual surveys of three companies were used in longitudinal analyses of well-being as a predictor of productivity level and productivity change among 2629 employees with diabetes or without any chronic conditions. Well-being was the most significant predictor of productivity cross-sectionally in a model that included disease status and demographic characteristics. Longitudinally, changes in well-being contributed to changes in productivity above and beyond what could be explained by the presence of chronic disease or other fixed characteristics. These findings support the use of well-being as the broader framework for understanding, explaining, and improving employee productivity in both the healthy and those with disease.

  20. Alkaline phosphatase levels in patients with coronary heart disease saliva and its relation with periodontal status

    Science.gov (United States)

    Yunita, Dina Suci; Masulili, Sri Lelyati C.; Tadjoedin, Fatimah M.; Radi, Basuni

    2017-02-01

    Coronary heart disease (CHD) is a disease that causes narrowing of the coronary arteries. Currently, there is a hypothesis regarding periodontal infection that increases risk for heart disease. Alkaline phosphatase (ALP) as a marker of inflammation will increase in atherosclerosis and periodontal disease. The objective of this research is analyzing the relationship between the levels of alkaline phosphatase in saliva with periodontal status in patients with CHD and non CHD. Here, saliva of 104 subjects were taken, each 1 ml, and levels of Alkaline Phosphatase was analyzed using Abbott ci4100 architect. We found that no significant difference of Alkaline Phosphatase levels in saliva between CHD patients and non CHD. Therefore, it can be concluded that Alkaline Phosphatase levels in patients with CHD saliva was higher than non CHD and no association between ALP levels with periodontal status.

  1. Socioeconomic status and risk factors for cardiovascular disease: Impact of dietary mediators.

    Science.gov (United States)

    Psaltopoulou, Theodora; Hatzis, George; Papageorgiou, Nikolaos; Androulakis, Emmanuel; Briasoulis, Alexandros; Tousoulis, Dimitris

    It is well known that cardiovascular disease is the leading cause of mortality in the western societies. A number of risk factors such as family history, diabetes, hypertension, obesity, diabetes, smoking and physical inactivity are responsible for a significant proportion of the overall cardiovascular risk. Interestingly, recent data suggest there is a gradient in the incidence, morbidity and mortality of cardiovascular disease across the spectrum of socioeconomic status, as this is defined by educational level, occupation or income. Additionally, dietary mediators seem to play significant role in the pathogenesis of cardiovascular disease, mediating some of the discrepancies in atherosclerosis among different socioeconomic layers. Therefore, in the present article, we aim to review the association between socioeconomic status and cardiovascular disease risk factors and the role of different dietary mediators. Copyright © 2017 Hellenic Society of Cardiology. Published by Elsevier B.V. All rights reserved.

  2. [Effects of nutritional status on the multiple sclerosis disease: systematic review].

    Science.gov (United States)

    Ródenas Esteve, Irene; Wanden-Berghe, Carmina; Sanz-Valero, Javier

    2018-01-19

    To review the available scientific literature about the effects of nutritional status on the multiple sclerosis disease. A systematic review of the scientific literature in the Medline (PubMed), Scopus, Cochrane Library and Web of Science databases through November 2016. Search equation: ("Multiple Sclerosis"[Mesh] OR "Multiple Sclerosis"[Title/Abstract] OR "Disseminated Sclerosis"[Title/Abstract] OR "Multiple Sclerosis Acute Fulminating"[Title/Abstract]) AND ("Nutritional Status"[Mesh] OR "Nutritional Status"[Title/Abstract] OR "Nutrition Status"[Title/Abstract]). The quality of the selected articles was discussed using the STROBE questionnaire. The search was completed through experts inquiry and additional review of the bibliographic references included in the selected papers. The concordance between authors (Kappa index) had to be higher than 80% for inclusion in this review. Of the 160 references recovered, after applying inclusion and exclusion criteria, 29 articles were selected for review. Concordance between evaluators was 100.00%. The most studies established vitamin D levels. Others focused their research on finding out which nutrient deficits might be related to the multiple sclerosis development. Vitamin D may influence multiple sclerosis improvement. Sunlight and physical activity would be important factors, with nutritional status, in the course of this disease. It is necessary to produce new specific works that will delve into the subject to find out more about the relationship between nutritional status and multiple sclerosis.

  3. Analysis of 855 upper extremity fistulas created using a standard protocol: the role of graft extension to achieve functional status.

    Science.gov (United States)

    Allan, Bassan J; Perez, Enrique R; Tabbara, Marwan

    2013-06-01

    The Fistula First Breakthrough Initiative (FFBI) has been one of the most important national programs to help achieve considerable improvements in the care of patients on chronic hemodialysis. FFBI has helped place guidelines to push practitioners to reduce the use of tunneled central venous catheters and to increase the rate of arteriovenous fistula use in patients requiring chronic hemodialysis access. However, despite current guidelines, no specific protocols exist for the creation and management of autogenous arteriovenous fistulas and outcomes at most centers are below national benchmarks. In this study, we examine the effectiveness of a standard protocol used at our institution for the creation of autogenous upper extremity fistulas for hemodialysis access in achieving early cannulation and early removal of tunneled dialysis catheters. Our review encompasses 855 consecutive autogenous fistulas created over a 10-year period. Our findings suggest that the use of a standard protocol for creation and management of autogenous fistulas can help increase the rate of functional accesses over national benchmarks. Additionally, extension/conversion of malfunctioning fistulas to grafts appears to be an excellent method to expedite removal of a tunneled dialysis catheter with concomitant preservation of a fistula.

  4. Childhood Health Status and Adulthood Cardiovascular Disease Morbidity in Rural China: Are They Related?

    Science.gov (United States)

    Wang, Qing; Shen, Jay J

    2016-06-06

    Cardiovascular diseases (CVDs) are among the top health problems of the Chinese population. Although mounting evidence suggests that early childhood health status has an enduring effect on late life chronic morbidity, no study so far has analyzed the issue in China. Using nationally representative data from the 2013 China Health and Retirement Longitudinal Study (CHARLS), a Probit model and Two-Stage Residual Inclusion estimation estimator were applied to analyze the relationship between childhood health status and adulthood cardiovascular disease in rural China. Good childhood health was associated with reduced risk of adult CVDs. Given the long-term effects of childhood health on adulthood health later on, health policy and programs to improve the health status and well-being of Chinese populations over the entire life cycle, especially in persons' early life, are expected to be effective and successful.

  5. Childhood Health Status and Adulthood Cardiovascular Disease Morbidity in Rural China: Are They Related?

    Directory of Open Access Journals (Sweden)

    Qing Wang

    2016-06-01

    Full Text Available Cardiovascular diseases (CVDs are among the top health problems of the Chinese population. Although mounting evidence suggests that early childhood health status has an enduring effect on late life chronic morbidity, no study so far has analyzed the issue in China. Using nationally representative data from the 2013 China Health and Retirement Longitudinal Study (CHARLS, a Probit model and Two-Stage Residual Inclusion estimation estimator were applied to analyze the relationship between childhood health status and adulthood cardiovascular disease in rural China. Good childhood health was associated with reduced risk of adult CVDs. Given the long-term effects of childhood health on adulthood health later on, health policy and programs to improve the health status and well-being of Chinese populations over the entire life cycle, especially in persons’ early life, are expected to be effective and successful.

  6. Low density lipoprotein levels linkage with the periodontal status patients of coronary heart disease

    Science.gov (United States)

    Ahmad, Nafisah Ibrahim; Masulili, Sri Lelyati C.; Lessang, Robert; Radi, Basuni

    2017-02-01

    Studies found an association between periodontitis and coronary heart disease (CHD), but relationship between periodontal status CHD patients with LDL (Low Density Lipoprotein) levels, as risk factors for atherosclerosis, has not been studied. Objective: To analyze relationship between LDL and periodontal status CHD. Methods: Periodontal status of 60 CHD, 40 controls were examined (PBI, PPD, CAL) and their blood was taken to assess levels of LDL. Result: Found significant differences LDL (p=0.005), correlation between LDL with PPD (p=0.003) and CAL CHD (p=0.013), and PPD (p=0.001), CAL (p=0.008) non-CHD, but no significant correlation between LDL with PBI CAD (p=0.689) and PBI non-CHD (p=0.320). Conclusion: There is a correlation between the LDL levels with periodontal status.

  7. Vitamins K and D status in patients with stages 3-5 chronic kidney disease

    Science.gov (United States)

    Background and Objectives: Vitamin K, vitamin K-dependent (VKD) proteins and vitamin D may be involved in the regulation of calcification in chronic kidney disease (CKD). Design, setting, participants and measurements: Vitamin K and D status was measured as dietary intake, plasma phylloquinone, se...

  8. Overweight Status, Obesity, and Risk Factors for Coronary Heart Disease in Adults with Intellectual Disability

    Science.gov (United States)

    Henderson, C. Michael; Robinson, Laura M.; Davidson, Philip W.; Haveman, Meindert; Janicki, Matthew P.; Albertini, Giorgio

    2008-01-01

    Research indicates that adults with intellectual disabilities (ID) have high rates of overweight status/obesity (OSO). OSO is associated with several important risk factors for coronary heart disease (CHD). This study focused on assessing whether such risk factors are being identified in adults with ID who are receiving their healthcare in…

  9. Global Status of DDT and Its Alternatives for Use in Vector Control to Prevent Disease

    NARCIS (Netherlands)

    Berg, van den H.

    2009-01-01

    Objective - I review the status of dichlorodiphenyltrichloroethane (DDT), used for disease vector control, along with current evidence on its benefits and risks in relation to the available alternatives. Data sources and extraction - Contemporary data on DDT use were largely obtained from

  10. Nutritional Status and Risk Factors for Chronic Disease in Urban-Dwelling Adults with Down Syndrome

    Science.gov (United States)

    Braunschweig, Carol L.; Gomez, Sandra; Sheean, Patricia; Tomey, Kristin M.; Rimmer, James; Heller, Tamar

    2004-01-01

    Nutritional status and biochemical risk factors for chronic disease were assessed in 48 community-dwelling adults with Down syndrome in the Chicago area. Dietary intake was measured using a food frequency questionnaire completed by the participant's primary caregiver; anthropometric measures included height and weight and waist circumference.…

  11. Cardiometabolic disease risk and HIV status in rural South Africa : establishing a baseline

    NARCIS (Netherlands)

    Clark, Samuel J.; Gomez-Olive, F. Xavier; Houle, Brian; Thorogood, Margaret; Klipstein-Grobusch, Kerstin; Angotti, Nicole; Kabudula, Chodziwadziwa; Williams, Jill; Menken, Jane; Tollman, Stephen

    2015-01-01

    Background: To inform health care and training, resource and research priorities, it is essential to establish how non-communicable disease risk factors vary by HIV-status in high HIV burden areas; and whether long-term anti-retroviral therapy (ART) plays a modifying role. Methods: As part of a

  12. Employment status, difficulties at work and quality of life in inflammatory bowel disease patients

    NARCIS (Netherlands)

    De Boer, Angela G. E. M.; Evertsz', Floor Bennebroek; Stokkers, Pieter C.; Bockting, Claudia L.; Sanderman, Robbert; Hommes, Daniel W.; Sprangers, Mirjam A. G.; Frings-Dresen, Monique H. W.

    2016-01-01

    ObjectivesTo assess employment status, difficulties at work and sick leave in inflammatory bowel disease (IBD) patients and their relation with sociodemographic and clinical factors, quality of life (QoL), and anxiety and depression.Materials and methodsIBD patients attending an IBD outpatients'

  13. Coronary Heart Disease Risk Factors in Young People of Differing Socio-Economic Status

    Science.gov (United States)

    Thomas, Non-Eleri; Cooper, Stephen-Mark; Williams, Simon P.; Baker, Julien S.; Davies, Bruce

    2005-01-01

    This study determined the prevalence of coronary heart disease (CHD) risk factors in young people of differing socio-economic status (SES). A cohort of 100 boys and 108 girls, aged 12.9, SD 0.3 years drawn of differing SES were assessed for CHD risk factors. Measurements included indices of obesity, blood pressure, aerobic fitness, diet, blood…

  14. Quality of life and understanding of disease status among cancer patients of different ethnic origin.

    Science.gov (United States)

    Tchen, N; Bedard, P; Yi, Q-L; Klein, M; Cella, D; Eremenco, S; Tannock, I F

    2003-08-18

    Patients managed in European or North American cancer centres have a variety of ethnic backgrounds and primary languages. To gain insight into the impact of ethnic origin, we have investigated understanding of disease status and quality of life (QoL) for 202 patients. Patients completed questionnaires in their first language (52 English, 50 Chinese, 50 Italian, 50 Spanish or Portuguese), including the Functional Assessment of Cancer Therapy - General (FACT-G) QoL instrument, questions about disease status, expectations of cure and the language and/or type of interpretation used at initial consultation. Physicians also evaluated their status of disease and expectation of cure, and performance status was estimated by a trained health professional. The initial consultation was usually provided in English (except for 32% of Chinese-speaking patients); interpretation was provided by a family member for 34% of patients with limited English proficiency (LEP) and by a bilingual member of staff for 21%. Patients underestimated their extent of disease and overestimated their probability of cure (P=0.001 and cultural differences is important for optimal management of patients with cancer.

  15. Climate change, air pollution and extreme events leading to increasing prevalence of allergic respiratory diseases.

    Science.gov (United States)

    D'Amato, Gennaro; Baena-Cagnani, Carlos E; Cecchi, Lorenzo; Annesi-Maesano, Isabella; Nunes, Carlos; Ansotegui, Ignacio; D'Amato, Maria; Liccardi, Gennaro; Sofia, Matteo; Canonica, Walter G

    2013-02-11

    The prevalence of asthma and allergic diseases has increased dramatically during the past few decades not only in industrialized countries. Urban air pollution from motor vehicles has been indicated as one of the major risk factors responsible for this increase.Although genetic factors are important in the development of asthma and allergic diseases, the rising trend can be explained only in changes occurred in the environment. Despite some differences in the air pollution profile and decreasing trends of some key air pollutants, air quality is an important concern for public health in the cities throughout the world.Due to climate change, air pollution patterns are changing in several urbanized areas of the world, with a significant effect on respiratory health.The observational evidence indicates that recent regional changes in climate, particularly temperature increases, have already affected a diverse set of physical and biological systems in many parts of the world. Associations between thunderstorms and asthma morbidity in pollinosis subjects have been also identified in multiple locations around the world.Allergens patterns are also changing in response to climate change and air pollution can modify the allergenic potential of pollens especially in presence of specific weather conditions.The underlying mechanisms of all these interactions are not well known yet. The consequences on health vary from decreases in lung function to allergic diseases, new onset of diseases, and exacerbation of chronic respiratory diseases.Factor clouding the issue is that laboratory evaluations do not reflect what happens during natural exposition, when atmospheric pollution mixtures in polluted cities are inhaled. In addition, it is important to recall that an individual's response to pollution exposure depends on the source and components of air pollution, as well as meteorological conditions. Indeed, some air pollution-related incidents with asthma aggravation do not depend

  16. Extremely Low Genetic Diversity Indicating the Endangered Status of Ranodon sibiricus (Amphibia: Caudata) and Implications for Phylogeography

    Science.gov (United States)

    Wang, Xiu-Ling; Sun, Jian-Yun; Xue, Yan; Zhang, Peng; Zhou, Hui; Qu, Liang-Hu

    2012-01-01

    Background The Siberian salamander (Ranodon sibiricus), distributed in geographically isolated areas of Central Asia, is an ideal alpine species for studies of conservation and phylogeography. However, there are few data regarding the genetic diversity in R. sibiricus populations. Methodology/Principal Findings We used two genetic markers (mtDNA and microsatellites) to survey all six populations of R. sibiricus in China. Both of the markers revealed extreme genetic uniformity among these populations. There were only three haplotypes in the mtDNA, and the overall nucleotide diversity in the mtDNA was 0.00064, ranging from 0.00000 to 0.00091 for the six populations. Although we recovered 70 sequences containing microsatellite repeats, there were only two loci that displayed polymorphism. We used the approximate Bayesian computation (ABC) method to study the demographic history of the populations. This analysis suggested that the extant populations diverged from the ancestral population approximately 120 years ago and that the historical population size was much larger than the present population size; i.e., R. sibiricus has experienced dramatic population declines. Conclusion/Significance Our findings suggest that the genetic diversity in the R. sibiricus populations is the lowest among all investigated amphibians. We conclude that the isolation of R. sibiricus populations occurred recently and was a result of recent human activity and/or climatic changes. The Pleistocene glaciation oscillations may have facilitated intraspecies genetic homogeneity rather than enhanced divergence. A low genomic evolutionary rate and elevated inbreeding frequency may have also contributed to the low genetic variation observed in this species. Our findings indicate the urgency of implementing a protection plan for this endangered species. PMID:22428037

  17. Orphan drugs for rare diseases: is it time to revisit their special market access status?

    Science.gov (United States)

    Simoens, Steven; Cassiman, David; Dooms, Marc; Picavet, Eline

    2012-07-30

    Orphan drugs are intended for diseases with a very low prevalence, and many countries have implemented legislation to support market access of orphan drugs. We argue that it is time to revisit the special market access status of orphan drugs. Indeed, evidence suggests that there is no societal preference for treating rare diseases. Although society appears to assign a greater value to severity of disease, this criterion is equally relevant to many common diseases. Furthermore, the criterion of equity in access to treatment, which underpins orphan drug legislation, puts more value on health improvement in rare diseases than in common diseases and implies that population health is not maximized. Finally, incentives for the development, pricing and reimbursement of orphan drugs have created market failures, including monopolistic prices and the artificial creation of rare diseases. We argue that, instead of awarding special market access status to orphan drugs, there is scope to optimize research and development (R&D) of orphan drugs and to control prices of orphan drugs by means of, for example, patent auctions, advance purchase commitments, pay-as-you-go schemes and dose-modification studies. Governments should consider carefully the right incentive strategy for R&D of orphan drugs in rare diseases.

  18. Climate Change, Extreme Weather Events, and Fungal Disease Emergence and Spread

    Science.gov (United States)

    Tucker, Compton J.; Yager, Karina; Anyamba, Assaf; Linthicum, Kenneth J.

    2011-01-01

    Empirical evidence from multiple sources show the Earth has been warming since the late 19th century. More recently, evidence for this warming trend is strongly supported by satellite data since the late 1970s from the cryosphere, atmosphere, oceans, and land that confirms increasing temperature trends and their consequences (e.g., reduced Arctic sea ice, rising sea level, ice sheet mass loss, etc.). At the same time, satellite observations of the Sun show remarkably stable solar cycles since the late 1970s, when direct observations of the Sun's total solar irradiance began. Numerical simulation models, driven in part by assimilated satellite data, suggest that future-warming trends will lead to not only a warmer planet, but also a wetter and drier climate depending upon location in a fashion consistent with large-scale atmospheric processes. Continued global warming poses new opportunities for the emergence and spread of fungal disease, as climate systems change at regional and global scales, and as animal and plant species move into new niches. Our contribution to this proceedings is organized thus: First, we review empirical evidence for a warming Earth. Second, we show the Sun is not responsible for the observed warming. Third, we review numerical simulation modeling results that project these trends into the future, describing the projected abiotic environment of our planet in the next 40 to 50 years. Fourth, we illustrate how Rift Valley fever outbreaks have been linked to climate, enabling a better understanding of the dynamics of these diseases, and how this has led to the development of an operational predictive outbreak model for this disease in Africa. Fifth, We project how this experience may be applicable to predicting outbreaks of fungal pathogens in a warming world. Lastly, we describe an example of changing species ranges due to climate change, resulting from recent warming in the Andes and associated glacier melt that has enabled amphibians to

  19. Mapping Disease Data: A Usability Test of an Internet-Based System of Disease Status Disclosure

    Directory of Open Access Journals (Sweden)

    Gareth Enticott

    2018-01-01

    Full Text Available Disease maps are important tools in the management of disease. By communicating risk, disease maps can help raise awareness of disease and encourage farmers and veterinarians to employ best practice to eliminate the spread of disease. However, despite the importance of disease maps in communicating risk and the existence of various online disease maps, there are few studies that explicitly examine their usability. Where disease maps are complicated to use, it seems that they are unlikely to be used effectively. The paper outlines an attempt to create an open access, online, searchable map of incidents of bovine tuberculosis in England and Wales, and analyzes its usability among veterinarians. The paper describes the process of creating the map before describing the results of a series of usability trials. Results show the map to score highly on different measures of usability. However, the trials also revealed a number of social and technical limitations and challenges facing the use of online disease maps, including reputational dangers, role confusion, data accuracy, and data representation. The paper considers the challenges facing disease maps and their potential role in designing new methodologies to evaluate the effectiveness of disease prevention initiatives.

  20. [SWOT Analysis of the National Survey on Current Status of Major Human Parasitic Diseases in China].

    Science.gov (United States)

    ZHU, Hui-hui; ZHOU, Chang-hai; CHEN, Ying-dan; ZANG, Wei; XIAO, Ning; ZHOU, Xiao-nong

    2015-10-01

    The National Survey on Current Status of Major Human Parasitic Diseases in China has been carried out since 2014 under the organization of the National Health and Family Planning Commission of the People's Republic of China. The National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (NIPD, China CDC) provided technical support and was responsible for quality control in this survey. This study used SWOT method to analyze the strengths, weaknesses, opportunities and threats that were encountered by he NIPD, China CDC during the completion of the survey. Accordingly, working strategies were proposed to facilitate the future field work.

  1. Minor rheumatology: Nonsystemic rheumatic disease of juxta-articular soft tissues of the upper extremity. Part 1

    Directory of Open Access Journals (Sweden)

    A. E. Karateev

    2015-01-01

    Full Text Available Rheumatic diseases of juxta-articular soft tissues (RDJAST (tendinitis, tenosynovitis, bursitis, etc. are one of the most common causes of disability and one the most common reasons for seeking medical advice. To manage patients with RDJAST is an important part of practising rheumatologists’ work. But unfortunately, the issues of diagnosis and therapy of this pathology have been relatively rarely discussed on the pages of Russian medical journals and at the scientific congresses and conferences of rheumatologists in recent years. This review is to refresh physicians’interest in this problem. Part 1 of this review briefly considers the general issues relating to the epidemiology, pathogenesis, and diagnosis of RDJAST of the upper extremity, such as rotator cuff tendinitis, lateral and medial epicondylitis, stenosing flexor tenosynovitis, de Quervain’s syndrome, and carpal tunnel syndrome.

  2. Clinical and nutritional status of surgical patients with and without malignant diseases: cross-sectional study

    Directory of Open Access Journals (Sweden)

    Vânia Aparecida Leandro-Merhi

    2011-03-01

    Full Text Available CONTEXT: Malnutrition is frequently observed in inpatients with malignant diseases and may contribute to longer hospital stays. OBJECTIVE: To compare the nutritional status, lymphocyte count, hemoglobin values and length of hospital stay of patients with and without malignant diseases. METHODS: This comparative study assessed indicators of nutritional status, namely body mass index, recent weight loss, lymphocyte count, hemoglobin and length of hospital stay, of 928 surgical patients with and without malignant diseases (50.2% females and 49.8% males. The chi-square test was used to compare proportions and the Mann-Whitney test was used to compare continuous measurements between two groups. The significance level was set at 5%. RESULTS: Patients with malignant diseases had longer hospital stays (P<0.0001, furthermore, a higher percentage of patients with malignant diseases had body mass index <18.5 (P<0.0001 and experienced recent weight changes (P<0.0002. Lymphocyte count also differed statistically between the groups (P = 0.0131, which lower levels were identified among patients with malignant diseases. CONCLUSION: The lymphocyte count, hemoglobin values and weight loss are important findings of nutritional depletion in patients with malignant diseases.

  3. Quality of life, health status and caregiver burden in Parkinson's disease: relationship to executive functioning.

    Science.gov (United States)

    Kudlicka, Aleksandra; Clare, Linda; Hindle, John V

    2014-01-01

    High-quality person-centred care for people with Parkinson's disease (PwPD) and their families relies on identifying and addressing factors that specifically impact on quality of life (QoL). Deficits in executive functions (EF) are common in Parkinson's disease, but their impact on PwPD and their caregivers is not well understood. The present study evaluated how EF contributes to QoL and health status for the PwPD and caregiver burden. Sixty-five PwPD completed measures of QoL, health status and EF, and 50 caregivers rated the EF of the PwPD and their own burden. Multiple regression analyses examined predictors of QoL (general life, health and movement disorders domains), health status and caregiver burden. Quality of life in the health and movement disorders domains was best explained by caregiver-rated EF, whereas QoL in the general life domain was best explained by level of depression. Health status was predicted by self-rated EF, with an objective EF measure also included in the regression model. Caregiver burden was best explained by caregiver-rated EF and disease severity, with general cognition and other factors also included in the regression model. Executive functions-related behavioural problems may contribute to QoL and health status in PwPD and affect caregiver burden. The findings support the view that the concepts of subjective QoL and self-assessed health status are only partially related and should not be seen as identical. Adequate strategies to reduce the impact of EF deficits are needed as this may have the potential to improve QoL in PwPD. Copyright © 2013 John Wiley & Sons, Ltd.

  4. HAND-FOOT-AND-MOUTH DISEASE EPIDEMIOLOGICAL STATUS AND RELATIONSHIP WITH METEOROLOGICAL VARIABLES IN GUANGZHOU, SOUTHERN CHINA, 2008-2012

    Directory of Open Access Journals (Sweden)

    Tiegang Li

    2014-12-01

    Full Text Available Hand-foot-and-mouth disease (HFMD is becoming one of the extremely common airborne and contact transmission diseases in Guangzhou, southern China, leading public health authorities to be concerned about its increased incidence. In this study, it was used an ecological study plus the negative binomial regression to identify the epidemic status of HFMD and its relationship with meteorological variables. During 2008-2012, a total of 173,524 HFMD confirmed cases were reported, 12 cases of death, yielding a fatality rate of 0.69 per 10,000. The annual incidence rates from 2008 to 2012 were 60.56, 132.44, 311.40, 402.76, and 468.59 (per 100,000, respectively, showing a rapid increasing trend. Each 1 °C rise in temperature corresponded to an increase of 9.47% (95% CI 9.36% to 9.58% in the weekly number of HFMD cases, while a one hPa rise in atmospheric pressure corresponded to a decrease in the number of cases by 7.53% (95% CI -7.60% to -7.45%. Similarly, each one percent rise in relative humidity corresponded to an increase of 1.48% or 3.3%, and a one meter per hour rise in wind speed corresponded to an increase of 2.18% or 4.57%, in the weekly number of HFMD cases, depending on the variables considered in the model. These findings revealed that epidemic status of HFMD in Guangzhou is characterized by high morbidity but low fatality. Weather factors had a significant influence on the incidence of HFMD.

  5. Hand-foot-and-mouth disease epidemiological status and relationship with meteorological variables in Guangzhou, southern China, 2008-2012.

    Science.gov (United States)

    Li, Tiegang; Yang, Zhicong; Liu, Xiangyi; Kang, Yan; Wang, Ming

    2014-01-01

    Hand-foot-and-mouth disease (HFMD) is becoming one of the extremely common airborne and contact transmission diseases in Guangzhou, southern China, leading public health authorities to be concerned about its increased incidence. In this study, it was used an ecological study plus the negative binomial regression to identify the epidemic status of HFMD and its relationship with meteorological variables. During 2008-2012, a total of 173,524 HFMD confirmed cases were reported, 12 cases of death, yielding a fatality rate of 0.69 per 10,000. The annual incidence rates from 2008 to 2012 were 60.56, 132.44, 311.40, 402.76, and 468.59 (per 100,000), respectively, showing a rapid increasing trend. Each 1 °C rise in temperature corresponded to an increase of 9.47% (95% CI 9.36% to 9.58%) in the weekly number of HFMD cases, while a one hPa rise in atmospheric pressure corresponded to a decrease in the number of cases by 7.53% (95% CI -7.60% to -7.45%). Similarly, each one percent rise in relative humidity corresponded to an increase of 1.48% or 3.3%, and a one meter per hour rise in wind speed corresponded to an increase of 2.18% or 4.57%, in the weekly number of HFMD cases, depending on the variables considered in the model. These findings revealed that epidemic status of HFMD in Guangzhou is characterized by high morbidity but low fatality. Weather factors had a significant influence on the incidence of HFMD.

  6. The peripheral artery questionnaire: a new disease-specific health status measure for patients with peripheral arterial disease.

    Science.gov (United States)

    Spertus, John; Jones, Philip; Poler, Sherri; Rocha-Singh, Krishna

    2004-02-01

    The most common indication for treating patients with peripheral arterial disease is to improve their health status: their symptoms, function, and quality of life. Quantifying health status requires a valid, reproducible, and sensitive disease-specific measure. The Peripheral Artery Questionnaire (PAQ) is a 20-item questionnaire developed to meet this need by quantifying patients' physical limitations, symptoms, social function, treatment satisfaction, and quality of life. Psychometric and clinical properties of the PAQ were evaluated in a prospective cohort study of 44 patients undergoing elective percutaneous peripheral revascularization. To establish reproducibility, 2 assessments were performed 2 weeks apart and before revascularization. The change in scores before and 6 weeks after revascularization were used to determine the instruments' responsiveness and were compared with the Short Form-36 and the Walking Impairment Questionnaire. A series of cross-sectional analyses were performed to establish the construct validity of the PAQ. The 7 domains of the PAQ were internally reliable, with Cronbach alpha = 0.80 to 0.94. The test-retest reliability analyses revealed insignificant mean changes of 0.6 to 2.3 points (P = not significant for all). Conversely, the change after revascularization ranged from 13.7 to 41.9 points (P PAQ to clinical improvement. The PAQ Summary Scale was the most sensitive of all scales tested. Construct validity was established by demonstrating correlations with other measures of patient health status. The PAQ is a valid, reliable, and responsive disease-specific measure for patients with peripheral arterial disease. It may prove to be a useful end point in clinical trials and a potential aid in disease management.

  7. Assessment of reference gene stability influenced by extremely divergent disease symptoms in Solanum lycopersicum L.

    Science.gov (United States)

    Wieczorek, Przemysław; Wrzesińska, Barbara; Obrępalska-Stęplowska, Aleksandra

    2013-12-01

    Tomato (Solanum lycopersicum L.) is one of the most important vegetables of great worldwide economic value. The scientific importance of the vegetable results from the fact that the genome of S. lycopersicum has been sequenced. This allows researchers to study fundamental mechanisms playing an essential role during tomato development and response to environmental factors contributing significantly to cell metabolism alterations. Parallel with the development of contemporary genetics and the constant increase in sequencing data, progress has to be aligned with improvement of experimental methods used for studying genes functions and gene expression levels, of which the quantitative polymerase chain reaction (qPCR) is still the most reliable. As well as with other nucleic acid-based methods used for comparison of the abundance of specific RNAs, the RT-qPCR data have to be normalised to the levels of RNAs represented stably in a cell. To achieve the goal, the so-called housekeeping genes (i.e., RNAs encoding, for instance, proteins playing an important role in the cell metabolism or structure maintenance), are used for normalisation of the target gene expression data. However, a number of studies have indicated the transcriptional instability of commonly used reference genes analysed in different situations or conditions; for instance, the origin of cells, tissue types, or environmental or other experimental conditions. The expression of ten common housekeeping genes of S. lycopersicum, namely EF1α, TUB, CAC, EXP, RPL8, GAPDH, TBP, ACT, SAND and 18S rRNA were examined during viral infections of tomato. Changes in the expression levels of the genes were estimated by comparison of the non-inoculated tomato plants with those infected with commonly known tomato viral pathogens, Tomato torrado virus, Cucumber mosaic virus, Tobacco mosaic virus and Pepino mosaic virus, inducing a diverse range of disease symptoms on the common host, ranging from mild leaves chlorosis to

  8. [Flowmetric, thermometric and rheologic studies in obliterating arterial diseases of the lower extremities treated with buflomedil].

    Science.gov (United States)

    Dorigo, B; Raspanti, D; Trapani, M; Albanese, B; Cameli, A M; Digiesi, V

    1985-02-25

    Ten subjects with peripheral arterial occlusive disease were treated with buflomedil, analysing the effect of every single intravenous administration of the drug, and the effect of the administration repeated for a period of 5 days. This controlled study was aimed at evaluating the state of the peripheral blood flow, not just relating to the flowmetric parameters, but also to those more directly connected to the metabolic and functional conditions of the microcirculation. During every single administration, blood flow, skin and muscular temperatures were recorded. As concerned the drug's chronic effect, endurance limit, skin and muscular temperatures, whole blood viscosity, plasma viscosity and red cell filterability were recorded before beginning the treatment and after 15 days. The results of this study show that during a single buflomedil infusion no modifications have been observed in blood flow and muscular temperature, whereas skin temperature showed a slight increase. On the contrary, after a 15 days treatment, muscular temperature and endurance limit significantly increased, without flowmetric changes. A significant decrease in values of blood viscosity at high shear-rate was recorded too. The overall results seem to indicate that after treatment with buflomedil there is an improvement of the metabolic muscular conditions, probably due to a stimulant effect of the drug on microcirculatory blood flow.

  9. Urine biomarkers in the early stages of diseases: current status and perspective.

    Science.gov (United States)

    Jing, Jian; Gao, Youhe

    2018-02-01

    As a noninvasive and easily available biological fluid, the urine is becoming an important source for disease biomarker study. Change is essential for the usefulness of a biomarker. Without homeostasis mechanisms, urine can accommodate more changes, especially in the early stages of diseases. In this review, we summarize current status and discuss perspectives on the discovery of urine biomarkers in the early stages of diseases. We emphasize the advantages of urine biomarkers compared to plasma biomarkers for the diagnosis of diseases at early stages, propose a urine biomarker research roadmap, and highlight a novel membrane storage technique that enables large-scale urine sample collection and storage efficiently and economically. It is anticipated that urine biomarker studies will greatly promote early diagnosis, prevention, treatment, and prognosis of a variety of diseases, and provide strong support for translational and precision medicine.

  10. Switching between Abstract Rules Reflects Disease Severity but Not Dopaminergic Status in Parkinson's Disease

    Science.gov (United States)

    Kehagia, Angie A.; Cools, Roshan; Barker, Roger A.; Robbins, Trevor W.

    2009-01-01

    This study sought to disambiguate the impact of Parkinson's disease (PD) on cognitive control as indexed by task set switching, by addressing discrepancies in the literature pertaining to disease severity and paradigm heterogeneity. A task set is governed by a rule that determines how relevant stimuli (stimulus set) map onto specific responses…

  11. Socioeconomic status in relation to Parkinson's disease risk and mortality: A population-based prospective study.

    Science.gov (United States)

    Yang, Fei; Johansson, Anna L V; Pedersen, Nancy L; Fang, Fang; Gatz, Margaret; Wirdefeldt, Karin

    2016-07-01

    Little is known about the role of socioeconomic status in relation to Parkinson's disease (PD) risk, and no study has investigated whether the impact of socioeconomic status on all-cause mortality differs between individuals with and without PD.In this population-based prospective study, over 4.6 million Swedish inhabitants who participated in the Swedish census in 1980 were followed from 1981 to 2010. The incidence rate of PD and incidence rate ratio were estimated for the association between socioeconomic status and PD risk. Age-standardized mortality rate and hazard ratio (HR) were estimated for the association between socioeconomic status and all-cause mortality for individuals with and without PD.During follow-up, 66,332 incident PD cases at a mean age of 76.0 years were recorded. Compared to individuals with the highest socioeconomic status (high nonmanual workers), all other socioeconomic groups (manual or nonmanual and self-employed workers) had a lower PD risk. All-cause mortality rates were higher in individuals with lower socioeconomic status compared with high nonmanual workers, but relative risks for all-cause mortality were lower in PD patients than in non-PD individuals (e.g., for low manual workers, HR: 1.12, 95% confidence interval [CI]: 1.09-1.15 for PD patients; HR: 1.36, 95% CI: 1.35-1.36 for non-PD individuals).Individuals with lower socioeconomic status had a lower PD incidence compared to the highest socioeconomic group. Lower socioeconomic status was associated with higher all-cause mortality among individuals with and without PD, but such impact was weaker among PD patients.

  12. Diagnosis of Alzheimer’s Disease Based on Structural MRI Images Using a Regularized Extreme Learning Machine and PCA Features

    Directory of Open Access Journals (Sweden)

    Ramesh Kumar Lama

    2017-01-01

    Full Text Available Alzheimer’s disease (AD is a progressive, neurodegenerative brain disorder that attacks neurotransmitters, brain cells, and nerves, affecting brain functions, memory, and behaviors and then finally causing dementia on elderly people. Despite its significance, there is currently no cure for it. However, there are medicines available on prescription that can help delay the progress of the condition. Thus, early diagnosis of AD is essential for patient care and relevant researches. Major challenges in proper diagnosis of AD using existing classification schemes are the availability of a smaller number of training samples and the larger number of possible feature representations. In this paper, we present and compare AD diagnosis approaches using structural magnetic resonance (sMR images to discriminate AD, mild cognitive impairment (MCI, and healthy control (HC subjects using a support vector machine (SVM, an import vector machine (IVM, and a regularized extreme learning machine (RELM. The greedy score-based feature selection technique is employed to select important feature vectors. In addition, a kernel-based discriminative approach is adopted to deal with complex data distributions. We compare the performance of these classifiers for volumetric sMR image data from Alzheimer’s disease neuroimaging initiative (ADNI datasets. Experiments on the ADNI datasets showed that RELM with the feature selection approach can significantly improve classification accuracy of AD from MCI and HC subjects.

  13. Disease Type- and Status-Specific Alteration of CSF Metabolome Coordinated with Clinical Parameters in Inflammatory Demyelinating Diseases of CNS.

    Directory of Open Access Journals (Sweden)

    Soo Jin Park

    Full Text Available Central nervous system (CNS inflammatory demyelinating diseases (IDDs are a group of disorders with different aetiologies, characterized by inflammatory lesions. These disorders include multiple sclerosis (MS, neuromyelitis optica spectrum disorder (NMOSD, and idiopathic transverse myelitis (ITM. Differential diagnosis of the CNS IDDs still remains challenging due to frequent overlap of clinical and radiological manifestation, leading to increased demands for new biomarker discovery. Since cerebrospinal fluid (CSF metabolites may reflect the status of CNS tissues and provide an interfacial linkage between blood and CNS tissues, we explored multi-component biomarker for different IDDs from CSF samples using gas chromatography mass spectrometry-based metabolite profiling coupled to multiplex bioinformatics approach. We successfully constructed the single model with multiple metabolite variables in coordinated regression with clinical characteristics, expanded disability status scale, oligoclonal bands, and protein levels. The multi-composite biomarker simultaneously discriminated four different immune statuses (a total of 145 samples; 54 MS, 49 NMOSD, 30 ITM, and 12 normal controls. Furthermore, systematic characterization of transitional metabolic modulation identified relapse-associated metabolites and proposed insights into the disease network underlying type-specific metabolic dysfunctionality. The comparative analysis revealed the lipids, 1-monopalmitin and 1-monostearin were common indicative for MS, NMOSD, and ITM whereas fatty acids were specific for the relapse identified in all types of IDDs.

  14. Vitamin D status, liver enzymes, and incident liver disease and mortality

    DEFF Research Database (Denmark)

    Skaaby, Tea; Husemoen, Lise Lotte Nystrup; Borglykke, Anders

    2014-01-01

    , alcohol consumption, smoking, physical activity, dietary habits, education, body mass index, and ALT). The risk of having a high level of ALT, AST, or GGT tended to be higher for lower vitamin D levels, although not statistically significant. In this general population study, vitamin D status...... was inversely associated with incident liver disease. Further studies are needed to determine whether patients in risk of developing impaired liver function should be screened for vitamin D deficiency for preventive purposes....

  15. Combined analysis of circulating epithelial cells and serum thyroglobulin for distinguishing disease status of the patients with papillary thyroid carcinoma

    OpenAIRE

    Lin, Hung-Chih; Liou, Miaw-Jene; Hsu, Hsung-Ling; Hsieh, Jason Chia-Hsun; Chen, Yi-An; Tseng, Ching-Ping; Lin, Jen-Der

    2015-01-01

    Papillary thyroid carcinoma (PTC) accounts for about 80% of the cases in thyroid cancer. Routine surveillance by serum thyroglobulin (Tg) and medical imaging is the current practice to monitor disease progression of the patients. Whether enumeration of circulating epithelial cells (CECs) helps to define disease status of PTC patients was investigated. CECs were enriched from the peripheral blood of the healthy control subjects (G1, n = 17) and the patients at disease-free status (G2, n = 26) ...

  16. Symptom Status Predicts Patient Outcomes in Persons with HIV and Comorbid Liver Disease

    Directory of Open Access Journals (Sweden)

    Wendy A. Henderson

    2012-01-01

    Full Text Available Persons living with human immunodeficiency virus (HIV are living longer; therefore, they are more likely to suffer significant morbidity due to potentially treatable liver diseases. Clinical evidence suggests that the growing number of individuals living with HIV and liver disease may have a poorer health-related quality of life (HRQOL than persons living with HIV who do not have comorbid liver disease. Thus, this study examined the multiple components of HRQOL by testing Wilson and Cleary’s model in a sample of 532 individuals (305 persons with HIV and 227 persons living with HIV and liver disease using structural equation modeling. The model components include biological/physiological factors (HIV viral load, CD4 counts, symptom status (Beck Depression Inventory II and the Medical Outcomes Study HIV Health Survey (MOS-HIV mental function, functional status (missed appointments and MOS-HIV physical function, general health perceptions (perceived burden visual analogue scale and MOS-HIV health transition, and overall quality of life (QOL (Satisfaction with Life Scale and MOS-HIV overall QOL. The Wilson and Cleary model was found to be useful in linking clinical indicators to patient-related outcomes. The findings provide the foundation for development and future testing of targeted biobehavioral nursing interventions to improve HRQOL in persons living with HIV and liver disease.

  17. A comparison of discharge functional status after rehabilitation in skilled nursing, home health, and medical rehabilitation settings for patients after lower-extremity joint replacement surgery.

    Science.gov (United States)

    Mallinson, Trudy R; Bateman, Jillian; Tseng, Hsiang-Yi; Manheim, Larry; Almagor, Orit; Deutsch, Anne; Heinemann, Allen W

    2011-05-01

    To examine differences in outcomes of patients after lower-extremity joint replacement across 3 post-acute care (PAC) rehabilitation settings. Prospective observational cohort study. Skilled nursing facilities (SNFs; n=5), inpatient rehabilitation facilities (IRFs; n=4), and home health agencies (HHAs; n=6) from 11 states. Patients with total knee (n=146) or total hip replacement (n=84) not related to traumatic injury. None. Self-care and mobility status at PAC discharge measured by using the Inpatient Rehabilitation Facility Patient Assessment Instrument. Based on our study sample, HHA patients were significantly less dependent than SNF and IRF patients at admission and discharge in self-care and mobility. IRF and SNF patients had similar mobility levels at admission and discharge and similar self-care at admission, but SNF patients were more independent in self-care at discharge. After controlling for differences in patient severity and length of stay in multivariate analyses, HHA setting was not a significant predictor of self-care discharge status, suggesting that HHA patients were less medically complex than SNF and IRF patients. IRF patients were more dependent in discharge self-care even after controlling for severity. For the full discharge mobility regression model, urinary incontinence was the only significant covariate. For the patients in our U.S.-based study, direct discharge to home with home care was the optimal strategy for patients after total joint replacement surgery who were healthy and had social support. For sicker patients, availability of 24-hour medical and nursing care may be needed, but intensive therapy services did not seem to provide additional improvement in functional recovery in these patients. Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  18. Impact of nutritional status on body functioning in chronic obstructive pulmonary disease and how to intervene.

    Science.gov (United States)

    Aniwidyaningsih, Wahju; Varraso, Raphaëlle; Cano, Noel; Pison, Christophe

    2008-07-01

    Chronic obstructive pulmonary disease is the fifth leading cause of mortality in the world. This study reviews diet as a risk or protective factor for chronic obstructive pulmonary disease, mechanisms of malnutrition, undernutrition consequences on body functioning and how to modulate nutritional status of patients with chronic obstructive pulmonary disease. Different dietary factors (dietary pattern, foods, nutrients) have been associated with chronic obstructive pulmonary disease and the course of the disease. Mechanical disadvantage, energy imbalance, disuse muscle atrophy, hypoxemia, systemic inflammation and oxidative stress have been reported to cause systemic consequences such as cachexia and compromise whole body functioning. Nutritional intervention makes it possible to modify the natural course of the disease provided that it is included in respiratory rehabilitation combining bronchodilators optimization, infection control, exercise and, in some patients, correction of hypogonadism. Diet, as a modifiable risk factor, appears more as an option to prevent and modify the course of chronic obstructive pulmonary disease. Reduction of mechanical disadvantage, physical training and anabolic agents should be used conjointly with oral nutrition supplements to overcome undernutrition and might change the prognosis of the disease in some cases. Major research challenges address the role of systemic inflammation and the best interventions for controlling it besides smoking cessation.

  19. Human disease mortality kinetics are explored through a chain model embodying principles of extreme value theory and competing risks.

    Science.gov (United States)

    Juckett, D A; Rosenberg, B

    1992-04-21

    The distributions for human disease-specific mortality exhibit two striking characteristics: survivorship curves that intersect near the longevity limit; and, the clustering of best-fitting Weibull shape parameter values into groups centered on integers. Correspondingly, we have hypothesized that the distribution intersections result from either competitive processes or population partitioning and the integral clustering in the shape parameter results from the occurrence of a small number of rare, rate-limiting events in disease progression. In this report we initiate a theoretical examination of these questions by exploring serial chain model dynamics and parameteric competing risks theory. The links in our chain models are composed of more than one bond, where the number of bonds in a link are denoted the link size and are the number of events necessary to break the link and, hence, the chain. We explored chains with all links of the same size or with segments of the chain composed of different size links (competition). Simulations showed that chain breakage dynamics depended on the weakest-link principle and followed kinetics of extreme-values which were very similar to human mortality kinetics. In particular, failure distributions for simple chains were Weibull-type extreme-value distributions with shape parameter values that were identifiable with the integral link size in the limit of infinite chain length. Furthermore, for chains composed of several segments of differing link size, the survival distributions for the various segments converged at a point in the S(t) tails indistinguishable from human data. This was also predicted by parameteric competing risks theory using Weibull underlying distributions. In both the competitive chain simulations and the parametric competing risks theory, however, the shape values for the intersecting distributions deviated from the integer values typical of human data. We conclude that rare events can be the source of

  20. Comparative study of multi-slice spiral CT angiography and color doppler ultrasound in diagnosis of arteriosclerotic occlusive disease of lower extremity

    International Nuclear Information System (INIS)

    Li Wanjun; Lai Zhenhui; Cui Dong; Lin Xiupeng; Du Muxuan

    2010-01-01

    Objective: To compare the difference between multi-slice spiral CT angiography (MSCTA) and color doppler ultrasound in diagnosis of arteriosclerotic occlusive disease of lower extremity. Methods: Patients with arteriosclerosis occlusion were assessed by color doppler ultrasound, multi-slice spiral CT angiography and digital subtraction angiography (DSA). The image information of color doppler ultrasound and MSCTA were compared with that of DSA. Results: Color doppler ultrasound showed the anatomical shape and hemodynamics of the arteries of lower extremity. The sensitivity, specificity, and accuracy for diagnosis arteriosclerotic occlusive disease of lower extremity were 88.04%, 90.69% and 88.77% respectively. MSCTA showed the three dimensional structure of the arteries of lower extremity as well as the collateral arteries and the distal arterials. The sensitivity, specificity and accuracy of MSCTA were 97.69%, 96.90% and 97.66%, respectively. Conclusion: Multi-slice spiral CT angiography is an ideal imaging method for the diagnosis of arteriosclerotic occlusive disease of lower extremity. (authors)

  1. The influence of genetic variability and proinflammatory status on the development of bone disease in patients with Gaucher disease.

    Directory of Open Access Journals (Sweden)

    Javier Gervas-Arruga

    Full Text Available Gaucher disease, the most common lysosomal storage disorder, is caused by β-glucocerebrosidase deficiency. Bone complications are the major cause of morbidity in patients with type 1 Gaucher disease (GD1. Genetic components strongly influence bone remodelling. In addition, chronic inflammation produced by Gaucher cells induces the production of several cytokines, which leads to direct changes in the bone remodelling process and can also affect the process indirectly through other immune cells. In this study, we analysed the association between bone mineral density (BMD, bone marrow burden score, and relevant genetic polymorphisms related to bone metabolism, as well as profiles of proinflammatory cytokines in a GD1 cohort. This study included 83 patients distributed according to bone status. BMD was measured with DXA and broadband ultrasound attenuation; bone marrow involvement was evaluated using MRI. We also analysed 26 SNPs located in 14 genes related to bone metabolism. To assess proinflammatory status, we analysed IL-4, IL-6, IL-7, IL-10, IL-13, MIP-1α, MIP-1β, and TNFα in plasma samples from 71 control participants and GD1 patients. SNP genotype proportions and BMD differed significantly between ESRI c.453-397T>C and VDR c.1024+283G>A variants. We also observed significant associations between GD1 genotypes and bone affectation. When patients were stratified by spleen status, we observed significant correlations between non-/splenectomized groups and Spanish MRI (S-MRI score. Across genotype proportions of non-/splenectomized patients and S-MRI, we observed significant differences in ESRI c.453-397T>C, VDR c.-83-25988G>A, and TNFRSF11B c.9C>G polymorphisms. We observed different significant proinflammatory profiles between control participants, treatment-naïve patients, and patients on enzyme replacement therapy (ERT; between non-/splenectomized patients (between untreated and ERT-treated patients and among those with differing GBA

  2. Iron Status and Inflammation in Early Stages of Chronic Kidney Disease

    Directory of Open Access Journals (Sweden)

    Ewelina Łukaszyk

    2015-06-01

    Full Text Available Background/Aims: One of the most common causes of anemia of chronic disease (ACD is chronic kidney disease. The main pathomechanism responsible for ACD is subclinical inflammation. The key element involved in iron metabolism is hepcidin, however, studies on new indices of iron status are in progress.The aim of the study was to assess the iron status in patients in early stages of chronic kidney disease, iron correlation with inflammation parameters and novel biomarkers of iron metabolism. Methods: The study included 69 patients. Standard laboratory measurements were used to measure the iron status, complete blood count, fibrinogen, prothrombin index, C-reactive protein concentration (CRP, creatinine, urea, uric acid. Commercially available kits were used to measure high-sensitivity CRP, interleukin 6 (IL-6, hepcidin-25, hemojuvelin, soluble transferrin receptor (sTfR, growth differentiation factor-15 (GDF-15 and zonulin. Results: Absolute iron deficiency was present in 17% of the patients, functional iron deficiency was present in 12% of the patients. Functional iron deficiency was associated with significantly higher serum levels of fibrinogen, ferritin, transferrin saturation, total iron binding capacity, hepcidin and older age relative to patients with absolute iron deficiency. In comparison with patients without iron deficiency, patients with functional iron deficiency were older, with lower prothrombin index, higher fibrinogen, CRP, hsCRP, sTfR, GDF-15, urea and lower eGFR. Hepcidin was predicted by markers of inflammation:ferritin, fibrinogen and IL-6. Conclusion: Inflammation is correlated with iron status. Novel biomarkers of iron metabolism might be useful to distinguish iron deficiency anemia connected with inflammation and absolute iron deficiency.

  3. Risk of lower extremity arterial disease in a cohort of workers occupationally exposed to ionizing radiation over a prolonged period

    Energy Technology Data Exchange (ETDEWEB)

    Azizova, Tamara V.; Bannikova, Maria V.; Grigorieva, Evgenia S.; Bagaeva, Yaroslava P.; Azizova, Elena V. [Southern Urals Biophysics Institute, Ozyorsk Chelyabinsk Region (Russian Federation)

    2016-05-15

    In this study the incidence risk of lower extremity arterial disease (LEAD; international classification of diseases version 9 code 440.2) was assessed in a cohort of workers occupationally exposed to radiation over a prolonged period. The study cohort includes 22,377 workers of the Mayak Production Association (25 % of whom are females) first employed at one of the main facilities in 1948-1982 and followed up to the end of 2008. Dose estimates used in the study are provided by Mayak Worker Dosimetry System 2008. The mean total dose from external gamma-rays is 0.54 Gy for males and 0.44 Gy for females. The mean absorbed liver dose from internal alpha-radiation due to incorporated plutonium is 0.23 Gy in males and 0.44 Gy in females. Relative risks and excess relative risks per unit dose (ERR/Gy) are calculated based on maximum likelihood. A total of 943 cases of LEAD are registered in the study cohort during the follow-up of 512,801 person-years. A significant association of LEAD incidence with total dose from external gamma-rays (based on a linear model) was revealed, and the ERR/Gy is 0.27 (95 % confidence interval (CI) 0.11; 0.48). It turned out that a linear-exponential model provides a better fit of the data (∇AIC = 9.957). Inclusion of an adjustment for internal alpha-radiation dose resulted in the reduction of the ERR/Gy to 0.19 (95 % CI 0.05; 0.39), but the risk remains significant. No association of LEAD incidence with dose from internal alpha-radiation was found in the study worker cohort. It is concluded that this study provides evidence for an association of LEAD incidence with dose from external gamma-rays taking non-radiation factors into account. (orig.)

  4. Acupuncture Combined with Hydrotherapy in Diabetes Patients with Mild Lower-Extremity Arterial Disease: A Prospective, Randomized, Nonblinded Clinical Study.

    Science.gov (United States)

    Qi, Zhengqin; Pang, Yan; Lin, Lin; Zhang, Bing; Shao, Juntao; Liu, Xiaodong; Zhang, Xin

    2018-05-08

    BACKGROUND The aim of this pragmatic study was to explore the intervention of acupuncture combined with hydrotherapy and perceived effects in type 2 diabetic patients with recently diagnosed, mild, lower-extremity arterial disease (LEAD) in comparison with a control group. MATERIAL AND METHODS One hundred twenty-six diabetes patients who were diagnosed mild LEAD according to ankle-brachial blood pressure index (ABPI) and peripheral neuropathy symptom were randomly assigned to either an experimental (n=64) or control group (n=62). The experimental group attended and completed (1) a 30-min session of acupuncture in certain selected points, and (2) a 30-min hydrotherapy exercise every 2 days for 15 weeks. The outcome parameters were assessed at baseline, after intervention, and at 6-week follow-up. RESULTS The intervention was associated with an improvement in leg flow conductance and partial physical capacities, including chair-sit-and-reach, the walking impairment questionnaire (WIQ), and physical component summary score (PCS), compared to the control group. The treatment benefits were sustained throughout the 6-week follow-up endpoint. There was no difference in fasting glucose levels, Hb1Ac, blood pressure, or BMI after the intervention. At the endpoint of 6-week follow-up, acupuncture plus hydrotherapy appeared to reduce inflammatory response by decreasing IL-6, TNF-α, malondialdehyde, and SOD, and increasing glutathione. CONCLUSIONS Acupuncture plus hydrotherapy, without significant glycemic-controlling effects in the type 2 diabetic patients with mild LEAD, exerts a measurable benefit in disease-specific physical functions and health-related quality of life. Our results suggest that the combined therapy regulates the inflammatory process and oxidative stress and contributes to immune protection.

  5. Current knowledge in the treatment of peripheral arterial disease of the lower extremities: surgical and endovascular therapy

    International Nuclear Information System (INIS)

    Pobehova, J.; Kubikova, M.; Frankovicova, M.; Zavacka, M.; Stasko, P.; Tomecko, M.

    2014-01-01

    The etiology of PAOD is the most common cause of disability atherosclerotic arteries. Significantly reduces the quality of life (leading to limb amputation). Chronic renal insufficiency, diabetes and smoking are risk factors for progression of PAOD. In patients with claudication significantly reduced in active life reconstruction is indicated in the form of classical femoropopliteal bypass. Surgery may be supplemented or replaced transluminal percutaneous angioplasty (PTA). The aim of this retrospective study at the Department of Vascular Surgery and LF UPJS VUSCH, a. s. in Kosice in 2008 – 2010 was due to the ambiguous result of several previous studies, analyze and compare the results of the surgical and endovascular revascularisation in patients with peripheral artery disease of the lower extremities in the femoropopliteal region. We found that the use of bypass respectively endovascular angioplasty in patients with infra inguinal disability for 1 year follow-up did not lead to differences in clinical and technical success in primary and secondary patency of blood vessels, or in improving claudication interval between groups. There also were no differences in the need for revascularization or limb amputation within 1 year of performance. Use bypass was associated with a higher incidence of improving symptoms of critical limb ischemia and a higher incidence of hematoma following exercise. (author)

  6. Nutritional status of Iranian women with rheumatoid arthritis: an assessment of dietary intake and disease activity.

    Science.gov (United States)

    Hejazi, Jalal; Mohtadinia, Javad; Kolahi, Soasan; Bakhtiyari, Mahmood; Delpisheh, Ali

    2011-09-01

    Long-standing chronic diseases such as rheumatoid arthritis are known to be associated with impairment of nutritional status to some degree. The present study aimed to assess nutritional status of women with rheumatoid arthritis and compare their ingestion of certain micronutrients with dietary reference intakes. In this cross-sectional study, 90 eligible women were recruited. After examination, all patients were evaluated on the basis of disease activity score, calculated using the number of tender and swollen joints, patient global assessment of pain and high sensitivity C-reactive protein (CRP). A three-day 24 h recall was completed and a 10 ml fasting blood sample was obtained to assess the plasma levels of malondialdehyde, total antioxidant and CRP. Despite normal BMI, intake of energy and micronutrients including calcium, folic acid, zinc, magnesium and vitamin B6 were considerably lower compared with the dietary reference intakes. There was no significant relationship between intake of different nutrients or food groups and disease activity score and the biochemical markers including malondialdehyde, CRP and total antioxidant. Intake of energy and some micronutrients were significantly lower than the recommended values. However, no relationship was found between intake of different food groups or nutrients with disease activity or serum antioxidant capacity.

  7. Reevaluation of the Thyroid Scan for the Assessment of Pathophysiologic Status of Thyroid Disease

    International Nuclear Information System (INIS)

    Woo, In Sook; Nah, Jung Il; Kim, Deog Yoon

    1991-01-01

    To diagnosis and understand the pathophysiologic status of thyroid disease, not only hormonal measurements but also thyroid scan is believed to have a unique role. Especially in the cases of the change of the thyroid function by thyroiditis, it is emphasized that thyroid scan can be helpful in differential diagnosis, Discordant results of thyroid hormone levels and thyroid scan are found in transient hyperthyroidism, or in transient hypothyroidism. We analysed and reevaluated thyroid scan to look at the importance of thyroid scan. The results are summarised as follows: 1) 80%. of hyperthyroid patients had hyperthyroidism increased RAIU with even density, they are compatible with Graves' disease. 2) 2.1% of hyperthyroid patients had normal or decreased RAIU, which are classified as high iodine turn over genuine hyperthyroidism. 3) 8.5% of hyperthyroid patients had markedly decreased RAIU at both 2 hour and 24 hour, whose pathologic processes are suggested to be heterogenous namely subacute thyroiditis, postpartum thyroiditis, Hashimoto's thyroiditis, and pamless thyroiditis. 4) 45% of hypothyroid patients had increased 24 hr RAIU, 30% of hypothyroid patients were normal, 25%, decreased. In conclusion, thyroid scan should be reevaluated its useful role to asses the pathophysiologic status of thyroid disease. Especially in cases of transient thyrotoxicosis, thyroid scan is essential to diagnose and follow up the disease process.

  8. Reevaluation of the Thyroid Scan for the Assessment of Pathophysiologic Status of Thyroid Disease

    Energy Technology Data Exchange (ETDEWEB)

    Woo, In Sook; Nah, Jung Il; Kim, Deog Yoon [Kyunghee University College of Medicine, Seoul (Korea, Republic of)

    1991-03-15

    To diagnosis and understand the pathophysiologic status of thyroid disease, not only hormonal measurements but also thyroid scan is believed to have a unique role. Especially in the cases of the change of the thyroid function by thyroiditis, it is emphasized that thyroid scan can be helpful in differential diagnosis, Discordant results of thyroid hormone levels and thyroid scan are found in transient hyperthyroidism, or in transient hypothyroidism. We analysed and reevaluated thyroid scan to look at the importance of thyroid scan. The results are summarised as follows: 1) 80%. of hyperthyroid patients had hyperthyroidism increased RAIU with even density, they are compatible with Graves' disease. 2) 2.1% of hyperthyroid patients had normal or decreased RAIU, which are classified as high iodine turn over genuine hyperthyroidism. 3) 8.5% of hyperthyroid patients had markedly decreased RAIU at both 2 hour and 24 hour, whose pathologic processes are suggested to be heterogenous namely subacute thyroiditis, postpartum thyroiditis, Hashimoto's thyroiditis, and pamless thyroiditis. 4) 45% of hypothyroid patients had increased 24 hr RAIU, 30% of hypothyroid patients were normal, 25%, decreased. In conclusion, thyroid scan should be reevaluated its useful role to asses the pathophysiologic status of thyroid disease. Especially in cases of transient thyrotoxicosis, thyroid scan is essential to diagnose and follow up the disease process.

  9. Comparison of gadofosveset-enhanced three-dimensional magnetic resonance angiography with digital subtraction angiography for lower-extremity peripheral arterial occlusive disease

    International Nuclear Information System (INIS)

    Grijalba, Fermin Urtasun; Esandi, Mercedes Ciriza

    2010-01-01

    Background: Minimally invasive imaging techniques are increasingly used for clinical decision making in patients with peripheral arterial occlusive disease (PAOD). Purpose: To assess whether gadofosveset-enhanced three-dimensional (3D) magnetic resonance (MR) angiography could replace digital subtraction angiography (DSA) for the evaluation of lower-extremity PAOD. Material and Methods: Thirty patients with symptomatic PAOD underwent prospectively both MR angiography and DSA. Gadofosveset-enhanced 3D MR angiography was performed on a 1.5T system equipped with a peripheral angio matrix coil. Four blinded observers independently analyzed MR angiograms and DSA images. The lower arterial vascular system was divided into three anatomic segments (aortoiliac, femoropopliteal, infrapopliteal) for review. The status of each segment was graded as normal, stenosis less than 50%, stenosis greater than 50%, or occluded and/or aneurismatic. Principal and secondary lesions were reported. Results: Although interobserver agreement for both was excellent, it was higher for DSA (?=0.92) than for MR angiography (?=0.86) for reporting the principal and secondary lesions in all segments. For different anatomic locations, the interobserver agreement of MR angiography and DSA was as follows: aortoiliac (?=0.93, k=0.95), femoropopliteal (?=0.86, k=0.90), and infrapopliteal (?=0.78, k=0.85). The lowest agreement was found for MR angiography on infrapopliteal segments (?=0.78). In four (13.3%) cases, MR angiography showed lesions that were not found by DSA. Five (16.6%) aneurysm cases, not observed by DSA, were shown by MR angiography. Conclusion: Gadofosveset-enhanced 3D MR angiography can be proposed for first-line imaging in the management of lower-limb PAOD patients and permits the selective use of DSA as a second-line examination when MR angiography fails or in an endovascular approach

  10. QUALITY OF LIFE IN PATIENTS WITH HYPERTENSION, CORONARY HEART DISEASE, AND ATHEROSCLEROTIC LESION OF LOWER EXTREMITY ARTERIES IN THE SECONDARY PREVENTION OF COMPLICATIONS

    Directory of Open Access Journals (Sweden)

    A. A. Karlov

    2014-07-01

    Full Text Available Atherosclerotic lesion of lower extremity arteries frequently complicates the long-term course of hypertension and it is generally associated with coronary heart disease. Our study has attempted to evaluate the impact of combination antihypertensive therapy involving amlodipine, bisoprolol, and lisinopril on quality of life in this category of patients.

  11. Nutritional status, functional capacity and exercise rehabilitation in end-stage renal disease.

    Science.gov (United States)

    Mercer, T H; Koufaki, P; Naish, P F

    2004-05-01

    A significant percentage of patients with end-stage renal disease are malnourished and/or muscle wasted. Uremia is associated with decreased protein synthesis and increased protein degradation. Fortunately, nutritional status has been shown to be a modifiable risk factor in the dialysis population. It has long been proposed that exercise could positively alter the protein synthesis-degradation balance. Resistance training had been considered as the only form of exercise likely to induce anabolism in renal failure patients. However, a small, but growing, body of evidence indicates that for some dialysis patients, favourable improvements in muscle atrophy and fibre hypertrophy can be achieved via predominantly aerobic exercise training. Moreover, some studies tentatively suggest that nutritional status, as measured by SGA, can also be modestly improved by modes and patterns of exercise training that have been shown to also increase muscle fibre cross-sectional area and improve functional capacity. Functional capacity tests can augment the information content of basic nutritional status assessments of dialysis patients and as such are recommended for routine inclusion as a feature of all nutritional status assessments.

  12. Mapping publication status and exploring hotspots in a research field: chronic disease self-management.

    Science.gov (United States)

    Lu, Yang; Li, Zheng; Arthur, David

    2014-08-01

    To provide insight into the characteristics of chronic disease self-management by mapping publication status and exploring hotspots. Chronic disease is becoming a major public health issue worldwide, highlighting the importance of self-management in this area. Despite the volume and variety of publications, little is known about how 'chronic disease self-management' has developed, since the first publication 40 years ago. Such is the number of publications in the area, that there is a need for a systematic bibliographic examination to enable clinicians and researchers to navigate this literature. A bibliometric analysis of publications was used. Publication status was achieved using BICOMB software, whereas hotspots were identified with Ucinet software. A search of PubMed was conducted for papers published between 1971-2012. By 2011, the number of publications reached 696, a fourfold increase from the previous 10 years, of which 75% came from the USA and UK. There were 1284 journals, which published chronic disease self-management research, involving various disciplines. The research hotspots highlighted various self-management strategies for the following: diabetes; cardiac vascular and pulmonary chronic disease; pain relief for neoplasms; and obesity. Psychological adjustment was a permeating theme in self-management processes as was using internet-based interventions. Self-management in chronic disease publication has been most evident in developed countries. The bibliographic mapping and identification of publication hotspots provides scholars and practitioners with key target journals, as well as a rigorous overview of the field for use in further research, evidence-based practice and health policy development. © 2014 John Wiley & Sons Ltd.

  13. Adjusting a cancer mortality-prediction model for disease status-related eligibility criteria

    Directory of Open Access Journals (Sweden)

    Kimmel Marek

    2011-05-01

    Full Text Available Abstract Background Volunteering participants in disease studies tend to be healthier than the general population partially due to specific enrollment criteria. Using modeling to accurately predict outcomes of cohort studies enrolling volunteers requires adjusting for the bias introduced in this way. Here we propose a new method to account for the effect of a specific form of healthy volunteer bias resulting from imposing disease status-related eligibility criteria, on disease-specific mortality, by explicitly modeling the length of the time interval between the moment when the subject becomes ineligible for the study, and the outcome. Methods Using survival time data from 1190 newly diagnosed lung cancer patients at MD Anderson Cancer Center, we model the time from clinical lung cancer diagnosis to death using an exponential distribution to approximate the length of this interval for a study where lung cancer death serves as the outcome. Incorporating this interval into our previously developed lung cancer risk model, we adjust for the effect of disease status-related eligibility criteria in predicting the number of lung cancer deaths in the control arm of CARET. The effect of the adjustment using the MD Anderson-derived approximation is compared to that based on SEER data. Results Using the adjustment developed in conjunction with our existing lung cancer model, we are able to accurately predict the number of lung cancer deaths observed in the control arm of CARET. Conclusions The resulting adjustment was accurate in predicting the lower rates of disease observed in the early years while still maintaining reasonable prediction ability in the later years of the trial. This method could be used to adjust for, or predict the duration and relative effect of any possible biases related to disease-specific eligibility criteria in modeling studies of volunteer-based cohorts.

  14. Employment status, difficulties at work and quality of life in inflammatory bowel disease patients.

    Science.gov (United States)

    De Boer, Angela G E M; Bennebroek Evertsz', Floor; Stokkers, Pieter C; Bockting, Claudia L; Sanderman, Robert; Hommes, Daniel W; Sprangers, Mirjam A G; Frings-Dresen, Monique H W

    2016-10-01

    To assess employment status, difficulties at work and sick leave in inflammatory bowel disease (IBD) patients and their relation with sociodemographic and clinical factors, quality of life (QoL), and anxiety and depression. IBD patients attending an IBD outpatients' clinic received self-report questionnaires on employment status, IBD-related difficulties at work and sick leave (Trimbos/iMTA questionnaire for Costs associated with Psychiatric Illness), sociodemographic factors, QoL (Inflammatory Bowel Disease Questionnaire and 12-item Short-form Health Survey) and anxiety and depression (Hospital Anxiety and Depression Scale). Disease activity was assessed by their gastroenterologist. Associations between paid employment and sick leave with sociodemographic and clinical factors, QoL and anxiety and depression were assessed by regression analyses. In total, 202 IBD patients of working age, with a mean age of 41 years, participated; 63% had Crohn's disease and 37% had ulcerative colitis, and 57% were women and 19% had active disease. In all, 123 (61%) patients were in paid employment, of whom 31 (25%) were on sick leave, whereas 46 (23%) received a disability pension. Concentration problems (72%), low working pace (78%) and delayed work production (50%) were the most prevalent IBD-related work difficulties. IBD patients without paid employment were older and more often women, with active disease, lower QoL and higher anxiety and depression rates. Sick leave was associated with lower QoL and higher anxiety and depression rates. More than half of IBD patients were in paid employment, whereas almost a quarter was receiving a disability pension. A large majority experienced work difficulties. Having no paid employment was associated with poorer QoL and more anxiety and depression symptomatology.

  15. Hashimoto’s Thyroiditis and Graves’ Disease in One Patient: The Extremes of Thyroid Dysfunction Associated with Interferon Treatment

    Directory of Open Access Journals (Sweden)

    R. H. Bishay

    2016-01-01

    Full Text Available Autoimmune thyroid disease associated with interferon therapy can manifest as destructive thyroiditis, Graves’ Hyperthyroidism, and autoimmune (often subclinical hypothyroidism, the latter persisting in many patients. There are scare reports of a single patient developing extremes of autoimmune thyroid disease activated by the immunomodulatory effects of interferon. A 60-year-old man received 48 weeks of pegylated interferon and ribavirin therapy for chronic HCV. Six months into treatment, he reported fatigue, weight gain, and slowed cognition. Serum thyroid stimulating hormone (TSH was 58.8 mIU/L [0.27–4.2], fT4 11.1 pmol/L [12–25], and fT3 4.2 pmol/L [2.5–6.0] with elevated anti-TPO (983 IU/mL [<35] and anti-TG (733 U/mL [<80] antibodies. He commenced thyroxine with initial clinical and biochemical resolution but developed symptoms of hyperthyroidism with weight loss and tremor 14 months later. Serum TSH was <0.02 mIU/L, fT4 54.3 pmol/L, and fT3 20.2 pmol/L, with an elevated TSH receptor (TRAb, 4.0 U/L [<1.0], anti-TPO (1,163 IU/mL and anti-TG (114 U/mL antibodies. Technetium scan confirmed Graves’ Disease with bilateral diffuse increased tracer uptake (5.9% [0.5–3.5%]. The patient commenced carbimazole therapy for 6 months. Treatment was ceased following spontaneous clinical and biochemical remission (TSH 3.84 mIU/L, fT4 17pmol/L, fT3 4.5 pmol/L, and TRAb <1 U/L. This raises the need to monitor thyroid function closely in patients both during and following completion of interferon treatment.

  16. [Changes in nutritional status of patients with different diseases during hospitalization].

    Science.gov (United States)

    Cui, H Y; Zhu, M W; Wei, J M; Chen, W; Yang, X; Zhu, S N

    2017-04-01

    Objective: To evaluate changes in nutritional status of hospitalized patients with different diseases by subjective global assessment (SGA) and nutritional risk screening (NRS-2002). Methods: A prospective and parallel research done by multi-center collaboration from 34 hospitals in China from June to September 2014. Hospitalized patients with the following diseases were investigated: malignant tumor (2 487 cases), benign disease of the digestive system (1 358 cases), benign disease of the nervous system (1 043 cases), benign bone disease (451 cases), benign disease of the respiratory system(395 cases), cardiovascular disease (227 cases), benign thyroid and breast disease (179 cases), and endocrine disease (149 cases). Patients above the age of 18 and hospitalization time between 7-30 days were included. Physical indexes were measured, the NRS-2002 and SGA scores were recorded, the nutritional support were recorded during hospitalization and 24 hours after discharge from hospital. Measurement data between groups were analyzed using t test or Wilcoxon rank sum test, enumeration data and ranked data between groups were analyzed using chi-square test or Fisher exact test. Results: There were 6 638 cases of hospitalized patients, 3 861 cases were males and 2 777 were females, the male/female ratio was 1.4∶1.0; the median age was 60 years; the median height was 1.66 m; the median weight was 62 kg; the median body mass index (BMI)was 22.89 kg/m(2). At discharge, compared with that of admission, the body weight, BMI, grip strength, upper arm and calf circumferences of patients with malignant tumor were significantly decreased ( t =20.15-259.67, all P nutritional risk incidence rate (from NRS-2002) of patients with malignant tumor was significantly higher(χ(2)=21.275, P =0.000); moderate malnutrition (from SGA) incidence rate was significantly higher(χ(2)=62.318, P =0.000; χ(2)=11.312, P nutritional deficiency(except those with digestive benign diseases )received

  17. Selenium status and over-expression of interleukin-15 in celiac disease and autoimmune thyroid diseases

    Directory of Open Access Journals (Sweden)

    Anna Velia Stazi

    2010-12-01

    Full Text Available In celiac disease (CD, for its multifactorial nature, the target organs are not limited to the gut, but include thyroid, liver, skin and reproductive and nervous systems. Between the extraintestinal symptoms associated with CD, autoimmune thyroid diseases (AITDs are more evident, underlining as CD-related autoimmune alterations can be modulated not only by gluten but also by various concurrent endogenous (genetic affinity, over-expression of cytokines and exogenous (environment, nutritional deficiency factors. In their pathogenesis a central role for over-expression of interleukin-15 (IL-15 is shown, by inhibiting apoptosis, leading to the perpetuation of inflammation and tissue destruction. Thyroid is particularly sensitive to selenium deficiency because selenoproteins are significant in biosynthesis and activity of thyroid hormones; besides, some selenoproteins as glutathione peroxidase are involved in inhibiting apoptosis. Thus, selenium malabsorption in CD can be thought as a key factor directly leading to thyroid and intestinal damage. Considering the complexity of this interaction and on the basis of available evidence, the aim of this review is to assess as preventive and therapeutic target the role of IL-15 and selenium in the pathogeneses of both CD and AITD.

  18. Association between socioeconomic status, learned helplessness, and disease outcome in patients with inflammatory polyarthritis.

    Science.gov (United States)

    Camacho, E M; Verstappen, S M M; Symmons, D P M

    2012-08-01

    Independent investigations have shown that socioeconomic status (SES) and learned helplessness (LH) are associated with poor disease outcome in patients with rheumatoid arthritis (RA). Our aim was to investigate the cross-sectional relationship between SES, LH, and disease outcome in patients with recent-onset inflammatory polyarthritis (IP), the broader group of conditions of which RA is the major constituent. SES was measured using the Index of Multiple Deprivation 2007 for 553 patients consecutively recruited to the Norfolk Arthritis Register. Patients also completed the Rheumatology Attitudes Index, a measure of LH. SES and LH were investigated as predictors of disease outcome (functional disability [Health Assessment Questionnaire (HAQ)] and disease activity [Disease Activity Score in 28 joints]) in a regression analysis, adjusted for age, sex, and symptom duration. The role of LH in the relationship between SES and disease outcome was then investigated. Compared to patients of the highest SES, those of the lowest SES had a significantly worse outcome (median difference in HAQ score 0.42; 95% confidence interval [95% CI] 0.08, 0.75). Compared to patients with normal LH, patients with low LH had a significantly better outcome and patients with high LH had a significantly worse outcome (median difference in HAQ score 1.12; 95% CI 0.82, 1.41). There was a significant likelihood that LH mediated the association between SES and disease outcome (P = 0.04). LH is robustly associated with cross-sectional disease outcome in patients with IP, and appears to mediate the relationship between SES and disease outcome. As LH is potentially modifiable, these findings have potential clinical implications. Copyright © 2012 by the American College of Rheumatology.

  19. A cross-sectional study on nutrient intake and -status in inflammatory bowel disease patients.

    Science.gov (United States)

    Vidarsdottir, Jona B; Johannsdottir, Sigridur E; Thorsdottir, Inga; Bjornsson, Einar; Ramel, Alfons

    2016-06-08

    Inflammatory bowel disease (IBD) can be associated with nutritional problems. The aim of this study was to investigate diet and nutritional status of IBD patients. A total of 78 participants (35 men and 43 women aged 18-74 years) were included in this cross-sectional study. The majority (80 %) of the participant received infliximab treatment. Participants filled out disease related questionnaires and 31 participants also a 3-day food record. Body composition was measured and blood samples analysed in order to estimate nutritional status. The majority (87 %) claimed that diet affects digestive tract symptoms and 72 % had changed diet accordingly. The most common foods restricted were dairy products (60 %), processed meat (55 %), soft drinks (46 %), alcohol (45 %) and fast food (44 %). Body mass index was mostly in the overweight range but 46 % of the participants had been diagnosed with some nutritional deficiency since IBD diagnosis (most common was iron deficiency: 39 %). Patients who restricted meat products had lower ferritin values (48 ± 39 vs. 95 ± 74 μg/L, P = 0.011). Intake of vitamin D and calcium were not adequate (65 % below recommeded intake for both) and 60 % had poor vitamin D status. IBD patients often change their dietary intake in order to affect digestive tract symptoms. Many patients have a history of nutrient deficiency. Restriction of dairy and meat consumption is common and is negatively associated with intake or status of micronutrients like calcium and iron. Dietary advice by a dietitian and use of potentially helpful dietary supplements is indicated.

  20. Women of low socioeconomic status living with diabetes: Becoming adept at handling a disease

    Directory of Open Access Journals (Sweden)

    Wimonrut Boonsatean

    2015-12-01

    Full Text Available Objective: The objective of this study was to explore how Thai women of low socioeconomic status handle their type 2 diabetes. Methods: A qualitative interpretative method was used to study 19 women with type 2 diabetes in a suburban community in Thailand. Data were collected via semi-structured interviews and were analysed using inductive and constructive processes. Results: Participants’ lives underwent many changes between their initial diagnoses and later stages when they became adept at handling diabetes. Two themes emerged, which involved (1 the transition to handling diabetes and (2 the influences of the social environment. The first theme encompassed confronting the disease, reaching a turning point in the process of adaptation and developing expertise in handling diabetes. The second theme involved threats of loss of status and empowerment by families. These findings showed that becoming adept at handling diabetes required significant changes in women’s behaviours and required taking advantage of influences from the social environment. Conclusion: The process of developing expertise in handling diabetes was influenced by both inner and outer factors that required adjustment to learn to live with diabetes. Furthermore, the reductions found in women’s social statuses when they become patients in the healthcare system might pose a barrier to women of low socioeconomic status becoming adept at handling diabetes. However, the experiences of empowerment received from the women’s families acted as a powerful strategy to strengthen their handling of the disease. To develop accessible and sensitive health care for this population, it is important to pay attention to these findings.

  1. Socioeconomic status and impact of treatment on families of children with congenital heart disease

    International Nuclear Information System (INIS)

    Mughal, A.R.; Sidiq, M.; Hyder, S.N.; Qureshi, A.U.

    2011-01-01

    Objective: To assess the socioeconomic status, treatment being offered and the impact of congenital heart disease treatment on families. Study Design: Observational study. Place and Duration of Study: The Children's Hospital / Institute of Child Health, Lahore, from first March to 31 August 2010. Methodology: All patients undergoing a cardiac surgical or angiographic intervention were enrolled. Socioeconomic status was assessed by Kuppuswamy socioeconomic status scale with income group modification. The impact was measured by the source of financing, effect on family financing source and schooling and health of siblings. Results: Of 211 patients undergoing treatment in the study period, surgery was the definitive treatment in 164 (77.7%) and angiographic intervention in 47 (22.3%) patients. Male to female ratio was 1.5:1. The mean age of the patient was 39.1 +- 3.2 months (range 01 day to 15 years). Majority of families belonged to middle (66.4%, n=140) and lower (27%, n=57) socioeconomic class. The mean cost of medicines and disposable was PKR 78378.2 +- 8845.9 (US$ 933.1 +- 105.3) in open heart surgery, PKR 12581 +- 7010.8 (US$ 149.8 +- 83.5) in closed heart surgery and PKR 69091 + 60906 in angiographic interventions. In 63.1% patients, families contributed towards these costs either completely (12.3%) or partly (50.8%) with significant contribution from the hospital. Adverse effect on families ranged from leave without pay to losing jobs or business (46%), and selling their assets (11.3%). It also affected schooling and health of siblings (22.7% and 26.1% respectively). Conclusion: Majority of children with congenital heart disease belonged to middle and lower socioeconomic status in this study. Main definitive treatment was surgery. The cost of health care facilities posed a marked socioeconomic burden on those families. (author)

  2. Socioeconomic status and impact of treatment on families of children with congenital heart disease.

    Science.gov (United States)

    Mughal, Abdul Razzaq; Sadiq, Masood; Hyder, Syed Najam; Qureshi, Ahmad Usaid; A Shah, S Salman; Khan, Mohammad Asim; Nasir, Jamal Abdul

    2011-07-01

    To assess the socioeconomic status, treatment being offered and the impact of congenital heart disease treatment on families. Observational study. The Children's Hospital / Institute of Child Health, Lahore, from 1st March to 31st August 2010. All patients undergoing a cardiac surgical or angiographic intervention were enrolled. Socioeconomic status was assessed by Kuppuswamy socioeconomic status scale with income group modification. The impact was measured by the source of financing, effect on family financing source and schooling and health of siblings. Of 211 patients undergoing treatment in the study period, surgery was the definitive treatment in 164 (77.7%) and angiographic intervention in 47 (22.3%) patients. Male to female ratio was 1.5:1. The mean age of the patient was 39.1 + 3.2 months (range 01 day to 15 years). Majority of families belonged to middle (66.4%, n=140) and lower (27%, n=57) socioeconomic class. The mean cost of medicines and disposables was PKR 78378.2 ± 8845.9 (US$ 933.1 ± 105.3) in open heart surgery, PKR 12581 ± 7010.8 (US$ 149.8 ± 83.5) in closed heart surgery and PKR 69091 + 60906 in angiographic interventions. In 63.1% patients, families contributed towards these costs either completely (12.3%) or partly (50.8%) with significant contribution from the hospital. Adverse effect on families ranged from leave without pay to losing jobs or business (46%), and selling their assets (11.3%). It also affected schooling and health of siblings (22.7% and 26.1% respectively). Majority of children with congenital heart disease belonged to middle and lower socioeconomic status in this study. Main definitive treatment was surgery. The cost of health care facilities posed a marked socioeconomic burden on those families.

  3. Physical activity, health status and risk of hospitalization in patients with severe chronic obstructive pulmonary disease.

    Science.gov (United States)

    Benzo, Roberto P; Chang, Chung-Chou H; Farrell, Max H; Kaplan, Robert; Ries, Andrew; Martinez, Fernando J; Wise, Robert; Make, Barry; Sciurba, Frank

    2010-01-01

    Chronic obstructive pulmonary disease (COPD) is a leading cause of death and 70% of the cost of COPD is due to hospitalizations. Self-reported daily physical activity and health status have been reported as predictors of a hospitalization in COPD but are not routinely assessed. We tested the hypothesis that self-reported daily physical activity and health status assessed by a simple question were predictors of a hospitalization in a well-characterized cohort of patients with severe emphysema. Investigators gathered daily physical activity and health status data assessed by a simple question in 597 patients with severe emphysema and tested the association of those patient-reported outcomes to the occurrence of a hospitalization in the following year. Multiple logistic regression analyses were used to determine predictors of hospitalization during the first 12 months after randomization. The two variables tested in the hypothesis were significant predictors of a hospitalization after adjusting for all univariable significant predictors: >2 h of physical activity per week had a protective effect [odds ratio (OR) 0.60; 95% confidence interval (95% CI) 0.41-0.88] and self-reported health status as fair or poor had a deleterious effect (OR 1.57; 95% CI 1.10-2.23). In addition, two other variables became significant in the multivariate model: total lung capacity (every 10% increase) had a protective effect (OR 0.88; 95% CI 0.78-0.99) and self-reported anxiety had a deleterious effect (OR 1.75; 95% CI 1.13-2.70). Self-reported daily physical activity and health status are independently associated with COPD hospitalizations. Our findings, assessed by simple questions, suggest the value of patient-reported outcomes in developing risk assessment tools that are easy to use.

  4. Cardiometabolic disease risk in metabolically healthy and unhealthy obesity: Stability of metabolic health status in adults.

    Science.gov (United States)

    Guo, Fangjian; Garvey, W Timothy

    2016-02-01

    To assess the stability of metabolic status and body mass index (BMI) status and their relative contribution to risk of diabetes, cardiovascular events, and mortality. A total of 14,685 participants from the Atherosclerosis Risk in Communities Study and 4,990 from the Coronary Artery Risk Development in Young Adults Study were included. People with healthy obesity (HO) are defined as those meeting all three indices of blood pressure, blood glucose, and blood lipids. People with unhealthy obesity crossed the risk threshold for all three criteria. In both healthy and unhealthy subgroups, risks for coronary heart disease (CHD), stroke, and mortality were comparable among BMI status during a mean 18.7-year follow-up. When compared with HO, hazard ratios were increased for diabetes (5.56, 95% confidence interval [CI] 4.12-7.48), CHD (5.60, 95% CI 3.14-9.98), stroke (4.84, 95% CI 2.13-10.97), and mortality (2.6, 95% CI 1.88-3.61) in people with unhealthy obesity. BMI only moderately increased the risks for diabetes among healthy subjects. In the Coronary Artery Risk Development in Young Adults Study over 20 years, 17.5% of lean subjects and 67.3% of overweight subjects at baseline developed obesity during follow-up. Despite rising BMI, metabolic status remained relatively stable. Metabolic status is relatively stable despite rising BMI. HO had lower risks for diabetes, CHD, stroke, and mortality than unhealthy subjects but increased diabetes risks than healthy lean people. Cardiometabolic risk factors confer much higher risk than obesity per se. © 2015 The Obesity Society.

  5. Connecting Gender, Race, Class, and Immigration Status to Disease Management at the Workplace

    Science.gov (United States)

    Rosemberg, Marie-Anne S.; Tsai, Jenny Hsin-Chun

    2016-01-01

    Objective Chronic diseases are the leading causes of death in the United States. Chronic disease management occurs within all aspects of an individual's life, including the workplace. Though the social constructs of gender, race, class, and immigration status within the workplace have been considered, their connection to disease management among workers has been less explicitly explored. Using a sample of immigrant hotel housekeepers, we explored the connections between these four social constructs and hypertension management. Methods This qualitative research study was guided by critical ethnography methodology. Twenty-seven hotel room cleaners and four housemen were recruited (N = 31) and invited to discuss their experiences with hypertension and hypertension management within the context of their work environments. Results Being a woman worker within the hotel industry was perceived to negatively influence participants’ experience with hypertension and hypertension management. In contrast, being a woman played a protective role outside the workplace. Being an immigrant played both a positive and a negative role in hypertension and its management. Being black and from a low socioeconomic class had only adverse influences on participants’ experience with hypertension and its management. Conclusion Being a woman, black, lower class, and an immigrant simultaneously contribute to immigrant hotel housekeepers’ health and their ability to effectively manage their hypertension. The connection between these four constructs (gender, race, class, and immigration status) and disease management must be considered during care provision. Hotel employers and policy stakeholders need to consider those constructs and how they impact workers’ well-being. More studies are needed to identify what mitigates the associations between the intersectionality of these constructs and immigrant workers’ health and disease management within their work environment. PMID:27695659

  6. Connecting Gender, Race, Class, and Immigration Status to Disease Management at the Workplace.

    Science.gov (United States)

    Rosemberg, Marie-Anne S; Tsai, Jenny Hsin-Chun

    2014-01-01

    Chronic diseases are the leading causes of death in the United States. Chronic disease management occurs within all aspects of an individual's life, including the workplace. Though the social constructs of gender, race, class, and immigration status within the workplace have been considered, their connection to disease management among workers has been less explicitly explored. Using a sample of immigrant hotel housekeepers, we explored the connections between these four social constructs and hypertension management. This qualitative research study was guided by critical ethnography methodology. Twenty-seven hotel room cleaners and four housemen were recruited ( N = 31) and invited to discuss their experiences with hypertension and hypertension management within the context of their work environments. Being a woman worker within the hotel industry was perceived to negatively influence participants' experience with hypertension and hypertension management. In contrast, being a woman played a protective role outside the workplace. Being an immigrant played both a positive and a negative role in hypertension and its management. Being black and from a low socioeconomic class had only adverse influences on participants' experience with hypertension and its management. Being a woman, black, lower class, and an immigrant simultaneously contribute to immigrant hotel housekeepers' health and their ability to effectively manage their hypertension. The connection between these four constructs (gender, race, class, and immigration status) and disease management must be considered during care provision. Hotel employers and policy stakeholders need to consider those constructs and how they impact workers' well-being. More studies are needed to identify what mitigates the associations between the intersectionality of these constructs and immigrant workers' health and disease management within their work environment.

  7. Serological survey of the infectious disease status of Old English Game fowl in the lower North Island, New Zealand.

    Science.gov (United States)

    Christensen, N H

    2006-08-01

    To investigate the serological status of Old English Game (OEG) cockerels for a range of infectious diseases of poultry. Standard methods were used to screen serum collected from approximately 200 birds during routine dubbing operations, in 2004 and 2005. There was no serological evidence of infection with Newcastle disease, infectious bursal disease, or Salmonella Pullorum. Antibodies to infectious bronchitis virus, avian encephalomyelitis (AE) virus, Mycoplasma gallisepticum and Mycoplasma synoviae were detected. The disease status of OEG birds is similar to that of commercial poultry.

  8. Modeling of the blood flow in the lower extremities for dynamic diffuse optical tomography of peripheral artery disease

    Science.gov (United States)

    Marone, A.; Hoi, J. W.; Khalil, M. A.; Kim, H. K.; Shrikhande, G.; Dayal, R.; Hielscher, A. H.

    2015-07-01

    Peripheral Arterial Disease (PAD) is caused by a reduction of the internal diameters of the arteries in the upper or lower extremities mainly due to atherosclerosis. If not treated, its worsening may led to a complete occlusion, causing the death of the cells lacking proper blood supply, followed by gangrene that may require chirurgical amputation. We have recently performed a clinical study in which good sensitivities and specificities were achieved with dynamic diffuse optical tomography. To gain a better understanding of the physiological foundations of many of the observed effects, we started to develop a mathematical model for PAD. The model presented in this work is based on a multi-compartment Windkessel model, where the vasculature in the leg and foot is represented by resistors and capacitors, the blood pressure with a voltage drop, and the blood flow with a current. Unlike existing models, the dynamics induced by a thigh-pressure-cuff inflation and deflation during the measurements are taken into consideration. This is achieved by dynamically varying the resistances of the large veins and arteries. By including the effects of the thigh-pressure cuff, we were able to explain many of the effects observed during our dynamic DOT measurements, including the hemodynamics of oxy- and deoxy-hemoglobin concentration changes. The model was implemented in MATLAB and the simulations were normalized and compared with the blood perfusion obtained from healthy, PAD and diabetic patients. Our preliminary results show that in unhealthy patients the total system resistance is sensibly higher than in healthy patients.

  9. [Effect of disease severity on upper extremity muscle strength, exercise capacity, and activities of daily living in individuals with pulmonary arterial hypertension].

    Science.gov (United States)

    Özcan Kahraman, Buse; Özsoy, İsmail; Acar, Serap; Özpelit, Ebru; Akdeniz, Bahri; Sevinç, Can; Savcı, Sema

    2017-07-01

    Pulmonary arterial hypertension (PAH) is a rare disease. Although muscle strength, exercise capacity, quality of life, and activities of daily living of patients with PAH are affected, it is not known how they are affected by disease severity. The purpose of the present study was to investigate effects of disease severity on upper extremity muscle strength, exercise capacity, and performance of activities of daily living in patients with PAH. Twenty-five patients with disease severity classified according to the New York Heart Association (NYHA) as functional class II (n=14) or class III (n=11) were included in the study. Upper-extremity exercise capacity and limitations in performing activities of daily living were assessed with 6-minute pegboard and ring test (6PBRT) and the Milliken activities of daily living scale (MAS), respectively. Shoulder flexion, elbow extension, elbow flexion muscle strength, and handgrip strength were measured with dynamometer. There were no significant differences in age, gender, body mass index, or mean pulmonary artery pressure between groups (p>0.05). The 6PBRT, MAS, and elbow flexion (right) and grip strength (right and left) results were significantly lower in NYHA III group than in NYHA II group (p=0.004, p=0.002, p=0.043, p=0.002 and p=0.003, respectively). There was no significant difference in shoulder flexion, elbow flexion (left), or elbow extension between groups (p>0.05). Results suggest that upper extremity exercise capacity, elbow flexion muscle strength (right), and handgrip strength decrease and that limitations in activities of daily living grow as disease severity increases in patients with PAH. When planning rehabilitation programs, disease severity should be considered and evaluations and treatments for the upper extremities should be included.

  10. Vitamin d status in patients with chronic obstructive pulmonary disease who participate in pulmonary rehabilitation

    DEFF Research Database (Denmark)

    Ringbaek, Thomas; Martinez, Gerd; Durakovic, Amal

    2011-01-01

    PURPOSE: Vitamin D deficiency is common in patients with chronic obstructive pulmonary disease; however, no study has evaluated the influence of vitamin D status on effects of pulmonary rehabilitation (PR). METHODS: We studied 311 patients, who participated in a 7-week outpatient PR. Vitamin D...... higher body mass index and fat-free mass index, had worse quality of life score, tended to have lower percent predicted value for forced expiratory volume in the first second of expiration, and more frequently were current smokers. They had a 3-time higher risk of dropout from the PR program (P = .003...

  11. A status survey of common water-borne diseases in desert city Bikaner (NW Rajasthan, India).

    Science.gov (United States)

    Saxena, M M; Chhabra, Chetna

    2004-03-01

    Water is scarce and, in general, a low quality resource in desert areas and the Indian desert is no exception. With this in view, the present study was taken up to survey the status of common water-borne diseases epidemiological trends in the desert city Bikaner (NW Rajasthan). In the city, 15.5 per cent population and 44.5 per cent families were found to suffer from one or more common water-borne diseases including amoebiasis, diarrhoea, dysentery, jaundice and typhoid. No case of fluorosis was recorded. The highest incidence was that of diarrhoea (5.4 per cent population). The worst affected and safe zones in the city were identified and the trends of different diseases in different zones of the city are discussed. The highest incidence of diseases was noted during summer (58.8 per cent) followed by winter (34.1 per cent) and monsoon (7.0 per cent). Relationship of diseases with population attributes like age, education, economy and family size are also discussed. Attributes for contamination of drinking water have been tried to identify and safety measures suggested.

  12. Association between nutritional status and Modic classification in degenerative disc disease.

    Science.gov (United States)

    Seyithanoglu, Hakan; Aydin, Teoman; Taşpınar, Ozgur; Camli, Adil; Kiziltan, Huriye; Eris, Ali Hikmet; Hocaoglu, Ilknur Turk; Ozder, Aclan; Denizli, Ebru; Kepekci, Muge; Keskin, Yasar; Mutluer, Ahmet Serdar

    2016-04-01

    [Purpose] This study was conducted to examine the association between Modic classification and the eating habits in patients with degenerative disc disease (DDD) and to determine the influence of nutrition on disease severity. [Subjects and Methods] Sixty patients with DDD visiting a low back pain outpatient clinic were enrolled. Through face-to-face interviews, they completed questionnaires regarding their demographics, disease activity, smoking and alcohol use, concomitant diseases, disease duration, and nutritional status.Exclusion criteria were age 65 years, other comorbidities, missing MRI data, and inability to speak Turkish. [Results] Forty patients were finally included in the study. The frequency with which they consumed water, salt, fast food, eggs, milk, yogurt, cheese, whole wheat bread, white bread, butter, and margarine was recorded. A weak negative correlation was observed between the Modic types and fish and egg consumption. [Conclusion] Modic changes, which indicate the severity of DDD, seem to be correlated to patients' dietary habits. However, studies with comparison groups and larger samples are needed to confirm our promising results before any cause-and-effect relationship can be proposed.

  13. Transgenesis and paratransgenesis to control insect-borne diseases: Current status and future challenges

    Science.gov (United States)

    Coutinho-Abreu, Iliano V.; Zhu, Kun Yan; Ramalho-Ortigao, Marcelo

    2009-01-01

    Insect-borne diseases cause significant human morbidity and mortality. Current control and preventive methods against vector-borne diseases rely mainly on insecticides. The emergence of insecticide resistance in many disease vectors highlights the necessity to develop new strategies to control these insects. Vector transgenesis and paratransgenesis are novel strategies that aim at reducing insect vectorial capacity, or seek to eliminate transmission of pathogens such as Plasmodium sp., Trypanosoma sp., and Dengue virus currently being developed. Vector transgenesis relies on direct genetic manipulation of disease vectors making them incapable of functioning as vectors of a given pathogen. Paratransgenesis focuses on utilizing genetically modified insect symbionts to express molecules within the vector that are deleterious to pathogens they transmit. Despite the many successes achieved in developing such techniques in the last several years, many significant barriers remain and need to be overcome prior to any of these approaches become a reality. Here, we highlight the current status of these strategies, pointing out advantages and constraints, and also explore issues that need to be resolved before the establishment of transgenesis and paratransgenesis as tools to prevent vector-borne diseases. PMID:19819346

  14. Clinical validity of a disease-specific health status questionnaire: the peripheral artery questionnaire.

    Science.gov (United States)

    Hoeks, Sanne E; Smolderen, Kim G; Scholte Op Reimer, Wilma J M; Verhagen, Hence J M; Spertus, John A; Poldermans, Don

    2009-02-01

    Measuring patient-centered outcomes is becoming increasingly important in patients with peripheral arterial disease (PAD), both as a means of determining the benefits of treatment and as an aid for disease management. In order to monitor health status in a reliable and sensitive way, the disease-specific measure Peripheral Artery Questionnaire (PAQ) was developed. However, to date, its correlation with traditional clinical indices is unknown. The primary aim of this study was to better establish the clinical validity of the PAQ by examining its association with functional indices related to PAD. Furthermore, we hypothesized that the clinical validity of this disease-specific measure is better as compared with the EuroQol-5-dimensional (EQ-5D), a standardized generic instrument. Data on 711 consecutive PAD patients undergoing surgery were collected from 11 Dutch hospitals in 2004. At 3-year follow-up, questionnaires including the PAQ, EQ-5D, and EuroQol-Visual Analogue Scale (EQ VAS) were completed in 84% of survivors. The PAQ was analyzed according to three domains, as established by a factor analyses in the Dutch population, and the summary score. Baseline clinical indices included the presence and severity of claudication intermittent (CI) and the Lee Cardiac Risk Index. All three PAQ domains (Physical Function, Perceived Disability, and Treatment Satisfaction) were significantly associated with CI symptoms (P values PAQ summary scores as compared with asymptomatic patients (58.6 +/- 27.8 vs 68.6 +/- 27.8, P = PAQ summary score and the subscale scores for Physical Functioning and Perceived Disability demonstrated a clear dose-response relation for walking distance and the Lee Risk Index (P values PAQ proved to be good as the PAQ subscales discriminated well between patients with or without symptomatic PAD and its severity as defined by walking distance. Furthermore, the PAQ subscales were directly proportional to the presence and number of risk factors relevant

  15. Epidemiology, Pathogenesis, and Control of a Tick-Borne Disease- Kyasanur Forest Disease: Current Status and Future Directions

    Directory of Open Access Journals (Sweden)

    Syed Z. Shah

    2018-05-01

    Full Text Available In South Asia, Haemaphysalis spinigera tick transmits Kyasanur Forest Disease Virus (KFDV, a flavivirus that causes severe hemorrhagic fever with neurological manifestations such as mental disturbances, severe headache, tremors, and vision deficits in infected human beings with a fatality rate of 3–10%. The disease was first reported in March 1957 from Kyasanur forest of Karnataka (India from sick and dying monkeys. Since then, between 400 and 500 humans cases per year have been recorded; monkeys and small mammals are common hosts of this virus. KFDV can cause epizootics with high fatality in primates and is a level-4 virus according to the international biosafety rules. The density of tick vectors in a given year correlates with the incidence of human disease. The virus is a positive strand RNA virus and its genome was discovered to code for one polyprotein that is cleaved post-translationally into 3 structural proteins (Capsid protein, Envelope Glycoprotein M and Envelope Glycoprotein E and 7 non-structural proteins (NS1, NS2A, NS2B, NS3, NS4A, NS4B, and NS5. KFDV has a high degree of sequence homology with most members of the TBEV serocomplex. Alkhurma virus is a KFDV variant sharing a sequence similarity of 97%. KFDV is classified as a NIAID Category C priority pathogen due to its extreme pathogenicity and lack of US FDA approved vaccines and therapeutics; also, the infectious dose is currently unknown for KFD. In India, formalin-inactivated KFDV vaccine produced in chick embryo fibroblast is being used. Nevertheless, further efforts are required to enhance its long-term efficacy. KFDV remains an understudied virus and there remains a lack of insight into its pathogenesis; moreover, specific treatment to the disease is not available to date. Environmental and climatic factors involved in disseminating Kyasanur Forest Disease are required to be fully explored. There should be a mapping of endemic areas and cross-border veterinary

  16. Prospective population-based study of the association between vitamin D status and incidence of autoimmune disease

    DEFF Research Database (Denmark)

    Skaaby, Tea; Husemoen, Lise Lotte Nystrup; Thuesen, Betina Heinsbæk

    2015-01-01

    Beside its traditional role in skeletal health, vitamin D is believed to have multiple immunosuppressant properties, and low vitamin D status has been suggested to be a risk factor in the development of autoimmune disease. We investigated the association between vitamin D status and development...... of autoimmune disease. We included a total of 12,555 individuals from three population-based studies with measurements of vitamin D status (25-hydroxy vitamin D). We followed the participants by linkage to the Danish National Patient Register (median follow-up time 10.8 years). Relative risks of autoimmune...... disease were estimated by Cox regression and expressed as hazard ratios, HRs (95 % confidence intervals CIs). There were 525 cases of incident autoimmune disease. The risk for a 10 nmol/l higher vitamin D was: for any autoimmune disease (HR = 0.94 % CI 0.90, 0.98); thyrotoxicosis (HR = 0.83, 95 % CI 0...

  17. Socioeconomic status, health inequalities and non-communicable diseases: a systematic review.

    Science.gov (United States)

    Lago, Santiago; Cantarero, David; Rivera, Berta; Pascual, Marta; Blázquez-Fernández, Carla; Casal, Bruno; Reyes, Francisco

    2018-01-01

    A comprehensive approach to health highlights its close relationship with the social and economic conditions, physical environment and individual lifestyles. However, this relationship is not exempt from methodological problems that may bias the establishment of direct effects between the variables studied. Thus, further research is necessary to investigate the role of socioeconomic variables, their composition and distribution according to health status, particularly on non-communicable diseases. To shed light on this field, here a systematic review is performed using PubMed, the Cochrane Library and Web of Science. A 7-year retrospective horizon was considered until 21 July 2017. Twenty-six papers were obtained from the database search. Additionally, results from "hand searching" were also included, where a wider horizon was considered. Five of the 26 studies analyzed used aggregated data compared to 21 using individual data. Eleven considered income as a study variable, while 17 analyzed the effect of income inequality on health status (2 of the studies considered both the absolute level and distribution of income). The most used indicator of inequality in the literature was the Gini index. Although different types of analysis produce very different results concerning the role of health determinants, the general conclusion is that income distribution is related to health where it represents a measure of the differences in social class in the society. The effect of income inequality is to increase the gap between social classes or to widen differences in status.

  18. Modelling Status Food Security Households Disease Sufferers Pulmonary Tuberculosis Uses the Method Regression Logistics Binary

    Science.gov (United States)

    Wulandari, S. P.; Salamah, M.; Rositawati, A. F. D.

    2018-04-01

    Food security is the condition where the food fulfilment is managed well for the country till the individual. Indonesia is one of the country which has the commitment to create the food security becomes main priority. However, the food necessity becomes common thing means that it doesn’t care about nutrient standard and the health condition of family member, so in the fulfilment of food necessity also has to consider the disease suffered by the family member, one of them is pulmonary tuberculosa. From that reasons, this research is conducted to know the factors which influence on household food security status which suffered from pulmonary tuberculosis in the coastal area of Surabaya by using binary logistic regression method. The analysis result by using binary logistic regression shows that the variables wife latest education, house density and spacious house ventilation significantly affect on household food security status which suffered from pulmonary tuberculosis in the coastal area of Surabaya, where the wife education level is University/equivalent, the house density is eligible or 8 m2/person and spacious house ventilation 10% of the floor area has the opportunity to become food secure households amounted to 0.911089. While the chance of becoming food insecure households amounted to 0.088911. The model household food security status which suffered from pulmonary tuberculosis in the coastal area of Surabaya has been conformable, and the overall percentages of those classifications are at 71.8%.

  19. Degree of glutathione deficiency and redox imbalance depend on subtype of mitochondrial disease and clinical status.

    Directory of Open Access Journals (Sweden)

    Gregory M Enns

    Full Text Available Mitochondrial disorders are associated with decreased energy production and redox imbalance. Glutathione plays a central role in redox signaling and protecting cells from oxidative damage. In order to understand the consequences of mitochondrial dysfunction on in vivo redox status, and to determine how this varies by mitochondrial disease subtype and clinical severity, we used a sensitive tandem mass spectrometry assay to precisely quantify whole blood reduced (GSH and oxidized (GSSG glutathione levels in a large cohort of mitochondrial disorder patients. Glutathione redox potential was calculated using the Nernst equation. Compared to healthy controls (n = 59, mitochondrial disease patients (n = 58 as a group showed significant redox imbalance (redox potential -251 mV ± 9.7, p<0.0001 with an increased level of oxidation by ∼ 9 mV compared to controls (-260 mV ± 6.4. Underlying this abnormality were significantly lower whole blood GSH levels (p = 0.0008 and GSH/GSSG ratio (p = 0.0002, and significantly higher GSSG levels (p<0.0001 in mitochondrial disease patients compared to controls. Redox potential was significantly more oxidized in all mitochondrial disease subgroups including Leigh syndrome (n = 15, electron transport chain abnormalities (n = 10, mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (n = 8, mtDNA deletion syndrome (n = 7, mtDNA depletion syndrome (n = 7, and miscellaneous other mitochondrial disorders (n = 11. Patients hospitalized in metabolic crisis (n = 7 showed the greatest degree of redox imbalance at -242 mV ± 7. Peripheral whole blood GSH and GSSG levels are promising biomarkers of mitochondrial dysfunction, and may give insights into the contribution of oxidative stress to the pathophysiology of the various mitochondrial disorders. In particular, evaluation of redox potential may be useful in monitoring of clinical status or response to redox-modulating therapies in clinical trials.

  20. G raves’ disease – anti-thyroid autoantibodies and function thyroid status

    International Nuclear Information System (INIS)

    Slavova, M.; Rusev, T; Donchev, M.; Dekova, M.; Tsarovska, T

    2013-01-01

    Full text: Introduction: Hyperthyroidism is an autoimmune disease in the pathogenesis of which a key role play the antibodies against the thyroid stimulating hormone receptor (TRAb). The aim of this study is to analyze the immune and hormonal status in patients with Graves' disease, who are on thyreostatic therapy and in remission. Materials and methods: 67 patients were studied - 11 men and 56 women - with Graves' disease, mean age 49.7 years (range - 20-76 ). Of these, 55 were on thyreostatic therapy (two subgroups: 27 - treated up to 24 months , and 28 with relapsed disease ) and 12 were in remission up to a year. Patient's condition is assessed as a complex of clinical, biochemical, including hormonal, immune status and ultrasonography of the thyroid gland. We examined thyroid stimulating hormone, free thyroxine, free triiodothyronine, antityreoperoxidase antibodies (Anti-TPO) and TRAb. The patients on therapy are: in hyperthyroidism - 10/ 14 with subclinical hyperthyroidism - 9/8, euthyroid - 7/6 and with subclinical hypothyroidism - 1/0. Results: The patients with hyperthyroidism ( 43.6% ) in both thyreostatic therapy groups have a significantly higher average values of TRAb. The patients with subclinical hyperthyroidism and relapse showed higher levels of TRAb in comparison with those undergoing therapy to 24 months after diagnosing. The values of TRAb in the euthyroid patients in both groups of treatment were 1,5 IU / l. The Anti-TPO values were increased in 78.2% of the patients on therapy and 55.5% of those in remission. Conclusion: With the decrease of thyroid hormones during treatment of Hyperthyroidism the levels of TRAb and Anti-TPO decrease. The TRAb values are useful for the monitoring the effect of the thyreostatic treatment, determining the therapeutic approach in patients with a sustained reduction of TRAb in the course thyreostatic therapy and particularly for relapse

  1. The influence of aerobic fitness status on ventilatory efficiency in patients with coronary artery disease

    Directory of Open Access Journals (Sweden)

    Danilo M.L. Prado

    2015-01-01

    Full Text Available OBJECTIVE: To test the hypotheses that 1 coronary artery disease patients with lower aerobic fitness exhibit a lower ventilatory efficiency and 2 coronary artery disease patients with lower initial aerobic fitness exhibit greater improvements in ventilatory efficiency with aerobic exercise training. METHOD: A total of 123 patients (61.0±0.7 years with coronary artery disease were divided according to aerobic fitness status into 3 groups: group 1 (n = 34, peak VO217.5 and 24.5 ml/kg/min. All patients performed a cardiorespiratory exercise test on a treadmill. Ventilatory efficiency was determined by the lowest VE/VCO2 ratio observed. The exercise training program comprised moderate-intensity aerobic exercise performed 3 times per week for 3 months. Clinicaltrials.gov: NCT02106533 RESULTS: Before intervention, group 1 exhibited both lower peak VO2 and lower ventilatory efficiency compared with the other 2 groups (p<0.05. After the exercise training program, group 1 exhibited greater improvements in aerobic fitness and ventilatory efficiency compared with the 2 other groups (group 1: ▵ = -2.5±0.5 units; group 2: ▵ = -0.8±0.3 units; and group 3: ▵ = -1.4±0.6 units, respectively; p<0.05. CONCLUSIONS: Coronary artery disease patients with lower aerobic fitness status exhibited lower ventilatory efficiency during a graded exercise test. In addition, after 3 months of aerobic exercise training, only the patients with initially lower levels of aerobic fitness exhibited greater improvements in ventilatory efficiency.

  2. FOOD CONSUMPTION OF CIRRHOTIC PATIENTS, COMPARISON WITH THE NUTRITIONAL STATUS AND DISEASE STAGING

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    Flavia Feijó NUNES

    Full Text Available ABSTRACT Background Patients with liver disease often present protein-energy malnutrition. The assessment of food intake is very important in the investigation regarding the "health-disease" process. Objective To assess dietary intake of cirrhotic patients through food record during 3 days, correlating it with the nutritional status of the patient and the stage of the disease. Methods Cirrhotic outpatients from the Santa Casa de Misericórdia Hospital, RS, Brazil, were assessed. Nutritional assessment was performed by anthropometry; non-dominating handgrip strength; adductor pollicis muscle thickness; phase angle by bioelectrical impedance analysis; and Subjective Global Assessment. For analysis of food consumption we used the food records of 3 days using scales for weighing of all foods. Results We evaluated 25 (68% patients, in which there was a prevalence of cirrhosis by hepatitis C virus. The upper arm circumference, handgrip strength and phase angle by bioelectrical impedance analysis diagnosed 56% of malnourished. Phase angle by bioelectrical impedance analysis and upper arm circumference were associated with Child-Pugh score (P<0.05. The average consumption of calories, carbohydrates, proteins and lipids were within the recommended. However, sodium was above the recommendations, 106±57.2 mEq, and was inversely associated with Child-Pugh score (rs=-0.410; P=0.042. Conclusion Food intake did not have a significant difference between the Child-Pugh scores and nutritional status. In addition, food intake did not vary neither according to the stage of the disease, nor to the nutritional assessment, by the phase angle by bioelectrical impedance analysis.

  3. Application of DCE-MRI in evaluating lower extremity capillary endothelial function in patients with diabetes mellitus complicated by peripheral vascular disease after PTA

    International Nuclear Information System (INIS)

    Tian Hao; Zhao Jinli; Chen Xiaohua; Wu Xianhua; Li Yuehua

    2014-01-01

    Objective: To quantify endothelial function of lower extremity capillary in patients with peripheral vascular disease associated with diabetes mellitus by using DCE-MRI, and to explore the feasibility of DCE-MRI in predicting vascular restenosis in lower extremity after PTA. Methods: During the period form May 2009 to Jan. 2012, a total of 51 patients (study group) with diabetic lower extremity vascular diseases (77 diseased legs in total) were admitted to the hospital and were treated with PTA. Another 20 volunteers were used as control group. K-trans values were measured in soleus muscle using DCE-MRI. Based on the results after 6 months follow-up, the patients were classified into restenosis group and non-restenosis group. The K -trans values and others clinical data were compared between the two groups. Results: Although clinical symptoms and signs were improved in both groups after the treatment, K-trans value of restenosis group showed no obvious changes after PTA, while K-trans value of non-restenosis group was improved significantly. Before PTA, the difference in K -trans value between the two groups was not statistically significant, while K-trans values of the two groups were significantly lower than that of the control group (P<0.05). Conclusion: K-trans value can reflect the endothelial function in diabetes mellitus patients with peripheral vascular disease, and it can also predict the occurrence of restenosis, providing a useful evidence for clinical. therapy. (authors)

  4. What are the antioxidant status predictors' factors among male chronic obstructive pulmonary disease (COPD) patients?

    Science.gov (United States)

    Pirabbasi, Elham; Najafiyan, Mahin; Cheraghi, Maria; Shahar, Suzana; Abdul Manaf, Zahara; Rajab, Norfadilah; Abdul Manap, Roslina

    2012-11-04

    Imbalance between antioxidant and oxidative stress is a major risk factor for pathogenesis of some chronic diseases such as chronic obstructive pulmonary disease (COPD). This study aimed to determine antioxidant and oxidative stress status, and also theirs association with respiratory function of male COPD patients to find the antioxidant predictors' factors. A total of 149 subjects were involved in a cross-sectional study. The study was conducted at two medical centers in Kuala Lumpur, Malaysia. Results of the study showed that plasma vitamin C was low in most of the subjects (86.6%). Total antioxidant capacity was the lowest in COPD stage IV compare to other stages (p < 0.05). Level of plasma vitamin A (p= 0.012) and vitamin C (p= 0.007) were low in malnourished subjects. The predictors for total antioxidant capacity were forced vital capacity (FVC) % predicted and intake of ?-carotene (R2= 0.104, p= 0.002). Number of cigarette (pack/ year) and smoking index (number/ year) were not associated with total antioxidant capacity of this COPD population. Plasma oxidative stress as assessed plasma lipid peroxidation (LPO) was only positively correlated with plasma glutathione (p= 0.002). It might be a need to evaluate antioxidant status especially in older COPD patients to treat antioxidant deficiency which is leading to prevent COPD progression.

  5. Ensuring good nutritional status in patients with Parkinson's disease: challenges and solutions

    Directory of Open Access Journals (Sweden)

    Baroni L

    2014-12-01

    Full Text Available Luciana Baroni,1 Cristina Zuliani2 1Primary Care Unit, Northern District, Azienda ULSS 9 Treviso, Italy; 2Department of Neurology, General Hospital, Mirano, Venice, Italy Abstract: Nutrition is becoming an important tool in the management of the main chronic diseases, including Parkinson's disease (PD. Nutritional status has been shown to deteriorate with the progression of PD, due to motor and nonmotor complications. Dietary protein can reduce the effectiveness of levodopa treatment in PD patients, since the large neutral amino acids and levodopa share the same saturated carrier system, while fiber can improve the drug bioavailability. Moreover, nutrition seems to be directly involved in PD risk: high dietary intakes of animal fat, iron, mercury, and dairy, as well as western dietary patterns can increase it, while intake of some antioxidant compounds and plant-based dietary patterns can be protective. The means of ensuring good nutritional status in PD range from providing adequate energy and nutrients for the body, to considering in a broader perspective, the management of motor and nonmotor symptoms and chronic levodopa treatment complications, as well as pursuing potential neuroprotection. This review summarizes the most relevant results in the literature, and discusses the contribution of diet in the management of PD. Keywords: levodopa, Mediterranean diet, plant-based diet, protein-redistribution diet, vegetarian diet

  6. Nutritional Risk, Micronutrient Status and Clinical Outcomes: A Prospective Observational Study in an Infectious Disease Clinic

    Directory of Open Access Journals (Sweden)

    Oguzhan Sıtkı Dizdar

    2016-02-01

    Full Text Available Malnutrition has been associated with increased morbidity and mortality. The objective of this study was to determine the nutritional status and micronutrient levels of hospitalized patients in an infectious disease clinic and investigate their association with adverse clinical outcomes. The nutritional status of the study participants was assessed using the Nutritional Risk Screening 2002 (NRS 2002 and micronutrient levels and routine biochemical parameters were tested within the first 24 h of the patient’s admission. The incidence of zinc, selenium, thiamine, vitamin B6, vitamin B12 deficiency were 66.7% (n = 40, 46.6% (n = 29, 39.7% (n = 27, 35.3% (n = 24, 14.1% (n = 9, respectively. Selenium levels were significantly higher in patients with urinary tract infections, but lower in soft tissue infections. Copper levels were significantly higher in patients with soft tissue infections. In the Cox regression models, lower albumin, higher serum lactate dehydrogenase levels and higher NRS-2002 scores were associated with increased death. Thiamine, selenium, zinc and vitamin B6 deficiencies but not chromium deficiencies are common in infectious disease clinics. New associations were found between micronutrient levels and infection type and their adverse clinical outcomes. Hypoalbuminemia and a high NRS-2002 score had the greatest accuracy in predicting death, systemic inflammatory response syndrome and sepsis on admission.

  7. Association between blood cholesterol level with periodontal status of coronary heart disease patients

    Science.gov (United States)

    Valensia, Rosy; Masulili, Sri Lelyati C.; Lessang, Robert; Radi, Basuni

    2017-02-01

    Coronary heart disease (CHD) is an abnormal narrowing of heart arteries associated with local accumulation of lipids, in the form of cholesterol and triglycerides. Periodontal disease is a chronic inflammatory that suggests link to the development of CHD. In periodontitis have been reported changes in lipid profile, include increased of cholesterol levels of blood. Objective: to analyse correlation between blood cholesterol level with periodontal status of CHD and non CHD subjects. Methods: Periodontal status and blood cholesterol level of 60 CHD and 40 non CHD subjects was measured. Result: Blood cholesterol level in CHD subjects differs from non CHD subjects (p=0.032). Blood cholesterol level correlates with pocket depth (p=0.003) and clinical attachment loss (CAL) (p=0.000) in CHD subjects. Blood cholesterol level correlates with pocket depth (p=0.010) in non CHD subjects. There is no significant correlation between blood cholesterol level and bleeding on probing (BOP) in CHD subjects. There is no significant correlation between blood cholesterol level with BOP and CAL in non CHD subjects. Conclusion: Blood cholesterol level in control group is higher than CHD patients. Blood cholesterol level positively associated with pocket depth (r=0.375) and CAL (r=0.450) in CHD patients. Blood cholesterol level is positively associated with pocket depth (r=0.404) in control group.

  8. Educational status and beliefs regarding non-communicable diseases among children in Ghana.

    Science.gov (United States)

    Badasu, Delali M; Abuosi, Aaron A; Adzei, Francis A; Anarfi, John K; Yawson, Alfred E; Atobrah, Deborah A

    2018-03-05

    Increasing prevalence of non-communicable diseases (NCDs) has been observed in Ghana as in other developing countries. Past research focused on NCDs among adults. Recent researches, however, provide evidence on NCDs among children in many countries, including Ghana. Beliefs about the cause of NCDs among children may be determined by the socioeconomic status of parents and care givers. This paper examines the relationship between educational status of parents and/or care givers of children with NCDs on admission and their beliefs regarding NCDs among children. A total of 225 parents and/or care givers of children with NCDS hospitalized in seven hospitals in three regions (Greater Accra, Ashanti and Volta) were selected for the study. Statistical techniques, including the chi-square and multinomial logistic regression, were used for the data analysis. Educational status is a predictor of care giver's belief about whether enemies can cause NCDs among children or not. This is the only belief with which all the educational categories have significant relationship. Also, post-secondary/polytechnic (p-value =0.029) and university (p-value = 0.009) levels of education are both predictors of care givers being undecided about the belief that NCDs among children can be caused by enemies, when background characteristics are controlled for. Significant relationship is found between only some educational categories regarding the other types of beliefs and NCDs among children. For example, those with Middle/Juniour Secondary School (JSS)/Juniour High School (JHS) education are significantly undecided about the belief that the sin of parents can cause NCDs among children. Education is more of a predictor of the belief that enemies can cause NCDs among children than the other types of beliefs. Some categories of ethnicity, residential status and age have significant relationship with the beliefs when background characteristics of the parents and/or care givers were controlled

  9. Differences in nutritional status between very mild Alzheimer's disease patients and healthy controls.

    Science.gov (United States)

    Olde Rikkert, Marcel G M; Verhey, Frans R; Sijben, John W C; Bouwman, Femke H; Dautzenberg, Paul L J; Lansink, Mirian; Sipers, Walther M W; van Asselt, Dieneke Z B; van Hees, Anneke M J; Stevens, Martijn; Vellas, Bruno; Scheltens, Philip

    2014-01-01

    Studies on the systemic availability of nutrients and nutritional status in Alzheimer's disease (AD) are widely available, but the majority included patients in a moderate stage of AD. This study compares the nutritional status between mild AD outpatients and healthy controls. A subgroup of Dutch drug-naïve patients with mild AD (Mini-Mental State Examination (MMSE) ≥20) from the Souvenir II randomized controlled study (NTR1975) and a group of Dutch healthy controls were included. Nutritional status was assessed by measuring levels of several nutrients, conducting the Mini Nutritional Assessment (MNA®) questionnaire and through anthropometric measures. In total, data of 93 healthy cognitively intact controls (MMSE 29.0 [23.0-30.0]) and 79 very mild AD patients (MMSE = 25.0 [20.0-30.0]) were included. Plasma selenium (p < 0.001) and uridine (p = 0.046) levels were significantly lower in AD patients, with a similar trend for plasma vitamin D (p = 0.094) levels. In addition, the fatty acid profile in erythrocyte membranes was different between groups for several fatty acids. Mean MNA screening score was significantly lower in AD patients (p = 0.008), but not indicative of malnutrition risk. No significant differences were observed for other micronutrient or anthropometric parameters. In non-malnourished patients with very mild AD, lower levels of some micronutrients, a different fatty acid profile in erythrocyte membranes and a slightly but significantly lower MNA screening score were observed. This suggests that subtle differences in nutrient status are present already in a very early stage of AD and in the absence of protein/energy malnutrition.

  10. Association between childhood allergic diseases, educational attainment and occupational status in later life: systematic review protocol

    Science.gov (United States)

    von Kobyletzki, Laura Beate; Beckman, Linda; Smeeth, Liam; McKee, Martin; Abuabara, Katrina; Langan, Sinead

    2017-01-01

    Introduction Childhood allergic diseases may prevent affected children from achieving their academic potential. Potential mechanisms include absence from school due to illness and medical appointments. Experience of symptoms in classes or leisure time, and stigma associated with visible signs and symptoms, including skin disease, requirements for medication during school time or the need for specific diets, may also contribute to reduced educational attainment. Studies have investigated the association between specific allergic diseases and educational attainment. The aim of this study is to systematically review the literature on allergic diseases, educational attainment and occupational status, and if possible, calculate meta-analytic summary estimates for the associations. Methods Systematic electronic searches in Medline, EMBASE, Cochrane, Cumulative Index to Nursing & Allied Health Literature (CINAHL), PsycINFO and education Resources Information Center (ERIC); hand search in reference lists of included papers and conference reports; search for unpublished studies in clinical trial registers and the New York Academy of Medicine Grey Literature Report; data extraction; and study quality assessment (Newcastle-Ottawa Scale) will be performed. Analysis Data will be summarised descriptively, and meta-analysis including meta-regression to explore sources of heterogeneities will be performed if possible. Ethics and dissemination Dissemination in a peer-reviewed, open-access, international scientific journal is planned. PROSPERO registration number CRD42017058036. PMID:29025838

  11. Host transcriptional responses following ex vivo re-challenge with Mycobacterium tuberculosis vary with disease status.

    Directory of Open Access Journals (Sweden)

    Elaine A Yu

    Full Text Available The identification of immune correlates that are predictive of disease outcome for tuberculosis remains an ongoing challenge. To address this issue, we evaluated gene expression profiles from peripheral blood mononuclear cells following ex vivo challenge with Mycobacterium tuberculosis, among participants with active TB disease (ATBD, n = 10, latent TB infection (LTBI, n = 10, and previous active TB disease (after successful treatment; PTBD, n = 10, relative to controls (n = 10. Differential gene expression profiles were assessed by suppression-subtractive hybridization, dot blot, real-time polymerase chain reaction, and the comparative cycle threshold methods. Comparing ATBD to control samples, greater fold-increases of gene expression were observed for a number of chemotactic factors (CXCL1, CXCL3, IL8, MCP1, MIP1α. ATBD was also associated with higher IL1B gene expression, relative to controls. Among LTBI samples, gene expression of several chemotactic factors (CXCL2, CXCL3, IL8 was similarly elevated, compared to individuals with PTBD. Our results demonstrated that samples from participants with ATBD and LTBI have distinct gene expression profiles in response to ex vivo M. tuberculosis infection. These findings indicate the value in further characterizing the peripheral responses to M. tuberculosis challenge as a route to defining immune correlates of disease status or outcome.

  12. Host transcriptional responses following ex vivo re-challenge with Mycobacterium tuberculosis vary with disease status.

    Science.gov (United States)

    Yu, Elaine A; John, Serene H; Tablante, Elizabeth C; King, Christine A; Kenneth, John; Russell, David G; Mehta, Saurabh

    2017-01-01

    The identification of immune correlates that are predictive of disease outcome for tuberculosis remains an ongoing challenge. To address this issue, we evaluated gene expression profiles from peripheral blood mononuclear cells following ex vivo challenge with Mycobacterium tuberculosis, among participants with active TB disease (ATBD, n = 10), latent TB infection (LTBI, n = 10), and previous active TB disease (after successful treatment; PTBD, n = 10), relative to controls (n = 10). Differential gene expression profiles were assessed by suppression-subtractive hybridization, dot blot, real-time polymerase chain reaction, and the comparative cycle threshold methods. Comparing ATBD to control samples, greater fold-increases of gene expression were observed for a number of chemotactic factors (CXCL1, CXCL3, IL8, MCP1, MIP1α). ATBD was also associated with higher IL1B gene expression, relative to controls. Among LTBI samples, gene expression of several chemotactic factors (CXCL2, CXCL3, IL8) was similarly elevated, compared to individuals with PTBD. Our results demonstrated that samples from participants with ATBD and LTBI have distinct gene expression profiles in response to ex vivo M. tuberculosis infection. These findings indicate the value in further characterizing the peripheral responses to M. tuberculosis challenge as a route to defining immune correlates of disease status or outcome.

  13. Self-rated health mediates the association between functional status and health-related quality of life in Parkinson's disease

    NARCIS (Netherlands)

    Saeedian, Radka Ghorbani; Nagyova, Iveta; Klein, Daniel; Skorvanek, Matej; Rosenberger, Jaroslav; Gdovinova, Zuzana; Groothoff, Johan W.; van Dijk, Jitze

    Aims and objectives To explore whether self-rated health acts as a potential mediator in the association between functional status and health-related quality of life in Parkinson's disease. Background Older persons (as most patients with Parkinson's disease are) who reported poor self-rated health

  14. Current status of PET imaging in Huntington's disease

    International Nuclear Information System (INIS)

    Pagano, Gennaro; Niccolini, Flavia; Politis, Marios

    2016-01-01

    To review the developments of recent decades and the current status of PET molecular imaging in Huntington's disease (HD). A systematic review of PET studies in HD was performed. The MEDLINE, Web of Science, Cochrane and Scopus databases were searched for articles in all languages published up to 19 August 2015 using the major medical subject heading ''Huntington Disease'' combined with text and key words ''Huntington Disease'', ''Neuroimaging'' and ''PET''. Only peer-reviewed, primary research studies in HD patients and premanifest HD carriers, and studies in which clinical features were described in association with PET neuroimaging results, were included in this review. Reviews, case reports and nonhuman studies were excluded. A total of 54 PET studies were identified and analysed in this review. Brain metabolism ([ 18 F]FDG and [ 15 O]H 2 O), presynaptic ([ 18 F]fluorodopa, [ 11 C]β-CIT and [ 11 C]DTBZ) and postsynaptic ([ 11 C]SCH22390, [ 11 C]FLB457 and [ 11 C]raclopride) dopaminergic function, phosphodiesterases ([ 18 F]JNJ42259152, [ 18 F]MNI-659 and [ 11 C]IMA107), and adenosine ([ 18 F]CPFPX), cannabinoid ([ 18 F]MK-9470), opioid ([ 11 C]diprenorphine) and GABA ([ 11 C]flumazenil) receptors were evaluated as potential biomarkers for monitoring disease progression and for assessing the development and efficacy of novel disease-modifying drugs in premanifest HD carriers and HD patients. PET studies evaluating brain restoration and neuroprotection were also identified and described in detail. Brain metabolism, postsynaptic dopaminergic function and phosphodiesterase 10A levels were proven to be powerful in assessing disease progression. However, no single technique may be currently considered an optimal biomarker and an integrative multimodal imaging approach combining different techniques should be developed for monitoring potential neuroprotective and preventive treatment

  15. Mandelbrot's Extremism

    NARCIS (Netherlands)

    Beirlant, J.; Schoutens, W.; Segers, J.J.J.

    2004-01-01

    In the sixties Mandelbrot already showed that extreme price swings are more likely than some of us think or incorporate in our models.A modern toolbox for analyzing such rare events can be found in the field of extreme value theory.At the core of extreme value theory lies the modelling of maxima

  16. Patent and exclusivity status of essential medicines for non-communicable disease.

    Directory of Open Access Journals (Sweden)

    Tim K Mackey

    Full Text Available OBJECTIVE: The threat of non-communicable diseases ("NCDs" is increasingly becoming a global health crisis and are pervasive in high, middle, and low-income populations resulting in an estimated 36 million deaths per year. There is a need to assess intellectual property rights ("IPRs" that may impede generic production and availability and affordability to essential NCD medicines. METHODS: Using the data sources listed below, the study design systematically eliminated NCD drugs that had no patent/exclusivity provisions on API, dosage, or administration route. The first step identified essential medicines that treat certain high disease burden NCDs. A second step examined the patent and exclusivity status of active ingredient, dosage and listed route of administration using exclusion criteria outlined in this study. MATERIALS: We examined the patent and exclusivity status of medicines listed in the World Health Organization's ("WHO" Model List of Essential Drugs (Medicines ("MLEM" and other WHO sources for drugs treating certain NCDs. i.e., cardiovascular and respiratory disease, cancers, and diabetes. We utilized the USA Food and Drug Administration Orange Book and the USA Patent and Trademark Office databases as references given the predominant number of medicines registered in the USA. RESULTS: Of the 359 MLEM medicines identified, 22% (79/359 address targeted NCDs. Of these 79, only eight required in-depth patent or exclusivity assessment. Upon further review, no NCD MLEM medicines had study patent or exclusivity protection for reviewed criteria. CONCLUSIONS: We find that ensuring availability and affordability of potential generic formulations of NCD MLEM medicines appears to be more complex than the presence of IPRs with API, dosage, or administration patent or exclusivity protection. Hence, more sophisticated analysis of NCD barriers to generic availability and affordability should be conducted in order to ensure equitable access to global

  17. [COMPARISON OF INTRAOPERATIVE SCLEROOBLITERATION AND ECHOSCLEROOBLITERATION EFFICIENCY OF VARICOSE DISEASES OF THE LOWER EXTREMITIES C6 CLASS IN PATIENTS BY TYPE II DIABETES MELLITUS].

    Science.gov (United States)

    Palamarchuk, V I; Odnorog, S I; Gvozdyak, M M; Vilgash, A M

    2015-06-01

    The experience of surgical treatment of 50 patients for varicose disease of lower extremities, complicated by trophic ulcers, in the presence of diabetes mellitus type II were analysed. During surgery in patients of the 1st group performed a combined phlebectomy, group 2--scleroobliteration and echoscleroobliteration. Using fleboscleroobliteration method helped reduce the frequency of early postoperative complications in (6.5 +/- 1.3) times.

  18. Definitive Radiotherapy for Ewing Tumors of Extremities and Pelvis: Long-Term Disease Control, Limb Function, and Treatment Toxicity

    International Nuclear Information System (INIS)

    Indelicato, Daniel J.; Keole, Sameer R.; Shahlaee, Amir H.; Shi Wenyin; Morris, Christopher G.; Marcus, Robert B.

    2008-01-01

    Purpose: More than 70% of Ewing tumors occur in the extremities and pelvis. This study identified factors influencing local control and functional outcomes after management with definitive radiotherapy (RT). Patients and Methods: A total of 75 patients with a localized Ewing tumor of the extremity or pelvis were treated with definitive RT at the University of Florida between 1970 and 2006 (lower extremity tumors in 30, pelvic tumors in 26, and upper extremity tumors in 19). RT was performed on a once-daily (40%) or twice-daily (60%) basis. The median dose was 55.2 Gy in 1.8-Gy daily fractions or 55.0 Gy in 1.2-Gy twice-daily fractions. The median observed follow-up was 4.7 years. Functional outcome was assessed using the Toronto Extremity Salvage Score. Results: The 10-year actuarial overall survival, cause-specific survival, freedom from relapse, and local control rate was 48%, 48%, 42%, and 71%, respectively. Of the 72 patients, 3 required salvage amputation. Inferior cause-specific survival was associated with larger tumors (81% for tumors 3 . Conclusions: Limb preservation was effectively achieved through definitive RT. Treating limited field sizes with hyperfractionated high-energy RT could minimize long-term complications and provides superior functional outcomes

  19. Use of expert opinion for animal disease decisions: an example of foot-and-mouth disease status designation.

    Science.gov (United States)

    Garabed, R B; Perez, A M; Johnson, W O; Thurmond, M C

    2009-11-01

    When data representing a preferred measurement of risk cannot be obtained, as is often the case for global animal diseases, decisions that affect millions of people and their animals are typically made based on expert opinion. Expert opinion can be and has been used to address the critical lack of data existing for prevalence and incidence of many global diseases, including foot-and-mouth disease (FMD). However, when a conclusion based on expert opinion applies to a topic as sensitive as FMD, which has tremendous economic, political, and social implications, care should be taken to understand the accuracy of and differences in the opinion data. The differences in experts' opinions and the relative accuracy of an expert opinion elicitation for "diagnosing" country-level FMD presence were examined for the years 1997-2003 using Bayesian methods. A formal survey of eight international FMD experts revealed that individual experts had different opinions as to the probability of finding FMD in a country. However, a weighted average of the experts' responses was relatively accurate (91% sensitivity and 85% specificity) at identifying the FMD status of a country, compared to using a method that employed information available from World Organization for Animal Health (OIE). The most apparent disagreements between individual experts and available information were found for Indonesia, South Korea, and South America, and, in general, the experts seemed to believe that countries in South Asia were more likely to be positive than other countries that reported FMD cases to OIE. This study highlights new methodology that offers a standardized, quantitative, and systematic means by which expert opinion can be used and assessed.

  20. Risk factors for heart disease and stroke among diabetic persons, by disability status.

    Science.gov (United States)

    Okoro, Catherine A; Denny, Clark H; Greenlund, Kurt J; Benjamin, Stephanie M; Strine, Tara W; Balluz, Lina S; Mokdad, Ali H

    2005-01-01

    To determine whether disabled diabetic persons have a higher prevalence of risk factors for heart disease and stroke than do diabetic persons without disability. RESEARCH, DESIGN, AND METHODS: Data were analyzed for noninstitutionalized adults in 27 states and the District of Columbia that participated in the Behavioral Risk Factor Surveillance System (BRFSS) in 2001 and/or 2003. Logistic regression analysis was used to estimate the adjusted prevalence and odds ratios of disabled diabetic persons, by sociodemographic characteristics. The logit form of each model was used to estimate conditional marginal probabilities of risk factors for heart disease and stroke among diabetic persons, by disability status. Diabetic persons with disability were more likely than those without disability to have more risk factors for heart disease and stroke, including insufficient leisure-time physical activity or inactivity (adjusted prevalence: 75.2% vs. 63.3%; Pvs. 43.3%; Pvs. 48.4%; P=.038), and hypertension (63.9% vs. 56.6%; Ptwo or more, three or more, and four or more risk factors (97.2% vs. 95.6%, 83.5% vs. 74.0%, 56.5% vs. 41.1%, and 22.2% vs. 13.6%, respectively; Pstroke. Health care guidelines specifically targeting diabetic patients with disability may be needed to aid health care providers in addressing these risk factors.

  1. Creutzfeldt-Jakob Disease Presenting as Expressive Aphasia and Nonconvulsive Status Epilepticus

    Directory of Open Access Journals (Sweden)

    Hafiz B. Mahboob

    2018-01-01

    Full Text Available Creutzfeldt-Jakob disease (CJD, the most common form of human prion diseases, is a fatal condition with a mortality rate reaching 85% within one year of clinical presentation. CJD is characterized by rapidly progressive neurological deterioration in combination with typical electroencephalography (EEG and magnetic resonance imaging (MRI findings and positive cerebrospinal spinal fluid (CSF analysis for 14-3-3 proteins. Unfortunately, CJD can have atypical clinical and radiological presentation in approximately 10% of cases, thus making the diagnosis often challenging. We report a rare clinical presentation of sporadic CJD (sCJD with combination of both expressive aphasia and nonconvulsive status epilepticus. This patient presented with slurred speech, confusion, myoclonus, headaches, and vertigo and succumbed to his disease within ten weeks of initial onset of his symptoms. He had a normal initial diagnostic workup, but subsequent workup initiated due to persistent clinical deterioration revealed CJD with typical MRI, EEG, and CSF findings. Other causes of rapidly progressive dementia and encephalopathy were ruled out. Though a rare condition, we recommend consideration of CJD on patients with expressive aphasia, progressive unexplained neurocognitive decline, and refractory epileptiform activity seen on EEG. Frequent reimaging (MRI, video EEGs and CSF examination might help diagnose this fatal condition earlier.

  2. Quantitative assessment of clinical disease status in primary Sjögren's syndrome

    DEFF Research Database (Denmark)

    Asmussen, K.; Andersen, V.; Bendixen, Gunnar

    1999-01-01

    ophthalmology, Sjögren's syndrome, terminology, classification criteria, status indices, immunoinflammation, cytokines......ophthalmology, Sjögren's syndrome, terminology, classification criteria, status indices, immunoinflammation, cytokines...

  3. Circumcision status and incident herpes simplex virus type 2 infection, genital ulcer disease, and HIV infection

    Science.gov (United States)

    Mehta, Supriya D.; Moses, Stephen; Parker, Corette B.; Agot, Kawango; Maclean, Ian; Bailey, Robert C.

    2013-01-01

    Objective We assessed the protective effect of medical male circumcision (MMC) against HIV, herpes simplex virus type 2 (HSV-2), and genital ulcer disease (GUD) incidence. Design Two thousand, seven hundred and eighty-seven men aged 18–24 years living in Kisumu, Kenya were randomly assigned to circumcision (n=1391) or delayed circumcision (n =1393) and assessed by HIV and HSV-2 testing and medical examinations during follow-ups at 1, 3, 6, 12, 18, and 24 months. Methods Cox regression estimated the risk ratio of each outcome (incident HIV, GUD, HSV-2) for circumcision status and multivariable models estimated HIV risk associated with HSV-2, GUD, and circumcision status as time-varying covariates. Results HIV incidence was 1.42 per 100 person-years. Circumcision was 62% protective against HIV [risk ratio =0.38; 95% confidence interval (CI) 0.22–0.67] and did not change when controlling for HSV-2 and GUD (risk ratio =0.39; 95% CI 0.23–0.69). GUD incidence was halved among circumcised men (risk ratio =0.52; 95% CI 0.37–0.73). HSV-2 incidence did not differ by circumcision status (risk ratio =0.94; 95% CI 0.70–1.25). In the multivariable model, HIV seroconversions were tripled (risk ratio =3.44; 95% CI 1.52–7.80) among men with incident HSV-2 and seven times greater (risk ratio =6.98; 95% CI 3.50–13.9) for men with GUD. Conclusion Contrary to findings from the South African and Ugandan trials, the protective effect of MMC against HIV was independent of GUD and HSV-2, and MMC had no effect on HSV-2 incidence. Determining the causes of GUD is necessary to reduce associated HIV risk and to understand how circumcision confers protection against GUD and HIV PMID:22382150

  4. The effect of extremity strength training on fibromyalgia symptoms and disease impact in an existing multidisciplinary treatment program.

    Science.gov (United States)

    Kas, Tamara; Colby, Megan; Case, Maureen; Vaughn, Dan

    2016-10-01

    The purpose of this study was to examine the effect of upper and lower body extremity strengthening exercise in patients with Fibromyalgia (FM) within an existing multidisciplinary treatment program. Patients between the ages of 18-65 with the medical diagnosis of FM. Comparative study design. The control and experimental group received the same multidisciplinary treatment except that the experimental group performed upper and lower extremity strengthening exercises. The Fibromyalgia Impact Questionnaire (FIQ) was administered at evaluation and discharge from the program in order to measure change in quality of life (QOL). Statistically significant changes in FIQ scores were found for both groups. The addition of extremity strengthening in the experimental group produced an average 4 points greater reduction in FIQ score, however, these results are not considered statistically significant. This study appears to validate the success of a multidisciplinary approach in treating patients with FM, with the possibility for further benefit with the addition of extremity strengthening. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Present status of doctors' awareness for radiation-induced carotid artery disease in Japan

    International Nuclear Information System (INIS)

    Taguchi, Yoshiharu; Takashima, Shutaro; Tanaka, Kortaro

    2013-01-01

    Radiation-induced carotid artery disease (RCAD) often develops in patients who have received neck radiotherapy for the treatment of various malignant tumors. However, the doctors who ordered or performed neck radiotherapy seem to pay little attention to RCAD which may subsequently occur, and the present status of the awareness in these doctors for RCAD is unclear in Japan. Therefore, we conducted a questionnaire survey of the present status of these doctors' awareness for RCAD. A questionnaire form regarding the recognition of RCAD was sent to 368 departments of otolaryngology, oral surgery, or radiology of university hospitals in Japan. Responses to the questionnaire were received from 213 of the 368 departments of otolaryngology, oral surgery or radiology of university hospitals (response collection rate: 57.9%). One hundred and sixty-one departments (75.9%) were aware of the existence of RCAD, but only 20 departments (9.4%) conducted regular examinations for RCAD after neck radiotherapy such as ultrasound neck echography and MR angiography. Only 6.3% departments took preventive measures for RCAD such as reduction in radiation dose or administration of antiplatelets. The present survey revealed that many patients who had undergone neck radiotherapy for the treatment of malignancy did not receive proper medical attention for RCAD in Japan. Healthcare providers should be given adequate education about RCAD including its risk factors, possible preventive measures, diagnostic modalities, and treatment. Furthermore, a systematic clinical network should be established in which stroke specialists conduct proper examinations for early diagnosis of RCAD. (author)

  6. Cardiovascular disease by diabetes status in five ethnic minority groups compared to ethnic Norwegians

    Directory of Open Access Journals (Sweden)

    Diep Lien M

    2011-07-01

    Full Text Available Abstract Background The population in Norway has become multi-ethnic due to migration from Asia and Africa over the recent decades. The aim of the present study was to explore differences in the self-reported prevalence of cardiovascular disease (CVD and associated risk factors by diabetes status in five ethnic minority groups compared to ethnic Norwegians. Methods Pooled data from three population-based cross-sectional studies conducted in Oslo between 2000 and 2002 was used. Of 54,473 invited individuals 24,749 (45.4% participated. The participants self-reported health status, underwent a clinical examination and blood samples were drawn. A total of 17,854 individuals aged 30 to 61 years born in Norway, Sri-Lanka, Pakistan, Iran, Vietnam or Turkey were included in the study. Chi-square tests, one-way ANOVAs, ANCOVAs, multiple and logistic regression were used. Results Age- and gender-standardized prevalence of self-reported CVD varied between 5.8% and 8.2% for the ethnic minority groups, compared to 2.9% among ethnic Norwegians (p Conclusions Ethnic differences in the prevalence of CVD were prominent for individuals without diabetes. Primary CVD prevention including identification of undiagnosed diabetes should be prioritized for ethnic minorities without known diabetes.

  7. Protein intake, nitrogen balance and nutritional status in patients with Parkinson's disease; time for a change?

    Science.gov (United States)

    Zilli Canedo Silva, Maryanne; Carol Fritzen, Natali; de Oliveira, Marlon; Paes da Silva, Michel; Rasmussen Petterle, Ricardo; Teive, Hélio Afonso; de Mesquita Barros Almeida Leite, Christiane; Rabito, Estela Iraci; Madalozzo Schieferdecker, Maria Eliana; Carvalho, Mauricio

    2015-06-01

    To evaluate protein intake, nitrogen balance and nutritional status of clinically stable patients with Parkinson's disease (PD). A cross-sectional study of PD patients Hoehn-Yahr scale stage 1-3 and subjects with no neurologic disease (controls) matched for age and gender. All participants underwent a diet history interview, anthropometric measurements, bioelectrical impedance and food record over three non-consecutive days, including a weekend. A 24-hour urine collection and fasting venous blood sampling were collected from the participants for evaluation of creatinine clearance, creatinine height index and the nitrogen balance. The mean age of PD patients was 58.9 ± 12.8 year compared to 54.7 ± 12.6 year of the controls, P = 0.34. One third of PD group had symptoms of dysphagia and ingested less water and fibers when compared to controls. Calf circumference was small in PD group (35.5 ± 2.8 vs. 38.4 ± 3.5 cm, P = 0.012). Intake of nitrogen was significantly lower and nitrogen balance was negative in PD patients (-1.8 ± 3.9 vs. 1.1 ± 4.2 controls, P = 0.06). The antioxidants folate and vitamin E were consumed in small amounts in both groups, although significantly less in PD patients (P = 0.04 and 0.03, respectively). Daily intakes of protein of approximately 1.1 g/kg by clinically stable PD patients may not be enough to ensure a neutral calorie-nitrogen balance and muscle tissue conservation. Larger studies are necessary to provide a more comprehensive picture of PD patients' metabolic status. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  8. Diseases of the circulatory system: health status and perspectives for changes

    Directory of Open Access Journals (Sweden)

    V. I. Klimenko

    2014-02-01

    Full Text Available During last 20 years rates of incidence and prevalence of diseases of the circulatory system in Ukraine have been growing from year to year and became problems of current interest. According to the program of WHO, realization of diseases prevention is provided by using of scientific justification and monitoring of health indexes, including diseases of the circulatory system. Goal of our research was to analyze health status of population of Zaporozhye region concerning cardiovascular diseases. Data since 1995 to 2012 y. were taken in the Center of medical statistics of Zaporozhye region. Comparative analysis of obtained data was conducted in dynamics and with definition of specific weight of able to work population in structure of indexes and gender differences. In article we showed, that on the background of depopulation of Ukraine during last 20 years, prevalence of diseases of the circulatory system increased by 2 times, and level of mortality from them increased for 45%. Specific weight of mortality from diseases of the circulatory system among adult population (state for 01.2013 y. in Ukraine was 65,7%, in Zaporozhye region – 63,6%, among able to work population – 30,5%, in Zaporozhye region – 33,4%, but mortality among able to work men in Zaporozhye region was in 5,5 times higher than in women. Specific weight of the diseases of the circulatory system in structure of general morbidity in total population in Ukraine was 31,5%, among able to work population – 24,1%; among total population of Zaporozhye region – 36,6% (in town – 35,0%; in country region – 39,8%, among able to work population of Zaporozhye region – 24,6% (in town – 22,8%; in country region – 27,6%. Structure of general morbidity of the cardiovascular diseases during last 10 years in Ukraine and in Zaporozhye region is stable. Leading place belongs to arterial hypertension: 56,1%- in Ukraine, 57,7 % - in Zaporozhye region. Comparing to Ukraine, before 2005 y

  9. Assessing Health Status in Inflammatory Bowel Disease using a Novel Single-Item Numeric Rating Scale

    Science.gov (United States)

    Surti, Bijal; Spiegel, Brennan; Ippoliti, Andrew; Vasiliauskas, Eric; Simpson, Peter; Shih, David; Targan, Stephan; McGovern, Dermot; Melmed, Gil Y.

    2014-01-01

    Background Current instruments used to measure disease activity and health-related quality of life (HRQOL) in patients with Crohn’s disease (CD) and ulcerative colitis (UC) are often cumbersome, time-consuming, and expensive; although used in clinical trials, they are not convenient for clinical practice. A numeric rating scale (NRS) is a quick, inexpensive, and convenient patient-reported outcome (PRO) that can capture the patient’s overall perception of health. Aims To assess the validity, reliability, and responsiveness of an NRS and evaluate its use in clinical practice in patients with CD and UC. Methods We prospectively evaluated patient-reported NRS scores and measured correlations between NRS and a range of severity measures, including physician-reported NRS, Crohn’s disease activity index (CDAI), Harvey-Bradshaw index (HBI), inflammatory bowel disease questionnaire (IBDQ), and C-reactive protein (CRP) in patients with CD. Subsequently, we evaluated the correlation between the NRS and standard measures of health status (HBI or simple colitis clinical activity index [SCCAI]) and laboratory tests (sedimentation rate [ESR], CRP, and fecal calprotectin) in patients with CD and UC. Results The patient-reported NRS showed excellent correlation with CDAI (R2=0.59, p<0.0001), IBDQ (R2=0.66, p<0.0001), and HBI (R2=0.32, p<0.0001) in patients with CD. The NRS showed poor, but statistically significant correlation with SCCAI (R2=0.25, p<0.0001) in patients with UC. The NRS did not correlate with CRP, ESR, or calprotectin. The NRS was reliable and responsive to change. Conclusions The NRS is a valid, reliable, and responsive measure that may be useful to evaluate patients with CD and possibly UC. PMID:23250673

  10. The Impact of Ostomy on Quality of Life and Functional Status of Crohn's Disease Patients.

    Science.gov (United States)

    Abdalla, Maisa I; Sandler, Robert S; Kappelman, Michael D; Martin, Christopher F; Chen, Wenli; Anton, Kristen; Long, Millie D

    2016-11-01

    The potential need for an ostomy is a main concern for patients with inflammatory bowel disease. We performed this study to evaluate the impact of a long-term ostomy (≥6 mo duration) on the functional status and specific patient-reported outcomes in a population of patients with Crohn's disease (CD). We performed a cross-sectional analysis within the Crohn's and Colitis Foundation of America Partners cohort. Bivariate analyses and logistic regression models were used to investigate associations between ostomy and various demographic, disease factors, and patient-reported outcomes for health-related quality of life. A total of 402 CD patients with ostomy for a minimum duration of 6 months were compared with 4331 CD patients with no ostomy. Patients with ostomy were more likely to be in clinical remission compared with those without ostomy, 48.5% versus 31.3%, respectively. Having an ostomy did not impact the overall health-related quality of life and was not associated with anxiety, depression, sleep disturbances, or reduced sexual interest and satisfaction. However, the presence of ostomy was associated with reduced social role satisfaction in both patients with controlled and active disease. Additionally, in the subset of patients who did not achieve clinical remission, those with ostomy experienced greater pain interference (odds ratio, 1.63; 95% confidence interval, 1.12-2.35) and fatigue (odds ratio, 1.66; 95% confidence interval, 1.15-2.39). Ostomy is well tolerated in CD patients, particularly when clinical remission is achieved.

  11. Socioeconomic status and subclinical coronary disease in the Whitehall II epidemiological study.

    Directory of Open Access Journals (Sweden)

    Andrew Steptoe

    2010-01-01

    Full Text Available There are pronounced socioeconomic disparities in coronary heart disease, but the extent to which these primarily reflect gradients in underlying coronary artery disease severity or in the clinical manifestation of advanced disease is uncertain. We measured the relationship between socioeconomic status (SES as indexed by grade of employment and coronary artery calcification (CAC in the Whitehall II epidemiological cohort, and tested the contribution of lifestyle, biological and psychosocial factors in accounting for this association.CAC was assessed in 528 asymptomatic men and women aged 53-76 years, stratified into higher, intermediate and lower by grade of employment groups. Lifestyle (smoking, body mass index, alcohol consumption, physical activity, biological (blood pressure, lipids, fasting glucose, inflammatory markers and psychosocial factors (work stress, financial strain, social support, depression, hostility, optimism were also measured. Detectable CAC was present in 293 participants (55.5%. The presence of calcification was related to lifestyle and biological risk factors, but not to grade of employment. But among individuals with detectable calcification, the severity of CAC was inversely associated with grade of employment (p = 0.010, and this relationship remained after controlling for demographic, lifestyle, biological and psychosocial factors. Compared with the higher grade group, there was a mean increase in log Agatston scores of 0.783 (95% C.I. 0.265-1.302, p = 0.003 in the intermediate and 0.941 (C.I. 0.226-1.657, p = 0.010 in the lower grade of employment groups, after adjustment for demographic, lifestyle, biological and psychosocial factors.Low grade of employment did not predict the presence of calcification in this cohort, but was related to the severity of CAC. These findings suggest that lower SES may be particularly relevant at advanced stages of subclinical coronary artery disease, when calcification has developed.

  12. Socioeconomic status and subclinical coronary disease in the Whitehall II epidemiological study.

    Science.gov (United States)

    Steptoe, Andrew; Hamer, Mark; O'Donnell, Katie; Venuraju, Shreenidhi; Marmot, Michael G; Lahiri, Avijit

    2010-01-25

    There are pronounced socioeconomic disparities in coronary heart disease, but the extent to which these primarily reflect gradients in underlying coronary artery disease severity or in the clinical manifestation of advanced disease is uncertain. We measured the relationship between socioeconomic status (SES) as indexed by grade of employment and coronary artery calcification (CAC) in the Whitehall II epidemiological cohort, and tested the contribution of lifestyle, biological and psychosocial factors in accounting for this association. CAC was assessed in 528 asymptomatic men and women aged 53-76 years, stratified into higher, intermediate and lower by grade of employment groups. Lifestyle (smoking, body mass index, alcohol consumption, physical activity), biological (blood pressure, lipids, fasting glucose, inflammatory markers) and psychosocial factors (work stress, financial strain, social support, depression, hostility, optimism) were also measured. Detectable CAC was present in 293 participants (55.5%). The presence of calcification was related to lifestyle and biological risk factors, but not to grade of employment. But among individuals with detectable calcification, the severity of CAC was inversely associated with grade of employment (p = 0.010), and this relationship remained after controlling for demographic, lifestyle, biological and psychosocial factors. Compared with the higher grade group, there was a mean increase in log Agatston scores of 0.783 (95% C.I. 0.265-1.302, p = 0.003) in the intermediate and 0.941 (C.I. 0.226-1.657, p = 0.010) in the lower grade of employment groups, after adjustment for demographic, lifestyle, biological and psychosocial factors. Low grade of employment did not predict the presence of calcification in this cohort, but was related to the severity of CAC. These findings suggest that lower SES may be particularly relevant at advanced stages of subclinical coronary artery disease, when calcification has developed.

  13. Impact of socioeconomic status on disease phenotype, genomic landscape and outcomes in myelodysplastic syndromes.

    Science.gov (United States)

    Mastaglio, Francesca; Bedair, Khaled; Papaemmanuil, Elli; Groves, Michael J; Hyslop, Ann; Keenan, Norene; Hothersall, Eleanor J; Campbell, Peter J; Bowen, David T; Tauro, Sudhir

    2016-07-01

    Genetic and epigenetic alterations contribute to the biological and clinical characteristics of myelodysplastic syndromes (MDS), but a role for socioeconomic environment remains unclear. Here, socioeconomic status (SES) for 283 MDS patients was estimated using the Scottish Index of Multiple Deprivation tool. Indices were assigned to quintile categorical indicators ranked from SES1 (lowest) to SES5 (highest). Clinicopathological features and outcomes between SES quintiles containing 15%, 20%, 19%, 30% and 16% of patients were compared. Prognostic scores identified lower-risk MDS in 82% of patients, with higher-risk disease in 18%. SES quintiles did not associate with age, gender, cytogenetics, International Prognostic scores or, in sub-analysis (n = 95), driver mutations. The odds ratio of a diagnosis of refractory anaemia was greater than other MDS sub-types in SES5 (OR 1·9, P = 0·024). Most patients (91%) exclusively received supportive care. SES did not associate with leukaemic transformation or cause of death. Cox regression models confirmed male gender (P < 0·05), disease-risk (P < 0·0001) and age (P < 0·01) as independent predictors of leukaemia-free survival, with leukaemic transformation an additional determinant of overall survival (P = 0·07). Thus, if access to healthcare is equitable, SES does not determine disease biology or survival in MDS patients receiving supportive treatment; additional studies are required to determine whether outcomes following disease-modifying therapies are influenced by SES. © 2016 John Wiley & Sons Ltd.

  14. Relationship between quantitative measurement of Porphyromonas gingivalis on dental plaque with periodontal status of patients with coronary heart disease

    Science.gov (United States)

    Dwiyanti, Stephani; Soeroso, Yuniarti; Sunarto, Hari; Radi, Basuni

    2017-02-01

    Coronary heart disease is a narrowing of coronary artery due to plaque build-up. [1] Chronic periodontitis increases risk of cardiovascular disease. P.gingivalis is linked to both diseases. Objective: to analyse quantitative difference of P.gingivalis on dental plaque and its relationship with periodontal status of CHD patient and control. Methods: Periodontal status of 66 CHD patient and 40 control was checked. Subgingival plaque was isolated and P.gingivalis was measured using real-time PCR. Result: P.gingivalis of CHD patient differs from control. P.gingivalis is linked to pocket depth of CHD patient. Conclusion: P.gingivalis count of CHD patient is higher than control. P.gingivalis count is not linked to any periodontal status, except for pocket depth of CHD patient.

  15. The immunization status of children with chronic neurological disease and serological assessment of vaccine-preventable diseases.

    Science.gov (United States)

    Dinleyici, Meltem; Carman, Kursat Bora; Kilic, Omer; Laciner Gurlevik, Sibel; Yarar, Coskun; Dinleyici, Ener Cagri

    2018-04-06

    The aim of this study was to evaluate the age-appropriate immunization coverage in 366 children with chronic neurological disease (CND), to evaluate the use of vaccines not included in routine program, to evaluate serological tests for vaccine-preventable diseases and to describe the related factors in unvaccinated children. 95.6% of all children with had received age-appropriate vaccinations according to the actual National Immunization Program (NIP) during childhood. 12 children (3.6%) had not received vaccines; only two had true contraindications. Because most of the vaccines have been implemented through the NIP for 10 years in Turkey, 88% of children required these new vaccines or booster doses. Moreover, 86.6% of the children and 92.6% of household contacts had no prior history of influenza vaccine. Furthermore, 88% of the patients had not received the varicella vaccine, and the anti-varicella IgG levels were only negative in 27.9%. In addition, 18.6% of the children were negative for anti-mumps IgG, 23.7% for anti-measles IgG, and 6.3% for anti-rubella IgG. Anti-HBs IgG level was 0-10 IU/L in 45.6% of the patients (most of them previously vaccinated) and 79.8% were negative for hepatitis A IgG antibodies. For pertussis infection, the antibody titers of 54.1% of patients were below the protective level, and 10% of patients had a prior acute pertussis infection. Therefore, it is suggested that children with CND should be evaluated for their vaccination status during their first and follow-up visits at certain intervals, and their primary immunization should be completed; moreover, many will need revaccination or booster doses.

  16. Current status of PET imaging in Huntington's disease

    Energy Technology Data Exchange (ETDEWEB)

    Pagano, Gennaro; Niccolini, Flavia; Politis, Marios [King' s College London, Neurodegeneration Imaging Group, Department of Basic and Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), Camberwell, London (United Kingdom)

    2016-06-15

    To review the developments of recent decades and the current status of PET molecular imaging in Huntington's disease (HD). A systematic review of PET studies in HD was performed. The MEDLINE, Web of Science, Cochrane and Scopus databases were searched for articles in all languages published up to 19 August 2015 using the major medical subject heading ''Huntington Disease'' combined with text and key words ''Huntington Disease'', ''Neuroimaging'' and ''PET''. Only peer-reviewed, primary research studies in HD patients and premanifest HD carriers, and studies in which clinical features were described in association with PET neuroimaging results, were included in this review. Reviews, case reports and nonhuman studies were excluded. A total of 54 PET studies were identified and analysed in this review. Brain metabolism ([{sup 18}F]FDG and [{sup 15}O]H{sub 2}O), presynaptic ([{sup 18}F]fluorodopa, [{sup 11}C]β-CIT and [{sup 11}C]DTBZ) and postsynaptic ([{sup 11}C]SCH22390, [{sup 11}C]FLB457 and [{sup 11}C]raclopride) dopaminergic function, phosphodiesterases ([{sup 18}F]JNJ42259152, [{sup 18}F]MNI-659 and [{sup 11}C]IMA107), and adenosine ([{sup 18}F]CPFPX), cannabinoid ([{sup 18}F]MK-9470), opioid ([{sup 11}C]diprenorphine) and GABA ([{sup 11}C]flumazenil) receptors were evaluated as potential biomarkers for monitoring disease progression and for assessing the development and efficacy of novel disease-modifying drugs in premanifest HD carriers and HD patients. PET studies evaluating brain restoration and neuroprotection were also identified and described in detail. Brain metabolism, postsynaptic dopaminergic function and phosphodiesterase 10A levels were proven to be powerful in assessing disease progression. However, no single technique may be currently considered an optimal biomarker and an integrative multimodal imaging approach combining different techniques should be developed

  17. [Relationship between socioeconomic status and the prevalence of cardiovascular disease among retired residents living in a community, Shanghai].

    Science.gov (United States)

    Xie, Chunyan; Qin, Chenxi; Wang, Geng; Yu, Canqing; Wang, Jin; Dai, Liqiang; Lyu, Jun; Gao, Wenjing; Wang, Shengfeng; Zhan, Siyan; Hu, Yonghua; Cao, Weihua; Li, Liming

    2014-05-01

    To explore the relationship between socioeconomic status and the risk factors of cardiovascular diseases in retirees from a community in Shanghai. Observational study involved 9 943 retirees aged 50 and over in Shanghai. Both single factor and multi-factor analyses methods were used to describe the correlation between factors as:educational level, marital status, annual household income and risk of hypertension, coronary heart disease, stroke etc. A new defined compound index was used to assess the relevance of socioeconomic status on the risk of cardiovascular diseases, based on logistic regression model. After adjusted for age, the risk of cardiovascular diseases in these retirees was influenced by socioeconomic status. In general, opponent correlations in education levels and prevalence of hypertension were found between female and male. Compared with those having received college or higher education, the risk of hypertension increased in females when the education level declined, with OR as 1.08 (95% CI:0.89-1.30). For those having had senior high school junior high school or elementary education, the risks of hypertension were 1.26 (95%CI:1.05-1.51), 1.34 (95%CI:1.08-1.65), 0.72 (95%CI:0.59-0.87),0.78 (95%CI:0.64-0.94), and 0.70 (95%CI:0.52-0.92) for males, respectively. The risk of cardiovascular diseases increased with annual household income. Compared with high level of socioeconomic status, lower socioeconomic status might decline the risk of cardiovascular diseases in males by approximately 30%, with OR for medium being 0.72 (95%CI:0.61-0.84) and for lower ones it was 0.70 (95% CI:0.57-0.87). However, similar correlations were not found in females. No significant relationship was found between marital status and the prevalence of cardiovascular diseases in this study. The risks of cardiovascular diseases varied with different socioeconomic status, indicating that tailored interventions should be conducted in different socioeconomic groups.

  18. Patients with type 1 Gaucher disease in Spain: A cross-sectional evaluation of health status.

    Science.gov (United States)

    Giraldo, Pilar; Pérez-López, Jordi; Núñez, Ramiro; de la Puebla, Rafael Fernández; Luño, Elisa; Saura-Grau, Salvador; Bureo, Juan Carlos; Plaza, Sylvia; de la Serna, Javier

    2016-01-01

    A multicentre, cross-sectional epidemiological survey was conducted to describe the health status of patients with type 1 Gaucher disease (GD1) in Spain. Patient data were collected retrospectively from clinical records. Therapeutic goals for seven clinical parameters were chosen as primary outcome measures. 108 GD1 patients (mean age 44.8 years; 53% male) were recruited from 28 hospitals. Ninety-five patients (88%) were receiving treatment for GD1. Hemoglobin concentration was the therapeutic goal with the highest level of achievement, being met by 105 of 108 patients (97%), followed by the goals for liver volume (86/98 patients; 88%), spleen volume (67/77 patients; 87%) and platelet count (81/108 patients; 75%). The goal for bone mineral density (BMD) was met by 48 of 75 patients (64%), and the goal for quality of life was met by 65 of 103 patients (63%). Bone pain was the parameter with the lowest level of achievement (goal met by 50/94 patients; 53%). The clinical information most often missing from patient records was the BMD Z-score (missing for 31% of patients). These data suggest that most Spanish GD1 patients have good control over hematological and visceral parameters, but there is a need to improve monitoring and treatment of GD-related bone disease. Copyright © 2015. Published by Elsevier Inc.

  19. Total oxidant status, total antioxidant capacity and ischemia modified albumin levels in children with celiac disease.

    Science.gov (United States)

    Sayar, Ersin; Özdem, Sebahat; Uzun, Gülbahar; İşlek, Ali; Yılmaz, Aygen; Artan, Reha

    2015-01-01

    In our study, we aimed to investigate ischemia modified albumin (IMA) as an oxidative stress marker, as well as other oxidant and antioxidant markers that have not been evaluated in children with celiac disease. A total of 37 pediatric patients who were diagnosed with celiac disease (CD) and 29 healthy children were enrolled in this prospective study. We evaluated the IMA, total oxidant status, total antioxidant capacity, sulfhydryl, and advanced oxidation protein products in all of the subjects. We also compared the levels at the time of the diagnosis, and following a gluten-free diet (GFD) in the children with CD. While the IMA and the other oxidant marker levels were significantly higher in the patient group compared to the control group, the antioxidant marker levels were found to be significantly lower in the patient group, compared to the control group. We also determined that the tissue transglutaminase IgA showed a highly positive correlation, and that the IMA showed a moderately positive correlation with the Marsh-Oberhuber histopathological stage. Additionally, the IMA and other oxidant marker levels were significantly lower, while the antioxidant marker levels were significantly higher after the GFD, compared to the pre-diet period. We detected that oxidative stress played a role in the pathogenesis of CD, and that this could be evaluated using oxidative stress markers, which would regress after the GFD. We also detected that IMA is a marker that shows a correlation with the histopathological stage, and may be used in the diagnosis.

  20. Nutritional status of children with inflammatory bowel disease in Saudi Arabia.

    Science.gov (United States)

    El Mouzan, Mohammad Issa; Al Edreesi, Mohammed Hadi; Al-Hussaini, Abdulrahman Abdullah; Saadah, Omar Ibrahim; Al Qourain, Abdulaziz Abdullatif; Al Mofarreh, Mohammad Abdullah; Al Saleem, Khalid Abdulrahman

    2016-02-07

    To assess the prevalence of nutritional disorders in children with inflammatory bowel disease (IBD) in Saudi Arabia. The data from a national cohort of children newly diagnosed with IBD between 2003 and 2012 were analyzed. The diagnosis of IBD and the differentiation between Crohn's disease (CD) and ulcerative colitis (UC) were confirmed by gastroenterologists according to the standard criteria. The body mass index (BMI) of each child [weight (kg)/height(2) (m)] was calculated at the time of diagnosis. The World Health Organization standards and references were used and the BMI for age > +1 and nutritional status between children anorexia at the time of diagnosis was found in 30 (25%) patients with UC and 99 (39%) patients with CD. The prevalence of thinness was 31%, 35% and 24% in children with IBD, CD and UC, respectively, with a significantly higher prevalence of thinness in children with CD than in children with UC (P = 0.037) only in the age group of 10-17 years (P = 0.030). The prevalence of overweight was 16 %, 15% and 20 % in the children with IBD, CD and UC, respectively, indicating a higher prevalence in UC that was statistically significant only in the age group of 10-17 years (P = 0.020). A high proportion of children with IBD presented with overweight instead of the classical underweight. Awareness of this finding is important for patient care.

  1. Lower Socio-economic Status and Cardiovascular Disease: Role of Healthcare Facility and Policy in India

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    Arti Singh

    2016-09-01

    Full Text Available Background: Cardio-vascular disease (CVD is one of the main cause of mortality Worldwide and India is no exception. Unlike developed countries, where both CVD prevalence and mortality has been established to affect lower socio-economic status (SES, in India there is no consensus among researchers over socio-economic patterning of CVD prevalence but the mortality rate has been reported to disproportionately affect the economically weaker sections. Aims & Objectives: This article, focuses at the issue of how lack of good healthcare facilities and non-supportive health policies are affecting CVD mortality positively among lower SES of India. Challenges of the Indian healthcare system in context of lower SES can be described in terms of the issue of availability, accessibility and affordability. Inadequate policy and public healthcare system either leads to the problem of high Out-of-Pocket Payments (OPP or opting out of the treatment, which further increases poverty and mortality among them. Moreover, limited insurance coverage and inadequate regulatory policies for alcohol and tobacco-leading CVD risk factors among lower SES groups – do little to discourage its use among them. Conclusion: Since, lower SES people in India are already under the burden of communicable diseases, government should take immediate steps to control the mortality among them by creating a supportive environment through pro-poor health policies and healthcare facilities.

  2. Critical review-current status of Tl-201 myocardial scintigraphy in patients with ischemic heart disease

    International Nuclear Information System (INIS)

    Kanemoto, Nariaki; Hoer, G.

    1982-01-01

    Thallium-201 myocardial scintigraphy (TMS) is the most important, accurate and noninvasive diagnostic tool for the detection of regional myocardial perfusion. This agent is a potassium analog and the biologic half life in normal myocardium is 4 hours. Therefore, serial imaging after a single dose of Tl-201 at the peak of the exercise makes differential diagnosis possible between stress induced ischemia (transient perfusion defect with redistribution) and myocardial fibrosis or scar (permanent defect). The reproducibility is around 90%. The overall sensitivity in 4,094 patients reviewed from the literature was 83% with a specificity of 87%. The accuracy of TMS for the diagnosis of ischemic heart disease was 85%. Sensitivity increases in the order of visual (83%), computer analysis of standard scintigraphy (91%), and computer analysis of pinhole tomography (96%), but there is no significant difference in specificity among them. Also, sensitivity increases in the order of single (73%), double (83%) and triple (90%) vessel d isease. However, TMS does not indicate the correct number of vessels involved. In this paper, we discuss the current status of use and limitations of TMS in the diagnosis of ischemic heart disease. (author)

  3. Oral health status of normal children and those affiliated with cardiac diseases.

    Science.gov (United States)

    Suma, G; Usha, Mohan Das; Ambika, G; Jairanganath

    2011-01-01

    If a child's general health is compromised, care for his/her oral and dental health becomes an absolute necessity. Children with heart diseases require special dental care because of the risk of developing infective endocarditis. Was to evaluate the oral health status, parental oral health care knowledge of the pediatric cardiac patients and non cardiac group and infective endocarditis awareness among the parents of the cardiac group. Include a total of 50 children with heart diseases and 50 non-cardiac children aged 2-12 years were examined for dental caries index and simplified debris index. A structured, administered questionnaire for parents/caregivers about knowledge of infective endocarditis and oral health were used for data collection. Showed no statistically significant differences between the caries experience score for the two groups and oral health knowledge. Knowledge about Infective Endocarditis in parents of study group was very poor. Simplified Debris Index of age group 6-12 years was higher in study groups compared to the controls. Improvements should be made in educating parents and children on the importance of caries prevention and maintaining a good oral hygiene in prevention of infective endocarditis.

  4. Correlation of Alzheimer Disease Neuropathologic Changes With Cognitive Status: A Review of the Literature

    Science.gov (United States)

    Nelson, Peter T.; Alafuzoff, Irina; Bigio, Eileen H.; Bouras, Constantin; Braak, Heiko; Cairns, Nigel J.; Castellani, Rudolph J.; Crain, Barbara J.; Davies, Peter; Del Tredici, Kelly; Duyckaerts, Charles; Frosch, Matthew P.; Haroutunian, Vahram; Hof, Patrick R.; Hulette, Christine M.; Hyman, Bradley T.; Iwatsubo, Takeshi; Jellinger, Kurt A.; Jicha, Gregory A.; Kövari, Enikö; Kukull, Walter A.; Leverenz, James B.; Love, Seth; Mackenzie, Ian R.; Mann, David M.; Masliah, Eliezer; McKee, Ann C.; Montine, Thomas J.; Morris, John C.; Schneider, Julie A.; Sonnen, Joshua A.; Thal, Dietmar R.; Trojanowski, John Q.; Troncoso, Juan C.; Wisniewski, Thomas; Woltjer, Randall L.; Beach, Thomas G.

    2013-01-01

    Clinicopathologic correlation studies are critically important for the field of Alzheimer disease (AD) research. Studies on human subjects with autopsy confirmation entail numerous potential biases that affect both their general applicability and the validity of the correlations. Many sources of data variability can weaken the apparent correlation between cognitive status and AD neuropathologic changes. Indeed, most persons in advanced old age have significant non-AD brain lesions that may alter cognition independently of AD. Worldwide research efforts have evaluated thousands of human subjects to assess the causes of cognitive impairment in the elderly, and these studies have been interpreted in different ways. We review the literature focusing on the correlation of AD neuropathologic changes (i.e. β-amyloid plaques and neurofibrillary tangles) with cognitive impairment. We discuss the various patterns of brain changes that have been observed in elderly individuals to provide a perspective for understanding AD clinicopathologic correlation and conclude that evidence from many independent research centers strongly supports the existence of a specific disease, as defined by the presence of Aβ plaques and neurofibrillary tangles. Although Aβ plaques may play a key role in AD pathogenesis, the severity of cognitive impairment correlates best with the burden of neocortical neurofibrillary tangles. PMID:22487856

  5. Vitamin D Status in Chronic Kidney Disease - UVB Irradiation Is Superior to Oral Supplementation.

    Science.gov (United States)

    Krause, Rolfdieter; Roth, Heinz Jürgen; Kaase, Heinrich; Stange, Rainer; Holick, Michael F

    2016-03-01

    In chronic kidney disease (CKD) a deficiency of 1,25-dihydroxyvitamin D is common. The aim of this review was to compare vitamin D status after oral supplementation of vitamin D3 to that of serial suberythemal irradiation in end-stage kidney disease (ESKD) patients. Ninety-five patients, with a mean age of 62 (range=35-82) years, were treated with a mean dose of 35,000 (20,000-60,000) IU vitamin D3 per week for a period of 18 months. Fourteen patients, with a mean age of 51 (range=41-57) years, were whole-body UVB irradiated for over 6 months. From 3 hemodialysis patients skin biopsies were performed. With oral supplementation 25(OH)D3 increased by 60%. With UV irradiation 25(OH)D3 increased by 400%. Gene expression analysis demonstrated an improvement in the vitamin D receptor (VDR) by 0.65 fold, in 1-alpha-hydroxylase (CYP27B1) by 1.0 fold, and in 25-hydroxylase (CYP2R) by 1.2 fold. Serial suberythemal UVB irradiation of patients with CKD on dialysis is capable to improve serum 25(OH)D3 and 1,25(OH)2D3 by enhancing the skin's ability to activate vitamin D. Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  6. Lactase persistence, NOD2 status and Mycobacterium avium subsp. paratuberculosis infection associations to Inflammatory Bowel Disease

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    Elguezabal Natalia

    2012-06-01

    Full Text Available Abstract Background Inflammatory Bowel Disease (IBD, which includes both Crohn’s disease (CD and ulcerative colitis (UC, is caused by a complex interplay involving genetic predisposition, environmental factors and an infectious agent. Mycobacterium avium subsp. paratuberculosis (MAP is a promising pathogen candidate since it produces a chronic intestinal inflammatory disease in ruminants that resembles CD in humans. MAP is a ubiquitous microorganism, although its presence in the food chain, especially in milk from infected animals, is what made us think that there could be an association between lactase persistence (LP and IBD. The LCT mutation has brought adaptation to dairy farming which in turn would have increased exposure of the population to infection by MAP. NOD2 gene mutations are highly associated to CD. Methods In our study, CD and UC patients and controls from the North of Spain were genotyped for the lactase gene (LCT and for three NOD-2 variants, R702W, G908R and Cins1007fs. MAP PCR was carried out in order to assess MAP infection status and these results were correlated with LCT and NOD2 genotypes. Results As for LP, no association was found with IBD, although UC patients were less likely to present the T/T−13910 variant compared to controls, showing a higher C-allele frequency and a tendency to lactase non-persistence (LNP. NOD2 mutations were associated to CD being the per-allele risk higher for the Cins1007fs variant. MAP infection was more extended among the healthy controls (45.2% compared to CD patients (21.38% and UC patients (19.04% and this was attributed to therapy. The Asturian CD cohort presented higher levels of MAP prevalence (38.6% compared to the Basque CD cohort (15.5%, differences also attributed to therapy. No interaction was found between MAP infection and LCT or NOD2 status. Conclusions We conclude that LP is not significantly associated with IBD, but that MAP infection and NOD2 do show not mutually

  7. INCIDENCE OF STUNTING AND ITS RELATIONSHIP WITH FOOD INTAKE, INFECTIOUS DISEASES, AND ECONOMIC STATUS IN KENDARI, SOUTHEAST SULAWESI, INDONESIA

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    Akhmad

    2016-12-01

    Full Text Available Background: Stunting is characterized by inhibition of growth in children that lead to failure in getting normal heights and healthy child's age. It is a public health problem in the working area of Public Health Center of Mata, Kelurahan Mangga Dua in Kendari in 2016. Objective: This study aims to examine the relationship between food intake, infectious diseases, economic status and the incidence of stunting in Kendari, Southeast Sulawesi, Indonesia Methods: This was a descriptive cross sectional study with retrospective approach. This research was conducted in Public Health Center of Mata. There were 41 respondents were selected as the samples. Data were collected by questionnaires, observation, and documentation. Data were analyzed using Chi-Square test. Results: The results showed that there were significant associations between food intake (p= 0.001, infectious diseases (p= 0.000, economic status (p= 0.000, and the incidence of stunting in infants. Conclusions: It can be concluded that there is a relationship between food intake, infectious diseases and economic status with the incidence of stunting in children aged 2-4 years in the working area of Public Health Center of Mata, Kendari. Therefore, good food intake is needed for the growth and development of the child. Moreover, changing the behavior of parents by doing the healthy and clean behavior in the household to prevent infectious diseases in children infectious diseases is also very important. Economic status however also plays key role in the incidence of stunting in children

  8. The U.S. Department of Energy Laboratory Accreditation Program for testing the performance of extremity dosimetry systems: a summary of the program status

    International Nuclear Information System (INIS)

    Cummings, F.M.; Carlson, R.D.; Gesell, T.F.; Loesch, R.M.

    1992-01-01

    In 1986, The U.S. Department of Energy (DOE) implemented a program to test the performance of its personnel whole-body dosimetry systems. This program was the DOE Laboratory Accreditation Program (DOELAP). The program parallels the performance testing program specified in the American National Standard for Dosimetry - Personnel Dosimetry Performance -Criteria for Testing (ANSI N13.11-1983), but also addresses the additional dosimetry needs of DOE facilities. As an extension of the whole-body performance testing program, the DOE is now developing a program to test the performance of personnel extremity dosimetry systems. The draft DOE standard for testing extremity dosimetry systems is much less complex than the whole-body dosimetry standard and reflects the limitations imposed on extremity dosimetry by dosimeter design and irradiation geometry. A pilot performance test session has been conducted to evaluate the proposed performance-testing standard. (author)

  9. The Risk of Tuberculosis Reinfection Soon after Cure of a First Disease Episode Is Extremely High in a Hyperendemic Community.

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    Pieter Uys

    Full Text Available Elevated rates of reinfection tuberculosis in various hyperendemic regions have been reported and, in particular, it has been shown that in a high-incidence setting near Cape Town, South Africa, the rate of reinfection tuberculosis (TB disease after cure of a previous TB disease episode is about four times greater than the rate of first-time TB disease. It is not known whether this elevated rate is caused by a high reinfection rate due, for instance, to living circumstances, or a high rate of progress to disease specific to the patients, or both. In order to address that question we analysed an extensive data set from clinics attended by TB patients in the high-incidence setting near Cape Town, South Africa and found that, in fact, the (average rate of reinfection (as opposed to the rate of reinfection disease after cure of a previous TB disease episode is initially about 0.85 per annum. This rate diminishes rapidly over time and after about ten years this rate is similar to the rate of infection in the general population. Also, the rate of progress to disease after reinfection is initially high but declines in subsequent years down to the figure typical for the general population. These findings suggest that the first few months after cure of a TB disease episode form a critical period for controlling reinfection disease in a hyperendemic setting and that monitoring such cured patients could pre-empt a reinfection progressing to active disease.

  10. Serum Levels of Gelatinase Associated Lipocalin as Indicator of the Inflammatory Status in Coronary Artery Disease

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    Nikolaos Kafkas

    2012-01-01

    Full Text Available Background. Atherosclerosis is a chronic inflammatory disease and the acute clinical manifestations represent acute on chronic inflammation. Neutrophil gelatinase-associated lipocalin (NGAL is found in the granules of human neutrophils, with many diverse functions. The aim of this study was to evaluate the hypothesis that levels NGAL in blood may reflect the inflammatory process in various stages of coronary artery disease. Methods. We studied 140 patients, with SA 40, UA 35, NSTEMI 40, and STEMI 25, and 20 healthy controls. Serum NGAL was measured upon admission and before coronary angiography. Results. Significant differences were observed in median serum-NGAL(ng/mL between patients with SA (79.23 (IQR, 37.50–100.32, when compared with UA (108.00 (68.34–177.59, NSTEMI (166.49 (109.24–247.20, and STEMI (178.63 (111.18–305.92 patients and controls (50.31 (44.30–69.78 with significant incremental value from SA to STEMI. We observed a positive and significant correlation between serum-NGAL and hs-CRP (spearman coefficient rho = 0.685, <0.0001 as well as with neutrophil counts (r = 0.511, <0.0001. Conclusions. In patients with coronary artery disease serum levels of NGAL increase and reflect the degree of inflammatory process. In patients with acute coronary syndromes, serum levels of NGAL have high negative predictive value and reflecting the inflammatory status could show the severity of coronary clinical syndrome.

  11. Oxidative stress markers in saliva and periodontal disease status: modulation during pregnancy and postpartum.

    Science.gov (United States)

    Gümüş, Pınar; Emingil, Gülnur; Öztürk, Veli-Özgen; Belibasakis, Georgios N; Bostanci, Nagihan

    2015-07-08

    Periodontal diseases may affect local and systemic inflammation, and reactive oxygen species (ROS) levels. This systemic health burden could compromise the outcome of pregnancy in expectant mothers. The aim of the present study was to evaluate oxidative stress markers, including glutathione peroxidase (GPx), thiobarbituric acid-reactive substances (TBARS) and 8-hydroxy-2'-deoxyguanosine (8-OHdG), and total bacterial loads in the saliva of pregnant and postpartum women, and to investigate their association with periodontal disease severity. A total of 187 women were originally recruited for this case-control study, assigned to the following groups a) pregnant group, b) postpartum group: the pregnant group re-evaluated 6 months after giving birth, c) control group: systemically healthy and non-pregnant women. The levels of the studied oxidative stress markers in saliva were measured by commercially available kits. The levels of salivary 8-OHdG were significantly elevated in the pregnant, compared with the control group. Although salivary 8-OHdG levels slightly decreased after giving birth (postpartum group), the difference did not reach significance. In contrast, the activity of antioxidant enzyme GPx in saliva was significantly lower in the pregnant than the control group. Although no differences in lipid peroxidation (represented by TBARS) were observed between the pregnant and control groups, after giving birth TBARS levels were significantly lowered. Only in the postpartum and control groups did clinical measurements of periodontal disease severity correlate with oxidative stress markers. Interestingly, there were no such correlations with TBARS in the pregnant and postpartum groups. The present study shows changes in the oxidant/antioxidant balance in saliva during pregnancy and after birth, which may be affected by periodontal health status in the latter case. Whether this is associated with adverse pregnancy outcomes, or not, remains to be elucidated. Early

  12. B-vitamin status in relation to bone mineral density in treated celiac disease patients.

    Science.gov (United States)

    Clarke, Michelle; Ward, Mary; Dickey, William; Hoey, Leane; Molloy, Anne M; Waldron, Lisa; Varghese, Abraham; McCann, Adrian; Blayney, Jaine K; McNulty, Helene

    2015-08-01

    Patients with celiac disease (CD) are at increased risk of osteoporosis and compromised B-vitamin status. Emerging evidence supports a beneficial role of folate and the metabolically related B-vitamins in bone health in generally healthy adults, but no previous study has investigated this in CD patients. The aim of the current study was to examine the relationship of folate, vitamins B12, B6 and B2 (riboflavin), and the related metabolite homocysteine, with bone mineral density (BMD) in CD patients. Of the 400 treated adult CD patients invited to participate, 110 responded and met the eligibility criteria for study participation. BMD was measured using dual energy X-ray absorptiometry scanning at the lumbar spine (L1-L4), femoral neck, and total hip sites. Biomarker status of the relevant B-vitamins and homocysteine, and dietary B-vitamin intakes, were measured. The significant predictors of low BMD were increasing age (B = 0.080, p B = 0.072, p = 0.004), whereas no significant relationship with serum 25-hydroxyvitamin D (B = 0.093, p = 0.928) was observed. Following adjustment for these predictors, serum vitamin B12 (but no other B-vitamin biomarker) was found to be a significant determinant of BMD at the femoral neck (β = 0.416, p = 0.011) and total hip (β = 0.327, p = 0.049) in men only. No significant relationships were found between any of the B-vitamin biomarkers investigated and BMD (at any measured site) in women. These findings add to current evidence suggesting a potential role of vitamin B12 in BMD, particularly in men, and show such a relationship for the first time in CD patients.

  13. Clinical global assessment of nutritional status as predictor of mortality in chronic kidney disease patients.

    Science.gov (United States)

    Dai, Lu; Mukai, Hideyuki; Lindholm, Bengt; Heimbürger, Olof; Barany, Peter; Stenvinkel, Peter; Qureshi, Abdul Rashid

    2017-01-01

    The value of subjective global assessment (SGA) as nutritional assessor of protein-energy wasting (PEWSGA) in chronic kidney disease (CKD) patients depends on its mortality predictive capacity. We investigated associations of PEWSGA with markers of nutritional status and all-cause mortality in CKD patients. In 1031 (732 CKD1-5 non-dialysis and 299 dialysis) patients, SGA and body (BMI), lean (LBMI) and fat (FBMI) body mass indices, % handgrip strength (% HGS), serum albumin, and high sensitivity C-reactive protein (hsCRP) were examined at baseline. The five-year all-cause mortality predictive strength of baseline PEWSGA and during follow-up were investigated. PEWSGA was present in 2% of CKD1-2, 16% of CKD3-4, 31% of CKD5 non-dialysis and 44% of dialysis patients. Patients with PEWSGA (n = 320; 31%) had higher hsCRP and lower BMI, LBMI, FBMI, %HGS and serum albumin. But, using receiver operating characteristics-derived cutoffs, these markers could not classify (by kappa statistic) or explain variations of (by multinomial logistic regression analysis) presence of PEWSGA. In generalized linear models, SGA independently predicted mortality after adjustments of multiple confounders (RR: 1.17; 95% CI: 1.11-1.23). Among 323 CKD5 patients who were re-assessed after median 12.6 months, 222 (69%) remained well-nourished, 37 (11%) developed PEWSGA de novo, 40 (12%) improved while 24 (8%) remained with PEWSGA. The latter independently predicted mortality (RR: 1.29; 95% CI: 1.13-1.46). SGA, a valid assessor of nutritional status, is an independent predictor of all-cause mortality both in CKD non-dialysis and dialysis patients that outperforms non-composite nutritional markers as prognosticator.

  14. The Effect of Glycemic Status on Kidney Stone Disease in Patients with Prediabetes

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    Tzu-Hsien Lien

    2016-04-01

    Full Text Available BackgroundWhile the evidence supporting a positive association between diabetes mellitus and kidney stone disease (KSD is solid, studies examining the association between impaired fasting glucose (IFG and KSD show inconsistent results. Currently, there are no studies examining the relationship between impaired glucose tolerance (IGT and KSD. The objective of this study is to investigate the effects of different glycemic statuses on KSD. The results may help to motivate patients with diabetes to conform to treatment regimens.MethodsWe conducted a cross sectional study of a population that underwent health check-ups between January 2000 and August 2009 at the Health Evaluation Center of National Cheng Kung University Hospital. A total of 14,186 subjects were enrolled. The following categories of glycemic status were used according to the criteria of the 2009 American Diabetes Association: normal glucose tolerance, isolated IGT, isolated IFG, combined IFG/IGT, and diabetes. The existence of KSD was evaluated using renal ultrasonography, and the presence of any hyperechoic structures causing acoustic shadowing was considered to be indicative of KSD.ResultsThe prevalence of KSD was 7.4% (712/9,621, 9.3% (163/1,755, 10.8% (78/719, 12.0% (66/548, and 11.3% (174/1,543 in subjects with NGT, isolated IGT, isolated IFG, combined IFG/IGT, and diabetes, respectively. Isolated IFG, combined IFG/IGT, and diabetes were associated with KSD after adjusting for other clinical variables, but isolated IGT was not. Age (41 to 64 years vs. ≤40 years, ≥65 years vs. ≤40 years, male gender, hypertension, and hyperuricemia were also independently associated with KSD.ConclusionIsolated IFG, combined IFG/IGT, and diabetes, but not isolated IGT, were associated with a higher risk of KSD.

  15. Management Status of Cardiovascular Disease Risk Factors for Dyslipidemia among Korean Adults.

    Science.gov (United States)

    Lee, Jongseok; Son, Heejeong; Ryu, Ohk Hyun

    2017-03-01

    Dyslipidemia, hypertension, and diabetes are well-established risk factors for cardiovascular disease (CVD). This study investigated the prevalence and management status of these factors for dyslipidemia among Korean adults aged 30 years old and older. The prevalence and management status of dyslipidemia, hypertension, and diabetes were analyzed among 12229 subjects (≥30 years) participating in the Korea National Health and Nutrition Survey 2010-2012. Dyslipidemia was defined according to treatment criteria rather than diagnostic criteria in Korea. Therefore, hyper-low-density lipoprotein (LDL) cholesterolemia was defined if LDL cholesterol levels exceeded the appropriate risk-based threshold established by the National Cholesterol Education Program Adult Treatment Panel III. The age-standardized prevalence was highest for dyslipidemia (39.6%), followed by hypertension (32.8%) and diabetes (9.8%). The lowest patient awareness was found for dyslipidemia (27.9%). The treatment rate was 66.5% for diabetes and 57.3% for hypertension, but only 15.7% for dyslipidemia. The control rate among those undergoing treatment was highest for hypertension (64.2%), followed by dyslipidemia (59.2%) and diabetes (22.1%). The higher the risk levels of CVD were, the lower the control rate of dyslipidemia. While the prevalence of dyslipidemia was higher than hypertension and diabetes, awareness and treatment rates thereof were lower. Higher CVD-risk categories showed lower control rates of dyslipidemia. In order to improve awareness and control rates of dyslipidemia, diagnostic criteria should be reconciled with treatment targets based on cardiovascular risk in Korean populations.

  16. FUNCTIONAL STATUS IN PATIENTS WITH CHRONIC KIDNEY DISEASE BEING TREATED WITH HEMODIALYSIS IN PKU MUHAMMADIYAH HOSPITAL, YOGYAKARTA, INDONESIA

    Directory of Open Access Journals (Sweden)

    Adiyati Mardiyah

    2017-08-01

    Full Text Available Background: Hemodialysis process is useful for patients with end-stage renal disease. However, this is a situation of abject dependence on a machine, a procedure and a group of qualified medical professionals for the rest of their lives that may influence their functional status. Objective: This study aims to describe the functional status of patients with chronic kidney disease undergoing hemodialysis. Method: This was a descriptive study with cross-sectional design, which conducted in the PKU Muhammadiyah Hospital Yogyakarta on March 2017. There were 78 patients selected using purposive sampling. Functional status was measured using SF-36 questionnaire. Descriptive statistic was performed for data analysis Result:. The total average of functional status level was 42.92, with Physical Component Scale (PCS of 42.31 and Mental Component Scale (MCS of 45.78. Conclusion: There were functional deficiencies in both physical and mental status in patients with CKD undergoing hemodialysis. Thus, it is suggested that pharmacological management of these patients need stringent monitoring on part of the psychiatrist to deal with mental health problems, and the interdisciplinary team need to do great efforts to improve functional status and quality of life of patients with CKD.

  17. Sociodemographic, disease status, and illness perceptions predictors of global self-ratings of health and quality of life among those with coronary heart disease

    DEFF Research Database (Denmark)

    Aalto, Anna-Mari; Aro, Arja R; Weinman, John

    2006-01-01

    This one-year follow-up study (n = 130 at baseline, n =2745 at follow-up, aged 45-74 years) examined the relationship of patients' perceptions of coronary heart disease (CHD) and illness-related factors with global health status and global quality of life (QOL) ratings. The independent variables...... were CHD history (myocardial infarction, revascularisation), CHD severity (use of nitrates, CHD risk factors and co-morbidities) and illness perceptions. In multivariate regression analysis, CHD history and severity explained 13% of variance in global health status and 8% in global QOL ratings...... at the baseline. Illness perceptions increased the share of explained variance by 18% and 16% respectively. In the follow-up, illness perceptions explained a significant but modest share of variance in change in health status and QOL when baseline health status and QOL and CHD severity were adjusted for more...

  18. Cardiovascular disease by diabetes status in five ethnic minority groups compared to ethnic Norwegians

    Science.gov (United States)

    2011-01-01

    Background The population in Norway has become multi-ethnic due to migration from Asia and Africa over the recent decades. The aim of the present study was to explore differences in the self-reported prevalence of cardiovascular disease (CVD) and associated risk factors by diabetes status in five ethnic minority groups compared to ethnic Norwegians. Methods Pooled data from three population-based cross-sectional studies conducted in Oslo between 2000 and 2002 was used. Of 54,473 invited individuals 24,749 (45.4%) participated. The participants self-reported health status, underwent a clinical examination and blood samples were drawn. A total of 17,854 individuals aged 30 to 61 years born in Norway, Sri-Lanka, Pakistan, Iran, Vietnam or Turkey were included in the study. Chi-square tests, one-way ANOVAs, ANCOVAs, multiple and logistic regression were used. Results Age- and gender-standardized prevalence of self-reported CVD varied between 5.8% and 8.2% for the ethnic minority groups, compared to 2.9% among ethnic Norwegians (p Corresponding CVD prevalence rates among individuals with diabetes were 15.3% vs. 12.6% (p = 0.364). For individuals without diabetes, the odds ratio (OR) for CVD in the ethnic minority groups remained significantly higher (range 1.5-2.6) than ethnic Norwegians (p employment, and body height, except for Turkish individuals. Regardless of diabetes status, obesity and physical inactivity were prevalent in the majority of ethnic minority groups, whereas systolic- and diastolic- blood pressures were higher in Norwegians. In nearly all ethnic groups, individuals with diabetes had higher triglycerides, waist-to-hip ratio (WHR), and body mass index compared to individuals without diabetes. Age, diabetes, hypertension, hypercholesterolemia, and WHR were significant predictors of CVD in both ethnic Norwegians and ethnic minorities, but significant ethnic differences were found for age, diabetes, and hypercholesterolemia. Conclusions Ethnic differences

  19. Why do people buy dogs with potential welfare problems related to extreme conformation and inherited disease? A representative study of Danish owners of four small dog breeds.

    Science.gov (United States)

    Sandøe, P; Kondrup, S V; Bennett, P C; Forkman, B; Meyer, I; Proschowsky, H F; Serpell, J A; Lund, T B

    2017-01-01

    A number of dog breeds suffer from welfare problems due to extreme phenotypes and high levels of inherited diseases but the popularity of such breeds is not declining. Using a survey of owners of two popular breeds with extreme physical features (French Bulldog and Chihuahua), one with a high load of inherited diseases not directly related to conformation (Cavalier King Charles Spaniel), and one representing the same size range but without extreme conformation and with the same level of disease as the overall dog population (Cairn Terrier), we investigated this seeming paradox. We examined planning and motivational factors behind acquisition of the dogs, and whether levels of experienced health and behavior problems were associated with the quality of the owner-dog relationship and the intention to re-procure a dog of the same breed. Owners of each of the four breeds (750/breed) were randomly drawn from a nationwide Danish dog registry and invited to participate. Of these, 911 responded, giving a final sample of 846. There were clear differences between owners of the four breeds with respect to degree of planning prior to purchase, with owners of Chihuahuas exhibiting less. Motivations behind choice of dog were also different. Health and other breed attributes were more important to owners of Cairn Terriers, whereas the dog's personality was reported to be more important for owners of French Bulldogs and Cavalier King Charles Spaniels but less important for Chihuahua owners. Higher levels of health and behavior problems were positively associated with a closer owner-dog relationship for owners of Cavalier King Charles Spaniels and Chihuahuas but, for owners of French Bulldogs, high levels of problems were negatively associated with an intention to procure the same breed again. In light of these findings, it appears less paradoxical that people continue to buy dogs with welfare problems.

  20. Exercise habituation is effective for improvement of periodontal disease status: a prospective intervention study

    Directory of Open Access Journals (Sweden)

    Omori S

    2018-03-01

    conducted before and after each intervention program. Results: In the exercise intervention group, the number of teeth with a probing pocket depth (PPD ≥4 mm significantly decreased from 14.4% to 5.6% (P<0.001, and the number of teeth with bleeding on probing (BOP significantly decreased from 39.8% to 14.4% (P<0.001. The copy counts of Tannerella forsythia and Treponema denticola decreased significantly (P=0.001. A positive correlation was found between the change in the copy count of T. denticola and the number of teeth with PPD ≥4 mm (P=0.003 and the number of teeth with BOP (P=0.010. A positive correlation was also found between the change in the copy count of T. denticola and body weight (P=0.008, low-density lipoprotein cholesterol (P=0.049, and fasting insulin (P=0.041. However, in the dietary intervention group the copy count of T. denticola decreased significantly (P=0.007 and there was no correlation between the number of periodontal disease-causing bacteria and PPD and BOP. Conclusion: Our results are the first to show that exercise might contribute to improvements in periodontal disease. Keywords: bacteria, intervention studies, lifestyle, metabolic syndrome, obesity, periodontal disease, periodontal status

  1. Diagnostic value of microRNA-143 in predicting in-stent restenosis for patients with lower extremity arterial occlusive disease

    OpenAIRE

    Yu, Zhi-Hai; Wang, Hai-Tao; Tu, Can

    2017-01-01

    Purpose This study was conducted to explore the diagnostic value of microRNA-143 (miRNA-143) in predicting in-stent restenosis (ISR) of lower extremity arterial occlusive disease (LEAOD). Methods From February 2012 to March 2015, 165 patients (112 males and 53 females) with LEAOD undergoing interventional treatment were enrolled in this study. Serum miRNA-143 expression was detected using quantitative real-time polymerase chain reaction (qRT-PCR). Patients were assigned into the restenosis an...

  2. Survival analysis in patients with metastatic spinal disease: the influence of surgery, histology, clinical and neurologic status

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    Matheus Fernandes de Oliveira

    2015-04-01

    Full Text Available Spine is the most common site for skeletal metastasis in patients with malignancy. Vertebral involvement quantification, neurological status, general health status and primary tumor histology are factors to set surgical planning and therapeutic targets. We evaluated the impact of general clinical and neurological status, histologic type and surgery in survival. Method : The study sample consisted of consecutive patients admitted from July 2010 to January 2013 for treatment. Results : Sixty eight patients were evaluated. 23 were female and 45 were male. Main primary neoplasic sites were: breast, prostate, lung/pleura and linfoproliferative. Thirty three out of 68 received surgical treatment, 2 received percutaneous biopsy and 33 had nonsurgical treatment. Survival : Log Rank curves revealed no statistical significant difference according to histological type, surgical approach and Frankel Score. Karnofsky Score was statistically different. Conclusion : Histological type and clinical status were statistically associated with life expectancy in vertebral metastatic disease.

  3. The Effects of Exercise Education Intervention on the Exercise Behaviour, Depression, and Fatigue Status of Chronic Kidney Disease Patients

    Science.gov (United States)

    Kao, Yu-Hsiu; Huang, Yi-Ching; Chen, Pei-Ying; Wang, Kuo-Ming

    2012-01-01

    Purpose: The purpose of this paper is to investigate the effects of an exercise education intervention on exercise behavior, depression and fatigue status of chronic kidney disease (CKD) patients. Design/methodology/approach: This was a pilot study using an exercise education program as an intervention for CKD patients. The authors used the…

  4. ‘Paving the way for Extremism: How Preventing the Symptoms Does Not Cure the Disease of Terrorism’

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    Imran Awan

    2011-11-01

    Full Text Available The British government’s controversial counter-terrorism strategies and policies have come under fierce opposition with critics arguing it has not actually prevented extremism but has manifested itself into a political and ideological campaign that unfairly targets the Muslim community. Moreover, such strategies have marginalised the Muslim community in the UK from wider civic society and created an atmosphere of hate and anger. The Prime Minister of Great Britain, David Cameron in 2010, spoke at a conference in Munich about security, radicalisation, and multi-culturalism, sparking a debate about how the UK monitors and deals with extremism. Blaming the doctrine of ‘state-multiculturalism’ the British coalition government argued for a more ‘active muscular liberalism’ which would identify the root causes of extremist ideologies.  Moreover, this paranoia and hysteria has led to a social, political, moral and theological debate about Islamism, Muslims, and terrorism which is fuelled by the way Britain is portrayed across the world as a country where extremist organisations employ tactics of persuasion, indoctrination, radicalisation and the promotion of religious intolerance.

  5. Frequency and characteristics of extremely low accumulation of 123I-metaiodobenzylguanidine (MIBG) in patients with and without cardiovascular diseases

    International Nuclear Information System (INIS)

    Sakata, Kazuyuki; Iida, Kei; Motiduki, Nao; Nakaya, Yoshihiro

    2008-01-01

    Very low accumulation of 123 I-metaiodobenzylguanidine (LoMIBG) in the human heart has been reported. This study assessed the frequency and characteristics of LoMIBG in the human heart. A total of 2212 patients (male/female ratio 1442/770, mean age 64±12 years) who underwent MIBG imaging were included. LoMIBG was defined as an initial heart-to-mediastinum (H/M) ratio of less than 1.4. Of the 114 patients with LoMIBG, 2 patients were excluded because of taking imipramine. Patients with LoMIBG were older than those without LoMIBG (P<0.0001). The main diagnosis and the number of patients with each disease were as follows: 28 of 410 coronary artery disease patients, 13 of 371 vasospastic angina patients, 3 of 86 various arrhythmias patients, 4 of 23 valvular heart disease patients, 9 of 101 dilated cardiomyopathy patients, 13 of 512 essential hypertension patients, 2 of 20 hypertrophic cardiomyopathy patients, 24 of 511 subjects without any definite disease (control), and 16 of 176 patients with miscellaneous diseases. When compared with patients without LoMIBG in each cardiovascular disease, LoMIBG patients had left ventricular function and frequency similar to critically ill patients. In the control group, the subjects with LoMIBG were significantly older (P<0.0001) and had significantly higher HF (P<0.03) and lower LF/HF (P<0.001) than those without LoMIBG. In addition, the incidence of LoMIBG was significantly elevated in the elderly (P<0.002). LoMIBG occurred in patients both with various diseases and without obvious diseases. Aging may be one of the mechanisms contributing to LoMIBG, especially in patients without obvious diseases. (author)

  6. Extreme cosmos

    CERN Document Server

    Gaensler, Bryan

    2011-01-01

    The universe is all about extremes. Space has a temperature 270°C below freezing. Stars die in catastrophic supernova explosions a billion times brighter than the Sun. A black hole can generate 10 million trillion volts of electricity. And hypergiants are stars 2 billion kilometres across, larger than the orbit of Jupiter. Extreme Cosmos provides a stunning new view of the way the Universe works, seen through the lens of extremes: the fastest, hottest, heaviest, brightest, oldest, densest and even the loudest. This is an astronomy book that not only offers amazing facts and figures but also re

  7. Current Status of Huntington’s Disease in Korea: A Nationwide Survey and National Registry Analysis

    Directory of Open Access Journals (Sweden)

    Hyun Sook Kim

    2015-01-01

    Full Text Available Objective Huntington’s disease (HD is a rare neurological disorder, and its current status in Korea is not well investigated. This study aims to determine the prevalence and incidence of HD and to investigate the clinical features of HD patients in Korea. Methods We estimated the crude prevalence and annual incidence of HD based on the databases of the Rare Diseases Registry (RDR and the National Health Insurance (NHI. The clinical data of genetically confirmed HD patients was collected from 10 referral hospitals and analyzed. Results The mean calculated annual incidence was 0.06 cases per 100,000 persons, and the mean calculated prevalence was 0.38 based on the NHI database. The estimated crude prevalence based on the RDR was 0.41. Of the sixty-eight HD patients recruited, the mean age of onset was 44.16 ± 14.08 years and chorea was most frequently reported as the initial symptom and chief complaint. The mean CAG repeat number of the expanded allele was 44.7 ± 4.8 and correlated inversely with the age of onset (p < 0.001. About two-thirds of the patients have a positive family history, and HD patients without positive family history showed a delay in onset of initial symptoms, a prolonged interval between initial symptom onset and genetic diagnosis and a delay in the age of genetic diagnosis. Conclusions To the best of our knowledge, this is the first study to estimate the prevalence and incidence of HD in Korea and the largest HD series in the Asian population. Our analyses might be useful for further studies and large-scale investigations in HD patients.

  8. Prevalence and management status of urologic diseases in geriatric hospitals in South Korea: A field research

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    Sang Heon Lee

    2017-01-01

    Full Text Available Purpose: We aimed to investigate the current management status of urologic diseases in geriatric hospitals in South Korea. Materials and Methods: Questionnaire surveys and in-depth person-to-person interviews were conducted at 13 hospitals within the Seoul and Incheon areas. Results: The study was carried out from July to December 2014; 75.6% of patients (1,858/2,458 and 77.5% (779/1,031 of medical personnel responded to our survey. All surveys and interviews were performed by urology specialists, fellows, residents, or nurses. The hospitals included in the study had an average of 215.2 beds (range, 110–367, 189.1 patients (range, 90–345, and 40.2 nurses (range, 10–83. The average number of physicians was 6.2 (range, 3–11, but none of these were certified urologists. Only 4 hospitals provided consultation services for urological disorders. In total, 64% of patients had urological disorders, although only 20.7% of patients were receiving medication. Most patients were being treated using urological interventions; diapers (49.7%, indwelling catheters (19.5%, clean intermittent catheters (12.2%, and external collection urinary drainage (7.9%. However, most interventions were inadequately implemented, and only 17% of the patients had been examined by a certified urologist. Urological complications were found in 20.2% of patients, and secondary complications occurred in 18.8%. Excluding redundant cases, the total prevalence of urological complications was 39.0%. Conclusions: Urologic diseases are poorly managed, and no certified urologists work in geriatric hospitals. Therefore, more designated urologists are needed in geriatric hospitals.

  9. Proinflammatory and Prothrombotic State in Subjects with Different Glucose Tolerance Status before Cardiovascular Disease

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    Irma Isordia-Salas

    2014-01-01

    Full Text Available Background. Inflammation has been associated with insulin resistance, type 2 diabetes mellitus (T2DM, and atherothrombosis. Aim. To determine differences in levels of proinflammatory and prothrombotic markers such as high sensitivity C-reactive protein (hs-CRP and fibrinogen in subjects with normal glucose tolerance (NGT, prediabetes, and T2DM and to establish their relationship with other cardiovascular risk factors before clinical manifestations of cardiovascular disease. Methods. We conducted a nonrandomized, cross-sectional assay in a hospital at México City. The levels of hs-CRP and fibrinogen were measured and compared according to glucose tolerance status. Results. We enrolled 1047 individuals and they were distributed into NGT n=473, pre-DM n=250, and T2DM n=216. There was a statistical difference between NGT and T2DM groups for fibrinogen (P=0.01 and hs-CRP (P=0.05. Fibrinogen and hs-CRP showed a significant positive correlation coefficient (r=0.53, P<0.0001. In a multiple stepwise regression analysis, the variability in fibrinogen levels was explained by age, HbA1c, and hs-CRP (adjusted R2=0.31, P<0.0001, and for hs-CRP it was explained by BMI and fibrinogen (adjusted R2=0.33, P<0.0001. Conclusion. Inflammation and prothrombotic state are present in people with T2DM lacking cardiovascular disease. Fibrinogen and Hs-CRP are positively correlated. Fibrinogen and hs-CRP concentrations are predominantly determined by BMI rather than glucose levels.

  10. Assessment of Quality of Life, Psychological and Functional Status and Disease Activity in Patients with Ankylosing Spondylitis and Fibromyalgia

    Directory of Open Access Journals (Sweden)

    Mehmet Caglayan

    2016-03-01

    Full Text Available Objective: Anxiety and depression are psychological dis­orders which frequently accompany and affect the course of rheumatic diseases. Quality of life is also affected by psychological status. In this study, we aimed to assess psychological status and quality of life in patients with an­kylosing spondylitis (AS and fibromyalgia (FM and in­vestigate their association with functional status, disease activity and physical limitation. Method: Thirty-seven patients with AS and thirty-four patients with FM were included in this study. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI and Bath Ankylosing Spondylitis Functional Index (BAS­FI were used for assessment of disease activity and physical functions respectively. The Ankylosing Spondy­litis Quality of Life (ASQoL questionnaire was used for disease-related quality of life in AS patients. Fibromyalgia Impact Questionnaire (FIQ was used for assessment of functional status in FM patients. Nottingham Health Pro­file (NHP and the Hospital Anxiety and Depression Scale (HADS were, respectively, used for assessment of qual­ity of life and psychological status in groups. Results: There was no significant difference between the groups in HADS-total, HADS-depression and HADS-anxiety scores (p>0.05. However, patients with FM had significantly higher NHP-total and NHP-pain scores com­pared to patients with AS (p<0.05. Conclusion: There was no significant difference be­tween the two groups in psychological distress. Higher NHP-pain scores in patients with FM might have been caused by lower pain threshold in these patients. The generalizability of our findings is also limited because of the relatively small sample size. J Clin Exp Invest 2016; 7 (1: 41-46

  11. The effects of socioeconomic status, clinical factors, and genetic ancestry on pulmonary tuberculosis disease in northeastern Mexico.

    Directory of Open Access Journals (Sweden)

    Bonnie N Young

    Full Text Available Diverse socioeconomic and clinical factors influence susceptibility to tuberculosis (TB disease in Mexico. The role of genetic factors, particularly those that differ between the parental groups that admixed in Mexico, is unclear. The objectives of this study are to identify the socioeconomic and clinical predictors of the transition from latent TB infection (LTBI to pulmonary TB disease in an urban population in northeastern Mexico, and to examine whether genetic ancestry plays an independent role in this transition. We recruited 97 pulmonary TB disease patients and 97 LTBI individuals from a public hospital in Monterrey, Nuevo León. Socioeconomic and clinical variables were collected from interviews and medical records, and genetic ancestry was estimated for a subset of 142 study participants from 291,917 single nucleotide polymorphisms (SNPs. We examined crude associations between the variables and TB disease status. Significant predictors from crude association tests were analyzed using multivariable logistic regression. We also compared genetic ancestry between LTBI individuals and TB disease patients at 1,314 SNPs in 273 genes from the TB biosystem in the NCBI BioSystems database. In crude association tests, 12 socioeconomic and clinical variables were associated with TB disease. Multivariable logistic regression analyses indicated that marital status, diabetes, and smoking were independently associated with TB status. Genetic ancestry was not associated with TB disease in either crude or multivariable analyses. Separate analyses showed that LTBI individuals recruited from hospital staff had significantly higher European genetic ancestry than LTBI individuals recruited from the clinics and waiting rooms. Genetic ancestry differed between individuals with LTBI and TB disease at SNPs located in two genes in the TB biosystem. These results indicate that Monterrey may be structured with respect to genetic ancestry, and that genetic

  12. The effects of socioeconomic status, clinical factors, and genetic ancestry on pulmonary tuberculosis disease in northeastern Mexico.

    Science.gov (United States)

    Young, Bonnie N; Rendón, Adrian; Rosas-Taraco, Adrian; Baker, Jack; Healy, Meghan; Gross, Jessica M; Long, Jeffrey; Burgos, Marcos; Hunley, Keith L

    2014-01-01

    Diverse socioeconomic and clinical factors influence susceptibility to tuberculosis (TB) disease in Mexico. The role of genetic factors, particularly those that differ between the parental groups that admixed in Mexico, is unclear. The objectives of this study are to identify the socioeconomic and clinical predictors of the transition from latent TB infection (LTBI) to pulmonary TB disease in an urban population in northeastern Mexico, and to examine whether genetic ancestry plays an independent role in this transition. We recruited 97 pulmonary TB disease patients and 97 LTBI individuals from a public hospital in Monterrey, Nuevo León. Socioeconomic and clinical variables were collected from interviews and medical records, and genetic ancestry was estimated for a subset of 142 study participants from 291,917 single nucleotide polymorphisms (SNPs). We examined crude associations between the variables and TB disease status. Significant predictors from crude association tests were analyzed using multivariable logistic regression. We also compared genetic ancestry between LTBI individuals and TB disease patients at 1,314 SNPs in 273 genes from the TB biosystem in the NCBI BioSystems database. In crude association tests, 12 socioeconomic and clinical variables were associated with TB disease. Multivariable logistic regression analyses indicated that marital status, diabetes, and smoking were independently associated with TB status. Genetic ancestry was not associated with TB disease in either crude or multivariable analyses. Separate analyses showed that LTBI individuals recruited from hospital staff had significantly higher European genetic ancestry than LTBI individuals recruited from the clinics and waiting rooms. Genetic ancestry differed between individuals with LTBI and TB disease at SNPs located in two genes in the TB biosystem. These results indicate that Monterrey may be structured with respect to genetic ancestry, and that genetic differences in TB

  13. Duke Activity Status Index for Cardiovascular Diseases: Validation of the Portuguese Translation

    International Nuclear Information System (INIS)

    Coutinho-Myrrha, Mariana A.; Dias, Rosângela C.; Fernandes, Aline A.; Araújo, Christiano G.; Hlatky, Mark A.; Pereira, Danielle G.; Britto, Raquel R.

    2014-01-01

    The Duke Activity Status Index (DASI) assesses the functional capacity of patients with cardiovascular disease (CVD), but there is no Portuguese version validated for CVD. To translate and adapt cross-culturally the DASI for the Portuguese-Brazil language, and to verify its psychometric properties in the assessment of functional capacity of patients with CVD. The DASI was translated into Portuguese, then checked by back-translation into English and evaluated by an expert committee. The pre-test version was first evaluated in 30 subjects. The psychometric properties and correlation with exercise testing was performed in a second group of 67 subjects. An exploratory factor analyses was performed in all 97 subjects to verify the construct validity of the DASI. The intraclass correlation coefficient for test-retest reliability was 0.87 and for the inter-rater reliability was 0.84. Cronbach's α for internal consistency was 0.93. The concurrent validity was verified by significant positive correlations of DASI scores with the VO 2 max (r = 0.51, p < 0.001). The factor analysis yielded two factors, which explained 54% of the total variance, with factor 1 accounting for 40% of the variance. Application of the DASI required between one and three and a half minutes per patient. The Brazilian version of the DASI appears to be a valid, reliable, fast and easy to administer tool to assess functional capacity among patients with CVD

  14. Evaluation of Growth Status in Children with Congenital Heart Disease: A Case- Control Study

    Directory of Open Access Journals (Sweden)

    Noor Mohammad Noori

    2017-12-01

    Full Text Available Background: Children with congenital heart disease (CHD are prone to malnutrition and growth retardation. This study aimed to compare growth status between children with CHD and healthy children.                Materials and Methods: This case–control study included 310 children with CHD and 300 healthy children matched in age and gender. CHD patients grouped according to cardiac diagnosis: group 1 (n=5, cyanotic patients with pulmonary hypertension; group 2 (n=22, cyanotic patients without pulmonary hypertension; group 3 (n=43, Acyanotic patients with pulmonary hypertension; and group 4 (n=240, Acyanotic patients without pulmonary hypertension. Anthropometric measurements of weight (Kg, height (cm, and head circumference (cm were measured and recorded for both case and control groups.  Descriptive and analytical statistics were performed using the by SPSS version 21.0. Results: Weight and head circumference were significantly lower in CHD children compared to healthy children (p

  15. Duke Activity Status Index for Cardiovascular Diseases: Validation of the Portuguese Translation

    Energy Technology Data Exchange (ETDEWEB)

    Coutinho-Myrrha, Mariana A. [Ciências da Reabilitação Programa de Pós-Graduação - Universidade Federal de Minas Gerais (UFMG) (Brazil); Dias, Rosângela C. [Ciências da Reabilitação Programa de Pós-Graduação - Universidade Federal de Minas Gerais (UFMG) (Brazil); Departamento de Fisioterapia - UFMG (Brazil); Fernandes, Aline A. [Ciências da Reabilitação Programa de Pós-Graduação - Universidade Federal de Minas Gerais (UFMG) (Brazil); Araújo, Christiano G. [Setor de Cardiologia do Hospital das Clínicas da UFMG (Brazil); Hlatky, Mark A. [Standford University School of Medicine (United States); Pereira, Danielle G.; Britto, Raquel R., E-mail: r3britto@gmail.com [Ciências da Reabilitação Programa de Pós-Graduação - Universidade Federal de Minas Gerais (UFMG) (Brazil); Departamento de Fisioterapia - UFMG (Brazil)

    2014-04-15

    The Duke Activity Status Index (DASI) assesses the functional capacity of patients with cardiovascular disease (CVD), but there is no Portuguese version validated for CVD. To translate and adapt cross-culturally the DASI for the Portuguese-Brazil language, and to verify its psychometric properties in the assessment of functional capacity of patients with CVD. The DASI was translated into Portuguese, then checked by back-translation into English and evaluated by an expert committee. The pre-test version was first evaluated in 30 subjects. The psychometric properties and correlation with exercise testing was performed in a second group of 67 subjects. An exploratory factor analyses was performed in all 97 subjects to verify the construct validity of the DASI. The intraclass correlation coefficient for test-retest reliability was 0.87 and for the inter-rater reliability was 0.84. Cronbach's α for internal consistency was 0.93. The concurrent validity was verified by significant positive correlations of DASI scores with the VO{sub 2}max (r = 0.51, p < 0.001). The factor analysis yielded two factors, which explained 54% of the total variance, with factor 1 accounting for 40% of the variance. Application of the DASI required between one and three and a half minutes per patient. The Brazilian version of the DASI appears to be a valid, reliable, fast and easy to administer tool to assess functional capacity among patients with CVD.

  16. Health status of newly arrived refugees in Toronto, Ont: Part 1: infectious diseases.

    Science.gov (United States)

    Redditt, Vanessa J; Janakiram, Praseedha; Graziano, Daniela; Rashid, Meb

    2015-07-01

    To determine the prevalence of selected infectious diseases among newly arrived refugee patients and whether there is variation by key demographic factors. Retrospective chart review. Primary care clinic for refugee patients in Toronto, Ont. A total of 1063 refugee patients rostered at the clinic from December 2011 to June 2014. Demographic information (age, sex, and region of birth); prevalence of HIV, hepatitis B, hepatitis C, Strongyloides, Schistosoma, intestinal parasites, gonorrhea, chlamydia, and syphilis infections; and varicella immune status. The median age of patients was 29 years and 56% were female. Refugees were born in 87 different countries. Approximately 33% of patients were from Africa, 28% were from Europe, 14% were from the Eastern Mediterranean Region, 14% were from Asia, and 8% were from the Americas (excluding 4% born in Canada or the United States). The overall rate of HIV infection was 2%. The prevalence of hepatitis B infection was 4%, with a higher rate among refugees from Asia (12%, P refugees (64%, P refugees from Africa (6%, P = .003). Schistosoma infection was identified in 15% of patients from Africa. Intestinal parasites were identified in 16% of patients who submitted stool samples. Approximately 8% of patients were varicella nonimmune, with higher rates in patients from the Americas (21%, P refugee patients to provide timely preventive and curative care. Our data also point to possible policy and clinical implications, such as targeted screening approaches and improved access to vaccinations and therapeutics. Copyright© the College of Family Physicians of Canada.

  17. Cognitive Status Correlates with CXCL10/IP-10 Levels in Parkinson’s Disease

    Directory of Open Access Journals (Sweden)

    Natália Pessoa Rocha

    2014-01-01

    Full Text Available Cognitive impairment and depressive symptoms are of great interest in Parkinson’s disease (PD, since they are very common and lead to increased disability with poor quality of life. Inflammatory mechanisms have been implicated in PD and its nonmotor symptoms. In the current pilot study, we aimed to evaluate plasma levels of chemokines in PD patients and to analyze the putative association of chemokines with depressive symptoms and cognitive performance. We hypothesized that higher chemokines levels are associated with worse cognitive performance and increased depressive symptoms in PD. For this purpose, 40 PD patients and 25 age- and gender-matched controls were subjected to a clinical evaluation including cognitive and mood tests. Peripheral blood was drawn and plasma levels of CCL2/MCP-1, CCL11/eotaxin, CCL24/eotaxin-2, and CXCL10/IP-10 were measured by enzyme-linked immunosorbent assay. PD patients and control individuals presented comparable plasma concentrations of all the evaluated chemokines. In PD patients, CXCL10/IP-10 plasma levels correlated positively with Hoehn and Yahr staging scale. In addition, the higher CXCL10/IP-10 levels, the worse performance on cognitive tests. Although there was no significant difference between PD patients and control individuals regarding chemokines levels, our preliminary results showed that CXCL10/IP-10 may be associated with cognitive status in PD.

  18. Nutritional Status and Nutrition Quality in Patients with Non-Alcoholic Fatty Liver Disease.

    Science.gov (United States)

    Vranešić Bender, Darija; Nutrizio, Marinela; Jošić, Mirja; Ljubas Kelečić, Dina; Karas, Irena; Premužić, Marina; Domislović, Viktor; Rotim, Cecilija; Krznarić, Željko

    2017-12-01

    Non-alcoholic fatty liver disease (NAFLD) is becoming a major health burden with increasing prevalence worldwide due to its close association with the epidemic of obesity. Currently there is no standardized pharmacological treatment, and the only proven effective therapeutic strategy is lifestyle modification, therefore it is important to determine the potential dietary targets for the prevention and treatment of NAFLD. We assessed nutritional status in 30 patients diagnosed with NAFLD using anthropometric parameters, hand grip strength, and lifestyle and dietetic parameters (physical activity, NRS2002 form and three-day food diary). The mean body mass index was 29.62±4.61 kg/m2, yielding 86.67% of obese or overweight patients. Physical activity results indicat-ed poorly active subjects. Excessive energy intake was recorded in 27.78% of patients. The mean in-take of macronutrients was as follows: 15.5% of proteins, 42.3% of carbohydrates and 42.2% of fat, with -deficient micronutrient intake of calcium, magnesium, iron, zinc, and vitamins A, B1 and B2. The -results showed that the quality of nutrition in study subjects was not accordant to current rec-ommendations and that they consumed a high proportion of fat, especially saturated fatty acids, along with low micronutrient intake. The results obtained might point to the importance of unbalanced diet as a contributing factor in NAFLD development.

  19. Pathways from childhood intelligence and socioeconomic status to late-life cardiovascular disease risk.

    Science.gov (United States)

    Hagger-Johnson, Gareth; Mõttus, René; Craig, Leone C A; Starr, John M; Deary, Ian J

    2012-07-01

    C-reactive protein (CRP) is an acute-phase marker of systemic inflammation and considered an established risk marker for cardiovascular disease (CVD) in old age. Previous studies have suggested that low childhood intelligence, lower socioeconomic status (SES) in childhood or in later life, unhealthy behaviors, poor wellbeing, and high body mass index (BMI) are associated with inflammation. Life course models that simultaneously incorporate all these risk factors can explain how CVD risks accumulate over time, from childhood to old age. Using the data from 1,091 Scottish adults (Lothian Birth Cohort Study, 1936), a path model was constructed to predict CRP at age 70 from concurrent health behaviors, self-perceived quality of life, and BMI and adulthood SES as mediating variables, and from parental SES and childhood intelligence as distal risk factors. A well-fitting path model (CFI = .92, SRMR = .05) demonstrated significant indirect effects from childhood intelligence and parental social class to inflammation via BMI, health behaviors and quality of life (all ps intelligence, unhealthy behaviors, and higher BMI were also direct predictors of CRP. The life course model illustrated how CVD risks may accumulate over time, beginning in childhood and being both direct and transmitted indirectly via low adult SES, unhealthy behaviors, impaired quality of life, and high BMI. Knowledge on the childhood risk factors and their pathways to poor health can be used to identify high-risk individuals for more intensive and tailored behavior change interventions, and to develop effective public health policies.

  20. Heart transplantation for adults with congenital heart disease: current status and future prospects.

    Science.gov (United States)

    Matsuda, Hikaru; Ichikawa, Hajime; Ueno, Takayoshi; Sawa, Yoshiki

    2017-06-01

    Increased survival rates after corrective or palliative surgery for complex congenital heart disease (CHD) in infancy and childhood are now being coupled with increased numbers of patients who survive to adulthood with various residual lesions or sequelae. These patients are likely to deteriorate in cardiac function or end-organ function, eventually requiring lifesaving treatment including heart transplantation. Although early and late outcomes of heart transplantation have been improving for adult survivors of CHD, outcomes and pretransplant management could still be improved. Survivors of Fontan procedures are a vulnerable cohort, particularly when single ventricle physiology fails, mostly with protein-losing enteropathy and hepatic dysfunction. Therefore, we reviewed single-institution and larger database analyses of adults who underwent heart transplantation for CHD, to enable risk stratification by identifying the indications and outcomes. As the results, despite relatively high early mortality, long-term results were encouraging after heart transplantation. However, further investigations are needed to improve the indication criteria for complex CHD, especially for failed Fontan. In addition, the current system of status criteria and donor heart allocation system in heart transplantation should be arranged as suitable for adults with complex CHD. Furthermore, there is a strong need to develop ventricular assist devices as a bridge to transplantation or destination therapy, especially where right-sided circulatory support is needed.

  1. Effect of radiotherapy and splenectomy on the bone marrow status in patients with Hodgkin's disease

    International Nuclear Information System (INIS)

    Bajsogolov, G.D.; Pavlov, V.V.; Bogatyreva, T.I.; Khait, S.E.; Kuz'mina, E.G.; Khoptynskaya, S.K.; Kolesnikova, A.I.

    1987-01-01

    A study was made of the bone marrow status in unirradiated zones on 33 patients with stage 1-2 Hodgkin's disease in complete 9-12 year remission after therapeutic irradiation of the lymphatic collectors of the upper part of the trunk in combination with irradiation of the system (16 patients) or splenectomy (17 patients). The total count of myelokaryocytes, myelogram, a relative and absolute content of lymphoid cells, immature granulocytes and elements of the erythroid series were defined in the punctates of the upper portion of the ilium. T- and B-lymphocyte count, the number of granulocytomacrophage (CFU-C) and stromal (CFU-F) precursor cells were defined using morphocytochemical and immunological methods. At that time an increase in the relative and absolute content of C- ad B-lymphocytes was noted. The T-cell count and the total number of myelokaryocytes, on the one hand, and the content of immature granulocytes and erythronormoblasts, on the other had, showed correlation of various degree which was particularly noticeable in the group of unoperated patients. The total number of myelokaryocytes in 1 μl of the bone marrow of the patients after splenectomy, on an average, significantly exceeded that in the group of patients with the irradiated spleen. These changes were considered to be a result of the rearragement of T-differentiating lymphocytes with their raised accumulation in the bone marrow after irradiation of a considerable volume of the lymphoid tissue and spleen or after splenectomy

  2. Nutritional Status Predicts 10-Year Mortality in Patients with End-Stage Renal Disease on Hemodialysis

    Directory of Open Access Journals (Sweden)

    Shin Sook Kang

    2017-04-01

    Full Text Available Protein-energy wasting (PEW is associated with mortality in patients with end-stage renal disease (ESRD on maintenance hemodialysis. The correct diagnosis of PEW is extremely important in order to predict clinical outcomes. However, it is unclear which parameters should be used to diagnose PEW. Therefore, this retrospective observational study investigated the relationship between mortality and nutritional parameters in ESRD patients on maintenance hemodialysis. A total of 144 patients were enrolled. Nutritional parameters, including body mass index, serum albumin, dietary intake, normalized protein catabolic rate (nPCR, and malnutrition inflammation score (MIS, were measured at baseline. Fifty-three patients died during the study. Survivors had significantly higher nPCR (1.10 ± 0.24 g/kg/day vs. 1.01 ± 0.21 g/kg/day; p = 0.048, energy intake (26.7 ± 5.8 kcal/kg vs. 24.3 ± 4.2 kcal/kg; p = 0.009 and protein intake (0.91 ± 0.21 g/kg vs. 0.82 ± 0.24 g/kg; p = 0.020, and lower MIS (5.2 ± 2.3 vs. 6.1 ± 2.1, p = 0.039. In multivariable analysis, energy intake <25 kcal/kg (HR 1.860, 95% CI 1.018–3.399; p = 0.044 and MIS > 5 (HR 2.146, 95% CI 1.173–3.928; p = 0.013 were independent variables associated with all-cause mortality. These results suggest that higher MIS and lower energy intake are harmful to ESRD patients on maintenance hemodialysis. Optimal energy intake could reduce mortality in these patients.

  3. The Association of Vitamin D Status in Lower Extremity Muscle Strains and Core Muscle Injuries at the National Football League Combine.

    Science.gov (United States)

    Rebolledo, Brian J; Bernard, Johnathan A; Werner, Brian C; Finlay, Andrea K; Nwachukwu, Benedict U; Dare, David M; Warren, Russell F; Rodeo, Scott A

    2018-04-01

    To evaluate the association between serum vitamin D level and the prevalence of lower extremity muscle strains and core muscle injuries in elite level athletes at the National Football League (NFL) combine. During the 2015 NFL combine, all athletes with available serum vitamin D levels were included for study. Baseline data were collected, including age, race, body mass index, position, injury history specific to lower extremity muscle strain or core muscle injury, and Functional Movement Screen scores. Serum 25-hydroxyvitamin D was collected and defined as normal (≥32 ng/mL), insufficient (20-31 ng/mL), and deficient (history. Subsequent multivariate regression analysis was used to examine this relation with adjustment for collected baseline data variables. The study population included 214 athletes, including 78% African American athletes and 51% skilled position players. Inadequate vitamin D was present in 59%, including 10% with deficient levels. Lower extremity muscle strain or core muscle injury was present in 50% of athletes, which was associated with lower vitamin D levels (P = .03). Athletes with a positive injury history also showed significantly lower vitamin D levels as compared with uninjured athletes (P = .03). African American/black race (P history (P history (P = .07). Inadequate vitamin D levels are a widespread finding in athletes at the NFL combine. Players with a history of lower extremity muscle strain and core muscle injury had a higher prevalence of inadequate vitamin D. Level IV, retrospective study-case series. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  4. The association between socioeconomic status and the symptoms at diagnosis of celiac disease: a retrospective cohort study.

    Science.gov (United States)

    Roy, Abhik; Mehra, Shilpa; Kelly, Ciarán P; Tariq, Sohaib; Pallav, Kumar; Dennis, Melinda; Peer, Ann; Lebwohl, Benjamin; Green, Peter H R; Leffler, Daniel A

    2016-07-01

    There are little data on patient factors that impact diagnosis rates of celiac disease. This study aims to evaluate the association between patient socioeconomic status and the symptoms at diagnosis of celiac disease. A total of 872 patients with biopsy-proven celiac disease were categorized based on the presence or absence of (1) diarrhea and (2) any gastrointestinal symptoms at diagnosis. Univariate and multivariate analyses were used to assess the association between socioeconomic status and symptoms. Patients without diarrhea at presentation had a higher mean per capita income (US$34,469 versus US$32,237, p = 0.02), and patients without any gastrointestinal symptoms had a higher mean per capita income (US$36,738 versus US$31,758, p symptoms. On multivariable analysis adjusting for sex, age, autoimmune or psychiatric comorbidities, and income, per capita income remained a significant predictor of diagnosis without gastrointestinal symptoms (odds ratio: 1.71, 95% confidence interval: 1.17-2.50, p symptoms of celiac disease are less likely to be diagnosed if they are of lower socioeconomic status. Celiac disease may be under-recognized in this population due to socioeconomic factors that possibly include lower rates of health-seeking behavior and access to healthcare.

  5. Where to next with animal health in Latin America? The transition from endemic to disease-free status.

    Science.gov (United States)

    Rojas, H; Romero, J R

    2017-04-01

    The Latin American and Caribbean region (LAC) is a leading global producer and exporter of animal products. Its livestock production systems are diverse, ranging from large-scale commercial enterprises to family farms. Countries in this region have sought to improve their animal health status through both public and private efforts. Despite significant advances in eradicating such diseases as foot and mouth disease and classical swine fever, other animal health challenges remain; constraining exports, causing negative economic impacts and threatening food security. Obtaining certification of disease-free status is only the first step towards gaining benefits from improvements in animal health. Increasing international trade means that countries must manage the sustainability of their disease-free status in conjunction with trade partners and must comply with additional food safety and animal welfare standards. This paper comments on the challenges created by this new scenario in relation to the epidemiology and economics of animal health, when seeking to improve decisionmaking for animal health management. The authors characterise the current LAC livestock landscape and animal health situation, describing transitions in disease control and the use of economics in improving animal health. They conclude with remarks on the challenges presented by decision-making, economic rationality, sources of benefits, distribution and incentives.

  6. Clinical status, quality of life, and work productivity in Crohn's disease patients after one year of treatment with adalimumab.

    Science.gov (United States)

    Saro, Cristina; Ceballos, Daniel; Muñoz, Fernando; de la Coba, Cristóbal; Aguilar, María Dolores; Lázaro, Pablo; García-Sánchez, Valle; Hernández, Mariola; Barrio, Jesús; de Francisco, Ruth; Fernández, Luis I; Barreiro-de Acosta, Manuel

    2017-02-01

    Clinical trials have shown the efficacy of adalimumab in Crohn's disease, but the outcome in regular practice remains unknown. The aim of the study was to examine clinical status, quality of life, and work productivity of Crohn's disease patients receiving adalimumab for one year in the context of usual clinical practice. This was a prospective, observational study with a one-year follow-up. After baseline, Crohn's disease patients were evaluated at 1, 3, 6, 9, and 12 months after starting treatment with adalimumab. Outcome variables included: clinical status (measured with CDAI), quality of life (measured with EuroQoL-5D and IBDQ), and work productivity (measured with WPAI questionnaire). These outcome variables were compared using the Student's t test or Wilcoxon test for paired comparison data according to the data distribution. Statistical significance was set at two-sided p work productivity impact decreased from 53% to 24% (p quality of life and work productivity.

  7. The Effect of Hyperhomocysteinemia on Motor Symptoms, Cognitive Status, and Vascular Risk in Patients with Parkinson’s Disease

    Directory of Open Access Journals (Sweden)

    Bilge Kocer

    2016-01-01

    Full Text Available Factors related with hyperhomocysteinemia (HHcy and the impact of HHcy in Parkinson’s disease (PD are not well understood. We investigated the factors associated with increased levels of homocysteine (Hcy and the relationship between HHcy and motor symptoms, cognitive status, and vascular risk in patients with Parkinson’s disease. Among 60 patients (29 males, 48.3% with PD, the stage of the disease, the severity of clinical symptoms, and the patients’ cognitive status were measured using a modified Hoehn and Yahr Staging Scale (mHY, Unified Parkinson’s Disease Rating Scale (UPDRS II and III, and Mini-Mental State Examination (MMSE, respectively. Patients were also noted for having dyskinesia and hallucinations. Serum vitamin B12, folic acid, and plasma Hcy ​​levels were measured. Furthermore, the presence of vascular risk factors was recorded. Finally, we investigated carotid artery intima-media thickening and stenosis using colour Doppler ultrasonography as well as the presence of ischemic lesions using brain imaging techniques. Plasma Hcy ​​levels were higher with advanced age and in males. In addition, there was an inverse relationship between Hcy ​​and vitamin B12 levels. There was no correlation between HHcy and the stage of the disease, severity of motor symptoms, cognitive status as assessed by the MMSE, vascular risk factors, carotid artery atherosclerotic findings, and ischemic brain lesions. Plasma Hcy levels may rise due to several factors in PD. However, the resulting HHcy has no significant effect on the clinical picture in terms of motor features, cognitive status, and vascular diseases.

  8. Combined analysis of circulating epithelial cells and serum thyroglobulin for distinguishing disease status of the patients with papillary thyroid carcinoma.

    Science.gov (United States)

    Lin, Hung-Chih; Liou, Miaw-Jene; Hsu, Hsung-Ling; Hsieh, Jason Chia-Hsun; Chen, Yi-An; Tseng, Ching-Ping; Lin, Jen Der

    2016-03-29

    Papillary thyroid carcinoma (PTC) accounts for about 80% of the cases in thyroid cancer. Routine surveillance by serum thyroglobulin (Tg) and medical imaging is the current practice to monitor disease progression of the patients. Whether enumeration of circulating epithelial cells (CECs) helps to define disease status of PTC patients was investigated. CECs were enriched from the peripheral blood of the healthy control subjects (G1, n = 17) and the patients at disease-free status (G2, n = 26) or with distant metastasis (G3, n = 22). The number of CECs expressing epithelial cell adhesion molecule (EpCAM) or thyroid-stimulating hormone receptor (TSHR) was determined by immunofluorescence microscopy analyses. The medium number of EpCAM+-CECs was 6 (interquartile range 1-11), 12 (interquartile range 7-16) and 91 (interquartile range 31-206) cells/ml of blood for G1, G2 and G3, respectively. EpCAM+-CEC counts were significantly higher in G3 than in G1 (p interquartile range 3-13), 16 (interquartile range 10-24) and 100 (interquartile range 31-226) cells/ml of blood for G1, G2 and G3, respectively. The TSHR+-CEC counts also distinguished G3 from G1 (p < 0.05) and G2 (p < 0.05). With an appropriate cut off value of CEC count, the disease status for 97.9% (47/48) of the cases was clearly defined. Notably, the metastatic disease for all patients in G3 (22/22) was revealed by combined analysis of serum Tg and CEC. This study implicates that CEC testing can supplement the current standard methods for monitoring disease status of PTC.

  9. Juvenile idiopathic arthritis in adulthood: fulfilment of classification criteria for adult rheumatic diseases, long-term outcomes and predictors of inactive disease, functional status and damage.

    Science.gov (United States)

    Oliveira-Ramos, Filipa; Eusébio, Mónica; M Martins, Fernando; Mourão, Ana Filipa; Furtado, Carolina; Campanilho-Marques, Raquel; Cordeiro, Inês; Ferreira, Joana; Cerqueira, Marcos; Figueira, Ricardo; Brito, Iva; Canhão, Helena; Santos, Maria José; Melo-Gomes, José A; Fonseca, João Eurico

    2016-01-01

    To determine how adult juvenile idiopathic arthritis (JIA) patients fulfil classification criteria for adult rheumatic diseases, evaluate their outcomes and determine clinical predictors of inactive disease, functional status and damage. Patients with JIA registered on the Rheumatic Diseases Portuguese Register (Reuma.pt) older than 18 years and with more than 5 years of disease duration were included. Data regarding sociodemographic features, fulfilment of adult classification criteria, Health Assessment Questionnaire, Juvenile Arthritis Damage Index-articular (JADI-A) and Juvenile Arthritis Damage Index-extra-articular (JADI-E) damage index and disease activity were analysed. 426 patients were included. Most of patients with systemic JIA fulfilled criteria for Adult Still's disease. 95.6% of the patients with rheumatoid factor (RF)-positive polyarthritis and 57.1% of the patients with RF-negative polyarthritis matched criteria for rheumatoid arthritis (RA). 38.9% of the patients with extended oligoarthritis were classified as RA while 34.8% of the patients with persistent oligoarthritis were classified as spondyloarthritis. Patients with enthesitis-related arthritis fulfilled criteria for spondyloarthritis in 94.7%. Patients with psoriatic arthritis maintained this classification. Patients with inactive disease had lower disease duration, lower diagnosis delay and corticosteroids exposure. Longer disease duration was associated with higher HAQ, JADI-A and JADI-E. Higher JADI-A was also associated with biological treatment and retirement due to JIA disability and higher JADI-E with corticosteroids exposure. Younger age at disease onset was predictive of higher HAQ, JADI-A and JADI-E and decreased the chance of inactive disease. Most of the included patients fulfilled classification criteria for adult rheumatic diseases, maintain active disease and have functional impairment. Younger age at disease onset was predictive of higher disability and decreased the

  10. Plasma nutrient status of patients with Alzheimer's disease: Systematic review and meta-analysis.

    Science.gov (United States)

    Lopes da Silva, Sofia; Vellas, Bruno; Elemans, Saskia; Luchsinger, José; Kamphuis, Patrick; Yaffe, Kristine; Sijben, John; Groenendijk, Martine; Stijnen, Theo

    2014-07-01

    Alzheimer disease (AD) patients are at risk of nutritional insufficiencies because of physiological and psychological factors. Nutritional compounds are postulated to play a role in the pathophysiological processes that are affected in AD. We here provide the first systematic review and meta-analysis that compares plasma levels of micronutrients and fatty acids in AD patients to those in cognitively intact elderly controls. A secondary objective was to explore the presence of different plasma nutrient levels between AD and control populations that did not differ in measures of protein/energy nourishment. We screened literature published after 1990 in the Cochrane Central Register of Controlled Trials, Medline, and Embase electronic databases using Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines for AD patients, controls, micronutrient, vitamins, and fatty acids, resulting in 3397 publications, of which 80 met all inclusion criteria. Status of protein/energy malnutrition was assessed by body mass index, mini nutritional assessment score, or plasma albumin. Meta-analysis, with correction for differences in mean age between AD patients and controls, was performed when more than five publications were retrieved for a specific nutrient. We identified five or more studies for folate, vitamin A, vitamin B12, vitamin C, vitamin D, vitamin E, copper, iron, and zinc but fewer than five studies for vitamins B1 and B6, long-chain omega-3 fatty acids, calcium, magnesium, manganese, and selenium (the results of the individual publications are discussed). Meta-analysis showed significantly lower plasma levels of folate and vitamin A, vitamin B12, vitamin C, and vitamin E (P vitamin D (P = .075) were found in AD patients. No significant differences were observed for plasma levels of copper and iron. A meta-analysis that was limited to studies reporting no differences in protein/energy malnourishment between AD and control populations yielded

  11. NUTRITIONAL STATUS IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE : A CROSS SECTIONAL STUDY

    Directory of Open Access Journals (Sweden)

    Rabindra Kumar

    2015-10-01

    Full Text Available INTRODUCTION : Changes in nutritional status, such as weight loss and malnutrition, are a very common complication in patients with chronic obstructive pulmonary disease (COPD.These changes primarily affect the patients' quality of life and functional capacity and they are also independent prognostic indicators of both morbidity and mortality. The above information inspired us to evaluate the nutritional status in these patients by measuring daily oral intake and anthropom etric measures. METHOD : This cross - sectional study was conducted during the period October 2008 to April 2009. Seventy two COPD patients in the age group of 40 - 65 years, with an FEV (1 < 65% of predicted and an FEV (1/FVC ratio < 70% were included in the study. All the patients were assessed for anthropometric parameters such as height, body weight (BW, Body Mass Index (BMI, Hip Circumference, waist circumference and mid upper arm circumference (MUAC. Daily dietary intakes were calculated by 24 hour re call method with the help of cups, spoons, and glasses which were standardized with commonly consumed recipes. Standardized models of chapatti, rice, fruits, and snacks items were used for accurate data. Energy and nutrient intakes were derived using the N utritive value of Indian foods. RESULTS : The prevalence of under nutrition were (30/72 41.6% based on body mass index (<18.5 kg/m(2 and (46/72 63.8% based on mid - upper arm circumference (<24 cm.More number of patients was above 60 years of age in the income grouping 3000 - 5000 INR / month living with family members of more than 3 per house. The daily intake of food as compared to reference RDA is as follows energy 54.51%, carbohydrates 84.85%, protein60.52% and Fats 71.2%. CONCLUSION : The prevalence of u nder nutrition were (30/72 41.6% based on body mass index (<18.5 kg/m2 and (46/72 63.8% based on mid - upper arm circumference (<24 cm . Nutritional assessment should be made mandatory in order to recognize

  12. Effect of Baseline Nutritional Status on Long-term Multivitamin Use and Cardiovascular Disease Risk

    Science.gov (United States)

    Rautiainen, Susanne; Gaziano, J. Michael; Christen, William G.; Bubes, Vadim; Kotler, Gregory; Glynn, Robert J.; Manson, JoAnn E.; Buring, Julie E.

    2017-01-01

    Importance Long-term multivitamin use had no effect on risk of cardiovascular disease (CVD) in the Physicians’ Health Study II. Baseline nutritional status may have modified the lack of effect. Objective To investigate effect modification by various baseline dietary factors on CVD risk in the Physicians’ Health Study II. Design, Setting, and Participants The Physicians’ Health Study II was a randomized, double-blind, placebo-controlled trial testing multivitamin use (multivitamin [Centrum Silver] or placebo daily) among US male physicians. The Physicians’ Health Study II included 14 641 male physicians 50 years or older, 13 316 of whom (91.0%) completed a baseline 116-item semiquantitative food frequency questionnaire and were included in the analyses. This study examined effect modification by baseline intake of key foods, individual nutrients, dietary patterns (Alternate Healthy Eating Index and Alternate Mediterranean Diet Score), and dietary supplement use. The study began in 1997, with continued treatment and follow-up through June 1, 2011. Interventions Multivitamin or placebo daily. Main Outcomes and Measures Major cardiovascular events, including nonfatal myocardial infarction, nonfatal stroke, and CVD mortality. Secondary outcomes included myocardial infarction, total stroke, CVD mortality, and total mortality individually. Results In total, 13 316 male physicians (mean [SD] age at randomization, 64.0 [9.0] years in those receiving the active multivitamin and 64.0 [9.1] years in those receiving the placebo) were observed for a mean (SD) follow-up of 11.4 (2.3) years. There was no consistent evidence of effect modification by various foods, nutrients, dietary patterns, or baseline supplement use on the effect of multivitamin use on CVD end points. Statistically significant interaction effects were observed between multivitamin use and vitamin B6 intake on myocardial infarction, between multivitamin use and vitamin D intake on CVD mortality

  13. Work and marital status in relation to depressive symptoms and social support among women with coronary artery disease.

    Science.gov (United States)

    Blom, May; Georgiades, Anastasia; László, Krisztina D; Alinaghizadeh, Hassan; Janszky, Imre; Ahnve, Staffan

    2007-11-01

    Work and marital status have been shown to be associated with health outcome in women. However, the effect of employment and marriage on psychosocial functioning has been studied predominantly in healthy subjects. We investigated whether work and marital status are associated with depressive symptoms, social support, and daily stress behavior in women with coronary artery disease (CAD). Data of 105 women with CAD and of working age were analyzed. General linear models were used to determine the association between work and marital status and depressive symptoms, social support, and daily stress behavior. Women who were working at the time of measurement had lower levels of depressive symptoms (7.0 +/- 1.2 vs. 12.1 +/- 0.9, p marital status was not related to any of the outcome variables. Results were similar after adjusting for potential confounders, that is, age, education, self-reported health, and risk factors for CAD. There was no significant interaction between marital status and working status on depressive symptoms, social support, or daily stress behavior. In women with CAD, all working had lower levels of depressive symptoms and a better social integration than those not working, regardless of reason for being nonemployed. Daily stress behavior, depression, and social support did not differ between cohabiting and not cohabiting women. Future interventions should take into consideration that women with CAD who are unemployed may have a higher risk for depression and social isolation and, therefore, poor clinical outcomes.

  14. Urinary Metabolic Phenotyping Reveals Differences in the Metabolic Status of Healthy and Inflammatory Bowel Disease (IBD Children in Relation to Growth and Disease Activity

    Directory of Open Access Journals (Sweden)

    Francois-Pierre Martin

    2016-08-01

    Full Text Available Background: Growth failure and delayed puberty are well known features of children and adolescents with inflammatory bowel disease (IBD, in addition to the chronic course of the disease. Urinary metabonomics was applied in order to better understand metabolic changes between healthy and IBD children. Methods: 21 Pediatric patients with IBD (mean age 14.8 years, 8 males were enrolled from the Pediatric Gastroenterology Outpatient Clinic over two years. Clinical and biological data were collected at baseline, 6, and 12 months. 27 healthy children (mean age 12.9 years, 16 males were assessed at baseline. Urine samples were collected at each visit and subjected to 1H Nuclear Magnetic Resonance (NMR spectroscopy. Results: Using 1H NMR metabonomics, we determined that urine metabolic profiles of IBD children differ significantly from healthy controls. Metabolic differences include central energy metabolism, amino acid, and gut microbial metabolic pathways. The analysis described that combined urinary urea and phenylacetylglutamine—two readouts of nitrogen metabolism—may be relevant to monitor metabolic status in the course of disease. Conclusion: Non-invasive sampling of urine followed by metabonomic profiling can elucidate and monitor the metabolic status of children in relation to disease status. Further developments of omic-approaches in pediatric research might deliver novel nutritional and metabolic hypotheses.

  15. Comparison of Doppler and oscillometric ankle blood pressure measurement in patients with angiographically documented lower extremity arterial occlusive disease.

    Science.gov (United States)

    Nukumizu, Yoshihito; Matsushita, Masahiro; Sakurai, Tsunehisa; Kobayashi, Masayoshi; Nishikimi, Naomichi; Komori, Kimihiro

    2007-01-01

    To assess the reliability of the oscillometric method in patients with peripheral vascular disease, ankle blood pressure measurement by Doppler and oscillometry was compared. This study represents a prospective, non-blinded examination of pressure measurements in 168 patients. Twenty-two patients were included who had abdominal aortic aneurysms (AAA) and 146 had peripheral arterial occlusive disease (PAOD). Patients with PAOD were divided into 2 groups according to angiography results: a crural artery occlusion group (CAO, n = 32), and a no crural artery occlusion group (NCAO, n = 114). All subjects underwent pressure measurement by both Doppler and oscillometry. The correlation coefficient was 0.928 in AAA patients and 0.922 in PAOD patients. In CAO patients, there were significantly fewer patients whose oscillometric pressure was equivalent to the Doppler pressure (DP), as compared to NCAO patients, because the oscillometric pressure (OP) was 10% higher than DP in 44% of CAO patients. A high correlation exists between Doppler and oscillometric ankle pressure measurements irrespective of the type of vascular disease. However, the oscillometric method could not be substituted for the Doppler method completely, because there were several patients whose OP was greater than DP especially in those with crural artery occlusive disease.

  16. Bone pain and extremely low bone mineral density due to severe vitamin D deficiency in celiac disease

    NARCIS (Netherlands)

    Rabelink, N.M.; Westgeest, H.M.; Bravenboer, N.; Jacobs, M.A.J.M.; Lips, P.T.A.M.

    2011-01-01

    Case report A 29-year-old wheelchair-bound woman was presented to us by the gastroenterologist with suspected osteomalacia. She had lived in the Netherlands all her life and was born of Moroccan parents. Her medical history revealed iron deficiency, growth retardation, and celiac disease, for which

  17. Human Papillomavirus 16, 18, 31 and 45 viral load, integration and methylation status stratified by cervical disease stage

    International Nuclear Information System (INIS)

    Marongiu, Luigi; Godi, Anna; Parry, John V; Beddows, Simon

    2014-01-01

    Persistent infection with oncogenic Human Papillomavirus (HPV) is associated with the development of cervical cancer with each genotype differing in their relative contribution to the prevalence of cervical disease. HPV DNA testing offers improved sensitivity over cytology testing alone but is accompanied by a generally low specificity. Potential molecular markers of cervical disease include type-specific viral load (VL), integration of HPV DNA into the host genome and methylation of the HPV genome. The aim of this study was to evaluate the relationship between HPV type-specific viral load, integration and methylation status and cervical disease stage in samples harboring HPV16, HPV18, HPV31 or HPV45. Samples singly infected with HPV16 (n = 226), HPV18 (n = 32), HPV31 (n = 75) or HPV45 (n = 29) were selected from a cohort of 4,719 women attending cervical screening in England. Viral load and integration status were determined by real-time PCR while 3’L1-URR methylation status was determined by pyrosequencing or sequencing of multiple clones derived from each sample. Viral load could differentiate between normal and abnormal cytology with a sensitivity of 75% and a specificity of 80% (odds ratio [OR] 12.4, 95% CI 6.2–26.1; p < 0.001) with some variation between genotypes. Viral integration was poorly associated with cervical disease. Few samples had fully integrated genomes and these could be found throughout the course of disease. Overall, integration status could distinguish between normal and abnormal cytology with a sensitivity of 72% and a specificity of 50% (OR 2.6, 95% CI 1.0–6.8; p = 0.054). Methylation levels were able to differentiate normal and low grade cytology from high grade cytology with a sensitivity of 64% and a specificity of 82% (OR 8.2, 95% CI 3.8–18.0; p < 0.001). However, methylation varied widely between genotypes with HPV18 and HPV45 exhibiting a broader degree and higher magnitude of methylated CpG sites than HPV16 and HPV31. This

  18. The Memory Alteration Test Discriminates between Cognitively Healthy Status, Mild Cognitive Impairment and Alzheimer's Disease

    Science.gov (United States)

    Custodio, Nilton; Lira, David; Herrera-Perez, Eder; Nuñez del Prado, Liza; Parodi, José; Guevara-Silva, Erik; Castro-Suarez, Sheila; Montesinos, Rosa; Cortijo, Patricia

    2014-01-01

    Background/Aims Dementia is a worldwide public health problem and there are several diagnostic tools for its assessment. The aim of this study was to evaluate the performance of the Memory Alteration Test (M@T) to discriminate between patients with early Alzheimer's disease (AD), patients with amnestic mild cognitive impairment (a-MCI), and subjects with a cognitively healthy status (CHS). Methods The discriminative validity was assessed in a sample of 90 patients with AD, 45 patients with a-MCI, and 180 subjects with CHS. Clinical, functional, and cognitive studies were independently performed in a blinded fashion and the gold standard diagnosis was established by consensus on the basis of these results. The test performance was assessed by means of a receiver operating characteristic curve analysis as area under the curve (AUC). Results M@T mean scores were 17.7 (SD = 5.7) in AD, 30.8 (SD = 2.3) in a-MCI, and 44.5 (SD = 3.1) in CHS. A cutoff score of 37 points had a sensitivity of 98.3% and a specificity of 97.8% to differentiate a-MCI from CHS (AUC = 0.999). A cutoff score of 27 points had a sensitivity of 100% and a specificity of 98.9% to differentiate mild AD from a-MCI and from CHS (AUC = 1.000). Conclusions The M@T had a high performance in the discrimination between early AD, a-MCI and CHS. PMID:25298775

  19. [A national survey on current status of the important parasitic diseases in human population].

    Science.gov (United States)

    2005-10-30

    In order to understand the current status and trends of the important parasitic diseases in human population, to evaluate the effect of control activities in the past decade and provide scientific base for further developing control strategies, a national survey was carried out in the country (Taiwan, Hongkong and Macau not included) from June, 2001 to 2004 under the sponsorship of the Ministry of Health. The sample sizes of the nationwide survey and of the survey in each province (autonomous region and municipality, P/A/M) were determined following a calculating formula based on an estimation of the sample size of random sampling to the rate of population. A procedure of stratified cluster random sampling was conducted in each province based on geographical location and economical condition with three strata: county/city, township/town, and spot, each spot covered a sample of 500 people. Parasitological examinations were conducted for the infections of soil-transmitted nematodes, Taenia spp, and Clonorchis sinensis, including Kato-Katz thick smear method, scotch cellulose adhesive tape technique and test tube-filter paper culture (for larvae). At the same time, another sampled investigation for Clonorchis sinensis infection was carried out in the known endemic areas in 27 provinces. Serological tests combined with questionnaire and/or clinical diagnosis were applied for hydatid disease, cysticercosis, paragonimiasis, trichinosis, and toxoplasmosis. A total sampled population of 356 629 from the 31 P/A/M was examined by parasitological methods and 26 species of helminth were recorded. Among these helminth, human infections of Metorchis orientalis and Echinostoma aegypti were detected in Fujian Province which seemed to be the first report in the world, and Haplorchis taichui infection in Guangxi Region was the first human infection record in the country. The overall prevalence of helminth infections was 21.74%. The prevalence of soil-transmitted nematodes was 19

  20. Vacuum assisted wound closure in patients with lower extremity arterial disease. The experience from two tertiary referral-centres.

    Science.gov (United States)

    Nordmyr, J; Svensson, S; Björck, M; Acosta, S

    2009-02-01

    The purpose of this investigation was to analyze predictors for wound healing, amputation and mortality after vacuum assisted closure (VAC) therapy of wounds in the lower limb in patients with arterial disease. One hundred and twenty one wounds were treated and followed for 12 months at two vascular centres in Uppsala and Malmö, Sweden. VAC therapy was applied in the wound at a topical negative pressure of 125 mmHg. Median age of the patients was 74 years and critical lower limb ischemia was present in 87% of the patients at admission. Intestinal flora was cultivated in 74% of the wounds. VAC associated bleeding occurred in four patients. Complete wound healing was achieved in 66%. Deep groin infections were associated with synthetic graft infection (Plower amputation rate (PVAC therapy of complex wounds in the lower limbs in patients with vascular disease was associated with high healing rates. Non-healed wounds after VAC therapy were predictors for amputation and death.

  1. Assessement of rheumatic diseases with computational radiology: current status and future potential

    DEFF Research Database (Denmark)

    Peloschek, Philipp; Boesen, Mikael; Donner, Rene

    2009-01-01

    In recent years, several computational image analysis methods to assess disease progression in rheumatic diseases were presented. This review article explains the basics of these methods as well as their potential application in rheumatic disease monitoring, it covers radiography, sonography...

  2. Access to Posthospitalization Acute Care Facilities is Associated with Payer Status for Open Abdominal Aortic Repair and Open Lower Extremity Revascularization in the Vascular Quality Initiative.

    Science.gov (United States)

    Ulloa, Jesus G; Woo, Karen; Tseng, Chi-Hong; Maggard-Gibbons, Melinda; Rigberg, David

    2017-07-01

    Uninsured patients may not have access to postacute care facilities that play an important role in clinical recovery, and functional outcomes after vascular surgery. We sought to determine whether discharge disposition is associated with insurance status. We retrospectively reviewed data from the Vascular Quality Initiative ® for patients who underwent open abdominal aortic repair, infrainguinal bypass, or suprainguinal bypass (SB) between January 2012 and July 2015. Mixed-effects logistic regression analysis with clustering at the surgeon and facility level was used to calculate 95% confidence intervals for discharge disposition to home, skilled nursing facility (SNF) or rehabilitation (Rehab) facility by payer status (Medicare, Medicaid, Commercial, Military/Veterans Affairs, Non-US Insurance, or Self-pay), with adjustment for patient, operative, and postoperative characteristics. The study cohort comprised 18,478 procedures (open abdominal aortic repair = 2,817; infrainguinal bypass = 11,572; suprainguinal bypass = 4,089) after we excluded procedures with missing data and in-hospital deaths. Twenty-four percent of the cohort was discharged to an SNF or Rehab site. On univariate analysis, the odds ratio (OR) of discharge home was 4.38 (95% CI: 3.33-5.77) for self-pay as compared to Medicare. On mixed-effects analysis, the adjusted odds of discharge home for self-pay as compared to Medicare remained high (OR = 3.09; 95% CI: 2.23-4.26), after adjustment for age, gender, race/ethnicity, preoperative ambulatory status, number of comorbidities, case urgency, total operative time, presence of a postoperative complication, procedure type, and length of stay. Adjusted odds for discharge to SNF (OR = 0.26; 95% CI: 0.15-0.46) and Rehab (OR = 0.50; 95% CI: 0.35-0.72) were lowest for self-pay status. Access to postacute care facilities is associated with insurance status. Self-pay (uninsured) patients are less likely to have access to discharge services that may

  3. Sex differences in disease-specific health status measures in patients with symptomatic peripheral artery disease: Data from the PORTRAIT study.

    Science.gov (United States)

    Roumia, Mazen; Aronow, Herbert D; Soukas, Peter; Gosch, Kensey; Smolderen, Kim G; Spertus, John A; Abbott, J Dawn

    2017-04-01

    Peripheral artery disease (PAD) is associated with poor health status (symptoms, functioning, quality of life (QOL)). Whether sex differences exist in PAD-specific health status is unknown. In patients presenting to a specialty clinic with new-onset or recent exacerbation of PAD, we examined sex differences as assessed by the Peripheral Artery Questionnaire (PAQ). The Patient-centered Outcomes Related to TReatment Practices in Peripheral Arterial Disease: Investigating Trajectories (PORTRAIT) study is a multicenter, international prospective study of patients with new or worsening PAD symptoms. Baseline characteristics and mean PAQ scores were compared among women ( n=481) and men ( n=793) before they underwent treatment. The independent association of sex with health status was assessed with multivariable linear regression. As compared with men, women were less often Caucasian, married and employed, and more often lacking health insurance, living alone (36.2% vs 23.6%, pPAQ scores on all domains (physical functioning adjusted mean difference of -8.40, p<0.001; social functioning adjusted mean difference of -6.8, p<0.001; QOL adjusted mean difference of -6.7, p<0.001), although no differences were observed in treatment satisfaction (adjusted mean difference -0.20, p=0.904). Despite similar ABIs, women presenting with symptoms of PAD had poorer PAD-specific functioning as compared with men, impacting all major health status domains, independent of socio-economic and clinical characteristics.

  4. Parasites, diseases, and health status of sympatric populations of sika deer and white-tailed deer in Maryland and Virginia.

    Science.gov (United States)

    Davidson, W R; Crow, C B

    1983-10-01

    In July 1981, investigations on parasites, diseases, and herd health status were conducted on sympatric populations of sika deer (Cervus nippon) and white-tailed deer (Odocoileus virginianus) from Blackwater National Wildlife Refuge (Maryland) and Chincoteague National Wildlife Refuge (Virginia) on the Delmarva Peninsula. Five adult deer of each species were collected from each location and subjected to thorough necropsy examinations and laboratory tests. White-tailed deer at both locations harbored protozoan, helminth, and arthropod parasites typically associated with this species throughout the southeastern United States. In contrast, sika deer at both locations harbored only light burdens of ticks, chiggers, and sarcocysts. Serologic tests for antibodies to seven infectious disease agents revealed evidence of exposure to bovine virus diarrhea (BVD) virus, infectious bovine rhinotracheitis virus, and parainfluenza3 virus in white-tailed deer, but only BVD virus in sika deer. At both locations the general health status of sika deer was superior to that of white-tailed deer.

  5. Education status determines 10-year (2002-2012) survival from cardiovascular disease in Athens metropolitan area: the ATTICA study, Greece.

    Science.gov (United States)

    Panagiotakos, Demosthenes; Georgousopoulou, Ekavi; Notara, Venetia; Pitaraki, Evangelia; Kokkou, Eleni; Chrysohoou, Christina; Skoumas, Yannis; Metaxa, Vassiliki; Pitsavos, Christos; Stefanadis, Christodoulos

    2016-05-01

    Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality worldwide, and educational level seems to be an important determinant of the disease occurrence. The aim of this work was to investigate the association between education status and 10-year incidence of CVD, controlling for various socio-demographic lifestyle and clinical factors. From May 2001 to December 2002, 1514 men and 1528 women (>18 years) without any clinical evidence of CVD or any other chronic disease, at baseline, living in greater Athens area, Greece, were enrolled. In 2011-2012, the 10-year follow-up was performed in 2583 participants (15% of the participants were lost to follow-up). Incidence of fatal or non-fatal CVD was defined according to WHO-ICD-10 criteria. Education status was measured in years of schooling. The 10-year incidence of CVD was 15.7% [95% confidence intervals (CI) 14.1%-17.4%], 19.7% in men and 11.7% in women (Pgender education (education (>12 years of schooling). People in the low education group had higher prevalence of hypertension, diabetes and dyslipidaemias, were more likely to be smokers and sedentary, had less healthy dietary habits, as compared with those in the high education group. When controlling for participants' medical history, smoking, dietary and lifestyle habits, low education was no longer significantly associated with CVD, illustrating the mediating effect of clinical and behavioural factors in the link between education and disease. It was of interest that low education status interacted with alcohol drinking, enhancing the adverse effect of low education on CVD risk (relative risk 1.44, 95% CI 0.94%-2.20%), after various adjustments made. In this study, it was concluded that low educational level was associated with increased CVD risk. This was mainly explained by the intermediate association of low education with unhealthy choices that consequently worsen clinical status. © 2015 John Wiley & Sons Ltd.

  6. Men's serostatus disclosure to parents: associations among social support, ethnicity, and disease status in men living with HIV.

    Science.gov (United States)

    Fekete, Erin M; Antoni, Michael H; Lopez, Corina R; Durán, Ron E; Penedo, Frank J; Bandiera, Frank C; Fletcher, Mary Ann; Klimas, Nancy; Kumar, Mahendra; Schneiderman, Neil

    2009-07-01

    Directly disclosing a positive HIV serostatus to family members can affect psychological and disease status. Perceptions that one is in a supportive family environment may moderate these effects; however, ethnic differences may exist in the support processes of families coping with HIV. We examined the role of serostatus disclosure to parents, HIV-specific family support, and ethnicity (Latino versus non-Hispanic White) in explaining disease status (HIV Viral Load, CD4+ cell count) in a sample of men living with HIV (MLWH). Men (n=120) reported whether they had disclosed their serostatus to their mothers and fathers, rated their perceptions of HIV-specific social support received from family members, and provided morning peripheral venous blood samples to assess immune function. We also collected psychosocial and urinary neuroendocrine indicators of stress/distress as possible mediator variables. A three-way interaction emerged between serostatus disclosure to mothers, HIV-specific family support, and ethnicity in explaining both viral load and CD4+ cell count. Non-Hispanic White men who had disclosed to mothers and were receiving high family support had a lower viral load and higher CD4+ cell count, but Latino men who had disclosed to mothers and were receiving low family support had a higher viral load. These associations were not accounted for by men's medication adherence, psychological distress, or neuroendocrine hormones. Disclosure to fathers was not related to disease status. The effects of serostatus disclosure on disease status may depend, in part, on ethnic differences in the interpersonal processes of men's close family relationships.

  7. Vitamin D and K status influences bone mineral density and bone accrual in children and adolescents with celiac disease.

    Science.gov (United States)

    Mager, D R; Qiao, J; Turner, J

    2012-04-01

    Children with celiac disease (CD) are at risk for decreased bone mineral density (BMD) because of fat-soluble vitamin malabsorption, inflammation and/or under-nutrition. The study objective was to determine the interrelationships between vitamin K/D status and lifestyle variables on BMD in children and adolescents with CD at diagnosis and after 1 year on the gluten-free diet (GFD). Children and adolescents aged 3-17 years with biopsy proven CD at diagnosis and after 1 year on the GFD were studied. BMD was measured using dual-energy X-ray absorptiometry. Relevant variables included: anthropometrics, vitamin D/K status, diet, physical activity and sunlight exposure. Whole-body and lumbar-spine BMD-z scores were low (vitamin D (90.3±24.8 versus 70.5±19.8 nmol/l) were significantly lower in older children (>10 years) when compared with younger children (vitamin D status (25(OH)-vitamin D vitamin K status at diagnosis; all resolved after 1 year. Children and adolescents with CD are at risk for suboptimal bone health at time of diagnosis and after 1 year on GFD; likely due in part to suboptimal vitamin D/K status. Therapeutic strategies aimed at optimizing vitamin K/D intake may contribute to improved BMD in children with CD.

  8. Comparison of the severity of lower extremity arterial disease in smokers and patients with diabetes using a novel duplex Doppler scoring system

    Energy Technology Data Exchange (ETDEWEB)

    Hiremath, Rudresh; Gowda, Goutham; Ibrahim, Jebin; Reddy, Harish T.; Chodiboina, Haritha; Shah, Rushit [Radiodiagnosis and Imaging, KVG Medical College and Hospital, Sullia (India)

    2017-07-15

    The aim of this study was to validate the diagnostic feasibility of a novel scoring system of peripheral arterial disease (PAD) in smokers and patients with diabetes depending on duplex Doppler sonographic features. Patients presenting with the symptomatology of PAD were divided into three groups: diabetes only, smoking only, and smokers with diabetes. The patients were clinically examined, a clinical severity score was obtained, and the subjects were categorized into the three extrapolated categories of mild, moderate, and severe. All 106 subjects also underwent a thorough duplex Doppler examination, and various aspects of PAD were assessed and tabulated. These components were used to create a novel duplex Doppler scoring system. Depending on the scores obtained, each individual was categorized as having mild, moderate, or severe illness. The Cohen kappa value was used to assess interobserver agreement between the two scoring systems. Interobserver agreement between the traditional Rutherford clinical scoring system and the newly invented duplex Doppler scoring system showed a kappa value of 0.83, indicating significant agreement between the two scoring systems (P<0.001). Duplex Doppler imaging is an effective screening investigation for lower extremity arterial disease, as it not only helps in its diagnosis, but also in the staging and grading of the disease, providing information that can be utilized for future management and treatment planning.

  9. [The shor-term clinical outcomes and safety of extreme lateral interbody fusion combined with percutaneous pedicle screw fixation for the treatment of degenerative lumbar disease].

    Science.gov (United States)

    Hu, Xu-Dong; Ma, Wei-Hu; Jiang, Wei-Yu; Ruan, Chao-Yue; Chen, Yun-Lin

    2017-02-25

    To evaluate the early efficacy and safety of extreme lateral interbody fusion (XLIF) combined with percutaneous pedicle screw fixation for lumbar degenerative disease. From January 2013 to June 2014, 13 patients with degenerative lumbar disease were treated with XLIF combined with percutaneous pedicle screw fixation, including 8 cases of lumbar instability, 5 cases of mild to moderate lumbar spondylolisthesis;there were 5 males and 8 females, aged from 56 to 73 years with an average of 62.1 years. All patients were single segment fusion. Operation time, perioperative bleeding and perioperative complications were recorded. Visual analogue scale (VAS) and Oswestry Disability Index (ODI) were used to evaluate the clinical efficacy. Interbody fusion rate was observed and the intervertebral foramen area changes were compared preoperation and postoperation by X-rays and CT scanning. The mean operation time and perioperative bleeding in the patients respectively was(62.8±5.2) min and(82.5±22.6) ml. One case occurred in the numbness of femoribus internus and 1 case occurred in the muscle weakness of hip flexion after operation, both of them recovered within 2 weeks. All the patients were followed up from 12 to 19 months with an average of 15.6 months. VAS was decreased from preoperative 7.31±0.75 to 2.31±0.75 at final follow-up( P degenerative disease.

  10. Comparison of the severity of lower extremity arterial disease in smokers and patients with diabetes using a novel duplex Doppler scoring system.

    Science.gov (United States)

    Hiremath, Rudresh; Gowda, Goutham; Ibrahim, Jebin; Reddy, Harish T; Chodiboina, Haritha; Shah, Rushit

    2017-07-01

    The aim of this study was to validate the diagnostic feasibility of a novel scoring system of peripheral arterial disease (PAD) in smokers and patients with diabetes depending on duplex Doppler sonographic features. Patients presenting with the symptomatology of PAD were divided into three groups: diabetes only, smoking only, and smokers with diabetes. The patients were clinically examined, a clinical severity score was obtained, and the subjects were categorized into the three extrapolated categories of mild, moderate, and severe. All 106 subjects also underwent a thorough duplex Doppler examination, and various aspects of PAD were assessed and tabulated. These components were used to create a novel duplex Doppler scoring system. Depending on the scores obtained, each individual was categorized as having mild, moderate, or severe illness. The Cohen kappa value was used to assess interobserver agreement between the two scoring systems. Interobserver agreement between the traditional Rutherford clinical scoring system and the newly invented duplex Doppler scoring system showed a kappa value of 0.83, indicating significant agreement between the two scoring systems (PDuplex Doppler imaging is an effective screening investigation for lower extremity arterial disease, as it not only helps in its diagnosis, but also in the staging and grading of the disease, providing information that can be utilized for future management and treatment planning.

  11. Characteristics and trends in required home care by GPs in Austria: diseases and functional status of patients

    Directory of Open Access Journals (Sweden)

    Pichler Ingrid

    2006-10-01

    Full Text Available Abstract Background Almost all societies carry responsibility towards patients who require continuous medical care at home. In many health systems the general practitioner cooperates with community based services of home care and coordinates all medical and non medical activities. In Austria the general practitioner together and in cooperation with relatives of the patient and professional organisations usually takes on this task by visiting his patients. This study was carried out to identify diseases that need home care and to describe the functional profile of home care patients in eastern Austria. Methods Cross sectional observational study with 17 GP practices participating during 2 study periods in 1997 and in 2004 in eastern Austria. Each GP identified patients requiring home care and assessed their underlying diseases and functional status by filling in a questionnaire personally after an encounter. Patients in nursing homes were excluded. Statistical tests used were t-tests, contingency tables, nonparametric Wilcoxon signed rank sum test and Fisher-combination test. Results Patients with degenerative diseases of the central nervous system (65% caused by Alzheimer's disease and cerebrovascular occlusive disease and patients with degenerative diseases of the skeletal system (53% were the largest groups among the 198 (1997 and 261 (2004 home care cases of the 11 (1997 and 13 (2004 practices. Malignant diseases in a terminal state constituted only 5% of the cases. More than two thirds of all cases were female with an average age of 80 years. Slightly more than 70% of the patients were at least partially mobile. Conclusion Home care and home visits for patients with degenerative diseases of the central nervous and skeletal system are important elements of GP's work. Further research should therefore focus on effective methods of training and rehabilitation to better the mental and physical status of patients living in their private homes.

  12. Experimental primates and non-human primate (NHP) models of human diseases in China: current status and progress.

    Science.gov (United States)

    Zhang, Xiao-Liang; Pang, Wei; Hu, Xin-Tian; Li, Jia-Li; Yao, Yong-Gang; Zheng, Yong-Tang

    2014-11-18

    Non-human primates (NHPs) are phylogenetically close to humans, with many similarities in terms of physiology, anatomy, immunology, as well as neurology, all of which make them excellent experimental models for biomedical research. Compared with developed countries in America and Europe, China has relatively rich primate resources and has continually aimed to develop NHPs resources. Currently, China is a leading producer and a major supplier of NHPs on the international market. However, there are some deficiencies in feeding and management that have hampered China's growth in NHP research and materials. Nonetheless, China has recently established a number of primate animal models for human diseases and achieved marked scientific progress on infectious diseases, cardiovascular diseases, endocrine diseases, reproductive diseases, neurological diseases, and ophthalmic diseases, etc. Advances in these fields via NHP models will undoubtedly further promote the development of China's life sciences and pharmaceutical industry, and enhance China's position as a leader in NHP research. This review covers the current status of NHPs in China and other areas, highlighting the latest developments in disease models using NHPs, as well as outlining basic problems and proposing effective countermeasures to better utilize NHP resources and further foster NHP research in China.

  13. Minor rheumatology: Nonsystemic rheumatic disease of juxta-articular soft tissues of the upper extremity. Part 2. Drug and non-drug treatments

    Directory of Open Access Journals (Sweden)

    Andrei Evgenyevich Karateev

    2015-01-01

    Full Text Available The treatment of rheumatic diseases of juxta-articular soft tissues (RDJAST of the upper extremity (rotator cuff tendinitis, epicondylitis, de Quervain’s syndrome, trigger finger, carpal tunnel syndrome entails a combination of drug and nondrug therapies. The basic agents that have been proven to be efficacious in this pathology are nonsteroidal anti-inflammatory drugs (NSAIDs and glucocorticosteroids (GCs. The paper considers the largest and known studies that are an evidence base for the expediency of using agents, such NSAIDs, local administration of GCs, hyaluronic acid, and plateletrich plasma, as well as different non-drug treatments, in RDJAST. The latter (physiotherapy, exercises, and rehabilitation programs should be regarded as a necessary component of the therapeutic process in patients with RDJAST-associated chronic pain. Preservation of obvious pain and impaired function despite medical therapy should be regarded as an indication for surgical treatment.

  14. Oral conditions, periodontal status and periodontal treatment need of chronic kidney disease patients

    Directory of Open Access Journals (Sweden)

    Modupeoluwa Omotunde Soroye

    2016-01-01

    Conclusion: Majority of the CKD patients reviewed had poor periodontal status with code 2 TN. We, therefore, recommend nonsurgical periodontal treatment for all CKD patients to improve their oral health and forestall the systemic effects of periodontal pathology.

  15. Zinc and Copper status in children with high family risk of premature cardiovascular disease

    International Nuclear Information System (INIS)

    Kelishadi, R.; Alikhassy, H.; Amiri, M.

    2002-01-01

    Zinc and copper are beneficial to health, growth and development and also for the prevention of cardiovascular disease (CVD) with regards to improved dietary habits as a preliminary step in CVD prevention. This study was conducted among 2-18 year old children with high family risk of premature CVD in comparison to controls. One hundred randomly selected children whose parents had premature myocardial infarction were included in this study. The controls were 100 individuals randomly selected from the case group's neighbors and matched for age, sex and socioeconomic status. A four-day food record questionnaire was used to assess zinc and copper intakes and their serum levels were determined using Flame-Atomic Absorption Spectrophotometry. The data were analyzed by SPSS/Windows V6 software, using the student's t and Mantel-Hanzel tests. Significance of differences was considered at P 0.05). Zinc deficiency was more prevalent among the case in boys than their controls (58% vs. 18%, P=0.04). This difference was not significant in girls (44% vs. 40%). The daily intake and serum of level of copper were not significantly different between the case and control groups. No case of copper efficiency was found. The mean systolic blood pressure was not significantly different between the zinc-deficient and zinc-sufficient subjects. Although the mean diastolic blood pressure of the former was higher than the latter, there was no statistically significant difference. About 23.7% of all studied sample had mild-to-moderate degree of failure to thrive, with significantly lower daily intake and serum zinc level than other subjects (5.41+-1.06 mg, 82.09+-12.74 ug/dL vs. 6.89+-2.14 mg, 99.25+-27.15 ug/dL, respectively, P<0.05). It is recommended that emphasis be placed on the consumption of food rich in zinc by children, especially those with high family risk of premature CVD. (author)

  16. Prognostic impact of nutritional status assessed by the Controlling Nutritional Status score in patients with stable coronary artery disease undergoing percutaneous coronary intervention.

    Science.gov (United States)

    Wada, Hideki; Dohi, Tomotaka; Miyauchi, Katsumi; Doi, Shinichiro; Konishi, Hirokazu; Naito, Ryo; Tsuboi, Shuta; Ogita, Manabu; Kasai, Takatoshi; Okazaki, Shinya; Isoda, Kikuo; Suwa, Satoru; Daida, Hiroyuki

    2017-11-01

    Recently, malnutrition has been shown to be related to worse clinical outcomes in patients with heart failure. However, the association between nutritional status and clinical outcomes in patients with coronary artery disease (CAD) remains unclear. We investigated the prognostic value of malnutrition assessed by the Controlling Nutritional Status (CONUT; range 0-12, higher = worse, consisting of serum albumin, cholesterol and lymphocytes) score in patients with CAD. The CONUT score was measured on admission in a total of 1987 patients with stable CAD who underwent elective percutaneous coronary intervention (PCI) between 2000 and 2011. Patients were divided into two groups according to their CONUT score (0-1 vs. ≥2). The incidence of major adverse cardiac events (MACE), including all-cause death and non-fatal myocardial infarction, was evaluated. The median CONUT score was 1 (interquartile range 0-2). During the median follow-up of 7.4 years, 342 MACE occurred (17.2%). Kaplan-Meier curves revealed that patients with high CONUT scores had higher rates of MACE (log-rank p < 0.0001). High CONUT scores showed a significant increase in the incidence of MACE compared with low CONUT scores, even after adjusting for confounding factors (hazard ratio: 1.64, 95% confidence interval 1.30-2.07, p < 0.0001). Adding CONUT scores to a baseline model with established risk factors improved the C-index (p = 0.02), net reclassification improvement (p = 0.004) and integrated discrimination improvement (p = 0.0003). Nutritional status assessed by the CONUT score was significantly associated with long-term clinical outcomes in patients with CAD. Pre-PCI assessment of the CONUT score may provide useful prognostic information.

  17. Haplotype Analysis Discriminates Genetic Risk for DR3-Associated Endocrine Autoimmunity and Helps Define Extreme Risk for Addison’s Disease

    Science.gov (United States)

    Baker, Peter R.; Baschal, Erin E.; Fain, Pam R.; Triolo, Taylor M.; Nanduri, Priyaanka; Siebert, Janet C.; Armstrong, Taylor K.; Babu, Sunanda R.; Rewers, Marian J.; Gottlieb, Peter A.; Barker, Jennifer M.; Eisenbarth, George S.

    2010-01-01

    Context: Multiple autoimmune disorders (e.g. Addison’s disease, type 1 diabetes, celiac disease) are associated with HLA-DR3, but it is likely that alleles of additional genes in linkage disequilibrium with HLA-DRB1 contribute to disease. Objective: The objective of the study was to characterize major histocompatability complex (MHC) haplotypes conferring extreme risk for autoimmune Addison’s disease (AD). Design, Setting, and Participants: Eighty-six 21-hydroxylase autoantibody-positive, nonautoimmune polyendocrine syndrome type 1, Caucasian individuals collected from 1992 to 2009 with clinical AD from 68 families (12 multiplex and 56 simplex) were genotyped for HLA-DRB1, HLA-DQB1, MICA, HLA-B, and HLA-A as well as high density MHC single-nucleotide polymorphism (SNP) analysis for 34. Main Outcome Measures: AD and genotype were measured. Result: Ninety-seven percent of the multiplex individuals had both HLA-DR3 and HLA-B8 vs. 60% of simplex AD patients (P = 9.72 × 10−4) and 13% of general population controls (P = 3.00 × 10−19). The genotype DR3/DR4 with B8 was present in 85% of AD multiplex patients, 24% of simplex patients, and 1.5% of control individuals (P = 4.92 × 10−191). The DR3-B8 haplotype of AD patients had HLA-A1 less often (47%) than controls (81%, P = 7.00 × 10−5) and type 1 diabetes patients (73%, P = 1.93 × 10−3). Analysis of 1228 SNPs across the MHC for individuals with AD revealed a shorter conserved haplotype (3.8) with the loss of the extended conserved 3.8.1 haplotype approximately halfway between HLA-B and HLA-A. Conclusion: Extreme risk for AD, especially in multiplex families, is associated with haplotypic DR3 variants, in particular a portion (3.8) but not all of the conserved 3.8.1 haplotype. PMID:20631027

  18. Status of Cardiovascular Disease and Stroke in Hispanics/Latinos in the United States

    Science.gov (United States)

    Rodriguez, Carlos J.; Allison, Matthew; Daviglus, Martha L.; Isasi, Carmen R.; Keller, Colleen; Leira, Enrique C.; Palaniappan, Latha; Piña, Ileana L.; Ramirez, Sarah M.; Rodriguez, Beatriz; Sims, Mario

    2015-01-01

    Background and Purpose This American Heart Association (AHA) scientific statement provides a comprehensive overview of current evidence on the burden cardiovascular disease (CVD) among Hispanics in the United States. Hispanics are the largest minority ethnic group in the United States, and their health is vital to the public health of the nation and to achieving the AHA’s 2020 goals. This statement describes the CVD epidemiology and related personal beliefs and the social and health issues of US Hispanics, and it identifies potential prevention and treatment opportunities. The intended audience for this statement includes healthcare professionals, researchers, and policy makers. Methods Writing group members were nominated by the AHA’s Manuscript Oversight Committee and represent a broad range of expertise in relation to Hispanic individuals and CVD. The writers used a general framework outlined by the committee chair to produce a comprehensive literature review that summarizes existing evidence, indicate gaps in current knowledge, and formulate recommendations. Only English-language studies were reviewed, with PubMed/MEDLINE as our primary resource, as well as the Cochrane Library Reviews, Centers for Disease Control and Prevention, and the US Census data as secondary resources. Inductive methods and descriptive studies that focused on CVD outcomes incidence, prevalence, treatment response, and risks were included. Because of the wide scope of these topics, members of the writing committee were responsible for drafting individual sections selected by the chair of the writing committee, and the group chair assembled the complete statement. The conclusions of this statement are the views of the authors and do not necessarily represent the official view of the AHA. All members of the writing group had the opportunity to comment on the initial drafts and approved the final version of this document. The manuscript underwent extensive AHA internal peer review before

  19. Comprehensive evaluation of nutritional status before and after hematopoietic stem cell transplantation in 170 patients with hematological diseases.

    Science.gov (United States)

    Liu, Peng; Wang, Boshi; Yan, Xia; Cai, Jingjing; Wang, Yu

    2016-12-01

    To investigate the nutritional status of patients before and after hematopoietic stem cell transplantation (HSCT), and explore optimal methods for assessing nutritional status in patients with hematological diseases. This cohort study enrolled 170 patients who were diagnosed with hematological diseases and underwent allogeneic HSCT in the Department of Hematology, Peking University People's Hospital between May 2011 and April 2013. We used fixed-point continuous sampling and four nutritional screening tools, Nutritional Risk Screening 2002 (NRS-2002), Mini Nutritional Assessment (MNA), Subjective Global Assessment (SGA) and Malnutrition Universal Screening Tools (MUST), in combination with body measurements, to extensively screen and evaluate nutritional risks and status in patients receiving HSCT before entering and after leaving laminar air flow rooms. After HSCT, patients had significant reduction in weight, hip circumference, waist-hip ratio, calf circumference, mid-upper arm circumference, and suprailiac skinfold thickness compared with pre-HSCT measurements. Before HSCT, NRS-2002 identified that 21.2% of patients were at nutritional risks, compared with 100% after HSCT. MUST indicated that before HSCT, 11.77% of patients were at high nutritional risk, compared with 59.63% after HSCT. MNA assessed that 0.06% of patients were malnourished before HSCT, compared with 19.27% after HSCT. SGA identified that before HSCT, 1.76% of patients had mild to severe malnutrition, which increased to 83.3% after HSCT. There is a significant increase in the nutritional risk and malnutrition in patients who received HSCT. Before HSCT, some patients already had nutritional risk or nutritional deficiencies, and prompt and close nutritional screening or assessment should be performed. The nutritional status of patients after HSCT was generally deteriorated compared with that before transplantation. Body measurements should be taken more frequently during the subsequent treatment

  20. PULSE OXIMETRY AS A POTENTIAL SCREENING TOOL FOR LOWER EXTREMITY ARTERIAL DISEASE IN ASYMPTOMATIC PATIENTS WITH DIABETES MELLITUS

    Directory of Open Access Journals (Sweden)

    Sankaran Nair Kailasanadhan

    2018-02-01

    Full Text Available BACKGROUND India, with a population greater than 1.1 billion, has the dubious distinction of having a larger number of people with diabetes than any other country in the world. It was estimated in the year. 2000 that there are 32 million diabetes patients. Diabetic foot ulcers will complicate the disease in more than 15% of these people during their life time. Foot ulcers precede more than 80% of non-traumatic lower limb amputation. Individuals with diabetes had a tenfold higher overall amputation prevalence than did people without diabetes, 2.8% versus 0.29%. MATERIALS AND METHODS A Cross sectional study was done in the department of general surgery, Government Medical College Kottayam and Diabetic Clinic, Kottayam Medical College, from April 1, 2013 to October 1, 2013. RESULTS Out of 150 patients studied 83 were males and 67 were females and 95 patients (63.3% had POVD Statically significant association was found between POVD and age, history of hypertension, hyperlipidaemia, smoking, alcoholism, duration of diabetes mellitus and family history of hypertension/diabetes and hyperlipidaemia. Sensitivity and specificity of Pulse Oximetry in diagnosing POVD is 80% and 92.7% respectively. Sensitivity and specificity of ABPI in diagnosing POVD is 77.9% and 89.1% respectively. CONCLUSION Pulse Oximetry is an accurate and efficient screening tool for POVD in patients with diabetes mellitus. It can be incorporated to regular outpatient visits of Diabetes patients for early detection of POVD.

  1. First record of black band disease in the Hawaiian archipelago: response, outbreak status, virulence, and a method of treatment.

    Directory of Open Access Journals (Sweden)

    Greta S Aeby

    Full Text Available A high number of coral colonies, Montipora spp., with progressive tissue loss were reported from the north shore of Kaua'i by a member of the Eyes of the Reef volunteer reporting network. The disease has a distinct lesion (semi-circular pattern of tissue loss with an adjacent dark band that was first observed in Hanalei Bay, Kaua'i in 2004. The disease, initially termed Montipora banded tissue loss, appeared grossly similar to black band disease (BBD, which affects corals worldwide. Following the initial report, a rapid response was initiated as outlined in Hawai'i's rapid response contingency plan to determine outbreak status and investigate the disease. Our study identified the three dominant bacterial constituents indicative of BBD (filamentous cyanobacteria, sulfate-reducing bacteria, sulfide-oxidizing bacteria in coral disease lesions from Kaua'i, which provided the first evidence of BBD in the Hawaiian archipelago. A rapid survey at the alleged outbreak site found disease to affect 6-7% of the montiporids, which is higher than a prior prevalence of less than 1% measured on Kaua'i in 2004, indicative of an epizootic. Tagged colonies with BBD had an average rate of tissue loss of 5.7 cm2/day over a two-month period. Treatment of diseased colonies with a double band of marine epoxy, mixed with chlorine powder, effectively reduced colony mortality. Within two months, treated colonies lost an average of 30% less tissue compared to untreated controls.

  2. Status of some soil nutrients of disease affected and non-diseases in semi-intensive shrimp ponds at Cox's Bazar

    International Nuclear Information System (INIS)

    Sayed, I.A.; Osman, K. T.; Ahmed, T. A.

    2005-01-01

    The study investigated the nutrient status of some ponds soils, considering the importance of bottom soils on the productivity and impact of Brackish water semi-intensive shrimp ponds. The study indicated the soils fairly rich in total N, available Ca and Na. p H , EC, organic matter, total N, available Ca, Na, P, S, due to ponds were highly significant statistically (P 1 >h 3 >h 2 . Available P in the fallow ponds was slightly less than the healthy ponds but much higher than the diseases ponds. Quite reverse the sequence (h 2 >h 3 >h 1 ) was found in regard to the variation in available S content of soils within the Health classes. The diseased pond soils generally had available S in amounts almost 100 μg/g more than the healthy ponds. The observation indicated that along with other environmental factor higher Sulfur and Phosphorus content of the soil might be responsible for the outbreak of disease.(author)

  3. Assessement of rheumatic diseases with computational radiology: Current status and future potential

    International Nuclear Information System (INIS)

    Peloschek, Philipp; Boesen, Mikael; Donner, Rene; Kubassova, Olga; Birngruber, Erich; Patsch, Janina; Mayerhoefer, Marius; Langs, Georg

    2009-01-01

    In recent years, several computational image analysis methods to assess disease progression in rheumatic diseases were presented. This review article explains the basics of these methods as well as their potential application in rheumatic disease monitoring, it covers radiography, sonography as well as magnetic resonance imaging in quantitative analysis frameworks.

  4. Marital Status, Hypertension, Coronary Heart Disease, Diabetes, and Death among African American Women and Men: Incidence and Prevalence in the Atherosclerosis Risk in Communities (ARIC) Study Participants

    Science.gov (United States)

    Schwandt, Hilary M.; Coresh, Josef; Hindin, Michelle J.

    2010-01-01

    Heart disease is the leading cause of death in the United States, and African Americans disproportionately experience more cardiovascular disease, including coronary heart disease (CHD), hypertension, and diabetes. The literature documents a complex relationship between marital status and health, which varies by gender. We prospectively examine…

  5. Hydration status of patients with end-stage renal disease after kidney transplantation.

    Science.gov (United States)

    Gueutin, Victor; Ficheux, Maxence; Châtelet, Valérie; Lecouf, Angélique; Henri, Patrick; Hurault de Ligny, Bruno; Ryckelynck, Jean-Philippe; Lobbedez, Thierry

    2011-01-01

    This study was carried out to estimate the modification of hydration status within the first three months of renal transplantation. Fifty patients who underwent a first kidney allograft were prospectively followed for three months after renal transplantation to assess hydration status by bioimpedance spectroscopy. Two hours before the transplant procedure, 10/42 (23.8%) patients were overhydrated. Two days after surgery, 32/40 (80.0%) patients were overhydrated and at three months, 14/27 (51.9%) patients remained fluid-overloaded. Peritoneal dialysis (PD) patients had a lower hydration status (-0.60 L) than hemodialysis (HD) patients (0.70 L; p hydration status before transplantation (p = 0.031). At three months, 12/14 of the overhydrated patients had a creatinine clearance between 30 and 60 mL/min/1.73 m(2) . Patients receiving a first kidney transplant frequently have a hydration disorder. Transplantation is associated with increased hydration status, which seems to persist if DGF or SGF occurs. © 2011 John Wiley & Sons A/S.

  6. The Effect of Iron Status on Risk of Coronary Artery Disease: A Mendelian Randomization Study-Brief Report.

    Science.gov (United States)

    Gill, Dipender; Del Greco M, Fabiola; Walker, Ann P; Srai, Surjit K S; Laffan, Michael A; Minelli, Cosetta

    2017-09-01

    Iron status is a modifiable trait that has been implicated in cardiovascular disease. This study uses the Mendelian randomization technique to investigate whether there is any causal effect of iron status on risk of coronary artery disease (CAD). A 2-sample Mendelian randomization approach is used to estimate the effect of iron status on CAD risk. Three loci (rs1800562 and rs1799945 in the HFE gene and rs855791 in TMPRSS6 ) that are each associated with serum iron, transferrin saturation, ferritin, and transferrin in a pattern suggestive of an association with systemic iron status are used as instruments. SNP (single-nucleotide polymorphism)-iron status association estimates are based on a genome-wide association study meta-analysis of 48 972 individuals. SNP-CAD estimates are derived by combining the results of a genome-wide association study meta-analysis of 60 801 CAD cases and 123 504 controls with those of a meta-analysis of 63 746 CAD cases and 130 681 controls obtained from Metabochip and genome-wide association studies. Combined Mendelian randomization estimates are obtained for each marker by pooling results across the 3 instruments. We find evidence of a protective effect of higher iron status on CAD risk (iron odds ratio, 0.94 per SD unit increase; 95% confidence interval, 0.88-1.00; P =0.039; transferrin saturation odds ratio, 0.95 per SD unit increase; 95% confidence interval, 0.91-0.99; P =0.027; log-transformed ferritin odds ratio, 0.85 per SD unit increase; 95% confidence interval, 0.73-0.98; P =0.024; and transferrin odds ratio, 1.08 per SD unit increase; 95% confidence interval, 1.01-1.16; P =0.034). This Mendelian randomization study supports the hypothesis that higher iron status reduces CAD risk. These findings may highlight a therapeutic target. © 2017 American Heart Association, Inc.

  7. Influence of socioeconomic and demographic status on spirometry testing in patients initiating medication targeting obstructive lung disease

    DEFF Research Database (Denmark)

    Koefoed, Mette M; Søndergaard, Jens; Christensen, René Depont

    2013-01-01

    a possible association between education, income, labour market affiliation, cohabitation status and having spirometry performed when initiating medication targeting obstructive pulmonary disease. METHODS: We conducted a population-based cohort study. Danish national registers were linked, retrieving data...... on prescriptions, spirometry testing, socioeconomic and demographic variables in all first time users of medication targeting obstructive lung disease in 2008. RESULTS: A total of 37,734 persons were included and approximately half of the cohort had spirometry performed. Among medication users under 65 years...... spirometry performed among men (OR = 0.78, CI = 0.69-0.88). CONCLUSION: Social inequity in spirometry testing among patients initiating medication targeting obstructive lung disease was confirmed in this study. Increased focus on spirometry testing among elderly men living alone, among the unemployed...

  8. The influence of radiographic phenotype and smoking status on peripheral blood biomarker patterns in chronic obstructive pulmonary disease.

    Directory of Open Access Journals (Sweden)

    Jessica M Bon

    2009-08-01

    Full Text Available Chronic obstructive pulmonary disease (COPD is characterized by both airway remodeling and parenchymal destruction. The identification of unique biomarker patterns associated with airway dominant versus parenchymal dominant patterns would support the existence of unique phenotypes representing independent biologic processes. A cross-sectional study was performed to examine the association of serum biomarkers with radiographic airway and parenchymal phenotypes of COPD.Serum from 234 subjects enrolled in a CT screening cohort was analyzed for 33 cytokines and growth factors using a multiplex protein array. The association of serum markers with forced expiratory volume in one second percent predicted (FEV1% and quantitative CT measurements of airway thickening and emphysema was assessed with and without stratification for current smoking status. Significant associations were found with several serum inflammatory proteins and measurements of FEV1%, airway thickening, and parenchymal emphysema independent of smoking status. The association of select analytes with airway thickening and emphysema was independent of FEV1%. Furthermore, the relationship between other inflammatory markers and measurements of physiologic obstruction or airway thickening was dependent on current smoking status.Airway and parenchymal phenotypes of COPD are associated with unique systemic serum biomarker profiles. Serum biomarker patterns may provide a more precise classification of the COPD syndrome, provide insights into disease pathogenesis and identify targets for novel patient-specific biological therapies.

  9. Improving the image quality of contrast-enhanced MR angiography by automated image registration: A prospective study in peripheral arterial disease of the lower extremities

    International Nuclear Information System (INIS)

    Menke, Jan

    2010-01-01

    Objective: If a patient has moved during digital subtraction angiography (DSA), manual pixel shift can improve the image quality. This study investigated whether such image registration can also improve the quality of contrast-enhanced magnetic resonance angiography (MRA) in patients with peripheral arterial disease of the lower extremities. Materials and methods: 404 leg MRAs of patients likely to have peripheral artery disease were included in this prospective study. The standard non-registered MRAs were compared to automatically linear, affine and warp registered MRAs by four image quality parameters, including the vessel detection probability (VDP) in maximum intensity projection (MIP) images and contrast-to-noise ratios (CNR). The different registration types were compared by analysis of variance. Results: All studied image quality parameters showed similar trends. Generally, registration improved the leg MRA quality significantly (P < 0.05). The 12% of lower legs with a body shift of 1 mm or more showed the highest gain in image quality when using linear registration instead of no registration, with an average VDP gain of 20-49%. Warp registration improved the image quality slightly further. Conclusion: Automated image registration can improve the MRA image quality especially in the lower legs, which is comparable to the effect of pixel shift in DSA.

  10. Observation and nursing of complications due to high re-perfusion injury occurring after balloon angioplasty for diabetic vascular diseases of lower extremity

    International Nuclear Information System (INIS)

    Zhang Lingling; Zhu Yueqi; Mou Ling

    2011-01-01

    Objective: To evaluate the symptomatic nursing in treating the complications caused by high re-perfusion which develops after balloon angioplasty for the treatment of diabetic vascular diseases of lower extremity. Methods: Eighteen patients with lower limb ischemia caused by diabetes mellitus developed high re-perfusion injury complications after receiving balloon angioplasty. The patients were randomly and equally divided into study group and control group. The special nursing measures designed by the author's department, including raising the diseased lower limb, enforcing the flexion and extension movement of the leg, cold compress, wound exposure, etc. were carried out for patients of study group, while no special nursing measures were adopted for patients of control group. The clinical results, such as limb pain, swelling and subcutaneous petechia after re-perfusion injury, were evaluated and compared between two groups. Results: After the treatment, the limb pain, swelling and subcutaneous petechia due to high re-perfusion injury in study group were relieved more markedly than that in control group, the difference in evaluation score between two groups was statistically significant (P<0.01). Conclusion: The special symptomatic nursing measures are very effective in relieving the high re-perfusion injury after balloon angioplasty for the treatment of diabetic lower limb ischemia. (authors)

  11. Associations of oxidative stress status parameters with traditional cardiovascular disease risk factors in patients with schizophrenia.

    Science.gov (United States)

    Vidović, Bojana; Stefanović, Aleksandra; Milovanović, Srđan; Ðorđević, Brižita; Kotur-Stevuljević, Jelena; Ivanišević, Jasmina; Miljković, Milica; Spasić, Slavica

    2014-04-01

    The purpose of this study was to assess oxidative stress status parameters and their possible associations with traditional cardiovascular risk factors in patients with schizophrenia, as well as their potential for patient-control discrimination. Fasting glucose, lipid profile and oxidative stress status parameters were assessed in 30 schizophrenic patients with atypical antipsychotic therapy and 60 control subjects. Malondialdehyde (MDA), pro-oxidant/antioxidant balance (PAB) and total anti-oxidant status (TAS) were significantly higher whereas total sulfhydryl (SH) groups were significantly lower in schizophrenic patients vs. control group. Higher serum PAB values showed an independent association with schizophrenia. The addition of PAB to conventional risk factors improved discrimination between healthy control subjects and patients. Increased oxidative stress and changed lipid profile parameters are associated in schizophrenic patients and may indicate risk for atherosclerosis. The serum PAB level may reflect the levels of oxidative stress in schizophrenia and improve discrimination of patients from controls.

  12. Impact of hepatitis C virus infection on disease activity, functional status and ultrasonography findings in Egyptian rheumatoid arthritis patients

    Directory of Open Access Journals (Sweden)

    Nabila Abd EI-Hamid Gohar

    2018-04-01

    Full Text Available Background: Hepatitis C virus (HCV infection is one of the most frequently encountered public health problems in Egypt. It is associated with many autoimmune diseases such as rheumatoid arthritis. Aim of the work: To assess the impact of HCV infection in rheumatoid arthritis (RA Egyptian patients; its relation to disease activity, functional status and ultrasonography findings. Patients and methods: The study included 155 RA patients further classified according to the presence of concomitant HCV infection into 2 groups; rheumatoid arthritis (RA and rheumatoid arthritis/hepatitis C virus (RA/HCV groups. All patients were subjected to full history taking, thorough clinical examination, laboratory investigations, assessment of disease activity using the disease activity score 28 (DAS28 and assessment of functional status using the modified health assessment questionnaire (MHAQ. Ultrasonography (US assessment was done using the German US7 score. Results: Both DAS28 and MHAQ scores showed significant differences between both the RA and the RA/HCV groups (p < 0.001, with higher mean values observed in the RA/HCV group (5.4 ± 1.1 and 1.05 ± 0.79 respectively. Significantly higher US7 synovitis scores were found in the RA/HCV group compared to the RA group (p = 0.03. US7 synovitis tenosynovitis scores revealed significant correlations with DAS28 and US7 synovitis scores correlated with MHAQ in both groups. Conclusion: Concomitant HCV infection in RA patients had an impact on disease activity. RA patients with concomitant HCV infection (RA/HCV had higher DAS28 and MHAQ scores, with higher US7 synovitis scores compared to RA patients. US7 score is a valuable objective tool for the assessment of RA disease activity. Keywords: Rheumatoid arthritis, HCV infection, Ultrasonography, DAS28, MHAQ

  13. Low serum and bone vitamin K status in patients with longstanding Crohn's disease: another pathogenetic factor of osteoporosis in Crohn's disease?

    Science.gov (United States)

    Schoon, E; Muller, M; Vermeer, C; Schurgers, L; Brummer, R; Stockbrugger, R

    2001-01-01

    BACKGROUND—A high prevalence of osteoporosis is reported in Crohn's disease. The pathogenesis is not completely understood but is probably multifactorial. Longstanding Crohn's disease is associated with a deficiency of fat soluble vitamins, among them vitamin K. Vitamin K is a cofactor in the carboxylation of osteocalcin, a protein essential for calcium binding to bone. A high level of circulating uncarboxylated osteocalcin is a sensitive marker of vitamin K deficiency.
AIMS—To determine serum and bone vitamin K status in patients with Crohn's disease and to elucidate its relationship with bone mineral density.
METHODS—Bone mineral density was measured in 32 patients with longstanding Crohn's disease and small bowel involvement, currently in remission, and receiving less than 5 mg of prednisolone daily. Serum levels of vitamins D and K, triglycerides, and total immunoreactive osteocalcin, as well as uncarboxylated osteocalcin ("free" osteocalcin) were determined. The hydroxyapatite binding capacity of osteocalcin was calculated. Data were compared with an age and sex matched control population.
RESULTS—Serum vitamin K levels of CD patients were significantly decreased compared with normal controls (p<0.01). "Free" osteocalcin was higher and hydroxyapatite binding capacity of circulating osteocalcin was lower than in matched controls (p<0.05 and p<0.001, respectively), indicating a low bone vitamin K status in Crohn's disease. In patients, an inverse correlation was found between "free" osteocalcin and lumbar spine bone mineral density (r=−0.375, p<0.05) and between "free" osteocalcin and the z score of the lumbar spine (r=−0.381, p<0.05). Multiple linear regression analysis showed that "free" osteocalcin was an independent risk factor for low bone mineral density of the lumbar spine whereas serum vitamin D was not.
CONCLUSIONS—The finding that a poor vitamin K status is associated with low bone mineral density in longstanding Crohn

  14. Drugs for Neglected Diseases initiative model of drug development for neglected diseases: current status and future challenges.

    Science.gov (United States)

    Ioset, Jean-Robert; Chang, Shing

    2011-09-01

    The Drugs for Neglected Diseases initiative (DNDi) is a patients' needs-driven organization committed to the development of new treatments for neglected diseases. Created in 2003, DNDi has delivered four improved treatments for malaria, sleeping sickness and visceral leishmaniasis. A main DNDi challenge is to build a solid R&D portfolio for neglected diseases and to deliver preclinical candidates in a timely manner using an original model based on partnership. To address this challenge DNDi has remodeled its discovery activities from a project-based academic-bound network to a fully integrated process-oriented platform in close collaboration with pharmaceutical companies. This discovery platform relies on dedicated screening capacity and lead-optimization consortia supported by a pragmatic, structured and pharmaceutical-focused compound sourcing strategy.

  15. Trait anxiety predicts disease-specific health status in early-stage breast cancer patients

    NARCIS (Netherlands)

    van Esch, Lotje; Roukema, Jan A.; van der Steeg, Alida F. W.; de Vries, Jolanda

    2011-01-01

    The objectives of this study were to examine the differences in health status (HS) of women with breast cancer (BC) at different moments in time, and between women scoring high and not high on trait anxiety, and to identify possible predictors of HS 6 and 12 months after surgery. Patients (N = 223)

  16. Iron status and anaemia of chronic disease in HIV-infected African ...

    African Journals Online (AJOL)

    2009-03-11

    Mar 11, 2009 ... status, more specifically to investigate the nutritional health of ... Respondents fasted overnight, abstained from exercise and avoided ... Nutrition is an important factor in the course of HIV infection1 and is ... activity, body perception and attitude toward weight control, ..... Krause's food, nutrition & diet therapy.

  17. Protein-energy nutritional status and kidney disease-specific quality of life in hemodialysis patients

    NARCIS (Netherlands)

    Mazairac, A.H.A.; de Wit, G.A.; Penne, E.L.; van der Weerd, N.C.; Grooteman, M.P.C.; van den Dorpel, M.A.; Nube, M.J.; Buskens, E.; Levesque, R.; ter Wee, P.M.; Bots, M.L.; Blankestijn, P.J.

    Objective: Health-related quality of life (HRQOL) is an important outcome in dialysis care. Previous research has related protein-energy nutritional status to generic HRQOL domains, but it is still not clear as to how it relates to HRQOL domains that are unique to hemodialysis patients. Therefore,

  18. Discriminative and predictive properties of disease-specific and generic health status indexes in elderly COPD patients

    Directory of Open Access Journals (Sweden)

    Forastiere Francesco

    2008-08-01

    Full Text Available Abstract Background The association between bronchial obstruction severity and mortality in Chronic Obstructive Pulmonary Disease (COPD is well established, but it is unknown whether disease-specific health status measures and multidimensional assessment (MDA have comparable prognostic value. Methods We analyzed data coming from the Salute Respiratoria nell'Anziano (Respiratory Health in the Elderly – SaRA study, enrolling elderly people attending outpatient clinics for respiratory and non-respiratory problems. From this population we selected 449 patients with bronchial obstruction (77.3% men, mean age 73.1. We classified patients' health status using tertiles of the Saint George Respiratory Questionnaire (SGRQ and a MDA including functional (the 6' walking test, WT, cognitive (Mini-Mental State Examination, MMSE and affective status (Geriatric Depression Scale, GDS. The agreement of the classification methods was calculated using the kappa statistic, and survival associated with group membership was evaluated using survival analysis. Results Pulmonary function, expressed by the FEV1, worsened with increasing SGRQ or MDA scores. Cognitive function was not associated with the SGRQ, while physical performance and mood status were impaired only in the highest tertile of SGRQ. A poor agreement was found between the two classification systems tested (k = 0.194. Compared to people in the first tertile of SGRQ score, those in the second tertile had a sex-adjusted HR of 1.22 (0.75 – 1.98 and those in the third tertile of 2.90 (1.92 – 4.40. The corresponding figures of the MDA were 1.49 (95% CI 1.02 – 2.18 and 2.01 (95% CI: 1.31 – 3.08. After adjustment for severity of obstruction, only a SGRQ in the upper tertile was associated with mortality (HR: 1.86; 95% CI: 1.14 – 3.02. Conclusion In elderly outpatients with mild-moderate COPD, a disease-specific health status index seems to be a better predictor of death compared to a MDA.

  19. Disease-modifying antirheumatic drugs in pregnancy - Current status and implications for the future

    NARCIS (Netherlands)

    Vroom, Fokaline; de Walle, Hermien E. K.; van de Laar, Mart A. J. F.; Brouwers, Jacobus R. B. J.; de Jong-van den Berg, Lolkje T. W.

    2006-01-01

    Drug use during pregnancy is sometimes unavoidable, especially in chronic inflammatory diseases such as rheumatoid arthritis (RA). The use of disease-modifying antirheumatic drugs (DMARDs) often starts in the early stage of RA; therefore, women of reproductive age are at risk for exposure to a DMARD

  20. Concise review: current status of stem cells and regenerative medicine in lung biology and diseases.

    Science.gov (United States)

    Weiss, Daniel J

    2014-01-01

    Lung diseases remain a significant and devastating cause of morbidity and mortality worldwide. In contrast to many other major diseases, lung diseases notably chronic obstructive pulmonary diseases (COPDs), including both asthma and emphysema, are increasing in prevalence and COPD is expected to become the third leading cause of disease mortality worldwide by 2020. New therapeutic options are desperately needed. A rapidly growing number of investigations of stem cells and cell therapies in lung biology and diseases as well as in ex vivo lung bioengineering have offered exciting new avenues for advancing knowledge of lung biology as well as providing novel potential therapeutic approaches for lung diseases. These initial observations have led to a growing exploration of endothelial progenitor cells and mesenchymal stem (stromal) cells in clinical trials of pulmonary hypertension and COPD with other clinical investigations planned. Ex vivo bioengineering of the trachea, larynx, diaphragm, and the lung itself with both biosynthetic constructs as well as decellularized tissues have been used to explore engineering both airway and vascular systems of the lung. Lung is thus a ripe organ for a variety of cell therapy and regenerative medicine approaches. Current state-of-the-art progress for each of the above areas will be presented as will discussion of current considerations for cell therapy-based clinical trials in lung diseases. © AlphaMed Press.

  1. Perceived health status : is obesity perceived as a risk factor and disease?

    NARCIS (Netherlands)

    Tommy L.S. Visscher; Jeroen Lakerveld; Nanna Olsen; Leanne Küpers; Sofia Ramalho; Laura Keaver; Christina Brei; Jan-Inge Bjune; Silvia Ezquerro; Volkan Yumuk

    2017-01-01

    One might expect that a perception of obesity being a risk factor and disease, contributes to effective obesity prevention and management strategies. However, obesity rates continue to increase worldwide. The question arises whether obesity is truly perceived as a risk factor and a disease. This

  2. The Rare Disease Bank of Japan: establishment, current status and future challenges.

    Science.gov (United States)

    Tada, Mayako; Hirata, Makoto; Sasaki, Mitsuho; Sakate, Ryuichi; Kohara, Arihiro; Takahashi, Ichiro; Kameoka, Yosuke; Masui, Toru; Matsuyama, Akifumi

    2018-04-02

    Research on rare diseases cannot be performed without appropriate samples from patients with such diseases. Due to the limited number of such patients, securing biosamples of sufficient quality for extensive research is a challenge and represents an important barrier to the advancement of research on rare diseases. To tackle this problem, the Rare Disease Bank (RDB) was established in 2009 at the National Institute of Biomedical Innovation (NIBIO; currently, the National Institutes of Biomedical Innovation, Health and Nutrition in Japan). Since then, the RDB has focused on three objectives: (1) emphasizing the importance of collecting biosamples from patients with rare diseases, together with appropriate clinical information, from various medical facilities nationwide; (2) maintaining strict high-quality sample management standards; and (3) sharing biosamples with research scientists across Japan for the advancement of research on rare diseases. As of August 2017, the bank has collected 4147 biosamples from patients with rare diseases, including DNA, serum, plasma, and cell samples from various university hospitals and other medical institutions across the country, and provided various research institutions with 13,686 biosample aliquots from 2850 cases. In addition, the management committee has successfully established a bank system that provides high-quality biosamples together with the results of human leukocyte antigen analysis. It is anticipated that the RDB, through the collection and sharing of biosamples with the medical research community, will enhance the understanding, prevention, and treatment of rare diseases in Japan and the world at large.

  3. Relationships between Fusarium population structure, soil nutrient status and disease incidence in field-grown asparagus

    NARCIS (Netherlands)

    Yergeau, E.; Sommerville, D.W.; Maheux, E.; Vujanovic, V.; Hamel, C.; Whalen, J.K.; St-Arnaud, M.

    2006-01-01

    Fusarium species cause important diseases in many crops. Lack of knowledge on how Fusarium species and strains interact with their environment hampers growth management strategies to control root diseases. A field experiment involving asparagus as host plant and three phosphorus fertilization levels

  4. "Don't know" answers concerning somatic disease status should not be regarded as "no" responses

    Directory of Open Access Journals (Sweden)

    Baumeister, Harald

    2008-06-01

    Full Text Available Background: With regard to patients' self-reported somatic diseases some researchers transformed “don't know (DK” responses into “no” responses. The present study examines the appropriateness of this procedure. Methods: Analyses were based on the nationally representative German National Health Interview and Examination Survey (GHS, which assessed both self-reported diseases and physician-diagnosed diseases (N = 7124. Prevalence rates of persons’ DK responses and the corresponding prevalences of physicians’ diagnoses were calculated for persons with hypertension, coronary heart disease (CHD, heart failure, asthma, chronic bronchitis, thyroid disease, diabetes, cancer, gout, arthrosis, arthritis and osteoporosis. Correlates of physicians' diagnosed diseases of DK cases are reported. Results: Between 1.6% and 9.8% of the participants responded with DK to the question of whether they have the disease. In 3.7% to 29.5% of DK cases, the physicians did regard the respective disease as being present. With regard to persons who responded with DK, the probability of a physicians' diagnosis was increased in the case of increased age and a higher number of somatic comorbidities. Conclusion: The procedure of transforming DK responses into “no” answers does not appear to be recommendable.

  5. Synchrotron radiation analysis of possible correlations between metal status in human cementum and periodontal disease

    Energy Technology Data Exchange (ETDEWEB)

    Martin, R.R.; Naftel, S.J.; Nelson, A.J.; Edwards, M.; Mithoowani, H.; Stakiw, J. (UWO); (Saskatchewan)

    2010-03-16

    Periodontitis is a serious disease that affects up to 50% of an adult population. It is a chronic condition involving inflammation of the periodontal ligament and associated tissues leading to eventual tooth loss. Some evidence suggests that trace metals, especially zinc and copper, may be involved in the onset and severity of periodontitis. Thus we have used synchrotron X-ray fluorescence imaging on cross sections of diseased and healthy teeth using a microbeam to explore the distribution of trace metals in cementum and adhering plaque. The comparison between diseased and healthy teeth indicates that there are elevated levels of zinc, copper and nickel in diseased teeth as opposed to healthy teeth. This preliminary correlation between elevated levels of trace metals in the cementum and plaque of diseased teeth suggests that metals may play a role in the progress of periodontitis.

  6. Immune and hormonal status of children at respiratory diseases have been born before and after the Chernobyl accident

    International Nuclear Information System (INIS)

    Lysenko, I.M.

    1997-01-01

    Immune- and hormonal status of preschool healthy children and of those often falling ill with respiratory diseases born of healthy mothers and of those with endocrine disorders before and after Chernobyl accident has been studied. The study has revealed evident deviation from the norm in the immune system and non-specific resistance indices of children from after 1986 and particularly of those living in the radionuclide contaminated areas as well as of children often falling ill. Breaks of correlation between separate hormonal systems have been found too

  7. Elimination of Guinea Worm Disease in Ethiopia; Current Status of the Disease's, Eradication Strategies and Challenges to the End Game.

    Science.gov (United States)

    Beyene, Habtamu Bedimo; Bekele, Abyot; Shifara, Amanu; Ebstie, Yehenew A; Desalegn, Zelalem; Kebede, Zeyede; Mulugeta, Abate; Deribe, Kebede; Tadesse, Zerihun; Abebe, Tamrat; Kebede, Biruck; Abrha, Getaneh; Jima, Daddi

    2017-01-01

    Dracunculiasis, also named Guinea Worm Disease (GWD), is one of the Neglected Tropical Diseases (NTDs) caused by a parasitic nematode known as Dracunculus medinensis and has been known since antiquity as 'fiery serpent' from Israelites. It is transmitted to humans via drinking contaminated water containing infective copepods. Given, its feasibility for eradication, the Guinea Worm Eradication Program (GWEP) was launched in 1980 with the aim of eradicating the disease. Since its inception, GWEP has made an extraordinary progress in interrupting transmission. Globally, the number of reported cases reduced from 3.5 million in 20 countries in 1986 to only 22 cases in 2015 from only four countries namely South Sudan, Mali, Chad and Ethiopia. Since Mali has interrupted transmission of GWD in 2016, currently, the disease remains endemic in only three sub-Saharan African countries namely, South Sudan, Chad and Ethiopia. Each endemic country has its own national Guinea Worm Eradication Program. In Ethiopia, the Ethiopian Dracunculiasis Eradication Program (EDEP) which was established in 1993 has made remarkable move towards interruption of disease transmission and now the endgame is fast approaching. The EDEP with support mainly from The Carter Center, WHO, and UNICEF has reduced GWD by more than 99% from 1994 to 2015. In 2015, only 3 indigenous cases in humans and 14 in animals (13 in dogs and 1 in baboon) were reported. In 2016, 3 human cases, 14 dogs and 2 baboon infections were reported.. Refugee influx from the Republic of South Sudan (RSS), increased animal infections with unknown role in transmission of Dracunculiasis, the presence of hard to reach communities and lack of safe water sources in remote non-village areas remain among important challenges at this final stage of GWD eradication in Ethiopia. This paper reviews progress made towards Guinea Worm Eradication with a focus on the experience of the Ethiopian Dracunculiasis Eradication Program (EDEP), and

  8. Socioeconomic status, non-communicable disease risk factors, and walking speed in older adults: multi-cohort population based study.

    Science.gov (United States)

    Stringhini, Silvia; Carmeli, Cristian; Jokela, Markus; Avendaño, Mauricio; McCrory, Cathal; d'Errico, Angelo; Bochud, Murielle; Barros, Henrique; Costa, Giuseppe; Chadeau-Hyam, Marc; Delpierre, Cyrille; Gandini, Martina; Fraga, Silvia; Goldberg, Marcel; Giles, Graham G; Lassale, Camille; Kenny, Rose Anne; Kelly-Irving, Michelle; Paccaud, Fred; Layte, Richard; Muennig, Peter; Marmot, Michael G; Ribeiro, Ana Isabel; Severi, Gianluca; Steptoe, Andrew; Shipley, Martin J; Zins, Marie; Mackenbach, Johan P; Vineis, Paolo; Kivimäki, Mika

    2018-03-23

    To assess the association of low socioeconomic status and risk factors for non-communicable diseases (diabetes, high alcohol intake, high blood pressure, obesity, physical inactivity, smoking) with loss of physical functioning at older ages. Multi-cohort population based study. 37 cohort studies from 24 countries in Europe, the United States, Latin America, Africa, and Asia, 1990-2017. 109 107 men and women aged 45-90 years. Physical functioning assessed using the walking speed test, a valid index of overall functional capacity. Years of functioning lost was computed as a metric to quantify the difference in walking speed between those exposed and unexposed to low socioeconomic status and risk factors. According to mixed model estimations, men aged 60 and of low socioeconomic status had the same walking speed as men aged 66.6 of high socioeconomic status (years of functioning lost 6.6 years, 95% confidence interval 5.0 to 9.4). The years of functioning lost for women were 4.6 (3.6 to 6.2). In men and women, respectively, 5.7 (4.4 to 8.1) and 5.4 (4.3 to 7.3) years of functioning were lost by age 60 due to insufficient physical activity, 5.1 (3.9 to 7.0) and 7.5 (6.1 to 9.5) due to obesity, 2.3 (1.6 to 3.4) and 3.0 (2.3 to 4.0) due to hypertension, 5.6 (4.2 to 8.0) and 6.3 (4.9 to 8.4) due to diabetes, and 3.0 (2.2 to 4.3) and 0.7 (0.1 to 1.5) due to tobacco use. In analyses restricted to high income countries, the number of years of functioning lost attributable to low socioeconomic status by age 60 was 8.0 (5.7 to 13.1) for men and 5.4 (4.0 to 8.0) for women, whereas in low and middle income countries it was 2.6 (0.2 to 6.8) for men and 2.7 (1.0 to 5.5) for women. Within high income countries, the number of years of functioning lost attributable to low socioeconomic status by age 60 was greater in the United States than in Europe. Physical functioning continued to decline as a function of unfavourable risk factors between ages 60 and 85. Years of functioning

  9. Values of iodine metabolism biomarkers in assessing the iodine nutrition status in surgically treated patients with thyroid disease.

    Science.gov (United States)

    Han, Jian-hua; Wu, Lian; Yu, Song-lin; Fang, Hui-ling; Kamg, Wei-ming; Cheng, Xin-qi; Lu, Jie; Yu, Jian-chun; Qiu, Ling

    2015-04-01

    To assess the clinical application value of iodine metabolism biomarkers in assessing iodine nutrition status in surgically treated patients with thyroid disease. Blood,morning urine and 24-hour urine samples were collected in 31 healthy volunteers and in 30 surgically treated patients with thyroid disease before and after surgery. Iodine concentration was analyzed by inductively coupled plasma mass spectrometry. The iodine metabolism biomarkers including serum iodine (SI), morning urine iodine(UI), morning urine iodine/urine creatinine ratio (UI/UCr), 24-hour urine iodine (24 h UI), and 24-hour urine iodine excretion (24 h UIE) were evaluated in these two groups. In addition, the validation coincidence rate of iodine metabolism biomarkers in healthy volunteers to different reference ranges including World Health Organization, Mayo Clinic, and Quest Diagnostics were calculated. The UI/UCr ratio of pre-operative thyroid disease patients was significantly lower than that of healthy volunteers (P0.05) between these two groups. The SI, UI ,and 24 h UI in postoperative thyroid disease patients were significantly higher than those of the pre-operative patients (all Piodine metabolism biomarkers. The UI/UCr ratio may be used for iodine nutrition evaluation in surgically treated patients with thyroid disease.

  10. The relationship of vitamin D status to risk of cardiovascular disease and mortality

    DEFF Research Database (Denmark)

    Skaaby, Tea

    2015-01-01

    , inconclusive and the possible pathways remain unresolved. The aims of the thesis were to investigate the association of vitamin D status to 5-year changes in cardiovascular risk factors such as blood pressure, lipid profile, the metabolic syndrome and urine albumin creatinine ratio (UACR); the association.......03) and 0.66% (p = 0.005), respectively. The odds ratios per 10 nmol/l higher baseline vitamin D level were 0.95 (p metabolic syndrome and hypercholesterolaemia, respectively. There was no association between vitamin D and blood pressure. With filaggrin......-adjusted significance level. The remaining lipids showed non-significant changes in a favourable direction. A doubling of vita-min D gave a non-significantly lower odds ratio = 0.26 (95% CI: 0.06, 1.17) of the metabolic syndrome. There were no statistically significant causal effects of vitamin D status on blood...

  11. Zonulin, inflammation and iron status in patients with early stages of chronic kidney disease

    OpenAIRE

    Lukaszyk, Ewelina; Lukaszyk, Mateusz; Koc-Zorawska, Ewa; Bodzenta-Lukaszyk, Anna; Malyszko, Jolanta

    2017-01-01

    Background/aims Zonulin is the only known regulator of intestinal permeability. It is also considered as a potential inflammatory marker in several conditions such as diabetes and inflammatory bowel syndrome. The aim of the study was to investigate zonulin levels in patients with early stages of CKD and its possible correlation with inflammation, anemia and iron status parameters. Methods Eighty-eight patients with early stages of CKD and 23 healthy volunteers were enrolled in the study. Zonu...

  12. Exercise habituation is effective for improvement of periodontal disease status: a prospective intervention study.

    Science.gov (United States)

    Omori, Shoei; Uchida, Fumihiko; Oh, Sechang; So, Rina; Tsujimoto, Takehiko; Yanagawa, Toru; Sakai, Satoshi; Shoda, Junichi; Tanaka, Kiyoji; Bukawa, Hiroki

    2018-01-01

    Periodontal disease is closely related to lifestyle-related diseases and obesity. It is widely known that moderate exercise habits lead to improvement in lifestyle-related diseases and obesity. However, little research has been undertaken into how exercise habits affect periodontal disease. The purpose of this study was to examine the effect of exercise habits on periodontal diseases and metabolic pathology. We conducted a prospective intervention research for 12 weeks. The subjects were 71 obese men who participated in an exercise and/or dietary intervention program. Fifty subjects were assigned to exercise interventions (exercise intervention group) and 21 subjects were assigned to dietary interventions (dietary intervention group). This research was conducted before and after each intervention program. In the exercise intervention group, the number of teeth with a probing pocket depth (PPD) ≥4 mm significantly decreased from 14.4% to 5.6% ( P periodontal disease-causing bacteria and PPD and BOP. Our results are the first to show that exercise might contribute to improvements in periodontal disease.

  13. Psychological Status of Adolescents with Respiratory Allergic Diseases and Their Caregivers

    Directory of Open Access Journals (Sweden)

    Duygu Erge

    2016-12-01

    Full Text Available Objective: The aim of the study was to evaluate the psychological status of adolescents with respiratory allergies and their caregivers. Materials and Methods: Child and adolescent psychiatrists evaluated the adolescents’ psychological status using the Children’s Depression Inventory (CDI and Screen for Child Anxiety-Related Emotional Disorders (SCARED. Psychiatrist evaluated the psychological status of their caregivers using the Hamilton Depression Scale (HAM-D and the Hamilton Anxiety Scale (HAM-A. Results: Anxiety symptoms were found in 21 of 63 patients. CDI scores were higher in controls than in patients (p=0.03. HAM-D scores were higher in the caregivers of adolescents with allergic rhinitis and comorbid asthma than in those of controls (p=0.025. None of the scores were affected by the severity of asthma and allergic rhinitis, asthma control levels, presence of an asthma attack in the preceding year as well as by pulmonary function tests (p>0.05. Moderate and strong positive correlations were found between SCARED and CDI (r=0.644, p<0.001 and HAM-A and HAM-D scores (r=0.860, p<0.001. Conclusion: Anxiety symptoms were found in one-third of the patients. HAM-D scores were higher in the caregivers of adolescents with allergic rhinitis and comorbid asthma than in those of controls.

  14. Vitamin D deficiency, oxidative stress and antioxidant status: only weak association seen in the absence of advanced age, obesity or pre-existing disease.

    Science.gov (United States)

    Wang, Erica W; Siu, Parco M; Pang, Marco Y; Woo, Jean; Collins, Andrew R; Benzie, Iris F F

    2017-07-01

    Vitamin D deficiency (plasma 25-hydroxycholecalciferol (25(OH)D)70 % of participants were vitamin D deficient. No significant correlations and no biomarker differences across 25(OH)D quartiles or groups were seen except for total antioxidant status. A weak direct association (r 0·252, Pstress biomarkers in the absence of advanced age, obesity and disease, though some evidence of depleted antioxidant status in those with vitamin D deficiency was seen. Poor antioxidant status may pre-date increased oxidative stress. Study of effects of correction of deficiency on antioxidant status and oxidative stress in vitamin D-deficient but otherwise healthy subjects is needed.

  15. Nutritional Status and Infectious Disease of Undernourished Children under five in Desa Cipacing, Jatinangor Subdistrict, West Java, from April to December 2012

    Directory of Open Access Journals (Sweden)

    Palomina Caesarea Nurhasanah

    2015-09-01

    Full Text Available Background: Undernutrition frequently occurs in children under five. If not treated, it will cause acute health effects and affect on cognitive development, social, physical work capacity and productivity. Undernutrition can be accompanied by the presence of infectious disease that can worsen the children’s nutritional status. This study aimed to describe the nutritional status and infectious disease of undernutrition children under five in Jatinangor Subdistrict. Methods: A qualitative study was carried out to 7 parents and undernourished children under five, in Desa Cipacing, Jatinangor. It was conducted from April to December 2012. The inclusion criterias were undernourished children under five with a history of infectious disease in the previous year, and the parents were willing to participate in this study. Exclusion criteria were parents and/or the children who were not at home when the collection of the data was conducted.. Data collection was conducted using measurement of nutritional status, in depth interview and environmental observation. The data were presented in tables, figures and narration. Results: Three subjects with undernutrition (-3SD to -2SD and four subjects with severe undernutrition (<-3SD. Factors affecting poor nutritional status were weight loss, no significant weight gain, diet and eating habit, and onset of disease. Commonly occurred infectious diseases were common cold, diarrhea, fever and cough. Some factors affecting infectious diseases were family member transmission, immunization, and treatment behavior. Conclusions: Poor nutritional status and infectious diseases contribute to undernutrition in children under five.

  16. Development of an integral assessment approach of health status in patients with obstructive airway diseases: the CORONA study

    Directory of Open Access Journals (Sweden)

    van den Akker EF

    2015-11-01

    Full Text Available Edmée FMM van den Akker,1 Alex J van ‘t Hul,2 Niels H Chavannes,3 Gert-Jan Braunstahl,1 Alie van Bruggen,1 Maureen PMH Rutten-van Mölken,4 Johannes CCM in ‘t Veen1 1Department of Pulmonary Diseases, STZ Center of Excellence for Asthma & COPD, Sint Franciscus Gasthuis, Rotterdam, 2Department of Pulmonary Disease, Radboud University Medical Center, Nijmegen, 3Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, 4Department of Health Care Policy and Management, Institute of Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, the Netherlands Background: Traditional assessment of patients with obstructive lung diseases (asthma and chronic obstructive pulmonary disease; COPD relies on physiological tests. The COPD and Asthma Rotterdam Integrated Care Approach (CORONA study aims to develop a diagnostic pathway with a more comprehensive approach to the assessment of patients with asthma and COPD in secondary care.Methods: An eight-step method was used to develop and implement the pathway for patients with asthma or COPD referred to an outpatient hospital setting.Results: The diagnostic pathway consists of an evidence-based set of measurements prioritized by a Delphi procedure. The pathway incorporates three innovative diagnostics: the metronome-paced hyperventilation test to measure dynamic hyperinflation, an activity monitor to objectively evaluate physical activity in daily life, and the Nijmegen Clinical Screening Instrument as a comprehensive assessment tool to acquire detailed insight into symptoms, functional limitations, and quality of life.Conclusion: An innovative diagnostic pathway was developed and implemented for patients with obstructive lung diseases referred to secondary care. As this pathway aims to provide a comprehensive analysis of health status, it focuses on biomedical aspects and also reviews behavioral aspects that further elucidate the patient’s health status. The

  17. Nutritional status and food intake of Brazilian patients at various stages of Alzheimer’s disease: A crosssectional study

    Directory of Open Access Journals (Sweden)

    Vanessa Fernanda Goes

    2014-04-01

    Full Text Available Alzheimer’s disease (AD is characterized by disorders that can impair the nutrition of the patient and lead to weight loss and nutritional deficits during the course of the disease. The aim of this study was to assess the nutritional status and food intake of Brazilian patients with Alzheimer’s disease at 3 different stages of the disease. The sample consisted of 30 subjects of both genders, mean age 77 years, with probable AD. Subjects were assessed by collecting anthropometric data, the Mini Nutritional Assessment (MNA, serum albumin content, Mini Mental State Examination and 24-hour records of food and drink. Although a steady decrease in average weight was observed as the disease progressed (CDR1: 70.8±15.9 kg; CDR2: 61.4±15.7 kg; CDR3: 56.1± 8.4 kg, the differences were not significant. MNA and serum albumin both fell during the progression of the disease (p = 0.042; p = 0.047, respectively and, at the severe stage, half the patients were found to be undernourished and the other half at risk of undernutrition. According to their body mass index, 23.3% of patients were overweight. The nutritional value of the food consumed was similar across the stages of AD. In conclusion, the majority of Brazilian patients with AD in this study exhibited cognitive decline and malnutrition. However, food intake was similar among the stages of the disease, thus having no direct association with the progression of AD.

  18. Structural and functional measures of social relationships and quality of life among older adults: does chronic disease status matter?

    Science.gov (United States)

    Liao, Jing; Brunner, Eric J

    2016-01-01

    To evaluate the relative importance of structural and functional social relationships for quality of life (QoL) and the extent to which diagnosed chronic disease modifies these associations. Multivariate linear regression was used to investigate time-lagged associations between structural and functional measures of social relationships and QoL assessed 5 years apart by CASP-19, in 5925 Whitehall II participants (mean age 61, SD 6.0). Chronic disease was clinically verified coronary heart disease, stroke, diabetes or cancer. Social relationships-QoL associations were consistent across disease status (P-values for interaction: 0.15-0.99). Larger friend network (β = 1.9, 95% CI 1.5-2.3), having a partner (β = 1.2, 95% CI 0.5-1.7), higher confiding support (β = 2.2, 95% CI 1.8-2.7) and lower negative aspects of close relationships (β = 3.3, 95% CI 2.8-3.8) were independently related to improved QoL in old age. The estimated difference in QoL due to social relationships was equivalent to up to 0.5 SD of the CASP-19 score and was stronger than the effect of chronic disease (coronary heart disease β = 2.0, 95% CI 1.4-2.6). We found that beneficial aspects of social relationships in relation to QoL were, in order of importance: avoiding negative aspects of close relationships, having confiding support, having a wide network of friends and having a partner. These associations were not modified by chronic disease. Thus, despite inevitable physical deterioration, we may be able to enhance a satisfying late life by optimizing our social relationships.

  19. secretor status of sickle cell disease patients in Zaria, Kaduna State

    African Journals Online (AJOL)

    olayemitoyin

    Secretor enzyme) and to products that reside on ... associated with non ABH secretors are autoimmune diseases ... 1980., Kauffman et al, 1996), dental caries and abscess ... lung, liver, bone, skin, and kidneys (Hiran, 2005). ... reaction to occur.

  20. Sero-prevalence status of foot and mouth disease in the North ...

    African Journals Online (AJOL)

    and South Gondar zones of North Western Amhara Regional State, Ethiopia to determine the ... sero-prevalence of foot and mouth disease in cattle at the North and South Gondar zones was ..... Coetzer, W., Thomson, R. and Tustin, C., 1994.

  1. Iron status and anaemia of chronic disease in HIV-infected African ...

    African Journals Online (AJOL)

    2009-03-11

    Mar 11, 2009 ... A large percentage of women had anaemia of chronic disease, with HIV-infected ... subjects were recruited per week over a 25-week period (March 2000 ..... Washington DC: Academy for Educational Development; 1993.

  2. Extremely low-frequency magnetic exposure appears to have no effect on pathogenesis of Alzheimer's disease in aluminum-overloaded rat.

    Directory of Open Access Journals (Sweden)

    Cheng Zhang

    Full Text Available OBJECTIVE: Extremely low-frequency magnetic field (ELF-MF has been reported to be of potential pathogenetic relevance to Alzheimer's disease (AD for years. However, evidence confirming this function remains inconclusive. Chronic Al treatment has been identified as a contributing factor to cognitive function impairment in AD. This study aims to examine whether or not ELF-MF and Al have synergistic effects toward AD pathogenesis by investigating the effects of ELF-MF with or without chronic Al treatment on SD rats. METHODS: Sprague-Dawley (SD rats were subjected one of the following treatments: sham (control group, oral Al (Al group, ELF-MF (100 µT at 50 Hz with oral Al (MF+Al group, or ELF-MF (100 µT at 50 Hz without oral Al (MF group. RESULTS: After 12 wk of treatment, oral Al treatment groups (Al and MF+Al groups showed learning and memory impairment as well as morphological hallmarks, including neuronal cell loss and high density of amyloid-β (Aβ in the hippocampus and cerebral cortex. ELF-MF without Al treatment showed no significant effect on AD pathogenesis. ELF-MF+Al treatment induced no more damage than Al treatment did. CONCLUSIONS: Our results showed no evidence of any association between ELF-MF exposure (100 µT at 50 Hz and AD, and ELF-MF exposure does not influence the pathogenesis of AD induced by Al overload.

  3. Elevated serum fibroblast growth factor 23 levels as an indicator of lower extremity atherosclerotic disease in Chinese patients with type 2 diabetes mellitus.

    Science.gov (United States)

    He, Xingxing; Hu, Xiang; Ma, Xiaojing; Su, Hang; Ying, Lingwen; Peng, Jiahui; Pan, Xiaoping; Bao, Yuqian; Zhou, Jian; Jia, Weiping

    2017-06-15

    Recently, basic and clinical studies have provided evidence supporting the relationship between circulating levels of fibroblast growth factor (FGF) 23 and the development of atherosclerosis. Given that diabetes is an established risk factor for lower extremity atherosclerotic disease (LEAD), the goal of the present study was to explore the relationship between serum FGF23 levels and LEAD, as well as the related factors, in Chinese patients with type 2 diabetes mellitus (T2DM). A total of 401 hospitalized T2DM patients (201 subjects with LEAD and 200 subjects without LEAD) were enrolled in this study. Serum FGF23 levels were determined by a sandwich enzyme-linked immunosorbent assay. Femoral intima-media thickness (F-IMT) and lower limb atherosclerotic plaque were assessed through color Doppler ultrasound. The median (interquartile range) serum FGF23 levels in the entire study population was 42.08 (35.59-49.17) pg/mL. Subjects with LEAD had significantly higher serum FGF23 levels compared with those without LEAD (44.00 [37.54-51.30] pg/mL versus 40.42 [32.61-48.23] pg/mL, P Chinese patients with T2DM, serum FGF23 levels were independently and positively correlated with the presence of LEAD.

  4. Relationship between Serum 25-Hydroxyvitamin D and Lower Extremity Arterial Disease in Type 2 Diabetes Mellitus Patients and the Analysis of the Intervention of Vitamin D

    Directory of Open Access Journals (Sweden)

    Wan Zhou

    2015-01-01

    Full Text Available The aim of this study was to explore the relationship between serum 25-hydroxyvitamin D [25(OHD] concentrations and lower extremity arterial disease (LEAD in type 2 diabetes mellitus (T2DM patients and to investigate the intervention effect of vitamin D. 145 subjects were assigned to a control group (Group NC, T2DM group (Group DM1, and T2DM complicated with LEAD group (Group DM2; then Group DM2 were randomly divided into Group DM3 who received oral hypoglycemic agents and Group DM4 who received oral hypoglycemic drugs and vitamin D3 therapy. Compared to Group NC, 25(OHD was significantly lower in Group DM2 and marginally lower in Group DM1. In contrast to baseline and Group DM3, 25(OHD rose while low density lipoprotein (LDL, retinol binding protein 4 (RBP4, and HbA1c significantly lowered in Group DM4. Statistical analysis revealed that 25(OHD had a negative correlation with RBP4, duration, HbA1c, homeostasis model assessment for insulin resistance (HOMA-IR, and fasting plasma glucose (FPG. LDL, systolic blood pressure (SBP, FPG, and smoking were risk factors of LEAD while high density lipoprotein (HDL and 25(OHD were protective ones. Therefore, we deduced that low level of 25(OHD is significantly associated with the occurrence of T2DM complicated with LEAD.

  5. Minor rheumatology: Nonsystemic rheumatic disease of juxta-articular soft tissues of the pelvis and lower extremity: Diagnosis and treatment. Part 3

    Directory of Open Access Journals (Sweden)

    A. E. Karateev

    2015-01-01

    Full Text Available Pain associated with rheumatic diseases of juxta-articular soft tissues (RDJAST of the pelvis and lower extremity is a frequent reason for seeking advice from general practitioners and rheumatologists. However, the true cause of painful sensations is often overlooked by a physician and the patient is long and frequently treated unsuccessfully for lumbago, coxarthrosis, or gonarthrosis.The complexities of topical diagnosis are largely associated with the fact that instrumental methods virtually always determine these or those degenerative changes in the lumbar spine and hip joint (HJ, which formally supports the presence of nonspecific low back pain and coxarthrosis. Differential diagnosis can be made between these conditions if their clinical features are considered, by discriminating symptoms, such as pains in the back or buttock, and those located predominantly in the hip and groin area.The most known forms of RDJAST of the pelvis and HJ may include trochanteritis, hip abductor and adductor syndromes, iliopectineal bursitis, and ischial tuberosity bursitis.This review briefly describes the major forms of RDJAST of the mentioned area, their clinical manifestations, and topical diagnostic techniques. It also considers main therapeutic approaches: the administration of nonsteroidal antiinflammatory drugs, local injections of glucocorticoids and plateletrich plasma, and physiotherapy.

  6. [Indicators and factors of influence on the long-term follow-up of psychogenic diseases--a comparison of extreme groups].

    Science.gov (United States)

    Franz, M; Schellberg, D; Schepank, H

    1995-02-01

    The present investigation aimed at the identification of possible indicators of course, predictors, and etiologically relevant factors of psychogenic diseases. According to their complaints a sample of probands suffering from psychogenic impairment of medium degree (n = 240) was chosen out of a representative sample of an urban adult population (n = 528). This procedure should ensure a relatively high intraindividual variance of course of the criterion, since a sufficient variability of course seems improbable with chronic and severe psychogenic impaired or stabile healthy probands. Within 10 years the sample was investigated three times by psychodynamically trained physicians and psychologists. By means of cluster analysis the sample was subdivided in different types of course of psychogenic impairment. Both extreme types of course-the probands who showed the most positive and the most negative spontaneous longterm course-were investigated univariately and by means of a multivariate discriminant analysis with regard to potentially course determining variables. It became obvious that personality variables and conditions of early childhood considerably influenced the spontaneous longterm course of psychogenic impairment.

  7. Association of plasma fetuin-a levels with peripheral arterial disease and lower extremity arterial calcification in subjects with type 2 diabetes mellitus.

    Science.gov (United States)

    Eleftheriadou, Ioanna; Grigoropoulou, Pinelopi; Kokkinos, Alexander; Mourouzis, Iordanis; Perrea, Despoina; Katsilambros, Nicholas; Sfikakis, Petros P; Tentolouris, Nikolaos

    2017-03-01

    Fetuin-A is a hepatic glycoprotein that is involved in insulin resistance and atherosclerosis. Herein we examined the association of plasma fetuin-A levels with peripheral arterial disease (PAD) in patients with type 2 diabetes mellitus (T2DM). A total of 71 patients with T2DM and 57 non-diabetic individuals were recruited. Diagnosis of PAD was based on the absence of triphasic waveform at pedal arteries, while ankle-brachial index (ABI) was calculated. Radiographs of both feet and ankles were taken for the assessment of lower extremity arterial calcification (LEAC). Plasma fetuin-A levels were measured using ELISA. Patients with T2DM had higher fetuin-A levels than non-diabetic participants. Participants with diabetes and PAD had lower fetuin-A levels than non-PAD diabetic patients. In subjects with T2DM fetuin-A levels were associated with ABI. Multivariate analysis demonstrated that in patients with T2DM the odds of PAD increased with long diabetes duration, smoking, presence of arterial hypertension and dyslipidemia, as well as with lower fetuin-A levels. A trend towards higher fetuin-A levels in subjects with less severe LEAC was found. Plasma fetuin-A levels are lower in patients with T2DM and PAD and are associated with PAD, irrespective of traditional cardiovascular risk factors. Moreover, fetuin-A may be involved in arterial calcification. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Importance of Extracranial Disease Status and Tumor Subtype for Patients Undergoing Radiosurgery for Breast Cancer Brain Metastases

    Energy Technology Data Exchange (ETDEWEB)

    Dyer, Michael A.; Kelly, Paul J. [Department of Radiation Oncology, Dana-Farber/Brigham and Women' s Cancer Center, Boston, MA (United States); Harvard Medical School, Boston, MA (United States); Chen, Yu-Hui [Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA (United States); Pinnell, Nancy E. [Department of Radiation Oncology, Dana-Farber/Brigham and Women' s Cancer Center, Boston, MA (United States); Claus, Elizabeth B. [Harvard Medical School, Boston, MA (United States); Department of Neurosurgery, Brigham and Women' s Hospital, Boston, MA (United States); Yale University School of Medicine, New Haven, CT (United States); Lee, Eudocia Q. [Harvard Medical School, Boston, MA (United States); Center for Neuro-Oncology, Dana-Farber/Brigham and Women' s Center, Boston, MA (United States); Weiss, Stephanie E. [Department of Radiation Oncology, Dana-Farber/Brigham and Women' s Cancer Center, Boston, MA (United States); Harvard Medical School, Boston, MA (United States); Arvold, Nils D. [Harvard Radiation Oncology Program, Boston, MA (United States); Lin, Nancy U. [Harvard Medical School, Boston, MA (United States); Department of Medical Oncology, Dana-Farber/Brigham and Women' s Cancer Center, Boston, MA (United States); Alexander, Brian M., E-mail: bmalexander@lroc.harvard.edu [Department of Radiation Oncology, Dana-Farber/Brigham and Women' s Cancer Center, Boston, MA (United States); Harvard Medical School, Boston, MA (United States)

    2012-07-15

    Purpose: In this retrospective study, we report on outcomes and prognostic factors for patients treated with stereotactic radiosurgery (SRS) for breast cancer brain metastases. Methods and Materials: We identified 132 consecutive patients with breast cancer who were treated with SRS for brain metastases from January 2000 through June 2010. We retrospectively reviewed records of the 51 patients with adequate follow-up data who received SRS as part of the initial management of their brain metastases. Overall survival (OS) and time to central nervous system (CNS) progression from the date of SRS were calculated using the Kaplan-Meier method. Prognostic factors were evaluated using the Cox proportional hazards model. Results: Triple negative subtype was associated with CNS progression on univariate analysis (hazard ratio [HR] = 5.0, p = 0.008). On multivariate analysis, triple negative subtype (HR = 8.6, p = 0.001), Luminal B subtype (HR = 4.3, p = 0.03), and omission of whole-brain radiation therapy (HR = 3.7, p = 0.02) were associated with CNS progression. With respect to OS, Karnofsky Performance Status (KPS) {<=} 80% (HR = 2.0, p = 0.04) and progressive extracranial disease (HR = 3.1, p = 0.002) were significant on univariate analysis; KPS {<=} 80% (HR = 4.1, p = 0.0004), progressive extracranial disease (HR = 6.4, p < 0.0001), and triple negative subtype (HR = 2.9, p = 0.04) were significant on multivariate analysis. Although median survival times were consistent with those predicted by the breast cancer-specific Graded Prognostic Assessment (Breast-GPA) score, the addition of extracranial disease status further separated patient outcomes. Conclusions: Tumor subtype is associated with risk of CNS progression after SRS for breast cancer brain metastases. In addition to tumor subtype and KPS, which are incorporated into the Breast-GPA, progressive extracranial disease may be an important prognostic factor for OS.

  9. A cross-sectional study of pain sensitivity, disease-activity assessment, mental health, and fibromyalgia status in rheumatoid arthritis.

    Science.gov (United States)

    Joharatnam, Nalinie; McWilliams, Daniel F; Wilson, Deborah; Wheeler, Maggie; Pande, Ira; Walsh, David A

    2015-01-20

    Pain remains the most important problem for people with rheumatoid arthritis (RA). Active inflammatory disease contributes to pain, but pain due to non-inflammatory mechanisms can confound the assessment of disease activity. We hypothesize that augmented pain processing, fibromyalgic features, poorer mental health, and patient-reported 28-joint disease activity score (DAS28) components are associated in RA. In total, 50 people with stable, long-standing RA recruited from a rheumatology outpatient clinic were assessed for pain-pressure thresholds (PPTs) at three separate sites (knee, tibia, and sternum), DAS28, fibromyalgia, and mental health status. Multivariable analysis was performed to assess the association between PPT and DAS28 components, DAS28-P (the proportion of DAS28 derived from the patient-reported components of visual analogue score and tender joint count), or fibromyalgia status. More-sensitive PPTs at sites over or distant from joints were each associated with greater reported pain, higher patient-reported DAS28 components, and poorer mental health. A high proportion of participants (48%) satisfied classification criteria for fibromyalgia, and fibromyalgia classification or characteristics were each associated with more sensitive PPTs, higher patient-reported DAS28 components, and poorer mental health. Widespread sensitivity to pressure-induced pain, a high prevalence of fibromyalgic features, higher patient-reported DAS28 components, and poorer mental health are all linked in established RA. The increased sensitivity at nonjoint sites (sternum and anterior tibia), as well as over joints, indicates that central mechanisms may contribute to pain sensitivity in RA. The contribution of patient-reported components to high DAS28 should inform decisions on disease-modifying or pain-management approaches in the treatment of RA when inflammation may be well controlled.

  10. Select tissue mineralconcentrations and chronic wasting disease status in mule deer from north-central Colorado

    OpenAIRE

    Wolfe, Lisa L.; Conner, Mary M.; Bedwell, Cathy L.; Lukacs, Paul M.; Miller, Michael W.

    2010-01-01

    Trace mineral imbalances have been suggested as having a causative or contributory role in chronic wasting disease (CWD), a prion disease of several North American cervid species. To begin exploring relationships between tissue mineral concentrations and CWD in natural systems, we measured liver tissue concentrations of copper, manganese, and molybdenum in samples from 447 apparently healthy, adult (≥2 yr old) mule deer (Odocoileus hemionus) culled or vehicle killed from free-ranging populati...

  11. Association between childhood allergic diseases, educational attainment and occupational status in later life: systematic review protocol

    OpenAIRE

    von Kobyletzki, Laura Beate; Beckman, Linda; Smeeth, Liam; McKee, Martin; Quint, Jennifer K; Abuabara, Katrina; Langan, Sinead

    2017-01-01

    Introduction Childhood allergic diseases may prevent affected children from achieving their academic potential. Potential mechanisms include absence from school due to illness and medical appointments. Experience of symptoms in classes or leisure time, and stigma associated with visible signs and symptoms, including skin disease, requirements for medication during school time or the need for specific diets, may also contribute to reduced educational attainment. Studies have investigated the a...

  12. On the Estimation of Disease Prevalence by Latent Class Models for Screening Studies Using Two Screening Tests with Categorical Disease Status Verified in Test Positives Only

    Science.gov (United States)

    Chu, Haitao; Zhou, Yijie; Cole, Stephen R.; Ibrahim, Joseph G.

    2010-01-01

    Summary To evaluate the probabilities of a disease state, ideally all subjects in a study should be diagnosed by a definitive diagnostic or gold standard test. However, since definitive diagnostic tests are often invasive and expensive, it is generally unethical to apply them to subjects whose screening tests are negative. In this article, we consider latent class models for screening studies with two imperfect binary diagnostic tests and a definitive categorical disease status measured only for those with at least one positive screening test. Specifically, we discuss a conditional independent and three homogeneous conditional dependent latent class models and assess the impact of misspecification of the dependence structure on the estimation of disease category probabilities using frequentist and Bayesian approaches. Interestingly, the three homogeneous dependent models can provide identical goodness-of-fit but substantively different estimates for a given study. However, the parametric form of the assumed dependence structure itself is not “testable” from the data, and thus the dependence structure modeling considered here can only be viewed as a sensitivity analysis concerning a more complicated non-identifiable model potentially involving heterogeneous dependence structure. Furthermore, we discuss Bayesian model averaging together with its limitations as an alternative way to partially address this particularly challenging problem. The methods are applied to two cancer screening studies, and simulations are conducted to evaluate the performance of these methods. In summary, further research is needed to reduce the impact of model misspecification on the estimation of disease prevalence in such settings. PMID:20191614

  13. Disease resistance breeding in rose: current status and potential of biotechnological tools.

    Science.gov (United States)

    Debener, Thomas; Byrne, David H

    2014-11-01

    The cultivated rose is a multispecies complex for which a high level of disease protection is needed due to the low tolerance of blemishes in ornamental plants. The most important fungal diseases are black spot, powdery mildew, botrytis and downy mildew. Rose rosette, a lethal viral pathogen, is emerging as a devastating disease in North America. Currently rose breeders use a recurrent phenotypic selection approach and perform selection for disease resistance for most pathogen issues in a 2-3 year field trial. Marker assisted selection could accelerate this breeding process. Thus far markers have been identified for resistance to black spot (Rdrs) and powdery mildew and with the ability of genotyping by sequencing to generate 1000s of markers our ability to identify markers useful in plant improvement should increase exponentially. Transgenic rose lines with various fungal resistance genes inserted have shown limited success and RNAi technology has potential to provide virus resistance. Roses, as do other plants, have sequences homologous to characterized R-genes in their genomes, some which have been related to specific disease resistance. With improving next generation sequencing technology, our ability to do genomic and transcriptomic studies of the resistance related genes in both the rose and the pathogens to reveal novel gene targets to develop resistant roses will accelerate. Finally, the development of designer nucleases opens up a potentially non-GMO approach to directly modify a rose's DNA to create a disease resistant rose. Although there is much potential, at present rose breeders are not using marker assisted breeding primarily because a good suite of marker/trait associations (MTA) that would ensure a path to stable disease resistance is not available. As our genomic analytical tools improve, so will our ability to identify useful genes and linked markers. Once these MTAs are available, it will be the cost savings, both in time and money, that will

  14. Roles of Cognitive Status and Intelligibility in Everyday Communication in People with Parkinson's Disease: A Systematic Review.

    Science.gov (United States)

    Barnish, Maxwell S; Whibley, Daniel; Horton, Simon M C; Butterfint, Zoe R; Deane, Katherine H O

    2016-03-16

    Communication is fundamental to human interaction and the development and maintenance of human relationships and is frequently affected in Parkinson's disease (PD). However, research and clinical practice have both tended to focus on impairment rather than participation aspects of communicative deficit in PD. In contrast, people with PD have reported that it is these participation aspects of communication that are of greatest concern to them rather than physical speech impairment. To systematically review the existing body of evidence regarding the association between cognitive status and/or intelligibility and everyday communication in PD. Five online databases were systematically searched in May 2015 (Medline Ovid, EMBASE, AMED, PsycINFO and CINAHL) and supplementary searches were also conducted. Two reviewers independently evaluated retrieved records for inclusion and then performed data extraction and quality assessment using standardised forms. Articles were eligible for inclusion if they were English-language original peer-reviewed research articles, book chapters or doctoral theses investigating the associations between at least one of cognitive status and level of intelligibility impairment and an everyday communication outcome in human participants with PD. 4816 unique records were identified through database searches with 16 additional records identified through supplementary searches. 41 articles were suitable for full-text screening and 15 articles (12 studies) met the eligibility criteria. 10 studies assessed the role of cognitive status and 9 found that participants with greater cognitive impairment had greater everyday communication difficulties. 4 studies assessed the role of intelligibility and all found that participants with greater intelligibility impairment had greater everyday communication difficulties, although effects were often weak and not consistent. Both cognitive status and intelligibility may be associated with everyday communicative

  15. The Impact of Ostomy on Quality of Life and Functional Status of Crohn’s Disease Patients within CCFA Partners

    Science.gov (United States)

    Abdalla, Maisa I.; Sandler, Robert S.; Kappelman, Michael D.; Martin, Christopher F.; Chen, Wenli; Anton, Kristen; Long, Millie D.

    2016-01-01

    Background The potential need for an ostomy is a main concern for patients with inflammatory bowel disease. We performed this study to evaluate the impact of a long term ostomy (≥ 6 months duration) on the functional status and specific patient-reported outcomes (PRO) in a population of patients with Crohn’s disease (CD). Methods We performed a cross-sectional analysis within the CCFA Partners cohort Study. Bivariate analyses and logistic regression models were used to investigate associations between ostomy and various demographic, disease factors, and PROs for health related quality of life (HRQOL). Results A total of 402 CD patients with ostomy for a minimum duration of 6 months were compared to 4331 CD patients with no ostomy. Patients with ostomy were more likely to be in clinical remission compared to those without ostomy, 48.5% vs. 31.3%, respectively. Having an ostomy did not impact overall HRQOL and was not associated with anxiety, depression, sleep disturbances, or reduced sexual interest and satisfaction. However, the presence of ostomy was associated with reduced social role satisfaction in patients both with controlled and active disease. Additionally, in the subset of patients who did not achieve clinical remission, those with ostomy experienced greater pain interference (OR 1.63, 95% CI 1.12–2.35) and fatigue (OR 1.66 95% CI 1.15–2.39). Conclusion Ostomy is well-tolerated in CD patients, particularly when clinical remission is achieved. PMID:27661669

  16. Disease activity, obesity, functional disability, and depression in patients with rheumatoid arthritis : Impact on lipid status, glycoregulation, and risk for coronary heart disease.

    Science.gov (United States)

    Ostojic, P; Bartolovic, D

    2016-09-01

    This study aims to estimate the impact of disease activity, obesity, functional disability, and depression on lipid status, glycoregulation, and risk for coronary heart disease (CHD) in patients with rheumatoid arthritis (RA). A total of 36 patients with RA (30 women and 6 men, mean age 54.9 years, mean disease duration 7.9 years) were included in this study. We estimated the impact of age, body mass index, disease activity [assessed by DAS28 index and C-reactive protein (CRP) value], functional ability (estimated using the HAQ disability index), and depression [assessed using the Beck Depression Inventory (BDI)] on glycoregulation, lipid status, and risk for CHD in our patients. Glycoregulation was assessed by measuring insulin resistance, insulin, and glucose in blood. Lipids tested in blood included total cholesterol, HDL and LDL cholesterol, and triglycerides (TG). The 10-year risk for CHD was estimated using the Framingham risk score. Of 36 patients, 11 (30.6 %) fulfilled the criteria for metabolic syndrome (MS). Ten of 11 patients (90.1 %) with MS have a 10-year risk for CHD greater than 10 % compared to only 3 of 25 patients (12 %) without MS (p = 0.0001). Patients with high disease activity had lower HDL values than patients with mild or moderate disease activity (1.4 vs. 1.7 mmol/l, p = 0.04). Significant correlations were observed between CRP level and insulinemia (ρ = 0.57, p = 0.003), as well as CRP level and the HOMA index (ρ = 0.59, p = 0.002). The body mass index (BMI) correlated significantly with total cholesterol (r = 0.46, p = 0.02), LDL (ρ = 0.41, p = 0.04), and TG (ρ = 0.65, p Obesity was found to be an independent risk factor for increased total cholesterol, LDL cholesterol, and TG. Depressed patients with RA tend to be overweight or obese and, therefore, have an unfavorable lipid profile.

  17. Diabetes and cardiovascular disease in older adults: current status and future directions.

    Science.gov (United States)

    Halter, Jeffrey B; Musi, Nicolas; McFarland Horne, Frances; Crandall, Jill P; Goldberg, Andrew; Harkless, Lawrence; Hazzard, William R; Huang, Elbert S; Kirkman, M Sue; Plutzky, Jorge; Schmader, Kenneth E; Zieman, Susan; High, Kevin P

    2014-08-01

    The prevalence of diabetes increases with age, driven in part by an absolute increase in incidence among adults aged 65 years and older. Individuals with diabetes are at higher risk for cardiovascular disease, and age strongly predicts cardiovascular complications. Inflammation and oxidative stress appear to play some role in the mechanisms underlying aging, diabetes, cardiovascular disease, and other complications of diabetes. However, the mechanisms underlying the age-associated increase in risk for diabetes and diabetes-related cardiovascular disease remain poorly understood. Moreover, because of the heterogeneity of the older population, a lack of understanding of the biology of aging, and inadequate study of the effects of treatments on traditional complications and geriatric conditions associated with diabetes, no consensus exists on the optimal interventions for older diabetic adults. The Association of Specialty Professors, along with the National Institute on Aging, the National Institute of Diabetes and Digestive and Kidney Diseases, the National Heart, Lung, and Blood Institute, and the American Diabetes Association, held a workshop, summarized in this Perspective, to discuss current knowledge regarding diabetes and cardiovascular disease in older adults, identify gaps, and propose questions to guide future research. © 2014 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  18. Perceived Health Status: Is Obesity Perceived as a Risk Factor and Disease?

    Science.gov (United States)

    Visscher, Tommy L.S.; Lakerveld, Jeroen; Olsen, Nanna; Küpers, Leanne; Ramalho, Sofia; Keaver, Laura; Brei, Christina; Bjune, Jan-Inge; Ezquerro, Silvia; Yumuk, Volkan

    2017-01-01

    One might expect that a perception of obesity being a risk factor and disease, contributes to effective obesity prevention and management strategies. However, obesity rates continue to increase worldwide. The question arises whether obesity is truly perceived as a risk factor and a disease. This paper aims at describing perception of obesity as risk factor and disease among individuals seeking care, individuals not seeking care, the society, and different professionals having a role in the field of obesity. The paper is a reflection of the lecture on the topic that was given at the EASO's New Investigators United's Summer School 2016 in Portugal and the discussion with the new investigators and other senior speakers. Individual obese patients seeking help are very much aware of obesity being a risk factor and disease, but perceptions regarding obesity seem to be flawed among those who do not seek help for obesity. Also, misperceptions regarding obesity play a role at different levels, including society, different political levels, the fields of health care and social work, prevention organizations, and the food and marketing industry. The food and marketing industry has an enormous role in changing perceptions by the society and policy makers. Obesity rates will continue to increase as long as individuals, the society, and professionals at different levels have false interpretations of the severity of obesity. Severe action is needed against those who are playing a role in maintaining false perceptions of obesity as a risk factor and disease. PMID:28278496

  19. Backyard chicken keeping in the Greater London Urban Area: welfare status, biosecurity and disease control issues.

    Science.gov (United States)

    Karabozhilova, I; Wieland, B; Alonso, S; Salonen, L; Häsler, B

    2012-01-01

    1. The aim of the study was to collect baseline data on welfare, biosecurity and diseases of backyard chickens kept in the Greater London Urban Area (GLUA), United Kingdom (UK). 2. A total of 65 backyard chicken flock-keepers were recruited from May to July 2010 through adverts on websites, at City farms, veterinary practices and pet feed stores and surveyed by means of a questionnaire. A total of 30 responses were suitable for analysis. 3. Information on keepers' and flocks' characteristics, housing and husbandry practices and owners' knowledge of health problems in chickens and zoonotic diseases was collected. A welfare assessment protocol was developed and the flocks assessed accordingly. 4. Results showed that chickens were generally provided with living conditions that allowed them to perform their natural behaviours. 5. Most of the flock owners did not comply with the regulations of the Department for Environment, Food and Rural Affairs (Defra) on the feeding of catering waste. 6. Disease prevention measures such as vaccination and biosecurity, including limiting the access of human visitors, wild birds and rodents to the flocks were rare. 7. A lack of avian and zoonotic disease knowledge and awareness among the owners has implications for disease control and highlights the need for improved communication between owners, authorities and veterinarians.

  20. [Meta-analysis of percutaneous transluminal atherectomy in the treatment for in-stent restenosis of lower extremity peripheral artery disease].

    Science.gov (United States)

    Li, Weihao; Zhang, Tao; Liu, Yunfeng; Zhang, Yongbao; Li, Qingle; Zhang, Xiaoming; Shen, Chenyang

    2015-11-24

    To evaluate the clinical safety and efficacy of percutaneous transluminal atherectomy for in-stent restenosis (ISR) in patients with low extremity peripheral arterial diseases (PAD). PubMed, Elsevier, EBSCO, Spring databases and Cochrane Library were searched for relevant articles. Based on the different mechanisms of atherectomy, the patients were divided into mechanic atherectomy group and laser atherectomy group. The safety end points included the rate of distal embolism and severe arterial wall injuries. And the efficacy end points included primary patency rate and freedom from target vessel revascularization (TVR-free) 6 months and 12 months after surgery. A total of 9 studies and 620 patients (published between 2006 and 2014) were accepted. The rate of distal embolism was 4.2% (95% confidence interval (CI): 1.7%-6.7%), while that of severe arterial wall injuries was 1.9% (95%CI: 0.9%-3.0%), respectively. Laser atherectomy was responsible for more distal embolism (6.8%) compared to mechanic atherectomy (2.0%), which was significantly different (Q=21.66, P=0.010). At 6-month follow-up, primary patency rate and rate of TVR-free were 63.0% (95% CI: 55.5%-70.6%) and 80.4% (95% CI: 70.5%-90.3%), while at 12-month follow-up were 43.5% (95%CI: 32.2%-54.9%) and 58.0% (95% CI: 52.1%-63.9%), respectively. The free-TVR rate at 6 months follow-up in mechanical atherectomy group was 77.9%, and was inferior to that in laser atherectomy group (80.8%, Q=13.49, P=0.009). Published bias was discovered at the analysis of 12-month TVR-free rate by means of Begg Test (P=0.039). Meta analysis concerned about the 3 randomized controlled trials demonstrated that there was no significant improvement using atherectomy for ISR comparing to standard balloon at 6-month TVR-free rate (OR=1.34, 95% CI: 0.86-2.07, P=0.196). To treat ISR lesion in lower extremities, laser atherectomy has a lower free-TVR rate in the middle term follow-up.A higher rate of distal embolism is noted though. On

  1. Biopterin status in dogs with myxomatous mitral valve disease is associated with disease severity and cardiovascular risk factors

    DEFF Research Database (Denmark)

    Reimann, Maria Josefine; Häggström, J.; Mortensen, Alan

    2014-01-01

    BACKGROUND: Endothelial dysfunction (ED) has been suggested to be associated with myxomatous mitral valve disease (MMVD) in dogs. Tetrahydrobiopterin (BH4) is an important cofactor for production of the endothelium-derived vasodilator nitric oxide (NO). Under conditions of oxidative stress, BH4...... is oxidized to the biologically inactive form dihydrobiopterin (BH2). Thus, plasma concentrations of BH2 and BH4 may reflect ED and oxidative stress. OBJECTIVE: To determine plasma concentrations of BH2 and BH4 in dogs with different degrees of MMVD. ANIMALS: Eighty-four privately owned dogs grouped according...... to ACVIM guidelines (37 healthy control dogs including 13 Beagles and 24 Cavalier King Charles Spaniels [CKCSs], 33 CKCSs with MMVD of differing severity including 18 CKCSs [group B1] and 15 CKCSs [group B2], and 14 dogs of different breeds with clinical signs of congestive heart failure [CHF] because...

  2. Alteration of fecal microbiota profiles in juvenile idiopathic arthritis. Associations with HLA-B27 allele and disease status.

    Directory of Open Access Journals (Sweden)

    Monica Di Paola

    2016-10-01

    Full Text Available Alteration of gut microbiota is involved in several chronic inflammatory and autoimmune diseases, including rheumatoid arthritis, and gut microbial pro-arthritogenic profiles have been hypothesized. Intestinal inflammation may be involved in spondyloarthropathies and in a subset of patients affected by Juvenile Idiopathic Arthritis (JIA, the most common chronic rheumatic disease of childhood. We compared the fecal microbiota composition of JIA patients with healthy subjects (HS, evaluating differences in microbial profiles between sub-categories of JIA, such as enthesitis-related arthritis (JIA-ERA, in which inflammation of entheses occurs, and polyarticular JIA, non-enthesitis related arthritis (JIA-nERA. Through taxon-level analysis, we discovered alteration of fecal microbiota components that could be involved in subclinical gut inflammation, and promotion of joint inflammation. We observed abundance in Ruminococcaceae in both JIA categories, reduction in Clostridiaceae and Peptostreptococcaceae in JIA-ERA, and increase in Veillonellaceae in JIA-nERA, respectively compared with HS. Among the more relevant genera, we found an increase in Clostridium cluster XIVb, involved in colitis and arthritis, in JIA-ERA patients compared with HS, and a trend of decrease in Faecalibacterium, known for anti-inflammatory properties, in JIA-nERA compared with JIA-ERA and HS. Differential abundant taxa identified JIA patients for the HLA-B27 allele, including Bilophila, Clostridium cluster XIVb, Oscillibacter and Parvimonas. Prediction analysis of metabolic functions showed that JIA-ERA metagenome was differentially enriched in bacterial functions related to cell motility and chemotaxis, suggesting selection of potential virulence traits. We also discovered differential microbial profiles and intra-group variability among active disease and remission, suggesting instability of microbial ecosystem in autoimmune diseases with respect to healthy status. Similarly

  3. Imaging technique and current status of valvular heart disease using cardiac MRI

    International Nuclear Information System (INIS)

    Lotz, J.; Sohns, J.M.

    2013-01-01

    The main indications for cardiac magnetic resonance imaging (MRI) in the evaluation of valvular heart disease are pathologies of the aortic and pulmonary valve. For mitral and tricuspid valve pathologies MRI is not the first line modality as these are usually well visualized by echocardiography. The advantages of MRI in valvular heart disease are a high reliability in the evaluation of ventricular volumes and function as well as the assessment of the perivalvular arterial or atrial structures. This reliability and the limitless access to any imaging plane partially compensates for the lower temporal and spatial resolution in comparison to echocardiography. In patients with congenital heart disease, cardiac MRI is established as a valuable diagnostic tool in daily clinical management, especially for the evaluation of pulmonary valve defects. Nevertheless, echocardiography remains the first-line diagnostic imaging tool for the foreseeable future. (orig.) [de

  4. Cytokine Status, Thyroid Autoantibodies and Their Dynamic Changes During the Treatment of Graves' Disease

    Directory of Open Access Journals (Sweden)

    V V Lazanovich

    2008-09-01

    Full Text Available It has been found during the research that the changes of Th1 and Th2 marker cytokine content in Graves Disease are dynamic and are directly correlated not only with the severity of autoimmune thyrotoxicosis, but also with the method of treatment used and duration of Thiamazole therapy. The beginning of autoimmune thyrotoxicosis shows the largest amounts of both pro-inflammatory (IL-1a, IL-8, IFN-γ and anti-inflammatory (IL-10 cytokines which are significantly reduced during Thiamazole therapy, with the exception of the cases of severe disease course. Thyroid resection does not result in immunologic remission either, which is confirmed by persisting high serum levels of IL-1a, IL-8, IFN-γ, IL-10 and TSH antibodies in the severe GBD group. Among the unfavorable prognostic factors for recurrent disease are high serum levels of TSH antibodies, IL-1a and IFN-γ during pre-surgery period.

  5. Neutron activation analysis techniques for identifying elemental status in Alzheimer's disease

    International Nuclear Information System (INIS)

    Ward, N.I.

    1987-01-01

    Brain tissue (hippocampus and cerebral cortex) from Alzheimer's disease and control individuals sampled from Eastern Canada and the United Kingdom were analyzed for Ag, Al, As, B, Br, Ca, Cd, Co, Cr, Cs, Cu, Fe, Hg, I, K, La, Mg, Mn, Mo, Ni, Rb, S, Sb, Sc, Se, Si, Sn, Sr, Ti, V and Zn. NAA (thermal and prompt gamma-ray) methods were used. Highly significant differences (probability less than 0.005) for both study areas were shown between Alzheimer's disease and control individuals. No statistical evidence of aluminium accumulation with age was noted. Possible zinc dificiency was observed. (author) 21 refs.; 5 tables

  6. Effect of Spirulina Intervention on Oxidative Stress, Antioxidant Status, and Lipid Profile in Chronic Obstructive Pulmonary Disease Patients

    Directory of Open Access Journals (Sweden)

    Md. Ismail

    2015-01-01

    Full Text Available Background and Objective. Oxidative stress is intimately associated with many diseases, including chronic obstructive pulmonary disease (COPD. Study objectives include a comparison of the oxidative stress, antioxidant status, and lipid profile between COPD patients and controls and evaluation of the effect of spirulina intervention on oxidative stress, antioxidant status, and lipid profile of COPD patients. Methods. 30 patients with COPD and 20 controls with no respiratory problems were selected. Global Initiative for Chronic Obstructive Lung Disease criteria were served as the basis of COPD diagnosis. The serum content of malondialdehyde (MDA, lipid hydroperoxide, glutathione (GSH, vitamin C, cholesterol, triglyceride (TG, and high density lipoprotein (HDL was measured. The activity of superoxide dismutase (SOD, catalase (CAT, and glutathione-s-transferase (GST was also measured. Two different doses, (500 × 2 mg and (500 × 4 mg spirulina, were given to two groups, each of which comprises 15 COPD patients. Results. All targeted blood parameters have significant difference (P=0.000 between COPD patients and controls except triglyceride (TG. Spirulina intake for 30 and 60 days at (500 × 2 mg dose has significantly reduced serum content of MDA, lipid hydroperoxide, and cholesterol (P=0.000 while increasing GSH, Vit C level (P=0.000, and the activity of SOD (P=0.000 and GST (P=0.038. At the same time, spirulina intake for 30 and 60 days at (500 × 4 mg dose has favorable significant effect (P=0.000 on all targeted blood parameters except for HDL (P=0.163.

  7. Brazilian status in blood irradiation in Graft-Versus-Host Disease (GVHD) prevention

    International Nuclear Information System (INIS)

    Goes, E.G. de; Borges, J.C.; Ghilardi Netto, T.

    1996-01-01

    A short overview of the Brazilian reality concerning Graft-Versus-Host Disease (GVHD) is presented. Suggestions of policies and procedures to optimise GVHD prevention are reported. A national irradiator device using cobalt teletherapy unit is proposed for irradiation of blood and cellular components

  8. Neurodevelopmental Status and Adaptive Behaviors in Preschool Children with Chronic Kidney Disease

    Science.gov (United States)

    Duquette, Peter J.; Hooper, Stephen R.; Icard, Phil F.; Hower, Sarah J.; Mamak, Eva G.; Wetherington, Crista E.; Gipson, Debbie S.

    2009-01-01

    This study examines the early neurodevelopmental function of infants and preschool children who have chronic kidney disease (CKD). Fifteen patients with CKD are compared to a healthy control group using the "Mullen Scales of Early Learning" (MSEL) and the "Vineland Adaptive Behavior Scale" (VABS). Multivariate analysis reveals…

  9. Dancing in the dark? The status of late-onset Alzheimer's disease genetics.

    Science.gov (United States)

    Bertram, L; Tanzi, R E

    2001-10-01

    Alzheimer's disease (AD) is a genetically complex and heterogeneous disorder. Recent estimates suggest that possibly over 70% of the genetic variance for the disease remains unaccounted for by apolipoprotein E (APOE) and the three known early-onset AD genes (APP, PSEN1, PSEN2). Specifically, one recent segregation analysis predicted the existence of up to four additional susceptibility genes having a similar or greater effect than APOE. However, most of the nearly three dozen putative AD loci proposed to date have only been inconsistently replicated in follow up analyses and more studies are necessary to distinguish false-positive findings from genuine signals. Novel AD genes will not only provide valuable clues for the development of novel therapeutic approaches, but will also allow the development of new genetic risk-profiling strategies that are an essential prerequisite for early prediction/prevention of this devastating disease. In this review, we will present a brief overview of analytic tools in complex disease genetics, as well as a summary of recent linkage and association findings indicating the existence of novel late-onset AD genes on chromosomes 12, 10, and 9.

  10. ABO (H) secretor status of sickle cell disease patients in Zaria ...

    African Journals Online (AJOL)

    Certain individuals secrete ABO blood group antigens in body fluids and secretions while others do not. In this study, the presence of water soluble agglutinogens in body fluids such as blood, saliva and urine of 64 sickle cell disease patients and 75 AA genotype subjects who served as control were taken and tested by ...

  11. Nutrigenetics and Metabolic Disease: Current Status and Implications for Personalised Nutrition

    Science.gov (United States)

    Phillips, Catherine M.

    2013-01-01

    Obesity, particularly central adiposity, is the primary causal factor in the development of insulin resistance, the hallmark of the metabolic syndrome (MetS), a common condition characterized by dyslipidaemia and hypertension, which is associated with increased risk of cardiovascular disease (CVD) and type 2 diabetes (T2DM). Interactions between genetic and environmental factors such as diet and lifestyle, particularly over-nutrition and sedentary behavior, promote the progression and pathogenesis of these polygenic diet-related diseases. Their current prevalence is increasing dramatically to epidemic proportions. Nutrition is probably the most important environmental factor that modulates expression of genes involved in metabolic pathways and the variety of phenotypes associated with obesity, the MetS and T2DM. Furthermore, the health effects of nutrients may be modulated by genetic variants. Nutrigenomics and nutrigenetics require an understanding of nutrition, genetics, biochemistry and a range of “omic” technologies to investigate the complex interaction between genetic and environmental factors relevant to metabolic health and disease. These rapidly developing fields of nutritional science hold much promise in improving nutrition for optimal personal and public health. This review presents the current state of the art in nutrigenetic research illustrating the significance of gene-nutrient interactions in the context of metabolic disease. PMID:23306188

  12. A Survey of Vitamin D Status in Patients with Degenerative Diseases of the Spine.

    Science.gov (United States)

    Zolfaghari, Farid; Faridmoayer, Alireza; Soleymani, Bahram; Taji, Mohammadreza; Mahabadi, Maryam

    2016-10-01

    Descriptive cross-sectional study. To determine the prevalence of vitamin D deficiency in patients with degenerative diseases of the spine about to undergo spinal surgery and the relations between such deficiency and potential risk factors. Vitamin D has a major role in musculoskeletal system health maintenance. Recently, studies on degenerative diseases of the spine have shown a high prevalence of vitamin D deficiency in patients undergoing spine surgery. Serum levels of 25(OH)D were determined by an electrochemiluminescence detection assay. The other variables were determined through relevant questionnaires, and the data was analyzed through analysis of variance, t -test, chi-square and multivariate logistic regression analysis. A total of 110 patients were enrolled in the study. The mean serum level of 25(OH)D was 27.45±18.75 ng/mL, and 44.5% of patients showed vitamin D deficiency (25(OH)Ddegenerative diseases of the spine. On the other hand, the conventional risk factors such as old age or female sex alone did not seem to be sufficient in determining the likelihood of deficiency. Thus, it is recommended that vitamin D deficiency prevention strategies comprise a broader spectrum of the population through which such degenerative diseases and their consequences may be prevented or delayed.

  13. Osteoprotegerin is higher in peripheral arterial disease regardless of glycaemic status.

    LENUS (Irish Health Repository)

    O'Sullivan, Eoin P

    2010-12-01

    Peripheral arterial disease (PAD) and type 2 diabetes mellitus (DM) are both associated with excessive vascular calcification and elevated levels of inflammatory markers IL-6 and hsCRP. The recently identified Osteoprotegerin(OPG)\\/RANKL\\/TRAIL pathway has been implicated in vascular calcification, but data on levels in PAD and effect of co-existent DM are lacking.

  14. Bone mineral density and vitamin D status in Parkinson's disease patients

    NARCIS (Netherlands)

    Bos, F. van den; Speelman, A.D.; Nimwegen-Arrachart, M.L. van; Schouw, Y.T. van der; Backx, F.J.; Bloem, B.R.; Munneke, M.; Verhaar, H.J.

    2013-01-01

    Bone loss is more common in Parkinson's disease (PD) than in the general population. Several factors may be involved in the development of bone loss, including malnutrition, immobilization, low body mass index, decreased muscle strength, vitamin D deficiency and medication use. This study

  15. Nutrigenetics and Metabolic Disease: Current Status and Implications for Personalised Nutrition

    Directory of Open Access Journals (Sweden)

    Catherine M. Phillips

    2013-01-01

    Full Text Available Obesity, particularly central adiposity, is the primary causal factor in the development of insulin resistance, the hallmark of the metabolic syndrome (MetS, a common condition characterized by dyslipidaemia and hypertension, which is associated with increased risk of cardiovascular disease (CVD and type 2 diabetes (T2DM. Interactions between genetic and environmental factors such as diet and lifestyle, particularly over-nutrition and sedentary behavior, promote the progression and pathogenesis of these polygenic diet-related diseases. Their current prevalence is increasing dramatically to epidemic proportions. Nutrition is probably the most important environmental factor that modulates expression of genes involved in metabolic pathways and the variety of phenotypes associated with obesity, the MetS and T2DM. Furthermore, the health effects of nutrients may be modulated by genetic variants. Nutrigenomics and nutrigenetics require an understanding of nutrition, genetics, biochemistry and a range of “omic” technologies to investigate the complex interaction between genetic and environmental factors relevant to metabolic health and disease. These rapidly developing fields of nutritional science hold much promise in improving nutrition for optimal personal and public health. This review presents the current state of the art in nutrigenetic research illustrating the significance of gene-nutrient interactions in the context of metabolic disease.

  16. Nutrigenetics and metabolic disease: current status and implications for personalised nutrition.

    Science.gov (United States)

    Phillips, Catherine M

    2013-01-10

    Obesity, particularly central adiposity, is the primary causal factor in the development of insulin resistance, the hallmark of the metabolic syndrome (MetS), a common condition characterized by dyslipidaemia and hypertension, which is associated with increased risk of cardiovascular disease (CVD) and type 2 diabetes (T2DM). Interactions between genetic and environmental factors such as diet and lifestyle, particularly over-nutrition and sedentary behavior, promote the progression and pathogenesis of these polygenic diet-related diseases. Their current prevalence is increasing dramatically to epidemic proportions. Nutrition is probably the most important environmental factor that modulates expression of genes involved in metabolic pathways and the variety of phenotypes associated with obesity, the MetS and T2DM. Furthermore, the health effects of nutrients may be modulated by genetic variants. Nutrigenomics and nutrigenetics require an understanding of nutrition, genetics, biochemistry and a range of "omic" technologies to investigate the complex interaction between genetic and environmental factors relevant to metabolic health and disease. These rapidly developing fields of nutritional science hold much promise in improving nutrition for optimal personal and public health. This review presents the current state of the art in nutrigenetic research illustrating the significance of gene-nutrient interactions in the context of metabolic disease.

  17. Nurse specialists in adult congenital heart disease: The current status in Europe

    NARCIS (Netherlands)

    Moons, P.; Scholte op Reimer, W.; De Geest, S.; Fridlund, B.; Heikkila, J.; Jaarsma, Trijntje (Tiny); Martensson, J.; Smith, K; Stewart, S.; Stromberg, A; Thompson, D.R.

    2006-01-01

    Aim: Recommendations for the management of adults with congenital heart disease indicate that specialist referral centres should employ nurse specialists who are trained and educated in the care for these patients. We surveyed the involvement, education and activities of nurse specialists in the

  18. Artificial intelligence in diagnosis of obstructive lung disease: current status and future potential.

    Science.gov (United States)

    Das, Nilakash; Topalovic, Marko; Janssens, Wim

    2018-03-01

    The application of artificial intelligence in the diagnosis of obstructive lung diseases is an exciting phenomenon. Artificial intelligence algorithms work by finding patterns in data obtained from diagnostic tests, which can be used to predict clinical outcomes or to detect obstructive phenotypes. The purpose of this review is to describe the latest trends and to discuss the future potential of artificial intelligence in the diagnosis of obstructive lung diseases. Machine learning has been successfully used in automated interpretation of pulmonary function tests for differential diagnosis of obstructive lung diseases. Deep learning models such as convolutional neural network are state-of-the art for obstructive pattern recognition in computed tomography. Machine learning has also been applied in other diagnostic approaches such as forced oscillation test, breath analysis, lung sound analysis and telemedicine with promising results in small-scale studies. Overall, the application of artificial intelligence has produced encouraging results in the diagnosis of obstructive lung diseases. However, large-scale studies are still required to validate current findings and to boost its adoption by the medical community.

  19. [Interrelation between trophological status and the course of stomach and duodenal ulcer diseases].

    Science.gov (United States)

    Butov, M A; Zhestkova, T V

    2014-01-01

    There was installed a significant positive relationship between body mass index (BMI) and the velocity of cicatrization of ulcer in patients with ulcer disease (PUD) with trophological violations. Change in the index ratio of lymphocytes and ESR in patients with PUD trophological violations can be used to predict the velocity of cicatrization of ulcer. The general maladjustment more often observed in patients (PUD) underweight.

  20. Educational level and employment status in adults with congenital heart disease.

    Science.gov (United States)

    Pfitzer, Constanze; Helm, Paul C; Rosenthal, Lisa-Maria; Walker, Christoph; Ferentzi, Hannah; Bauer, Ulrike M M; Berger, Felix; Schmitt, Katharina R L

    2018-01-01

    Purpose Through this study we aimed to assess the educational level and employment status of adults with CHD in Germany. Data were acquired from an online survey carried out in 2015 by the German National Register for Congenital Heart Defects. A total of 1458 adults with CHD participated in the survey (response rate: 37.6%). For 1198 participants, detailed medical information, such as main cardiac diagnosis and information from medical reports, was available. Of the participants surveyed (n=1198), 54.5% (n=653) were female, and the mean age was 30 years. The majority of respondents (59.4%) stated that they had high education levels and that they were currently employed (51.1%). Patients with simple CHD had significantly higher levels of education (peducation levels and the majority were employed. The association between CHD and its severity and individuals' educational attainment should be investigated more closely in future studies.

  1. Skeletal and muscular status in juveniles with GFD treated clinical and newly diagnosed atypical celiac disease--preliminary data.

    Science.gov (United States)

    Płudowski, Paweł; Karczmarewicz, Elzbieta; Socha, Jerzy; Matusik, Halina; Syczewska, Małgorzata; Lorenc, Roman S

    2007-01-01

    Undiagnosed and untreated celiac disease (CD) constitutes an increasing skeletal health problem due to its association with low bone density and fractures. Examinations of skeletal status in children using dual-energy X-ray absorptiometry (DXA) are prone to size-related misinterpretation. In contrary, the analysis of muscle-bone relationship seems to limit a possibility of misdiagnosis because skeletal status is evaluated from the functional perspective. The study was aimed to assess skeletal status of children suffering from CD with the use of muscle-bone functional algorithm. The study group comprised 29 celiac patients (13.7yr+/-2.9) on gluten-free diet (GFD), and 24 newly diagnosed atypical celiac patients, including subgroup with normal height (n=14; 12.6yr+/-3.9) and subgroup with short stature (n=10; 12.2yr+/-2.9). Muscular and skeletal status was evaluated by DXA (DPX-L, GE). Anthropometry, total body bone mineral density (TBBMD, g/cm(2)). and total body bone mineral content (TBBMC, g) as well as lean body mass (LBM, g) were evaluated. Muscle-bone interactions were estimated using TBBMC/LBM ratio. Previously established references for healthy controls were used for the calculation of Z-scores (age-matched) and SD-scores (height-matched). GFD treated celiacs and atypical celiacs with normal body height had TBBMD, TBBMC, LBM, and TBBMC/LBM ratio Z-scores and SD-scores within normal range for healthy controls. In contrary, atypical celiacs with short stature had significantly lower Z-scores for TBBMD (-2.3+/-0.4), TBBMC (-2.1+/-0.3), LBM (-1.4+/-0.3). and TBBMC/LBM ratio (-2.3+/-0.6) when compared to respective values observed in GFD treated celiacs (pnormal height (pvalues observed in GFD treated celiacs (+0.04+/-0.2; pnormal height (-0.4+/-0.2; pvalues of DXA assessed indicators of bone and muscle status as well as normal muscle-bone interactions. Untreated atypical celiacs may present a broad spectrum of heterogeneous abnormalities from normal to markedly

  2. Circulating levels of insulin-like growth factor-I (IGF-I correlate with disease status in leprosy

    Directory of Open Access Journals (Sweden)

    Rodrigues Luciana

    2011-12-01

    Full Text Available Abstract Background Caused by Mycobacterium leprae (ML, leprosy presents a strong immune-inflammatory component, whose status dictates both the clinical form of the disease and the occurrence of reactional episodes. Evidence has shown that, during the immune-inflammatory response to infection, the growth hormone/insulin-like growth factor-I (GH/IGF-I plays a prominent regulatory role. However, in leprosy, little, if anything, is known about the interaction between the immune and neuroendocrine systems. Methods In the present retrospective study, we measured the serum levels of IGF-I and IGBP-3, its major binding protein. These measurements were taken at diagnosis in nonreactional borderline tuberculoid (NR BT, borderline lepromatous (NR BL, and lepromatous (NR LL leprosy patients in addition to healthy controls (HC. LL and BL patients who developed reaction during the course of the disease were also included in the study. The serum levels of IGF-I, IGFBP-3 and tumor necrosis factor-alpha (TNF-α were evaluated at diagnosis and during development of reversal (RR or erythema nodosum leprosum (ENL reaction by the solid phase, enzyme-labeled, chemiluminescent-immunometric method. Results The circulating IGF-I/IGFBP-3 levels showed significant differences according to disease status and occurrence of reactional episodes. At the time of leprosy diagnosis, significantly lower levels of circulating IGF-I/IGFBP-3 were found in NR BL and NR LL patients in contrast to NR BT patients and HCs. However, after treatment, serum IGF-I levels in BL/LL patients returned to normal. Notably, the levels of circulating IGF-I at diagnosis were low in 75% of patients who did not undergo ENL during treatment (NR LL patients in opposition to the normal levels observed in those who suffered ENL during treatment (R LL patients. Nonetheless, during ENL episodes, the levels observed in RLL sera tended to decrease, attaining similar levels to those found in NR LL patients

  3. Extremely low frequency electromagnetic fields stimulation modulates autoimmunity and immune responses: a possible immuno-modulatory therapeutic effect in neurodegenerative diseases

    Directory of Open Access Journals (Sweden)

    Fabio Guerriero

    2016-01-01

    Full Text Available Increasing evidence shows that extremely low frequency electromagnetic fields (ELF-EMFs stimulation is able to exert a certain action on autoimmunity and immune cells. In the past, the efficacy of pulsed ELF-EMFs in alleviating the symptoms and the progression of multiple sclerosis has been supported through their action on neurotransmission and on the autoimmune mechanisms responsible for demyelination. Regarding the immune system, ELF-EMF exposure contributes to a general activation of macrophages, resulting in changes of autoimmunity and several immunological reactions, such as increased reactive oxygen species-formation, enhanced phagocytic activity and increased production of chemokines. Transcranial electromagnetic brain stimulation is a non-invasive novel technique used recently to treat different neurodegenerative disorders, in particular Alzheimer's disease. Despite its proven value, the mechanisms through which EMF brain-stimulation exerts its beneficial action on neuronal function remains unclear. Recent studies have shown that its beneficial effects may be due to a neuroprotective effect on oxidative cell damage. On the basis of in vitro and clinical studies on brain activity, modulation by ELF-EMFs could possibly counteract the aberrant pro-inflammatory responses present in neurodegenerative disorders reducing their severity and their onset. The objective of this review is to provide a systematic overview of the published literature on EMFs and outline the most promising effects of ELF-EMFs in developing treatments of neurodegenerative disorders. In this regard, we review data supporting the role of ELF-EMF in generating immune-modulatory responses, neuromodulation, and potential neuroprotective benefits. Nonetheless, we reckon that the underlying mechanisms of interaction between EMF and the immune system are still to be completely understood and need further studies at a molecular level.

  4. Diffusion-weighted MRI in Crohn's disease: Current status and recommendations

    OpenAIRE

    Dohan, A.; Taylor, S.; Hoeffel, C.; Barret, M.; Allez, M.; Dautry, R.; Zappa, M.; Savoye-Collet, C.; Dray, X.; Boudiaf, M.; Reinhold, C.; Soyer, P.

    2016-01-01

    Over the past years, technological improvements and refinements in magnetic resonance imaging (MRI) hardware have made high-quality diffusion-weighted imaging (DWI) routinely possible for the bowel. DWI is promising for the detection and characterization of lesions in Crohn's disease (CD) and has been advocated as an alternative to intravenous gadolinium-based contrast agents. Furthermore, quantification using the apparent diffusion coefficient may have value as a biomarker of CD activity and...

  5. Survey of health status, nutrition and geography of food selection of chronic liver disease patients.

    Science.gov (United States)

    Leslie, Timothy; Pawloski, Lisa; Kallman-Price, Jillian; Escheik, Carey; Hossain, Noreen; Fang, Yun; Gerber, Lynn H; Younossi, Zobair M

    2014-01-01

    Obesity, a complex disease determined both by genetic and environmental factors, is strongly associated with NAFLD, and has been demonstrated to have a negative impact on HCV and other chronic liver diseases (CLD). This study assessed the association between type and location of food sources and chronic liver disease (CLD) using Geographic Information Systems (GIS). CLD patients completed surveys [267 subjects, 56.5% female, age 55.8 ± 12.0, type of CLD: 36.5% hepatitis C (HCV), 19.9% hepatitis B (HBV), 19.9% non-alcoholic fatty liver disease (NAFLD); primary food source (PFS): 80.8% grocery store, secondary: 26.2% bulk food store, tertiary: 20.5% restaurants; fresh food (FF): 83%, pre-packaged (PP) 8.7%, already prepared (AP) 8.3%]. FF consumers had significantly fewer UEH servings/month (p = 0.030) and lived further away from convenience stores (1.69 vs. 0.95 km, p = 0.0001). Stepwise regression reveals the lowest FF consumers were NAFLD patients, subjects with UEH or restaurants and ethnic food stores as their PFS (R = 0.557, p = 0.0001). Eating already-packaged foods and utilizing restaurants or ethnic food stores as the PFS positively correlated with NAFLD (R = 0.546, p = 0.0001). Environmental food source measures, including type and density, should be included when examining areas hyper-saturated with a variety of food options. In hyper-saturated food environments, NAFLD patients consume more prepared food and less FF. CLD patients with UEH also eat significantly more prepared food and frequent restaurants and ethnic food stores as their PFS.

  6. Current status of treating neurodegenerative disease with induced pluripotent stem cells.

    Science.gov (United States)

    Pen, A E; Jensen, U B

    2017-01-01

    Degenerative diseases of the brain have proven challenging to treat, let alone cure. One of the treatment options is the use of stem cell therapy, which has been under investigation for several years. However, treatment with stem cells comes with a number of drawbacks, for instance the source of these cells. Currently, a number of options are tested to produce stem cells, although the main issues of quantity and ethics remain for most of them. Over recent years, the potential of induced pluripotent stem cells (iPSCs) has been widely investigated and these cells seem promising for production of numerous different tissues both in vitro and in vivo. One of the major advantages of iPSCs is that they can be made autologous and can provide a sufficient quantity of cells by culturing, making the use of other stem cell sources unnecessary. As the first descriptions of iPSC production with the transcription factors Sox2, Klf4, Oct4 and C-Myc, called the Yamanaka factors, a variety of methods has been developed to convert somatic cells from all germ layers to pluripotent stem cells. Improvement of these methods is necessary to increase the efficiency of reprogramming, the quality of pluripotency and the safety of these cells before use in human trials. This review focusses on the current accomplishments and remaining challenges in the production and use of iPSCs for treatment of neurodegenerative diseases of the brain such as Alzheimer's disease and Parkinson's disease. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Interactions between Host and Oral Commensal Microorganisms are Key Events in Health and Disease Status

    Directory of Open Access Journals (Sweden)

    Mahmoud Rouabhia

    2002-01-01

    Full Text Available The oral cavity has sometimes been described as a mirror that reflects a person's health. Systemic diseases such as diabetes or vitamin deficiency may be seen as alterations in the oral mucosa. A variety of external factors cause changes in the oral mucosa, thus altering mucosal structure and function, and promoting oral pathologies (most frequently bacterial, fungal and viral infections. Little is known, however, about immune surveillance mechanisms that involve the oral mucosa.

  8. Psoriatic arthritis mutilans (PAM) in the Nordic countries: demographics and disease status. The Nordic PAM study.

    Science.gov (United States)

    Gudbjornsson, B; Ejstrup, L; Gran, J T; Iversen, L; Lindqvist, U; Paimela, L; Ternowitz, T; Ståhle, M

    2013-01-01

    To determine the prevalence and clinical characteristics of psoriatic arthritis mutilans (PAM) in the Nordic countries. Patients with putative PAM aged ≥ 18 years were recruited. Fifty-nine patients were included after clinical examination. The prevalence of PAM in the adult Nordic population was estimated to be 3.69 per million inhabitants [95% confidence interval (CI) 2.75-4.63]. The female to male ratio was close to 1:1. The mean age of skin disease onset was 25 years and the mean age of onset of joint disease was 30 years. The onset of skin disease was 2 years earlier among female patients. At inclusion, the mean duration of arthritis was 27 ± 11 years for male patients and 33 ± 11 years for female patients. PAM was most frequently seen in the distal interphalangeal (DIP) joints of the toes, followed by the IP joint of the thumb and the DIP joint of the little finger on the left hand. Female and male patients had similar numbers of painful and swollen joints. Enthesitis was found in 19 patients (32%), while 38 patients (64%) had a history of dactylitis. Twenty-three of these 38 patients (61%) had a history of dactylitis in the same finger/toe as they had PAM. At the time of inclusion, 45% of the patients were found to have clear or almost clear skin. PAM in the Nordic countries has a low prevalence, with only three to five cases per million inhabitants. The majority of the patients present with mild skin disease.

  9. Nutrition Therapy for Liver Diseases Based on the Status of Nutritional Intake

    OpenAIRE

    Yasutake, Kenichiro; Kohjima, Motoyuki; Nakashima, Manabu; Kotoh, Kazuhiro; Nakamuta, Makoto; Enjoji, Munechika

    2012-01-01

    The dietary intake of patients with nonalcoholic fatty liver disease (NAFLD) is generally characterized by high levels of carbohydrate, fat, and/or cholesterol, and these dietary patterns influence hepatic lipid metabolism in the patients. Therefore, careful investigation of dietary habits could lead to better nutrition therapy in NAFLD patients. The main treatment for chronic hepatitis C (CHC) is interferon-based antiviral therapy, which often causes a decrease in appetite and energy intake;...

  10. Iron status and chronic kidney disease predict restless legs syndrome in an older hospital population.

    LENUS (Irish Health Repository)

    Quinn, Colin

    2011-03-01

    Iron deficiency is important in the pathogenesis of restless legs syndrome (RLS), and serum ferritin measurement, using a cutoff of 45-50ng\\/ml, is widely recommended as the optimal screening test for iron deficiency in RLS. Serum ferritin often increases with inflammation, and a higher cutoff may be better in those with acute and chronic inflammatory conditions, including those with chronic kidney disease (CKD).

  11. Association between body energy content in the dry period and post-calving production disease status in dairy cattle.

    Science.gov (United States)

    Smith, G L; Friggens, N C; Ashworth, C J; Chagunda, M G G

    2017-09-01

    The transition from gestation to lactation is marked by significant physiological changes for the individual cow such that disease incidence is highest in early lactation. Around the time of calving, cows rely on mobilisation of body energy reserves to fill the energy deficit created by an increase in nutrient demands at a time of restricted feed intake. It is well established that monitoring of body energy reserves in lactation is an important component of herd health management. However, despite their influence on future health and productivity, monitoring of body energy reserves in the dry period is often sparse. Further, there is increasing concern that current dry off management is inappropriate for modern cattle and may influence future disease risk. This study aimed to identify candidate indicators of early lactation production disease from body energy data collected in the dry period and production data recorded at the time of dry off. Retrospective analysis was performed on 482 cow-lactations collected from a long-term Holstein-Friesian genetic and management systems project, the Langhill herd in Scotland. Cow-lactations were assigned to one of four health groups based on health status in the first 30 days of lactation. These four groups were as follows: healthy, reproductive tract disorders (retained placenta and metritis), subclinical mastitis and metabolic disorders (ketosis, hypocalcaemia, hypomagnesaemia and left displaced abomasum). ANOVA, employing a GLM was used to determine effects for the candidate indicator traits. Cows which were diagnosed with a reproductive tract disorder in the first 30 days of lactation experienced a significantly greater loss in body energy content, body condition score and weight in the preceding dry period than healthy cows. The rate of change in body energy content during the first 15 days of the dry period was -18.26 MJ/day for cows which developed reproductive tract disorder compared with +0.63 MJ/day for healthy cows

  12. Growth Status of Iranian Children with Hemodynamically Important Congenital Heart Disease

    Directory of Open Access Journals (Sweden)

    Mohammad Dalili

    2011-02-01

    Full Text Available The relationship between congenital heart disease (CHD and growth retardation is well documented. We investigated the growth condition of Iranian children with several types of congenital heart disease (CHD and compared it with worldwide researches. Growth condition was investigated in 469 patients with important CHD aged from 1 month to 18 years. The patients were divided into two groups; infants (aged 12 months or less, and children (1-18 yrs of age. Children with hemodynamically unimportant small VSDs or small ASDs were not studied. Other exclusion criteria were prematurity, known genetic disorders and neurologic disease affecting growthd. All patients' cardiac diagnoses were made on the basis of clinical and laboratory examinations; including electrocardiography, echocardiography, cardiac catheterization, and angiography. Body weight and height of all patients were measured using conventional methods and compared with standard growth charts. In all patients body weights and heights were significantly lower than normal population. This difference was greater in the weight of female children. Other risk factors for growth failure were large left-to-right intracardiac shunts, pulmonary hypertension and cyanosis. Iranian children with CHD have growth failure somewhat different from other countries. Lower body weights of cyanotic patients and female children indicated that these patients need more nutritional and psychosocial attention.

  13. Nutritional status and eating disorders: neglected risks factor for nontuberculous mycobacterial lung disease?

    Science.gov (United States)

    Portillo, Karina; Morera, Josep

    2012-01-01

    Nontuberculous mycobacterial lung disease (NTMLD) in immunocompetent patients is an increasingly important epidemiologic concern. However, risk factors associated with susceptibility to NTMLD are not completely known. A prevalence of NTMLD appears to be rising, mainly in some populations such as middle-aged or elderly thin women, (a group including those with Lady Windermere syndrome) with neither remarkable history of respiratory disease nor smoking habit. Right middle lobe (RML) and lingula are often involved. Various predisposing factors and genetic defects have been described as possible causes of development of NTMLD, namely: voluntary suppression of cough, RML anatomical factors, menopause and mutations in cystic fibrosis transmembrane conductance regulator (CFTR). Malnutrition is also an important and common risk factor associated with other mycobacterial disease like tuberculosis (TB) and its probable association with NTMLD as have been pointed out for some authors. However, a real description of all nutritional aspects and eating habits of patients prior to NTMLD diagnosis is lacking. We hypothesized that malnutrition and eating disorders like anorexia nervosa could be risk factors that may promoting NTMLD. From a clinical viewpoint, if this hypothesis proves to be correct, eating habits and nutritional aspects should be taken into account in the diagnosis process of suspected NTMLD, since they are easily identifiable and treatable conditions. Copyright © 2011 Elsevier Ltd. All rights reserved.

  14. Neutron activation analysis techniques for identifying elemental status in Alzheimer's disease

    International Nuclear Information System (INIS)

    Ward, N.I.; Mason, J.A.

    1986-01-01

    Brain tissue (hippocampus and cerebral cortex) from Alzheimer's disease and control individuals sampled from Eastern Canada and the United Kingdom were analyzed for Ag, Al, As, B, Br, Ca, Cd, Co, Cr, Cs, Cu, Fe, Hg, I, K, La, Mg, Mn, Mo, Ni, Rb, S, Sb, Sc, Se, Si, Sn, Sr, Ti, V and Zn. Neutron activation analysis (thermal and prompt gamma-ray) methods were used. Very highly significant differences (S**: probability less than 0.005) for both study areas were shown between Alzheimer's disease (AD) and control (C) individuals: AD>C for Al, Br, Ca and S, and AD< C for Se, V and Zn. Aluminium content of brain tissue ranged form 3.605 to 21.738 μg/g d.w. (AD) and 0.379 to 4.768 μg/g d.w. (C). No statistical evidence of aluminium accumulation with age was noted. Possible zinc deficiency (especially for hippocampal tissue), was observed with zinc ranges of 31.42 to 57.91 μg/g d.w. (AD) and 37.31 to 87.10 μg/g d.w. (C), for Alzheimer's disease patients. (author)

  15. The effects of balneotherapy on disease activity, functional status, pulmonary function and quality of life in patients with ankylosing spondylitis.

    Science.gov (United States)

    Aydemir, Koray; Tok, Fatih; Peker, Fatma; Safaz, Ismail; Taskaynatan, Mehmet Ali; Ozgul, Ahmet

    2010-01-01

    This study aimed to determine the effects of balneotherapy on disease activity, functional status, metrology index, pulmonary function and quality of life in patients with ankylosing spondylitis (AS). The study included 28 patients (27 male and 1 female) diagnosed with AS according to modified New York criteria. The patients were treated with balneotherapy for 3 weeks (30 min/day, 5 days/week). The patients were evaluated using the global index, Bath ankylosing spondylitis disease activity index (BASDAI), disease functional index (BASFI), metrology index (BASMI), chest expansion measures, pulmonary function testing, and the medical outcomes study-short form-36 Health Survey (SF-36) (measure of quality of life) before balneotherapy and 1 month after treatment. Post balneotherapy BASDAI and global index decreased, BASMI parameters improved, chest expansion increased, and some SF-36 parameters improved; however, none of these changes were statistically significant (P > 0.05), except for the decrease in BASMI total score (P balneotherapy 6 patients had restrictive pulmonary disorder, according to pulmonary function test results. Pulmonary function test results in 3 (50%) patients were normalized following balneotherapy; however, as for the other index, balneotherapy did not significantly affect pulmonary function test results. The AS patients' symptoms, clinical findings, pulmonary function test results, and quality of life showed a trend to improve following balneotherapy, although without reaching significant differences. Comprehensive randomized controlled spa intervention studies with longer follow-up periods may be helpful in further delineating the therapeutic efficacy of balneotherapy in AS patients.

  16. Cognitive change in patients with Huntington disease on the Repeatable Battery for the Assessment of Neuropsychological Status.

    Science.gov (United States)

    Beglinger, Leigh J; Duff, Kevin; Allison, Jessica; Theriault, Danielle; O'Rourke, Justin J F; Leserman, Anne; Paulsen, Jane S

    2010-07-01

    Huntington disease (HD) is a neurodegenerative disease associated with cognitive, motor, and psychiatric deterioration over time. Although there is currently no cure for HD, there has been a surge of clinical trials available to patients with HD over the past 5 years. However, cognitive measures have generally been lacking from these trials. A brief, repeatable neuropsychological battery is needed to assess cognitive endpoints. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) may be useful for assessing change in interventional studies or for clinical monitoring. A total of 38 patients with HD were assessed using the RBANS, other cognitive tests, and the standardized HD battery (Unified Huntington's Disease Rating Scale, UHDRS) at two clinic visits approximately 16 months apart. The RBANS Attention Index, as well as individual subtest scores on Coding, Digit Span, List Recognition, Figure Copy, and Figure Recall all declined significantly over this interval. Performance on the UHDRS cognitive tests (Symbol Digit Modalities; Stroop Color, and Stroop Word) also declined, as did functional capacity. Results suggest that cognitive changes were detected both on established cognitive tasks used in HD research and on the RBANS in patients with measurable functional decline. The RBANS provided additional information about other cognitive domains affected (e.g., memory) and may be a useful measure for tracking longitudinal change.

  17. Decreased expression level of BER genes in Alzheimer's disease patients is not derivative of their DNA methylation status.

    Science.gov (United States)

    Sliwinska, Agnieszka; Sitarek, Przemysław; Toma, Monika; Czarny, Piotr; Synowiec, Ewelina; Krupa, Renata; Wigner, Paulina; Bialek, Katarzyna; Kwiatkowski, Dominik; Korycinska, Anna; Majsterek, Ireneusz; Szemraj, Janusz; Galecki, Piotr; Sliwinski, Tomasz

    2017-10-03

    Neurodegeneration in Alzheimer's disease can be caused by accumulation of oxidative DNA damage resulting from altered expression of genes involved in the base excision repair system (BER). Promoter methylation can affect the profile of BER genes expression. Decreased expression of BER genes was observed in the brains of AD patients. The aim of our study was to compare the expression and methylation profiles of six genes coding for proteins involved in BER, namely: hOGG1, APE1, MUTYH, NEIL1, PARP1 and XRCC1, in the peripheral blood cells of AD patients and healthy volunteers. The study consisted of 100 persons diagnosed with Alzheimer's disease according to DSM-IV criteria, and 110 healthy volunteers. DNA and total RNA were isolated from venous blood cells. Promoter methylation profiles were obtained by High Resolution Melting (HRM) analysis of bisulfide converted DNA samples. Real-time PCR with TaqMan probes was employed for gene expression analysis. APE1, hOGG1, MUTYH, PARP1 and NEIL1 were significantly (pgenes. The methylation status of promoters is not associated with downregulation of BER genes. Our results show that downregulation of BER genes detected in peripheral blood samples could reflect the changes occurring in the brain of patients with AD, and may be a useful biomarker of this disease. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Oral health status of children with congenital heart disease and the awareness, attitude and knowledge of their parents.

    Science.gov (United States)

    Rai, Kavita; Supriya, S; Hegde, Amitha M

    2009-01-01

    The oral health status of children with congenital heart diseases and the parental awareness on maintaining good oral health and attitude towards preventive dental health measures were evaluated. A total of 170 children between the age group of 1-16 yrs belonging to both genders, with the history of congenital heart disease from Sree Chitra Tirunal Institute of Medical Science and Technology, Thiruvananthapuram and Narayana Hrudayalaya Institute of Medical Sciences, Bangalore were examined. Oral lesions and caries experience were recorded using modified WHO oral health assessment form. Oral hygiene of the children with congenital heart disease was found to be poor with tongue coating (50.6%), plaque (41.8%), calculus (35.3%), and caries (42.4%). Parental awareness on the importance of maintaining good oral hygiene, preventive dentistry, medicinal decay and its systemic effects has been found to be very poor. Dentistry should give priority to patients whose general health may be put at risk by poor dental health. Closer cooperation between Pediatrician, Pediatric Cardiologists and Pediatric Dentists could help improve dental care for these children.

  19. Diagnosing Sporadic Creutzfeldt-Jakob Disease in a Patient with a Suspected Status Epilepticus in the Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Harm J. van der Horn

    2013-01-01

    Full Text Available Objective. Several tests are available in the diagnostics of sporadic Creutzfeldt-Jakob disease (sCJD; however, none of these is conclusive. We review the values of these tests, from an intensive care unit (ICU perspective. Methods. Case report and review of the literature. Results. A 53-year-old woman initially presenting with psychiatric symptoms developed myoclonus and was admitted 1 month later to the ICU with a suspected nonconvulsive status epilepticus and respiratory insufficiency, probably due to extensive antiepileptic drug therapy. Typical MRI and EEG findings and a positive 14-3-3 protein led to the diagnosis of sCJD. All treatments were terminated, and autopsy confirmed sCJD. Conclusions. Clinical signs combined with MRI, EEG, and 14-3-3 and/or tau protein determination might be sufficient to diagnose or exclude sCJD and may therefore prevent the application of unnecessary diagnostic tests.

  20. Cardiovascular disease risk factors among children of different socioeconomic status in Istanbul, Turkey: Directions for public health and nutrition policy

    Directory of Open Access Journals (Sweden)

    Keskin Yasar

    2004-06-01

    Full Text Available Abstract Objectives The aim of the current study was to examine the influence of socioeconomic status (SES on physiological (lipid profile, obesity indices and behavioral (dietary habits, physical activity cardiovascular disease (CVD risk factors among primary schoolchildren in Istanbul. Design Cross sectional study. Setting One private school and two public schools from different SES districts in Istanbul. Participants 510 randomly selected children aged 12 and 13 years old (257 boys, 253 girls. Results The prevalence of overweight (15.2% and the energy intake (p Conclusion The findings of the current study revealed a coexistence of both overweight and higher energy intake in middle/ high SES children, as well as a coexistence of underweight and lower physical activity levels in low SES children. These observations should guide the public health policy in developing appropriate intervention strategies to efficiently tackle these health and social issues early in life.

  1. Vitamin D status and vascular dementia due to cerebral small vessel disease in the elderly Asian Indian population.

    Science.gov (United States)

    Prabhakar, Puttachandra; Chandra, Sadanandavalli Retnaswami; Supriya, Manjunath; Issac, Thomas Gregor; Prasad, Chandrajit; Christopher, Rita

    2015-12-15

    Vitamin D plays vital roles in human health and recent studies have shown its beneficial effect on brain functioning. The present study was designed to evaluate the association of vitamin D with vascular dementia (VaD) due to cerebral small vessel disease (SVD) in Asian Indian population. 140 VaD patients aged ≥ 60 years with neuroimaging evidence of SVD, and 132 age and gender-matched controls, were investigated. Vitamin D status was estimated by measuring serum 25-hydroxy vitamin D. Logistic regression model revealed that deficient levels of vitamin D (vitamin D deficiency and insufficiency (12-20 ng/ml), the odds were increased to 31.6-fold and 14.4-fold, respectively. However, in hypertensives with vitamin D sufficiency (>20 ng/ml), the odds of VaD were increased by 3.8-fold only. Pearson correlation showed that serum vitamin D was inversely associated with systolic and diastolic blood pressure (r=-0.401 and -0.411, pvitamin D-deficient subjects. Since the combined presence of hypertension and vitamin D deficiency increases the probability of developing VaD, screening for vitamin D status in addition to regular monitoring of blood pressure, could reduce the risk of VaD associated with cerebral SVD in the elderly Asian Indian subjects. Copyright © 2015 Elsevier B.V. All rights reserved.

  2. [Investigation on the current status of oral health care in the disease controls system in Sichuan Province].

    Science.gov (United States)

    Zhuo, Wang; Ying, Deng; Wei, Yin; Xiaoxia, Liu; Yujin, He; Jun, He

    2015-04-01

    To analyze the status and characteristics of dental manpower in the center for disease controls (CDC) in Sichuan Province and to provide more evidence for strengthening the oral healthcare workforce in the CDC system. A mass survey on dental manpower was made in CDCs in Sichuan Province through questionnaire investigation. Data were collected and entered with the Epidemiological Dynamic Data Collection (EDDC) platform and analyzed with SPSS 13.0 software. Sichuan Province had 0.15 hospitals providing oral health services and 0.38 dentists on average per 10,000 people. About 65.53% (135/206) of the CDCs had one department responsible for the oral health service. However, oral health care personnel comprised only 2.23% (237/10,624) of the personnel of the whole CDC system. About 64.67% (119/184) of county CDCs and 47.62% (10/21) of city CDCs knew well the dental health status of local residents. Less than 5% of the CDCs used the data and assisted in the policy making of public health administrators. The dental care personal deficit exists in the CDC system in Sichuan Province. The distribution and composition of dental manpower are not reasonable. The oral health service ability of CDCs in Sichuan Province should be strengthened and improved.

  3. Management of endocrine disease: value and limitations of assessing vitamin D nutritional status and advised levels of vitamin D supplementation.

    Science.gov (United States)

    Romagnoli, Elisabetta; Pepe, Jessica; Piemonte, Sara; Cipriani, Cristiana; Minisola, Salvatore

    2013-10-01

    The growing attention to the role of vitamin D in skeletal and extra-skeletal diseases over the last decade induced an increased demand for vitamin D determination as well as a dramatic rise of sales of vitamin D supplement. However, several critical points in this field remain to be clarified. We lack a clear consensus about the definition of vitamin D deficiency, insufficiency, and sufficiency. The identification of different thresholds defining vitamin D status has relevant implications in clinical practice. In fact, the worldwide prevalence of low vitamin D status is highly varying according to the level of 25(OH)D utilized to define sufficiency. Therefore, the assessment of 25-hydroxyvitamin D levels may have a critical role, but a number of different technical problems associated with its determination may interfere in interpreting the results. The hydrophobic nature of vitamin D and the tight binding to its carrier (vitamin D binding protein), the different forms circulating in blood, and the issue of standardization are among the most important factors influencing the measurement of this metabolite. Another controversial point relies on the conflicting guidance on prevention and treatment of vitamin D deficiency endorsed by different medical and scientific communities. In particular, uncertainty exists about how to replete vitamin D stores, how to maintain normal 25(OH)D levels after repletion, which form of vitamin D is preferable for supplementation, and which route of administration and dosing regimens are advisable. Finally, concerns have been raised regarding vitamin D toxicity and its adverse effects.

  4. Vascular status in human primary and permanent teeth in health and disease.

    Science.gov (United States)

    Rodd, Helen D; Boissonade, Fiona M

    2005-04-01

    The present study sought to compare the vascular status of human primary teeth with that of human permanent teeth, and to determine whether caries or painful pulpitis was associated with changes in vascularity. Coronal pulps were removed from 62 primary and 62 permanent mandibular molars with a known pain history. Teeth were categorized as intact, moderately carious or grossly carious. Pulp sections were labelled with Ulex europaeus I lectin (UEIL), which is a marker of human vascular endothelium. Image analysis was then used to quantify the percentage area of UEIL-labelled tissue (vascularity) and the number of blood vessels present within three regions: the pulp horn, the subodontoblastic region, and the mid-coronal pulp. Only the mid-coronal region of the primary tooth pulp was found to be significantly more vascular than the corresponding area of the permanent tooth pulp. Both dentitions showed a significant increase in vascularity within the pulp horn region with caries progression, but this was not accompanied by an increase in vessel number. There was no correlation between vascularity and pain symptoms. These findings suggest that the primary tooth pulp is more vascular than its successor within the mid-coronal region. However, the functional and clinical significance of this finding remains speculative.

  5. Disclosure of disease status among employed multiple sclerosis patients: association with negative work events and accommodations.

    Science.gov (United States)

    Frndak, Seth E; Kordovski, Victoria M; Cookfair, Diane; Rodgers, Jonathan D; Weinstock-Guttman, Bianca; Benedict, Ralph H B

    2015-02-01

    Unemployment is common in multiple sclerosis (MS) and detrimental to quality of life. Studies suggest disclosure of diagnosis is an adaptive strategy for patients. However, the role of cognitive deficits and psychiatric symptoms in disclosure are not well studied. The goals of this paper were to (a) determine clinical factors most predictive of disclosure, and (b) measure the effects of disclosure on workplace problems and accommodations in employed patients. We studied two overlapping cohorts: a cross-sectional sample (n = 143) to determine outcomes associated with disclosure, and a longitudinal sample (n = 103) compared at four time points over one year on reported problems and accommodations. A case study of six patients, disclosing during monitoring, was also included. Disclosure was associated with greater physical disability but not cognitive impairment. Logistic regression predicting disclosure status retained physical disability, accommodations and years of employment (p work problems and accommodations over time. The case study revealed that reasons for disclosing are multifaceted, including connection to employer, decreased mobility and problems at work. Although cognitive impairment is linked to unemployment, it does not appear to inform disclosure decisions. Early disclosure may help maintain employment if followed by appropriate accommodations. © The Author(s), 2014.

  6. Zonulin, inflammation and iron status in patients with early stages of chronic kidney disease.

    Science.gov (United States)

    Lukaszyk, Ewelina; Lukaszyk, Mateusz; Koc-Zorawska, Ewa; Bodzenta-Lukaszyk, Anna; Malyszko, Jolanta

    2018-01-01

    Zonulin is the only known regulator of intestinal permeability. It is also considered as a potential inflammatory marker in several conditions such as diabetes and inflammatory bowel syndrome. The aim of the study was to investigate zonulin levels in patients with early stages of CKD and its possible correlation with inflammation, anemia and iron status parameters. Eighty-eight patients with early stages of CKD and 23 healthy volunteers were enrolled in the study. Zonulin, hepcidin-25, soluble transferrin receptor, interleukin-6 and high-sensitivity C-reactive protein were measured using commercially available assays. Zonulin was significantly lower among patients with CKD in comparison with healthy volunteers. There were no statistically significant differences in zonulin concentration between patients with and without inflammation. Zonulin was significantly correlated with hepcidin only in patients with inflammation. Zonulin was neither related to iron nor related to ferritin. Zonulin cannot be considered as an inflammatory marker in CKD. It does not play a role in the disturbances of iron metabolism in CKD. Its physiological role remains to be elucidated.

  7. NAFLD as a Sexual Dimorphic Disease: Role of Gender and Reproductive Status in the Development and Progression of Nonalcoholic Fatty Liver Disease and Inherent Cardiovascular Risk.

    Science.gov (United States)

    Ballestri, Stefano; Nascimbeni, Fabio; Baldelli, Enrica; Marrazzo, Alessandra; Romagnoli, Dante; Lonardo, Amedeo

    2017-06-01

    Nonalcoholic fatty liver disease (NAFLD) spans steatosis through nonalcoholic steatohepatis, cirrhosis, and hepatocellular carcinoma (HCC) associated with striking systemic features and excess cardiovascular and liver-related mortality. The pathogenesis of NAFLD is complex and multifactorial. Endocrine derangements are closely linked with dysmetabolic traits. For example, in animal and human studies, female sex is protected from dysmetabolism thanks to young individuals' ability to partition fatty acids towards ketone body production rather than very low density lipoprotein (VLDL)-triacylglycerol, and to sex-specific browning of white adipose tissue. Ovarian senescence facilitates both the development of massive hepatic steatosis and the fibrotic progression of liver disease in an experimental overfed zebrafish model. Consistently, estrogen deficiency, by potentiating hepatic inflammatory changes, hastens the progression of disease in a dietary model of nonalcoholic steatohepatitis (NASH) developing in ovariectomized mice fed a high-fat diet. In humans, NAFLD more often affects men; and premenopausal women are equally protected from developing NAFLD as they are from cardiovascular disease. It would be expected that early menarche, definitely associated with estrogen activation, would produce protection against the risk of NAFLD. Nevertheless, it has been suggested that early menarche may confer an increased risk of NAFLD in adulthood, excess adiposity being the primary culprit of this association. Fertile age may be associated with more severe hepatocyte injury and inflammation, but also with a decreased risk of liver fibrosis compared to men and postmenopausal status. Later in life, ovarian senescence is strongly associated with severe steatosis and fibrosing NASH, which may occur in postmenopausal women. Estrogen deficiency is deemed to be responsible for these findings via the development of postmenopausal metabolic syndrome. Estrogen supplementation may at

  8. Relationship between alcohol-attributable disease and socioeconomic status, and the role of alcohol consumption in this relationship: a systematic review and meta-analysis.

    Science.gov (United States)

    Jones, Lisa; Bates, Geoff; McCoy, Ellie; Bellis, Mark A

    2015-04-18

    Studies show that alcohol consumption appears to have a disproportionate impact on people of low socioeconomic status. Further exploration of the relationship between alcohol consumption, socioeconomic status and the development of chronic alcohol-attributable diseases is therefore important to inform the development of effective public health programmes. We used systematic review methodology to identify published studies of the association between socioeconomic factors and mortality and morbidity for alcohol-attributable conditions. To attempt to quantify differences in the impact of alcohol consumption for each condition, stratified by SES, we (i) investigated the relationship between SES and risk of mortality or morbidity for each alcohol-attributable condition, and (ii) where, feasible explored alcohol consumption as a mediating or interacting variable in this relationship. We identified differing relationships between a range of alcohol-attributable conditions and socioeconomic indicators. Pooled analyses showed that low, relative to high socioeconomic status, was associated with an increased risk of head and neck cancer and stroke, and in individual studies, with hypertension and liver disease. Conversely, risk of female breast cancer tended to be associated with higher socioeconomic status. These findings were attenuated but held when adjusted for a number of known risk factors and other potential confounding factors. A key finding was the lack of studies that have explored the interaction between alcohol-attributable disease, socioeconomic status and alcohol use. Despite some limitations to our review, we have described relationships between socioeconomic status and a range of alcohol-attributable conditions, and explored the mediating and interacting effects of alcohol consumption where feasible. However, further research is needed to better characterise the relationship between socioeconomic status alcohol consumption and alcohol-attributable disease risk

  9. Evaluation of the dental status and identification of factors influencing oral health for the purpose of the periodontal disease prophylaxis in dogs

    OpenAIRE

    Vilimaitė, Ilona

    2016-01-01