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Sample records for prevalent chronic diseases

  1. Prevalence of maternal chronic diseases during pregnancy

    DEFF Research Database (Denmark)

    Jølving, Line Riis; Nielsen, Jan; Kesmodel, Ulrik Schiøler

    2016-01-01

    INTRODUCTION: There is substantial evidence of a negative impact of maternal chronic disease during pregnancy on reproductive outcomes. Knowledge of the prevalence of chronic diseases during pregnancy is limited, but essential for a focused preventive effort regarding optimal disease control during...... pregnancy. We aimed to analyze the prevalence of chronic diseases during pregnancy. MATERIAL AND METHODS: This register-based cohort study included all women giving birth in Denmark between 1989 and 2013 based on data from Danish health registers. Maternal chronic diseases included 23 disease categories...... of both physical and mental health conditions recorded within a period of 10 years before childbirth. RESULTS: We included 1 362 200 childbirths during the study period. The overall prevalence of maternal chronic disease increased from 3.71% in 1989 to 15.76% in 2013. The most frequently registered...

  2. Prevalence of chronic kidney disease after preeclampsia.

    Science.gov (United States)

    Lopes van Balen, Veronica Agatha; Spaan, Julia Jeltje; Cornelis, Tom; Spaanderman, Marc Erich August

    2017-06-01

    Preeclampsia (PE), an endothelial disease that affects kidney function during pregnancy, is correlated to an increased future risk of cardiovascular and chronic kidney disease. The Kidney Disease Improving Global Outcomes (KDIGO) 2012 guideline emphasizes the combined role of glomerular filtration rate (GFR) and albuminuria in determining the frequency of monitoring of kidney function. In this study we evaluated the prevalence of CKD in women with a history of PE. We investigated how many seemingly healthy women required monitoring of kidney function according to the KDIGO guideline. We included 775 primiparous women with a history of PE. They were at least 4 months postpartum, and had no pre-existing hypertension, diabetes or kidney disease. We estimated GFR by the CKD-Epidemiology equation and urinary albumin loss by albumin creatinine ratio in a 24-h urine collection. Most women, 669 (86.3 %), had a normal GFR and absent albuminuria. Based on the KDIGO guideline, 13.7 % would require at least yearly monitoring of kidney function. Only 1.4 % were classified to be at high risk for kidney function deterioration. Monitoring of kidney function seems relevant for about one in seven women with a history of PE, mainly due to albuminuria. Albuminuria should be evaluated postpartum to identify those women that need further monitoring of kidney function.

  3. Prevalence of chronic diseases in adolescents with intellectual disability

    NARCIS (Netherlands)

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

    2010-01-01

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

  4. Prevalence of Chronic Kidney Disease in a Nigerian Family Practice ...

    African Journals Online (AJOL)

    Background: Chronic kidney disease (CKD) is a global public health problem, with a greater burden and prohibitive cost of care particularly in developing countries. This study determined the prevalence of chronic kidney disease and identified its associated risk factors in patients attending the Family Practice Clinic, Wesley ...

  5. Prevalence of chronic diseases in private healthcare sector of South ...

    African Journals Online (AJOL)

    Prevalence of chronic diseases in private healthcare sector of South Africa: A threat to public health. Lourens Johannes Rothmann, Martha Susanna Lubbe, Jan Hendrik Philippus Serfontein, Jan Jakobus Gerber, Madeeha Malik ...

  6. Prevalence and correlates of chronic kidney disease among civil ...

    African Journals Online (AJOL)

    2014-01-31

    Jan 31, 2014 ... Introduction: Chronic kidney disease (CKD) has become a public health problem with rising incidence and prevalence ... Conclusion: The prevalence of CKD among Nigerian civil servants was fairly high and was associated with advancing ... including Nigeria, hypertension (HTN) and diabetes mellitus.

  7. Estimating multimorbidity prevalence with the Canadian Chronic Disease Surveillance System

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    Allison Feely

    2017-07-01

    Full Text Available Introduction: The Public Health Agency of Canada’s Canadian Chronic Disease Surveillance System (CCDSS uses a validated, standardized methodology to estimate prevalence of individual chronic diseases, such as diabetes. Expansion of the CCDSS for surveillance of multimorbidity, the co-occurrence of two or more chronic diseases, could better inform health promotion and disease prevention. The objective of this study was to assess the feasibility of using the CCDSS to estimate multimorbidity prevalence. Methods: We used administrative health data from seven provinces and three territories and five validated chronic conditions (i.e. cardiovascular disease, respiratory disease, mental illness, hypertension and diabetes to estimate multimorbidity prevalence. We produced age-standardized (using Canada’s 1991 population and age-specific estimates for two multimorbidity definitions: (1 two or more conditions, and (2 three or more conditions from the five validated conditions, by sex, fiscal year and geography. Results: Among Canadians aged 40 years and over in the fiscal year 2011/12, the prevalence of two or more and three or more chronic conditions was 26.5% and 10.2%, respectively, which is comparable to other estimates based on administrative health data. The increase in multimorbidity prevalence with increasing age was similar across provinces. The difference in prevalence for males and females varied by province and territory. We observed substantial variation in estimates over time. Results were consistent for the two definitions of multimorbidity. Conclusion: The CCDSS methodology can produce comparative estimates of multimorbidity prevalence across provinces and territories, but there are challenges in using it to estimate temporal trends. Further expansion of the CCDSS in the number and breadth of validated case definitions will improve the accuracy of multimorbidity surveillance for the Canadian population.

  8. Prevalence of chronic diseases at the onset of inflammatory arthritis.

    NARCIS (Netherlands)

    Ursum, J.; Korevaar, J.C.; Twisk, J.W.R.; Peters, M.J.L.; Schellevis, F.G.; Nurmohamed, M.T.; Nielen, M.M.J.

    2012-01-01

    Background: To explore the prevalence of chronic diseases at the onset of inflammatory arthritis (IA) in the general practice and compare this to a group of control patients without IA. Methods: In this nested-case-control study, data were used from the Netherlands Information Network of eneral

  9. Prevalence of Chronic Diseases in the Elderly in Ilam

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    Hadi Peiman

    2012-01-01

    Full Text Available Objectives: Extra weight and obesity are the most important preventable risk factors for cardiovascular disease (CVD, especially in the elderly. The present study aimed to investigate the prevalence and associated factors of obesity and hypertension (HTN as well as cardiovascular diseases and diabetes mellitus (MD amongst the elderly population in Ilam. Methods & Materials: Using cluster sampling, a random sample of 121 elderly people (62.4% male with a mean age of 70.4±11.0 years were recruited through a cross-sectional study in the city of Ilam. The height, weight and blood pressure of all samples were measured by an experienced nurse. Results: Mean BMI was 25.3±4.2 Kg/m2. More than half the women (56.1% and 46.2% of men were affected by either extra weight or obesity. The prevalence of medically-diagnosed CVD, hypertension and diabetes mellitus were 53%, 36.8% and 17.4%, respectively. There was no significant relationship between obesity and extra weight and CVD, HTN and DM. Conclusion: The prevalence of chronic diseases in the studied elderly is associated with aging, literacy and too much time watching TV. In the present study, the prevalence of obesity and being overweight was similar to that of other studies done nationally, but the cardiovascular diseases and hypertension prevalence was higher. In order to decrease the prevalence of chronic diseases in the elderly population, screening and health education programs are suggested.

  10. Prevalence of chronic kidney disease in adults with metabolic syndrome

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    P C Emem-Chioma

    2011-01-01

    Full Text Available The burden of chronic kidney disease (CKD and other non- communicable diseases continues to rise globally, and recent studies suggest that metabolic syndrome (MS may add to this burden by contributing to the development of CKD. Given that reports on the prevalence of CKD in patients with MS in this environment are scanty, this study was undertaken with the sole aim of determining the prevalence of CKD in subjects with MS as defined by the International Diabetes Federation (IDF and the National Cholesterol Education Project Adult Treatment Panel III (NCEP ATP III. A total of 240 consenting adults (18-70 years attending the general out- patient clinic of the General Hospital Okrika for various ailments were studied. Subjects were screened for MS as per the above- mentioned criteria. Estimated GFR (eGFR was determined with Modification of Diet for Renal Disease (MDRD formula and CKD was defined as eGFR less than 60 mL/min/1.73 m2 . Data was analyzed using SPSS version 12.0 and Epi info version 4.06d; P 0.05. CKD was more common in subjects with MS compared with those without, although the difference was not statistically significant. The prevalence of CKD in subjects with MS in our study population did not differ significantly when the different MS definitions were employed.

  11. Prevalence of chronic kidney disease in Peruvian primary care setting.

    Science.gov (United States)

    Herrera-Añazco, Percy; Taype-Rondan, Alvaro; Lazo-Porras, María; Alberto Quintanilla, E; Ortiz-Soriano, Victor Manuel; Hernandez, Adrian V

    2017-07-19

    Chronic Kidney Disease (CKD) is a worldwide public health problem. There are few studies in Latin America, especially in primary care settings. Our objective was to determine the prevalence, stages, and associated factors of CKD in primary care setting. We did a retrospective secondary analysis of a database from the Diabetes and Hypertension Primary Care Center of the Peruvian Social Security System (EsSalud) in Lima, Peru. We defined CKD as the presence of eGFR 30 mg/day in 24 h, according to Kidney Disease: Improving Global Outcomes (KDIGO). Factors associated with CKD were evaluated with Poisson Regression models; these factors included age, gender, type 2 diabetes mellitus (DM2), hypertension (HTN), body mass index (BMI), and uric acid. Associations were described as crude and adjusted prevalence ratios (PR) and their 95% confidence intervals (95% CI). We evaluated 1211 patients (women [59%], mean age 65.8 years [SD: 12.7]). Prevalence of CKD was 18%. Using the estimated glomerular filtration rate (eGFR), the prevalence was 9.3% (95% CI 5.3 - 13.3) in patients without HTN or DM2; 20.2% (95% CI 17.6 - 22.8) in patients with HTN, and 23.9% (95% CI 19.4 - 28.4) in patients with DM2. The most common stages were 1 and 2 with 41.5% and 48%, respectively. Factors associated with CKD in the adjusted analysis were: age in years (PR = 1.03, 95% CI 1.01 - 1.04), DM2 (PR = 3.37, 95% CI 1.09 - 10.39), HTN plus DM2 (PR = 3.90, 95% CI 1.54 - 9.88), and uric acid from 5 to DM2, older age and hyperuricemia have higher prevalence of CKD.

  12. Prevalence of chronic obstructive pulmonary disease in asymptomatic smokers.

    Science.gov (United States)

    Sansores, Raúl H; Velázquez-Uncal, Mónica; Pérez-Bautista, Oliver; Villalba-Caloca, Jaime; Falfán-Valencia, Ramcés; Ramírez-Venegas, Alejandra

    2015-01-01

    Physicians do not routinely recommend smokers to undergo spirometry unless they are symptomatic. To test the hypothesis that there are a significant number of asymptomatic smokers with chronic obstructive pulmonary disease (COPD), we estimated the prevalence of COPD in a group of asymptomatic smokers. Two thousand nine hundred and sixty-one smokers with a cumulative consumption history of at least 10 pack-years, either smokers with symptoms or smokers without symptoms (WOS) were invited to perform a spirometry and complete a symptom questionnaire. Six hundred and thirty-seven (21.5%) smokers had no symptoms, whereas 2,324 (78.5%) had at least one symptom. The prevalence of COPD in subjects WOS was 1.5% when considering the whole group of smokers (45/2,961) and 7% when considering only the group WOS (45/637). From 329 smokers with COPD, 13.7% were WOS. Subjects WOS were younger, had better lung function and lower cumulative consumption of cigarettes, estimated as both cigarettes per day and pack-years. According to severity of airflow limitation, 69% vs 87% of subjects were classified as Global Initiative for Chronic Obstructive Lung Disease stages I-II in the WOS and smokers with symptoms groups, respectively (Psmokers. Prevalence of COPD in asymptomatic smokers is 1.5%. This number of asymptomatic smokers may be excluded from the benefit of an "early" intervention, not just pharmacological but also from smoking cessation counseling. The higher forced expiratory volume in 1 second may contribute to prevent early diagnosis.

  13. Prevalence of chronic obstructive pulmonary disease in the Canary Islands.

    Science.gov (United States)

    Cabrera López, Carlos; Juliá Serdá, Gabriel; Cabrera Lacalzada, Cristina; Martín Medina, Ana; Gullón Blanco, José Antonio; García Bello, Miguel Ángel; Cabrera Navarro, Pedro

    2014-07-01

    The prevalence of chronic obstructive pulmonary disease (COPD) varies significantly among the different geographical areas reported. In Spain, two epidemiological studies have shown a prevalence of 9-10% in the population aged over 40. However, neither of these studies included the Canary Islands, which are of interest due to their climatic conditions and high incidence of smoking. A random group of 1,353 subjects aged between 40 and 70years was selected from a sample population of 596,478 individuals. Participants completed a questionnaire and then performed spirometry with bronchodilator testing if obstruction was observed. COPD was diagnosed when the post-bronchodilator FEV1/FVC ratio was less than 0.70. The prevalence of COPD was 7.3% (95%CI: 5.5-9.5) and was higher in males than in females (8.7% vs. 6.3%, P=.134). The incidence of smoking was 29.4% (95%CI: 25.4-33.1) and was also higher in males than in females (35.1% vs 25.4%, P<.001). The prevalence of COPD stratified by severity of obstruction, according to the GOLD criteria, was 16% in groupi, 69.9% in groupii, 10.4% in groupiii and 3.3% in groupiv. 71.6% of the subjects were underdiagnosed and 63.5% undertreated. Despite having one of the highest rates of smoking in Spain, the prevalence of COPD in the Canary Islands is lower than in most of the Spanish regions studied. Copyright © 2013 SEPAR. Published by Elsevier Espana. All rights reserved.

  14. Prevalence of chronic obstructive pulmonary disease in asymptomatic smokers

    Directory of Open Access Journals (Sweden)

    Sansores RH

    2015-11-01

    Full Text Available Raúl H Sansores, Mónica Velázquez-Uncal, Oliver Pérez-Bautista, Jaime Villalba-Caloca, Ramcés Falfán-Valencia, Alejandra Ramírez-VenegasTobacco Smoking and COPD Research Department, National Institute of Respiratory Diseases, Ismael Cosio Villegas, Mexico City, MexicoBackground: Physicians do not routinely recommend smokers to undergo spirometry unless they are symptomatic.Objective: To test the hypothesis that there are a significant number of asymptomatic smokers with chronic obstructive pulmonary disease (COPD, we estimated the prevalence of COPD in a group of asymptomatic smokers.Methods: Two thousand nine hundred and sixty-one smokers with a cumulative consumption history of at least 10 pack-years, either smokers with symptoms or smokers without symptoms (WOS were invited to perform a spirometry and complete a symptom questionnaire.Results: Six hundred and thirty-seven (21.5% smokers had no symptoms, whereas 2,324 (78.5% had at least one symptom. The prevalence of COPD in subjects WOS was 1.5% when considering the whole group of smokers (45/2,961 and 7% when considering only the group WOS (45/637. From 329 smokers with COPD, 13.7% were WOS. Subjects WOS were younger, had better lung function and lower cumulative consumption of cigarettes, estimated as both cigarettes per day and pack-years. According to severity of airflow limitation, 69% vs 87% of subjects were classified as Global Initiative for Chronic Obstructive Lung Disease stages I–II in the WOS and smokers with symptoms groups, respectively (P<0.001. A multivariate analysis showed that forced expiratory volume in 1 second (mL was the only predictive factor for COPD in asymptomatic smokers.Conclusion: Prevalence of COPD in asymptomatic smokers is 1.5%. This number of asymptomatic smokers may be excluded from the benefit of an “early” intervention, not just pharmacological but also from smoking cessation counseling. The higher forced expiratory volume in 1 second may

  15. Prevalence of Diabetes Mellitus in Patients with Chronic Kidney Disease

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    Olivera Stojceva-Taneva

    2016-01-01

    CONCLUSION: Our study showed that chronic kidney disease is frequent in the Republic of Macedonia and is associated with older age and diabetes. Diabetes had a significantly stronger association with CKD at younger age.

  16. Prevalence and changes in chronic diseases among South Korean farmers: 1998 to 2005

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    Moon Eun

    2009-07-01

    Full Text Available Abstract Background Epidemiologic studies have suggested a unique pattern of disease among farmers in Western countries, but limited information is available about the magnitude of disease prevalence and their changes over time in Asian farmers. The aim of this study was to compare the prevalence and changes in chronic diseases among farmers with those of other occupational groups in South Korea. Methods Using data from three consecutive cross-sectional national surveys: the Korean National Health and Nutrition Examination Survey 1998 (n = 39,060, 2001 (n = 37,769, and 2005 (n = 34,145, we calculated age and gender-standardized prevalence of chronic diseases by the direct method and compared the prevalence changes from 1998 to 2005. Results Female farmers had significantly higher chronic disease prevalence than other occupational groups in all three surveys. Arthritis was the most prevalent chronic disease among farmers for both men and women. Compared with other populations, farmers demonstrated a higher prevalence of arthritis and intervertebral disc disorders. Farmers showed higher prevalence changes for intervertebral disc disorders than other occupational workers. Conclusion Our findings support that South Korean farmers have a distinct pattern of diseases prevalence from other populations. More detailed studies investigating the risk of musculoskeletal diseases and intensive intervention efforts to reduce the prevalence these diseases, particularly among female farmers, are required.

  17. Prevalence estimates of chronic kidney disease in Canada: results of a nationally representative survey

    Science.gov (United States)

    Arora, Paul; Vasa, Priya; Brenner, Darren; Iglar, Karl; McFarlane, Phil; Morrison, Howard; Badawi, Alaa

    2013-01-01

    Background: Chronic kidney disease is an important risk factor for death and cardiovascular-related morbidity, but estimates to date of its prevalence in Canada have generally been extrapolated from the prevalence of end-stage renal disease. We used direct measures of kidney function collected from a nationally representative survey population to estimate the prevalence of chronic kidney disease among Canadian adults. Methods: We examined data for 3689 adult participants of cycle 1 of the Canadian Health Measures Survey (2007–2009) for the presence of chronic kidney disease. We also calculated the age-standardized prevalence of cardiovascular risk factors by chronic kidney disease group. We cross-tabulated the estimated glomerular filtration rate (eGFR) with albuminuria status. Results: The prevalence of chronic kidney disease during the period 2007–2009 was 12.5%, representing about 3 million Canadian adults. The estimated prevalence of stage 3–5 disease was 3.1% (0.73 million adults) and albuminuria 10.3% (2.4 million adults). The prevalence of diabetes, hypertension and hypertriglyceridemia were all significantly higher among adults with chronic kidney disease than among those without it. The prevalence of albuminuria was high, even among those whose eGFR was 90 mL/min per 1.73 m2 or greater (10.1%) and those without diabetes or hypertension (9.3%). Awareness of kidney dysfunction among adults with stage 3–5 chronic kidney disease was low (12.0%). Interpretation: The prevalence of kidney dysfunction was substantial in the survey population, including individuals without hypertension or diabetes, conditions most likely to prompt screening for kidney dysfunction. These findings highlight the potential for missed opportunities for early intervention and secondary prevention of chronic kidney disease. PMID:23649413

  18. Prevalence of chronic diseases in private healthcare sector of South ...

    African Journals Online (AJOL)

    Diabetes insipudus. Parkinson's disease. Diabetes mellitus type I. Rheumatoid arthritis. Diabetes mellitus type II. Schizophrenia. Systemic lupus erythematosus Ulcerative colitis. Analyses were performed on patient level. The prevalence of each condition was calculated by dividing the number of patients with the condition.

  19. Prevalence of chronic diseases at the onset of inflammatory arthritis: a population-based study.

    NARCIS (Netherlands)

    Ursum, J.; Korevaar, J.C.; Twisk, J.W.R.; Peters, M.J.L.; Schellevis, F.G.; Nurmohamed, M.T.; Nielen, M.M.J.

    2013-01-01

    Objective. Little is known about the presence of chronic morbidity in inflammatory arthritis (IA) patients at disease onset. Previous studies have been mainly performed in established IA patients or they focus on isolated co-morbid diseases. Our aim was to determine the prevalence of chronic

  20. Prevalence, predictors, and survival in pulmonary hypertension related to end-stage chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Andersen, Kasper Hasseriis; Iversen, Martin; Kjaergaard, Jesper

    2012-01-01

    The prevalence, prognostic importance, and factors that predict the presence and degree of pulmonary hypertension (PH) diagnosed with right heart catheterization (RHC) in patients with end-stage chronic obstructive pulmonary disease (COPD) remain unclear....

  1. Determinants and prevalence of depression in patients with chronic renal disease, and their caregivers

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    Hawamdeh S

    2017-07-01

    Full Text Available Sana Hawamdeh, Aljawharah Mohammed Almari, Asrar Salem Almutairi, Wireen Leila T Dator College of Nursing, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia Introduction: This study explored the prevalence of depression among the patients with chronic kidney disease and their caregivers and its association to their demographic profile.Methods: A descriptive, correlational, cross-sectional study that used the Hamilton rating scale tool to assess the prevalence of depression among 226 patients undergoing hemodialysis and 105 of their caregivers in a hospital in Saudi Arabia.Results: Patients with chronic renal disease and their caregivers experience depression at varying levels. Depression was positively associated with the socioeconomic and marital status of the patients. Socioeconomic status of the caregivers was seen to be associated with their depression.Conclusion: Depression is highly prevalent among patients with chronic renal disease and their caregivers. Keywords: caregivers, chronic renal disease, depression

  2. The Prevalence of Fabry Disease in Patients with Chronic Kidney Disease in Turkey: The TURKFAB Study.

    Science.gov (United States)

    Turkmen, Kultigin; Guclu, Aydın; Sahin, Garip; Kocyigit, Ismail; Demirtas, Levent; Erdur, Fatih Mehmet; Sengül, Erkan; Ozkan, Oktay; Emre, Habib; Turgut, Faruk; Unal, Hilmi; Karaman, Murat; Acıkel, Cengiz; Esen, Hasan; Balli, Ebru; Bıtırgen, Gulfidan; Tonbul, Halil Zeki; Yılmaz, Mahmut Ilker; Ortiz, Alberto

    2016-01-01

    Fabry disease is a treatable cause of chronic kidney disease (CKD) characterized by a genetic deficiency of α-galactosidase A. European Renal Best Practice (ERBP) recommends screening for Fabry disease in CKD patients. However, this is based on expert opinion and there are no reports of the prevalence of Fabry disease in stage 1-5 CKD. Hence, we investigated the prevalence of Fabry disease in CKD patients not receiving renal replacement therapy. This prospective study assessed α-galactosidase activity in dried blood spots in 313 stage 1-5 CKD patients, 167 males, between ages of 18-70 years whose etiology of CKD was unknown and were not receiving renal replacement therapy. The diagnosis was confirmed by GLA gene mutation analysis. Three (all males) of 313 CKD patients (0.95%) were diagnosed of Fabry disease, for a prevalence in males of 1.80%. Family screening identified 8 aditional Fabry patients with CKD. Of a total of 11 Fabry patients, 7 were male and started enzyme replacement therapy and 4 were female. The most frequent manifestations in male patients were fatigue (100%), tinnitus, vertigo, acroparesthesia, hypohidrosis, cornea verticillata and angiokeratoma (all 85%), heat intolerance (71%), and abdominal pain (57%). The most frequent manifestations in female patients were fatigue and cornea verticillata (50%), and tinnitus, vertigo and angiokeratoma (25%). Three patients had severe episodic abdominal pain attacks and proteinuria, and were misdiagnosed as familial Mediterranean fever. The prevalence of Fabry disease in selected CKD patients is in the range found among renal replacement therapy patients, but the disease is diagnosed at an earlier, treatable stage. These data support the ERBP recommendation to screen for Fabry disease in patients with CKD of unknown origin. © 2016 The Author(s) Published by S. Karger AG, Basel.

  3. Increased prevalence of coronary artery disease risk markers in patients with chronic hepatitis C

    DEFF Research Database (Denmark)

    Roed, Torsten; Kristoffersen, Ulrik Sloth; Knudsen, Andreas

    2014-01-01

    OBJECTIVE: Chronic hepatitis C is a global health problem and has been associated with coronary artery disease. Our aim was to examine the prevalence of coronary artery disease risk markers including endothelial biomarkers in patients with chronic hepatitis C and matched comparisons without...... manifest cardiovascular disease or diabetes in a cross-sectional design. METHODS: Sixty patients with chronic hepatitis C (mean age 51 years) were recruited from the Department of Infectious Diseases at Copenhagen University Hospital, and compared with 60 age-matched non-hepatitis C virus......-infected individuals from a general population survey. We examined traditional coronary artery disease risk factors, metabolic syndrome, carotid intima media thickness, and a range of endothelial biomarkers. RESULTS: Patients with chronic hepatitis C had more hypertension (40% versus 25%, prevalence ratio [PR] 1.6; 95...

  4. Prevalence of chronic kidney disease among patients undergoing transradial percutaneous coronary interventions.

    Science.gov (United States)

    Hossain, Mohammad A; Quinlan, Amy; Heck-Kanellidis, Jennifer; Calderon, Dawn; Patel, Tejas; Gandhi, Bhavika; Patel, Shrinil; Hetavi, Mahida; Costanzo, Eric J; Cosentino, James; Patel, Chirag; Dewan, Asa; Kuo, Yen-Hong; Salman, Loay; Vachharajani, Tushar J

    2018-03-01

    While transradial approach to conduct percutaneous coronary interventions offers multiple advantages, the procedure can cause radial artery damage and occlusion. Because radial artery is the preferred site for the creation of an arteriovenous fistula to provide dialysis, patients with chronic kidney disease are particularly dependent on radial artery for their long-term survival. In this retrospective study, we investigated the prevalence of chronic kidney disease in patients undergoing coronary interventions via radial artery. Stage of chronic kidney disease was based on estimated glomerular filtration rate and National Kidney Foundation - Kidney Disease Outcomes Quality Initiative guidelines. A total of 497 patients undergoing transradial percutaneous coronary interventions were included. Over 70.4% (350/497) of the patients had chronic kidney disease. Stage II chronic kidney disease was observed in 243 (69%) patients (estimated glomerular filtration rate = 76.0 ± 8.4 mL/min). Stage III was observed in 93 (27%) patients (estimated glomerular filtration rate = 49 ± 7.5 mL/min). Stage IV chronic kidney disease was observed in 5 (1%) patients (estimated glomerular filtration rate = 25.6 ± 4.3 mL/min) and Stage V chronic kidney disease was observed in 9 (3%) patients (estimated glomerular filtration rate = 9.3 ± 3.5 mL/min). Overall, 107 of 350 patients (30%) had advanced chronic kidney disease, that is, stage III-V chronic kidney disease. Importantly, 14 of the 107 (13%) patients had either stage IV or V chronic kidney disease. This study finds that nearly one-third of the patients undergoing transradial percutaneous coronary interventions have advanced chronic kidney disease. Because many of these patients may require dialysis, the use of radial artery to conduct percutaneous coronary interventions must be carefully considered in chronic kidney disease population.

  5. Deer density and disease prevalence influence transmission of Chronic Wasting Disease in White-tailed Deer

    Science.gov (United States)

    Samuel, Michael D.; Richards, Bryan J.; Storm, Daniel J.; Rolley, Robert E.; Shelton, Paul; Nicholas S. Keuler,; Timothy R. Van Deelen,

    2013-01-01

    Host-parasite dynamics and strategies for managing infectious diseases of wildlife depend on the functional relationship between disease transmission rates and host density. However, the disease transmission function is rarely known for free-living wildlife, leading to uncertainty regarding the impacts of diseases on host populations and effective control actions. We evaluated the influence of deer density, landscape features, and soil clay content on transmission of chronic wasting disease (CWD) in young (density-dependent, and intermediate transmission models predicted CWD incidence rates in harvested yearling deer. An intermediate transmission model, incorporating both disease prevalence and density of infected deer, performed better than simple density- and frequency-dependent models. Our results indicate a combination of social structure, non-linear relationships between infectious contact and deer density, and distribution of disease among groups are important factors driving CWD infection in young deer. The landscape covariates % deciduous forest cover and forest edge density also were positively associated with infection rates, but soil clay content had no measurable influences on CWD transmission. Lack of strong density-dependent transmission rates indicates that controlling CWD by reducing deer density will be difficult. The consequences of non-linear disease transmission and aggregation of disease on cervid populations deserves further consideration.

  6. Chronic obstructive pulmonary disease prevalence in Lisbon, Portugal: The burden of obstructive lung disease study

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    C. Bárbara

    2013-05-01

    Full Text Available Background: There is a great heterogeneity in the prevalence of Chronic Obstructive Pulmonary Disease (COPD across the world. The Burden of Obstructive Lung Disease (BOLD initiative was started to measure the prevalence of COPD in a standardized way. We aimed to estimate the prevalence of COPD in Portuguese adults aged 40 years or older of a target population of 2,700,000 in the Lisbon region, in accordance with BOLD protocol. Methods: A stratified, multi-stage random sampling procedure was used which included 12 districts. The survey included a questionnaire with information on risk factors for COPD and reported respiratory disease and a post-bronchodilator spirometry performed at survey centres. Results: For the 710 participants with questionnaires and acceptable spirometry, the overall weighted prevalence of GOLD stage I+ COPD was 14.2% (95% C.I. 11.1, 18.1, and stage II+ was 7.3% (95% C.I. 4.7, 11.3. Unweighted prevalence was 20.2% (95% C.I.17.4, 23.3 for stage I+ and 9.5% (95% C.I. 7.6, 11.9 for stage II+. Prevalence of COPD in GOLD stage II+ increased with age and was higher in men. The prevalence of GOLD stage I+ COPD was 9.2% (95% C.I. 5.9, 14.0 in never smokers versus 27.4% (95% C.I. 18.5, 38.5 in those who had smoked ≥20 pack-years. The agreement between previous doctor diagnosis and spirometric diagnosis was low, with 86.8% of underdiagnosed individuals. Conclusions: The 14.2% of COPD estimated prevalence indicates that COPD is a common disease in the Lisbon region. In addition, a large proportion of underdiagnosed disease was detected. The high prevalence of COPD with a high level of underdiagnosis, points to the need of raising awareness of COPD among health professionals, and requires more use of spirometry in the primary care setting. Resumo: Introdução: A prevalência da doença pulmonar obstrutiva crónica (DPOC apresenta valores muito heterogéneos em todo o mundo. A iniciativa Burden of Obstructive Lung

  7. The Prevalence of Chronic Kidney Disease in Apparently Healthy ...

    African Journals Online (AJOL)

    estimates have been reported in Asia,[2] Australia,[3] and across Europe.[4-6] It is more difficult to get accurate estimates in the developing countries like Nigeria, due to lack of national registries of CKD and limited surveys. However, the risk factors for CKD are known to be just as prevalent in many developing countries as ...

  8. Prevalence rates of chronic diseases: the Netherlands and the United Kingdom compared.

    NARCIS (Netherlands)

    Schellevis, F.G.; Fleming, D.M.; Linden, M.W. van der; Westert, G.P.

    2004-01-01

    Background: Information about the European population’s health origins from different sources. For some chronic diseases general practice is the most useful source for prevalence data. On the European level comparability of data from general practice is complicated by differences in the position of

  9. Action plan for determining and monitoring the prevalence of chronic kidney disease

    NARCIS (Netherlands)

    Coresh, Josef; Hu, Jiun-Ruey; Bello, Aminu K.; Feldman, Harold I.; Fogo, Agnes B.; Ganji, Mohammad Reza; Harris, David C.; Levey, Andrew S.; Okpechi, Ikechi G.; Stengel, Benedicte; Thomas, Bernadette; Wiecek, Andrzej; Gansevoort, Ron T.

    2017-01-01

    Chronic kidney disease (CKD) continues to remain high globally, up to 13.4% by one estimate. Although the number, geographic distribution, size, and quality of the studies examining CKD prevalence and incidence have increased over the past decade, the global capacity for CKD surveillance is still

  10. The Prevalence of Chronic Kidney Disease and Associated Factors ...

    African Journals Online (AJOL)

    2016-06-27

    Jun 27, 2016 ... programs in high-risk populations (hypertensives, diabetes, and HIV) which aims to identify patients at early stages of CKD, and ... (HTN) and diabetes to be the two major causes of kidney disease worldwide.[7,9] Older age followed by HTN were ... AIDS and tuberculosis.[12] There has been no study done.

  11. Prevalence and characteristics of chronic kidney disease among Danish adults with cystic fibrosis

    DEFF Research Database (Denmark)

    Berg, Kristina H; Ryom, Lene; Faurholt-Jepsen, Daniel

    2018-01-01

    BACKGROUND: With improved prognosis of CF, comorbidities including chronic kidney disease (CKD) are becoming increasingly important. Identification of those at highest CKD risk is hence a priority. METHODS: In this cross-sectional study, adults with CF attending the Copenhagen CF Centre...... median duration of chronic pulmonary infection (28.3 (20.0-35.8) vs. 20.0 (9.9-34.7) years; p=0.008) and with longer intravenous aminoglycosides use (606 (IQR, 455-917) vs. 273 (IQR, 91-826) days, p=0.005). CONCLUSIONS: The CKD prevalence is high and related to age, diabetes, chronic infection...

  12. [Prevalence of celiac disease in children with chronic diarrhea in China].

    Science.gov (United States)

    Wang, Xin-qiong; Liu, Wei; Xu, Jun-jie; Mei, Hong; Peng, Han-ming; Gao, Yuan; Yuan, Lan; Xu, Chun-di

    2010-04-01

    To investigate the prevalence of celiac disease in children with chronic diarrhea in China. Inpatients of the pediatric hospitals in Shanghai, Jinan, Wuhan and Chengdu who were diagnosed as chronic diarrhea were recruited from Jan. 2005 to Dec. 2008. Their clinical history, physical examination and laboratory data were collected. The SPSS version 11.5 statistical package for Microsoft Windows was used for statistical analysis. Data of 199 patients and finally enrolled 118 hospitalized chronic diarrhea inpatients during the observation period were collected and 14 (12%) of the chronic diarrhea patients were suspected as having celiac disease and in one the diagnosis of celiac disease was confirmed. Gluten-free diet (GFD) treatment was effective. M/F: 12/2, the age ranged from 6 months to 12 years; 43% (6/14) had malnutrition, 29% (4/14) had anemia, villous atrophy was found in 4 patients by endoscopy. Duodenal biopsies revealed stage I in 1, stage II in 2, stage IIIa in 7, stage IIIb in 3 and stage IIIc in 1 patient according to the modified Marsh classification. This study was the first time to report the research of celiac disease in children with chronic diarrhea in China. The percentage of suspicious celiac disease patients was 12% (14/118) in children and one was confirmed. CD exists in China. Chinese pediatricians should pay attention to the disease.

  13. Prevalence and Outcomes of Left-Sided Valvular Heart Disease Associated With Chronic Kidney Disease.

    Science.gov (United States)

    Samad, Zainab; Sivak, Joseph A; Phelan, Matthew; Schulte, Phillip J; Patel, Uptal; Velazquez, Eric J

    2017-10-11

    Chronic kidney disease (CKD) is an adverse prognostic marker for valve intervention patients; however, the prevalence and related outcomes of valvular heart disease in CKD patients is unknown. Included patients underwent echocardiography (1999-2013), had serum creatinine values within 6 months before index echocardiogram, and had no history of valve surgery. CKD was defined as diagnosis based on the International Classification of Diseases, Ninth Revision or an estimated glomerular filtration rate <60 mL/min per 1.73 m 2 . Qualitative assessment determined left heart stenotic and regurgitant valve lesions. Cox models assessed CKD and aortic stenosis (AS) interaction for subsequent mortality; analyses were repeated for mitral regurgitation (MR). Among 78 059 patients, 23 727 (30%) had CKD; of these, 1326 were on hemodialysis. CKD patients were older; female; had a higher prevalence of hypertension, hyperlipidemia, diabetes, history of coronary artery bypass grafting/percutaneous coronary intervention, atrial fibrillation, and heart failure ≥mild AS; and ≥mild MR (all P <0.001). Five-year survival estimates of mild, moderate, and severe AS for CKD patients were 40%, 34%, and 42%, respectively, and 69%, 54%, and 67% for non-CKD patients. Five-year survival estimates of mild, moderate, and severe MR for CKD patients were 51%, 38%, and 37%, respectively, and 75%, 66%, and 65% for non-CKD patients. Significant interaction occurred among CKD, AS/MR severity, and mortality in adjusted analyses; the CKD hazard ratio increased from 1.8 (non-AS patients) to 2.0 (severe AS) and from 1.7 (non-MR patients) to 2.6 (severe MR). Prevalence of at least mild AS and MR is substantially higher and is associated with significantly lower survival among patients with versus without CKD. There is significant interaction among CKD, AS/MR severity, and mortality, with increasingly worse outcomes for CKD patients with increasing AS/MR severity. © 2017 The Authors. Published on

  14. Prevalence and patterns of chronic disease multimorbidity and associated determinants in Canada

    Directory of Open Access Journals (Sweden)

    K. C. Roberts

    2015-08-01

    Full Text Available Introduction: Multimorbidity is increasingly recognized as a key issue in the prevention and management of chronic diseases. We examined the prevalence and correlates of chronic disease multimorbidity in the general adult Canadian population in relation to age and other key determinants. Methods: We extracted data from the Canadian Community Health Survey 2011/12 on 105 416 Canadians adults. We analysed the data according to the number of multimorbidities (defined as 2+ or 3+ diseases from a list of 9 and examined the determinants of multimorbidity using regression analyses. Results: Our findings show that 12.9% of Canadians report 2+ chronic diseases and 3.9% report 3+ chronic diseases. Those reporting 3 or more chronic diseases were more likely to be female, older, living in the lowest income quintile and to have not completed high school. In the overall population, social deprivation is associated with a 3.7 odds of multimorbidity, but when examined across age groups, the odds of multimorbidity were notably higher in middle age, 7.5 for those aged 35 to 49 years and 5.4 for those aged 50 to 64 years. Discussion: As the proportion of Canadians living with multiple chronic diseases increases, we need to assess chronic disease from a holistic perspective that captures multimorbidity and upstream factors, to facilitate broader and more context-appropriate associations with healthy living, quality of life, health care costs and mortality. Special consideration should be given to the role that social deprivation plays in the development of multimorbidity. Canadians living in the lowest socioeconomic group are not only more likely to develop multimorbidity, but the onset of multimorbidity is also likely to be significantly earlier.

  15. Prevalence of Chronic Obstructive Pulmonary Disease in Kocaeli: An Industrialised City in Turkey

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    Zeliha Arslan

    2013-12-01

    Full Text Available Background: Chronic obstructive pulmonary disease (COPD is an important cause of mortality worldwide. Aims: The aim of this study was to establish the prevalence of chronic obstructive pulmonary disease (COPD in residents who were ≥40 years old and living in a heavily industrialised city of Turkey, Kocaeli, using the Burden of Obstructive Lung Disease Initiative questionnaire. Study Design: Cross-sectional study. Methods: 1035 residents ≥40 years old and living in Kocaeli were surveyed. Spirometry and the basic BOLD questionnaire was performed. Results: 946 subjects entered into the analysis. The prevalence of stage I or higher COPD was 13.3% (8.7% for women and 16.5% for men, the prevalence of COPD at GOLD stage II or higher was 7.1% (4.1% for women and 9.2% for men. We also noted a high prevalence of COPD in never-smokers. Conclusion: Besides cigarette smoking, occupational exposure to fumes, chemicals and dusts might have also contributed to the high prevalence of COPD noted in residents who were ≥40 years old and living in Kocaeli, Turkey.

  16. Prevalence of HBV and/or HDV markers using RIA in patients with chronic liver disease

    International Nuclear Information System (INIS)

    Marcus, S.; Almoslih, M.; Altawil, N.G.; Kassir, Z.A.

    1995-01-01

    Sixty six with different chronic liver disease (CLD) were studied for the prevalence of HBV and/or HDV markers using radioimmunoassay. The total prevalence of HBV markers (i.e. when any of the markers is present) for chronic active hepatitis (CAH), post viral cirrhosis, chronic persistent hepatitis (CPH), cryptogenic cirrhosis, primary biliary cirrhosis (PBC), alcoholic cirrhosis, hepatocellular carcinoma (HCCA) and methyldopa induced chronic hepatitis were 6/13 (46.2%), 6/6 (100%), 7/9 (77.8%), 0/10, 0/2, 10/15 (66.7%), 7/10 (70%) and 0/1 respectively; whereas the total prevalence of anti-delta antibody was 0/13, 1/6 (16.7%), 3/9 (33.3%), 0/10 0/2, 0/15, 2/10 (20%) and 0/1 respectively, while the prevalence of anti-delta antibody for the control group was 4/102 (3.9%). Various patients with CLD, though they showed various viral markers yet they showed different pattern groups. 3 tabs

  17. Chronic obstructive pulmonary disease in patients with lung cancer: prevalence, impact and management challenges

    OpenAIRE

    Spyratos, Dionisios; Papadaki, Eleni; Lampaki, Sofia; Kontakiotis, Theodoros

    2017-01-01

    Dionisios Spyratos, Eleni Papadaki, Sofia Lampaki, Theodoros Kontakiotis Pulmonary Department, Lung Cancer Oncology Unit, Aristotle University of Thessaloniki, G. Papanicolaou Hospital, Thessaloniki, Greece Abstract: Chronic obstructive pulmonary disease (COPD) and lung cancer share a common etiological factor (cigarette smoking) and usually coexist in everyday clinical practice. The prevalence of COPD among newly diagnosed patients with lung cancer sometimes exceed...

  18. Activities of Daily Living and Prevalence of Chronic diseases Among Elderly People in Yazd

    Directory of Open Access Journals (Sweden)

    2014-09-01

    Results: The mean grade scores of ADL and IADL were 36.03±5.99 and 24.25±8.22diseases (r=-0.332, p=0.001. The most prevalent diseases of the participants were arthralgia (74/8%, osteoporosis (53/8%, hypertension (49/4%, sleep problems (39/2% and cardiovascular diseases (38/5% respectively. Conclusions: A significant proportion of the elderly in our population were relatively dependent in terms of their activities of daily living.Bathing in this context is one of the most important dependencies. In addition, high prevalence of chronic diseases was arthritis and osteoporosis among others. They needed to be taken care of more andit seems that theeducationalinterventionprograms forthe elderlyand their families seems to be veryuseful.

  19. Prevalence, awareness, and treatment of anemia in Chinese patients with nondialysis chronic kidney disease

    Science.gov (United States)

    Li, Ya; Shi, Hao; Wang, Wei-Ming; Peng, Ai; Jiang, Geng-Ru; Zhang, Jin-Yuan; Ni, Zhao-Hui; He, Li-Qun; Niu, Jian-Ying; Wang, Nian-Song; Mei, Chang-Lin; Xu, Xu-Dong; Guo, Zhi-Yong; Yuan, Wei-Jie; Yan, Hai-Dong; Deng, Yue-Yi; Yu, Chen; Cen, Jun; Zhang, Yun; Chen, Nan

    2016-01-01

    Abstract This was the first multicenter, cross-sectional survey to assess the prevalence of anemia, patient awareness, and treatment status in China. Data of patients with chronic kidney disease (CKD; age, 18–75 years; both out- and inpatients) from 25 hospitals in Shanghai, seeking medical treatment at the nephrology department, were collected between July 1, 2012 and August 31, 2012. The prevalence, awareness, and treatment of anemia in patients with nondialysis CKD (ND-CKD) were assessed. Anemia was defined as serum hemoglobin (Hb) levels ≤12 g/dL in women and ≤13 g/dL in men. A total of 2420 patients with ND-CKD were included. Anemia was established in 1246 (51.5%) patients: 639 (51.3%) men and 607 (48.7%) women. The prevalence of anemia increased with advancing CKD stage (χ2trend = 675.14, P Anemia was more prevalent in patients with diabetic nephropathy (68.0%) than in patients with hypertensive renal damage (56.6%) or chronic glomerulonephritis (46.1%, both P anemia patients, only 7.5% received more effective and recommended intravenous supplementation. Anemia is highly prevalent in patients with ND-CKD in China, with a low target-achieving rate and poor treatment patterns. The study highlights the need to improve multiple aspects of CKD management to delay the progression of renal failure. PMID:27310973

  20. Prevalence and characteristics of patients with resistant hypertension and chronic kidney disease.

    Science.gov (United States)

    Verdalles, Úrsula; Goicoechea, Marian; Garcia de Vinuesa, Soledad; Quiroga, Borja; Galan, Isabel; Verde, Eduardo; Perez de Jose, Ana; Luño, José

    Resistant hypertension (RH) is a common problem in patients with chronic kidney disease (CKD). A decline in the glomerular filtration rate (GFR) and increased albuminuria are associated with RH; however, there are few published studies about the prevalence of this entity in patients with CKD. To estimate the prevalence of RH in patients with different degrees of kidney disease and analyse the characteristics of this group of patients. A total of 618 patients with hypertension and CKD stages i-iv were enrolled, of which 82 (13.3%) met the criteria for RH. RH prevalence increased significantly with age, the degree of CKD and albuminuria. The prevalence of RH was 3.2% in patients under 50 years, 13.8% between 50-79 years and peaked at 17.8% in patients older than 80 years. Renal function prevalence was 4, 15.8 and 18.1% in patients with an estimated glomerular filtration rate (GFR) of > 60, 30-59 and  300mg/g respectively. In a logistic regression model, the characteristics associated with resistant hypertension were age, history of cardiovascular disease, GFR, albuminuria and diabetes mellitus. A total of 47.5% of patients with resistant hypertension had controlled BP (<140/90mmHg) with 4 or more antihypertensive drugs. These patients were younger, with better renal function, less albuminuria and received more aldosterone antagonists. RH prevalence increases with age, the degree of CKD and albuminuria. Strategies such as treatment with aldosterone receptor antagonists are associated with better blood pressure control in this group of patients, leading to reduced prevalence. Copyright © 2016 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  1. Global Prevalence of Chronic Kidney Disease - A Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Nathan R Hill

    Full Text Available Chronic kidney disease (CKD is a global health burden with a high economic cost to health systems and is an independent risk factor for cardiovascular disease (CVD. All stages of CKD are associated with increased risks of cardiovascular morbidity, premature mortality, and/or decreased quality of life. CKD is usually asymptomatic until later stages and accurate prevalence data are lacking. Thus we sought to determine the prevalence of CKD globally, by stage, geographical location, gender and age. A systematic review and meta-analysis of observational studies estimating CKD prevalence in general populations was conducted through literature searches in 8 databases. We assessed pooled data using a random effects model. Of 5,842 potential articles, 100 studies of diverse quality were included, comprising 6,908,440 patients. Global mean(95%CI CKD prevalence of 5 stages 13·4%(11·7-15·1%, and stages 3-5 was 10·6%(9·2-12·2%. Weighting by study quality did not affect prevalence estimates. CKD prevalence by stage was Stage-1 (eGFR>90+ACR>30: 3·5% (2·8-4·2%; Stage-2 (eGFR 60-89+ACR>30: 3·9% (2·7-5·3%; Stage-3 (eGFR 30-59: 7·6% (6·4-8·9%; Stage-4 = (eGFR 29-15: 0·4% (0·3-0·5%; and Stage-5 (eGFR<15: 0·1% (0·1-0·1%. CKD has a high global prevalence with a consistent estimated global CKD prevalence of between 11 to 13% with the majority stage 3. Future research should evaluate intervention strategies deliverable at scale to delay the progression of CKD and improve CVD outcomes.

  2. Hidden prevalence of chronic kidney disease in hypertensive patients: the strategic role of primary health care.

    Science.gov (United States)

    da Silva, L S; Cotta, R M M; Moreira, T R; da Silva, R G; Rosa, C de O B; Machado, J C; da Silva, L S; Bastos, M A P

    2016-11-01

    To identify the hidden prevalence of chronic kidney disease (CKD) in hypertensive patients. Cross-sectional study of individuals with systemic arterial hypertension (SAH) who were registered for primary health care (PHC). In total, 293 individuals participated. Data were collected through interviews, as well as biochemical and anthropometric assessments. The CKD-EPI formula was used to identify the occurrence of CKD. Pearson's chi-squared test or Fisher's exact test were used to compare proportions. Prevalence ratios were estimated with a confidence interval of 95% for associations between the explanatory variables and CKD. Most of the individuals assessed were female (74%), elderly (69%), with a low income (90%), low education levels (84%) and overweight (66.9%). A CKD prevalence of 38.6% (95% CI: 33.0-44.2) was found and approximately 14% were at an advanced stage of the disease. Upon comparison of the variables in the different stages of CKD, statistically significant association could be suggested between CKD and age, education, alcohol intake, overweight individuals, cardiovascular risk, abnormal creatinine and abnormal microalbuminuria. When the prevalence ratio was assessed, association could be suggested between CKD and age, and CKD and creatinine. The high hidden prevalence of CKD confirms the need to train health professionals involved in the treatment of SAH through PHC, enabling the prevention and diagnosis of CKD in its early stages. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  3. Prevalence of chronic kidney disease in diabetic adult out-patients in Tanzania.

    Science.gov (United States)

    Janmohamed, Mubarakali N; Kalluvya, Samuel E; Mueller, Andreas; Kabangila, Rodrick; Smart, Luke R; Downs, Jennifer A; Peck, Robert N

    2013-08-31

    The number of adults with diabetes mellitus is increasing worldwide, particularly in Asia and Africa. In sub-Saharan Africa, renal complications of diabetes may go unrecognized due to limited diagnostic resources. The prevalence of chronic kidney disease (CKD) among adult diabetics in sub-Saharan Africa has not been well described. This study was conducted at the diabetes mellitus clinic of Bugando Medical Centre in Mwanza, Tanzania. A total 369 consecutive adult diabetic patients were enrolled and interviewed. Each patient provided a urine sample for microalbuminuria and proteinuria and a blood sample for serum creatinine level. Estimated glomerular filtration rate (eGFR) was calculated using the Cockroft-Gault equation. CKD was staged according to the Kidney Disease Improving Global Outcomes system. A total of 309 (83.7%) study participants had CKD; 295 (80.0%) had significant albuminuria and 91 (24.7%) had eGFR patients were aware of their renal disease, and only 5 (1.3%) had a diagnosis of diabetic nephropathy recorded in their file. Older age was significantly associated with CKD in this population [OR 1.03, p = 0.03, 95%CI (1.00-1.05)]. Chronic kidney disease is highly prevalent among adult diabetic outpatients attending our clinic in Tanzania, but is usually undiagnosed. Nearly ¼ of patients had an eGFR low enough to require dose adjustment of diabetic medications. More diagnostic resources are needed for CKD screening among adults in Tanzania in order to slow progression and prevent complications.

  4. Hospital-based prevalence of chronic kidney disease among the newly registered patients with diabetes

    Directory of Open Access Journals (Sweden)

    P A Khanam

    2016-01-01

    Full Text Available Chronic kidney disease (CKD is proved to be a major public health issue worldwide and an important contributor to the overall non-communicable disease burden. It increases risk of mortality, end-stage renal disease and accelerated cardiovascular disease (CVD. Diabetes is the biggest contributor to CKD and end stage renal disease (ESRD. In Bangladesh, very few data on CKD is available. This study aimed to estimate the prevalence of CKD among the newly registered diabetic patients at BIRDEM (Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders, a referral center for diabetes in Bangladesh. Methods: The study included all diabetic patients aged 18 - 80 years and were registered in the year 2012. Socio-demographic (age, sex, residence, income, literacy, clinical (obesity, blood pressure and biochemical (blood glucose, lipids, eGFR information were collected from the BIRDEM registry. CKD was defined according to the K/ DOQI guidelines. Results: A total of 1317 type 2 diabetic patients of age 18 to 80 years were studied. Of them, men and women were 54.7% and 45.3%, respectively. The overall prevalence of CKD (eGFR ≤60 (ml/min/m2 was 13.9%. The prevalence was significantly higher in women than men (21.3 v. 7.8%, p50y, higher sBP (≥140mmHg and taking oral hypoglycemic agent (OHA were significant. Conclusions: Thus, the study concludes that the prevalence of CKD among the newly registered diabetic patients is quite high in Bangladesh. The female diabetic patients with older age and with higher SBP bear the brunt of CKD. Considering high prevalence of CKD with severe lifelong complications it is of utmost importance for early detection and intervention at the primary health care (PHC level.

  5. [Chronic kidney disease in Primary Health Care: prevalence and associated risk factors].

    Science.gov (United States)

    Salvador González, Betlem; Rodríguez Pascual, Mercedes; Ruipérez Guijarro, Laura; Ferré González, Antonia; Cunillera Puertolas, Oriol; Rodríguez Latre, Luisa M

    2015-04-01

    To determine the prevalence of chronic kidney disease and associated risk factors in subjects over 60 years of age, as well as its staging by determining the glomerular filtration rate (GFR). Cross-sectional observational study. Primary Health Care. Patients≥60 years of age who were seen in 40 Primary Health Care centres with serum creatinine measured in a central laboratory between January 1 and December 31, 2010. kidney transplant, home care. Social-demographic and anthropometric data, cardiovascular risk factors, and diseases established according to electronic clinical records. Serum creatinine was measured using standardised Jaffe kinetic method, and GFR estimated with MDRD-4-IDMS and CKD-EPI. A total of 97,665 subjects (57.3% women, median age 70.0 years [Q1: 65.0, Q3: 77.0]). GFR-MDRD prevalencedisease (OR=1.40; 95% CI 1.30 to 1.50), peripheral arterial disease (OR=1.31; 95% CI 1.09 to 1.57), dyslipidaemia (OR=1.28; 95% CI 1.23 to 1.33), diabetes (OR=1.26; 95% CI 1.17 to 1.34), and stroke (OR=1.17; 95% CI 1.09 to 1.25). The GFR-CKD-EPI model showed an increase in OR with age and male sex, that became significant as a chronic kidney disease risk factor. Chronic kidney disease has considerable prevalence in subjects≥60 years seen in Primary Health Care, more in women, and increasing with age. Hypertension, more than diabetes, was the main associated cardiovascular risk factor. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  6. Impact of farm modernity on the prevalence of chronic obstructive pulmonary disease in dairy farmers.

    Science.gov (United States)

    Marescaux, Alexia; Degano, Bruno; Soumagne, Thibaud; Thaon, Isabelle; Laplante, Jean-Jacques; Dalphin, Jean-Charles

    2016-02-01

    Dairy farming is associated with an excess of chronic obstructive pulmonary disease (COPD). The dairy industry has been changing for the past three decades with larger, more efficient farms and potentially less exposure to agents involved in COPD development. However, the impact of farm modernisation on COPD prevalence is unknown. We studied respiratory symptoms, respiratory function by spirometry and tobacco smoking in 575 male dairy farmers working either in traditional or in modern farms in the French Doubs region. COPD was defined by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criterion (forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC) system for the animals (model 2). The prevalence of COPD in dairy farmers was 12.0 ± 2.7% (GOLD), and 5.6 ± 4.1% (LLN definition). By multivariate analysis using the LLN definition, tobacco smoking (OR (95% CI) 3.96 (1.53 to 10.3) and 3.42 (1.32 to 8.84) for models 1 and 2, respectively) and characteristics of traditional farms (1.97 (1.02 to 4.47) and 5.20 (1.73 to 15.64) for models 1 and 2, respectively) were associated with higher COPD prevalence. Working in a traditional farm plus current smoking had an additive effect on COPD prevalence in model 1 and a synergistic effect in model 2. These findings support a positive impact of farm modernity on COPD prevalence in dairy farmers. Occupational and smoking-related risk factors are of nearly the same magnitude. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  7. Chronic obstructive pulmonary disease prevalence in Lebanon: a cross-sectional descriptive study

    Directory of Open Access Journals (Sweden)

    Waked M

    2011-11-01

    Full Text Available Mirna Waked1, George Khayat2, Pascale Salameh31Saint George Hospital University Medical Center, Beirut, Lebanon; 2Faculty of Medicine, Hotel-Dieu de France Hospital, Saint-Joseph University, Beirut, Lebanon; 3Faculties of Pharmacy and Public Health, Lebanese University, Beirut, LebanonBackground: Chronic obstructive pulmonary disease (COPD continues to increase worldwide. The objective of this study was to determine the prevalence of COPD in Lebanese adults.Methods: A cross-sectional study was carried out using a multistage cluster sample from all over Lebanon. Residents aged 40 years and over were enrolled. Subjects underwent baseline spirometry and answered a questionnaire. After an albuterol + ipratropium bromide bronchodilator, a posttest was performed.Results: Of 2201 individuals, only 33.3% had never smoked. The prevalence of COPD by the Global Initiative for Chronic Obstructive Lung Disease definition, was 9.7% (95% confidence interval [CI]: 8.5%–10.9%. According to the 5% lower limit of normal definition of COPD, the prevalence was 12.5% (95% CI: 11.2%–13.9%. A total of 20.2% were already diagnosed by a physician. No differences in symptoms across stages of COPD were found, but there was a significant trend for a higher number of visits to the emergency room and to the doctor (P < 0.001, and a higher number of hospitalizations (P < 0.001. Older individuals had an increased risk of COPD (adjusted odds ratio [ORa] = 1.05; so did “ever” cigarette smokers (ORa = 4.88 and water-pipe smokers (ORa = 2.53.Conclusion: This is the first epidemiological study in Lebanon that determined COPD prevalence and the link with water-pipe smoking.Keywords: COPD, prevalence, water-pipe smoking

  8. Prevalence of depression and anxiety in patients with chronic digestive system diseases: A multicenter epidemiological study.

    Science.gov (United States)

    Zhang, An-Zhong; Wang, Qing-Cai; Huang, Kun-Ming; Huang, Jia-Guo; Zhou, Chang-Hong; Sun, Fu-Qiang; Wang, Su-Wen; Wu, Feng-Ting

    2016-11-14

    To investigate the prevalence of depression and anxiety in patients with chronic digestive system diseases. A total of 1736 patients with chronic digestive system diseases were included in this cross-sectional study, including 871 outpatients and 865 in-patients. A self-designed General Information for Patients of the Department of Gastroenterology of General Hospitals questionnaire was used to collect each patient's general information, which included demographic data (including age, sex, marital status, and education) and disease characteristics (including major diseases, disease duration, principal symptoms, chronic pain, sleep disorder, and limited daily activities). The overall detection rate was 31.11% (540/1736) for depression symptoms alone, 27.02% (469/1736) for anxiety symptoms alone, 20.68% (359/1736) for both depression and anxiety symptoms, and 37.44% (650/1736) for either depression or anxiety symptoms. Subjects aged 70 years or above had the highest detection rate of depression (44.06%) and anxiety symptoms (33.33%). χ 2 trend test showed: the higher the body mass index (BMI), the lower the detection rate of depression and anxiety symptoms ( χ 2 trend = 13.697, P digestive system tumors had the highest detection rate of depression (57.55%) and anxiety (55.19%), followed by patients with liver cirrhosis (41.35% and 48.08%). Depression and anxiety symptoms were also high in subjects with comorbid hypertension and coronary heart disease. Depression and anxiety occur in patients with tumors, liver cirrhosis, functional dyspepsia, and chronic viral hepatitis. Elderly, divorced/widowed, poor sleep quality, and lower BMI are associated with higher risk of depression and anxiety.

  9. Prevalence and Determinants of Chronic Obstructive Pulmonary Disease (COPD) in Bangladesh.

    Science.gov (United States)

    Alam, Dewan S; Chowdhury, Muhammad Ah; Siddiquee, Ali T; Ahmed, Shyfuddin; Clemens, John D

    2015-01-01

    There is a paucity of population-based data on COPD prevalence and its determinants in Bangladesh. To measure COPD prevalence and socioeconomic and lifestyle determinants among ≥40 years Bangladeshi adults. In a cross-sectional study, we measured lung function of 3744 randomly selected adults ≥40 years from rural and urban areas in Bangladesh, using a handheld spirometer. COPD was defined according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria as post-bronchodilator ratio of Forced Expiratory Volume in 1st second (FEV1) to Forced Vital Capacity (FVC) COPD was also assessed by the lower limit of normal (LLN) threshold defined as lower fifth percentile for the predicted FEV1/FVC. The prevalence of COPD was 13.5% by GOLD criteria and 10.3% by LLN criteria. Prevalence of COPD was higher among rural than urban residents and in males than females. More than half of the COPD cases were stage II COPD by both criteria. Milder cases (Stages I and II) were over estimated by the GOLD fixed criteria, but more severe cases (Stages III and IV) were similarly classified. In multiple logistic regression analysis, older age, male sex, illiteracy, underweight, history of smoking (both current and former), history of asthma and solid fuel use were significant predictors of COPD. COPD is a highly prevalent and grossly underdiagnosed public health problem in Bangladeshi adults aged 40 years or older. Illiteracy, smoking and biomass fuel burning are modifiable determinants of COPD.

  10. Prevalence and factors associated with rheumatic diseases and chronic joint symptoms in the elderly.

    Science.gov (United States)

    Falsarella, Gláucia R; Coimbra, Ibsen B; Barcelos, Caroline C; Costallat, Lilian Tl; Carvalho, Olga Mf; Coimbra, Arlete Mv

    2013-10-01

    In the elderly population, rheumatic conditions are major causes of pain that restrict participation in activities and mobility, and cause difficulties in the execution of self-care tasks. The present study aimed to analyze the prevalence and factors associated with the self-reported rheumatic diseases and chronic joint symptoms of the elderly. This transversal epidemiological survey involved 2209 older adults (aged ≥ 60 years). The investigation included sociodemographic factors, anthropometrics, activities of daily living, chronic conditions, medication and quality of life. Univariate and multivariate regression analysis were used for statistical procedures, P ≤ 0.05. The prevalence of rheumatism was 22.7%. Multivariate analysis showed that rheumatism was correlated with the following: female sex (OR = 1.91), high income (OR = 2.34), cardiovascular disease (OR = 1.42), cataracts (OR = 1.39), glucocorticoids (OR = 5.24), other anti-inflammatory medications (OR = 2.24) and pain (OR = 0.983). After adjusting for age and glucocorticoids, an association between cataracts and rheumatism was detected (OR = 1.32). The prevalence of symptoms was 45.6%. Multivariate regression results for symptoms included the following: female sex (OR = 1.40), body mass index ≥ 30.0 kg/m(2) (OR = 3.31), functional capacity (OR = 0.990), general health (OR = 0.993) and pain (OR = 0.981). After adjustment for age and glucocorticoids, an association between cataracts and symptoms was detected (OR = 1.26). There was a significant association of rheumatism and symptoms with women and high incomes. Obesity was associated with joint symptoms, which in turn were associated with an impaired quality of life. Cataracts and cardiovascular disease were associated with rheumatism. The identification of these characteristics in the elderly will contribute to a better understanding of this systemic disease and should be used to plan effective preventive measures. © 2013 Japan Geriatrics Society.

  11. Comorbidities and Chronic Obstructive Pulmonary Disease: Prevalence, Influence on Outcomes, and Management

    Science.gov (United States)

    Putcha, Nirupama; Drummond, M. Bradley; Wise, Robert A.; Hansel, Nadia N.

    2016-01-01

    Comorbidities impact a large proportion of patients with chronic obstructive pulmonary disease (COPD), with over 80% of patients with COPD estimated to have at least one comorbid chronic condition. Guidelines for the treatment of COPD are just now incorporating comorbidities to their management recommendations of COPD, and it is becoming increasingly clear that multimorbidity as well as specific comorbidities have strong associations with mortality and clinical outcomes in COPD, including dyspnea, exercise capacity, quality of life, healthcare utilization, and exacerbation risk. Appropriately, there has been an increased focus upon describing the burden of comorbidity in the COPD population and incorporating this information into existing efforts to better understand the clinical and phenotypic heterogeneity of this group. In this article, we summarize existing knowledge about comorbidity burden and specific comorbidities in COPD, focusing on prevalence estimates, association with outcomes, and existing knowledge about treatment strategies. PMID:26238643

  12. Low prevalence of chronic beryllium disease among workers at a nuclear weapons research and development facility.

    Science.gov (United States)

    Arjomandi, Mehrdad; Seward, James; Gotway, Michael B; Nishimura, Stephen; Fulton, George P; Thundiyil, Josef; King, Talmadge E; Harber, Philip; Balmes, John R

    2010-06-01

    To study the prevalence of beryllium sensitization (BeS) and chronic beryllium disease (CBD) in a cohort of workers from a nuclear weapons research and development facility. We evaluated 50 workers with BeS with medical and occupational histories, physical examination, chest imaging with high-resolution computed tomography (N = 49), and pulmonary function testing. Forty of these workers also underwent bronchoscopy for bronchoalveolar lavage and transbronchial biopsies. The mean duration of employment at the facility was 18 years and the mean latency (from first possible exposure) to time of evaluation was 32 years. Five of the workers had CBD at the time of evaluation (based on histology or high-resolution computed tomography); three others had evidence of probable CBD. These workers with BeS, characterized by a long duration of potential Be exposure and a long latency, had a low prevalence of CBD.

  13. Low Prevalence of Chronic Beryllium Disease among Workers at a Nuclear Weapons Research and Development Facility

    Energy Technology Data Exchange (ETDEWEB)

    Arjomandi, M; Seward, J P; Gotway, M B; Nishimura, S; Fulton, G P; Thundiyil, J; King, T E; Harber, P; Balmes, J R

    2010-01-11

    To study the prevalence of beryllium sensitization (BeS) and chronic beryllium disease (CBD) in a cohort of workers from a nuclear weapons research and development facility. We evaluated 50 workers with BeS with medical and occupational histories, physical examination, chest imaging with HRCT (N=49), and pulmonary function testing. Forty of these workers also underwent bronchoscopy for bronchoalveolar lavage (BAL) and transbronchial biopsies. The mean duration of employment at the facility was 18 yrs and the mean latency (from first possible exposure) to time of evaluation was 32 yrs. Five of the workers had CBD at the time of evaluation (based on histology or HRCT); three others had evidence of probable CBD. These workers with BeS, characterized by a long duration of potential Be exposure and a long latency, had a low prevalence of CBD.

  14. What do health interview surveys tell us about the prevalences of somatic chronic diseases?: a study into concurrent validity.

    NARCIS (Netherlands)

    Velden, J. van der; Abrahamse, H.P.H.; Donker, G.; Steen, J. van der; Sonsbeek, J.L.A. van; Bos, G.A.M. van den

    1998-01-01

    This study examines the concurrent validity of a list of chronic conditions used in health interview surveys. The results regarding the prevalence of chronic diseases from three health interview surveys, carried out in The Netherlands during the 1980s, were compared. In addition, the results for

  15. PREVALENCE OF CARDIOVASCULAR RISK AND PHYSICAL ACTIVITY LEVEL IN PATIENTS WITH CHRONIC RENAL DISEASE IN HEMODIALITIC TREATMENT

    OpenAIRE

    Danilo Rocha Santos Caracas; Daliane Barbosa Lima; Gleidson Ferreira Santos; Mariane Alves Sousa; Constança Margarida Sampaio Cruz

    2017-01-01

    Chronic kidney disease is a health problem that has reached more and more individuals due to the aging and increase of diseases such as hypertension and diabetes mellitus. The presence of chronic uremic syndrome along with aggravating factors such as sedentary lifestyle is directly associated with a high risk of developing cardiovascular diseases. This study aimed to describe the prevalence of cardiovascular risk and determine the levels of regular physical activity...

  16. Prevalence and care-seeking for chronic diseases among Syrian refugees in Jordan.

    Science.gov (United States)

    Doocy, Shannon; Lyles, Emily; Roberton, Timothy; Akhu-Zaheya, Laila; Oweis, Arwa; Burnham, Gilbert

    2015-10-31

    There are currently more people displaced by conflict than at any time since World War II. The profile of displaced populations has evolved with displacement increasingly occurring in urban and middle-income settings. Consequently, an epidemiological shift away from communicable diseases that have historically characterized refugee populations has occurred. The high prevalence of non-communicable diseases (NCDs) poses a challenge to in terms of provision of appropriate secondary and tertiary services, continuity of care, access to medications, and costs. In light of the increasing burden of NCDs faced by refugees, we undertook this study to characterize the prevalence of NCDs and better understand issues related to care-seeking for NCDs among Syrian refugees in non-camp settings in Jordan. A cross-sectional survey of 1550 refugees was conducted using a multi-stage cluster design with probability proportional to size sampling to obtain a nationally representative sample of Syrian refugees outside of camps. To obtain information on chronic conditions, respondents were asked a series of questions about hypertension, cardiovascular disease, diabetes, chronic respiratory disease, and arthritis. Differences by care-seeking for these conditions were examined using chi-square and t-test methods and characteristics of interest were included in the adjusted logistic regression model. Among adults, hypertension prevalence was the highest (9.7%, CI: 8.8-10.6), followed by arthritis (6.8%, CI: 5.9-7.6), diabetes (5.3%, CI: 4.6-6.0), chronic respiratory diseases (3.1%, CI: 2.4-3.8), and cardiovascular disease (3.7%, CI: 3.2, 4.3). Of the 1363 NCD cases, 84.7% (CI: 81.6-87.3) received care in Jordan; of the five NCDs assessed, arthritis cases had the lowest rates of care seeking at 65%, (CI:0-88, p = 0.005). Individuals from households in which the head completed post-secondary and primary education, respectively, had 89% (CI: 22-98) and 88% (CI: 13-98) lower odds of seeking care

  17. Prevalence of Chronic Kidney Disease in Korea: the Korean National Health and Nutritional Examination Survey 2011-2013.

    Science.gov (United States)

    Park, Ji In; Baek, Hyunjeong; Jung, Hae Hyuk

    2016-06-01

    Chronic kidney disease is a leading public health problem related to poor quality of life and premature death. As a resource for evidence-informed health policy-making, we evaluated the prevalence of chronic kidney disease using the data of non-institutionalized adults aged ≥ 20 years (n = 15,319) from the Korean National Health and Nutrition Examination Survey in 2011-2013. Chronic kidney disease was defined as a urine albumin-to-creatinine ratio ≥ 30 mg/g or an estimated glomerular filtration rate Chronic Kidney Disease-Epidemiology Collaboration equation. The total prevalence estimate of chronic kidney disease for adults aged ≥ 20 years in Korea was 8.2%. By disease stage, the prevalence of chronic kidney disease was as follows: stage 1, 3.0%; stage 2, 2.7%; stage 3a, 1.9%; stage 3b, 0.4%; and stages 4-5, 0.2%. When grouped into three risk categories according to the 2012 Kidney Disease: Improving Global Outcomes guidelines, the proportions for the moderately increased risk, high risk, and very high risk categories were 6.5%, 1.2%, and 0.5%, respectively. Factors including older age, diabetes, hypertension, cardiovascular disease, body mass indexes of ≥ 25 kg/m(2) and chronic kidney disease. Based on this comprehensive analysis, evidence-based screening strategies for chronic kidney disease in the Korean population should be developed to optimize prevention and early intervention of chronic kidney disease and its associated risk factors.

  18. Prevalence and determinants of diabetes mellitus among Iranian patients with chronic liver disease

    Directory of Open Access Journals (Sweden)

    Nematizadeh Fariborz

    2004-11-01

    Full Text Available Abstract Background Alterations in carbohydrate metabolism are frequently observed in cirrhosis. We conducted this study to define the prevalence of diabetes mellitus (DM and impaired glucose tolerance (IGT in Iranian patients with chronic liver disease (CLD, and explore the factors associated with DM in these patients. Methods One hundred and eighty-five patients with CLD were enrolled into the study. Fasting plasma glucose and two-hour plasma glucose were measured in patients' sera. DM and IGT were diagnosed according to the latest American Diabetes Association criteria. Results The subjects included 42 inactive HBV carriers with a mean age of 42.2 ± 12.0 years, 102 patients with HBV or HCV chronic hepatitis with a mean age of 41.2 ± 10.9 years, and 41 cirrhotic patients with a mean age of 52.1 ± 11.4 years. DM and IGT were diagnosed in 40 (21.6% and 21 (11.4% patients, respectively. Univariate analysis showed that age (P = 0.000, CLD status (P = 0.000, history of hypertension (P = 0.007, family history of DM (P = 0.000, and body mass index (BMI (P = 0.009 were associated with DM. Using Multivariate analysis, age (OR = 4.7, 95%CI: 1.8–12.2, family history of DM (OR = 6.6, 95%CI: 2.6–17.6, chronic hepatitis (OR = 11.6, 95%CI: 2.9–45.4, and cirrhosis (OR = 6.5, 95%CI: 2.4–17.4 remained as the factors independently associated with DM. When patients with cirrhosis and chronic hepatitis were analyzed separately, higher Child-Pugh's score in cirrhotic patients (OR = 9.6, 95%CI: 1.0–88.4 and older age (OR = 7.2, 95%CI: 1.0–49.1, higher fibrosis score (OR = 59.5, 95%CI: 2.9–1211.3/ OR = 11.9, 95%CI: 1.0–132.2, and higher BMI (OR = 30.3, 95%CI: 3.0–306.7 in patients with chronic hepatitis were found to be associated with higher prevalence of DM. Conclusions Our findings indicate that patients with cirrhosis and chronic hepatitis are at the increased risk of DM occurrence. Older age, severe liver disease, and obesity were associated

  19. Models for estimating projections for disease prevalence and burden: a systematic review focusing on chronic obstructive pulmonary disease.

    Science.gov (United States)

    McLean, Susannah; Barbour, Victoria; Wild, Sarah; Simpson, Colin; Sheikh, Aziz

    2015-10-01

    Epidemiological models for estimating the prevalence and burden of disease inform health policy and service planning decisions. Our aim was to describe the challenges in evaluating such models using the example of epidemiological models for chronic obstructive pulmonary disease (COPD). Two reviewers searched Medline, Embase, CAB Abstracts and World Health Organization (WHO) Databases from 1980 to November 2013 for epidemiological models of COPD prevalence and burden. Two reviewers extracted data and assessed the quality of the studies. We then undertook a descriptive and narrative synthesis of data. We identified 22 models employing a variety of techniques to calculate the prevalence and/or burden of COPD. Models calculated prevalence and/or mortality or other facet of disease burden using demographics and risk factors or trends, Markov-type modelling and microsimulation modelling. The six models which scored highly on the quality framework were: the Peabody model, which generated estimates of COPD prevalence; the WHO DISMOD II model which produced burden estimates in terms of disability adjusted life years with COPD and life years lost to COPD; the Atsou model which gave the life expectancy gains of individual smokers who quit smoking and associated costs; two Dutch COPD models which produced estimates of mortality and health care costs related to COPD; and the Pichon-Riviere model which gave the costs and cost effectiveness of smoking quit programmes. The field of chronic disease modelling is burgeoning. As a result, policy makers need to understand how to interpret epidemiological models and their data sources. © The Author(s) 2015.

  20. Prevalence of comorbidities according to predominant phenotype and severity of chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Camiciottoli G

    2016-09-01

    Full Text Available Gianna Camiciottoli,1,2 Francesca Bigazzi,1 Chiara Magni,1 Viola Bonti,1 Stefano Diciotti,3 Maurizio Bartolucci,4 Mario Mascalchi,5 Massimo Pistolesi1 1Section of Respiratory Medicine, Department of Clinical and Experimental Medicine, 2Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, 3Department of Electrical, Electronic, and Information Engineering “Guglielmo Marconi,” University of Bologna, Cesena, 4Department of Diagnostic Imaging, Careggi University Hospital, 5Radiodiagnostic Section, Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy Background: In addition to lung involvement, several other diseases and syndromes coexist in patients with chronic obstructive pulmonary disease (COPD. Our purpose was to investigate the prevalence of idiopathic arterial hypertension (IAH, ischemic heart disease, heart failure, peripheral vascular disease (PVD, diabetes, osteoporosis, and anxious depressive syndrome in a clinical setting of COPD outpatients whose phenotypes (predominant airway disease and predominant emphysema and severity (mild and severe diseases were determined by clinical and functional parameters. Methods: A total of 412 outpatients with COPD were assigned either a predominant airway disease or a predominant emphysema phenotype of mild or severe degree according to predictive models based on pulmonary functions (forced expiratory volume in 1 second/vital capacity; total lung capacity %; functional residual capacity %; and diffusing capacity of lung for carbon monoxide % and sputum characteristics. Comorbidities were assessed by objective medical records. Results: Eighty-four percent of patients suffered from at least one comorbidity and 75% from at least one cardiovascular comorbidity, with IAH and PVD being the most prevalent ones (62% and 28%, respectively. IAH prevailed significantly in predominant airway disease, osteoporosis prevailed

  1. Prevalence and variation of Chronic Kidney Disease in the Irish health system: initial findings from the National Kidney Disease Surveillance Programme.

    LENUS (Irish Health Repository)

    Stack, Austin G

    2014-01-01

    Chronic Kidney Disease (CKD) is a major non-communicable chronic disease that is associated with adverse clinical and economic outcomes. Passive surveillance systems are likely to improve efforts for prevention of chronic kidney disease (CKD) and inform national service planning. This study was conducted to determine the overall prevalence of CKD in the Irish health system, assess period trends and explore patterns of variation as part of a novel surveillance initiative.

  2. Prevalence and Prognostic Implications of Vitamin D Deficiency in Chronic Kidney Disease

    Directory of Open Access Journals (Sweden)

    Yoshitsugu Obi

    2015-01-01

    Full Text Available Vitamin D is an important nutrient involved in bone mineral metabolism, and vitamin D status is reflected by serum total 25-hydroxyvitamin D (25[OH]D concentrations. Vitamin D deficiency is highly prevalent in patients with chronic kidney disease (CKD, and nutritional vitamin D supplementation decreases elevated parathyroid hormone concentrations in subgroups of these patients. Furthermore, vitamin D is supposed to have pleiotropic effects on various diseases such as cardiovascular diseases, malignancies, infectious diseases, diabetes, and autoimmune diseases. Indeed, there is cumulative evidence showing the associations of low vitamin D with the development and progression of CKD, cardiovascular complication, and high mortality. Recently, genetic polymorphisms in vitamin D-binding protein have received great attention because they largely affect bioavailable 25(OHD concentrations. This finding suggests that the serum total 25(OHD concentrations would not be comparable among different gene polymorphisms and thus may be inappropriate as an index of vitamin D status. This finding may refute the conventional definition of vitamin D status based solely on serum total 25(OHD concentrations.

  3. Prevalence and prognostic implications of vitamin D deficiency in chronic kidney disease.

    Science.gov (United States)

    Obi, Yoshitsugu; Hamano, Takayuki; Isaka, Yoshitaka

    2015-01-01

    Vitamin D is an important nutrient involved in bone mineral metabolism, and vitamin D status is reflected by serum total 25-hydroxyvitamin D (25[OH]D) concentrations. Vitamin D deficiency is highly prevalent in patients with chronic kidney disease (CKD), and nutritional vitamin D supplementation decreases elevated parathyroid hormone concentrations in subgroups of these patients. Furthermore, vitamin D is supposed to have pleiotropic effects on various diseases such as cardiovascular diseases, malignancies, infectious diseases, diabetes, and autoimmune diseases. Indeed, there is cumulative evidence showing the associations of low vitamin D with the development and progression of CKD, cardiovascular complication, and high mortality. Recently, genetic polymorphisms in vitamin D-binding protein have received great attention because they largely affect bioavailable 25(OH)D concentrations. This finding suggests that the serum total 25(OH)D concentrations would not be comparable among different gene polymorphisms and thus may be inappropriate as an index of vitamin D status. This finding may refute the conventional definition of vitamin D status based solely on serum total 25(OH)D concentrations.

  4. Prevalence of ocular hypertension and glaucoma in patients with chronic ocular graft-versus-host disease.

    Science.gov (United States)

    Saboo, Ujwala S; Amparo, Francisco; Shikari, Hasanain; Dana, Reza

    2016-05-01

    To evaluate the prevalence of ocular hypertension (OHT) and glaucoma in patients with chronic ocular graft-versus-host disease (GVHD). We performed a retrospective chart review of 218 patients diagnosed with chronic ocular GVHD. Ocular hypertension was defined as intraocular pressure (IOP) ≥ 24 mmHg in either eye without any glaucomatous optic disc changes. Glaucoma suspect was defined as optic disc changes with a cup-to-disc ratio ≥ 0.7 in either eye or asymmetry of ≥ 0.3 between the two eyes. Glaucoma was defined by glaucomatous optic disc changes plus glaucomatous visual field defects in two consecutive reliable visual field tests. The number of cases of ocular hypertension, glaucoma, and glaucoma suspects was evaluated. Thirty-three patients (15 %) were diagnosed with OHT, eight patients (3.6 %) with suspicion of glaucoma, and one patient (0.4 %) with glaucoma. OHT occurred within 6 months of developing ocular GVHD in 60 % of the cases and within the first year in 76 %. High IOP normalized in 67 % of patients when the dosage of topical or systemic corticosteroids was lowered, and 27 % of patients required anti-glaucoma therapy. Ocular hypertension is a common complication in patients with ocular GVHD, with a prevalence of 15 %. The rise in intraocular pressure is often transient and resolves with management of corticosteroids in most cases. However, clinicians should be aware that nearly one-third of the patients with OHT might require anti-glaucoma treatment. The prevalences of glaucoma and suspicion of glaucoma were not higher than in the general population.

  5. Chronic obstructive pulmonary disease in patients with lung cancer: prevalence, impact and management challenges.

    Science.gov (United States)

    Spyratos, Dionisios; Papadaki, Eleni; Lampaki, Sofia; Kontakiotis, Theodoros

    2017-01-01

    Chronic obstructive pulmonary disease (COPD) and lung cancer share a common etiological factor (cigarette smoking) and usually coexist in everyday clinical practice. The prevalence of COPD among newly diagnosed patients with lung cancer sometimes exceeds 50%. COPD is an independent risk factor (2-4 times higher than non-COPD subjects) for lung cancer development. The presence of emphysema in addition to other factors (e.g., smoking history, age) could be incorporated into risk scores in order to define the most appropriate target group for lung cancer screening using low-dose computed tomography. Clinical management of patients with coexistence of COPD and lung cancer requires a multidisciplinary oncology board that includes a pulmonologist. Detailed evaluation (lung function tests, cardiopulmonary exercise test) and management (inhaled drugs, smoking cessation, pulmonary rehabilitation) of COPD should be taken into account for lung cancer treatment (surgical approach, radiotherapy).

  6. Prevalence of colorectal adenomatous polyps in patients with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Chun EM

    2015-05-01

    Full Text Available Eun Mi Chun, Seo Woo Kim, So Yeon Lim Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Republic of Korea Background: Colorectal adenomatous polyps are precancerous lesions of colorectal cancer. The aim of this study was to assess the prevalence of colorectal adenomatous polyps in chronic obstructive pulmonary disease (COPD patients and determine whether COPD is associated with colorectal malignant potential.Methods: Subjects who had undergone post-bronchodilator spirometry and colonoscopy and were 40 years or older were selected from the hospital database. COPD was defined as a spirometry in which the ratio of forced expiratory volume in 1 second (FEV1 and forced vital capacity (FVC is <0.7 in post-bronchodilator spirometry. The non-COPD group was matched for both age and sex, and were defined as having an FEV1, FVC, and FEV1/FVC ≥0.7 in spirometry. Finally, 333 patients were retrospectively reviewed; of this group, 82 patients had COPD.Results: Among the subjects, 201 patients (60% were nonsmokers, while 78 (23% were current smokers. The prevalence of colorectal adenomatous polyps was 39% (98/251 in the non-COPD group and 66% (54/82 in the COPD group. Among 54 patients with adenomatous polyps in the COPD group, 47 had tubular adenoma and seven had villous adenoma. Multiple logistic regression analyses revealed that only COPD patients whom matched to the criteria of COPD by pulmonary function test (odds ratio 2.1, 95% confidence interval: 1.1–3.8; P=0.019 were independently associated with colorectal malignant potential.Conclusion: The risk of colorectal malignant potential in the COPD group was higher than in the non-COPD group. We may suggest that COPD patients should consider regular colonoscopic evaluation to screen for premalignant colon polyps regardless of smoking. Keywords: COPD, colorectal adenomatous polyp, smoking, chronic obstructive pulmonary

  7. Prevalence and global initiative for chronic obstructive lung disease group distribution of chronic obstructive pulmonary disease detected by preoperative pulmonary function test.

    Directory of Open Access Journals (Sweden)

    Sun Mi Choi

    Full Text Available Despite being a major public health problem, chronic obstructive pulmonary disease (COPD remains underdiagnosed, and only 2.4% COPD patients are aware of their disease in Korea. The objective of this study was to estimate the prevalence of COPD detected by spirometry performed as a preoperative screening test and to determine the Global Initiative for Chronic Obstructive Lung Disease (GOLD group distribution and self-awareness of COPD.We reviewed the medical records of adults (age, ≥ 40 years who had undergone spirometry during preoperative screening between April and August 2013 at a tertiary hospital in Korea. COPD was defined as a postbronchodilator forced expiratory volume in 1 s/forced vital capacity ratio of 40 years who had undergone spirometry as a preoperative screening test, 474 (15.6%; 404 men; median age, 70 years; range, 44-93 years were diagnosed with COPD. Only 26 (5.5% patients reported previous diagnosis of COPD (2.1%, emphysema (0.8%, or chronic bronchitis (2.5%. The GOLD group distribution was as follows: 63.3% in group A, 31.2% in group B, 1.7% in group C, and 3.8% in group D.The prevalence of COPD diagnosed by preoperative spirometry was 15.6%, and only 5.5% patients were aware of their disease. Approximately one-third of the COPD patients belonged to GOLD groups B, C, and D, which require regular treatment.

  8. [Prevalence of chronic kidney disease in community-dwelling elderly and associated cardiovascular risk factors].

    Science.gov (United States)

    Almirall, J; Vaqueiro, M; Antón, E; Baré, M L; González, V; Jaimez, E; Gimeno, C

    2005-01-01

    Chronic kidney disease is a major public health problem in developed countries. The incidence of patients on dialysis is increasing progressively in the last years. The ageing population and increasing incidence of diabetes and hypertension are the main causes. Moreover, the level of kidney function is now recognised as a major risk factor for cardiovascular disease, even in mild cases. There is a great unaware about the prevalence of mild to moderate chronic kidney disease in the general population. The aim of the present study was to know the kidney function level in our general population over 64 years old, and the associated cardiovascular risk. This is an epidemiological descriptive cross-sectional study, obtained by a representative random sampling of the population over 64 years living in the reference area of our Hospital. The glomerular filtration rate was estimated by the Cockroft-Gault formula and the MDRD equations. Kidney function has been classified by the K/DOQI stages. We examined the univariate and multivariate association between the estimated glomerular filtration rate and the presence of cardiovascular events. We analysed 253 subjects aged 65 to 93 years (mean 72 +/- 5.4). Present comorbidities were: HTA 64%, dislipemia 29%, diabetes 14%, active smokers: 10% of men, 1,5% of women. A previous cardiovascular event was present in 11% of patients (15% of men; 6,8% of women). A serum creatinin level over 1,3 and 1,5 mg/dl was present in 3,8% of women and 8% of men respectively. Nevertheless, chronic kidney insufficiency (estimated clreatinie clearance less than 60 mix') was present in 31-49% relying on the utilised formula. In addition to age, sex, and diabetes, an independent graded association was observed between reduced glomerular filtration rate and the existence of cardiovascular events. We have confirmed a high prevalence of renal insufficiency among elderly people, usually not detected by the isolated plasma creatinin concentration This

  9. Prevalence and risk factors for chronic kidney disease in a rural region of Haiti.

    Science.gov (United States)

    Burkhalter, Felix; Sannon, Herriot; Mayr, Michael; Dickenmann, Michael; Ernst, Silvia

    2014-01-01

    In the Caribbean region chronic kidney disease (CKD) is an increasing challenge. High rates of non-communicable and infectious diseases and the rise in people suffering from diabetes and hypertension explain the observed and further expected increase of CKD. However, data about the magnitude of the problem are rare and in some countries such as Haiti completely lacking. The aim of our study was to generate data about the prevalence and risk factors for CKD in a rural region in Haiti. In this prospective cross-sectional study, adult patients visiting the medical outpatient clinic of the Hôpital Albert Schweitzer (HAS) in Deschapelles Haiti were included. CKD was assessed by estimated glomerular filtration rate (eGFR) and measurement of proteinuria by dipstick test. Risk factors for CKD were assessed by clinical examinations and questionnaires. Overall 608 patients were screened for CKD, of whom 27% had CKD. CKD stages 1 to 2 were found in 15.3% and stages 3 to 5 in 11.7%. The prevalence of hypertension and diabetes mellitus was 49.2% and 36.3%, respectively. Risk factors independently associated with CKD were hypertension (p = 0.0002) and HIV infection (p = 0.019) and age >60 years (p = 0.0052), whereas diabetes mellitus was not independently associated (p = 0.72). Our data show a high prevalence of CKD and traditional risk factors, and their association with CKD in Haiti. These findings have now to be confirmed in other regions in longitudinal analyses as a basic step to build up screening and prevention programmes for CKD.

  10. Prevalence of chronic obstructive pulmonary disease (COPD) in China in 1990 and 2010.

    Science.gov (United States)

    Chan, Kit Yee; Li, Xue; Chen, Wanjing; Song, Peige; Wong, Nuen Wing Katy; Poon, Adrienne N; Jian, Weiyan; Soyiri, Ireneous N; Cousens, Simon; Adeloye, Davies; Sheikh, Aziz; Campbell, Harry; Rudan, Igor

    2017-12-01

    Chronic obstructive pulmonary disease (COPD) is set to become the third most frequent cause of death and also the third largest cause of global morbidity by 2020. In China, where the population is aging rapidly, COPD has become one of the leading causes of disability and a large economic burden. An epidemiological assessment of the COPD in China is required, with a focus on the number of cases living with disease, main determinants of the disease and time trends. We systematically searched large Chinese bibliographic databases and English databases to identify spirometry-based epidemiological studies of the prevalence of COPD in China diagnosed according to GOLD criteria. We estimated age- and gender-specific prevalence of COPD using a multilevel mixed-effect logistic regression. We also presented the time trends of COPD between 1990 and 2010 by age, gender and setting (urban vs rural). In 1990, the prevalence of COPD ranged from 0.49% (95% CI = 0.29-0.85) in  = 80 years group, and the crude prevalence for China was 2.70% (95% CI = 1.86-3.51). In 2010, the prevalence in  = 80 years was 22.89% (95% CI = 18.13-28.96), with the crude prevalence for China of 3.84% (95% CI = 3.30-4.77). The COPD prevalence in males was about two-fold higher than in females, and it increased with increasing age. Between 1990-2010, the total number of Chinese people living with COPD increased by 66.73%, from 30.90 million (95% CI = 21.28-40.02) in 1990 to 51.52 million (95% CI = 44.26-63.93) in 2010. This increase was most striking in middle age, and greater in females than in males from 30 years up to 64 years. Our estimates, which used an independent approach to acquiring data and development of analytical methods, and were based on a more complete data set, are remarkably similar to those produced recently by the GBD 2013 collaboration, differing by only about 5% in the estimated number of COPD cases in 1990 and by 1% in 2010. COPD is a highly prevalent

  11. Chronic obstructive pulmonary disease in Portugal: Pneumobil (1995 and 2002 Prevalence Studies revisited

    Directory of Open Access Journals (Sweden)

    J. Cardoso

    2013-05-01

    Full Text Available Summary: Background: Chronic obstructive pulmonary disease (COPD has been a leading cause of morbidity and mortality worldwide, over the years. In 1995, the implementation of a respiratory function survey seemed to be an adequate way to draw attention to neglected respiratory symptoms and increase the awareness of spirometry surveys. By 2002 there were new consensual guidelines in place and the awareness that prevalence of COPD depended on the criteria used for airway obstruction definition. The purpose of this study is to revisit the two studies and to turn public some of the data and respective methodologies. Methods: From Pneumobil Study database of 12,684 subjects, only the individuals with 40+ years old (n = 9.061 were selected. The 2002 Study included a randomized representative sample of 1384 individuals with 35–69 years old. Results: The prevalence of COPD was 8.96% in Pneumobil and 5.34% in the 2002 Study. In both studies, presence of COPD was greater in males and there was a positive association between presence of COPD and older age groups. Smokers and ex-smokers showed a higher proportion of cases of COPD. Conclusions: Prevalence in Portugal is lower than in other European countries. This may be related to lower smokers’ prevalence. Globally, the most important risk factors associated with COPD were age over 60 years, male gender and smoking exposure. All aspects and limitations regarding different recruitment methodologies and different criteria for defining COPD cases highlight the need of a standardized method to evaluate COPD prevalence and associated risks factors, whose results can be compared across countries, as it is the case of BOLD project. Resumo: Introdução: A doença pulmonar obstrutiva crónica (DPOC tem sido, ao longo dos anos, uma importante causa de morbilidade e mortalidade no mundo. Em 1995, a implementação de um rastreio da função respiratória pareceu a forma mais adequada

  12. Prevalence and correlates of osteoporosis in chronic obstructive pulmonary disease patients in India

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    Jyothi Hattiholi

    2014-01-01

    Full Text Available Background: Chronic obstructive pulmonary disease (COPD is a syndrome of progressive airflow limitation caused by the abnormal inflammatory reaction of the airway and lung parenchyma. Osteoporosis is one of the major extrapulmonary manifestations of COPD. The, prevalence of osteoporosis in COPD patients in Indian population is unknown. Objectives: To study the prevalence of osteoporosis in COPD and to define various risk factors associated with reduced bone mineral density (BMD in COPD. Materials and Methods: The study was done in the department of Pulmonary Medicine of a tertiary care hospital. All the diagnosed cases of COPD according to the Global Initiative for Obstructive Lung Disease (GOLD guidelines were included in this study. The present study was a prospective study in for a period of 1 year. A brief history of the patients was taken, especially regarding duration of illness, number of exacerbations in the past 3 years, smoking in pack years, and history of steroid use (both systemic and inhaled steroids after which cumulative dose of steroids was calculated. Spirometry was done in all these patients to stage the severity of COPD according to GOLD criteria. DEXA scan of the lumbar spine was done using bone densitometer to determine osteoporosis. A world Health Organization (WHO criterion for definition of osteoporosis was applied and patients with T-score of > –2.5 standard deviation (SD were diagnosed to have osteoporosis, –1 SD to –2.5 SD were diagnosed to have osteopenia and 3 (OR: 30.3, 95% CI: 4.74-200, P 1,000 mg (OR: 7.35, 95% CI: 0.92-58.5, P < 0.04 were observed to be significant risk factors for osteoporosis in COPD patients. Conclusions: In the present study, the prevalence of osteoporosis was 66.6% and another 19.6% had osteopenia. As the severity of COPD increased, the risk of osteoporosis increased. GOLD stage III and stage IV patient had significantly lower BMD as compared to stage I and stage II of COPD disease

  13. Prevalence of Chronic non Communicable Diseases and Risk Factors in Older Adults in Holguín

    Directory of Open Access Journals (Sweden)

    Pedro Enrique Miguel Soca

    2017-09-01

    Full Text Available Foundation: chronic non communicable diseases and their associated risk factors constitute a health problem in the elderly. Objective: to determine the prevalence of non communicable chronic diseases and to identify their associated risk factors in the elderly in Holguín province. Method: across-sectional study was carried out with a multistage sampling of 2 085 adults from 4 municipalities in the province of Holguín. The variables analyzed were: age, weight, height, body mass index, abdominal perimeter, hip circumference, waist / hip index, waist / height index, blood pressure and laboratory complement. Quantitative variables were expressed as mean ± standard deviation of the mean with their respective 95 % confidence intervals. Results: prevalence rates of chronic diseases and associated factors were overweight: 33.7 %, obesity: 45.2 %, abdominal obesity: 68 %, waist / tall index: 91.2 %, prehypertension: 5.4 % , hypertension: 29.6 %, hypertriglyceridemia: 60.9 %, hypercholesterolemia 54.1 %, HDL-cholesterol under 43,9 %, high LDL-cholesterol 20.7 %, high plasma atherogenic index 53.4 %, metabolic syndrome 56.5 %, ischemic heart disease 24.8 %, hypothyroidism 8.5 %, smoking 17.3 % , positive C-reactive protein 6, 8 % and positive microalbuminuria 3.4 %. Conclusions: older adults presented greater deterioration of anthropometric and lipid profile measurements than non - elderly adults, with high prevalence rates of most of the non - communicable chronic diseases studied and their associated risk factors.

  14. High prevalence of secondary hyperparathyroidism in chronic kidney disease patients on dialysis in Argentina.

    Science.gov (United States)

    Douthat, Walter G; Castellano, Mauro; Berenguer, Leandro; Guzmán, M Alejandra; de Arteaga, Javier; Chiurchiu, Carlos R; Massari, Pablo U; Garay, Gabriela; Capra, Raúl; de La Fuente, Jorge L

    2013-01-01

    There are few data in Argentina on the prevalence and management of bone and mineral metabolism (BMM) in patients with chronic kidney disease (CKD). A survey was carried out in dialysis units in 2010 to measure the prevalence of and types of treatments for BMM disorders in Argentina. The data obtained was then compared to the published results from other large population studies. We recorded characteristics of dialysis centres and participating patients, the frequency of measurements and individual results for BMM biochemical markers, as well as the type of management used to control hyperphosphataemia and secondary hyperparathyroidism. 1210 patients from 25 dialysis centres in Argentina participated in the study (representing 4.7% of the country’s prevalent dialysis population in 2010). The mean patient age was 55.3±17.6 years, 60.8% were male, 3.3% were on peritoneal dialysis and 29.1% suffered diabetes. In all centres, phosphataemia and calcaemia were measured on a monthly basis, 60% of centres measured intact parathyroid hormone (iPTH) every 6 months, 36% every 3 to 4 months, and 4% annually. As recommended by K/DOQI, 51.6% of patients had adequate levels of calcium (8.4-9.5 mg/dl), 51.6% had adequate phosphorus (3.5-5.5 mg/dl) and 21.1% displayed acceptable iPTH levels (150-300 pg/ml). 24% had iPTH 300 pg/ml. iPTH ≥600 pg/ml was present in 28.3%, and 13.3% had values ≥1000 pg/ml. These figures differed from those published by the DOPPS II study, in which 51.1% of patients had iPTH hyperparathyroidism, oral or intravenous calcitriol was predominantly used (50.5%) with a small percentage of patients receiving paricalcitol or doxercalciferol. The present study shows a high prevalence of secondary hyperparathyroidism, which differs from that published by other large population studies. There was a high proportion of patients with BMM markers outside the ranges suggested by K/DOQI. Mainly phosphate binders based on calcium and calcitriol continue to be used

  15. Prevalence, classification, and etiology of pain in Parkinson's disease: association between Parkinson's disease and fibromyalgia or chronic widespread pain.

    Science.gov (United States)

    Toda, Katsuhiro; Harada, Toshihide

    2010-09-01

    Parkinson's disease (PD) is characterized by resting tremor, slow and decreased movement (hypokinesia and akinesia), rigidity, postural instability, problems with gait, and coordination. The prevalence of PD is between 0.1% and 0.3% in the general population and between 1% and 2% in persons 65 years of age or older. Patients with PD are more likely to suffer from pain. Indeed, the chief complaint of patients with severe motor disturbance and severe pain is pain rather than motor disturbance. Fibromyalgia (FM) is defined by widespread pain (pain in the left and right sides of the body, pain above the waist, pain below the waist, and axial skeletal pain) for more than 3 months and the presence of at least 11 of the 18 specified tender points. FM and chronic widespread pain (CWP), which is usually an incomplete form of FM, cause pain in the musculoskeletal region, but their etiologies are unknown. Therefore, it is almost impossible to determine whether or not pain in the musculoskeletal region is in the musculoskeletal origin. We suspect that dysfunction or degeneration of the nerves that control pain, mind, and movement in the brain causes FM, depression, and PD, respectively. When pain in PD is discussed, FM and CWP should be considered because their prevalence is high. Patients with PD may be likely to suffer from FM and CWP; however, the prevalence of FM and CWP in patients with PD has not been reported. Here, we discuss the relationship between PD and FM or CWP.

  16. Protein-energy wasting syndrome in advanced chronic kidney disease: prevalence and specific clinical characteristics.

    Science.gov (United States)

    Pérez-Torres, Almudena; González Garcia, M Elena; San José-Valiente, Belén; Bajo Rubio, M Auxiliadora; Celadilla Diez, Olga; López-Sobaler, Ana M; Selgas, Rafael

    Protein-energy wasting (PEW) is associated with increased mortality and differs depending on the chronic kidney disease (CKD) stage and the dialysis technique. The prevalence in non-dialysis patients is understudied and ranges from 0 to 40.8%. To evaluate the nutritional status of a group of Spanish advanced CKD patients by PEW criteria and subjective global assessment (SGA). Cross-sectional study of 186 patients (101 men) with a mean age of 66.1±16 years. The nutritional assessment consisted of: SGA, PEW criteria, 3-day dietary records, anthropometric parameters and bioelectrical impedance vector analysis. The prevalence of PEW was 30.1%, with significant differences between men and women (22.8 vs. 33.8%, p intake. Women had higher levels of total cholesterol, HDL and a higher body fat percentage. The characteristics of patients with PEW were low albumin levels and a low total lymphocyte count, high proteinuria, low fat and muscle mass and a high Na/K ratio. The multivariate analysis found PEW to be associated with: proteinuria (OR: 1.257; 95% CI: 1.084-1.457, p=0.002), percentage of fat intake (OR: 0.903; 95% CI: 0.893-0.983, p=0.008), total lymphocyte count (OR: 0.999; 95% CI: 0.998-0.999, p=0.001) and cell mass index (OR: 0.995; 95% CI: 0.992-0.998). Malnutrition was identified in Spanish advanced CKD patients measured by different tools. We consider it appropriate to adapt new diagnostic elements to PEW criteria. Copyright © 2017 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  17. [Prevalence and difficulties in chronic obstructive pulmonary disease diagnosis in patients suffering from severe peripheral arterial disease].

    Science.gov (United States)

    Sleszycka, Justyna; Woźniak, Krzysztof; Banaszek, Marta; Wiechno, Wiesław; Domagała-Kulawik, Joanna

    2009-08-01

    Cigarette smoking is the most prominent risk factor for chronic obstructive pulmonary disease (COPD) and peripheral arterial disease (PAD). Prevalence of COPD among cigarette smokers is about 23% in Poland. Effort dyspnea which develops in advanced stage of COPD is the leading cause of seeking medical advice. Physical activity among patients with PAD is reduced due to intermittent claudication. It may cause delayed COPD diagnosis in this group of patients. To estimate the prevalence of COPD among patients suffering from severe PAD who were hospitalized in surgery department due to critical limb ischemia and to evaluate difficulties during COPD diagnosis in this group of patients. We examined 64 patients suffering from severe PAD (at least IIb stage according to Fontaine's scale). Patients were asked about the typical symptoms of COPD: chronic cough, regular sputum production and dyspnea. To evaluate the intensity of dyspnea we used British Medical Research Council scale. Spirometry was performed to every patient. Patients with airways obstruction underwent spirometry after the administration of inhaled bronchodilator. Every patient who had the post-bronchodilator value of FEV,/FVC ratio below the lower limit of normal values was diagnosed with COPD. It was not possible to evaluate the dyspnea intensity using MRC scale in 44% of 34 patients who reported dyspnea. During the study we diagnosed 16 patients with COPD (9 pts had 1st stage of COPD according to GOLD classification, 7 pts--2nd). 9 patients had been formerly diagnosed with COPD (2 pts--1st stage, 5 pts--2nd, and 2 pts--3rd). Spirometry-defined COPD was present in 39% of study group. The analysis of data from patients with PAD coexistent COPD revealed that 60% of them were current cigarette smokers and 28% of them declared passive smoking exposure. The other known negative prognostic factors in patients with COPD such as BMI lower than 21 kg/mr2, FEV1% of predicted value below 65% and X-rays photograph

  18. Prevalence and correlates of gout in a large cohort of patients with chronic kidney disease: the German Chronic Kidney Disease (GCKD) study.

    Science.gov (United States)

    Jing, Jiaojiao; Kielstein, Jan T; Schultheiss, Ulla T; Sitter, Thomas; Titze, Stephanie I; Schaeffner, Elke S; McAdams-DeMarco, Mara; Kronenberg, Florian; Eckardt, Kai-Uwe; Köttgen, Anna

    2015-04-01

    Reduced kidney function is a risk factor for hyperuricaemia and gout, but limited information on the burden of gout is available from studies of patients with chronic kidney disease (CKD). We therefore examined the prevalence and correlates of gout in the large prospective observational German Chronic Kidney Disease (GCKD) study. Data from 5085 CKD patients aged 18-74 years with an estimated glomerular filtration rate (eGFR) of 30-patients on urate lowering therapy, 47.2% still showed hyperuricaemia. Factors associated with gout were serum urate, lower eGFR, advanced age, male sex, higher body mass index and waist-to-hip ratio, higher triglyceride and C-reactive protein (CRP) concentrations, alcohol intake and diuretics use. While lower eGFR categories showed significant associations with gout in multivariable-adjusted models (prevalence ratio 1.46 for eGFR patients with CKD and lower GFR is strongly associated with gout. Pharmacological management of gout in patients with CKD is suboptimal. Prospective follow-up will show whether gout and hyperuricaemia increase the risk of CKD progression and cardiovascular events in the GCKD study. © The Author 2014. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

  19. Prevalence of Chronic Kidney Disease in Turkish Adults With Obesity and Metabolic Syndrome: A Post Hoc Analysis from Chronic Renal Disease in Turkey Study.

    Science.gov (United States)

    Arinsoy, Turgay; Deger, Serpil Muge; Ates, Kenan; Altun, Bulent; Ecder, Tevfik; Camsari, Taner; Serdengecti, Kamil; Suleymanlar, Gultekin

    2016-11-01

    Obesity confers an increased risk of chronic kidney disease (CKD), which is increased further by accompanying metabolic abnormalities. To investigate the relationship of the risk of CKD with obesity and metabolic syndrome (MS) in adults by means of post hoc analysis of data from the Chronic Renal Disease in Turkey (CREDIT) study. The anthropometric measurements of a total of 9,100 adult participants in the CREDIT study were included in the analyses. Subjects were classified according to the presence or absence of obesity (body mass index [BMI] > 30) and MS. Logistic regression analyses were used to estimate odds ratio for CKD. Effect modification analyses were also performed. The prevalence of obesity was 20.6% and that of MS was 31.3%. The prevalence of CKD was higher among obese subjects compared to those with a normal BMI (20.5% vs. 14%; P obesity, 1.983 (95% CI, 1.489-2.641) for those with class II obesity and 2.799 (95% CI, 1.719-4.557) for subjects with extreme obesity (P obese subjects with MS (adjusted OR, 1.321; 95% CI, 1.109-1.573; P = .002). The stratification of obese individuals based on their metabolic phenotype is important for prevention and treatment of CKD. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  20. Sarcopenia in chronic kidney disease on conservative therapy: prevalence and association with mortality.

    Science.gov (United States)

    Pereira, Raíssa A; Cordeiro, Antonio C; Avesani, Carla M; Carrero, Juan J; Lindholm, Bengt; Amparo, Fernanda C; Amodeo, Celso; Cuppari, Lilian; Kamimura, Maria A

    2015-10-01

    In chronic kidney disease (CKD), multiple metabolic and nutritional abnormalities contribute to the impairment of skeletal muscle mass and function thus predisposing patients to the condition of sarcopenia. Herein, we investigated the prevalence and mortality predictive power of sarcopenia, defined by three different methods, in non-dialysis-dependent (NDD) CKD patients. We evaluated 287 NDD-CKD patients in stages 3-5 [59.9 ± 10.5 years; 62% men; 49% diabetics; glomerular filtration rate (GFR) 25.0 ± 15.8 mL/min/1.73 m(2)]. Sarcopenia was defined as reduced muscle function assessed by handgrip strength (HGS <30th percentile of a population-based reference adjusted for sex and age) plus diminished muscle mass assessed by three different methods: (i) midarm muscle circumference (MAMC) <90% of reference value (A), (ii) muscle wasting by subjective global assessment (B) and (iii) reduced skeletal muscle mass index (<10.76 kg/m² men; <6.76 kg/m² women) estimated by bioelectrical impedance analysis (BIA) (C). Patients were followed for up to 40 months for all-cause mortality, and there was no loss of follow-up. The prevalence of sarcopenia was 9.8% (A), 9.4% (B) and 5.9% (C). The kappa agreement between the methods were 0.69 (A versus B), 0.49 (A versus C) and 0.46 (B versus C). During follow-up, 51 patients (18%) died, and the frequency of sarcopenia was significantly higher among non-survivors. In crude Cox analysis, sarcopenia diagnosed by the three methods was associated with a higher hazard for mortality; however, only sarcopenia diagnosed by method C remained as a predictor of mortality after multivariate adjustment. The prevalence of sarcopenia in CKD patients on conservative therapy varies according to the method applied. Sarcopenia defined as reduced handgrip strength and low skeletal muscle mass index estimated by BIA was an independent predictor of mortality in these patients. © The Author 2015. Published by Oxford University Press on behalf of ERA

  1. Prevalence of Chronic Kidney Disease in Morbidly Obese Japanese and the Impact of Bariatric Surgery on Disease Progression.

    Science.gov (United States)

    Wakamatsu, Kotaro; Seki, Yosuke; Kasama, Kazunori; Uno, Kohei; Hashimoto, Kenkichi; Seto, Yasuyuki; Kurokawa, Yoshimochi

    2018-02-01

    The prevalence of chronic kidney disease (CKD) among Japanese morbidly obese patients undergoing bariatric surgery and the impact of bariatric surgery on their renal function has not previously been investigated. The aims were to assess the prevalence of CKD patients who underwent bariatric surgery in our institution and to elucidate the impact of bariatric surgery on their kidney function as measured by the estimated glomerular filtration rate by Cystatin-C (eGFRcys). The setting of the study was in a single private hospital. Two hundred fifty-four consecutive Japanese patients who underwent bariatric surgery were retrospectively analyzed to elucidate the prevalence of CKD. The eGFRcys was calculated to assess the change in the kidney function for 1 year after surgery. The preoperative prevalence of CKD was as follows: G1, 45.3%; G2, 47.2%; G3, 6.5%; and G4, 0.9%. The eGFRcys values before and after surgery were compared; the G1 and G2 patients showed significantly improved eGFRcys values after surgery (G1 101 [94-108] vs 114 [103-127]; G2 79 [74-84] vs 97 [87-104] ml/min/1.73 m 2 ; p surgery (44 [42-47] vs 45 [43-63] ml/min/1.73 m 2 ; p = 0.08), successful weight loss was achieved (36.1 ± 6.3 vs 26.6 ± 3.6 kg/m 2 ; p Bariatric surgery resulted in the significant improvement in the eGFRcys values of Japanese patients with morbid obesity, particularly those with pre-CKD (eGFRcys ≥ 60 ml/min/1.73 m 2 ), while the eGFRcys values of CKD patients (surgery.

  2. Investigating relations between environmental toxins in Northern Irish soils and streams and Chronic Kidney Disease prevalence

    International Nuclear Information System (INIS)

    Jackson, Chloe E.; McKinley, Jennifer M.; Ofterdinger, Ulrich; Fogarty, Damian; Atkinson, Peter M.; Palmer, Sherry

    2016-01-01

    The unknown aetiology of Chronic Kidney Disease (CKD) has attracted recent attention as a result of the increasing global prevalence and recent reviews of occupational and environmental exposure to nephrotoxins. The main focus of this research is to examine the potential relationship between environmental exposure to known nephrotoxins including arsenic, cadmium and lead and the potential health risk associated with the progressive dysfunction of the kidneys in renal impaired patients with CKD across Northern Ireland. In addition to these known nephrotoxins, co-abundance with several essential elements has been found to play a role as protecting mechanisms while others increase the uptake of nephrotoxic elements as a result of similar absorption mechanisms within the body. Key elements protecting the body from toxicity include selenium and zinc, whereas those which have been attributed to enhance the uptake of arsenic, cadmium and lead include iron and calcium. The compositional nature of the soil and stream geochemical data is explored to aid in the analysis of interactions between elements. Two approaches, one data-driven and the other knowledge-driven, are explored to investigate the associations between co-abundant elements. The bioaccessibility of these elements, which is the portion of the relevant toxin absorbed within the body, is also investigated to identify areas across Northern Ireland with an increased environmental hazard and potential health risk. The study uses a combination of datasets from the United Kingdom Renal Registry (UKRR) unknown aetiology subset, the soil and stream geochemical dataset from the Tellus Survey (GSNI) with the addition of a bioaccessibility subset. Findings suggest a relationship between the presence of elevated arsenic in stream waters and impaired renal function of the kidneys. Interactions between essential elements and potentially toxic elements could explain the regional variation of CKD of uncertain aetiology across

  3. [Chagas' disease in patients in chronic hemodialysis. Prevalence and risk of transmission by blood transfusion].

    Science.gov (United States)

    Lorca, M; Lorca, E; Atías, A; Plubins, L

    1989-06-01

    A serologic study of Chagas disease was performed in 110 patients submitted to chronic hemodialisis and blood transfusions. Immunofluorescence antibody testing (IgG and IgM) was positive in 6 out of 62 patients receiving multiple blood transfusions (9.7%), but negative in all 48 subjects without transfusions. Thus, repeated blood transfusion is a significant risk for T cruzi infection in chronic hemodialized patients.

  4. Sleep Disordered Breathing in Four Resource-Limited Settings in Peru: Prevalence, Risk Factors, and Association with Chronic Diseases.

    Science.gov (United States)

    Schwartz, Noah G; Rattner, Adi; Schwartz, Alan R; Mokhlesi, Babak; Gilman, Robert H; Bernabe-Ortiz, Antonio; Miranda, J Jaime; Checkley, William

    2015-09-01

    Sleep disordered breathing (SDB) is a highly prevalent condition in high-income countries, with major consequences for cardiopulmonary health, public safety, healthcare utilization, and mortality. However, its prevalence and effect in low- and middle-income countries are less well known. We sought to determine the prevalence, risk factors, and comorbidities of SDB symptoms in four resource-limited settings. Cross-sectional analysis of the CRONICAS Cohort, a population-based age- and sex-stratified sample. Four resource-limited settings in Peru varying in altitude, urbanization, and air pollution. There were 2,682 adults aged 35 to 92 y. Self-reported SDB symptoms (habitual snoring, observed apneas, Epworth Sleepiness Scale), sociodemographics, medical history, anthropometrics, spirometry, blood biomarkers were reported. We found a high prevalence of habitual snoring (30.2%, 95% confidence interval [CI] 28.5-32.0%), observed apneas (20.9%, 95% CI 19.4-22.5%) and excessive daytime sleepiness (18.6%, 95% CI 17.1-20.1%). SDB symptoms varied across sites; prevalence and adjusted odds for habitual snoring were greatest at sea level, whereas those for observed apneas were greatest at high altitude. In multivariable analysis, habitual snoring was associated with older age, male sex, body mass index (BMI), and higher socioeconomic status; observed apneas were associated with BMI; and excessive daytime sleepiness was associated with older age, female sex, and medium socioeconomic status. Adjusted odds of cardiovascular disease, depression, and hypertension and total chronic disease burden increased progressively with the number of SDB symptoms. A threefold increase in the odds of having an additional chronic comorbid disease (adjusted odds ratio 3.57, 95% CI 2.18-5.84) was observed in those with all three versus no SDB symptoms. Sleep disordered breathing symptoms were highly prevalent, varied widely across four resource-limited settings in Peru, and exhibited strong

  5. The importance of localized culling in stabilizing chronic wasting disease prevalence in white-tailed deer populations.

    Science.gov (United States)

    Manjerovic, Mary Beth; Green, Michelle L; Mateus-Pinilla, Nohra; Novakofski, Jan

    2014-01-01

    Strategies to contain the spread of disease often are developed with incomplete knowledge of the possible outcomes but are intended to minimize the risks associated with delaying control. Culling of game species by government agencies is one approach to control disease in wild populations but is unpopular with hunters and wildlife enthusiasts, politically unpalatable, and erodes public support for agencies responsible for wildlife management. We addressed the functional differences between hunting and government culling programs for managing chronic wasting disease (CWD) in white-tailed deer by comparing prevalence over a 10-year period in Illinois and Wisconsin. When both Illinois and Wisconsin were actively culling from 2003 - 2007, there were no statistical differences between state CWD prevalence estimates. Wisconsin government culling concluded in 2007 and average prevalence over the next five years was 3.09 ± 1.13% with an average annual increase of 0.63%. During that same time period, Illinois continued government culling and there was no change in prevalence throughout Illinois. Despite its unpopularity among hunters, localized culling is a disease management strategy that can maintain low disease prevalence while minimizing impacts on recreational deer harvest. Copyright © 2013 The Authors. Published by Elsevier B.V. All rights reserved.

  6. Prevalence of chronic obstructive pulmonary disease and its association with tobacco smoking and environmental tobacco smoke exposure among rural population.

    Science.gov (United States)

    Parasuramalu, B G; Huliraj, N; Prashanth Kumar, S P; Ramesh Masthi, N R; Srinivasa Babu, C R

    2014-01-01

    A field survey was conducted for chronic obstructive pulmonary disease (COPD) epidemiology in the rural field practice area of Kempegowda Institute of Medical Sciences, Bangalore, India, which covers a population of 44,387 to find out the prevalence of COPD in adult subjects of 35 years and above using cluster sampling technique and to determine the association of tobacco smoking, environmental tobacco smoking (ETS) exposure and type of cooking fuel used with COPD. The overall prevalence of COPD was 4.36%. The prevalence among males and females were 5.32% and 3.41% respectively. The prevalence was found to be increasing with an increase in age. The tobacco smoke and exposure to ETS was significantly associated with higher odds of COPD with adjusted odds ratio 2.97 and 2.67 respectively. Thus, there was a significant association between tobacco smoking and ETS exposure with COPD.

  7. Different prevalence and clinical characteristics of asthma-chronic obstructive pulmonary disease overlap syndrome according to accepted criteria.

    Science.gov (United States)

    Jo, Yong Suk; Lee, Jinwoo; Yoon, Ho Il; Kim, Deog Kyeom; Yoo, Chul-Gyu; Lee, Chang-Hoon

    2017-06-01

    A unified definition of asthma-chronic obstructive pulmonary disease overlap syndrome (ACOS) is not available, which makes it difficult to evaluate the prevalence and clinical features of patients with ACOS. To investigate the prevalence and clinical characteristics of ACOS according to the updated widely accepted diagnostic criteria. Participants were enrolled from a prospective cohort study conducted between April 2013 and November 2016 in South Korea. We adopted 4 criteria of ACOS: modified Spanish, American Thoracic Society (ATS) Roundtable criteria, the Latin American Project for the Investigation of Obstructive Lung Disease (PLATINO), and the Global Initiative for Asthma/Global Initiative for Chronic Obstructive Lung Disease (GINA/GOLD) criteria. The prevalence, clinical characteristics, and exacerbations of ACOS were investigated. Among 301 patients with chronic obstructive pulmonary disease, 31.3%, 11.9%, 48.3%, and 46.15% were diagnosed with ACOS according to the modified Spanish, ATS Roundtable criteria, PLATINO, and GINA/GOLD criteria, respectively. Compared with other criteria, patients with ACOS diagnosed according to the modified Spanish criteria had better exercise capacity and lung function at baseline but higher risk of moderate to severe (adjusted hazard ratio, 1.97; 95% confidence interval, 1.14-3.41; P = .01) and total (adjusted odds ratio, 2.10; 95% confidence interval, 1.33-3.31; P < .01) exacerbations during at least a 1-year follow-up period than patients without ACOS. The prevalence of ACOS varied according to the diagnostic criteria. Among the different criteria, the modified Spanish criteria could identify patients with more asthmatic features and higher risk of exacerbation. ClinicalTrials.gov Identifier: NCT02527486. Copyright © 2017 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  8. Prevalence, awareness, and treatment of anemia in Chinese patients with nondialysis chronic kidney disease: First multicenter, cross-sectional study.

    Science.gov (United States)

    Li, Ya; Shi, Hao; Wang, Wei-Ming; Peng, Ai; Jiang, Geng-Ru; Zhang, Jin-Yuan; Ni, Zhao-Hui; He, Li-Qun; Niu, Jian-Ying; Wang, Nian-Song; Mei, Chang-Lin; Xu, Xu-Dong; Guo, Zhi-Yong; Yuan, Wei-Jie; Yan, Hai-Dong; Deng, Yue-Yi; Yu, Chen; Cen, Jun; Zhang, Yun; Chen, Nan

    2016-06-01

    This was the first multicenter, cross-sectional survey to assess the prevalence of anemia, patient awareness, and treatment status in China. Data of patients with chronic kidney disease (CKD; age, 18-75 years; both out- and inpatients) from 25 hospitals in Shanghai, seeking medical treatment at the nephrology department, were collected between July 1, 2012 and August 31, 2012. The prevalence, awareness, and treatment of anemia in patients with nondialysis CKD (ND-CKD) were assessed. Anemia was defined as serum hemoglobin (Hb) levels ≤12 g/dL in women and ≤13 g/dL in men. A total of 2420 patients with ND-CKD were included. Anemia was established in 1246 (51.5%) patients: 639 (51.3%) men and 607 (48.7%) women. The prevalence of anemia increased with advancing CKD stage (χtrend = 675.14, P Anemia was more prevalent in patients with diabetic nephropathy (68.0%) than in patients with hypertensive renal damage (56.6%) or chronic glomerulonephritis (46.1%, both P anemia patients, only 7.5% received more effective and recommended intravenous supplementation. Anemia is highly prevalent in patients with ND-CKD in China, with a low target-achieving rate and poor treatment patterns. The study highlights the need to improve multiple aspects of CKD management to delay the progression of renal failure.

  9. Prevalence and impact of chronic obstructive pulmonary disease in a rural district of Uganda : FRESH AIR methodology for sub-Saharan Africa

    NARCIS (Netherlands)

    van Gemert, Frederik

    2017-01-01

    Prevalence and impact of chronic obstructive pulmonary disease in a rural district of Uganda: FRESH AIR methodology for sub-Saharan Africa Worldwide, tobacco smoking is the most common encountered risk factor for chronic obstructive pulmonary disease (COPD). However, in many low and middle-income

  10. Prevalence of chronic kidney diseases in patients with chronic obstructive pulmonary disease: assessment based on glomerular filtration rate estimated from creatinine and cystatin C levels

    Directory of Open Access Journals (Sweden)

    Yoshizawa T

    2015-07-01

    Full Text Available Takayuki Yoshizawa,1,2 Kazuyoshi Okada,3 Sachiko Furuichi,1,2 Toshihiko Ishiguro,1 Akitaka Yoshizawa,1 Toshiki Akahoshi,2 Yasuhiro Gon,2 Tsuneto Akashiba,2 Yoshifumi Hosokawa,1,2 Shu Hashimoto2 1Department of Internal Medicine, Kanamecho Hospital, Toshima-ku, 2Division of Respiratory Medicine, Department of Internal Medicine, 3Division of Nephrology, Hypertension and Endocrinology, Department of Medicine, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan Background: Cardiovascular diseases, osteoporosis, and depression are identified comorbidities of chronic obstructive pulmonary disease (COPD, but there have been few reports of chronic kidney disease (CKD as a comorbidity of COPD. The objective of this study was to investigate the prevalence of CKD in COPD patients using estimated glomerular filtration rate (eGFR based on creatinine (Cr and cystatin C (Cys levels. Methods: The prevalence of CKD and the values of various CKD-related parameters were compared between 108 stable COPD outpatients (COPD group and a non-COPD control group consisting of 73 patients aged 60 years or more without a history of COPD or kidney disease. CKD was defined as an eGFR less than 60 mL/min/1.73 m2. Results: The Cr level was significantly higher in the COPD group, but eGFR based on serum Cr (eGFRCr was not significantly different between the two groups (73.3±25.3 vs 79.7±15.5 mL/min/1.73 m2. The Cys level was significantly higher and eGFR based on serum Cys (eGFRCys was significantly lower in the COPD group (60.0±19.4 vs 74.0±13.5 mL/min/1.73 m2, P<0.0001. The prevalence of CKD evaluated based on eGFRCr was 31% in the COPD group and 8% in the non-COPD group with an odds ratio of 4.91 (95% confidence interval, 1.94–12.46, P=0.0008, whereas the evaluated prevalence based on eGFRCys was 53% in the COPD group and 15% in the non-COPD group with an odds ratio of 6.30 (95% confidence interval, 2.99–13.26, P<0.0001, demonstrating a higher prevalence of

  11. Protein-energy wasting syndrome in advanced chronic kidney disease: Prevalence and specific clinical characteristics

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    Almudena Pérez-Torres

    2018-03-01

    Full Text Available Introduction: Protein-energy wasting (PEW is associated with increased mortality and differs depending on the chronic kidney disease (CKD stage and the dialysis technique. The prevalence in non-dialysis patients is understudied and ranges from 0 to 40.8%. Objective: To evaluate the nutritional status of a group of Spanish advanced CKD patients by PEW criteria and subjective global assessment (SGA. Patients and methods: Cross-sectional study of 186 patients (101 men with a mean age of 66.1 ± 16 years. The nutritional assessment consisted of: SGA, PEW criteria, 3-day dietary records, anthropometric parameters and bioelectrical impedance vector analysis. Results: The prevalence of PEW was 30.1%, with significant differences between men and women (22.8 vs. 33.8%, p < 0.005, while 27.9% of SGA values were within the range of malnutrition. No differences were found between the 2 methods. Men had higher proteinuria, percentage of muscle mass and nutrient intake. Women had higher levels of total cholesterol, HDL and a higher body fat percentage. The characteristics of patients with PEW were low albumin levels and a low total lymphocyte count, high proteinuria, low fat and muscle mass and a high Na/K ratio.The multivariate analysis found PEW to be associated with: proteinuria (OR: 1.257; 95% CI: 1.084–1.457, p = 0.002, percentage of fat intake (OR: 0.903; 95% CI: 0.893–0.983, p = 0.008, total lymphocyte count (OR: 0.999; 95% CI: 0.998–0.999, p = 0.001 and cell mass index (OR: 0.995; 95% CI: 0.992–0.998. Conclusion: Malnutrition was identified in Spanish advanced CKD patients measured by different tools. We consider it appropriate to adapt new diagnostic elements to PEW criteria. Resumen: Introducción: El desgaste proteico energético (DPE se asocia a mayor mortalidad y difiere dependiendo del estadio de la enfermedad renal y de la técnica de diálisis. Su prevalencia en pacientes sin di

  12. About Chronic Kidney Disease

    Science.gov (United States)

    ... Advocacy Donate A to Z Health Guide About Chronic Kidney Disease Tweet Share Print Email Chronic kidney disease (CKD) ... Learn about Glomerular Filtration Rate (GFR) What is chronic kidney disease (CKD)? Chronic kidney disease includes conditions that damage ...

  13. Chronic mucus hypersecretion: prevalence and risk factors in younger individuals

    DEFF Research Database (Denmark)

    Harmsen, Lotte; Thomsen, S F; Ingebrigtsen, Truls

    2010-01-01

    Chronic mucus hypersecretion (CMH) is a common condition in patients with chronic respiratory diseases. Little is known about the incidence, prevalence and determinants of CMH in younger individuals.......Chronic mucus hypersecretion (CMH) is a common condition in patients with chronic respiratory diseases. Little is known about the incidence, prevalence and determinants of CMH in younger individuals....

  14. Prevalence of Hepatitis B core antibodies with negative Hepatitis B surface antigen in dialysis and chronic kidney disease patients

    OpenAIRE

    Nauman Tarif; Muhammad Mohsin Riaz; Omer Sabir; Rizwan Akhter; Kashif Rafique; Nabiha Rizvi

    2017-01-01

    Occult hepatitis B infection (OBI) is a potential cause of infection transmission in patients with chronic kidney disease (CKD) and dialysis-dependant patients. It is liable to be missed since the marker for OBI, hepatitis B core antibody (HBcAb), is not done routinely. We carried out a study to assess the prevalence of OBI in CKD Stage II–V or requiring renal replacement therapy. It was a cross-sectional study carried out at Fatima Memorial Hospital, Lahore, from May 2104 to May 2015. A tota...

  15. The Prevalence of Oral Inflammation Among Denture Wearing Patients with Chronic Obstructive Pulmonary Disease.

    Science.gov (United States)

    Przybyłowska, D; Rubinsztajn, R; Chazan, R; Swoboda-Kopeć, E; Kostrzewa-Janicka, J; Mierzwińska-Nastalska, E

    2015-01-01

    Oral inflammation is an important contributor to the etiology of chronic obstructive pulmonary disease, which can impact patient's health status. Previous studies indicate that people with poor oral health are at higher risk for nosocomial pneumonia. Denture wearing is one promoting factor in the development of mucosal infections. Colonization of the denture plaque by Gram-negative bacteria, Candida spp., or other respiratory pathogens, occurring locally, may be aspirated to the lungs. The studies showed that chronic obstructive pulmonary disease (COPD) patients treated with combinations of medicines with corticosteroids more frequently suffer from Candida-associated denture stomatitis. Treatment of oral candidiasis in patients with COPD constitutes a therapeutic problem. Therefore, it is essential to pay attention to the condition of oral mucosal membrane and denture hygiene habits. The guidelines for care and maintenance of dentures for COPD patients are presented in this paper. The majority of patients required improvement of their prosthetic and oral hygiene. Standard oral hygiene procedures in relation to dentures, conducted for prophylaxis of stomatitis complicated by mucosal infection among immunocompromised patients, are essential to maintain healthy oral tissues. The elimination of traumatic denture action in dental office, compliance with oral and denture hygiene, proper use and storage of prosthetic appliances in a dry environment outside the oral cavity can reduce susceptibility to infection. Proper attention to hygiene, including brushing and rinsing the mouth, may also help prevent denture stomatitis in these patients.

  16. Prevalence of secondary hyperparathyroidism in patients with stage 3 and 4 chronic kidney disease seen in internal medicine.

    Science.gov (United States)

    Bureo, Juan Carlos; Arévalo, Jose Carlos; Antón, Joaquín; Adrados, Gaspar; Jiménez Morales, Jose Luis; Robles, Nicolás Roberto

    2015-01-01

    Despite the high prevalence of chronic kidney disease in the elderly population, few data are available on the frequency of secondary hyperparathyroidism in the Spanish population affected by this problem. We undertook a study on this issue in patients attending the internal medicine departments in our area. An observational, cross-sectional survey performed at internal medicine departments on 415 patients with stage 3 and 4 chronic kidney disease. Clinical history and risk factors were collected using a standardized protocol. Serum creatinine, phosphate, calcium, intact parathormone (PTH) and 25-hydroxy-cholecalciferol (25-OH-vitD) levels were measured in all patients. Among stage 3 patients, 62.9% had PTH levels ≥70pg/mL and 32.7% levels ≥110pg/mL. Median PTH level in stage 4 patients was 120pg/mL (p Hyperparathyroidism is a common complication of stage 3 and 4 chronic kidney disease which is not associated to detectable changes in serum calcium and phosphate levels. It is therefore advisable to measure PTH levels in all patients with decreased glomerular filtration rate. Copyright © 2015 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

  17. Prevalence and correlates of self-reported chronic non-communicable diseases in Botswana: a cross-sectional study.

    Science.gov (United States)

    Letamo, Gobopamang; Keetile, Mpho; Navaneetham, Kannan; Phatsimo, Mpho

    2017-01-01

    The purpose of this paper is to estimate the prevalence of self-reported chronic non-communicable diseases and their correlates in Botswana. This is a nationally representative, cross-sectional survey. This is a cross-sectional study of respondents aged 10-64 years using data from the Botswana AIDS Impact Survey IV conducted in 2013. Three self-reported non-communicable diseases, namely, hypertension, diabetes and asthma were used. Multivariate logistic regression models were used to identify their correlates. Out of the 2153 participants, the prevalence rates of hypertension, diabetes and asthma were 14.2%, 3.3% and 5.3%, respectively. The study found that among other factors, older populations are at a much higher risk of having more than one non-communicable disease. After controlling for other covariates, the ORs of self-reported non-communicable disease was highest among older respondents aged 50 years and over (AOR=12.01, pnon-communicable diseases are likely to increase in the future due to the rise in the old age population resulting from fertility transition and improvement in life expectancy in Botswana. Therefore urgent and holistic intervention programmes are required to halt the problem. Failure to act now is likely to result in high morbidity and mortality. © The Author 2016. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  18. PREVALENCE OF CARDIOVASCULAR RISK AND PHYSICAL ACTIVITY LEVEL IN PATIENTS WITH CHRONIC RENAL DISEASE IN HEMODIALITIC TREATMENT

    Directory of Open Access Journals (Sweden)

    Danilo Rocha Santos Caracas

    2017-07-01

    Full Text Available Chronic kidney disease is a health problem that has reached more and more individuals due to the aging and increase of diseases such as hypertension and diabetes mellitus. The presence of chronic uremic syndrome along with aggravating factors such as sedentary lifestyle is directly associated with a high risk of developing cardiovascular diseases. This study aimed to describe the prevalence of cardiovascular risk and determine the levels of regular physical activity in patients on hemodialysis. Cross-sectional analytical study with quantitative approach. A sociodemographic and anamnestic questionnaire was applied, followed by cardiovascular risk assessment using the Framingham scale; Of weekly energy expenditure related to daily activities, using the International Physical Activity Questionnaire. The sample consisted of 113 individuals with a mean age of 54.13 years, the predominant male gender being 50.4%. 86.7% presented a moderate to high cardiovascular risk classification and 46% were classified as sedentary. From the analyzed data the present research obtained statistically significant value for the variables sedentarism x cardiovascular risk, time of hemodialysis x cardiovascular risk. It is concluded that patients are at risk of developing cardiovascular diseases, associated with sedentary lifestyle and the time the patient is exposed to dialysis.

  19. Chronic kidney disease

    Science.gov (United States)

    Kidney failure - chronic; Renal failure - chronic; Chronic renal insufficiency; Chronic kidney failure; Chronic renal failure ... that you do not have symptoms until your kidneys have almost ... end-stage renal disease (ESRD). At this stage, the kidneys are ...

  20. Chronic obstructive pulmonary disease

    Science.gov (United States)

    COPD; Chronic obstructive airways disease; Chronic obstructive lung disease; Chronic bronchitis; Emphysema; Bronchitis - chronic ... The best test for COPD is a lung function test called spirometry . ... into a small machine that tests lung capacity. The results can ...

  1. Prevalence of diet-related risk factors for chronic disease in male prisoners in a high secure prison.

    Science.gov (United States)

    Hannan-Jones, M; Capra, S

    2016-02-01

    Research on prisoners is limited and demonstrates a group with disproportionate numbers from disadvantaged backgrounds, known to have a high burden of disease, much of which is diet related. The aim of this study was to gauge the presence of markers of chronic disease, as a basis for food and nutrition policy in prisons. A cross-sectional study design was used with a convenience sample of prisoners in a male 945 bed high secure facility. Face-to-face interviews with physical measures of height, weight, body fat, waist circumference and blood pressure were collected along with fasting bloods. Data were confirmed with facility records, observations and staff interviews. Full ethics approval was obtained. Results were compared with studies of Australian prisoners and the general population. The mean age was 35.5 years (n=120). Prevalence rates were as follows: obesity 14%, diabetes 5%, hypertension 26.7% and smoking 55.8%. Self-report of daily physical activity was 84%, with 51% participating ⩾2 times daily. Standard food provision was consistent with dietary recommendations, except that sodium was high. Where fasting bloods were obtained (n=78), dyslipidaemia was 56.4% with the metabolic syndrome (MS) present in 26%. Prevalence of diabetes and heart disease risk appear similar to the general population; however, obesity was lower and smoking higher. The data provide evidence that markers of chronic disease are present, with this the first study to describe the MS in prisoners. Food and nutrition policy in this setting is complex and should address the duty of care issues that exist.

  2. Prevalence and severity of pain in adult end-stage renal disease patients on chronic intermittent hemodialysis: a systematic review

    Directory of Open Access Journals (Sweden)

    Brkovic T

    2016-06-01

    Full Text Available Tonci Brkovic,1 Eliana Burilovic,2 Livia Puljak3 1Department of Internal Medicine, Division of Nephrology, 2Department of Psychiatry, University Hospital Split, 3Department of Anatomy, Histology and Embryology, Laboratory for Pain Research, University of Split School of Medicine, Split, Croatia Objectives: Understanding the epidemiology of pain in patients on hemodialysis (HD is crucial for further improvement in managing pain. The aim of this study was to systematically review available evidence on the prevalence and severity of pain in adult end-stage renal disease patients on chronic intermittent HD. Materials and methods: We carried out a systematic review of the literature and developed a comprehensive search strategy based on search terms on pain and HD. We searched the databases MEDLINE, Scopus, PsycINFO, and CINAHL from the earliest date of each database to July 24, 2014. Manuscripts in all languages were taken into consideration. Two authors performed each step independently, and all disagreements were resolved after discussion with the third author. The quality of studies was estimated using the STROBE checklist and Cochrane risk-of-bias tool.Results: We included 52 studies with 6,917 participants. The prevalence of acute and chronic pain in HD patients was up to 82% and 92%, respectively. A considerable number of patients suffered from severe pain. Various locations and causes of pain were described, with most of the studies reporting pain in general, pain related to arteriovenous access, headache, and musculoskeletal pain.Conclusion: The findings of this systematic review indicate high prevalence of pain in HD patients and considerable gaps and limitations in the available evidence. Pain in this population should be recognized as a considerable health concern, and the nephrology community should promote pain management in HD patients as a clinical and research priority to improve patients’ quality of life and pain

  3. Prevalence of Baseline Chronic Kidney Disease in Patients Presenting with Solid Renal Tumors

    Science.gov (United States)

    Canter, Daniel; Kutikov, Alexander; Sirohi, Mohit; Street, Ryan; Viterbo, Rosalia; Chen, David YT; Greenberg, Richard E.; Uzzo, Robert G.

    2011-01-01

    Objectives Serum creatinine (sCr) inadequately reflects renal function. Estimated glomerular filtration rate (eGFR) and CKD stage are more clinically relevant parameters to reflect the risk of morbidity and mortality in patients following nephron loss. Comparing sCr and eGFR, we evaluated the prevalence of baseline CKD in a large cohort of patients presenting with renal masses to a tertiary care center. Methods Using the prospectively maintained Fox Chase Kidney Cancer Database, we identified patients undergoing kidney surgery between 1/2000– 5/2010. eGFR was calculated using the Modification of Diet in Renal Disease (MDRD) and the CKDEpidemiology formulas. CKD stages I–V were defined using the National Kidney Foundation definitions. Results 1114 patients had adequate data available to calculate a preoperative eGFR (ml/min). Although 88% of all patients presenting for surgery at our institution had a “normal” baseline sCr (≤1.4 mg/dl), 22% of patients had CKD Stage III or greater. Moreover, of the 282 patients 70 years and older, 40% (113/282) had CKD stage III. 23% (51/220) of patients older than 70 years had a CKD stage III with a seemingly normal sCr. Conclusions Many patients with a normal sCr have CKD III or higher, particularly patients older 70 years old. Given the high prevalence of baseline CKD in patients with a solid renal tumor, a concerted effort must be made to preserve renal function when surgically treating solid renal masses. PMID:21316090

  4. Overview of the prevalence, impact, and management of depression and anxiety in chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Panagioti M

    2014-11-01

    Full Text Available Maria Panagioti,1 Charlotte Scott,1 Amy Blakemore,1,2 Peter A Coventry31National Institute for Health Research School for Primary Care Research, Centre for Primary Care, Institute of Population Health, Manchester Academic Health Science Centre, University of Manchester, 2Department of Psychiatry, Manchester Mental Health and Social Care Trust, Manchester Royal Infirmary, 3National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care – Greater Manchester and Manchester Academic Health Science Centre, University of Manchester, Manchester, UKAbstract: More than one third of individuals with chronic obstructive pulmonary disease (COPD experience comorbid symptoms of depression and anxiety. This review aims to provide an overview of the burden of depression and anxiety in those with COPD and to outline the contemporary advances and challenges in the management of depression and anxiety in COPD. Symptoms of depression and anxiety in COPD lead to worse health outcomes, including impaired health-related quality of life and increased mortality risk. Depression and anxiety also increase health care utilization rates and costs. Although the quality of the data varies considerably, the cumulative evidence shows that complex interventions consisting of pulmonary rehabilitation interventions with or without psychological components improve symptoms of depression and anxiety in COPD. Cognitive behavioral therapy is also an effective intervention for managing depression in COPD, but treatment effects are small. Cognitive behavioral therapy could potentially lead to greater benefits in depression and anxiety in people with COPD if embedded in multidisciplinary collaborative care frameworks, but this hypothesis has not yet been empirically assessed. Mindfulness-based treatments are an alternative option for the management of depression and anxiety in people with long-term conditions, but their efficacy is unproven in

  5. Clinical characteristics and prevalence of complications of chronic kidney disease in children: the Taiwan Pediatric Renal Collaborative study.

    Science.gov (United States)

    Chou, Hsin-Hsu; Lin, Ching-Yuang; Chiou, Yee-Hsuan; Tain, You-Lin; Wang, Yi-Fan; Wang, Hsin-Hui; Chiou, Yuan-Yow

    2016-07-01

    Little information is available regarding the clinical characteristics and prevalence of complications in children with chronic kidney disease (CKD), especially in early disease stages. The objective of this study was to determine the clinical characteristics and prevalence of complications in children with predialytic CKD. This multicenter, cross-sectional study enrolled children at all stages of predialytic CKD. Children who were between the ages of 1 year and 18 years and who fulfilled the clinical criteria of CKD were included in the study. Baseline demographic data, previous history, clinical characteristics, and laboratory data were collected. A total of 757 children were included in the study. The median age at the time of enrollment was 10.6 years; 397 patients (52.4 %) were males. A total of 39.0 % of the patients were in CKD stage 1, 37.6 % were in stage 2, 14.8 % were in stage 3, 3.0 % were in stage 4, and 5.5 % were in stage 5. Nonglomerular renal diseases were the primary cause of CKD, comprising 51.9 % of the patients with CKD. The age at disease onset, gender, CKD stage distribution, and proportion of co-morbidities varied between the glomerular and nonglomerular CKD cases. Anemia, hyperlipidemia, hypocalcemia, and hyperphosphatemia were more prevalent in patients with glomerular CKD. The overall prevalence of complications was as follows: uncontrolled blood pressure, 44.1 %; anemia, 34.2 %; hyperlipidemia, 44.9 %; short stature, 10.3 %; and failure to thrive, 8.2 %. Uncontrolled blood pressure (BP), anemia, and hyperlipidemia were common, even in the early CKD stages. The prevalence of CKD complications generally increased with the worsening stage of CKD. This study reveals differences in CKD etiology and prevalence of specific complications according to the stage of CKD. Early recognition and awareness of complications are mandatory for clinicians during the follow-up visits of children with CKD.

  6. Prevalence of allergic rhinitis and asthma in patients with chronic rhinosinusitis and gastroesophageal reflux disease.

    Science.gov (United States)

    Mahdavinia, Mahboobeh; Bishehsari, Faraz; Hayat, Waqas; Codispoti, Christopher D; Sarrafi, Shahram; Husain, Inna; Mehta, Arpita; Benhammuda, Mohamed; Tobin, Mary C; Bandi, Sindhura; LoSavio, Philip S; Jeffe, Jill S; Palmisano, Erica L; Schleimer, Robert P; Batra, Pete S

    2016-08-01

    An association between chronic rhinosinusitis (CRS) and gastroesophageal reflux disease (GERD) has been previously reported; however, the underlying factors linking CRS and GERD remain to be elucidated. To assess the association of GERD and CRS using prospective and retrospective approaches. The retrospective study comprised a large cohort of CRS cases, whereas the prospective arm evaluated a series of CRS cases and controls. In the retrospective arm of the study, of the 1066 patients with CRS, 112 (10.5%) had GERD. Among patients with CRS, GERD was associated with higher body mass index, older age, and female sex. The odds ratios (ORs) for asthma and allergic rhinitis in the CRS group with GERD compared with the CRS group without GERD were 2.89 (95% confidence interval [CI], 1.905-4.389) and 2.021 (95% CI, 1.035-3.947). Furthermore, GERD was associated with a greater duration of CRS. Ninety patients with CRS and 81 controls were enrolled in the prospective arm of the study. In the CRS group, GERD was associated with asthma (OR, 4.77; 95% CI, 1.27-18.01). Patients with CRS and GERD had a longer duration and a younger age at onset of CRS. In controls, no association was found between GERD and asthma (OR, 0.67; 95% CI, 0.09-5.19) or allergic rhinitis (OR, 0.35; 95% CI, 0.05-2.59). Patients with CRS and GERD are more likely to have atopic conditions and asthma when compared with patients with CRS but without GERD. One of the potential explanations of this link is that comorbid GERD and atopic disease are potential risk factors for development of CRS. Copyright © 2016 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  7. Prevalence of chronic kidney disease in newly diagnosed patients with Human immunodeficiency virus in Ilorin, Nigeria.

    Science.gov (United States)

    Ayokunle, Dada Samuel; Olusegun, Olanrewaju Timothy; Ademola, Aderibigbe; Adindu, Chijioke; Olaitan, Rafiu Mojeed; Oladimeji, Ajayi Akande

    2015-01-01

    Human immunodeficiency virus (HIV) the causative agent of Acquired immunodeficiency syndrome (AIDS) is an important cause of renal diseases in sub-Saharan Africa. There is paucity of studies on the burden of chronic kidney disease (CKD) among patients with HIV/AIDS in the North-Central zone of Nigeria. This is a cross-sectional study of 227 newly-diagnosed, antiretroviral naïve patients with HIV/AIDS seen at the HIV clinic of the Medical Out-patient Department (MOPD) of University of Ilorin Teaching Hospital (UITH). They were matched with 108 control group. Laboratory investigations were performed for the participants. CKD was defined as estimated glomerular filtration rate (eGFR) 30 mg/g. There were 100 (44%) males among the patients and 47 (43.5%) among the control group. The mean ages of the patients and controls were 40.3 ± 10.3 years and 41.8 ± 9.5 years respectively. CKD was observed in 108 (47.6%) among the patients and 18 (16.7%) of the controls (p = 0.01). The median CD4 T-cell count was significantly lower in patients with CKD. Ninety-three (41.0%) of the patients had dipstick proteinuria of > 2 +. The median albumin creatinine ratio (ACR) was significantly higher among the HIV-positive patients (272.3 mg/g) compared with the HIV-negative controls (27.22 mg/g) p = 0.01. The CD4 T-cell count correlates positively with eGFR (r = 0.463, p = 0.001) and negatively with ACR (r = -0.806, p = 0.001). CKD is very common among patients with HIV/AIDS in Ilorin. Screening and early intervention for CKD should be part of the protocols in the management of these patients.

  8. Prevalence of osteoporosis and osteopenia in advanced chronic obstructive pulmonary disease patients

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    Parthasarathi Bhattacharyya

    2011-01-01

    Full Text Available Background: Reduction of bone mineral density (BMD is a known and established phenomenon in chronic obstructive pulmonary disease (COPD. However, there have been no data regarding osteoporosis/osteopenia in COPD patients in India. Aim: To look for the degree and frequency of osteoporosis/osteopenia in our OPD patients being diagnosed as COPD. Materials and Methods: Thirty-seven randomly selected patients with COPD were assessed for BMD with commercially available ultrasound bone densitometer (HOLOGIC SAHARA in a pulmonary OPD. Some cofactors for reduced BMD were also noted. Results: Out of the 37 COPD (all belonging to the GOLD III/IV category patients studied, the BMD was found to be normal in 10 (27% patients, while 27 (73% patients were found to have osteopenia/osteoporosis [19 (51.35% and 8 (21.62% patients having osteopenia and osteoporosis, respectively]. Conclusion: Frequency of osteoporosis and osteopenia was found to be very high (73% in our population of advanced COPD. The data suggest a need for further in-depth study regarding the issue.

  9. TV Viewing in 60,202 Adults From the National Brazilian Health Survey: Prevalence, Correlates, and Associations With Chronic Diseases.

    Science.gov (United States)

    Werneck, André O; Cyrino, Edilson S; Collings, Paul J; Ronque, Enio R V; Szwarcwald, Célia L; Sardinha, Luís B; Silva, Danilo R

    2018-03-15

    This study describes the levels and patterns of television (TV) viewing in Brazilian adults and investigates associations of TV viewing with hypertension, type 2 diabetes, and heart disease. Data from the Brazilian Health Survey, a nationally representative survey that was conducted in 2013 (N = 60,202 men and women aged ≥18 y), were used. Information regarding TV viewing, physician diagnoses of type 2 diabetes, hypertension, and heart disease was collected via interview-administered questionnaire. Data on covariables (including chronological age, educational status, skin color, sodium consumption, sugar consumption, tobacco smoking, alcohol consumption, and leisure-time physical activity) were also self-reported. Logistic regression models and population attributable fractions were used for the etiological analyses. The prevalence (95% confidence interval) of >4 hours per day of TV viewing was 12.7% (12.0-13.4) in men and 17.5% (16.8-18.3) in women. Men and women being younger or older, moderately educated, living alone, smoking tobacco, and drinking alcohol were associated with higher reported TV viewing time. Odds ratios (95% confidence interval) revealed that >4 hours per day of TV viewing was associated with type 2 diabetes [male: 1.64 (1.23-2.17) and female: 1.33 (1.09-1.63)], hypertension [male: 1.36 (1.14-1.63) and female: 1.20 (1.05-1.37)], and heart disease [male: 1.96 (1.43-2.69) and female: 1.30 (1.00-1.68)]. Exceeding 4 hours per day of TV viewing was responsible for 6.8% of type 2 diabetes, 3.7% of hypertension, and 7.5% of heart disease cases. Independent of covariates, >4 hours per day of TV viewing was associated with type 2 diabetes, hypertension, and heart disease. High volumes of TV viewing are prevalent and appear to contribute to chronic disease burden.

  10. Sarcopenia in patients with chronic kidney disease not yet on dialysis: Analysis of the prevalence and associated factors

    Science.gov (United States)

    Oliveira, Dílmerson; Barbosa, Sérgio Ribeiro; Corrêa, José Otávio do Amaral; Colugnati, Fernando Antônio Basile; Mansur, Henrique Novais; Fernandes, Natália Maria da Silva; Bastos, Marcus Gomes

    2017-01-01

    Introduction Sarcopenia is a chronic condition that is associated with aging and characterized by a reduction of muscle mass, strength, and function. Sarcopenia is prevalent in patients with chronic kidney disease (CKD) and associated with increased morbidity and mortality, as well as cardiovascular complications. Objectives To investigate the prevalence of sarcopenia in patients with CKD not yet on dialysis and its correlation with clinical and laboratory variables and inflammatory markers. Methods A total of 100 patients of both sexes aged over 18 were evaluated. Sarcopenia was defined using the criteria of the European Working Group on Sarcopenia in Older People (EWGSOP) and of the Foundation for the National Institutes of Health (FNIH) Sarcopenia Project. Sociodemographic and clinical data, activities of daily living, functional capacity, and physical activity were also evaluated. Inflammation was assessed by the serum levels of high-sensitivity C-reactive protein (hsCRP) and interleukin (IL) 4 and 6. Results The prevalence of sarcopenia was 11.9% and 28.7% using the EWGSOP and FNIH criteria, respectively. Sarcopenia was more prevalent in the more advanced stages of CKD (34.5% in stages 2 and 3A; and 65.5% in stages 3B, 4, and 5) and associated with worse performance in activities of daily living (p = 0.049), lower walking speeds (p sarcopenia had lower functional capacity (p = 0.012) and higher prevalence of physical inactivity (p = 0.041) compared with patients without sarcopenia. After adjustment for confounding variables, sarcopenia was still significantly correlated with walking speed (p = 0.004) and BMI (p = 0.002). HsCRP levels were inversely correlated with appendicular lean mass adjusted for BMI (p = 0.007) and were also positively associated with BMI (p = 0.001). IL4 levels were positively correlated with walking speed (p = 0.007) and lean mass in the lower limbs (p = 0.022). Conclusions Sarcopenia is common in patients with CKD, particularly in the

  11. Prevalence of depressive symptoms among patients with a chronic nonspecific lung disease in five ethnic minority groups.

    Science.gov (United States)

    Perini, Wilco; Snijder, Marieke B; Schene, Aart H; Kunst, Anton E

    2015-01-01

    Earlier studies found chronic nonspecific lung disease (CNSLD) to be associated with depressive symptoms. We aimed to assess whether the association between CNSLD and depressive symptoms varies between ethnic groups. We used questionnaire data from 10916 participants of the HELIUS study in Amsterdam from six different ethnic groups. We applied logistic regression analysis to determine the association between CNSLD and depressive symptoms and interaction terms to test whether this association varied between ethnic groups. CNSLD prevalence was higher among South-Asian Surinamese, Turkish and Moroccans (10.1% to 12.5%) than African Surinamese, Dutch and Ghanaians (4.8% to 6.3%). The prevalence of depressive symptoms was higher among participants with CNSLD (28.4% vs. 13.7%). This association was not significantly different between ethnic groups. The absolute prevalence of depressive symptoms was higher among the CNSLD patients from ethnic minority groups (19.2 % to 35.6%) as compared with the Dutch-origin majority group (11.2%). CNSLD is associated with a high risk of depressive symptoms, especially among the five ethnic minority groups. These results imply a need to monitor the mental health of CNSLD patients in particular when a patient is from an ethnic minority group. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Prevalence of chronic kidney disease of non-traditional causes in patients on hemodialysis in southwest Guatemala.

    Science.gov (United States)

    Laux, Timothy S; Barnoya, Joaquin; Cipriano, Ever; Herrera, Erick; Lopez, Noemi; Polo, Vicente Sanchez; Rothstein, Marcos

    2016-04-01

    Objective To document the prevalence of patients on hemodialysis in southwestern Guatemala who have chronic kidney disease (CKD) of non-traditional causes (CKDnt). Methods This cross-sectional descriptive study interviewed patients on hemodialysis at the Instituto Guatemalteco de Seguridad Social on their health and occupational history. Laboratory serum, urine and vital sign data at the initiation of hemodialysis were obtained from chart reviews. Patients were classified according to whether they had hypertension or obesity or neither. The proportion of patients with and without these traditional CKD risk factors was recorded and the association between demographic and occupational factors and a lack of traditional CKD risk factors analyzed using multivariate logistic regression. Results Of 242 total patients (including 171 non-diabetics) enrolled in hemodialysis in southwestern Guatemala, 45 (18.6% of total patients and 26.3% of non-diabetics) lacked traditional CKD risk factors. While agricultural work history was common, only travel time greater than 30 minutes and age less than 50 years old were significantly associated with CKD in the absence of traditional risk factors. Individuals without such risk factors lived throughout southwestern Guatemala's five departments. Conclusions The prevalence of CKDnT appears to be much lower in this sample of patients receiving hemodialysis in Southwestern Guatemala than in hospitalized patients in El Salvador. It has yet to be determined whether the prevalence is higher in the general population and in patients on peritoneal dialysis.

  13. Prevalence of chronic obstructive pulmonary disease in independent community-dwelling older adults: The Fujiwara-kyo study.

    Science.gov (United States)

    Yoshikawa, Masanori; Yamamoto, Yoshifumi; Tomoda, Koichi; Fujita, Yukio; Yamauchi, Motoo; Osa, Takao; Uyama, Hiroki; Okamoto, Nozomi; Kurumatani, Norio; Kimura, Hiroshi

    2017-12-01

    As the Japanese population ages, the number of older patients with chronic obstructive pulmonary disease (COPD) is expected to increase, but the prevalence of COPD in patients aged ≥80 years remains unclear. The purpose of the present study was to determine the prevalence of COPD in independent community-dwelling older adults aged ≥80 years. We investigated the prevalence of COPD in 2862 independent community-dwelling older adults (1504 men, 1358 women, mean age 77.7 ± 7.0 years) who underwent spirometry in the Fujiwara-kyo study, a study of successful aging in older adults. Those participants with airflow limitation (forced expiratory volume in 1 s/forced vital capacity dwelling older adults aged ≥80 years. However, the benefits of the spirometric screening and treatment for these patients needs to be determined. Geriatr Gerontol Int 2017; 17: 2421-2426. © 2017 Japan Geriatrics Society.

  14. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013

    DEFF Research Database (Denmark)

    Vos, Theo; Barber, Ryan M.; Bell, Brad

    2015-01-01

    for acute and chronic diseases and injuries for 188 countries between 1990 and 2013. Methods Estimates were calculated for disease and injury incidence, prevalence, and YLDs using GBD 2010 methods with some important refinements. Results for incidence of acute disorders and prevalence of chronic disorders......, with the notable exception of tooth pain due to permanent caries with more than 200 million incident cases in 2013. Conversely, leading chronic sequelae were largely attributable to non-communicable diseases, with prevalence estimates for asymptomatic permanent caries and tension-type headache of 2·4 billion and 1...... the age-standardised rate decreased little from 114·87 per 1000 people to 110·31 per 1000 people between 1990 and 2013. Leading causes of YLDs included low back pain and major depressive disorder among the top ten causes of YLDs in every country. YLD rates per person, by major cause groups, indicated...

  15. Racial and Ethnic Disparities in Preventable Hospitalizations for Chronic Disease: Prevalence and Risk Factors.

    Science.gov (United States)

    Doshi, Riddhi P; Aseltine, Robert H; Sabina, Alyse B; Graham, Garth N

    2017-12-01

    Hospitalizations due to ambulatory care sensitive conditions (ACSCs) result in high morbidity and economic burden on the American healthcare system. Admissions due to chronic ACSCs, in particular, cost the American healthcare system over 30 billion dollars annually. This paper presents the current research on racial and ethnic disparities in the burden of hospitalizations due to chronic ACSCs. For this narrative review, we evaluated over 800 abstracts from MEDLINE and Google Scholar and cited 62 articles. Since 1998, racial and ethnic disparities in hospitalizations from chronic ACSCs have increased resulting in over 430,000 excess hospitalizations among non-Hispanic Blacks compared to non-Hispanic Whites. Racial disparities in chronic ACSCs hospitalizations are pervasive in the USA. There is need for more research on the pathways through which an individual's race modifies the risk for hospitalizations due to chronic ACSCs.

  16. Prevalence, clinical predictors, and prognostic impact of chronic renal insufficiency in very old Chinese patients with coronary artery disease.

    Science.gov (United States)

    Fu, Shihui; Yi, Shuangyan; Zhu, Bing; Liu, Yuan; Wang, Liang; Bai, Yongyi; Ye, Ping; Luo, Leiming

    2013-08-01

    An aging population leads to the increased prevalence of coronary artery disease (CAD) and chronic renal insufficiency (CRI). Nevertheless, the prevalence, clinical predictors, and prognostic impact of CRI in very old Chinese patients with CAD are unclear. Baseline characteristics were obtained from 1,050 old patients with CAD. The endpoint was all-cause mortality during the mean follow-up period of 417 days. The median age of the subjects was 86 years (range 60-104 years). CRI was present in 372 patients (35.4%). Age [hazard ratio (HR) 1.032, 95% confidence interval (95% CI) 1.010-1.054], chronic heart failure (CHF) (HR 2.361, 95% CI 1.747-3.191), hypertension (HR 1.878, 95% CI 1.291-2.731), hemoglobin (HR 0.973, 95% CI 0.965-0.981), serum albumin (HR 0.954, 95% CI 0.912-0.995), HDL-C (HR 0.371, 95% CI 0.238-0.580), and LDL-C levels (HR 0.795, 95% CI 0.656-0.965) were independent predictors of CRI (all P acute myocardial infarction (AMI; HR 1.795, 95% CI 1.239-2.602), CHF New York Heart Association class IV (HR 1.691, 95% CI 1.187-2.410), heart rate (HR 1.019, 95% CI 1.011-1.026), hemoglobin (HR 0.982, 95% CI 0.975-0.990), and serum albumin levels (HR 0.905, 95% CI 0.874-0.938) were also independently related to mortality in CAD patients (all P < 0.05). A high prevalence of CRI with a high associated mortality rate existed in very old Chinese patients with CAD. CRI was an independent risk factor of adverse prognosis for these patients, and multiple predictors could be used to identify CAD patients at increased risk for CRI or poor survival.

  17. Chronic renal disease is more prevalent in patients with hemolytic uremic syndrome who had a positive history of diarrhea.

    Science.gov (United States)

    Sharma, Ajay P; Filler, Guido; Dwight, Prabo; Clark, William F

    2010-09-01

    Many uncontrolled studies and a subsequent meta-analysis suggest that hemolytic uremic syndrome (HUS) with a positive history for diarrhea is associated with a significant increase in chronic renal disease. Two recent controlled studies that followed children with this type of HUS after Escherichia coli O157:H7 outbreaks, and where the controls were selected from a group exposed in the outbreak, gave conflicting results. To clarify this apparent difference, we retrospectively compared a cohort of 30 children with sporadic diarrhea-positive HUS with 30 healthy controls who had no history of bloody diarrhea or HUS and who had similar age and gender. Significantly more children with previous HUS than the controls had albuminuria over a median follow-up of 6.2 years. Of these albuminuric patients, one-third had macroalbuminuria compared with none of the controls. Following HUS, children were three times more prone to hypertension and prehypertension, although the difference was not statistically significant. Glomerular filtration rates, estimated by cystatin C, were significantly lower by 30 ml/min/1.73 m(2). Thus, children with sporadic HUS with positive history of diarrhea compared with unexposed controls had a higher prevalence of chronic renal disease; results consistent with the meta-analysis. Prospective studies with appropriate controls are needed to completely resolve this issue.

  18. Chronic kidney disease prevalence in Rivas, Nicaragua: use of a field device for creatinine measurement.

    Science.gov (United States)

    Minnings, Kailey; Kerns, Eric; Fiore, Melissa; Fiore, Madeline; Parekh, Rulan S; DuBois, Jeff; Isbell, T Scott; Ferguson, Ryan; Fiore, Louis

    2015-04-01

    An epidemic of chronic kidney disease (CKD) has been identified in Pacific coastal regions of Central America, and screening in the field in these low income countries remains logistically problematic. We tested the performance characteristics of a point of care creatinine analyzer compared to standardized serum creatinine measurements. Measurements were conducted in 100 persons from a local health center (n=34) and hospital (n=66) in Rivas, Nicaragua using both a point-of-care analyzer (StatSensor Xpress, Nova Biomedical) and serum creatinine by Jaffe kinetic method with a Roche Cobas Integra 400 analyzer. Percent coefficient of variation, sensitivity and specificity of the StatSensor Xpress were determined. The average coefficient of variation (CV) was 1.28% for the serum creatinine and CV for the StatSensor Xpress analyzer was 6.8%. The median intra-individual creatinine results obtained with the StatSensor Xpress device were 0.32 mg/dL higher than those by serum creatinine by Jaffe kinetic method. The sensitivity and specificity of the StatSensor Xpress device for identifying subjects with abnormal creatinine (defined as >1.2 mg/dL) was 100% and 79%, respectively. Point of care testing for creatinine demonstrated acceptable repeatability, excellent sensitivity (100%) and modest specificity (79%). Using the point of care testing will allow for generalized screening in the field in low income countries; however, confirmation for elevated levels >1.2 mg/dL will require a second laboratory test confirmation. Copyright © 2015 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  19. Prevalence and determinants of chronic obstructive pulmonary disease among a sample of adult smokers in Baghdad, Iraq, 2014.

    Science.gov (United States)

    Al Lami, Faris; Salim, Zainab

    2017-03-30

    This cross-sectional study was conducted to estimate the prevalence and identify determinants of chronic obstructive pulmonary disease (COPD) among a convenience sample of 325 adult smokers in Baghdad, Iraq, 2014. Beside demographic variables, participants had Lung Function Questionnaire to assess respiratory symptoms; individuals with a score of ≤18 had a spirometry examination. Those with FEV1/FVC ratio spirometry; those with FEV1/FVC% of 55 (OR=2.14, 95% confidence interval = 1.04-4.39), and pack year smoking >40 (OR =5.37, 95% confidence interval = 1.70-16.91) were the significant independent determinants. All adult smokers should have a spirometry testing and counseled to stop smoking.

  20. CHRONIC KIDNEY DISEASE IN ADULTS WITH THE METABOLIC SYNDROME IN BENIN CITY: PREVALENCE AND CORRELATES.

    Directory of Open Access Journals (Sweden)

    Oghenekaro Egbi

    2012-06-01

    In conclusion, CKD is prevalent in patients with the metabolic syndrome and may be due to a synergistic effect of the various components of the syndrome. Diastolic blood pressure and obesity may predict CKD in MetS patients. Albuminuria may also be prevalent in MetS patients; increasing with increasing number of MetS traits.

  1. Chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    V K Vijayan

    2013-01-01

    Full Text Available The global prevalence of physiologically defined chronic obstructive pulmonary disease (COPD in adults aged >40 yr is approximately 9-10 per cent. Recently, the Indian Study on Epidemiology of Asthma, Respiratory Symptoms and Chronic Bronchitis in Adults had shown that the overall prevalence of chronic bronchitis in adults >35 yr is 3.49 per cent. The development of COPD is multifactorial and the risk factors of COPD include genetic and environmental factors. Pathological changes in COPD are observed in central airways, small airways and alveolar space. The proposed pathogenesis of COPD includes proteinase-antiproteinase hypothesis, immunological mechanisms, oxidant-antioxidant balance, systemic inflammation, apoptosis and ineffective repair. Airflow limitation in COPD is defined as a postbronchodilator FEV1 (forced expiratory volume in 1 sec to FVC (forced vital capacity ratio <0.70. COPD is characterized by an accelerated decline in FEV1. Co morbidities associated with COPD are cardiovascular disorders (coronary artery disease and chronic heart failure, hypertension, metabolic diseases (diabetes mellitus, metabolic syndrome and obesity, bone disease (osteoporosis and osteopenia, stroke, lung cancer, cachexia, skeletal muscle weakness, anaemia, depression and cognitive decline. The assessment of COPD is required to determine the severity of the disease, its impact on the health status and the risk of future events (e.g., exacerbations, hospital admissions or death and this is essential to guide therapy. COPD is treated with inhaled bronchodilators, inhaled corticosteroids, oral theophylline and oral phosphodiesterase-4 inhibitor. Non pharmacological treatment of COPD includes smoking cessation, pulmonary rehabilitation and nutritional support. Lung volume reduction surgery and lung transplantation are advised in selected severe patients. Global strategy for the diagnosis, management and prevention of Chronic Obstructive Pulmonary Disease

  2. Occult hepatitis B infection in Portuguese patients with chronic hepatitis C liver disease: prevalence and clinical significance.

    Science.gov (United States)

    Cardoso, Claudia; Alves, Ana L; Augusto, Fátima; Freire, Ricardo; Quintana, Carlos; Gonçalves, Matilde; Oliveira, Ana P

    2013-02-01

    Occult hepatitis B virus (HBV) infection, defined as the presence of HBV DNA in the liver (with detectable or undetectable HBV DNA in the serum), has been reported in patients with chronic hepatitis C. Some data suggest its association with a more severe liver disease and a worse response to interferon therapy in this subgroup of patients. However, the clinical significance of this condition is still under debate. To determine the prevalence of occult HBV infection and its clinical significance in patients with chronic hepatitis C liver disease. A prospective analysis of consecutive outpatients with chronic hepatitis C who underwent a liver biopsy recruited between January 2008 and June 2011 was carried out. Data included patient's sex and age, source of hepatitis C virus (HCV) infection, HCV genotype and viral load, presence of serologic markers of previous HBV infection, HBV DNA presence in the liver, histologic findings, and response to interferon and ribavirin treatment. HBV DNA and HCV RNA detection were carried out using a sensitive commercially available PCR kit. HBV DNA was tested in liver samples using a nested PCR procedure. One hundred patients were included, 73% men, mean age 49 ± 11.9 years. Most patients had a genotype 1, with a high viral load, HCV infection. Of the patients, 33% had HBV serologic markers of past infection. The presence of HBV DNA in liver samples was found in 57% of the patients. No statistically significant difference in the epidemiological, histological, or virological or response to therapy data was found in patients with occult HBV infection. Occult HBV infection occurred in a high percentage of patients but was not clinically significant.

  3. [Find your 1%: prevalence and mortality of a community cohort of people with advanced chronic disease and palliative needs].

    Science.gov (United States)

    Blay, Carles; Martori, Joan Carles; Limón, Esther; Oller, Ramon; Vila, Laura; Gómez-Batiste, Xavier

    2017-11-17

    To determine the prevalence and profiles of people with advanced chronic diseases in Primary Care and to analyse the elements related to their mortality in order to orient strategies for improvement in this level of care. An observational, analytical and prospective study during 3 years conducted on a cohort of patients with palliative needs. Three Primary Care teams of Osona (Catalonia). A total of 251 people identified as advanced patients using a systematic population-based strategy that included the NECPAL tool. Basic demographic and clinical profile (age, gender, type of residence, health stratification level and main disease); date, place, and cause of eventual deaths. 1% of the adult Primary Care population suffer from advanced diseases, of which 56.6% are women, and with a median age of 85 years. Dementia or advanced frailty is observed in 49.3%, and only 13.7% have cancer. Just under one-quarter (24.3%) live in nursing homes. The accumulated mortality at 3 years is 62.1%, with a median survival of 23 months. Factors significantly associated with the likelihood of dying are cancer, female gender, and over-aging. Patients died at their home (47.3%), in an intermediate care hospital (37.2%), or in an acute care hospital (15.5%), depending on certain explanatory factors. The prevalence and characteristics of advanced community-based disease coincide with that reported in the literature. Potentially, Primary Care is the reference level of care for these patients, especially if it incorporates nursing homes as a usual field of practice. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  4. An estimation of the prevalence and progression of chronic kidney disease in a rural diabetic cambodian population.

    Directory of Open Access Journals (Sweden)

    Bernadette Thomas

    Full Text Available To date, there are no known estimates of the prevalence of chronic kidney disease within Cambodia, the vast majority of whose citizens live in rural areas with limited access to renal replacement therapy.Observational analysis of patients from the Takeo province in Cambodia who presented to MoPoTsyo, a non-governmental organization, for screening and management of diabetes mellitus between 2010 and 2012 (n = 402; 75% females. Estimated glomerular filtration rate (eGFR was calculated using the CKD-Epi equation.On average, women were younger, with a higher percentage of hypercholesterolemia but also high-density lipoprotein level. Men had a higher serum creatinine level (1.31 mg/dl than that of women (1.13 mg/dl at 95% CI. More than half of all screened patients had a reduced eGFR; 60% (95% CI 55%, 65% had an eGFR<60 ml/min/1.73 m(2; 54% (49%, 59% had an eGFR 30-60 ml/min/1.73 m(2, and 5.7% (3.4%, 8.0% with eGFR 15-30 ml/min/1.73 m(2. Women had a greater prevalence of stage 3 CKD (57% women vs. 47% men and stage 4 CKD (7.0% vs. 2.0%. The adjusted odds ratio for females compared to males having an eGFR <60 ml/min/1.73 m(2 was 3.19 (95% CI 1.78, 5.43; p value<0.001. Thirty-two percent of patients lost ≥ 5 ml/min/1.73 m2 eGFR during median follow-up time of 433 days (IQR 462 days days.Over one-half of Cambodians with diabetes mellitus had reduced eGFR, implying a point-prevalence of chronic kidney disease of 1.2% in among adult Cambodians within the country. This high burden of kidney disease in a society that lacks universal access to renal replacement therapy underscores the importance of early diagnosis - a largely unmet need in Cambodia.

  5. Prevalence of Tobacco Smoking and Determinants of Success in Quitting Smoking among Patients with Chronic Diseases: A Cross-Sectional Study in Rural Western China

    Directory of Open Access Journals (Sweden)

    Hang Fu

    2017-02-01

    Full Text Available Abstract: Tobacco use is one of the behavioral risk factors for chronic diseases. The aim of the study was to investigate smoking prevalence in chronically ill residents and their smoking behavior in western rural China, to identify factors associated with success in quitting smoking, and to provide appropriate intervention strategies for tobacco control. Cross-sectional survey data from patients with chronic diseases from rural western China were analyzed. Among the 906 chronically ill patients, the current smoking prevalence was 26.2%. About 64.3% of smokers with chronic diseases attempted to quit smoking, 21.0% of which successfully quitted. The odds ratio (OR of smokers with only one chronic disease to quit smoking successfully was higher than that of those who have other diseases (OR = 2.037, 95% confidence interval (CI = 1.060-3.912; p < 0.05. The smokers who were always restricted to smoking in public places were more likely to quit smoking successfully than those who were free to smoke (OR = 2.188, 95% CI = 1.116–4.291; p < 0.05. This study suggests that health literacy, comorbidity of diseases, and psychological counseling should be considered when developing targeted tobacco prevention strategies. Strengthening tobacco control measures in public places such as rural medical institutions will be effective.

  6. Prevalence of Tobacco Smoking and Determinants of Success in Quitting Smoking among Patients with Chronic Diseases: A Cross-Sectional Study in Rural Western China.

    Science.gov (United States)

    Fu, Hang; Feng, Da; Tang, Shangfeng; He, Zhifei; Xiang, Yuanxi; Wu, Tailai; Wang, Ruoxi; Shao, Tian; Liu, Chunyan; Shao, Piaopiao; Feng, Zhanchun

    2017-02-09

    Tobacco use is one of the behavioral risk factors for chronic diseases. The aim of the study was to investigate smoking prevalence in chronically ill residents and their smoking behavior in western rural China, to identify factors associated with success in quitting smoking, and to provide appropriate intervention strategies for tobacco control. Cross-sectional survey data from patients with chronic diseases from rural western China were analyzed. Among the 906 chronically ill patients, the current smoking prevalence was 26.2%. About 64.3% of smokers with chronic diseases attempted to quit smoking, 21.0% of which successfully quitted. The odds ratio (OR) of smokers with only one chronic disease to quit smoking successfully was higher than that of those who have other diseases (OR = 2.037, 95% confidence interval (CI) = 1.060-3.912; p successfully than those who were free to smoke (OR = 2.188, 95% CI = 1.116-4.291; p < 0.05). This study suggests that health literacy, comorbidity of diseases, and psychological counseling should be considered when developing targeted tobacco prevention strategies. Strengthening tobacco control measures in public places such as rural medical institutions will be effective.

  7. Chronic diseases in elderly men

    DEFF Research Database (Denmark)

    Nielsen, Morten Frost Munk; Wraae, Kristian; Gudex, Claire

    2012-01-01

    OBJECTIVE: prevalence estimates for chronic diseases and associated risk factors are needed for priority setting and disease prevention strategies. The aim of this cross-sectional study was to estimate the self-reported and clinical prevalence of common chronic disorders in elderly men. STUDY......-reported data on risk factors and disease prevalence were compared with data from hospital medical records. RESULTS: physical inactivity, smoking and excessive alcohol intake were reported by 27, 22 and 17% of the study population, respectively. Except for diabetes, all the chronic diseases investigated......, including hypertension, musculoskeletal and respiratory diseases were underreported by study participants. Erectile dysfunction and hypogonadism were substantially underreported in the study population even though these diseases were found to affect 48 and 21% of the participants, respectively. CONCLUSIONS...

  8. Prevalence of hypothyroidism in nondiabetic chronic kidney disease and effect of thyroxine replacement on estimated glomerular filtration rate

    Directory of Open Access Journals (Sweden)

    S Bajaj

    2017-01-01

    Full Text Available Reduced T3 and free T4, elevated thyroid stimulating hormone, and hyporesponsiveness to thyrotropin releasing hormone raise questions about the presence of hypothyroidism in chronic kidney disease (CKD and raise the possibility of benefit from thyroxine supplementation. A prospective cohort study was conducted on 73 nondiabetic CKD cases. Hypothyroid patients were started on levothyroxine and were reviewed after 3 and 6 months. The mean age of study population was 42.3 ± 16.8 years. Of the total population, 32 (43.8% cases had hypothyroidism, among whom 2 (2.7% had overt hypothyroidism and 30 (41.1% had subclinical hypothyroidism. Prevalence of hypothyroidism increased with increasing severity of CKD. There were 1 (3.1% case with hypothyroidism in stage 3b, 8 (25% cases in stage 4, and 23 (71.9% cases in stage 5. The mean estimated glomerular filtration rate (ml/min/1.73 m2 at baseline was 13.7 ± 8.9 which increased to 17.5 ± 6.8 and 22.4 ± 9.3 after 3 and 6 months of thyroid hormone replacement therapy (THRT, respectively (P < 0.001. Hypothyroidism is commonly associated with nondiabetic CKD and its prevalence increases with declining renal function. THRT significantly improves renal function in nondiabetic CKD with hypothyroidism.

  9. Prevalence and predictors of chronic kidney disease in newly diagnosed human immunodeficiency virus patients in Owerri, Nigeria

    Directory of Open Access Journals (Sweden)

    E N Anyabolu

    2016-01-01

    Full Text Available Human immunodeficiency virus (HIV infection is a common cause of chronic kidney disease (CKD in Sub-Saharan Africa. This study aims at identifying the prevalence and predictors of CKD in newly diagnosed HIV patients in Owerri, South East Nigeria. This was a cross-sectional study consisting of 393 newly diagnosed HIV-seropositive subjects and 136 age- and sex-matched seronegative subjects as controls. CKD was defined as 24-hour urine protein (24-HUP ≥0.3 g and/or glomerular filtration rate (GFR < 60 ml/min. Subjects were recruited from the HIV clinic and the Medical Outpatient Department of Federal Medical Centre, Owerri. Clinical and anthropometric data were collected. Relevant investigations were performed, including HIV screening and relevant urine and blood investigations. The mean age of the HIV subjects was 38.84 ± 10.65 years. CKD was present in 86 (22.9% HIV subjects and 11 (8.l % controls. Low waist circumference (WC, high serum creatinine, high spot urine protein/creatinine ratio (SUPCR, high 24-HUP/creatinine Ratio (24-HUPCR, high 24-HUP/osmolality Ratio (24-HUPOR predicted CKD in HIV subjects. CKD prevalence is high (22.9% among newly diagnosed HIV patients in South East Nigeria. The predictors of CKD included WC, serum creatinine, SUPCR, 24-HUPCR, and 24-HUPOR.

  10. Prevalence of Hepatitis B core antibodies with negative Hepatitis B surface antigen in dialysis and chronic kidney disease patients

    Directory of Open Access Journals (Sweden)

    Nauman Tarif

    2017-01-01

    Full Text Available Occult hepatitis B infection (OBI is a potential cause of infection transmission in patients with chronic kidney disease (CKD and dialysis-dependant patients. It is liable to be missed since the marker for OBI, hepatitis B core antibody (HBcAb, is not done routinely. We carried out a study to assess the prevalence of OBI in CKD Stage II–V or requiring renal replacement therapy. It was a cross-sectional study carried out at Fatima Memorial Hospital, Lahore, from May 2104 to May 2015. A total of 188 patients were included in this study, 124 were dialysis dependent and 64 had acute or CKD Stage II–V. About 17.55% (n = 33 of patients had isolated HBcAb positive. Nearly 33.5% (n = 63 of patients were found to have hepatitis B surface antigen positive, indicating development of immunity by exposure to virus. About 20.74% (n = 39 of patients were co-positive with HBcAb also. The prevalence of isolated HBcAb in dialysis and CKD patients is high; therefore, testing for HBcAb should be a routine part of screening in our CKD population to rule out OBI. Further confirmation with polymerase chain reaction analysis for HBV viral DNA is recommended. Considering our circumstances, a consensus statement from the hepatologists and nephrologists is needed to further plan for the management of such cases.

  11. Prevalence of Hepatitis B core antibodies with negative Hepatitis B surface antigen in dialysis and chronic kidney disease patients.

    Science.gov (United States)

    Tarif, Nauman; Riaz, Muhammad Mohsin; Sabir, Omer; Akhter, Rizwan; Rafique, Kashif; Rizvi, Nabiha

    2017-01-01

    Occult hepatitis B infection (OBI) is a potential cause of infection transmission in patients with chronic kidney disease (CKD) and dialysis-dependant patients. It is liable to be missed since the marker for OBI, hepatitis B core antibody (HBcAb), is not done routinely. We carried out a study to assess the prevalence of OBI in CKD Stage II-V or requiring renal replacement therapy. It was a cross-sectional study carried out at Fatima Memorial Hospital, Lahore, from May 2104 to May 2015. A total of 188 patients were included in this study, 124 were dialysis dependent and 64 had acute or CKD Stage II-V. About 17.55% (n = 33) of patients had isolated HBcAb positive. Nearly 33.5% (n = 63) of patients were found to have hepatitis B surface antigen positive, indicating development of immunity by exposure to virus. About 20.74% (n = 39) of patients were co-positive with HBcAb also. The prevalence of isolated HBcAb in dialysis and CKD patients is high; therefore, testing for HBcAb should be a routine part of screening in our CKD population to rule out OBI. Further confirmation with polymerase chain reaction analysis for HBV viral DNA is recommended. Considering our circumstances, a consensus statement from the hepatologists and nephrologists is needed to further plan for the management of such cases.

  12. Prevalence of chronic kidney disease among adults in a rural community in South India: Results from the kidney disease screening (KIDS project

    Directory of Open Access Journals (Sweden)

    Y J Anupama

    2014-01-01

    Full Text Available Prevalence of chronic kidney disease (CKD appears to be increasing in India. A few studies have studied the prevalence of CKD in urban populations, but there is a paucity of such studies in the rural populations. This project was undertaken to study the prevalence of CKD among adults in a rural population near Shimoga, Karnataka and to study the risk factor profile. Door-to-door screening of 2091 people aged 18 and above was carried out. Demographic and anthropometric data were obtained, urine was analyzed for protein by dipstick and serum creatinine was measured in all participants. Glomerular filtration rate was estimated (eGFR using the 4-variable modification of diet in renal disease (MDRD equation and Cockcroft-Gault equation corrected to the body surface area (CG-BSA. The total number of subjects studied was 2091. Mean age was 39.88 ± 15.87 years. 45.57% were males. The prevalence of proteinuria was 2.8%. CKD was seen in 131 (6.3% subjects when GFR was estimated by MDRD equation. The prevalence of CKD was 16.54% by the CG-BSA method. There was a statistically significant relationship of CKD with gender, advancing age, abdominal obesity, smoking, presence of diabetes and hypertension. The prevalence of CKD is higher compared to the previous studies from rural India and is comparable to that in the studies from the urban Indian populations. The wide difference between the CKD prevalence between MDRD and CG-BSA equations suggests the need for a better measure of kidney function applicable to Indian population.

  13. Chronic obstructive pulmonary disease.

    Science.gov (United States)

    Vijayan, V K

    2013-02-01

    The global prevalence of physiologically defined chronic obstructive pulmonary disease (COPD) in adults aged >40 yr is approximately 9-10 per cent. Recently, the Indian Study on Epidemiology of Asthma, Respiratory Symptoms and Chronic Bronchitis in Adults had shown that the overall prevalence of chronic bronchitis in adults >35 yr is 3.49 per cent. The development of COPD is multifactorial and the risk factors of COPD include genetic and environmental factors. Pathological changes in COPD are observed in central airways, small airways and alveolar space. The proposed pathogenesis of COPD includes proteinase-antiproteinase hypothesis, immunological mechanisms, oxidant-antioxidant balance, systemic inflammation, apoptosis and ineffective repair. Airflow limitation in COPD is defined as a postbronchodilator FEV1 (forced expiratory volume in 1 sec) to FVC (forced vital capacity) ratio metabolic diseases (diabetes mellitus, metabolic syndrome and obesity), bone disease (osteoporosis and osteopenia), stroke, lung cancer, cachexia, skeletal muscle weakness, anaemia, depression and cognitive decline. The assessment of COPD is required to determine the severity of the disease, its impact on the health status and the risk of future events (e.g., exacerbations, hospital admissions or death) and this is essential to guide therapy. COPD is treated with inhaled bronchodilators, inhaled corticosteroids, oral theophylline and oral phosphodiesterase-4 inhibitor. Non pharmacological treatment of COPD includes smoking cessation, pulmonary rehabilitation and nutritional support. Lung volume reduction surgery and lung transplantation are advised in selected severe patients. Global strategy for the diagnosis, management and prevention of Chronic Obstructive Pulmonary Disease guidelines recommend influenza and pneumococcal vaccinations.

  14. Prevalence of chronic rhinosinusitis in a population of patients with gastroesophageal reflux disease

    DEFF Research Database (Denmark)

    Bohnhorst, Idar; Jawad, Samir; Lange, Bibi

    2015-01-01

    and anterior/posterior rhinoscopy results. Sinonasal-related quality of life was assessed by using the Sino-Nasal Outcome Test 22 (SNOT-22). These results were compared with those of a population-based control group examined for CRS in the same way. RESULTS: The prevalence of CRS among patients with GERD......-related quality of life is decreased in patients with CRS who also suffer from GERD....

  15. Chronic disease prevalence from Italian administrative databases in the VALORE project: A validation through comparison of population estimates with general practice databases and national survey

    NARCIS (Netherlands)

    R. Gini (Rosa); P. Francesconi (Paolo); G. Mazzaglia (Giampiero); C. Cricelli (Claudio); A. Pasqua (Alessandro); P. Gallina (Pietro); S. Brugaletta (Salvatore); D. Donato (Daniele); A. Donatini (Andrea); A. Marini (Alessandro); C. Zocchetti (Carlo); C. Cricelli (Claudio); L. Damiani; M. Bellentani (Mariadonata); M.C.J.M. Sturkenboom (Miriam); M.J. Schuemie (Martijn)

    2013-01-01

    textabstractBackground: Administrative databases are widely available and have been extensively used to provide estimates of chronic disease prevalence for the purpose of surveillance of both geographical and temporal trends. There are, however, other sources of data available, such as medical

  16. CHRONIC KIDNEY DISEASE PREVALENT IN SMALL VILLAGES OF NORTH COASTAL , ANDHRA PRADESH , INDIA , UDDANAM NEPHROPATHY

    Directory of Open Access Journals (Sweden)

    Valluri Satya

    2015-05-01

    Full Text Available There are hamlets in and around Uddanam , Gunupalli , Kaviti of Srikakulam District , a North Coastal Andhra P radesh region with high prevalence of CKD presenting clinically or sub clinically ultimately leading to high mortality and morbidity with RRT and other types of conservative management , we were detected some facts during our survey in these villages. The many of them who are living in that belt eat Dry salted fish , less water intake , hardworking people , these peo ple approach quacks , using illicit drugs etc.

  17. The Platino project: methodology of a multicenter prevalence survey of chronic obstructive pulmonary disease in major Latin American cities

    Directory of Open Access Journals (Sweden)

    Perez-Padilla Rogelio

    2004-06-01

    Full Text Available Abstract Background The prevalence of Chronic Obstructive Pulmonary Disease (COPD in many developed countries appears to be increasing. There is some evidence from Latin America that COPD is a growing cause of death, but information on prevalence is scant. It is possible that, due to the high frequency of smoking in these countries, this disease may represent a major public health problem that has not yet been recognized as such. The PLATINO study is aimed at measuring COPD prevalence in major cities in Latin America. Methods/Design A multi-country survey is being carried out in major cities in Latin America. In each metropolitan area, a population-based sample of approximately 1,000 individuals aged 40 years or older is being interviewed using standardized questionnaires. Eligible subjects are submitted to pre- and post-bronchodilator spirometry, and classified according to several criteria for COPD. Anthropometric examinations are also performed. Several risk factors are being studied, including smoking, socioeconomic factors, exposure to domestic biomass pollution, occupational exposure to dust and hospital admissions due to respiratory conditions during childhood. Whether or not subjects affected by COPD are aware of their disease, and if so how it is being managed by health services, is also being investigated, as are the consequences of this condition on quality of life and work performance. Results At the present time, the study is completed in São Paulo, Mexico City and Montevideo; Chile has started the study in March 2004 and it will be followed by Venezuela; two other metropolitan areas could still join the PLATINO project. Similar sampling procedures, with stratification for socio-economic status, are being used in all sites. Strict coordination, training and standardization procedures have been used to ensure comparability of results across sites. Overall 92% of the pre-bronchodilator spirometry tests fulfilled ATS criteria of

  18. Prevalence of chronic obstructive pulmonary disease in rural women of Tamilnadu: implications for refining disease burden assessments attributable to household biomass combustion

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    Priscilla Johnson

    2011-11-01

    Full Text Available Chronic obstructive1 1This paper was orally presented in the Annual conference International Society of Environmental Epidemiology held in Pasadena in 2008. pulmonary disease (COPD is the 13th leading cause of burden of disease worldwide and is expected to become 5th by 2020. Biomass fuel combustion significantly contributes to COPD, although smoking is recognized as the most important risk factor. Rural women in developing countries bear the largest share of this burden resulting from chronic exposures to biomass fuel smoke. Although there is considerable strength of evidence for the association between COPD and biomass smoke exposure, limited information is available on the background prevalence of COPD in these populations.This study was conducted to estimate the prevalence of COPD and its associated factors among non-smoking rural women in Tiruvallur district of Tamilnadu in Southern India.This cross-sectional study was conducted among 900 non-smoking women aged above 30 years, from 45 rural villages of Tiruvallur district of Tamilnadu in Southern India in the period between January and May 2007. COPD assessments were done using a combination of clinical examination and spirometry. Logistic regression analysis was performed to examine the association between COPD and use of biomass for cooking. R software was used for statistical analysis.The overall prevalence of COPD in this study was found to be 2.44% (95% CI: 1.43–3.45. COPD prevalence was higher in biomass fuel users than the clean fuel users 2.5 vs. 2%, (OR: 1.24; 95% CI: 0.36–6.64 and it was two times higher (3% in women who spend >2 hours/day in the kitchen involved in cooking. Use of solid fuel was associated with higher risk for COPD, although no statistically significant results were obtained in this study.The estimates generated in this study will contribute significantly to the growing database of available information on COPD prevalence in rural women. Moreover, with

  19. Prevalence of chronic obstructive pulmonary disease (COPD) not diagnosed in a population with cardiovascular risk factors.

    Science.gov (United States)

    Montserrat-Capdevila, Josep; Seminario, María Asunción; Godoy, Pere; Marsal, Josep Ramon; Ortega, Marta; Pujol, Jesús; Castañ, Maria Teresa; Alsedà, Miquel; Betriu, Àngels; Lecube, Albert; Portero, Manel; Purroy, Francisco; Valdivielso, José Manuel; Barbé, Ferran

    2018-03-07

    The magnitude of undiagnosed COPD in our population with cardiovascular risk factors (CVRF) is unknown. The objective of this study was to estimate the prevalence of undiagnosed COPD and its specific characteristics in a population with CVRF. Study the prevalence of COPD in patients with CVRF. Spirometry was performed between 01/01/2015 and 12/31/2016 and the percentage of patients with COPD, who had not previously been diagnosed, was determined. Each patient's variables of interest were recorded; the records of patients who had spirometry showing COPD were checked to confirm whether a diagnosis had been recorded or not. The association of undiagnosed COPD with different independent variables was determined with adjusted odds ratio (aOR) by non conditional logistic regression models. 2,295 patients with CVRF were studied. The overall prevalence of COPD was 14.5%. An underdiagnosis of 73.3% was observed. Newly diagnosed COPD vs. undiagnosed COPD showed to be higher in women (74.1% vs. 36.0%; P=.081), non-smokers (21.3% vs. 12.4%; P=.577), mild cases (GOLD1) (42.6% vs. 32.4%, P=.008) and cases with lower than average HbA1c (5.5% vs. 5.6%; P=.008) and uric acid (5.1mg/dL vs. 5.6mg/dL; P=.011). The variables associated with undiagnosed COPD were: women (aOR=1.27; 95%CI: 0.74-2.17; P=.383); age (aOR=0.94; 95%CI: 0.87-0.99; P=.018); smokers (smoker/non-smoker) (aOR=0.47; 95%CI: 0.22-1.01; P=.054) and HbA1c (%) (aOR=0.45; 95%CI: 0.23-0.88; P=.019). The under-diagnosis of COPD is very high. The contact patients aged between 50 and 65 years-old who have CVRF with their health system should be reassessed, and they need to ask for a spirometry. Copyright © 2018 Elsevier España, S.L.U. All rights reserved.

  20. Prevalence and predictors for compensated Advanced Chronic Liver Disease (c-ACLD) in patients with chronic Hepatitis Delta Virus (HDV) infection.

    Science.gov (United States)

    Couto, Ingrid; Victoria, Marilu; Veloso, Valdiléa G; Rodrigues, Lorena; Grinsztejn, Beatriz; Lacerda, Marcus; Victoria, Flamir; Perazzo, Hugo

    2017-01-01

    The study aimed to evaluate the prevalence and predictor factors for compensated advanced chronic liver disease (c-ACLD) in patients with hepatitis Delta virus (HDV) infection. This cross-sectional study included consecutive HDV-infected patients defined by positive anti-HDV. Patients with hepatitis C coinfection, liver transplantation or presence of conditions that limit liver (LSM) or spleen stiffness measurement (SSM) were excluded. Blood tests, abdominal ultrasound, SSM and LSM by transient elastography (FibroScan®) were performed at the same day. Alcohol consumption was quantified using the AUDIT score and c-ACLD was defined by LSM ≥ 15 kPa performed by an experimented operator blinded for clinical and laboratory data. 101 patients were eligible and few patients were excluded due to negative anti-HDV (n = 7), hepatitis C coinfection (n = 2), liver transplantation (n = 10) and limitation for LSM or SSM (n = 5). Therefore, 77 patients [61% male, age = 43 (IQR,36-52) years] were included. The prevalence of c-ACLD was 57% (n = 44/77). Patients with c-ACLD had a higher rate of detectable HBV viral load (p = 0.039), higher levels of transaminases, GGT, alkaline phosphatases, total bilirubin and INR (p0.001 for both) compared to those without c-ACLD. Patients with c-ACLD had higher SSM [65.2 (IQR,33.8-75.0) vs 21.8 (16.5-32.0) kPa; p10 UI/ml), alkaline phosphatase (per IU/L) and GGT levels (per IU/L) were independently associated with c-ACLD in all multivariate models. Splenic volume [per cm3,OR = 1.01 (95%CI,1.01-1.02);p = 0.002], SSM [per kPa, OR = 1.04 (1.01-1.07);p = 0.012] and splenomegaly [yes vs no,OR = 28.45 (4.42-182.95);pc-ACLD. The prevalence of c-ACLD was high in patients with chronic HDV infection in western Amazon basin. HBV viral load, liver enzymes and splenic features can be used to predict severe liver disease in HDV-infected patients.

  1. Prevalence and predictors for compensated Advanced Chronic Liver Disease (c-ACLD in patients with chronic Hepatitis Delta Virus (HDV infection.

    Directory of Open Access Journals (Sweden)

    Ingrid Couto

    Full Text Available The study aimed to evaluate the prevalence and predictor factors for compensated advanced chronic liver disease (c-ACLD in patients with hepatitis Delta virus (HDV infection.This cross-sectional study included consecutive HDV-infected patients defined by positive anti-HDV. Patients with hepatitis C coinfection, liver transplantation or presence of conditions that limit liver (LSM or spleen stiffness measurement (SSM were excluded. Blood tests, abdominal ultrasound, SSM and LSM by transient elastography (FibroScan® were performed at the same day. Alcohol consumption was quantified using the AUDIT score and c-ACLD was defined by LSM ≥ 15 kPa performed by an experimented operator blinded for clinical and laboratory data.101 patients were eligible and few patients were excluded due to negative anti-HDV (n = 7, hepatitis C coinfection (n = 2, liver transplantation (n = 10 and limitation for LSM or SSM (n = 5. Therefore, 77 patients [61% male, age = 43 (IQR,36-52 years] were included. The prevalence of c-ACLD was 57% (n = 44/77. Patients with c-ACLD had a higher rate of detectable HBV viral load (p = 0.039, higher levels of transaminases, GGT, alkaline phosphatases, total bilirubin and INR (p0.001 for both compared to those without c-ACLD. Patients with c-ACLD had higher SSM [65.2 (IQR,33.8-75.0 vs 21.8 (16.5-32.0 kPa; p10 UI/ml, alkaline phosphatase (per IU/L and GGT levels (per IU/L were independently associated with c-ACLD in all multivariate models. Splenic volume [per cm3,OR = 1.01 (95%CI,1.01-1.02;p = 0.002], SSM [per kPa, OR = 1.04 (1.01-1.07;p = 0.012] and splenomegaly [yes vs no,OR = 28.45 (4.42-182.95;p<0.001] were independently associated with c-ACLD.The prevalence of c-ACLD was high in patients with chronic HDV infection in western Amazon basin. HBV viral load, liver enzymes and splenic features can be used to predict severe liver disease in HDV-infected patients.

  2. Prevalence of hepatobiliary dysfunction in a regional group of patients with chronic inflammatory bowel disease

    DEFF Research Database (Denmark)

    Wewer, V; Gluud, C; Schlichting, P

    1991-01-01

    primary sclerosing cholangitis, of whom two were primarily diagnosed; one patient had cholangiocarcinoma also primarily diagnosed; and two patients were found to have alcoholic hepatic damage. Among the 125 patients with Crohn's disease, 38 (30%; 95% confidence limits, 23-38%) had at least 1 abnormal...

  3. Chronic renal disease in spain: prevalence and related factors in persons with diabetes mellitus older than 64 years.

    Science.gov (United States)

    Martínez Candela, Juan; Sangrós González, Javier; García Soidán, Francisco Javier; Millaruelo Trillo, José Manuel; Díez Espino, Javier; Bordonaba Bosque, Daniel; Ávila Lachica, Luis

    2018-02-07

    Type 2 diabetes mellitus and chronic kidney disease (CKD) are conditions which have a high prevalence in individuals ≥ 65 years of age and represent a major public health problem. To determine the prevalence of CKD, its categories and its relationship with various demographic and clinical factors in elderly patients with type 2 diabetes mellitus in Spain. Observational, cross-sectional, multicenter, Spanish epidemiological study. Patients with known type 2 diabetes mellitus, age ≥ 65 years of age treated in Primary Care were included. We collected demographic, anthropometric and analytical variables from the previous 12 months, including the albumin-to-creatinine ratio and estimated glomerular filtration rate to evaluate renal function. The prevalence of CKD was 37.2% (95% CI, 34.1-40.3%), renal failure was 29.7% (95% CI, 26.8-32.6%) and increased albuminuria was 20.6% (95% CI, 17.3-23.9%), moderately increased albuminuria was 17.8% (95% CI, 14.7-20.9%) and severely increased albuminuria was 2.8% (95% CI, 1.4-4.2%). In turn, the prevalence of CKD categories were: G1 1.3% (95% CI, 0.6-2%), G2 6.2% (95% CI, 4.6-7.8%), G3a 17.2% (95% CI, 14.8-19.6%), G3b 9.8% (95% CI, 7.9-11.7%), G4 2% (95% CI, 1.1-2.9%) and G5 0.7% (95% CI, 0.2-1.2%). In the multivariate analysis, after adjusting for the remaining variables, CKD was associated with elderly age (OR 5.13, 95% CI, 3.15-8.35), high comorbidity (OR 3.36. 95% CI, 2.2-5.12) and presence of antihypertensive treatment (OR 2.43. 95% CI, 1.48-4.02). CKD is frequent in the diabetic population ≥ 65 years of age and is associated with elderly age, high comorbidity and with treated hypertension. No relationship has been found with gender and time in years since onset of diabetes. Copyright © 2018 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  4. Prevalence of hepatobiliary dysfunction in a regional group of patients with chronic inflammatory bowel disease

    DEFF Research Database (Denmark)

    Wewer, V; Gluud, C; Schlichting, P

    1991-01-01

    evaluation consisting of ultrasonography, liver biopsy, and endoscopic retrograde cholangiography was performed in patients who had biochemical values more than twice the upper normal limit in two consecutive blood tests within a fortnight. Six patients (1%) fulfilled this criterion. Three patients had...... the criteria for further evaluation as described above. One patient appeared to have epithelioid granuloma in the liver and one patient had alcoholic liver disease, whereas one patient refused further examination.(ABSTRACT TRUNCATED AT 250 WORDS)...

  5. Airway malacia in chronic obstructive pulmonary disease: prevalence, morphology and relationship with emphysema, bronchiectasis and bronchial wall thickening

    Energy Technology Data Exchange (ETDEWEB)

    Sverzellati, Nicola; Rastelli, Andrea; Schembri, Valentina; Filippo, Massimo de [University of Parma, Department of Clinical Sciences, Section of Radiology, Parma (Italy); Chetta, Alfredo [University of Parma, Department of Clinical Sciences, Section of Respiratory Diseases, Parma (Italy); Fasano, Luca; Pacilli, Angela Maria [Policlinico Sant' Orsola-Malpighi, Unita Operativa di Fisiopatologia Respiratoria, Bologna (Italy); Di Scioscio, Valerio; Bartalena, Tommaso; Zompatori, Maurizio [University of Bologna, Department of Radiology, Cardiothoracic Institute, Policlinico S.Orsola-Malpighi, Bologna (Italy)

    2009-07-15

    The aim of this study was to determine the prevalence of airway malacia and its relationship with ancillary morphologic features in patients with chronic obstructive pulmonary disease (COPD). A retrospective review was performed of a consecutive series of patients with COPD who were imaged with inspiratory and dynamic expiratory multidetector computed tomography (MDCT). Airway malacia was defined as {>=}50% expiratory reduction of the airway lumen. Both distribution and morphology of airway malacia were assessed. The extent of emphysema, extent of bronchiectasis and severity of bronchial wall thickness were quantified. The final study cohort was comprised of 71 patients. Airway malacia was seen in 38 of 71 patients (53%), and such proportion was roughly maintained in each stage of COPD severity. Almost all tracheomalacia cases (23/25, 92%) were characterised by an expiratory anterior bowing of the posterior membranous wall. Both emphysema and bronchiectasis extent did not differ between patients with and without airway malacia (p > 0.05). Bronchial wall thickness severity was significantly higher in patients with airway malacia and correlated with the degree of maximal bronchial collapse (p < 0.05). In conclusion, we demonstrated a strong association between airway malacia and COPD, disclosing a significant relationship with bronchial wall thickening. (orig.)

  6. Diet - chronic kidney disease

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/002442.htm Diet - chronic kidney disease To use the sharing features on this page, ... make changes to your diet when you have chronic kidney disease (CKD). These changes may include limiting fluids, eating ...

  7. Associations of chronic stress burden, perceived stress, and traumatic stress with cardiovascular disease prevalence and risk factors in the HCHS/SOL Sociocultural Ancillary Study

    Science.gov (United States)

    Gallo, Linda C.; Roesch, Scott C.; Fortmann, Addie L.; Carnethon, Mercedes R.; Penedo, Frank J.; Perreira, Krista; Birnbaum-Weitzman, Orit; Wassertheil-Smoller, Sylvia; Castañeda, Sheila F.; Talavera, Gregory A.; Sotres-Alvarez, Daniela; Daviglus, Martha L.; Schneiderman, Neil; Isasi, Carmen R.

    2015-01-01

    Objective The current study examined multiple stress indicators (chronic, perceived, traumatic) in relation to prevalent coronary heart disease (CHD), stroke, and major cardiovascular disease (CVD) risk factors (i.e., diabetes, dyslipidemia, hypertension, current smoking) in the multi-site Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Sociocultural Ancillary Study (2010–2011). Methods Participants were 5313 men and women, 18–74 years old, representing diverse Hispanic/Latino ethnic backgrounds, who underwent a comprehensive baseline clinical exam and sociocultural exam with measures of stress. Results Chronic stress burden was related to a higher prevalence of CHD after adjusting for sociodemographic, behavioral and biological risk factors [OR (95% CI) = 1.22, (1.10–1.36)] and related to stroke prevalence in the model adjusted for demographic and behavioral factors [OR (95% CI) = 1.26, (1.03–1.55∂)]. Chronic stress was also related to a higher prevalence of diabetes [OR=1.20, (1.11–1.31)] and hypertension [OR=1.10 (1.02–1.19)] in individuals free from CVD (N=4926). Perceived stress [OR=1.03 (1.01–1.05)] and traumatic stress [OR=1.15 (1.05–1.26)] were associated with a higher prevalence of smoking. Participants who reported a greater number of lifetime traumatic events also unexpectedly showed a lower prevalence of diabetes [OR=.89 (.83–.97)] and hypertension [OR=.88 (.82–.93)]. Effects were largely consistent across age and sex groups. Conclusions The study underscores the utility of examining multiple indicators of stress in relation to health, since the direction and consistency of associations may vary across distinct stress conceptualizations. In addition, the study suggests that chronic stress is related to higher CVD risk and prevalence in Hispanics/Latinos, the largest U.S. ethnic minority group. PMID:24979579

  8. Estimating prevalence of chronic obstructive pulmonary disease in the Southern Cone of Latin America: how different spirometric criteria may affect disease burden and health policies.

    Science.gov (United States)

    Sobrino, Edgardo; Irazola, Vilma E; Gutierrez, Laura; Chen, Chung-Shiuan; Lanas, Fernando; Calandrelli, Matías; Ponzo, Jacqueline; Mores, Nora; Serón, Pamela; Lee, Allison; He, Jiang; Rubinstein, Adolfo L

    2017-12-11

    Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death worldwide. The study aimed to determine and compare the prevalence of COPD in the general population aged 45-74 years old according to fixed ratio and lower limit of normal (LLN) thresholds in four cities in the Southern Cone of Latin America. The Pulmonary Risk in South America (PRISA) study used a 4-stage stratified sampling method to select 5814 participants from 4 cities in the Southern Cone of Latin America (Bariloche and Marcos Paz, Argentina; Temuco, Chile; and Pando-Barros Blancos, Uruguay). Data on demographic information, medical history, risk factors, pre-bronchodilator and post-bronchodilator spirometry were obtained using a standard protocol. According to GOLD, COPD was defined as a post-bronchodilator ratio of forced expiratory volume in one second (FEV1) over forced vital capacity (FVC) less than 70%. The LLN threshold was defined as the lower fifth percentile for predicted FEV1/FVC, and was evaluated as an alternative COPD definition. Overall COPD prevalence was 9.3% (95% CI 8.4, 10.2%), and men had a higher prevalence [11.8% (95% CI 10.3, 13.3%)] than women [7.3% (95% CI 6.2, 8.3%)] with the fixed ratio. Overall COPD prevalence using LLN was 4.7% (95% CI 4.1, 5.3%), higher in men: 5.8% (95% CI 4.7, 6.8%) than women: 3.9% (95% CI 3.1, 4.7%). COPD prevalence was significantly higher among those who were older, had Latin America.

  9. Co-occurrence of behavioral risk factors for chronic non-communicable diseases in adolescents: Prevalence and associated factors

    Directory of Open Access Journals (Sweden)

    Alessandra Silva Dias de OLIVEIRA

    Full Text Available ABSTRACT Objective To examine the prevalence of the behavioral risk factors – both isolated and clustered – for chronic diseases, among adolescents. Additionally, its association with various social and demographic variables was estimated. Methods This was a cross-sectional study conducted on 1,039 high school students, from public and private schools, elected for convenience, in Rio de Janeiro, Brazil. A Chi-square test, Mann-Whitney U test, as well as crude and adjusted ordinal logistic regression were used to assess the association between the variables. Results The most frequently observed risk factors were sedentary behavior (68.8%, alcohol consumption (36.8%, and overweight (26.8%. The clustering of risk factors was observed in 67.5% of the students. Being a girl (OR=1.28; 95%CI=1.01–1.63, Caucasian (OR=1.35; 95%CI=1.06–1.72 or private school student (OR=1.46; 95%CI=1.12–1.88 increased the chance of the clustering of risk factors. The co-occurrence of risk factors was predominantly observed in the case of smoking (OR=4.94; 95%CI=1.46–16.75, alcohol consumption (OR=1.43; 95%CI=1.09–1.88, high consumption of ultra-processed foods (OR=1.57; 95%CI=1.19–2.07, and sedentary behavior (OR=1.40; 95%CI=1.07–1.82. Conclusion The co-occurrence of behavioral risk factors was observed to be higher among girls, Caucasian adolescents, and private school students, as well as, among smokers, alcohol users and adolescents with sedentary habits and a high consumption of ultra-processed foods.

  10. Prevalence of Hypertension and Diabetes and Coexistence of Chronic Kidney Disease and Cardiovascular Risk in the Population of the Republic of Moldova

    Science.gov (United States)

    Codreanu, Igor; Sali, Vera; Gaibu, Sergiu; Suveica, Luminita; Popa, Sergiu; Perico, Norberto; Ene-Iordache, Bogdan; Carminati, Sergio; Feehally, John; Remuzzi, Giuseppe

    2012-01-01

    In 2005, the International Society of Nephrology (ISN) established the Global Outreach Program (GO) aimed at building a capacity for detecting and managing chronic kidney disease and its complications in low- and middle-income countries. Here we report data from the 2006-2007 screening program (1025 subjects from the general population) in the Republic of Moldova aimed to determine the prevalence of hypertension, diabetes, and their coexistence with microalbuminuria. The likelihood of a serious cardiovascular (CV) event was also estimated. Hypertension and diabetes were very common among screened subjects. The prevalence of microalbuminuria was 16.9% and that of estimated GFR Moldova patients with hypertension and diabetes should be screened for the coexistence of renal abnormalities, with the intention of developing disease-specific health-care interventions with the primary goal to reduce CV morbidity and mortality and prevent renal disease progression to end stage renal disease. PMID:23251790

  11. Chronic thyroiditis (Hashimoto disease)

    Science.gov (United States)

    ... common in people with a family history of thyroid disease. In very rare cases, the disease may be ... syndrome - Hashimoto; PGA II - Hashimoto Images Endocrine glands Thyroid enlargement - scintiscan Hashimoto's disease (chronic thyroiditis) Thyroid gland References Amino N, Lazarus ...

  12. Self-reported questionnaire survey on the prevalence and symptoms of adverse food reactions in patients with chronic inhalant diseases in Tangshan city, China.

    Science.gov (United States)

    Hao, Guodong; Lai, Xuxin; Song, Zhijing; Wang, Zhixing; Kong, Xing-Ai; Zhong, Haifeng; Hui, Sui Fu; Zheng, Yiwu

    2018-01-01

    The prevalence of adverse food reactions in patients with chronic inhalant diseases has seldom been studied in China. This study is to investigate the prevalence of adverse food reactions and the symptoms caused in respiratory patients. Respiratory patients in allergy clinics were asked to complete a questionnaire. Patients' information such as age, gender, family history of allergy, and adverse reactions to a list of 48 foods and the symptoms caused, was recorded. Multivariate analyses were performed to determine the prevalence of adverse food reactions and their associated symptoms. 459 subjects, with an average age of 32 years old, completed the questionnaire; 45.3% were male. Among the 459 subjects, 38.1% (175/459) had an adverse reaction to food: 13.6% had an adverse food reaction to crab, 12.4% had an adverse food reaction to shrimp; and 9.9% had an adverse reaction to shellfish. Peach and nectarine were also shown to be common causative foods with 6.8% of the study group showing an adverse reaction to peach and 5.2% to nectarine. Seafood mainly caused skin symptoms and fruits gave rise to more throat, oral, and gastrointestinal problems. The prevalence of adverse food reactions is high for patients with respiratory diseases. This indicates that adverse food reactions should be considered in the treatment and management of patients with chronic inhalant diseases.

  13. PREVALENCE OF VITAMIN D DEFICIENCY IN CHRONIC KIDNEY DISEASE: A SINGLE CENTERED STUDY FROM A RURAL TERTIARY CARE HOSPITAL IN SOUTH INDIA

    Directory of Open Access Journals (Sweden)

    Ravi

    2016-03-01

    Full Text Available BACKGROUND Vitamin D deficiency is highly prevalent among patients with chronic kidney disease (CKD. Accumulating evidence indicates the associations of vitamin D deficiency with morbidities and mortality in patients with CKD. The recent Kidney Disease Outcomes Quality Initiative (KDOQI Clinical Practice Guidelines for Bone Mineral Metabolism and Disease in Chronic Kidney Disease had recommended the measurements of 25-hydroxyvitamin D levels in patients with CKD who are not on dialysis. Little is known about the magnitude of vitamin D deficiency in patients with CKD living in rural South India. AIM To assess the prevalence of vitamin D deficiency among the patients with chronic kidney disease. METHODOLOGY The prevalence of 25-hydroxyvitamin D3 (25OHD deficiency (defined as a level <20 ng/ml were examined in 100 patients with CKD. Patients on dialysis and those receiving medication known to influence vitamin D, were excluded. CKD was diagnosed based on history, clinical features, USG abdomen and renal function test and eGFR. We examined the levels of 25OHD in 100 patients with CKD stages 3 and 4. Patients were investigated for hemogram, renal function tests, serum vitamin D level, fasting blood sugar and ECG. RESULTS The overall prevalence of vitamin D deficiency among the CRF patients in our study was 69% and the insufficiency was present in 17% of the CRF patients and only 14% of the study subjects had normal vitamin D levels. Among the various factor influencing the prevalence of vitamin D deficiency in CRF patients, diabetes and hypertension are the most important factors. In our study the mean levels of vitamin D was much lower in patients with diabetes and hypertension when compared to patients without diabetes and hypertension and the difference was found to be statistically significant (p=0.003. CONCLUSION Our study concluded that vitamin D deficiency is highly prevalent among CKD patients. Diabetes and hypertension are the most important

  14. Chronic Beryllium Disease

    Science.gov (United States)

    ... 2001, 177-220. Balkissoon RC, Newman LS. Beryllium cooper alloy (2%) causes chronic beryllium disease . J Occup ... Newman LA, Mroz M, Campbell PA. Screening blood test identifies subclinical beryllium disease. J Occup Med 1989; ...

  15. Chronic Kidney Disease

    Science.gov (United States)

    ... control blood pressure, and make hormones. Chronic kidney disease (CKD) means that your kidneys are damaged and ... don't have any symptoms until their kidney disease is very advanced. Blood and urine tests are ...

  16. Prevalence of chronic obstructive pulmonary disease according to BTS, ERS, GOLD and ATS criteria in relation to doctor's diagnosis, symptoms, age, gender, and smoking habits.

    Science.gov (United States)

    Lindberg, Anne; Jonsson, Ann-Christin; Rönmark, Eva; Lundgren, Rune; Larsson, Lars-Gunnar; Lundbäck, Bo

    2005-01-01

    Guidelines and standards for diagnosis and management of chronic obstructive pulmonary disease (COPD) have been presented by different national and international societies, but the spirometric criteria for COPD differ between guidelines. To estimate prevalence of COPD using the guidelines of the British Thoracic Society (BTS), the European Respiratory Society (ERS), the Global Initiative for Chronic Obstructive Lung Disease (GOLD), and the American Thoracic Society (ATS). Further, to evaluate reported airway symptoms, contacts with health care providers, and physician diagnosis of COPD in relation to the respective criteria, and gender differences. In 1992 a postal questionnaire was sent to a random sample of adults aged 20-69 years, 4,851 (85%) out of 5,681 subjects responded. In 1994-1995 a random sample of the responders, 970 subjects, were invited to a structured interview and a lung function test; 666 (69%) participated. The prevalence of COPD was 7.6, 14.0, 14.1, 12.2 and 34.1% according to BTS, ERS, GOLD, clinical ATS (with symptoms or physician diagnosis), and spirometric ATS criteria, respectively. Prevalent COPD was related to age, smoking habits and family history of obstructive airway disease but not to gender. Physician diagnosis of chronic bronchitis or emphysema was only reported by 16.3, 12.2, 11.0, 23.4 and 8.2% of subjects fulfilling the respective criteria, though a majority reported airway symptoms. The main determinants for prevalent COPD were age, smoking habits and spirometric criteria of COPD. Though a majority reported airway symptoms and contact with health care providers due to respiratory complaints, only a minority was diagnosed as having COPD, indicating a large underdiagnosis. Copyright (c) 2005 S. Karger AG, Basel.

  17. Anemia of chronic disease

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/000565.htm Anemia of chronic disease To use the sharing features on this page, ... body tissues. There are many types of anemia. Anemia of chronic disease (ACD) is anemia that is found in people ...

  18. Substitution scenario in follow-up of chronic cancer patients in primary care: prevalence, disease duration and estimated extra consultation time.

    Science.gov (United States)

    van Dipten, C; Olde Hartman, T C; Biermans, M C J; Assendelft, W J J

    2016-02-01

    The incidence of cancer as well as survival rates for it are increasing. It is debated whether care in the chronic phase of cancer can be positioned in primary care due to doubts about capacity and workload. To estimate GPs' extra consultation time if they assume responsibility for the care in the chronic phase of cancer. Retrospective cohort study. Estimation of extra consultation time by quantifying prevalence, incidence, survival, number of chronic cancer patients, current practice contacts and registration of risk factors in patients with all types of cancers. The most prevalent types of cancer (with 5-year survival rates) are as follows: breast cancer (91.5%), colorectal cancer (63.8%), prostate cancer (78.3%), melanoma (91.9%) and bladder and urinary tract cancer (77.3%). Primary care practices include ~32 chronic cancer patients, with a potential extra consultation time of ~19 hours per year per 1000 patients. One-third (35%) are already in a chronic disease management programme and 57% were diagnosed >5 years ago. Registration of risk factors for cancer is incomplete, but of better quality when comorbidity is present. Numbers of chronic cancer patients and possible time investment by primary care professionals in the case of a substitution scenario should not be a limiting factor for transition of follow-up from secondary to primary care, as most of the patients were diagnosed >5 years ago and a large proportion of these patients are already monitored in an existing chronic care programme. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  19. PREVALENCE OF CHRONIC DISEASES IN INDIVIDUALS ASSISTED BY THE FAMILY HEALTH PROGRAM IN NITEROI, BRAZIL: EVALUATION OF SELECTION BIAS AND PROTOCOL

    Directory of Open Access Journals (Sweden)

    Rosa Maria Luiza G, Mesquita Evandro T, Jorge Antonio José L, Correia Dayse MS, Lugon Josemir R, Kang HC, Yokoo EM, Wahrlich V

    2015-07-01

    Full Text Available Background: The strategy of the Family Health Program has been used as an alternative scenario for prevalence studies. This study intended to present the protocol of the Digitalis Study (DS, prevalence study of chronic diseases, to assess sources of possible selection bias and estimate their impact on the prevalence of self-reported hypertension, diabetes, and myocardial infarction. Methods: Randomization was performed between 38 160 registered individuals with 45 to 99 years by the Family Health Program .Differences between the sources of selection bias (non-acceptance, non-attendance, substitutions were observed for gender and age. Results: Of the 1,190 residents contacted, 67.1% agreed to participate. There were 144 residents who were not randomly selected but whose participation was confirmed (substitutes. Women and individuals in the intermediate age groups and the prevalence of hypertension were higher among substitutes compared with the randomly selected individuals. Conclusion: The approach of the DS was adequate for the purposes of estimating prevalences, but there was a significant percentage of non-participation. The randomization strategy did not assume outdated records; alternative schedules for visits were not provided for; follow-up at the invitation stage was not sufficient to prevent substitutions and the inclusion of substitutes with a higher prevalence of hypertension.

  20. Prevalence, incidence, indication, and choice of antidepressants in patients with and without chronic kidney disease: a matched cohort study in UK Clinical Practice Research Datalink.

    Science.gov (United States)

    Iwagami, Masao; Tomlinson, Laurie A; Mansfield, Kathryn E; McDonald, Helen I; Smeeth, Liam; Nitsch, Dorothea

    2017-07-01

    People with chronic kidney disease (CKD) have an increased prevalence of depression, anxiety, and neuropathic pain. We examined prevalence, incidence, indication for, and choice of antidepressants among patients with and without CKD. Using the UK Clinical Practice Research Datalink, we identified patients with CKD (two measurements of estimated glomerular filtration rate antidepressant prescribing in the six months prior to index date (prevalence), the first prescription after index date among non-prevalent users (incidence), and recorded diagnoses (indication). We compared antidepressant choice between patients with and without CKD among patients with a diagnosis of depression. There were 242 349 matched patients (median age 76 [interquartile range 70-82], male 39.3%) with and without CKD. Prevalence of antidepressant prescribing was 16.3 and 11.9%, and incidence was 57.2 and 42.4/1000 person-years, in patients with and without CKD, respectively. After adjusting for confounders, CKD remained associated with higher prevalence and incidence of antidepressant prescription. Regardless of CKD status, selective serotonin reuptake inhibitors were predominantly prescribed for depression or anxiety, while tricyclic antidepressants were prescribed for neuropathic pain or other reasons. Antidepressant choice was similar in depressed patients with and without CKD. The rate of antidepressant prescribing was nearly one and a half times higher among people with CKD than in the general population. © 2017 The Authors. Pharmacoepidemiology & Drug Safety Published by John Wiley & Sons Ltd. © 2017 The Authors. Pharmacoepidemiology & Drug Safety Published by John Wiley & Sons Ltd.

  1. Desigualdades sociais na prevalência de doenças crônicas no Brasil, PNAD-2003 Social inequalities in the prevalence of chronic diseases in Brazil, PNAD-2003

    Directory of Open Access Journals (Sweden)

    Marilisa Berti de Azevedo Barros

    2006-12-01

    Full Text Available Os inquéritos de saúde de base populacional constituem o principal instrumento utilizado para conhecer a prevalência de doenças crônicas, de restrições de atividades e de uso de serviços de saúde. Com base nos dados da PNAD-2003, foram estimadas as prevalências das 12 doenças crônicas pesquisadas, segundo sexo, idade, cor, escolaridade, macrorregião de residência e situação urbana ou rural do domicílio. Foram analisados a presença de limitações e o uso de serviços de saúde segundo a presença de doença crônica. Utilizando regressão de Poisson, foram estimadas as razões de prevalências ajustadas por idade, sexo, macrorregião de residência e tipo de respondente. A prevalência de pelo menos uma doença crônica aumentou com a idade, foi maior entre mulheres, indígenas, pessoas com menor escolaridade, cidadãos detentores de plano de saúde, migrantes de outros estados, residentes em áreas urbanas e moradores da região Sul. A presença de doença crônica provocou aumento de limitação de atividades e da demanda por serviços de saúde. As condições mais prevalentes foram: doença de coluna, hipertensão, artrite e depressão. Foi detectada significativa desigualdade social no padrão das doenças crônicas, segundo gênero, cor/raça, nível de escolaridade, região de residência e situação do domicílio.Population-based health surveys are the main tool for obtaining data on the prevalence of chronic diseases, disabilities and use of healthcare services. Based on the data of the PNAD-2003, this study estimated the prevalence of 12 chronic diseases according to: gender, age, skin color, educational level, macro-region and urban or rural situation of the households. We analyzed the relation between presence of disabilities and use of healthcare services due to the presence of a chronic disease. The prevalence ratios adjusted according to age, gender, macro-region and type of respondent were estimated using

  2. Prevalence and burden of chronic kidney disease among the general population and high-risk groups in Africa: a systematic review

    Science.gov (United States)

    Abd ElHafeez, Samar; Bolignano, Davide; D’Arrigo, Graziella; Dounousi, Evangelia; Tripepi, Giovanni; Zoccali, Carmine

    2018-01-01

    Objectives While increasing attention is paid to the rising prevalence of chronic diseases in Africa, there is little focus on chronic kidney disease (CKD). This systematic review assesses CKD burden among the general population and high-risk groups on the entire African continent. Design, setting and participants We searched Medline and PubMed databases for articles published between 1 January 1995 and 7 April 2017 by sensitive search strategies focusing on CKD surveys at the community level and high-risk groups. In total, 7918 references were evaluated, of which 7766 articles were excluded because they did not meet the inclusion criteria. Thus, 152 studies were included in the final analysis. Outcome measurement The prevalence of CKD in each study group was expressed as a range and pooled prevalence rate of CKD was calculated as a point estimate and 95% CI. No meta-analysis was done. Data were presented for different populations. Results In the community-level studies, based on available medium-quality and high-quality studies, the prevalence of CKD ranged from 2% to 41% (pooled prevalence: 10.1%; 95% CI 9.8% to 10.5%). The prevalence of CKD in the high-risk groups ranged from 1% to 46% (pooled prevalence: 5.6%; 95% CI 5.4% to 5.8%) in patients with HIV (based on available medium-quality and high-quality studies), 11%–90% (pooled prevalence: 24.7%; 95% CI 23.6% to 25.7%) in patients with diabetes (based on all available studies which are of low quality except four of medium quality) and 13%–51% (pooled prevalence: 34.5%; 95 % CI 34.04% to 36%) in patients with hypertension (based on all available studies which are of low quality except two of medium quality). Conclusion In Africa, CKD is a public health problem, mainly attributed to high-risk conditions as hypertension and diabetes. The poor data quality restricts the validity of the findings and draws the attention to the importance of designing future robust studies. PMID:29326180

  3. Prevalence and burden of chronic kidney disease among the general population and high-risk groups in Africa: a systematic review.

    Science.gov (United States)

    Abd ElHafeez, Samar; Bolignano, Davide; D'Arrigo, Graziella; Dounousi, Evangelia; Tripepi, Giovanni; Zoccali, Carmine

    2018-01-10

    While increasing attention is paid to the rising prevalence of chronic diseases in Africa, there is little focus on chronic kidney disease (CKD). This systematic review assesses CKD burden among the general population and high-risk groups on the entire African continent. We searched Medline and PubMed databases for articles published between 1 January 1995 and 7 April 2017 by sensitive search strategies focusing on CKD surveys at the community level and high-risk groups. In total, 7918 references were evaluated, of which 7766 articles were excluded because they did not meet the inclusion criteria. Thus, 152 studies were included in the final analysis. The prevalence of CKD in each study group was expressed as a range and pooled prevalence rate of CKD was calculated as a point estimate and 95% CI. No meta-analysis was done. Data were presented for different populations. In the community-level studies, based on available medium-quality and high-quality studies, the prevalence of CKD ranged from 2% to 41% (pooled prevalence: 10.1%; 95% CI 9.8% to 10.5%). The prevalence of CKD in the high-risk groups ranged from 1% to 46% (pooled prevalence: 5.6%; 95% CI 5.4% to 5.8%) in patients with HIV (based on available medium-quality and high-quality studies), 11%-90% (pooled prevalence: 24.7%; 95% CI 23.6% to 25.7%) in patients with diabetes (based on all available studies which are of low quality except four of medium quality) and 13%-51% (pooled prevalence: 34.5%; 95 % CI 34.04% to 36%) in patients with hypertension (based on all available studies which are of low quality except two of medium quality). In Africa, CKD is a public health problem, mainly attributed to high-risk conditions as hypertension and diabetes. The poor data quality restricts the validity of the findings and draws the attention to the importance of designing future robust studies. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights

  4. The Prevalence and Management of Anemia in Chronic Kidney Disease Patients: Result from the KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease (KNOW-CKD).

    Science.gov (United States)

    Ryu, Sang Ryol; Park, Sue K; Jung, Ji Yong; Kim, Yeong Hoon; Oh, Yun Kyu; Yoo, Tae Hyun; Sung, Suah

    2017-02-01

    Anemia is a common and significant complication of chronic kidney disease (CKD). However, its prevalence and current management status has not been studied thoroughly in Korea. We examined the prevalence of anemia, its association with clinical and laboratory factors, and utilization of iron agents and erythropoiesis stimulating agents using the baseline data from the large-scale CKD cohort in Korea. We defined anemia when hemoglobin level was lower than 13.0 g/dL in males and 12.0 g/dL in females, or received by erythropoiesis stimulating agents. Overall prevalence of anemia was 45.0% among 2,198 non-dialysis CKD patients from stage 1 to 5. Diabetic nephropathy (DN) as a cause, CKD stages, body mass index (BMI), smoking, leukocyte count, serum albumin, iron markers, calcium, and phosphorus concentration were identified as independent risk factors for anemia. Considering the current coverage of Korean National Health Insurance System, only 7.9% among applicable patients were managed by intravenous iron agents, and 42.7% were managed by erythropoiesis stimulating agents.

  5. The coexistence of asthma and chronic obstructive pulmonary disease (COPD: prevalence and risk factors in young, middle-aged and elderly people from the general population.

    Directory of Open Access Journals (Sweden)

    Roberto de Marco

    Full Text Available BACKGROUND: The joint distribution of asthma and chronic obstructive pulmonary disease (COPD has not been well described. This study aims at determining the prevalence of self-reported physician diagnoses of asthma, COPD and of the asthma-COPD overlap syndrome and to assess whether these conditions share a common set of risk factors. METHODS: A screening questionnaire on respiratory symptoms, diagnoses and risk factors was administered by mail or phone to random samples of the general Italian population aged 20-44 (n = 5163 45-64 (n = 2167 and 65-84 (n = 1030 in the frame of the multicentre Gene Environment Interactions in Respiratory Diseases (GEIRD study. RESULTS: A physician diagnosis of asthma or COPD (emphysema/chronic bronchitis/COPD was reported by 13% and 21% of subjects aged <65 and 65-84 years respectively. Aging was associated with a marked decrease in the prevalence of diagnosed asthma (from 8.2% to 1.6% and with a marked increase in the prevalence of diagnosed COPD (from 3.3% to 13.3%. The prevalence of the overlap of asthma and COPD was 1.6% (1.3%-2.0%, 2.1% (1.5%-2.8% and 4.5% (3.2%-5.9% in the 20-44, 45-64 and 65-84 age groups. Subjects with both asthma and COPD diagnoses were more likely to have respiratory symptoms, physical impairment, and to report hospital admissions compared to asthma or COPD alone (p<0.01. Age, sex, education and smoking showed different and sometimes opposite associations with the three conditions. CONCLUSION: Asthma and COPD are common in the general population, and they coexist in a substantial proportion of subjects. The asthma-COPD overlap syndrome represents an important clinical phenotype that deserves more medical attention and further research.

  6. Long-term trends in the prevalence of chronic kidney disease and the influence of cardiovascular risk factors in Norway.

    Science.gov (United States)

    Hallan, Stein I; Øvrehus, Marius A; Romundstad, Solfrid; Rifkin, Dena; Langhammer, Arnulf; Stevens, Paul E; Ix, Joachim H

    2016-09-01

    Surveillance of chronic kidney disease (CKD) prevalence over time and information on how changing risk factors influence this trend are needed to evaluate the effects of general practice and public health interventions. Because very few studies addressed this, we studied the total adult population of a demographically stable county representative of Norway using cross-sectional studies 10 years apart (Nord-Trøndelag Health Study (HUNT)2 and Nord-Trøndelag Health Study (HUNT)3, 65,237 and 50,586 participants, respectively). Thorough quality-control procedures and comparisons of methods over time excluded analytical drift, and multiple imputations of missing data combined with nonattendance weights contributed to unbiased estimates. CKD prevalence remained stable in Norway from 1995 through 1997 (11.3%) to 2006 through 2008 (11.1%). The association of survey period with CKD prevalence was modified by a strong decrease in blood pressure, more physical activity, and lower cholesterol levels. Without these improvements, a 2.8, 0.7, and 0.6 percentage points higher CKD prevalence could have been expected, respectively. In contrast, the prevalence of diabetes and obesity increased moderately, but the proportion of diabetic patients with CKD decreased significantly (from 33.4% to 28.6%). A CKD prevalence of 1 percentage point lower would have been expected without these changes. Thus, CKD prevalence remained stable in Norway for more than a decade in association with marked improvements in blood pressure, lipid levels, and physical activity and despite modest increases in diabetes and obesity. Copyright © 2016 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

  7. Chronic kidney disease

    NARCIS (Netherlands)

    Romagnani, Paola; Remuzzi, Giuseppe; Glassock, Richard; Levin, Adeera; Jager, Kitty J.; Tonelli, Marcello; Massy, Ziad; Wanner, Christoph; Anders, Hans-Joachim

    2017-01-01

    Chronic kidney disease (CKD) is defined by persistent urine abnormalities, structural abnormalities or impaired excretory renal function suggestive of a loss of functional nephrons. The majority of patients with CKD are at risk of accelerated cardiovascular disease and death. For those who progress

  8. Liver steatosis in children with chronic hepatitis B and C: Prevalence, predictors, and impact on disease progression.

    Science.gov (United States)

    Pokorska-Śpiewak, Maria; Kowalik-Mikołajewska, Barbara; Aniszewska, Małgorzata; Pluta, Magdalena; Walewska-Zielecka, Bożena; Marczyńska, Magdalena

    2017-01-01

    Only scarce data on liver steatosis in children with chronic hepatitis B and C (CHB and CHC) are available. The objective of this study was to evaluate the prevalence, predictors, and impact of hepatic steatosis on children with CHB and CHC. A total of 78 patients aged 11.5 ± 3.4 years were included: 30 (38%) had CHB, and 48 (62%) had CHC. Steatosis was scored on a 5-point scale, as follows: absent; minimal (≤5% hepatocytes affected), mild (6-33%), moderate (34-66%), and severe (>66%). Stepwise logistic regression was used to determine the factors associated with steatosis and moderate-to-severe steatosis. Steatosis was observed in 4/30 (13%) patients with CHB and 13/48 (27%) patients with CHC (P = 0.17). Moderate-to-severe steatosis was observed in 6/78 (8%) patients: 1/30 (3%) had CHB and 5/48 (10%) had CHC (P = 0.40). The body mass index (BMI) z-score was positively associated with the presence of steatosis in children with CHB (odds ratio [OR] = 3.3, 95% confidence interval [CI]: 1.02-10.64). In CHC, steatosis occurred more frequently in patients with hepatitis C virus genotype 3 compared with other genotypes (P = 0.002). In patients with non-3 genotype hepatitis C virus, steatosis was associated with the stage of fibrosis (OR = 3.35, 95% CI: 1.01-11.07) and inversely associated with the duration of infection (OR = 0.74, 95% CI: 0.55-0.97). Moderate-to-severe steatosis was positively associated with the BMI z-score (OR = 3.62, 95% CI: 1.22-10.75) and stage of fibrosis (OR = 3.89, 95% CI: 1.05-14.47). Steatosis is a common finding in children with chronic viral hepatitis. It is associated with metabolic factors in CHB, whereas in patients with CHC, metabolic and viral factors may have a combined effect, leading to more advanced grades of steatosis in children with higher BMI z-scores. Moderate-to-severe steatosis is a predictor of advanced fibrosis in children with CHC.

  9. Left ventricular diastolic dysfunction in patients with chronic obstructive pulmonary disease (COPD, prevalence and association with disease severity: Using tissue Doppler study

    Directory of Open Access Journals (Sweden)

    Abeer M. Rawy

    2015-10-01

    Conclusion: There is a high prevalence of LVDD in COPD patients which is associated with increased disease severity and associated with high levels of inflammatory markers (serum MMP-9 and TIMP-1. It is important to exclude decompensated heart failure during COPD exacerbation.

  10. Prevalence and diagnosis of chronic obstructive pulmonary disease among smokers at risk. A comparative study of case-finding vs. screening strategies.

    Science.gov (United States)

    Sansores, Raul H; Ramírez-Venegas, Alejandra; Hernández-Zenteno, Rafael; Mayar-Maya, María Eugenia; Pérez-Bautista, Oliver G; Velázquez Uncal, Mónica

    2013-04-01

    Early diagnosis of chronic obstructive pulmonary disease (COPD) remains the main intervention to prevent disease progression. However, conflicting results exist on the utility of two different diagnostic strategies that preclude freely recommending one strategy in favor of the other. Spirometry was used to determine the effectiveness of a symptom-based (case-finding) strategy vs. a screening strategy to detect COPD in smokers. The case-finding strategy was undertaken during the COPD Day campaign in smokers with respiratory symptoms who were willing to submit to lung function testing. Screening was carried out with smokers attending a smoking cessation program. A short standardized questionnaire on respiratory symptoms along with spirometry were carried out and analyzed for both strategies. We evaluated 2781 smokers (mean pack/years 23.38): 1999 from the case-finding strategy and 782 from the smoking cessation program strategy (SCS). Prevalence of COPD according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria was 10.1 and 13.3%, respectively (p smokers from the case-finding strategy. Multivariate logistic regression analysis showed that dyspnea [OR = 2.09 (95% CI 1.41-3.1)] was the only common predictor of COPD after jointly and separately analyzing case-finding and screening strategies. For early diagnosis of COPD in a primary care setting, a screening strategy aimed at all smokers may be more useful than a case-finding strategy. Copyright © 2013 Elsevier Ltd. All rights reserved.

  11. Prevalence of symptoms of depression among patients with chronic ...

    African Journals Online (AJOL)

    Objective: Depression is the most common psychiatric illness in patients with chronic kidney disease (CKD). Depression has been shown to affect mortality in end-stage renal disease patients. The objective of this study was to determine prevalence of depressive symptoms among CKD patients. Materials and Methods: A ...

  12. Major and chronic diseases, report 2007.

    NARCIS (Netherlands)

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

    2008-01-01

    Blind spots in European health information On June 6th 2008 the European Commission has published the Major and Chronic Diseases Report 2007. This report describes the state of the art of health information in Europe on 13 prevalent chronic conditions. Large differences between the Member States of

  13. The prevalence and patient characteristics of chronic obstructive pulmonary disease in non-smokers in Vietnam and Indonesia: An observational survey.

    Science.gov (United States)

    Nguyen Viet, Nhung; Yunus, Faisal; Nguyen Thi Phuong, Anh; Dao Bich, Van; Damayanti, Triya; Wiyono, Wiwien Heru; Billot, Laurent; Jakes, Rupert W; Kwon, Namhee

    2015-05-01

    An estimated 25-40% of patients with chronic obstructive pulmonary disease (COPD) have never smoked. We investigated the prevalence and patient characteristics of COPD in non-smokers from Vietnam and Indonesia. This population-based cross-sectional survey of participants from urban and rural Vietnam and Indonesia used a stratified multistage cluster sampling design, with sample and population weights applied to ensure representativeness. Participants were female or male (recruited in the ratio 2:1) non-smokers, 40 years or older and able to perform a spirometry test. Spirometry was performed at a single study visit. Other clinical information was collected via standardized questionnaires. The 1506 evaluable participants were approximately equally distributed between Vietnam and Indonesia, and rural and urban areas. Overall prevalence of COPD was found to be 6.9% (95% confidence interval (CI): 5.7-8.3), with almost three times higher prevalence in men than women (12.9% (95% CI: 9.1-18.0) vs 4.4% (95% CI: 3.0-6.5)). We found higher rates of COPD in Vietnam than Indonesia (8.1% (95% CI: 5.8-11.3) vs 6.3% (95% CI: 4.8-8.3)), with a particularly high prevalence in urban Vietnam (11.1% (95% CI: 8.1-15.1)). Very few participants (6%) diagnosed to have COPD during the study had been previously diagnosed with COPD. Respiratory symptoms and lower health-related quality of life were more common in participants with COPD. The prevalence of COPD in non-smoking individuals from rural and urban Vietnam and Indonesia was 6.9%, of which a significant proportion (94%) were previously undiagnosed. © 2015 Asian Pacific Society of Respirology.

  14. Influence of the Method of Definition on the Prevalence of Left-Ventricular Hypertrophy in Children with Chronic Kidney Disease: Data from the Know-Ped CKD Study.

    Science.gov (United States)

    Cho, Heeyeon; Choi, Hyun Jin; Kang, Hee Gyung; Ha, Il-Soo; Cheong, Hae Il; Han, Kyung Hee; Kim, Seong Heon; Cho, Min Hyun; Shin, Jae Il; Lee, Joo Hoon; Park, Young Seo

    2017-01-01

    Children with chronic kidney disease (CKD) have a high risk of cardiovascular disease. Left-ventricular (LV) hypertrophy (LVH) is an early marker of cardiovascular disease in pediatric CKD, and the prevalence of LVH in pediatric CKD is approximately 20-30% in pre-dialysis CKD patients. However, there is no consensus on the ideal method of defining LVH in pediatric CKD patients. Previous studies have typically used the LV mass index (LVMI), which is calculated as LV mass in grams divided by height in meters to the 2.7th power ≥ 38 g/m2.7, to diagnose LVH in children with CKD. Recently, age-specific reference values for LVMI ≥ 95th percentile and LV wall-thickness z-score > 1.64 in children were addressed. The aim of this study was to assess the prevalence and contributing factors of LVH in pediatric CKD patients according to each measurement and evaluate the concordance between each measurement. We used the baseline data of the KoreaN cohort study for Outcome in patients With Pediatric Chronic Kidney Disease (KNOW-Ped CKD), which is a nationwide, 10-year, prospective, observational cohort study of pediatric CKD. A total of 469 patients were enrolled, and 458 patients were included in the final analysis. Univariate and multiple logistic regression analysis were performed to evaluate the association of the variables with LVH. Kappa statistics were used to analyze the concordance. According to an LVH diagnosis of LVMI ≥ 38 g/m2.7, 188 patients (41.0%) were diagnosed with LVH, and the prevalence of LVH was high in younger patients ( 1.64. There is poor concordance between the diagnosis of LVH using the LV wall-thickness z-score and the LVMI method. The results of this study show that there is poor concordance between the diagnosis of LVH using the wall-thickness z-score and the LVMI2.7 criteria. Further investigation is needed to estimate the correlation between LVH and cardiac dysfunction and to find a better method for defining LVH in the pediatric CKD cohort

  15. Chronic granulomatous disease

    NARCIS (Netherlands)

    Roos, Dirk

    2016-01-01

    Chronic granulomatous disease (CGD) is a primary immunodeficiency characterized by recurrent, life-threatening bacterial and fungal infections of the skin, the airways, the lymph nodes, the liver, the brain and the bones. Frequently found pathogens are Staphylococcus aureus, Aspergillus species,

  16. Chronic Diseases Overview

    Science.gov (United States)

    ... Brault MW, Hootman J, Helmick CG, Theis KA, Armour BS. Prevalence and most common causes of disability ... Heart disease and stroke statistics—2017 update: a report from the American Heart ... JW, Dietz W. Annual medical spending attributable to obesity: payer- and service- ...

  17. Prevalence of chronic obstructive pulmonary disease and variation in risk factors across four geographically diverse resource-limited settings in Peru.

    Science.gov (United States)

    Jaganath, Devan; Miranda, J Jaime; Gilman, Robert H; Wise, Robert A; Diette, Gregory B; Miele, Catherine H; Bernabe-Ortiz, Antonio; Checkley, William

    2015-03-18

    It is unclear how geographic and social diversity affects the prevalence of chronic obstructive pulmonary disease (COPD). We sought to characterize the prevalence of COPD and identify risk factors across four settings in Peru with varying degrees of urbanization, altitude, and biomass fuel use. We collected sociodemographics, clinical history, and post-bronchodilator spirometry in a randomly selected, age-, sex- and site-stratified, population-based sample of 2,957 adults aged ≥35 years (median age was 54.8 years and 49.3% were men) from four resource-poor settings: Lima, Tumbes, urban and rural Puno. We defined COPD as a post-bronchodilator FEV1/FVC urban Tumbes, 6.1% in urban Puno, 6.2% in Lima, and 9.9% in rural Puno (p < 0.001). Population attributable risks (PARs) of COPD due to smoking ≥10 pack-years were less than 10% for all sites, consistent with a low prevalence of daily smoking (3.3%). Rather, we found that PARs of COPD varied by setting. In Lima, for example, the highest PARs were attributed to post-treatment tuberculosis (16% and 22% for men and women, respectively). In rural Puno, daily biomass fuel for cooking among women was associated with COPD (prevalence ratio 2.22, 95% CI 1.02-4.81) and the PAR of COPD due to daily exposure to biomass fuel smoke was 55%. The burden of COPD in Peru was not uniform and, unlike other settings, was not predominantly explained by tobacco smoking. This study emphasizes the role of biomass fuel use, and highlights pulmonary tuberculosis as an often neglected risk factor in endemic areas.

  18. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.

    Science.gov (United States)

    2015-08-22

    Up-to-date evidence about levels and trends in disease and injury incidence, prevalence, and years lived with disability (YLDs) is an essential input into global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013), we estimated these quantities for acute and chronic diseases and injuries for 188 countries between 1990 and 2013. Estimates were calculated for disease and injury incidence, prevalence, and YLDs using GBD 2010 methods with some important refinements. Results for incidence of acute disorders and prevalence of chronic disorders are new additions to the analysis. Key improvements include expansion to the cause and sequelae list, updated systematic reviews, use of detailed injury codes, improvements to the Bayesian meta-regression method (DisMod-MR), and use of severity splits for various causes. An index of data representativeness, showing data availability, was calculated for each cause and impairment during three periods globally and at the country level for 2013. In total, 35 620 distinct sources of data were used and documented to calculated estimates for 301 diseases and injuries and 2337 sequelae. The comorbidity simulation provides estimates for the number of sequelae, concurrently, by individuals by country, year, age, and sex. Disability weights were updated with the addition of new population-based survey data from four countries. Disease and injury were highly prevalent; only a small fraction of individuals had no sequelae. Comorbidity rose substantially with age and in absolute terms from 1990 to 2013. Incidence of acute sequelae were predominantly infectious diseases and short-term injuries, with over 2 billion cases of upper respiratory infections and diarrhoeal disease episodes in 2013, with the notable exception of tooth pain due to permanent caries with more than 200 million incident cases in 2013. Conversely, leading chronic sequelae were largely attributable to non-communicable diseases, with

  19. The Prevalence of Allergic Rhinitis in Patients with Chronic Rhinosinusitis

    OpenAIRE

    Mehdi Bakhshaee; Farahzad Jabari; Mohammad Mehdi Ghassemi; Shiva Hourzad; Russell Deutscher; Kianoosh Nahid

    2014-01-01

    Introduction: Chronic rhinosinusitis (CRS) is a multifactorial disease. Allergies are considered a predisposing factor to CRS; however, this remains controversial. The objective of this research was to investigate the prevalence of co-morbidities and allergic reaction, and to specify the most common allergens in patients with confirmed CRS.   Materials and Methods: One hundred patients with signs and symptoms of CRS who met the diagnostic endoscopic and radiologic criteria of chronic rhinosi...

  20. Screening for Chronic Kidney Disease

    Science.gov (United States)

    Understanding Task Force Recommendations Screening for Chronic Kidney Disease The U.S. Preventive Services Task Force (Task Force) has issued a final recommendation on Screening for Chronic Kidney Disease (CKD) . This recommendation ...

  1. Prevalence, determinants and clinical correlates of vitamin D deficiency in patients with Chronic Obstructive Pulmonary Disease in London, UK.

    Science.gov (United States)

    Jolliffe, David A; James, Wai Yee; Hooper, Richard L; Barnes, Neil C; Greiller, Claire L; Islam, Kamrul; Bhowmik, Angshu; Timms, Peter M; Rajakulasingam, Raj K; Choudhury, Aklak B; Simcock, David E; Hyppönen, Elina; Walton, Robert T; Corrigan, Christopher J; Griffiths, Christopher J; Martineau, Adrian R

    2018-01-01

    Vitamin D deficiency is common in patients with chronic obstructive pulmonary disease (COPD), yet a comprehensive analysis of environmental and genetic determinants of serum 25-hydroxyvitamin D (25[OH]D) concentration in patients with this condition is lacking. We conducted a multi-centre cross-sectional study in 278 COPD patients aged 41-92 years in London, UK. Details of potential environmental determinants of vitamin D status and COPD symptom control and severity were collected by questionnaire, and blood samples were taken for analysis of serum 25(OH)D concentration and DNA extraction. All participants performed spirometry and underwent measurement of weight and height. Quadriceps muscle strength (QS) was measured in 134 participants, and sputum induction with enumeration of lower airway eosinophil and neutrophil counts was performed for 44 participants. Thirty-seven single nucleotide polymorphisms (SNP) in 11 genes in the vitamin D pathway (DBP, DHCR7, CYP2R1, CYP27B1, CYP24A1, CYP27A1, CYP3A4, LRP2, CUBN, RXRA, and VDR) were typed using Taqman allelic discrimination assays. Linear regression was used to identify environmental and genetic factors independently associated with serum 25(OH)D concentration and to determine whether vitamin D status or genetic factors independently associated with % predicted forced expiratory volume in one second (FEV 1 ), % predicted forced vital capacity (FVC), the ratio of FEV 1 to FVC (FEV 1 :FVC), daily inhaled corticosteroid (ICS) dose, respiratory quality of life (QoL), QS, and the percentage of eosinophils and neutrophils in induced sputum. Mean serum 25(OH)D concentration was 45.4nmol/L (SD 25.3); 171/278 (61.5%) participants were vitamin D deficient (serum 25[OH]D concentration D status was independently associated with higher body mass index (P=0.001), lower socio-economic position (P=0.037), lack of vitamin D supplement consumption (PP for trend=0.006) and lack of a recent sunny holiday (P=0.002). Vitamin D deficiency

  2. Anemia in Chronic Kidney Disease

    Science.gov (United States)

    ... artérielle Heart Disease Mineral & Bone Disorder Anemia in Chronic Kidney Disease What is anemia? Anemia is a condition in ... as they should. How is anemia related to chronic kidney disease? Anemia commonly occurs in people with chronic kidney ...

  3. The prevalence of chronic diseases and major disease risk factors at different ages among 150 000 men and women living in Mexico City: cross-sectional analyses of a prospective study

    Directory of Open Access Journals (Sweden)

    Peto Richard

    2009-01-01

    Full Text Available Abstract Background While most of the global burden from chronic diseases, and especially vascular diseases, is now borne by low and middle-income countries, few large-scale epidemiological studies of chronic diseases in such countries have been performed. Methods From 1998–2004, 52 584 men and 106 962 women aged ≥35 years were visited in their homes in Mexico City. Self reported diagnoses of chronic diseases and major disease risk factors were ascertained and physical measurements taken. Age- and sex-specific prevalences and means were analysed. Results After about age 50 years, diabetes was extremely common – for example, 23.8% of men and 26.9% of women aged 65–74 reported a diagnosis. By comparison, ischaemic heart disease was reported by 4.8% of men and 3.0% of women aged 65–74, a history of stroke by 2.8% and 2.3%, respectively, and a history of cancer by 1.3% and 2.1%. Cancer history was generally more common among women than men – the excess being largest in middle-age, due to breast and cervical cancer. At older ages, the gap narrowed because of an increasing prevalence of prostate cancer. 51% of men and 25% of women aged 35–54 smoked cigarettes, while 29% of men and 41% of women aged 35–54 were obese (i.e. BMI ≥30 kg/m2. The prevalence of treated hypertension or measured blood pressure ≥140/90 mmHg increased about 50% more steeply with age among women than men, to 66% of women and 58% of men aged 65–74. Physical inactivity was highly prevalent but daily alcohol drinking was relatively uncommon. Conclusion Diabetes, obesity and tobacco smoking are highly prevalent among adults living in Mexico City. Long-term follow-up of this and other cohorts will establish the relevance of such factors to the major causes of death and disability in Mexico.

  4. The prevalence of chronic diseases and major disease risk factors at different ages among 150 000 men and women living in Mexico City: cross-sectional analyses of a prospective study

    Science.gov (United States)

    Kuri-Morales, Pablo; Emberson, Jonathan; Alegre-Díaz, Jesús; Tapia-Conyer, Roberto; Collins, Rory; Peto, Richard; Whitlock, Gary

    2009-01-01

    Background While most of the global burden from chronic diseases, and especially vascular diseases, is now borne by low and middle-income countries, few large-scale epidemiological studies of chronic diseases in such countries have been performed. Methods From 1998–2004, 52 584 men and 106 962 women aged ≥35 years were visited in their homes in Mexico City. Self reported diagnoses of chronic diseases and major disease risk factors were ascertained and physical measurements taken. Age- and sex-specific prevalences and means were analysed. Results After about age 50 years, diabetes was extremely common – for example, 23.8% of men and 26.9% of women aged 65–74 reported a diagnosis. By comparison, ischaemic heart disease was reported by 4.8% of men and 3.0% of women aged 65–74, a history of stroke by 2.8% and 2.3%, respectively, and a history of cancer by 1.3% and 2.1%. Cancer history was generally more common among women than men – the excess being largest in middle-age, due to breast and cervical cancer. At older ages, the gap narrowed because of an increasing prevalence of prostate cancer. 51% of men and 25% of women aged 35–54 smoked cigarettes, while 29% of men and 41% of women aged 35–54 were obese (i.e. BMI ≥30 kg/m2). The prevalence of treated hypertension or measured blood pressure ≥140/90 mmHg increased about 50% more steeply with age among women than men, to 66% of women and 58% of men aged 65–74. Physical inactivity was highly prevalent but daily alcohol drinking was relatively uncommon. Conclusion Diabetes, obesity and tobacco smoking are highly prevalent among adults living in Mexico City. Long-term follow-up of this and other cohorts will establish the relevance of such factors to the major causes of death and disability in Mexico. PMID:19134207

  5. Relationship between femur neck bone mineral density and prevalent chronic obstructive pulmonary disease (COPD) or COPD mortality in older non-Hispanic white adults from NHANES III.

    Science.gov (United States)

    Looker, A C

    2014-03-01

    The relationship between femur neck bone mineral density (FNBMD), prevalent COPD, and COPD mortality was examined in older non-Hispanic white adults from NHANES III. FNBMD was significantly related to prevalent COPD and COPD mortality before and after adjusting for shared risk factors. Bone mineral density (BMD) has been linked to chronic obstructive pulmonary disease (COPD), but little is known about its relationship with COPD mortality. The present study examined the relationship between FNBMD, prevalent COPD, and COPD mortality in older non-Hispanic white adults from the third National Health and Nutrition Examination Survey (NHANES III, 1988-1994). COPD status at baseline was defined by self-reported physician's diagnosis and by airway obstruction based on spirometry measurements in 3,275 non-Hispanic whites aged 50 years and older. COPD mortality cases were identified using linked mortality records obtained through 2006. FNBMD was measured by dual-energy x-ray absorptiometry. Multiple regression was used to examine the baseline relationship between COPD and FNBMD. Cox proportional hazards models were used to estimate the hazards ratio (HR) for COPD mortality by FNBMD. Twelve percent self-reported a physician's diagnosis of COPD, 23 % had mild or moderate airway obstruction, and 9 % had severe or very severe airway obstruction. There were 180 COPD mortality cases in the sample. FNBMD was significantly lower in those with self-reported COPD diagnosis or airway obstruction before and after adjusting for shared risk factors (p COPD mortality risk was significantly increased for each standard deviation decline in FNBMD before (by 68 %) and after (by 26-38 %) adjusting for shared risk factors. Low FNBMD was associated with both baseline COPD and future COPD mortality. Shared risk factors appeared to explain some, but not all, of these relationships.

  6. Prevalence and reasons for intentional use of complementary and alternative medicine as an adjunct to future visits to a medical doctor for chronic disease.

    Science.gov (United States)

    Kristoffersen, Agnete E; Stub, Trine; Musial, Frauke; Fønnebø, Vinjar; Lillenes, Ola; Norheim, Arne Johan

    2018-03-27

    Intentional use of complementary and alternative medicine (CAM) has previously only been researched in small, possibly biased, samples. There seems to be a lack of scientific information regarding healthy individual's attitudes and presumed use of CAM. The aim of this study is to describe prevalence and characteristics of participants who intend to see a CAM provider compared to participants who intend to see a medical doctor (MD) only when suffering from a chronic, non- life-threatening disease and in the need of treatment. Further to describe differences between the groups regarding expected reasons for CAM use and expected skills of CAM providers. The survey was conducted in January 2016 as part of the "TNS Gallup Health policy Barometer". In total, 1728 individuals aged 16-92 years participated in the study, constituting an overall response rate of 47%. The survey included questions regarding opinions and attitudes towards health, health services and health politics in Norway. The majority of the participants (90.2%) would see a MD only if they were suffering from a chronic, non- life-threatening disease and were in the need of treatment. Men over the age of 60 with a university education tended to see a MD only. Only 9.8% of all respondents would in addition visit a CAM provider. Being an intentional user of a MD + CAM provider was associated with being a woman under the age of 60. The respondents believed that CAM providers have professional competence based on formal training in CAM. They also believed that individuals seeing a CAM provider have poor health and are driven by the hope of being cured. Further, that they have heard that others have good experience with such treatment. Intentional use of CAM is associated with positive attitudes, trustworthiness, and presumed positive experiences in the CAM-patient-setting. Intentional CAM users also have the impression that CAM providers have professional competence based on formal training in alternative

  7. Chronic disease prevalence and care among the elderly in urban and rural Beijing, China - a 10/66 Dementia Research Group cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Sousa Renata

    2009-10-01

    Full Text Available Abstract Background Demographic ageing is occurring at an unprecedented rate in China. Chronic diseases and their disabling consequences will become much more common. Public policy has a strong urban bias, and older people living in rural areas may be especially vulnerable due to limited access to good quality healthcare, and low pension coverage. We aim to compare the sociodemographic and health characteristics, health service utilization, needs for care and informal care arrangements of representative samples of older people in two Beijing communities, urban Xicheng and rural Daxing. Methods A one-phase cross-sectional survey of all those aged 65 years and over was conducted in urban and rural catchment areas in Beijing, China. Assessments included questionnaires, a clinical interview, physical examination, and an informant interview. Prevalence of chronic diseases, self-reported impairments and risk behaviours was calculated adjusting for household clustering. Poisson working models were used to estimate the independent effect of rural versus urban residence, and to explore the predictors of health services utilization. Results We interviewed 1002 participants in rural Daxing, and 1160 in urban Xicheng. Those in Daxing were more likely to be younger, widowed, less educated, not receiving a pension, and reliant on family transfers. Chronic diseases were more common in Xicheng, when based on self-report rather than clinical assessment. Risk exposures were more common in Daxing. Rural older people were much less likely to access health services, controlling for age and health. Community health services were ineffective, particularly in Daxing, where fewer than 3% of those with hypertension were adequately controlled. In Daxing, care was provided by family, who had often given up work to do so. In Xicheng, 45% of those needing care were supported by paid caregivers. Caregiver strain was higher in Xicheng. Dementia was strongly associated with

  8. Chronic granulomatous disease associated with chronic glomerulonephritis

    DEFF Research Database (Denmark)

    Frifelt, J J; Schønheyder, Henrik Carl; Valerius, Niels Henrik

    1985-01-01

    A boy with chronic granulomatous disease (CGD) developed glomerulonephritis at the age of 12 years. The glomerulonephritis progressed to terminal uraemia at age 15 when maintenance haemodialysis was started. The clinical course was complicated by pulmonary aspergillosis and Pseudomonas septicaemia...

  9. The Prevalence of Fibromyalgia in Other Chronic Pain Conditions

    Directory of Open Access Journals (Sweden)

    Muhammad B. Yunus

    2012-01-01

    Full Text Available Central sensitivity syndromes (CSS include fibromyalgia syndrome (FMS, irritable bowel syndrome, temporomandibular disorder, restless legs syndrome, chronic fatigue syndrome, and other similar chronic painful conditions that are based on central sensitization (CS. CSS are mutually associated. In this paper, prevalence of FMS among other members of CSS has been described. An important recent recognition is an increased prevalence of FMS in other chronic pain conditions with structural pathology, for example, rheumatoid arthritis, systemic lupus, ankylosing spondylitis, osteoarthritis, diabetes mellitus, and inflammatory bowel disease. Diagnosis and proper management of FMS among these diseases are of crucial importance so that unwarranted use of such medications as corticosteroids can be avoided, since FMS often occurs when RA or SLE is relatively mild.

  10. Chronic granulomatous disease

    Directory of Open Access Journals (Sweden)

    Nair Pradeep

    2005-01-01

    Full Text Available A 2½-year-old child presented with multiple discrete granulomatous lesions on the face and flexural regions since the age of 2 months along with lymphadenopathy. The patient also had recurrent bouts of pyodermas and respiratory tract infections. Biopsy of the lesion showed necrosis of tissue with suppuration and histiocytes but no evidence of tuberculosis, fungal infections or atypical mycobacteria. Lymph node biopsy also showed necrosis with suppuration but no infective organism. Nitroblue tetrazolium test was negative indicating that the neutrophils failed to oxidize the dye. We are reporting here a rare case of chronic granulomatous disease.

  11. An Overview of Chronic Obstructive Pulmonary Disease (COPD ...

    African Journals Online (AJOL)

    Background: Chronic Obstructive Pulmonary Disease (COPD) is one of the most common chronic respiratory diseases which contribute significantly to the burden of non-communicable diseases. With the increasing prevalence of COPD in developing countries a good knowledge of disease burden and process is essential.

  12. Cardiovascular risk factors in childhood chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Ahmet Midhat Elmacı

    2013-03-01

    Full Text Available Cardiovascular diseases are the principal cause of morbidityand mortality among child and adults with chronicrenal disease. Recent data demonstrate a high incidenceand prevalence of traditional and uremia related cardiovascularrisk factors in children. This review summarizesthe current literature on cardiovascular risk factors, mortalityand morbidity in children with chronic kidney disease.Key words: Child, chronic kidney disease, cardiovascular

  13. Prevalence and risk factors associated to chronic kidney disease in HIV-infected patients on HAART and undetectable viral load in Brazil.

    Directory of Open Access Journals (Sweden)

    Andréia M Menezes

    Full Text Available BACKGROUND: To determine the prevalence and associated factors with chronic kidney disease (CKD in a cohort of HIV-positive individuals with undetectable viral load on HAART. METHODS: From March, 2009 to September 2009, 213 individuals between 18-70 years, period on HAART ≥12 months, viral load < 50 copies/mm(3, and CD4 ≥ 200 cells/mm(3, were consecutively enrolled at the outpatient clinic of Hospital de Clínicas, Porto Alegre, Brazil. Exclusion criteria were obesity, malnourishment, amputee, paraplegic, previous history of renal disease, pregnancy and hepatic insufficiency. Renal function was determined by estimated glomerular filtration rate (eGFR assessed by the modification of diet in renal disease. CKD was defined as an eGFR less or equal than 60 ml/min/1.73 m(2, for a period of at least 3 months. Poisson regression was used to determine factors associated with CKD. RESULTS: CKD was diagnosed in 8.4% of the population, and after adjustment, the risk factors were hypertension (RR = 3.88, 95%CI, 1.84-8.16, time on HAART (RR = 1.15, 95%CI,1.03-1.27 and tenofovir exposure (RR = 2.25, 95%CI, 1.04-4.95. Higher weight (RR = 0.88 95%CI, 0.82-0.96 was associated to normal function. CONCLUSIONS: CKD was a common finding in this cohort of patients and was related to hypertension, time on HAART and tenofovir exposure. We suggest a more frequent monitoring of renal function, especially for those with risk factors to early identify renal impairment.

  14. No longer diseases of the wealthy: prevalence and health-seeking for self-reported chronic conditions among urban poor in Southern India.

    Science.gov (United States)

    Bhojani, Upendra; Beerenahalli, Thriveni S; Devadasan, Roopa; Munegowda, C M; Devadasan, Narayanan; Criel, Bart; Kolsteren, Patrick

    2013-08-13

    The burden of chronic conditions is high in low- and middle-income countries and poses a significant challenge to already weak healthcare delivery systems in these countries. Studies investigating chronic conditions among the urban poor remain few and focused on specific chronic conditions rather than providing overall profile of chronic conditions in a given community, which is critical for planning and managing services within local health systems. We aimed to assess the prevalence and health- seeking behaviour for self-reported chronic conditions in a poor neighbourhood of a metropolitan city in India. We conducted a house-to-house survey covering 9299 households (44514 individuals) using a structured questionnaire. We relied on self-report by respondents to assess presence of any chronic conditions, including diabetes and hypertension. Multivariable logistic regression was used to analyse the prevalence and health-seeking behaviour for self-reported chronic conditions in general as well as for diabetes and hypertension in particular. The predictor variables included age, sex, income, religion, household poverty status, presence of comorbid chronic conditions, and tiers in the local health care system. Overall, the prevalence of self-reported chronic conditions was 13.8% (95% CI = 13.4, 14.2) among adults, with hypertension (10%) and diabetes (6.4%) being the most commonly reported conditions. Older people and women were more likely to report chronic conditions. We found reversal of socioeconomic gradient with people living below the poverty line at significantly greater odds of reporting chronic conditions than people living above the poverty line (OR = 3, 95% CI = 1.5, 5.8). Private healthcare providers managed over 80% of patients. A majority of patients were managed at the clinic/health centre level (42.9%), followed by the referral hospital (38.9%) and the super-specialty hospital (18.2%) level. An increase in income was positively associated with the use

  15. Recalibration of blood analytes over 25 years in the atherosclerosis risk in communities study: impact of recalibration on chronic kidney disease prevalence and incidence.

    Science.gov (United States)

    Parrinello, Christina M; Grams, Morgan E; Couper, David; Ballantyne, Christie M; Hoogeveen, Ron C; Eckfeldt, John H; Selvin, Elizabeth; Coresh, Josef

    2015-07-01

    Equivalence of laboratory tests over time is important for longitudinal studies. Even a small systematic difference (bias) can result in substantial misclassification. We selected 200 Atherosclerosis Risk in Communities Study participants attending all 5 study visits over 25 years. Eight analytes were remeasured in 2011-2013 from stored blood samples from multiple visits: creatinine, uric acid, glucose, total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, and high-sensitivity C-reactive protein. Original values were recalibrated to remeasured values with Deming regression. Differences >10% were considered to reflect substantial bias, and correction equations were applied to affected analytes in the total study population. We examined trends in chronic kidney disease (CKD) pre- and postrecalibration. Repeat measures were highly correlated with original values [Pearson r > 0.85 after removing outliers (median 4.5% of paired measurements)], but 2 of 8 analytes (creatinine and uric acid) had differences >10%. Original values of creatinine and uric acid were recalibrated to current values with correction equations. CKD prevalence differed substantially after recalibration of creatinine (visits 1, 2, 4, and 5 prerecalibration: 21.7%, 36.1%, 3.5%, and 29.4%, respectively; postrecalibration: 1.3%, 2.2%, 6.4%, and 29.4%). For HDL cholesterol, the current direct enzymatic method differed substantially from magnesium dextran precipitation used during visits 1-4. Analytes remeasured in samples stored for approximately 25 years were highly correlated with original values, but 2 of the 8 analytes showed substantial bias at multiple visits. Laboratory recalibration improved reproducibility of test results across visits and resulted in substantial differences in CKD prevalence. We demonstrate the importance of consistent recalibration of laboratory assays in a cohort study. © 2015 American Association for Clinical Chemistry.

  16. Recalibration of blood analytes over 25 years in the Atherosclerosis Risk in Communities Study: The impact of recalibration on chronic kidney disease prevalence and incidence

    Science.gov (United States)

    Parrinello, Christina M.; Grams, Morgan E.; Couper, David; Ballantyne, Christie M.; Hoogeveen, Ron C.; Eckfeldt, John H.; Selvin, Elizabeth; Coresh, Josef

    2016-01-01

    Background Equivalence of laboratory tests over time is important for longitudinal studies. Even a small systematic difference (bias) can result in substantial misclassification. Methods We selected 200 Atherosclerosis Risk in Communities Study participants attending all 5 study visits over 25 years. Eight analytes were re-measured in 2011–13 from stored blood samples from multiple visits: creatinine, uric acid, glucose, total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides, and high-sensitivity C-reactive protein. Original values were recalibrated to re-measured values using Deming regression. Differences >10% were considered to reflect substantial bias, and correction equations were applied to affected analytes in the total study population. We examined trends in chronic kidney disease (CKD) pre- and post-recalibration. Results Repeat measures were highly correlated with original values (Pearson’s r>0.85 after removing outliers [median 4.5% of paired measurements]), but 2 of 8 analytes (creatinine and uric acid) had differences >10%. Original values of creatinine and uric acid were recalibrated to current values using correction equations. CKD prevalence differed substantially after recalibration of creatinine (visits 1, 2, 4 and 5 pre-recalibration: 21.7%, 36.1%, 3.5%, 29.4%; post-recalibration: 1.3%, 2.2%, 6.4%, 29.4%). For HDL-cholesterol, the current direct enzymatic method differed substantially from magnesium dextran precipitation used during visits 1–4. Conclusions Analytes re-measured in samples stored for ~25 years were highly correlated with original values, but two of the 8 analytes showed substantial bias at multiple visits. Laboratory recalibration improved reproducibility of test results across visits and resulted in substantial differences in CKD prevalence. We demonstrate the importance of consistent recalibration of laboratory assays in a cohort study. PMID:25952043

  17. Prevalence of anemia in patients with type II diabetes and mild to moderate chronic kidney disease and the impact of anti-RAS medications.

    Science.gov (United States)

    Dousdampanis, Periklis; Trigka, Konstantina; Fourtounas, Costas

    2014-05-01

    Anemia is a common feature of diabetes and chronic kidney disease (CKD) mainly due to erythropoietin (EPO) deficiency and uremic toxicity. Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) have been established as first-choice medications for the treatment of diabetic nephropathy. However, there are conflicting data regarding their impact on hemoglobin levels in patients with diabetic nephropathy. We evaluated the prevalence of anemia in 101 patients with diabetes mellitus type II and CKD at stage III-IV (group A) compared with 101 non-diabetic patients with similar renal function (group B). Moreover, we evaluated the impact of ACE inhibitors and ARBs on patients' anemia. Anemia was observed in 60 patients in group A and in 47 patients in group B (P patients in group A and 19 patients in group B were receiving exogenous EPO for correction of renal anemia (P patients in group A and 52 patients in group B were receiving ACE inhibitors and/or ARBs (P medications. Anemia is more common in diabetic patients with CKD stage III-IV than in non-diabetic patients with similar renal function. Our results indicate that ACE inhibitors and ARBs are not a significant cause of anemia for both populations.

  18. Incidence, mortality, and prevalence of end-stage chronic renal disease in the Bajo Lempa region of El Salvador: A ten-year community registry.

    Science.gov (United States)

    García-Trabanino, Ramón; Hernández, Carolina; Rosa, Adrián; Domínguez Alonso, Jesús

    The Bajo Lempa is an impoverished rural coastal region of El Salvador affected by the chronic kidney disease (CKD) epidemic known as Mesoamerican nephropathy. The local community organisation Fondo Social de Emergencia para la Salud (FSES) (Emergency social fund for health) is helping to fight the epidemic in 42 communities of the region (19,223 inhabitants; average age 26.7 years; 48.5% male; 40.2% social security and 1 in the military health system. 246 patients died (annual average 24.6 deaths; 89.4% male; average age 56.1 years; 92.3% at home). Average annual mortality rate: 128/100,000 population. Prevalence of patients receiving RRT in 2013: 1300.5 pmp (N=25; 84% male; average age 51 years). This region has a high incidence of ESRD. Few receive RRT. Patient mortality is high even with RRT. Most patients are male (9:1). Social determinants influence the high mortality. Copyright © 2016 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  19. Cerebral small vessel disease and chronic kidney disease.

    Science.gov (United States)

    Toyoda, Kazunori

    2015-01-01

    Chronic kidney disease, defined by a decreased glomerular filtration rate or albuminuria, is recognized as a major global health burden, mainly because it is an established risk factor for cardiovascular and cerebrovascular diseases. The magnitude of the effect of chronic kidney disease on incident stroke seems to be higher in persons of Asian ethnicity. Since the kidney and brain share unique susceptibilities to vascular injury due to similar anatomical and functional features of small artery diseases, kidney impairment can be predictive of the presence and severity of cerebral small vessel diseases. Chronic kidney disease has been reported to be associated with silent brain infarcts, cerebral white matter lesions, and cerebral microbleeds, independently of vascular risk factors. In addition, chronic kidney disease affects cognitive function, partly via the high prevalence of cerebral small vessel diseases. Retinal artery disease also has an independent relationship with chronic kidney disease and cognitive impairment. Stroke experts are no longer allowed to be ignorant of chronic kidney disease. Close liaison between neurologists and nephrologists can improve the management of cerebral small vessel diseases in kidney patients.

  20. Correlation between caries prevalence and chronic perodontitis

    Directory of Open Access Journals (Sweden)

    Sara Entezari

    2014-03-01

    Full Text Available Introduction : Periodontitis and dental caries may be synergistically associated, negatively associated, or completely independent.The aim of this study was to evaluate the correlation between these two diseases and investigate the prevalence of dental caries in periodontitis. Methods: This cross- sectional study has been performed in 180 samples in two groups: periodontal and control group during 2012-2013 in Babol Dental School.All 180 patients were divided into two groups, including 90 cases with chronic periodontitis as the periodontal group (PG and 90 cases with healthy gums as the control group ( probing depth between 2- 3 mm (HG.Clinical measurments including Gingival Index ( GI, Bleeding Index( BI, Clinical Attachment Loss (CAL, Periodontal Pocket Depth (PPD were used to assess the severity of periodontal disease . The clinical features of control group were healthy gums , probing less than 3 mm in depth, and CAL< 1mm . The examination to measure AL was conducted using a Williams’s periodontal probe .In chronic periodontitis group , the patients had GI≥1 and CAL ≥ 1 .The assessment of caries of patients was conducted using bitewing radiography for proximal caries detection , dent on the use of explorer and direct observation. A p-value≤0.05 is considered as significant. Results: The results of this study showed that the mean number of decayed and filled teeth (DFT in periodontal group was 4.32 ± 0.17, and in healthy group was 2.16 ± 0.17.DFT in males with periodontitis was 4.85 ± 0.17 and in females was 4.3 ± 0.17 ,while the healthy males was 2.54 ± 0.17, and females was 2.25 ± 0.17 therefore, the mean DFT in the periodontal group was more than the healthy group (p≤0.05 . Conclusion : Based on our findings, in patients with periodontitis, more dental carries were more significant than the healthy group.

  1. Prevalence of Pulmonary Hypertension and its Influence on Survival in Patients With Advanced Chronic Obstructive Pulmonary Disease Prior to Lung Transplantation.

    Science.gov (United States)

    Hayes, Don; Black, Sylvester M; Tobias, Joseph D; Mansour, Heidi M; Whitson, Bryan A

    2016-01-01

    Prevalence of pulmonary hypertension (PH) and its influence on survival in chronic obstructive pulmonary disease (COPD) are not well studied in the lung allocation score (LAS) era. The UNOS database was queried from 2005 to 2013 to identify first-time adult lung transplant candidates with COPD who were tracked from wait list entry date until death or censoring to determine both prevalence and influence of PH. Using right heart catheterization measurements, mild PH was defined as mean pulmonary artery pressure (mPAP) ≥ 25 mmHg and severe ≥ 35 mmHg. Of 1315 COPD candidates not transplanted, 1243 were used for survival analysis using Cox proportional hazards models, and 1010 (mild PH) and 244 (severe PH) were used for propensity score matching, respectively. A total of 52% (652) of subjects had PH mPAP ≥ 25 mmHg. Univariate analysis revealed significant differences in survival for mild PH (HR = 1.769; 95% CI: 1.331, 2.351; p < 0.001) and severe PH (HR = 3.271; 95% CI: 2.311, 4.630; p < 0.001). Kaplan-Meier survival function demonstrated significant disparities for mild PH (Log-rank test: Chi-square1: 15.87, p < 0.0001) and severe PH (Log-rank test: Chi-square1: 50.13, p < 0.0001). Multivariate Cox models identified significant risk for death for mild PH (HR = 1.987; 95% CI: 1.484, 2.662; p < 0.001) and severe PH (HR = 3.432; 95% CI: 2.410, 4.888; p < 0.001). Propensity score matching confirmed increased mortality hazard associated with mild PH (HR = 2.280; 95% CI: 1.425, 3.649; p = 0.001) and severe PH (HR = 7.000; 95% CI: 2.455, 19.957; p < 0.001). PH is highly prevalent in advanced COPD and associated with a significantly higher risk for mortality.

  2. Accounting for frailty when treating chronic diseases.

    Science.gov (United States)

    Onder, Graziano; Vetrano, Davide L; Marengoni, Alessandra; Bell, J Simon; Johnell, Kristina; Palmer, Katie

    2018-03-08

    Chronic diseases are considered to be major determinants of frailty and it could be hypothesized that their treatment may counteract the development of frailty. However, the hypothesis that intensive treatment of chronic diseases might reduce the progression of frailty is poorly supported by existing studies. In contrast, some evidence suggests that intensive treatment of chronic diseases may increase negative health outcomes in frail older adults. In particular, if treatment of symptoms related to chronic diseases (i.e. pain in osteoarthritis, dyspnoea in respiratory disease, motor symptoms in Parkinson disease) might potentially reverse frailty, the benefits related to preventive pharmacological treatment of chronic diseases (i.e. antihypertensive treatment) in patients with prevalent frailty is not certain. In particular, several factors might alter the risk/benefit ratio of a given treatment in persons with frailty. These include: exclusion of frail persons from clinical studies, reduced life expectancy in frail persons, increased susceptibility to iatrogenic events, and functional deficits associated with frailty. Therefore, frailty acts as an effect modifier, by modifying the risks and benefits of chronic disease treatments. This hypothesis must be considered and tested in future clinical intervention studies and clinical guidelines should provide specific recommendations for the treatment of frail people, underlining the pros and the cons of pharmacological treatment and possible targets for therapy in this population. Meanwhile, in older patients, the prescribing process should be individualized and flexible. Copyright © 2018 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  3. Changes in the prevalence of psychological distress and use of antidepressants or anti-anxiety medications associated with comorbid chronic diseases in the adult Australian population, 2001-2008.

    Science.gov (United States)

    Atlantis, Evan; Sullivan, Thomas; Sartorius, Norman; Almeida, Osvaldo P

    2012-05-01

    To investigate changes in the prevalence of psychological distress and use of antidepressants or anti-anxiety medications associated with comorbid chronic diseases in the adult Australian population from 2001 to 2008. Participants were 48,359 adults aged ≥ 25 years from the 2001, 2004-05 or 2007-08 Australian National Health Surveys. Clinically significant psychological distress was determined with the 10-item Kessler Psychological Distress Scale (using scores ≥ 30). Contemporaneous use of antidepressants or anti-anxiety medications and the presence of chronic diseases including diabetes, cardiovascular disease, cancer, asthma and arthritis were by self-report. Overall, the prevalence of psychological distress was relatively stable (3.9 vs. 3.7%) between 2001 and 2008, but increased from 5.9 to 7.0% and 4.6 to 5.0% for people with diabetes and cardiovascular disease. In contrast, the use of antidepressants or anti-anxiety medications decreased from 7.3 to 4.8% across all disease categories. On average, the odds of psychological distress and use of antidepressants or anti-anxiety medications was 1.15 to 1.59-fold and 1.10 to 1.64-fold higher, respectively, for all chronic diseases after adjustments for socio-demographic and lifestyle variables. After further adjustment for all chronic disease predictors fitted jointly, these associations decreased in strength (percentage change in the log odds ratio) by 14 to 98%. Each additional chronic disease increased the odds of both psychological distress (1.34-fold higher) and use of antidepressants or anti-anxiety medications (1.40-fold higher) in a dose-response manner. Although the prevalence of psychological distress changed little for adult Australians between 2001 and 2008, it increased for people with diabetes and cardiovascular disease. Conversely, the reported use of antidepressants or anti-anxiety medications progressively decreased for people with, and without, chronic diseases. Overall, there was a

  4. Prevalence and severity of disordered mineral metabolism in patients with chronic kidney disease: A study from a tertiary care hospital in India

    Directory of Open Access Journals (Sweden)

    Sanjay Vikrant

    2016-01-01

    Full Text Available Background: Disordered mineral metabolism is common complications of chronic kidney disease (CKD. However, there are limited data on the pattern of these disturbances in Indian CKD population. Materials and Methods: This was a prospective observational study of CKD-mineral and bone disorder (CKD-MBD over a period of 3 years. The biochemical markers of CKD-MBD, namely, calcium, phosphorus, alkaline phosphatase, intact parathyroid hormone (iPTH, and 25-hydoxyvitamin Vitamin D3 (25OHD, were measured in newly diagnosed CKD Stage 3–5 and prevalent CKD Stage 5D adult patients. Results: A total of 462 patients of CKD Stage 3–5D were studied. The frequency of various biochemical abnormalities was hypocalcemia (23.8%, hypercalcemia (5.4%, hypophosphatemia (2.8%, hyperphosphatemia (55.4%, raised alkaline phosphatase (56.9%, secondary hyperparathyroidism (82.7%, and hypoparathyroidism (1.5%. 25OHD was done in 335 (72.5% patients and 90.4% were found to have Vitamin D deficiency. About 70.6% of the patients had iPTH levels were above kidney disease outcomes quality initiative (KDOQI target range. Nondiabetic CKD as compared to diabetic CKD had a higher alkaline phosphatase (P = 0.016, a higher iPTH (P = 0.001 a higher proportion of patients with iPTH above KDOQI target range (P = 0.09, and an elevated alkaline phosphatase (P = 0.004. The 25OHD levels were suggestive of severe Vitamin D deficiency in 33.7%, Vitamin D deficiency in 45.4%, and Vitamin D insufficiency in 11.3% patients. There was a significant positive correlation between iPTH with alkaline phosphatase (r = 0.572, P = 0.001, creatinine (r = 0.424, P = 0.001, and phosphorus (r = 0.241, P = 0.001 and a significant negative correlation with hemoglobin (r = −0.325, 0.001, age (r = −0.169, P = 0.002, and 25OHD (r = −0.126, P = 0.021. On multivariate logistic regression analysis, an elevated alkaline phosphatase was a significant predictor of hyperparathyroidism (odds ratio 9.7, 95

  5. Chronic Obstructive Pulmonary Disease (COPD): A Review of the ...

    African Journals Online (AJOL)

    Background: Chronic Obstructive Pulmonary disease (COPD) is one of the most common chronic respiratory diseases which contribute significantly to the burden of non-communicable diseases(NCDs). With the increasing prevalence of COPD in developing countries a good knowledge of the diagnosis and adequate ...

  6. Prevalence of Obstructive Sleep Apnea in Patients with Chronic Wounds

    Science.gov (United States)

    Patt, Brian T.; Jarjoura, David; Lambert, Lynn; Roy, Sashwati; Gordillo, Gayle; Schlanger, Richard; Sen, Chandan K.; Khayat, Rami N.

    2010-01-01

    Study Objectives: Chronic non-healing wounds are a major human and economic burden. Obstructive sleep apnea (OSA) is prevalent in patients with obesity, diabetes, aging, and cardiovascular disease, all of which are risk factors for chronic wounds. We hypothesized that OSA would have more prevalence in patients of a wound center than the general middle-aged population. Methods: Consecutive patients of the Ohio State University Comprehensive Wound Center (CWC) were surveyed with the Berlin and Epworth questionnaires. In the second stage of the protocol, 50 consecutive unselected CWC patients with lower extremity wounds underwent home sleep studies. Results: In 249 patients of the CWC who underwent the survey study, OSA had been previously diagnosed in only 22%. The prevalence of high-risk status based on questionnaires for OSA was 46% (95% CI 40%, 52%). In the 50 patients who underwent home sleep studies, and using an apnea hypopnea index of 15 events per hour, the prevalence of OSA was 57% (95% CI 42%, 71%). There was no difference between the Berlin questionnaire score and weight between patients with OSA and those without. Conclusions: The prevalence of OSA in patients with chronic wounds exceeds the estimated prevalence of OSA in the general middle aged population. This study identifies a previously unrecognized population with high risk for OSA. Commonly used questionnaires were not sufficiently sensitive for the detection of high risk status for OSA in this patient population. Citation: Patt BT; Jarjoura D; Lambert L; Roy S; Gordillo G; Schlanger R; Sen CK; Khayat RN. Prevalence of obstructive sleep apnea in patients with chronic wounds. J Clin Sleep Med 2010;6(6):541-544. PMID:21206743

  7. Moderate alcohol consumption and chronic disease

    DEFF Research Database (Denmark)

    Mukamal, Kenneth J; Clowry, Catherine M; Murray, Margaret M

    2016-01-01

    Drinking within recommended limits is highly prevalent in much of the world, and strong epidemiological associations exist between moderate alcohol consumption and risk of several major chronic diseases, including coronary heart disease, diabetes, and breast cancer. In many cases, plausible...... the observed associations have been termed impossible, clinical investigators have now successfully completed randomized trials of complex nutritional interventions in a variety of settings, along with trials of alcohol consumption itself of up to 2 years duration. The successful completion of these trials...

  8. Increased Prevalence of Human Polyomavirus JC Viruria in Chronic Inflammatory Rheumatic Diseases Patients in Treatment with Anti-TNF α: A 18 Month Follow-Up Study.

    Science.gov (United States)

    Rodio, Donatella Maria; Anzivino, Elena; Mischitelli, Monica; Bellizzi, Anna; Scrivo, Rossana; Scribano, Daniela; Conte, Gianlorenzo; Prezioso, Carla; Trancassini, Maria; Valesini, Guido; Palamara, Anna Teresa; Pietropaolo, Valeria

    2016-01-01

    Chronic inflammatory rheumatic diseases (CIRDs) are immune-mediated pathologies involving joints. To date, TNFα-blocking agents administration is the most promising therapy, although these treatments are associated with an increased Polyomavirus JC (JCPyV) reactivation, the etiological agent of the Progressive Multifocal Leukoencephalopathy (PML). The aim of this study was the recruitment and the analysis of a CIRDs cohort in order to investigate a possible correlation between JCPyV presence and the influence of anti-TNF-α agents on viral loads. Blood and urine samples were collected from 34 CIRDs subjects prior the first anti-TNF-α infusion (T0) and after 3 (T3), 6 (T6), 12 (T12), and 18 (T18) months. Results showed persistent JC viruria significantly higher than JC viremia throughout the 18 month follow-up study (p = 0.002). In JCPyV positive samples, the non-coding control region (NCCR) was analyzed. Results evidenced archetypal structures (type II-S) in all isolates with the exception of a sequence isolated from a plasma sample, that corresponds to the type II-R found in PML subjects. Finally, the viral protein 1 (VP1) genotyping was performed and results showed the prevalence of the European genotypes 1A, 1B, and 4. Since only few studies have been carried out to understand whether there is a PML risk in CIRDs population infected by JCPyV, this study contributes to enrich literature insight on JCPyV biology in this cluster. Further investigations are necessary in order to recognize the real impact of biologics on JCPyV life cycle and to identify possible and specific viral variants related to increased virulence in CIRDs patients.

  9. Chronic kidney disease in children (literature review

    Directory of Open Access Journals (Sweden)

    I.A. Karimdzhanov

    2017-10-01

    Full Text Available The article presents modern concepts of chronic kidney disease in children as a condition that develops due to the irreversible decrease in renal homeostatic functions in any severe progressive kidney disease, data on epidemiological prevalence, etiological factors, diagnostic methods, stages and clinical course of chronic kidney disease in children. Moreover, it was indicated that early detection and timely treatment of chronic kidney disease in children is an important background for preventing or postponing its adverse outcome. In addition, a high degree of disability and a significant decrease in the quality of life of patients, the complexity and high cost of therapy for patients with terminal chronic renal failure were shown, ma­king it very important to prevent its development in patients with nephropathies. We outlined the main principles of pathogenetic therapy based on the analysis of domestic and foreign guidelines for the treatment of chronic kidney disease in children. The schemes of treatment for protein-energy insufficiency, arterial hypertension, anemia, correction of mi­neral metabolism disorders are given. We discussed the question of reducing the level of azotemia with various drugs, and the development of new drugs to initiate early treatment and to prevent the development of severe forms of chronic kidney disease in children. The search for necessary literature sources was performed in Scopus, MedLine, The Cochrane Library, CyberLeninka, RINC databases.

  10. The use of a chronic disease and risk factor surveillance system to determine the age, period and cohort effects on the prevalence of obesity and diabetes in South Australian adults--2003-2013

    OpenAIRE

    Taylor, Anne W; Shi, Zumin; Montgomerie, Alicia; Dal Grande, Eleonora; Campostrini, Stefano

    2015-01-01

    Background Age, period and cohort (APC) analyses, using representative, population-based descriptive data, provide additional understanding behind increased prevalence rates. Methods Data on obesity and diabetes from the South Australian (SA) monthly chronic disease and risk factor surveillance system from July 2002 to December 2013 (n = 59,025) were used. Age was the self-reported age of the respondent at the time of the interview. Period was the year of the interview and cohort was age subt...

  11. Efficacy of antemortem rectal biopsies to diagnose and estimate prevalence of chronic wasting disease in free-ranging elk (Cervus elaphus nelsoni)

    Science.gov (United States)

    Chronic wasting disease (CWD) is the naturally occurring transmissible spongiform encephalopathy (TSE) of captive and free ranging cervid ruminants. Rocky Mountain elk (Cervus elaphus nelsoni) are a free-ranging species of large cervid with a habitat that includes large US national parks. Minimally ...

  12. Chronic Kidney Disease in Pregnancy.

    Science.gov (United States)

    Koratala, Abhilash; Bhattacharya, Deepti; Kazory, Amir

    2017-09-01

    With the increasing prevalence of chronic kidney disease (CKD) worldwide, the number of pregnant women with various degrees of renal dysfunction is expected to increase. There is a bidirectional relation between CKD and pregnancy in which renal dysfunction negatively affects pregnancy outcomes, and the pregnancy can have a deleterious impact on various aspects of kidney disease. It has been shown that even mild renal dysfunction can increase considerably the risk of adverse maternal and fetal outcomes. Moreover, data suggest that a history of recovery from acute kidney injury is associated with adverse pregnancy outcomes. In addition to kidney dysfunction, maternal hypertension and proteinuria predispose women to negative outcomes and are important factors to consider in preconception counseling and the process of risk stratification. In this review, we provide an overview of the physiologic renal changes during pregnancy as well as available data regarding CKD and pregnancy outcomes. We also highlight the important management strategies in women with certain selected renal conditions that are seen commonly during the childbearing years. We call for future research on underexplored areas such as the concept of renal functional reserve to develop a potential clinical tool for prognostication and risk stratification of women at higher risk for complications during pregnancy.

  13. Hypogonadism in patients with chronic obstructive pulmonary disease

    African Journals Online (AJOL)

    Rasha Galal Daabis

    2015-02-24

    Feb 24, 2015 ... d Department of Chemical Pathology, Medical Research Institute, Alexandria University, Egypt ... Exercise capacity. Abstract Objectives: To determine the prevalence of hypogonadism in male patients with Chronic obstructive pulmonary diseases ... capacity, muscle weakness, impaired quality of life, and.

  14. Prevalence of sleep disturbance in chronic pain.

    Science.gov (United States)

    Karaman, S; Karaman, T; Dogru, S; Onder, Y; Citil, R; Bulut, Y E; Tapar, H; Sahin, A; Arici, S; Kaya, Z; Suren, M

    2014-01-01

    Sleep is a vital function for human beings, which can be affected by several factors. Chronic pain is one of these factors where it is the most frequent cause for seeking medical care in combination with insomnia. The aim of this study is to examine the prevalence and relationship between sleep disturbance and chronic pain. After approval, a total of 85 Family Medicine Units from over 170 in Tokat were randomly selected using a 50% sampling. A sample of 2635 subjects, over the age of 19 years, who were registered with the selected Family Medicine Units, were assessed due to gender, age group, and the urban/rural population size of Tokat using the stratified sampling method. The sample size distribution was calculated as 1515 urban subjects, 1120 rural subjects; 1345 female subjects, 1290 male subjects; 1123 subjects between 20-39 years of age, 1103 subjects between the ages of 40-64, and 409 subjects over 64 years of age. After sampling, subjects were invited to participate in the study via an invitation letter, and agreeing individuals were taken to the Family Medicine Unit for face-to-face meetings. Written, informed consent was obtained, along with demographic data. The presence of chronic pain was recorded. According to the presence of chronic pain, all subjects were separated into two groups as Group Chronic Pain and Group Non-Chronic Pain. The visual analog scale for pain intensity, and Pittsburgh Sleep Quality Index for sleep quality, were performed with all subjects. A multiple linear regression model was used to assess the predictors of sleep quality. Analyses were conducted using the Statistical Package for Social Sciences program (SPSS Inc., Chicago, IL, USA), version 20.0. The statistical significance for all analyses was set at p 5. A moderate positive correlation was found between the global Pittsburgh Sleep Quality Index and Visual Analog Scale scores (r = 0.310, p < 0.01). A multiple linear regression analysis showed that age, gender, income, Visual

  15. Empowering Patients with Chronic Diseases

    DEFF Research Database (Denmark)

    Bestek, Mate; Meglič, Matic; Kurent, Blaž

    2012-01-01

    Background: Chronic diseases require most of the resources in todays healthcare systems. Healthcare systems, as such, are thus not sustainable in the long term. Solutions to this problem are needed and a lot of research is focused on finding new approaches to more sustainable healthcare systems...... himself to become empowered. The patient needs to see data about his health in order to start thinking about new decisions in life that can lead to change in his behaviour. Objective: We have approached the problem of empowering patients with chronic diseases from a biological, psychological, sociological....... We want to develop extensible technology to support even more new interventions for different chronic diseases. We want the technology to enable semantic interoperability with other systems. Methods: We have collaborated with doctors in order to model the care plans for different chronic diseases...

  16. An observational, cross-sectional study to assess the prevalence of chronic kidney disease in type 2 diabetes patients in India (START -India

    Directory of Open Access Journals (Sweden)

    M Prasannakumar

    2015-01-01

    Full Text Available Objective: The primary objective of this study is to estimate the prevalence of chronic kidney disease (CKD among type 2 diabetes mellitus (T2DM patients in India. Materials and Methods: This cross-sectional, observational, epidemiological, multi-center, study is enrolling T2DM patients of either gender aged 30 years or above. This study aimed to enroll a total of 3000 T2DM patients at 30 participating hospitals/clinics across India and the data from a planned interim analysis of 1500 patients are presented here. The primary endpoint of the study is to estimate proportion of T2DM patients with CKD (glomerular filtration rate [GFR] <60 ml/min/1.73 m 2 or albumin creatinine ratio [ACR] ≥30 mg/g or ≥3 mg/mmol or both. Routine treatment, as administered by the treating physician, was continued without any study specific intervention. Patients′ data pertaining to demographic characteristics, medical history, current medication and physical examination were recorded. The blood/plasma and urine samples, were collected for estimation of hemoglobin A1c, microalbuminuria, serum creatinine, urine creatinine, and routine urine analysis. ACR was calculated from urine creatinine and albumin while GFR was estimated by using a modification of diet in the renal disease equation. Results: Study recruited 1500 patients from 18 centers across India. The study population included 840 (56.05% males. Mean age, body mass index and systolic blood pressure were 55.1 years, 27.4 kg/m 2 and 134.5 mmHg respectively. The mean duration of diabetes was 102.2 months. History of co-morbid diseases such as dyslipidemia, hypertension, microvascular complications and macrovascular complications was present in 657 (43.8%, 655 (43.7%, 268 (17.9% and 104 (6.93%, respectively. This interim analysis revealed that about 46% of the T2DM patients had CKD (urinary albumin creatinine ratio (UACR ≥30 mg/g and/or estimated GFR [eGFR] <60 mL/min/1.73 m 2 . The renal dysfunction as per e

  17. Occupational chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Omland, Oyvind; Würtz, Else Toft; Aasen, Tor Børvig

    2014-01-01

    Occupational-attributable chronic obstructive pulmonary disease (COPD) presents a substantial health challenge. Focusing on spirometric criteria for airflow obstruction, this review of occupational COPD includes both population-wide and industry-specific exposures.......Occupational-attributable chronic obstructive pulmonary disease (COPD) presents a substantial health challenge. Focusing on spirometric criteria for airflow obstruction, this review of occupational COPD includes both population-wide and industry-specific exposures....

  18. Chronic mucus hypersecretion: prevalence and risk factors in younger individuals.

    Science.gov (United States)

    Harmsen, L; Thomsen, S F; Ingebrigtsen, T; Steffensen, I E; Skadhauge, L R; Kyvik, K O; Backer, V

    2010-08-01

    Chronic mucus hypersecretion (CMH) is a common condition in patients with chronic respiratory diseases. Little is known about the incidence, prevalence and determinants of CMH in younger individuals. To determine prevalence, incidence and risk factors for CMH in a young general population. A cohort of Danish twins (aged 12-41 years) was prospectively examined using questionnaires in 1994 (n = 29 180) and in 2002 (n = 21 130). Prevalence and incidence of CMH were determined, and risk factors for the condition were assessed using logistic regression. Lifetime prevalence of CMH was 8.6% in females and 6.9% in males in 1994, and the cumulative incidence among females and males was respectively 10.7% and 8.7% during the study period. Smoking and asthma were risk factors for CMH, with a dose-response effect of tobacco consumption, and smoking habits also predicting incidence of CMH. Among the young, CMH is a condition related to asthma and smoking, with a dose-response relationship with tobacco consumption and a relation between smoking habits and incidence. Female susceptibility to development of CMH was observed, as well as signs of greater susceptibility related to young age.

  19. Chronic kidney disease in the type 2 diabetic patients: prevalence and associated variables in a random sample of 2642 patients of a Mediterranean area

    Directory of Open Access Journals (Sweden)

    Coll-de-Tuero Gabriel

    2012-08-01

    Full Text Available Abstract Background Kidney disease is associated with an increased total mortality and cardiovascular morbimortality in the general population and in patients with Type 2 diabetes. The aim of this study is to determine the prevalence of kidney disease and different types of renal disease in patients with type 2 diabetes (T2DM. Methods Cross-sectional study in a random sample of 2,642 T2DM patients cared for in primary care during 2007. Studied variables: demographic and clinical characteristics, pharmacological treatments and T2DM complications (diabetic foot, retinopathy, coronary heart disease and stroke. Variables of renal function were defined as follows: 1 Microalbuminuria: albumin excretion rate & 30 mg/g or 3.5 mg/mmol, 2 Macroalbuminuria: albumin excretion rate & 300 mg/g or 35 mg/mmol, 3 Kidney disease (KD: glomerular filtration rate according to Modification of Diet in Renal Disease 2 and/or the presence of albuminuria, 4 Renal impairment (RI: glomerular filtration rate 2, 5 Nonalbuminuric RI: glomerular filtration rate 2 without albuminuria and, 5 Diabetic nephropathy (DN: macroalbuminuria or microalbuminuria plus diabetic retinopathy. Results The prevalence of different types of renal disease in patients was: 34.1% KD, 22.9% RI, 19.5% albuminuria and 16.4% diabetic nephropathy (DN. The prevalence of albuminuria without RI (13.5% and nonalbuminuric RI (14.7% was similar. After adjusting per age, BMI, cholesterol, blood pressure and macrovascular disease, RI was significantly associated with the female gender (OR 2.20; CI 95% 1.86–2.59, microvascular disease (OR 2.14; CI 95% 1.8–2.54 and insulin treatment (OR 1.82; CI 95% 1.39–2.38, and inversely associated with HbA1c (OR 0.85 for every 1% increase; CI 95% 0.80–0.91. Albuminuria without RI was inversely associated with the female gender (OR 0.27; CI 95% 0.21–0.35, duration of diabetes (OR 0.94 per year; CI 95% 0.91–0.97 and directly associated with HbA1c (OR 1.19 for every

  20. Understanding anemia of chronic disease.

    Science.gov (United States)

    Fraenkel, Paula G

    2015-01-01

    The anemia of chronic disease is an old disease concept, but contemporary research in the role of proinflammatory cytokines and iron biology has shed new light on the pathophysiology of the condition. Recent epidemiologic studies have connected the anemia of chronic disease with critical illness, obesity, aging, and kidney failure, as well as with the well-established associations of cancer, chronic infection, and autoimmune disease. Functional iron deficiency, mediated principally by the interaction of interleukin-6, the iron regulatory hormone hepcidin, and the iron exporter ferroportin, is a major contributor to the anemia of chronic disease. Although anemia is associated with adverse outcomes, experimental models suggest that iron sequestration is desirable in the setting of severe infection. Experimental therapeutic approaches targeting interleukin-6 or the ferroportin-hepcidin axis have shown efficacy in reversing anemia in either animal models or human patients, although these agents have not yet been approved for the treatment of the anemia of chronic disease. © 2015 by The American Society of Hematology. All rights reserved.

  1. Nursing contributions to chronic disease management in primary care.

    Science.gov (United States)

    Lukewich, Julia; Edge, Dana S; VanDenKerkhof, Elizabeth; Tranmer, Joan

    2014-02-01

    As the prevalence of chronic diseases continues to increase, emphasis is being placed on the development of primary care strategies that enhance healthcare delivery. Innovations include interprofessional healthcare teams and chronic disease management strategies. To determine the roles of nurses working in primary care settings in Ontario and the extent to which chronic disease management strategies have been implemented. We conducted a cross-sectional survey of a random sample of primary care nurses, including registered practical nurses, registered nurses, and nurse practitioners, in Ontario between May and July 2011. Nurses in primary care reported engaging in chronic disease management activities but to different extents depending on their regulatory designation (licensure category). Chronic disease management strategy implementation was not uniform across primary care practices where the nurses worked. There is the potential to optimize and standardize the nursing role within primary care and improve the implementation of chronic disease management strategies.

  2. Prevalence of angiotensin converting enzyme (ACE gene insertion/deletion polymorphism in South Indian population with hypertension and chronic kidney disease

    Directory of Open Access Journals (Sweden)

    R Shanmuganathan

    2015-01-01

    Full Text Available Context: Chronic Kidney Disease (CKD is associated with a high risk of developing further severe complications such as, cardiovascular disease and eventually End Stage Renal Disease (ESRD leading to death. Hypertension plays a key role in the progression of renal failure and is also a chief risk factor for the occurrence of End Stage Renal Disease (ESRD. Aim: This study investigates the possible association of insertion (I and deletion (D polymorphism of ACE gene in patients of Chronic Kidney Disease (CKD with and without hypertension (HT. Settings and Design: Total 120 participants with 30 members in each group (Control, HT, CKD and CKD-HT were chosen followed by informed consent. Materials and Methods: Blood samples were collected and subjected to biochemical analyses and nested PCR amplification was performed to genotype the DNA, for ACE I/D using specific primers. Statistical Analysis: Statistical analyses were performed using SPSS version 13. Allele and genotypic frequency was calculated by direct gene counting method. Comparison of the different genotypes was done by using Chi square test. Odd′s ratios were calculated with a 95% confidence interval limit. Results: The ACE genotype were distributed as II, 27 (90%; DD, 2 (6.67% and ID, 1 (3.33% in control, II, 1 (3.33%; DD, 5 (16.67% and ID, 24 (80% in HT, II, 4 (13.33%; DD, 24 (80% and ID, 2 (6.67% in CKD and II, 0 (0%; DD, 2 (6.67% and ID, 28 (93.33% in CKD-HT group. Conclusions: D allele of ACE gene confers a greater role in genetic variations underlying CKD and hypertension. This result suggest that CKD patients should be offered analysis for defects in ACE I/D polymorphisms, especially if they are hypertensive.

  3. A Cross-Sectional Study of Prisoners in Mexico City Comparing Prevalence of Transmissible Infections and Chronic Diseases with That in the General Population.

    Science.gov (United States)

    Bautista-Arredondo, Sergio; González, Andrea; Servan-Mori, Edson; Beynon, Fenella; Juarez-Figueroa, Luis; Conde-Glez, Carlos J; Gras, Nathalie; Sierra-Madero, Juan; Lopez-Ridaura, Ruy; Volkow, Patricia; Bertozzi, Stefano M

    2015-01-01

    To describe patterns of transmissible infections, chronic illnesses, socio-demographic characteristics and risk behaviors in Mexico City prisons, including in comparison to the general population, to identify those currently needing healthcare and inform policy. A cross-sectional study among 17,000 prisoners at 4 Mexico City prisons (June to December 2010). Participation was voluntary, confidential and based on informed consent. Participants were tested for HIV, Hepatitis B & C, syphilis, hypertension, obesity, and, if at risk, glucose and cholesterol. A subset completed a questionnaire on socio-demographic characteristics and risk behaviors. Positive results were delivered with counseling and treatment or referral. 76.8% (15,517/20,196) of men and 92.9% (1,779/1,914) of women participated. Complete data sets were available for 98.8%. The following prevalence data were established for transmissible infections: HIV 0.7%; syphilis: Anti-TP+/VDRL+ 2.0%; Hepatitis B: HBcAb 2.8%, HBsAg 0.15%; Anti-HCV 3.2%. Obesity: 9.5% men, 33.8% women. Compared with national age- and sex-matched data, the relative prevalence was greater for HIV and syphilis among women, HIV and Hepatitis C in men, and all infections in younger participants. Obesity prevalence was similar for women and lower among male participants. The prevalence of previously diagnosed diabetes and hypertension was lower. Questionnaire data (1,934 men, 520 women) demonstrated lower educational levels, increased smoking and substance use compared to national data. High levels of non-sterile tattooing, physical abuse and histories of sexual violence were found. The study identified that health screening is acceptable to Mexico City prisoners and feasible on a large-scale. It demonstrated higher prevalence of HIV and other infections compared to national data, though low rates compared to international data. Individual participants benefited from earlier diagnosis, treatment and support. The data collected will also

  4. A Cross-Sectional Study of Prisoners in Mexico City Comparing Prevalence of Transmissible Infections and Chronic Diseases with That in the General Population.

    Directory of Open Access Journals (Sweden)

    Sergio Bautista-Arredondo

    Full Text Available To describe patterns of transmissible infections, chronic illnesses, socio-demographic characteristics and risk behaviors in Mexico City prisons, including in comparison to the general population, to identify those currently needing healthcare and inform policy.A cross-sectional study among 17,000 prisoners at 4 Mexico City prisons (June to December 2010. Participation was voluntary, confidential and based on informed consent. Participants were tested for HIV, Hepatitis B & C, syphilis, hypertension, obesity, and, if at risk, glucose and cholesterol. A subset completed a questionnaire on socio-demographic characteristics and risk behaviors. Positive results were delivered with counseling and treatment or referral.76.8% (15,517/20,196 of men and 92.9% (1,779/1,914 of women participated. Complete data sets were available for 98.8%. The following prevalence data were established for transmissible infections: HIV 0.7%; syphilis: Anti-TP+/VDRL+ 2.0%; Hepatitis B: HBcAb 2.8%, HBsAg 0.15%; Anti-HCV 3.2%. Obesity: 9.5% men, 33.8% women. Compared with national age- and sex-matched data, the relative prevalence was greater for HIV and syphilis among women, HIV and Hepatitis C in men, and all infections in younger participants. Obesity prevalence was similar for women and lower among male participants. The prevalence of previously diagnosed diabetes and hypertension was lower. Questionnaire data (1,934 men, 520 women demonstrated lower educational levels, increased smoking and substance use compared to national data. High levels of non-sterile tattooing, physical abuse and histories of sexual violence were found.The study identified that health screening is acceptable to Mexico City prisoners and feasible on a large-scale. It demonstrated higher prevalence of HIV and other infections compared to national data, though low rates compared to international data. Individual participants benefited from earlier diagnosis, treatment and support. The data collected

  5. A Cross-Sectional Study of Prisoners in Mexico City Comparing Prevalence of Transmissible Infections and Chronic Diseases with That in the General Population

    Science.gov (United States)

    Bautista-Arredondo, Sergio; González, Andrea; Servan-Mori, Edson; Beynon, Fenella; Juarez-Figueroa, Luis; Conde-Glez, Carlos J.; Gras, Nathalie; Sierra-Madero, Juan; Lopez-Ridaura, Ruy; Volkow, Patricia; Bertozzi, Stefano M.

    2015-01-01

    Objectives To describe patterns of transmissible infections, chronic illnesses, socio-demographic characteristics and risk behaviors in Mexico City prisons, including in comparison to the general population, to identify those currently needing healthcare and inform policy. Materials and Methods A cross-sectional study among 17,000 prisoners at 4 Mexico City prisons (June to December 2010). Participation was voluntary, confidential and based on informed consent. Participants were tested for HIV, Hepatitis B & C, syphilis, hypertension, obesity, and, if at risk, glucose and cholesterol. A subset completed a questionnaire on socio-demographic characteristics and risk behaviors. Positive results were delivered with counseling and treatment or referral. Results 76.8% (15,517/20,196) of men and 92.9% (1,779/1,914) of women participated. Complete data sets were available for 98.8%. The following prevalence data were established for transmissible infections: HIV 0.7%; syphilis: Anti-TP+/VDRL+ 2.0%; Hepatitis B: HBcAb 2.8%, HBsAg 0.15%; Anti-HCV 3.2%. Obesity: 9.5% men, 33.8% women. Compared with national age- and sex-matched data, the relative prevalence was greater for HIV and syphilis among women, HIV and Hepatitis C in men, and all infections in younger participants. Obesity prevalence was similar for women and lower among male participants. The prevalence of previously diagnosed diabetes and hypertension was lower. Questionnaire data (1,934 men, 520 women) demonstrated lower educational levels, increased smoking and substance use compared to national data. High levels of non-sterile tattooing, physical abuse and histories of sexual violence were found. Conclusion The study identified that health screening is acceptable to Mexico City prisoners and feasible on a large-scale. It demonstrated higher prevalence of HIV and other infections compared to national data, though low rates compared to international data. Individual participants benefited from earlier diagnosis

  6. Chronic kidney disease among children in Guatemala

    Directory of Open Access Journals (Sweden)

    Alejandro Cerón

    2014-12-01

    Full Text Available OBJECTIVE: To describe the distribution of pediatric chronic kidney disease (CKD in Guatemala, estimate incidence and prevalence of pediatric end-stage renal disease (ESRD, and estimate time to progress to ESRD. METHODS: This study analyzed the registry of the only pediatric nephrology center in Guatemala, from 2004-2013. Incidence and prevalence were calculated for annual periods. Moran's index for spatial autocorrelation was used to determine significance of geographic distribution of incidence. Time to progress to ESRD and associated risk factors were calculated with multivariate Cox regression. RESULTS: Of 1 545 patients from birth to less than 20 years of age, 432 had chronic renal failure (CRF. Prevalence and incidence of ESRD were 4.9 and 4.6 per million age-related population, respectively. Incidence was higher for the Pacific coast and Guatemala City. The cause of CRF was undetermined in 43% of patients. Average time to progress to ESRD was 21.9 months; factors associated with progression were: older age, diagnosis of glomerulopathies, and advanced-stage CKD at consultation. CONCLUSIONS: Prevalence and incidence of ESRD in Guatemala are lower than in other countries. This may reflect poor access to diagnosis. Areas with higher incidence and large proportion of CKD of undetermined cause are compatible with other studies from the geographic subregion. Findings on progression to ESRD may reflect delayed referral.

  7. Chronic Kidney Diseases

    Science.gov (United States)

    ... changes, vitamins, minerals, and medications to help with growth and to prevent bone disease. Sometimes unhealthy kidneys have problems producing a hormone that helps make red blood cells, the cells ...

  8. Living With Chronic Lower Pulmonary Disease

    Science.gov (United States)

    Pooler, Charlotte

    2014-01-01

    In this article, I present a phenomenological study of individuals’ experiences of living with moderate to very severe chronic lower pulmonary disease (chronic obstructive pulmonary disease, asthma, or both). Phenomenology is a philosophy, distinct from descriptive or thematic research, which is useful as a foundation for scientific inquiry. In this study, I used the lens of Merleau-Ponty to understand and interpret participants’ experiences of living with pulmonary disease, and the approach of van Manen for analysis. I conclude that in chronic pulmonary disease, awareness of breathing and the body is experienced in the sounds, sensations, and signals of breathing and the body, and in the experiences of the body-in-the-world. Central themes of being-in-the-world from the study describe the disruption of the embodied phenomenological self: Participants experienced slowing down, doing less, and having to stop due to shortness of breath. Both chronic and acute dyspnea were prevalent and the taken-for-granted aspects of daily activities were disrupted. Findings of this study have implications for public and patient education, and opportunities for integration of experiential aspects within nursing education and practice. PMID:28462289

  9. Living With Chronic Lower Pulmonary Disease

    Directory of Open Access Journals (Sweden)

    Charlotte Pooler

    2014-09-01

    Full Text Available In this article, I present a phenomenological study of individuals’ experiences of living with moderate to very severe chronic lower pulmonary disease (chronic obstructive pulmonary disease, asthma, or both. Phenomenology is a philosophy, distinct from descriptive or thematic research, which is useful as a foundation for scientific inquiry. In this study, I used the lens of Merleau-Ponty to understand and interpret participants’ experiences of living with pulmonary disease, and the approach of van Manen for analysis. I conclude that in chronic pulmonary disease, awareness of breathing and the body is experienced in the sounds, sensations, and signals of breathing and the body, and in the experiences of the body-in-the-world. Central themes of being-in-the-world from the study describe the disruption of the embodied phenomenological self: Participants experienced slowing down, doing less, and having to stop due to shortness of breath. Both chronic and acute dyspnea were prevalent and the taken-for-granted aspects of daily activities were disrupted. Findings of this study have implications for public and patient education, and opportunities for integration of experiential aspects within nursing education and practice.

  10. Dyslipidemia in children with chronic kidney disease.

    Science.gov (United States)

    Saland, Jeffrey M; Pierce, Christopher B; Mitsnefes, Mark M; Flynn, Joseph T; Goebel, Jens; Kupferman, Juan C; Warady, Bradley A; Furth, Susan L

    2010-12-01

    Dyslipidemia, a known risk factor for atherosclerosis, is frequent among both adults and children with chronic kidney disease. Here, we describe the prevalence and pattern of dyslipidemia from a cross-sectional analysis of 391 children aged 1-16 years, enrolled in the multicenter Chronic Kidney Disease in Children (CKiD) study, with a median glomerular filtration rate (GFR), measured by the plasma disappearance of iohexol, of 43 ml/min per 1.73 m2. Multivariate analysis was applied to adjust for age, gender, body mass index (BMI), GFR, and the urinary protein/creatinine ratio. Proteinuria was in the nephrotic range in 44 and the BMI exceeded the 95th percentile in 57 patients of this cohort. Baseline lipid analysis found a high prevalence of hypertriglyceridemia in 126, increased non-HDL-C in 62, and reduced HDL-C in 83. Overall, 177 children had dyslipidemia, of whom 79 had combined dyslipidemia. Lower GFR was associated with higher triglycerides, lower HDL-C, and higher non-HDL-C. Nephrotic-range proteinuria was significantly associated with dyslipidemia and combined dyslipidemia. Compared with children with a GFR>50, children with a GFRchildren with moderate chronic kidney disease, dyslipidemia is common and is associated with lower GFR, nephrotic proteinuria, and non-renal factors including age and obesity.

  11. Prevalence of chronic pancreatitis: Results of a primary care physician-based population study.

    Science.gov (United States)

    Capurso, Gabriele; Archibugi, Livia; Pasquali, Piera; Aceti, Alessandro; Balducci, Paolo; Bianchi, Patrizia; Buono, Francesco; Camerucci, Stefano; Cantarini, Rosanna; Centofanti, Sergio; Colantonio, Patrizia; Cremaschi, Riccarda; Crescenzi, Sergio; Di Mauro, Caterina; Di Renzi, Davide; Filabozzi, Andrea; Fiorillo, Alfonso; Giancaspro, Giuseppe; Giovannetti, Paola; Lanna, Giuseppe; Medori, Claudio; Merletti, Emilio; Nunnari, Enzo; Paris, Francesca; Pavone, Marco; Piacenti, Angela; Rossi, Almerindo; Scamuffa, Maria Cristina; Spinelli, Giovanni; Taborchi, Marco; Valente, Biagio; Villanova, Antonella; Chiriatti, Alberto; Delle Fave, Gianfranco

    2017-05-01

    Data on chronic pancreatitis prevalence are scanty and usually limited to hospital-based studies. Investigating chronic pancreatitis prevalence in primary care. Participating primary care physicians reported the prevalence of chronic pancreatitis among their registered patients, environmental factors and disease characteristics. The data were centrally reviewed and chronic pancreatitis cases defined according to M-ANNHEIM criteria for diagnosis and severity and TIGAR-O classification for etiology. Twenty-three primary care physicians participated in the study. According to their judgment, 51 of 36.401 patients had chronic pancreatitis. After reviewing each patient data, 11 turned out to have definite, 5 probable, 19 borderline and 16 uncertain disease. Prevalence was 30.2/100.000 for definite cases and 44.0/100.000 for definite plus probable cases. Of the 16 patients with definite/probable diagnosis, 8 were male, with mean age of 55.6 (±16.7). Four patients had alcoholic etiology, 5 post-acute/recurrent pancreatitis, 6 were deemed to be idiopathic. Four had pancreatic exocrine insufficiency, 10 were receiving pancreatic enzymes, and six had pain. Most patients had initial stage and non-severe disease. This is the first study investigating the prevalence of chronic pancreatitis in primary care. Results suggest that the prevalence in this context is higher than in hospital-based studies, with specific features, possibly representing an earlier disease stage. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  12. Chronic venous disease.

    Science.gov (United States)

    Wolinsky, Claire D; Waldorf, Heidi

    2009-11-01

    Identifying characteristic cutaneous findings is important in determining the appropriate management of certain venous diseases. The health care provider should be familiar with the classic description of patterns and distributions of skin manifestations, such as varicose veins, stasis dermatitis, palpable cord, petechiae, and telangiectasias. In addition to the gross appearance of the skin, a skin biopsy may help elucidate a diagnosis. General treatment and prevention of the underlying venous pathology is essential. Furthermore, specific management of skin findings should include therapy to ameliorate progression of disease and symptomatology when warranted.

  13. Paediatric chronic kidney disease

    African Journals Online (AJOL)

    presence of markers of kidney damage. • Markers of kidney disease include any of the following: • proteinuria (urine dipstick ≥2+ or urine protein:creatinine ratio 5 × the upper limit of normal). • urine sediment abnormalities. • electrolyte and other abnormalities caused by tubular disorders. • histological abnormalities.

  14. Paediatric chronic kidney disease

    African Journals Online (AJOL)

    (oliguria) (<1.0 mL/kg/hour). • Serum calcium, phosphate, alkaline phosphatase and plasma parathyroid hormone should be determined to assess bone mineral disease and secondary hyperparathyroidism. • Renal ultrasound is necessary to demonstrate kidney size (small shrunken kidneys are characteristic of CKD) and.

  15. Chronic kidney disease of unknown etiology in agricultural communities.

    Science.gov (United States)

    Almaguer, Miguel; Herrera, Raúl; Orantes, Carlos M

    2014-04-01

    In recent years, Central America, Egypt, India and Sri Lanka have reported a high prevalence of chronic kidney disease of unknown etiology in agricultural communities, predominantly among male farmworkers. This essay examines the disease's case definitions, epidemiology (disease burden, demographics, associated risk factors) and causal hypotheses, by reviewing published findings from El Salvador, Nicaragua, Costa Rica, Sri Lanka, Egypt and India. The range of confirmed chronic kidney disease prevalence was 17.9%-21.1%. Prevalence of reduced glomerular filtration (homemade alcohol use and family history of chronic kidney disease. There is no strong evidence for a single cause, and multiple environmental, occupational and social factors are probably involved. Further etiological research is needed, plus interventions to reduce preventable risk factors.

  16. Chronic Kidney Disease and Lipid Disorders.

    Science.gov (United States)

    Zubovic, Sandra Vegar; Kristic, Spomenka; Prevljak, Sabina; Pasic, Irmina Sefic

    2016-06-01

    Chronic kidney disease (CKD) represents a serious public health problem due to the increase in incidence and prevalence of this disease worldwide. Given the significant morbidity and mortality from cardiovascular disease (CVD) in the population of patients with CKD, and the fact that dyslipidemia itself is a risk factor for CVD, increases the importance of lipid metabolism study in patients with CKD. Evaluate the lipid status of patients with chronic kidney disease. A one-year prospective study included 150 adult patients who were in various stages of chronic renal failure (stage I to IV). Estimate of creatinine clearance was performed using Cockroft-Goult formula. The classification of patients according to stages of chronic renal insufficiency was performed in accordance with the criteria of Kidney Disease Outcomes Quality Initiative (K/DOQI). Of the total number of patients (N=150) there was 71 males and 79 females. The mean age of patients was 55.43 years. Average values of serum cholesterol were highest in patients with stage II renal disease and the lowest in patients classified as stage IV (5.76±1.60 mmol/L vs. 5.07±1.88 mmol/L). Analysis of the average value of triglycerides in blood show a slight increase through the stages of CKD in a manner that patients classified into stage I have low serum triglyceride levels (1.73±1.17 mmol/L (range 0.61 to 5.5 mmol/L), and patients classified in stage III the highest value 2.13±1.11 mmol/L (range 0.62 to 4.66 mmol/L). Average cholesterol levels does not statistically significantly change with progression of chronic renal disease. There is an almost linear increase in average triglyceride levels in chronic renal disease. Triglyceride levels in serum begins to increase in the early stage of chronic renal disease and reach the peak in stage IV.

  17. Stage effect of chronic kidney disease in erectile function.

    Science.gov (United States)

    Costa, Márcio Rodrigues; Ponciano, Viviane Campos; Costa, Théo Rodrigues; Gomes, Caio Pereira; de Oliveira, Enio Chaves

    2018-01-01

    The study aims to assess the influence of the stage of chronic kidney disease and glomerular filtration rate on prevalence and degree of erectile dysfunction. This transversal study, conducted from May 2013 to December 2015, included patients with chronic kidney disease in conservative treatment, stages III/IV/V. Erectile dysfunction was evaluated by the International Index of Erectile Function. Data classically associated with erectile dysfunction were obtained by medical record review. Erectile dysfunction, degree of erectile dysfunction, and other main variables associated with erectile dysfunction were compared between patients with chronic kidney disease on conservative treatment stages III versus IV/V using the Chi-square test. The relationship between score of the International Index of Erectile Dysfunction and glomerular filtration rate was established by Pearson correlation coefficient. Two hundred and forty five patients with chronic kidney disease in con-servative treatment participated of the study. The prevalence of erectile dysfunction in patients with chronic kidney disease in stages IV/V was greater than in stage III. Glomerular filtration rate positively correlated with score of the International Index of Erectile Dysfunction. The study suggests that chronic kidney disease progression (glomerular filtration rate decrease and advance in chronic kidney disease stages) worsen erectile function. Hypothetically, diagnosis and treatment of erectile dysfunction may be anticipated with the analysis of chronic kidney disease progression. Copyright® by the International Brazilian Journal of Urology.

  18. Stage effect of chronic kidney disease in erectile function

    Directory of Open Access Journals (Sweden)

    Márcio Rodrigues Costa

    Full Text Available ABSTRACT Purpose The study aims to assess the influence of the stage of chronic kidney disease and glomerular filtration rate on prevalence and degree of erectile dysfunction. Materials and Methods This transversal study, conducted from May 2013 to December 2015, included patients with chronic kidney disease in conservative treatment, stages III/IV/V. Erectile dysfunction was evaluated by the International Index of Erectile Function. Data classically associated with erectile dysfunction were obtained by medical record review. Erectile dysfunction, degree of erectile dysfunction, and other main variables associated with erectile dysfunction were compared between patients with chronic kidney disease on conservative treatment stages III versus IV/V using the Chi-square test. The relationship between score of the International Index of Erectile Dysfunction and glomerular filtration rate was established by Pearson correlation coefficient. Results Two hundred and forty five patients with chronic kidney disease in conservative treatment participated of the study. The prevalence of erectile dysfunction in patients with chronic kidney disease in stages IV/V was greater than in stage III. Glomerular filtration rate positively correlated with score of the International Index of Erectile Dysfunction. Conclusions The study suggests that chronic kidney disease progression (glomerular filtration rate decrease and advance in chronic kidney disease stages worsen erectile function. Hypothetically, diagnosis and treatment of erectile dysfunction may be anticipated with the analysis of chronic kidney disease progression.

  19. Sleep disorders and chronic kidney disease.

    Science.gov (United States)

    Maung, Stephanie C; El Sara, Ammar; Chapman, Cherylle; Cohen, Danielle; Cukor, Daniel

    2016-05-06

    Sleep disorders have a profound and well-documented impact on overall health and quality of life in the general population. In patients with chronic disease, sleep disorders are more prevalent, with an additional morbidity and mortality burden. The complex and dynamic relationship between sleep disorders and chronic kidney disease (CKD) remain relatively little investigated. This article presents an overview of sleep disorders in patients with CKD, with emphasis on relevant pathophysiologic underpinnings and clinical presentations. Evidence-based interventions will be discussed, in the context of individual sleep disorders, namely sleep apnea, insomnia, restless leg syndrome and excessive daytime sleepiness. Limitations of the current knowledge as well as future research directions will be highlighted, with a final discussion of different conceptual frameworks of the relationship between sleep disorders and CKD.

  20. [Advance care planning and severe chronic diseases].

    Science.gov (United States)

    Diestre Ortín, Germán; González Sequero, Vanessa; Collell Domènech, Núria; Pérez López, Francisca; Hernando Robles, Pablo

    2013-01-01

    Advanced care planning (ACP) helps in make decisions on the health problems of people who have lost the capacity for informed consent. It has proven particularly useful in addressing the end of life. The aim of this study was to determine the prevalence of ACP in patients with severe chronic diseases. Review of medical records of patients with dementia, amyotrophic lateral sclerosis, Parkinson's disease, chronic obstructive pulmonary disease or interstitial lung disease, heart failure, chronic kidney disease on dialysis and cancer, all in advanced stages. We collected data on living wills or registered prior decisions by the physician according to clinical planned. A total of 135 patients were studied. There was a record of ACP in 22 patients (16.3%). In most of them it was planned not to start any vital treatment in the event of high risk of imminent death and lacking the ability to make decisions. Only two patients were had a legal living will. The registration of ACP is relatively low, and this can affect decision-making in accordance with the personal values of patients when they do not have the capacity to exercise informed consent. Copyright © 2012 SEGG. Published by Elsevier Espana. All rights reserved.

  1. Peripheral arterial disease in patients with chronic obstructive pulmonary disease.

    Science.gov (United States)

    Pecci, R; De La Fuente Aguado, J; Sanjurjo Rivo, A B; Sanchez Conde, P; Corbacho Abelaira, M

    2012-10-01

    Cardiovascular disease (CV) is the second leading cause of morbidity and mortality in chronic obstructive pulmonary disease (COPD). Peripheral arterial disease (PAD) is associated with cardiovascular disease, and its risk factors are common to other atherosclerotic diseases. The objective is to determine the prevalence of PAD in a population of patients with COPD using the ankle / brachial index (ABI) and to investigate the relationship between PAD and lung disease severity. In a prospective cross-sectional study, 246 patients with COPD were recruited. Patients were enrolled consecutively according to their admission to Povisa hospital from September 1, 2008, until March 1, 2010, and were assessed by clinical history, spirometry and ABI. The COPD severity was graded by GOLD criteria in spirometry. Overall, 84 patients (36.8%) had abnormal ABI results and 59 (70.2%) were asymptomatic for PAD. COPD patients with PAD had a higher prevalence of moderate to severe COPD (61.9% vs. 41.7%, P=0.004), lower mean forced expiratory volume in 1 second (FEV1) values (46.7% ± 15 vs. 52.3±14%, P=0.001) and a higher prevalence of hypertension (69% vs. 54.3%, P=0.03) and previous cardiovascular disease (34.5% vs. 21.3%, P=0.03). There was a high prevalence of asymptomatic PAD in the COPD patients we examined. Abnormal ABI results were associated with a higher prevalence of cardiovascular risk factors and more severe lung disease. The diagnosis of peripheral arterial disease in COPD is important because this is an entity that limits the patient's physical activity and impairs their quality of life in addition to turn it into a high cardiovascular risk patient that requiring additional therapeutic measures.

  2. Chronic Venous Disease under pressure

    NARCIS (Netherlands)

    S.W.I. Reeder (Suzan)

    2013-01-01

    textabstractIn chapter 1 we provide a general introduction of this thesis. Chronic venous disease (CVD) is a common medical condition that affects 2-64% of the worldwide population and leads to leg ulcers in 1% of the Western population. Venous leg ulceration (VLU) has an unfavorable prognosis with

  3. NAFLD and Chronic Kidney Disease.

    Science.gov (United States)

    Marcuccilli, Morgan; Chonchol, Michel

    2016-04-14

    Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in developed countries and it is now considered a risk factor for cardiovascular disease. Evidence linking NAFLD to the development and progression of chronic kidney disease (CKD) is emerging as a popular area of scientific interest. The rise in simultaneous liver-kidney transplantation as well as the significant cost associated with the presence of chronic kidney disease in the NAFLD population make this entity a worthwhile target for screening and therapeutic intervention. While several cross-sectional and case control studies have been published to substantiate these theories, very little data exists on the underlying cause of NAFLD and CKD. In this review, we will discuss the most recent publications on the diagnosis of NAFLD as well new evidence regarding the pathophysiology of NAFLD and CKD as an inflammatory disorder. These mechanisms include the role of obesity, the renin-angiotensin system, and dysregulation of fructose metabolism and lipogenesis in the development of both disorders. Further investigation of these pathways may lead to novel therapies that aim to target the NAFLD and CKD. However, more prospective studies that include information on both renal and liver histology will be necessary in order to understand the relationship between these diseases.

  4. NAFLD and Chronic Kidney Disease

    Directory of Open Access Journals (Sweden)

    Morgan Marcuccilli

    2016-04-01

    Full Text Available Non-alcoholic fatty liver disease (NAFLD is the most common cause of chronic liver disease in developed countries and it is now considered a risk factor for cardiovascular disease. Evidence linking NAFLD to the development and progression of chronic kidney disease (CKD is emerging as a popular area of scientific interest. The rise in simultaneous liver-kidney transplantation as well as the significant cost associated with the presence of chronic kidney disease in the NAFLD population make this entity a worthwhile target for screening and therapeutic intervention. While several cross-sectional and case control studies have been published to substantiate these theories, very little data exists on the underlying cause of NAFLD and CKD. In this review, we will discuss the most recent publications on the diagnosis of NAFLD as well new evidence regarding the pathophysiology of NAFLD and CKD as an inflammatory disorder. These mechanisms include the role of obesity, the renin-angiotensin system, and dysregulation of fructose metabolism and lipogenesis in the development of both disorders. Further investigation of these pathways may lead to novel therapies that aim to target the NAFLD and CKD. However, more prospective studies that include information on both renal and liver histology will be necessary in order to understand the relationship between these diseases.

  5. Social inequality in chronic disease outcomes.

    Science.gov (United States)

    Nordahl, Helene

    2014-11-01

    methodology, the additive hazards models, in which the potential role of behavioural risk factors can be regarded not only as mediation but also as interaction with the effect of socioeconomic position on chronic disease outcomes. The results support that two central mechanisms, differential exposure and differential vulnerability to behavioural risk factors, particularly smoking; have contributed substantially to the social inequality in chronic disease outcomes in Denmark. These mechanism are not mutually exclusive and should be regarded simultaneously. However, the findings could be non-causal associations due to, for instance, psychosocial or environmental factors. Nevertheless, research on social inequality in chronic disease outcomes should regard not only that the smoking prevalence is higher in lower socioeconomic groups (differential exposure), but also that health consequences of being a smoker seem to be worse in these subgroups (differential vulnerability).

  6. Chronic disease risk factors among hotel workers.

    Science.gov (United States)

    Gawde, Nilesh Chandrakant; Kurlikar, Prashika R

    2016-01-01

    Non-communicable diseases have emerged as a global health issue. Role of occupation in pathogenesis of non-communicable diseases has not been explored much especially in the hospitality industry. Objectives of this study include finding risk factor prevalence among hotel workers and studying relationship between occupational group and chronic disease risk factors chiefly high body mass index. A cross-sectional study was conducted among non-managerial employees from classified hotels in India. The study participants self-administered pre-designed pilot-tested questionnaires. The risk factor prevalence rates were expressed as percentages. Chi-square test was used for bi-variate analysis. Overweight was chosen as 'outcome' variable of interest and binary multi-logistic regression analysis was used to identify determinants. The prevalence rates of tobacco use, alcohol use, inadequate physical activity and inadequate intake of fruits and vegetables were 32%, 49%, 24% and 92% respectively among hotel employees. Tobacco use was significantly common among those in food preparation and service, alcohol use among those in food service and security and leisure time physical activity among front office workers. More than two-fifths (42.7%) were overweight. Among the hotel workers, those employed in food preparation and security had higher odds of 1.650 (CI: 1.025 - 2.655) and 3.245 (CI: 1.296 - 8.129) respectively of being overweight. Prevalence of chronic disease risk factors is high among hotel workers. Risk of overweight is significantly high in food preparation and security departments and workplace interventions are necessary to address these risks.

  7. Chronic disease risk factors among hotel workers

    Science.gov (United States)

    Gawde, Nilesh Chandrakant; Kurlikar, Prashika R.

    2016-01-01

    Context: Non-communicable diseases have emerged as a global health issue. Role of occupation in pathogenesis of non-communicable diseases has not been explored much especially in the hospitality industry. Aims: Objectives of this study include finding risk factor prevalence among hotel workers and studying relationship between occupational group and chronic disease risk factors chiefly high body mass index. Settings and Design: A cross-sectional study was conducted among non-managerial employees from classified hotels in India. Materials and Methods: The study participants self-administered pre-designed pilot-tested questionnaires. Statistical analysis used: The risk factor prevalence rates were expressed as percentages. Chi-square test was used for bi-variate analysis. Overweight was chosen as ‘outcome’ variable of interest and binary multi-logistic regression analysis was used to identify determinants. Results: The prevalence rates of tobacco use, alcohol use, inadequate physical activity and inadequate intake of fruits and vegetables were 32%, 49%, 24% and 92% respectively among hotel employees. Tobacco use was significantly common among those in food preparation and service, alcohol use among those in food service and security and leisure time physical activity among front office workers. More than two-fifths (42.7%) were overweight. Among the hotel workers, those employed in food preparation and security had higher odds of 1.650 (CI: 1.025 – 2.655) and 3.245 (CI: 1.296 – 8.129) respectively of being overweight. Conclusions: Prevalence of chronic disease risk factors is high among hotel workers. Risk of overweight is significantly high in food preparation and security departments and workplace interventions are necessary to address these risks PMID:27390474

  8. Cinnamon and Chronic Diseases.

    Science.gov (United States)

    Hariri, Mitra; Ghiasvand, Reza

    2016-01-01

    Cinnamon (Cinnamomum zeylanicum and Cinnamon cassia), the eternal tree of tropical medicine, belongs to the Lauraceae family and is one of the most important spices used daily by people all over the world. It contains a lot of manganese, iron, dietary fiber, and calcium. Cinnamon contains derivatives, such as cinnamaldehyde, cinnamic acid, cinnamate, and numerous other components such as polyphenols and antioxidant, anti-inflammatory, antidiabetic, antimicrobial, anticancer effects. Several reports have dealt with the numerous properties of cinnamon in the forms of bark, essential oils, bark powder, and phenolic compounds, and each of these properties can play a key role in human health. Recently, many trials have explored the beneficial effects of cinnamon in Alzheimer's disease, diabetes, arthritis, and arteriosclerosis, but still we need further investigations to provide additional clinical evidence for this spice against cancer and inflammatory, cardioprotective, and neurological disorders.

  9. Chronic kidney disease in neurogenic bladder.

    Science.gov (United States)

    Sung, Bong Mo; Oh, Dong-Jin; Choi, Moon Hee; Choi, Hye Min

    2018-03-01

    It was believed that neurogenic bladder (NB) might be a risk factor of chronic kidney disease (CKD). However, data are limited regarding the real incidence or risk of CKD in NB. In addition, serum creatinine (sCr), a classical marker of renal function, is not reliable in NB patients because they present muscle wasting due to disuse or denervation. The aim of the study was to estimate the prevalence of CKD in NB patients using serum Cystatin-C. Secondly, we aimed to identify the risk factors for CKD development in NB. This was a cross-sectional study in a public hospital, a specialized center for patients who were victims of industrial accidents. Serum Cystatin-C was checked at the regular laboratory test in the structured NB programme of the hospital, and 313 patients were included in the study. The overall prevalence of CKD, defined as estimated glomerular filtration rate (eGFR) bladder volume, recurrent urinary tract infection, and proteinuria were significantly associated with CKD in the multivariable analysis. Chronic kidney disease prevalence was more than three times higher in NB patients than in the general population despite recent progress in the medical care of NB. Co-morbid diabetes, small bladder volume, recurrent urinary tract infection, and proteinuria seem to be the risk factors for CKD development in NB. © 2016 Asian Pacific Society of Nephrology.

  10. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

    NARCIS (Netherlands)

    Vos, T.; Barber, R.M.; Bell, B.; Geleijnse, J.M.

    2015-01-01

    Background Up-to-date evidence about levels and trends in disease and injury incidence, prevalence, and years lived with disability (YLDs) is an essential input into global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013), we estimated these quantities

  11. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013 : a systematic analysis for the Global Burden of Disease Study 2013

    NARCIS (Netherlands)

    Vos, Theo; Barber, Ryan M.; Bell, Brad; Bertozzi-Villa, Amelia; Biryukov, Stan; Bolliger, Ian; Charlson, Fiona; Davis, Adrian; Degenhardt, Louisa; Dicker, Daniel; Duan, Leilei; Erskine, Holly; Feigin, Valery L.; Ferrari, Alize J.; Fitzmaurice, Christina; Fleming, Thomas; Graetz, Nicholas; Guinovart, Caterina; Haagsma, Juanita; Hansen, Gillian M.; Hanson, Sarah Wulf; Heuton, Kyle R.; Higashi, Hideki; Kassebaum, Nicholas; Kyu, Hmwe; Laurie, Evan; Liang, Xiofeng; Lofgren, Katherine; Lozano, Rafael; MacIntyre, Michael F.; Moradi-Lakeh, Maziar; Naghavi, Mohsen; Nguyen, Grant; Odell, Shaun; Ortblad, Katrina; Roberts, David Allen; Roth, Gregory A.; Sandar, Logan; Serina, Peter T.; Stanaway, Jeffrey D.; Steiner, Caitlyn; Thomas, Bernadette; Vollset, Stein Emil; Whiteford, Harvey; Wolock, Timothy M.; Ye, Pengpeng; Zhou, Maigeng; Avila, Marco A.; Aasvang, Gunn Marit; Hoek, Hans W.

    2015-01-01

    Background Up-to-date evidence about levels and trends in disease and injury incidence, prevalence, and years lived with disability (YLDs) is an essential input into global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013), we estimated these quantities

  12. [Chronic prostatitis and Bechterew's disease].

    Science.gov (United States)

    Kohlicek, J; Svec, V

    1977-11-01

    A group of patients between 35 and 65 years old with chronic prostatitis were examined for the presence of Becherew's disease. In this connection the New York and Roman criterions for morbus Bechterew were applied. There were found one ankyosing spondylarthritis, one ankylosis of the sacroiliac joint, and 11 times a tentative sacroileitis were stated. Altogether the proved and tentative findings were only 3.68 per cent of all examinations. In our countries the morbus Bechterew is found in 0,21 per cent of the normal population. So the protion of the Bechterew's disease in patients with chronic prostatitis is indeed a little higher than average, but not so frequent as often pretended in recent times. After a second series 58 patients being treated because of Bechterew's disease of different stages and different terms were examined for the possibility of a simultaneously elapsing chronic prostatitis. A chronic prostatitis was found in 38 per cent of these patients which correspondents to the incidence published in literature for the medium-age manhood. Nobody of the test persons had complaints on the part of the urologenital tract.

  13. Prevalence of self-reported chronic diseases in individuals over the age of 40 in São Paulo, Brazil: the Platino study Prevalência de doenças crônicas autorrelatadas em indivíduos acima de 40 anos em São Paulo, Brasil: estudo Platino

    Directory of Open Access Journals (Sweden)

    Andréa K. Carvalho

    2012-05-01

    Full Text Available Few studies have been conducted to determine the prevalence of chronic diseases and its impact in individuals aged 40 years or over in Brazil. The objective of this study is to evaluate the prevalence of some common chronic diseases in the Brazilian subgroup assessed by the PLATINO study using a self-reported survey. A total of 918 individuals (55% women with a mean age of 54.6 ± 10.9 years were evaluated. The most prevalent diseases were obesity (62.5%, hypertension (39.2% and gastritis (30.9%. We conclude from this study that there is a high prevalence of chronic diseases in the population over 40 years of age: 88% of the population suffers from a minimum of one disease and 26% of the sample suffers from at least three diseases. We also observed that the number of comorbidities increases with age.Poucos estudos foram desenvolvidos para determinar a prevalência de doenças crônicas e suas associações em indivíduos com mais de 40 anos de idade no Brasil. O objetivo deste trabalho foi avaliar a prevalência de algumas doenças crônicas altamente prevalentes no país, de modo autorreferido, avaliadas no Estudo PLATINO em São Paulo, em uma amostra de base populacional. Novecentos e dezoito indivíduos (55% mulheres com média de idade de 54,6 ± 10,9 anos foram avaliados. As três doenças mais prevalentes foram obesidade (62,5%, hipertensão (39,2% e gastrite (30,9%. Há uma alta prevalência de doenças crônicas na população acima de 40 anos: 88% da amostra apresentaram pelo menos uma doença e 26%, pelo menos, três doenças; e o número de doenças apresentava tendência a aumentar com a idade.

  14. The Prevalence and Determinants of Chronic Non-Communicable Disease Risk Factors amongst Adults in the Dikgale Health Demographic and Surveillance System (HDSS Site, Limpopo Province of South Africa.

    Directory of Open Access Journals (Sweden)

    Eric Maimela

    Full Text Available The aim of the study was to determine the prevalence and determinants of chronic non-communicable disease (NCD risk factors in a rural community in the Limpopo Province of South Africa.This survey was conducted using the WHO "STEPwise approach to the surveillance of non-communicable diseases" (STEPS methodology. Participants were residents of the Dikgale HDSS site and standardised international protocols were used to measure behavioural risk factors (smoking, alcohol consumption, fruit and vegetable intake and, physical activity and physical characteristics (weight, height, waist and hip circumferences and blood pressure-BP. Fasting blood glucose, triglyceride, cholesterol and HDL-C were determined in 732 participants. Data were analysed using STATA 12 for Windows.The prevalence of current smokers amongst the participants was 13.7%, of which 81.3% were daily smokers. Alcohol was consumed by 16.3% of the participants. The majority of participants (88.6% had low daily intake of fruit and vegetables and low physical activity (66.5%. The prevalence of hypertension amongst the participants was 38.2%. Overweight, obesity and high waist circumference were prevalent in females. The cardio-metabolic risk profile was not significantly different between men and women. People who were older than 40 years, overweight or obese and those who consumed alcohol were more likely to be hypertensive. Smoking was associated significantly with older age, males, never married and divorced people. Alcohol consumption was associated with older age, males, low educational status and low income.High levels of risk factors for NCDs among adults in the Dikgale HDSS suggest an urgent need for health interventions to control these risk factors at the population level in order to reduce the prevalence of NCDs.

  15. Chronic kidney disease in HIV patients

    Science.gov (United States)

    Bakri, S.; Rasyid, H.; Kasim, H.; Katu, S.

    2018-03-01

    Chronic kidney disease (CKD) is a health problem in human immunodeficiency virus (HIV) population. Prediction of CKD in HIV patients needsto have done. This study aimis to identify the prevalence of CKD in HIV patients.Thisis a cross-sectional studyofmale and female, age 18-60 years old, diagnosedHIVat Wahidin Sudirohusodo & Hasanuddin University Hospital Makassar. Diagnosed as CKD if estimated glomerular filtration rate (eGFR) HIV patients included in the analyses. Distribution of CKD, showed 3 (3.5%) subjects with eGFRHIV populations in Makassar is still quite low.

  16. Nonalcoholic fatty liver disease in chronic obstructive pulmonary disease.

    Science.gov (United States)

    Viglino, Damien; Jullian-Desayes, Ingrid; Minoves, Mélanie; Aron-Wisnewsky, Judith; Leroy, Vincent; Zarski, Jean-Pierre; Tamisier, Renaud; Joyeux-Faure, Marie; Pépin, Jean-Louis

    2017-06-01

    Nonalcoholic fatty liver disease (NAFLD) is independently linked to cardiometabolic morbidity and mortality. Low-grade inflammation, oxidative stress and ectopic fat, common features of chronic obstructive pulmonary disease (COPD), might contribute to the development of NAFLD.We aimed to investigate the prevalence of NAFLD and to evaluate the relationship between various types of liver damage and COPD severity, comorbidities and circulating inflammatory cytokines. Validated noninvasive tests (FibroMax: SteatoTest, NashTest and FibroTest) were used to assess steatosis, nonalcoholic steatohepatitis (NASH) and liver fibrosis. Patients underwent an objective assessment of COPD comorbidities, including sleep studies. Biological parameters included a complete lipid profile and inflammatory markers.In COPD patients the prevalence of steatosis, NASH and fibrosis were 41.4%, 36.9% and 61.3%, respectively. In multivariate analysis, SteatoTest and FibroTest were significantly associated with sex, body mass index (BMI), untreated sleep apnoea and insulin resistance, and, in addition, COPD Global Initiative for Chronic Obstructive Lung Disease stage for SteatoTest. Patients with steatosis had higher tumour necrosis factor-α levels and those with NASH or a combination of liver damage types had raised leptin levels after adjustment for age, sex and BMI.We concluded that NAFLD is highly prevalent in COPD and might contribute to cardiometabolic comorbidities. Copyright ©ERS 2017.

  17. Growth and nutrition in children with chronic kidney disease.

    Science.gov (United States)

    Furth, Susan L

    2005-10-01

    Growth failure remains an important problem for children with kidney disease secondary to medical kidney disease or urologic disorders. In children with chronic kidney disease, growth remains suboptimal even with energy intake above 80% of the recommend daily allowance. Adults who had chronic kidney disease as children frequently report dissatisfaction with final adult height. Additionally, growth failure in children with end-stage renal disease is associated with adverse clinical outcomes, including more frequent hospitalizations and increased mortality. This review describes the prevalence and morbidity associated with growth retardation in US children with chronic kidney disease. Additionally, available strategies to optimize growth and nutrition and current controversies in nutritional management and assessment of nutritional status in children with chronic kidney disease are discussed.

  18. Diet in chronic kidney disease in a Mediterranean African country

    OpenAIRE

    Kammoun, Khawla; Chaker, Hanen; Mahfoudh, Hichem; Makhlouf, Nouha; Jarraya, Faical; Hachicha, Jamil

    2017-01-01

    Background Mediterranean diet is characterized by low to moderate consumption of animal protein and high consumption of fruits, vegetables, bread, beans, nuts, seeds and other cereals. It has been associated with reduced risk of cardiovascular disease. However, it is not suitable for chronic kidney disease because of high potassium intake. Discussion Tunisia is an emerging Mediterranean country with limited resources, a high prevalence of chronic hemodialysis treatment and high dialysis expen...

  19. Obstructive sleep apnea in chronic obstructive pulmonary disease patients.

    LENUS (Irish Health Repository)

    Lee, Ruth

    2011-03-01

    Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) represent two of the most prevalent chronic respiratory disorders and cardiovascular diseases are major co-morbidities in both. Co-existence of both disorders (overlap syndrome) occurs in 1% of adults and overlap patients have worse nocturnal hypoxemia and hypercapnia than COPD and OSA patients alone. The present review discusses recent data concerning the pathophysiological and clinical significance of the overlap syndrome.

  20. Estimating the U.S. prevalence of chronic obstructive pulmonary disease using pre- and post-bronchodilator spirometry: the National Health and Nutrition Examination Survey (NHANES) 2007–2010

    Science.gov (United States)

    2013-01-01

    Background During 2007–2010, the National Health and Nutrition Examination Survey (NHANES) conducted a spirometry component which obtained pre-bronchodilator pulmonary lung function data on a nationally representative sample of US adults aged 6–79 years and post-bronchodilator pulmonary lung function data for the subset of adults with airflow limitation. The goals of this study were to 1) compute prevalence estimates of chronic obstructive pulmonary disease (COPD) using pre-bronchodilator and post-bronchodilator spirometry measurements and fixed ratio and lower limit of normal (LLN) diagnostic criteria and 2) examine the potential impact of nonresponse on the estimates. Methods This analysis was limited to those aged 40–79 years who were eligible for NHANES pre-bronchodilator spirometry (n=7,104). Examinees with likely airflow limitation were further eligible for post-bronchodilator testing (n=1,110). Persons were classified as having COPD based on FEV1/FVC spirometry but self-reporting both daytime supplemental oxygen therapy plus emphysema and/or current chronic bronchitis were also classified as having COPD. The final analytic samples for pre-bronchodilator and post-bronchodilator analyses were 77.1% (n=5,477) and 50.8% (n=564) of those eligible, respectively. To account for non-response, NHANES examination weights were adjusted to the eligible pre-bronchodilator and post-bronchodilator subpopulations. Results In 2007–2010, using the fixed ratio criterion and pre-bronchodilator test results, COPD prevalence was 20.9% (SE 1.1) among US adults aged 40–79 years. Applying the same criterion to post-bronchodilator test results, prevalence was 14.0% (SE 1.0). Using the LLN criterion and pre-bronchodilator test results, the COPD prevalence was 15.4% (SE 0.8), while applying the same criterion to post-bronchodilator test results, prevalence was 10.2% (SE 0.8). Conclusions The overall COPD prevalence among US adults aged 40–79 years varied from 10.2% to 20

  1. The Prevalence of Allergic Rhinitis in Patients with Chronic Rhinosinusitis

    Directory of Open Access Journals (Sweden)

    Mehdi Bakhshaee

    2014-10-01

    Full Text Available Introduction: Chronic rhinosinusitis (CRS is a multifactorial disease. Allergies are considered a predisposing factor to CRS; however, this remains controversial. The objective of this research was to investigate the prevalence of co-morbidities and allergic reaction, and to specify the most common allergens in patients with confirmed CRS.   Materials and Methods: One hundred patients with signs and symptoms of CRS who met the diagnostic endoscopic and radiologic criteria of chronic rhinosinusitis were selected. They filled out a questionnaire and underwent a skin prick test for the common inhalant allergens. Allergic rhinitis was diagnosed according to the history and positive skin prick tests.   Results: The mean age of patients was 34. Males were slightly more involved (54%. The prevalence of polypoid and none-polypoid rhinosinusitis was 54% and 46% respectively. The patients’ most common symptoms were nasal discharge (95%, blockage (94%, smell disorders (63%, cough (45%, halitosis (41%, lethargy (37%, and aural fullness (36%. Allergy to at least one allergen was noted in 64% of the CRS patients which is higher than general population in Mashhad, Iran with allergic rhinitis (22.4%. Salsola was the most common allergen. There was no significant difference in allergic reactions between polypoid and non-polypoid CRS patients.   Conclusion:  Allergic reactions was found in Iranian CRS patients with or without polyposis to be much higher than general population in Mashhad with allergic rhinitis alone.

  2. Anemia of Inflammation and Chronic Disease

    Science.gov (United States)

    ... is anemia of inflammation and chronic disease (AI/ACD)? Anemia of inflammation and chronic disease is a ... after iron-deficiency anemia. 1 Who gets AI/ACD? While AI/ACD can affect people at any ...

  3. Life course epidemiology and chronic diseases

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. Life course epidemiology and chronic diseases. Study of long term effects on chronic disease risk of physical and social exposures during gestation, childhood, adolescence, young adulthood and early adult life.

  4. Chronic Kidney Disease and Kidney Failure

    Science.gov (United States)

    ... Education Visitor Information RePORT NIH Fact Sheets Home > Chronic Kidney Disease and Kidney Failure Small Text Medium Text Large Text Chronic Kidney Disease and Kidney Failure YESTERDAY One third of diabetic ...

  5. Chronic Kidney Disease in Police Forces Households in Khartoum ...

    African Journals Online (AJOL)

    Introduction: In the Police Forces Hypertension, Diabetes, Renal Insufficiency and Thyroid Derangement (HyDRIT) pilot study we explored the prevalence, risk factors, awareness, treatment adequacy and complications of chronic kidney disease (CKD) and other non-communicable diseases among adult Police Forces ...

  6. Chronic kidney disease in sub-Saharan Africa: Hypothesis for ...

    African Journals Online (AJOL)

    diseases are now considerably the leading cause of morbidity and mortality in ... is an underrated cause of poverty and hampers the economic growth of ... health problem is chronic kidney disease (CKD),[4] which recently has an increased prevalence in sub-. Saharan Africa.[5] CKD is defined according to the presence or ...

  7. 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...

  8. Ghana's burden of chronic non-communicable diseases: Future ...

    African Journals Online (AJOL)

    The prevalence of major chronic non-communicable diseases and their risk factors has increased over time and contributes significantly to the Ghana's disease burden. Conditions like hypertension, stroke and diabetes affect young and old, urban and rural, and wealthy and poor communities. The high cost of care

  9. Comparação das informações sobre as prevalências de doenças crônicas obtidas pelo suplemento saúde da PNAD/98 e as estimadas pelo estudo Carga de Doença no Brasil Comparison of the information on prevalences of chronic diseases obtained by the health suplement of PNAD/98 and the estimated ones by the study Burden of Disease in Brazil

    Directory of Open Access Journals (Sweden)

    Iúri da Costa Leite

    2002-01-01

    Full Text Available Neste estudo, estimativas de prevalência de cinco doenças crônicas ­ cirrose, depressão, diabetes, insuficiência renal crônica e tuberculose ­ obtidas pelo Suplemento Saúde da PNAD/98 foram comparadas com as obtidas no Projeto Carga Global de Doença no Brasil. Essas estimativas foram baseadas em análise sistemática de literatura e banco de dados de morbidade disponíveis. Os resultados mostram que a PNAD apresentou número de casos mais elevados para depressão e insuficiência renal crônica, enquanto as estimativas do Projeto Carga de Doença no Brasil apresentou maiores prevalências para cirrose, diabetes e tuberculose.In this study, prevalence estimates of five chronic disease cirrhosis, depression, diabetes, chronic rhenal insufficiency and tuberculosis based on the 1998 PNAD Health Supplement were compared to those obtained by the Brazilian Global Burden of Disease Project. These estimates were based on systematic literature review as well as on available data set of morbidities. The results show that PNAD presented higher number of cases for depression and Chronic rhenal insufficiency while the prevalence rates estimated by Brazilian Global Burden of Disease Project were higher for cirrhosis, diabetes and tuberculosis.

  10. Endothelins in chronic liver disease

    DEFF Research Database (Denmark)

    Møller, Søren; Henriksen, Jens Henrik

    1996-01-01

    renal failure. Studies on liver biopsies have revealed synthesis of ET-1 in hepatic endothelial and other cells, and recent investigations have identified the hepatosplanchnic system as a major source of ET-1 and ET-3 spillover into the circulation, with a direct relation to portal venous hypertension......This review describes recent progress in the accumulation of knowledge about the endothelins (ETs), a family of vasoactive 21-amino acid polypeptides, in chronic liver disease. Particular prominence is given to the dynamics of ET-1 and ET-3 and their possible relation to the disturbed circulation....... In addition, marked associations with disturbance of systemic haemodynamics and with abnormal distribution of blood volume have been reported. Although the pathophysiological importance of the ET system in chronic liver disease is not completely understood, similarities to other vasopressive...

  11. Vouchers for chronic disease care.

    Science.gov (United States)

    Watts, Jennifer J; Segal, Leonie

    2008-08-01

    This paper explores the economic implications of vouchers for chronic disease management with respect to achieving objectives of equity and efficiency. Vouchers as a payment policy instrument for health care services have a set of properties that suggest they may address both demand-side and supply-side issues, and contribute to equity and efficiency. They provide a means whereby health care services can be targeted at selected groups, enabling consumer choice of provider, and encouraging competition in the supply of health services. This analysis suggests that, when structured appropriately, vouchers can support consumers to choose services that will meet their health care needs and encourage competition among providers. Although they may not be appropriate across the entire health care system, there are features of vouchers that make them a potentially attractive option, especially for the management of chronic disease.

  12. Endothelins in chronic liver disease

    DEFF Research Database (Denmark)

    Møller, S; Henriksen, Jens Henrik Sahl

    1996-01-01

    This review describes recent progress in the accumulation of knowledge about the endothelins (ETs), a family of vasoactive 21-amino acid polypeptides, in chronic liver disease. Particular prominence is given to the dynamics of ET-1 and ET-3 and their possible relation to the disturbed circulation...... renal failure. Studies on liver biopsies have revealed synthesis of ET-1 in hepatic endothelial and other cells, and recent investigations have identified the hepatosplanchnic system as a major source of ET-1 and ET-3 spillover into the circulation, with a direct relation to portal venous hypertension....... In addition, marked associations with disturbance of systemic haemodynamics and with abnormal distribution of blood volume have been reported. Although the pathophysiological importance of the ET system in chronic liver disease is not completely understood, similarities to other vasopressive...

  13. Chronic diseases among older cancer patients.

    OpenAIRE

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

    2011-01-01

    Introduction: With the growing number of older cancer patients, the burden of chronic diseases among older cancer patients will become increasingly important. Chronic diseases often interfere with treatment decisions and prognosis for cancer patients. However, little is known about the occurrence of chronic diseases among older cancer patients. Aim: We aim to examine the frequency of pre-existing and subsequent chronic diseases among cancer patients above age 60 in comparison with non-cancer ...

  14. High prevalence of severe coronary artery disease in elderly patients with non-operable chronic thromboembolic pulmonary hypertension referred for balloon pulmonary angioplasty

    Directory of Open Access Journals (Sweden)

    Marek Roik

    2016-11-01

    Full Text Available Introduction : Balloon pulmonary angioplasty (BPA is a new emerging catheter-based alternative treatment option for patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH. Aim : To show that all elderly CTEPH patients referred for BPA are at higher risk of obstructive coronary artery disease and that, in daily practice, they should undergo invasive coronary angiography. Material and methods : Eleven patients at the age of at least 65 years (6 males, 5 females, 77.2 ±5.9 years with confirmed non-operable type II or type III CTEPH, considered for BPA, underwent elective coronary angiography. Severe obstructive coronary artery disease (CAD was diagnosed when stenosis of left main coronary artery ≥ 50% or stenosis of ≥ 70% of epicardial arteries was angiographically confirmed. We also screened for CAD consecutive age- and sex-matched 114 PE survivors (52 males, 62 females, 74.8 ±7.2 years with excluded CTEPH. Results : Severe CAD was more frequent in elderly patients with non-operable type II or type III CTEPH candidates for BPA than in elderly acute PE survivors with excluded CTEPH (54.5% vs. 16.7%, p < 0.01, and therefore elderly CTEPH patients referred for BPA were at higher risk of CAD (OR = 5.9, 95% CI: 1.64–21.46, p = 0.007 when compared to elderly survivors after acute PE with excluded CTEPH. Conclusions : All elderly CTEPH patients referred for BPA are at higher risk of severe CAD and should routinely undergo invasive coronary angiography before BPA.

  15. Chronic kidney disease and anticoagulation

    DEFF Research Database (Denmark)

    Sciascia, Savino; Radin, Massimo; Schreiber, Karen

    2017-01-01

    Anticoagulation in patients with impaired kidney function can be challenging since drugs' pharmacokinetics and bioavailability are altered in this setting. Patients with chronic kidney disease (CKD) treated with conventional anticoagulant agents [vitamin K antagonist (VKA), low-molecular weight...... are eliminated via the kidneys pose additional challenges. More recently, two classes of direct oral anticoagulant agents (DOACs) have been investigated for the prevention and management of venous thromboembolic events: the direct factor Xa inhibitors rivaroxaban, apixaban and edoxaban, and the direct thrombin...

  16. Data summarization method for chronic disease tracking.

    Science.gov (United States)

    Aleksić, Dejan; Rajković, Petar; Vučković, Dušan; Janković, Dragan; Milenković, Aleksandar

    2017-05-01

    Bearing in mind the rising prevalence of chronic medical conditions, the chronic disease management is one of the key features required by medical information systems used in primary healthcare. Our research group paid a particular attention to this specific area by offering a set of custom data collection forms and reports in order to improve medical professionals' daily routine. The main idea was to provide an overview of history for chronic diseases, which, as it seems, had not been properly supported in previous administrative workflows. After five years of active use of medical information systems in more than 25 primary healthcare institutions, we were able to identify several scenarios that were often end-user-action dependent and could result in the data related to chronic diagnoses being loosely connected. An additional benefit would be a more effective identification of potentially new patients suffering from chronic diseases. For this particular reason, we introduced an extension of the existing data structures and a summarizing method along with a specific tool that should help in connecting all the data related to a patient and a diagnosis. The summarization method was based on the principle of connecting all of the records pertaining to a specific diagnosis for the selected patient, and it was envisaged to work in both automatic and on-demand mode. The expected results were a more effective identification of new potential patients and a completion of the existing histories of diseases associated with chronic diagnoses. The current system usage analysis shows that a small number of doctors used functionalities specially designed for chronic diseases affecting less than 6% of the total population (around 11,500 out of more than 200,000 patients). In initial tests, the on-demand data summarization mode was applied in general practice and 89 out of 155 users identified more than 3000 new patients with a chronic disease over a three-month test period

  17. Chronic Liver Disease and African Americans

    Science.gov (United States)

    ... Stay Connected OMH Home > Policy and Data > Minority Population Profiles > Black/African American > Chronic Liver Disease Chronic Liver Disease and African Americans Among African Americans, chronic liver disease is a leading cause of death. While the cause is not always known, some ...

  18. Metformin in chronic kidney disease

    DEFF Research Database (Denmark)

    Heaf, James

    2014-01-01

    Metformin has traditionally been regarded as contraindicated in chronic kidney disease (CKD), though guidelines in recent years have been relaxed to permit therapy if the glomerular filtration rate (GFR) is > 30 mL/min. The main problem is the perceived risk of lactic acidosis (LA). Epidemiological...... reduction, including weight loss, which are beneficial to patients. The risk of death and cardiovascular disease is reduced by about a third in non-CKD patients. Since metformin intoxication undoubtedly causes LA, and metformin is renally excreted, inappropriate dosage of metformin will increase the risk...

  19. Chronic Obstructive Pulmonary Disease Biomarkers

    Directory of Open Access Journals (Sweden)

    Tatsiana Beiko

    2016-04-01

    Full Text Available Despite significant decreases in morbidity and mortality of cardiovascular diseases (CVD and cancers, morbidity and cost associated with chronic obstructive pulmonary disease (COPD continue to be increasing. Failure to improve disease outcomes has been related to the paucity of interventions improving survival. Insidious onset and slow progression halter research successes in developing disease-modifying therapies. In part, the difficulty in finding new therapies is because of the extreme heterogeneity within recognized COPD phenotypes. Novel biomarkers are necessary to help understand the natural history and pathogenesis of the different COPD subtypes. A more accurate phenotyping and the ability to assess the therapeutic response to new interventions and pharmaceutical agents may improve the statistical power of longitudinal clinical studies. In this study, we will review known candidate biomarkers for COPD, proposed pathways of pathogenesis, and future directions in the field.

  20. A global systematic review of Chagas disease prevalence among migrants.

    Science.gov (United States)

    Conners, Erin E; Vinetz, Joseph M; Weeks, John R; Brouwer, Kimberly C

    2016-04-01

    Human migration has been identified as a potential factor for increased Chagas disease risk and has transformed the disease from a Latin American problem to a global one. We conducted a systematic review of the scientific literature between 2004-2014 in order to: summarize recent seroprevalence estimates of Chagas disease among Latin American migrants, in both endemic and non-endemic settings; compare seroprevalence estimates in migrants to countrywide prevalence estimates; and identify risk factors for Chagas disease among migrants. A total of 320 studies were screened and 23 studies were included. We found evidence that the prevalence of Chagas disease is higher than expected in some migrant groups and that reliance on blood donor screening prevalence estimates underestimates the burden of disease. Overall there is a dearth of high quality epidemiologic studies on the prevalence of Chagas disease in migrants, especially among intra-regional migrants within Latin America. Given that this zoonotic disease cannot likely be eradicated, improved surveillance and reporting is vital to continuing control efforts. More accurate health surveillance of both Latin American migrants and the Chagas disease burden will help countries appropriately scale up their response to this chronic disease. Overall, improved estimates of Chagas disease among migrants would likely serve to highlight the real need for better screening, diagnostics, and treatment of individuals living with the disease. Copyright © 2016 Elsevier B.V. All rights reserved.

  1. Asthma-chronic obstructive pulmonary disease overlap syndrome in the urban Chinese population: prevalence and disease burden using the 2010, 2012, and 2013 China National Health and Wellness Surveys.

    Science.gov (United States)

    Ding, Bo; DiBonaventura, Marco; Karlsson, Niklas; Ling, Xia

    2016-01-01

    Research has suggested a significant burden for patients with asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS). However, few studies have studied this population in the People's Republic of China, a region in the midst of rapid epidemiological change with respect to respiratory disease. The aim of this study was to assess the prevalence of ACOS and its association with patient outcomes in urban China. Data from the 2010, 2012, and 2013 China National Health and Wellness Survey, an Internet-based survey of adults in urban China, were used (N=59,935). Respondents were categorized into one of four groups based on self-reported physician diagnoses: ACOS, asthma only, COPD only, or control (ie, no asthma or COPD). A propensity score matching procedure was conducted to cull the control group into a subgroup (ie, matched controls) who resembled patients with ACOS, asthma only, and COPD only. These four groups (ACOS, asthma only, COPD only, matched controls) were then compared with respect to health status (Short Form-12 version 2/Short Form-36 version 2), work productivity, and health care resource use using generalized linear models. Patients with ACOS (N=366) comprised 0.61% of the adult population, 30.73% of the asthma population, and 18.60% of the COPD population in the People's Republic of China. Patients with ACOS reported significantly worse health status (eg, health utilities =0.63, 0.66, 0.63, and 0.69 for ACOS, COPD only, asthma only, and matched controls, respectively) and significantly greater work impairment (eg, overall work impairment =43.65%, 35.19%, 48.55%, and 29.80%, respectively) and health care resource use (eg, physician visits in the past 6 months =5.13, 3.84, 4.65, and 2.39, respectively) compared with matched controls and patients with COPD only. Few significant differences were observed between patients with ACOS and asthma only. Patients with ACOS have a greater comorbidity burden and significantly worse health

  2. Placental Origins of Chronic Disease

    Science.gov (United States)

    Burton, Graham J.; Fowden, Abigail L.; Thornburg, Kent L.

    2016-01-01

    Epidemiological evidence links an individual's susceptibility to chronic disease in adult life to events during their intrauterine phase of development. Biologically this should not be unexpected, for organ systems are at their most plastic when progenitor cells are proliferating and differentiating. Influences operating at this time can permanently affect their structure and functional capacity, and the activity of enzyme systems and endocrine axes. It is now appreciated that such effects lay the foundations for a diverse array of diseases that become manifest many years later, often in response to secondary environmental stressors. Fetal development is underpinned by the placenta, the organ that forms the interface between the fetus and its mother. All nutrients and oxygen reaching the fetus must pass through this organ. The placenta also has major endocrine functions, orchestrating maternal adaptations to pregnancy and mobilizing resources for fetal use. In addition, it acts as a selective barrier, creating a protective milieu by minimizing exposure of the fetus to maternal hormones, such as glucocorticoids, xenobiotics, pathogens, and parasites. The placenta shows a remarkable capacity to adapt to adverse environmental cues and lessen their impact on the fetus. However, if placental function is impaired, or its capacity to adapt is exceeded, then fetal development may be compromised. Here, we explore the complex relationships between the placental phenotype and developmental programming of chronic disease in the offspring. Ensuring optimal placentation offers a new approach to the prevention of disorders such as cardiovascular disease, diabetes, and obesity, which are reaching epidemic proportions. PMID:27604528

  3. Prevalência de doenças crônicas auto-referidas e utilização de serviços de saúde, PNAD/1998, Brasil Prevalence of self reported chronic diseases and health services consumption from the National Household Sample Survey of 1998 in Brazil

    Directory of Open Access Journals (Sweden)

    Márcia Furquim de Almeida

    2002-01-01

    Full Text Available Com o envelhecimento da população brasileira torna-se cada vez mais importante conhecer a prevalência das doenças crônicas. Essas doenças constituem-se em forte demanda aos serviços de saúde. Foram utilizados os dados da amostra da PNAD/98. Analisou-se o conjunto de doenças crônicas auto-referidas, empregou-se a razão de prevalência e razão de odds ratios com intervalo de confiança de 95% para verificar a presença de associações. Comprovou-se o aumento da prevalência das doenças crônicas com o aumento da idade; padronizando-se a idade identificou-se um gradiente de redução da prevalência com aumento da escolaridade e da renda. Observou-se maior prevalência entre mulheres e entre os que não possuíam plano de saúde. A presença de doença crônica estava associada à má avaliação do estado de saúde e de restrição de atividade. A utilização dos serviços de saúde foi de 1,8 vezes entre os portadores de doenças crônicas; com um consumo significativamente maior do número médio de consultas. Não se verificou diferença significante do número médio de consultas médicas por estrato de renda. Entre os portadores de doença crônica não houve diferença significativa do número médio de consultas entre usuários do SUS e de planos privados de saúde.The prevalence and the distribution of chronic diseases became of overwhelming importance with the ageing process of Brazilian population. These diseases are responsible by an increased demand of health services. It was analyzed the data from the sample of the Health Supplement of PNAD/98 (National Household Sample Survey. It was used the data from all self reported chronic diseases by sociodemographic variables and health services consumption. It was employed prevalence ratios and odds ratios, with 95% confidence interval to evaluate the presence of possible associations. As expected it was observed an increase of chronic diseases prevalence with age; and a

  4. K/DOQI clinical practice guidelines for chronic kidney disease: Evaluation, classification, and stratification

    NARCIS (Netherlands)

    Levey, Andrew S.; Coresh, Josef; Bolton, Kline; Culleton, Bruce; Harvey, Kathy Schiro; Ikizler, T. Alp; Johnson, Cynda Ann; Kausz, Annamaria; Kimmel, Paul L.; Kusek, John; Levin, Adeera; Minaker, Kenneth L.; Nelson, Robert; Rennke, Helmut; Steffes, Michael; Witten, Beth; Hogg, Ronald J.; Furth, Susan; Lemley, Kevin V.; Portman, Ronald J.; Schwartz, George; Lau, Joseph; Balk, Ethan; Perrone, Ronald D.; Karim, Tauqeer; Rayan, Lara; Al-Massry, Inas; Chew, Priscilla; Astor, Brad C.; De Vine, Deirdre; Eknoyan, Garabed; Levin, Nathan; Burrows-Hudson, Sally; Keane, William; Kliger, Alan; Latos, Derrick; Mapes, Donna; Oberley, Edith; Willis, Kerry; Bailie, George; Becker, Gavin; Burrowes, Jerrilynn; Churchill, David; Collins, Allan; Couser, William; de Zeeuw, Dick; Garber, Alan; Golper, Thomas; Gotch, Frank; Gotto, Antonio; Greer, Joel W.; Grimm Jr., Richard; Hannah, Ramon G.; Acosta, Jaime Herrera; Hogg, Ronald; Hunsicker, Lawrence; Klag, Michael; Klahr, Saulo; Lewis, Caya; Lowrie, Edmund; Matas, Arthur; McCulloch, Sally; Michael, Maureen; Nally, Joseph V.; Newmann, John M.; Nissenson, Allen; Norris, Keith; Owen Jr., William; Patel, Thakor G.; Payne, Glenda; Rivera-Mizzoni, Rosa A.; Smith, David; Star, Robert; Steinman, Theodore; Valderrabano, Fernando; Walls, John; Wauters, Jean-Pierre; Wenger, Nanette; Briggs, Josephine

    2002-01-01

    Introduction: Chronic kidney disease as a public health problem. Chronic kidney disease is a worldwide public health problem. In the United States, there is a rising incidence and prevalence of kidney failure, with poor outcomes and high cost. There is an even higher prevalence of earlier stages of

  5. Metabolic syndrome and chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Anis Belarbia

    2015-01-01

    Full Text Available To determine the prevalence of metabolic syndrome (MS in chronic kidney disease (CKD patients as well as its effects on the progression of CKD, we conducted a prospective, longitudinal study including 180 patients with chronic renal failure followed at the outpatient service of Nephrology at the Saloul′s University Hospital of Sousse (Tunisia over six months. Our study population consisted of 101 men and 79 women. Chronic glomerulonephritis (36.6% was the most frequent nephropathy. The mean serum creatinine was 249 ± 200 mmol/L and the mean estimated glomerular filtration rate (eGFR was 55.8 ± 49.2 mL/min. Cardiovascular (CV impairment was found in 27.2% of the patients. The prevalence of MS was 42.2%. Women had significantly more abdominal obesity than men. Subjects with MS were significantly older and predominantly females who had higher blood pressure and body mass index (BMI. CV complications were more frequent among the MS subjects than among the controls. Glycemia, triglycerides, total cholesterol and low-density lipoprotein-cholesterol (LDL-c were significantly higher in the group of CKD patients with MS. However, the occurrence of MS was not influenced by the nature of nephropathy, the degree of the CKD and the use of renin-angiotensin blockers or statins. In multivariate analysis, predictors of occurrence of MS in our series included older age, female gender and higher BMI and LDL-c levels. The prevalence of MS in patients with CKD is higher than the general population. These patients should receive special multidisciplinary care to limit CV complications.

  6. Metabolic syndrome and chronic kidney disease.

    Science.gov (United States)

    Belarbia, Anis; Nouira, Safa; Sahtout, Wissal; Guedri, Yosra; Achour, Abdellatif

    2015-09-01

    To determine the prevalence of metabolic syndrome (MS) in chronic kidney disease (CKD) patients as well as its effects on the progression of CKD, we conducted a prospective, longitudinal study including 180 patients with chronic renal failure followed at the outpatient service of Nephrology at the Saloul's University Hospital of Sousse (Tunisia) over six months. Our study population consisted of 101 men and 79 women. Chronic glomerulonephritis (36.6%) was the most frequent nephropathy. The mean serum creatinine was 249 ± 200 mmol/L and the mean estimated glomerular filtration rate (eGFR) was 55.8 ± 49.2 mL/min. Cardiovascular (CV) impairment was found in 27.2% of the patients. The prevalence of MS was 42.2%. Women had significantly more abdominal obesity than men. Subjects with MS were significantly older and predominantly females who had higher blood pressure and body mass index (BMI). CV complications were more frequent among the MS subjects than among the controls. Glycemia, triglycerides, total cholesterol and low-density lipoprotein-cholesterol (LDL-c) were significantly higher in the group of CKD patients with MS. However, the occurrence of MS was not influenced by the nature of nephropathy, the degree of the CKD and the use of renin-angiotensin blockers or statins. In multivariate analysis, predictors of occurrence of MS in our series included older age, female gender and higher BMI and LDL-c levels. The prevalence of MS in patients with CKD is higher than the general population. These patients should receive special multidisciplinary care to limit CV complications.

  7. Global strategies to prevent chronic diseases1

    African Journals Online (AJOL)

    Nicky

    diseases have been the leading causes of death and disease in most wealthy countries. Only recently has it ... Of all chronic disease deaths 80% occur in low- and middle-income countries, and the death rates .... know, especially in low- and middle-income countries that will bear the brunt of the global chronic disease.

  8. Prevalence and Predictors of Chronic Health Conditions of Inmates Newly Admitted to Maximum Security Prisons

    Science.gov (United States)

    Bai, Jennifer R.; Befus, Montina; Mukherjee, Dhritiman V.; Lowy, Franklin D.; Larson, Elaine L.

    2015-01-01

    This study estimated the prevalence of chronic medical conditions and risk predictors of 759 newly admitted inmates in two New York State maximum-security prisons. The most prevalent conditions were respiratory (34.1%), cardiovascular (17.4%), and sexually transmitted diseases (STD; 16.1%); least prevalent were HIV (3.6%), cancer (1.7%), and kidney disease (1.7%). Results of the multivariable logistic regression showed that females had higher risk for all conditions except cardiovascular and liver disease; individuals aged 40 years and older had significantly higher risk for all conditions except asthma and STD; non-Hispanic Black inmates had higher risk for respiratory disease and STD; cigarette smoking was associated with asthma; and obesity was significantly associated with diabetes, asthma, and cardiovascular conditions. These findings highlight the heavy burden of chronic illnesses among newly admitted inmates and the need to address adequate screening, prevention, and treatment services. PMID:26084947

  9. Prevalence of osteoporosis in patients with chronic kidney disease (stages 3-5) in comparison with age- and sex-matched controls: A study from Kashmir Valley Tertiary Care Center.

    Science.gov (United States)

    Najar, M Saleem; Mir, Mohamad Muzzafer; Muzamil, Mudasir

    2017-01-01

    Chronic kidney disease (CKD) is associated with a range of metabolic bone diseases. Fracture rates are higher in CKD patients than age-matched controls throughout all the five stages of CKD. Dialysis patients have 4 times as many hip fractures as expected for their age. CKD forms an independent risk factor for osteoporosis, even in the absence of traditional risk factors. This study was carried out at the nephrology unit in a tertiary care center of Kashmir to know the prevalence of osteoporosis in CKD patients having glomerular filtration rate (GFR) stages 3-5). Among the 151 cases studied, the average estimated GFR was 16.78 ± 10.714 mL/min. There were 98 males (64.9%) and 53 females (35.1%). Their mean age was 51.01 ± 14.138 years. Osteoporosis based on femoral neck T-Score was seen in 31 patients (31.6%) while 43 patients (28.5%) had osteoporosis at L1, L2 lumbar vertebrae. The prevalence of osteoporosis based on femoral neck T-Score as well as osteopenia was highest in stage-5 CKD. In our study, the body mass index (BMI) had a positive correlation with osteoporosis; low BMI patients were at higher risk for osteoporosis (P = 0.014). In the Kashmir valley, the prevalence of osteoporosis was 31.8% in CKD patients against 22% in controls. Thus, CKD forms an important risk factor for osteoporosis even in the absence of traditional risk factors. We recommend early screening, detection, and management of osteoporosis to reduce the burden of morbidity and mortality in this subset of patients.

  10. Prevalence of osteoporosis in patients with chronic kidney disease (stages 3–5 in comparison with age- and sex-matched controls: A study from Kashmir Valley Tertiary Care Center

    Directory of Open Access Journals (Sweden)

    M Saleem Najar

    2017-01-01

    Full Text Available Chronic kidney disease (CKD is associated with a range of metabolic bone diseases. Fracture rates are higher in CKD patients than age-matched controls throughout all the five stages of CKD. Dialysis patients have 4 times as many hip fractures as expected for their age. CKD forms an independent risk factor for osteoporosis, even in the absence of traditional risk factors. This study was carried out at the nephrology unit in a tertiary care center of Kashmir to know the prevalence of osteoporosis in CKD patients having glomerular filtration rate (GFR <60 mL/min (stages 3–5. Among the 151 cases studied, the average estimated GFR was 16.78 ± 10.714 mL/min. There were 98 males (64.9% and 53 females (35.1%. Their mean age was 51.01 ± 14.138 years. Osteoporosis based on femoral neck T-Score was seen in 31 patients (31.6% while 43 patients (28.5% had osteoporosis at L1, L2 lumbar vertebrae. The prevalence of osteoporosis based on femoral neck T-Score as well as osteopenia was highest in stage-5 CKD. In our study, the body mass index (BMI had a positive correlation with osteoporosis; low BMI patients were at higher risk for osteoporosis (P = 0.014. In the Kashmir valley, the prevalence of osteoporosis was 31.8% in CKD patients against 22% in controls. Thus, CKD forms an important risk factor for osteoporosis even in the absence of traditional risk factors. We recommend early screening, detection, and management of osteoporosis to reduce the burden of morbidity and mortality in this subset of patients.

  11. Chronic Disease and Childhood Development: Kidney Disease and Transplantation.

    Science.gov (United States)

    Klein, Susan D.; Simmons, Roberta G.

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

  12. Anemia of Chronic Liver Diseases

    International Nuclear Information System (INIS)

    Shin, Hyun Chung; Lee, Jhung Sang; Koh, Chang Soon; Lee, Mun Ho

    1971-01-01

    The pathogenetic mechanisms of anemia in patients with chronic liver disease were observed. Seventeen patients with moderate to advanced hepatic diseases were studied by various methods. Only patients without previous blood loss were included : 14 had cirrhosis, 2 had active chronic hepatitis, and one had inferior vena cava obstruction with associated liver cirrhosis. The followings were the results: 1. The anemia based on red blood cell count, Hb., and Ht. was found in 76.5-78.6% of the patients. 2. Red cell indices indicated that normo-macrocytic and normochromic anemia was present is the majority of the patients. 3. No evidence of megaloblastic anemia was found on the basis of the morphological examinations. 4. Serum iron, TIBC, % saturation and iron content in the bone marrow indicated that iron deficiency anemia was present in about half of the patients. 5. In the view of the erythrocyte dynamics, primary increase in the red cell destruction was ascribed to the cause of the anemia. 6. Decrease in the red cell survival time was not correlated with MCV, % saturation and S.L. ratio. Also, hemoglobin level was not correlated with MCV, % saturation and T 50 Cr. Therefore, multiple causes may be involved in the pathogenesis of the anemia. 7. Anemia as determined by the red cell volume was found in only 60% of the patients. It may be possible that hemodilutional anemia is present.

  13. New Directions in Chronic Disease Management

    Directory of Open Access Journals (Sweden)

    Hun-Sung Kim

    2015-06-01

    Full Text Available A worldwide epidemic of chronic disease, and complications thereof, is underway, with no sign of abatement. Healthcare costs have increased tremendously, principally because of the need to treat chronic complications of non-communicable diseases including cardiovascular disease, blindness, end-stage renal disease, and amputation of extremities. Current healthcare systems fail to provide an appropriate quality of care to prevent the development of chronic complications without additional healthcare costs. A new paradigm for prevention and treatment of chronic disease and the complications thereof is urgently required. Several clinical studies have clearly shown that frequent communication between physicians and patients, based on electronic data transmission from medical devices, greatly assists in the management of chronic disease. However, for various reasons, these advantages have not translated effectively into real clinical practice. In the present review, we describe current relevant studies, and trends in the use of information technology for chronic disease management. We also discuss limitations and future directions.

  14. Prevalence And Factors Associated With Chronic Diabetic ...

    African Journals Online (AJOL)

    Background: A substantial proportion of patients with diabetes develop long-term macrovascular and microvascular complications. Many risk factors have identified for development and progression of these complications. Objectives: The aim of the present study was to determine the prevalence of these complications ...

  15. Cryptosporidiosis in patients with diarrhea and chronic liver diseases.

    Science.gov (United States)

    Mousa, Nasser; Abdel-Razik, Ahmed; El-Nahas, Hala; El-Shazly, Atef; Abdelaziz, Mohammad; Nabih, Marwa; Hamed, Magdy; Eissa, Mohammad; Effat, Narmin; Eldars, Walled

    2014-12-15

    The aim of this study was to evaluate the epidemiology and clinical significance of Cryptosporidium in patients with diarrhea and chronic liver diseases. The study included 150 patients with chronic liver diseases and diarrhea, and 50 subjects with diarrhea as a control group. Stool samples were screened for the presence of Cryptosporidium by microscopic examination after modified Ziehl-Neelsen staining and detection of Cryptosporidium coproantigen by enzyme-linked immunosorbent assay (ELISA). The prevalence of Cryptosporidium infection in patients with chronic liver diseases was 30% (45/150) versus 14% (7/50) in controls. Cryptosporidium infection increased with the progression of chronic liver diseases from Child-Pugh class A to Child-Pugh class C (p 9 (pdiarrhea associated with Cryptosporidium infection developed hepatic encephalopathy, and only diarrhea was identified as a precipitating factor for hepatic encephalopathy. Cryptosporidium is one of the important causes of diarrhea in patients with chronic liver diseases. The infection significantly increased with the progression of chronic liver diseases. In patients with advanced chronic liver diseases, Cryptosporidium infection may be a precipitating factor of hepatic encephalopathy.

  16. Chronic periodontitis prevalence and the inflammatory burden in a sample population from South India.

    Science.gov (United States)

    Balaji, S K; Lavu, Vamsi; Rao, Suresh

    2018-01-01

    Periodontal diseases are among the most prevalent oral diseases in the world. Apart from repercussions in the oral cavity, there is evidence that periodontitis contributes to systemic damage in chronic diseases such as cardiovascular disease, diabetes, and preterm low birth weight. The aims of this study were to estimate the prevalence of chronic periodontitis in a sample urban population (<18 years) in Tamil Nadu and to estimate the inflammatory burden posed by chronic periodontitis by calculating the periodontal inflammatory surface area. This was a population-based study and cross-sectional design. A total of 1000 individuals (<18 years) were selected and screened for their periodontal status, oral hygiene status (OHI), and the periodontal inflamed surface area (PISA) in an outreach center located in Chennai, India. The proportion of individuals with different periodontal states (health, gingivitis, and periodontitis) was determined. A multivariate logistic regression analysis was performed to assess the influence of the individual risk factors such as habits (tobacco use), systemic conditions (diabetes), and oral hygiene maintenance on periodontitis prevalence in the sample population. A high prevalence of periodontal disease was observed in the study population (42.3%). Among the urban participants, age, cigarette smoking, pan chewing, decayed, missing, and filled teeth scores, OHI scores, and PISA scores were found to be significantly associated with periodontitis (P < 0.05). Periodontitis prevalence appears to be high even in areas with adequate access to oral health care and an inflammatory burden risk exists in a definitive manner.

  17. Chronic non-communicable diseases.

    Science.gov (United States)

    Unwin, N; Alberti, K G M M

    2006-01-01

    Chronic non-communicable diseases (NCD) account for almost 60% of global mortality, and 80% of deaths from NCD occur in low- and middle-income countries. One quarter of these deaths--almost 9 million in 2005--are in men and women aged globalisation of the food, tobacco and alcohol industries. Because NCD have a major impact on men and women of working age and their elderly dependents, they result in lost income, lost opportunities for investment, and overall lower levels of economic development. Reductions in the incidences of many NCD and their complications are, however, already possible. Up to 80% of all cases of cardiovascular disease or type-2 diabetes and 40% of all cases of cancer, for example, are probably preventable based on current knowledge. In addition, highly cost-effective measures exist for the prevention of some of the complications of established cardiovascular disease and diabetes. Achieving these gains will require a broad range of integrated, population-based interventions as well as measures focused on the individuals at high risk. At present, the international-assistance community provides scant resources for the control of NCD in poor countries, partly, at least, because NCD continue to be wrongly perceived as predominantly diseases of the better off. As urbanization continues apace and populations age, investment in the prevention and control of NCD in low-and middle-income countries can no longer be ignored.

  18. Fruit and vegetable consumption and prevalence of diet-related chronic non-communicable diseases in Zanzibar, Tanzania: a mixed-methods study

    DEFF Research Database (Denmark)

    Dræbel, Tania Aase; Keller, Amélie; de Courten, Max

    2012-01-01

    of fruit and vegetables is associated with NCDs. In Zanzibar, the incidence of diabetes has increased from 252 new cases in 2006, to 373 in 2008, in an adult population of just over a million people and hypertension is the second commonest cause of death. We explored the association between fruit...... and vegetable consumption and prevalence of diet-related NCDs in Zanzibar....

  19. The dyslipidemia of chronic renal disease: effects of statin therapy

    NARCIS (Netherlands)

    Ozsoy, Riza C.; van Leuven, Sander I.; Kastelein, John J. P.; Arisz, Lambertus; Koopman, Marion G.

    2006-01-01

    PURPOSE OF REVIEW: Dyslipidemia is a prevalent condition in patients with chronic renal disease, but is often left untreated. Statin treatment constitutes an effective way to improve lipid abnormalities. This review summarizes present studies on dyslipidemia and its treatment in patients with

  20. Epidemiology of chronic kidney disease in northern region of Senegal

    African Journals Online (AJOL)

    Introduction: Chronic kidney disease (CKD) is an emerging worldwide epidemic but few data are available in African populations. We aimed to assess prevalence of CKD in adult populations of Saint-Louis (northern Senegal). Methods: In a population-based survey between January and May 2012, we included 1,037 adults ...

  1. Sickle Cell Chronic Lung Disease among Young Adult Nigerians ...

    African Journals Online (AJOL)

    BACKGROUND: Sickle cell chronic lung disease (SCLD) is often underappreciated by health care providers because its exact prevalence and methods of diagnosis ... admissions (82.4%, OR=10.02, CI=4.51–22.22) and presence of symptoms suggesting previous acute chest syndrome (dyspnoea in 58.8%, OR=33.33, ...

  2. Chronic kidney disease screening: Results of the 2013 World ...

    African Journals Online (AJOL)

    Background: Chronic kidney disease (CKD) is on the rise globally due to the increase in prevalence of common risk factors. Screening for CKD risk factors is important for early detection and institution of measures to retard its progression. This study aimed to determine the markers of CKD and its risk factors in a selected ...

  3. Chronic kidney disease in rheumatoid arthritis at Kenyatta National ...

    African Journals Online (AJOL)

    Objective: To determine the prevalence of chronic kidney disease among patients with rheumatoid arthritis on follow up at the rheumatology outpatient clinic at Kenyatta National Hospital. Design: Descriptive, cross-sectional study. Setting: Rheumatology outpatient clinic at the Kenyatta National Hospital, a public national ...

  4. Chronic kidney disease in Nigeria: primary care physicians must ...

    African Journals Online (AJOL)

    Chronic Kidney disease (CKD) is one of the world's major public health problems and the prevalence of Kidney failure is rising steadily. ... Only thirty percent (30%) of the doctors tested for proteinuria in thirty nine percent (39%) of those they were treating for Diabetes Mellitus and only thirty five percent (35%) of the doctors ...

  5. Sitting Time and Associated Factors among Chronic Disease ...

    African Journals Online (AJOL)

    The aim of this study was to assess the prevalence of high sitting time and associate factors among chronic disease patients in Cambodia, Myanmar and Vietnam. Sitting time and physical activity were measured using the General Physical Activity Questionnaire (GPAQ). A number of logistic regression models investigated ...

  6. The use of a chronic disease and risk factor surveillance system to determine the age, period and cohort effects on the prevalence of obesity and diabetes in South Australian adults--2003-2013.

    Science.gov (United States)

    Taylor, Anne W; Shi, Zumin; Montgomerie, Alicia; Dal Grande, Eleonora; Campostrini, Stefano

    2015-01-01

    Age, period and cohort (APC) analyses, using representative, population-based descriptive data, provide additional understanding behind increased prevalence rates. Data on obesity and diabetes from the South Australian (SA) monthly chronic disease and risk factor surveillance system from July 2002 to December 2013 (n = 59,025) were used. Age was the self-reported age of the respondent at the time of the interview. Period was the year of the interview and cohort was age subtracted from the survey year. Cohort years were 1905 to 1995. All variables were treated as continuous. The age-sex standardised prevalence for obesity and diabetes was calculated using the Australia 2011 census. The APC models were constructed with ''apcfit'' in Stata. The age-sex standardised prevalence of obesity and diabetes increased in 2002-2013 from 18.6% to 24.1% and from 6.2% to 7.9%. The peak age for obesity was approximately 70 years with a steady increasing rate from 20 to 70 years of age. The peak age for diabetes was approximately 80 years. There were strong cohort effects and no period effects for both obesity and diabetes. The magnitude of the cohort effect is much more pronounced for obesity than for diabetes. The APC analyses showed a higher than expected peak age for both obesity and diabetes, strong cohort effects with an acceleration of risk after 1960s for obesity and after 1940s for diabetes, and no period effects. By simultaneously considering the effects of age, period and cohort we have provided additional evidence for effective public health interventions.

  7. The Use of a Chronic Disease and Risk Factor Surveillance System to Determine the Age, Period and Cohort Effects on the Prevalence of Obesity and Diabetes in South Australian Adults - 2003–2013

    Science.gov (United States)

    Taylor, Anne W.; Shi, Zumin; Montgomerie, Alicia; Dal Grande, Eleonora; Campostrini, Stefano

    2015-01-01

    Background Age, period and cohort (APC) analyses, using representative, population-based descriptive data, provide additional understanding behind increased prevalence rates. Methods Data on obesity and diabetes from the South Australian (SA) monthly chronic disease and risk factor surveillance system from July 2002 to December 2013 (n = 59,025) were used. Age was the self-reported age of the respondent at the time of the interview. Period was the year of the interview and cohort was age subtracted from the survey year. Cohort years were 1905 to 1995. All variables were treated as continuous. The age-sex standardised prevalence for obesity and diabetes was calculated using the Australia 2011 census. The APC models were constructed with ‘‘apcfit’’ in Stata. Results The age-sex standardised prevalence of obesity and diabetes increased in 2002-2013 from 18.6% to 24.1% and from 6.2% to 7.9%. The peak age for obesity was approximately 70 years with a steady increasing rate from 20 to 70 years of age. The peak age for diabetes was approximately 80 years. There were strong cohort effects and no period effects for both obesity and diabetes. The magnitude of the cohort effect is much more pronounced for obesity than for diabetes. Conclusion The APC analyses showed a higher than expected peak age for both obesity and diabetes, strong cohort effects with an acceleration of risk after 1960s for obesity and after 1940s for diabetes, and no period effects. By simultaneously considering the effects of age, period and cohort we have provided additional evidence for effective public health interventions. PMID:25923664

  8. The use of a chronic disease and risk factor surveillance system to determine the age, period and cohort effects on the prevalence of obesity and diabetes in South Australian adults--2003-2013.

    Directory of Open Access Journals (Sweden)

    Anne W Taylor

    Full Text Available Age, period and cohort (APC analyses, using representative, population-based descriptive data, provide additional understanding behind increased prevalence rates.Data on obesity and diabetes from the South Australian (SA monthly chronic disease and risk factor surveillance system from July 2002 to December 2013 (n = 59,025 were used. Age was the self-reported age of the respondent at the time of the interview. Period was the year of the interview and cohort was age subtracted from the survey year. Cohort years were 1905 to 1995. All variables were treated as continuous. The age-sex standardised prevalence for obesity and diabetes was calculated using the Australia 2011 census. The APC models were constructed with ''apcfit'' in Stata.The age-sex standardised prevalence of obesity and diabetes increased in 2002-2013 from 18.6% to 24.1% and from 6.2% to 7.9%. The peak age for obesity was approximately 70 years with a steady increasing rate from 20 to 70 years of age. The peak age for diabetes was approximately 80 years. There were strong cohort effects and no period effects for both obesity and diabetes. The magnitude of the cohort effect is much more pronounced for obesity than for diabetes.The APC analyses showed a higher than expected peak age for both obesity and diabetes, strong cohort effects with an acceleration of risk after 1960s for obesity and after 1940s for diabetes, and no period effects. By simultaneously considering the effects of age, period and cohort we have provided additional evidence for effective public health interventions.

  9. [ANEMIA IN CHRONIC KIDNEY DISEASE].

    Science.gov (United States)

    Bukmir, L; Fišić, M; Diminić-Lisica, I; Ljubotina, A

    2016-12-01

    Renal anemia develops secondary to chronic kidney disease (CKD) and its incidence increases with the progression of CKD. The aim is to inform family physicians about the latest developments and ways of approaching the issue, in accordance with national guidelines. The PubMed and Cochrane systematic reviews databases were searched for the 1996-2015 period using the following key words: anemia, chronic renal failure, erythropoietin, and primary health care. In addition, all relevant articles and textbooks available were manually searched to suggest the following conclusions. The use of erythropoiesis-stimulating agents (ESA) slows down the progression of CKD, reduces the need for blood transfusions and improves the patient quality of life. Target hemoglobin (Hb) concentration to be permanently maintained is 110-120 g/L. Higher Hb levels are associated with higher mortality and major cardiovascular events in dialysis patients. Target hemoglobin level should be strictly individualized depending on CKD stage (both non-dialyzed and dialyzed population), age, other risks, initial and maintenance treatment. Early recognition and appropriate correction of anemia using ESA is of utmost importance in CKD patients. Systematic primary and secondary prevention measures along with education and professional implementation of national guidelines in daily work of family practitioners can improve medical care of patients with CKD.

  10. Chronic lung disease in newborns.

    Science.gov (United States)

    Sankar, M Jeeva; Agarwal, Ramesh; Deorari, Ashok K; Paul, Vinod K

    2008-04-01

    Chronic lung disease (CLD) or bronchopulmonary dysplasia (BPD) occurs in preterm infants who require respiratory support in the first few days of birth. Apart from prematurity, oxygen therapy and assisted ventilation, factors like intrauterine/postnatal infections, patent ductus arteriosus, and genetic polymorphisms also contribute to its pathogenesis. The severe form of BPD with extensive inflammatory changes is rarely seen nowadays; instead, a milder form characterized by decreased alveolar septation due to arrest in lung development is more common. A multitude of strategies, mainly pharmacological and ventilatory, have been employed for prevention and treatment of BPD. Unfortunately, most of them have not been proved to be beneficial. A comprehensive protocol for management of BPD based on the current evidence is discussed here.

  11. Is Chronic Obstructive Pulmonary Disease an Accelerated Aging Disease?

    Science.gov (United States)

    MacNee, William

    2016-12-01

    Aging is one of the most important risk factors for most chronic diseases. The worldwide increase in life expectancy has been accompanied by an increase in the prevalence of age-related diseases that result in significant morbidity and mortality and place an enormous burden on healthcare and resources. Aging is a progressive degeneration of the tissues that has a negative impact on the structure and function of vital organs. The lung ages, resulting in decreased function and reduced capacity to respond to environmental stresses and injury. Many of the changes that occur in the lungs with normal aging, such as decline in lung function, increased gas trapping, loss of lung elastic recoil, and enlargement of the distal air spaces, also are present in chronic obstructive pulmonary disease (COPD). The prevalence of COPD is two to three times higher in people over the age of 60 years than in younger age groups. Indeed, COPD has been considered a condition of accelerated lung aging. Several mechanisms associated with aging are present in the lungs of patients with COPD. Cell senescence is present in emphysematous lungs and is associated with shortened telomeres and decreased antiaging molecules, suggesting accelerated aging in the lungs of patients with COPD. Increasing age leads to elevated basal levels of inflammation and oxidative stress (inflammaging) and to increased immunosenescence associated with changes in both the innate and adaptive immune responses. These changes are similar to those that occur in COPD and may enhance the activity of the disease as well as increase susceptibility to exacerbations in patients with COPD. Understanding the mechanism of age-related changes in COPD may identify novel therapies for this condition.

  12. Prevalence and correlates of heart disease among adults in Singapore.

    Science.gov (United States)

    Picco, Louisa; Subramaniam, Mythily; Abdin, Edimansyah; Vaingankar, Janhavi Ajit; Chong, Siow Ann

    2016-02-01

    Heart disease is one of the leading causes of morbidity and mortality worldwide and it has been well established that it is associated with both mental and physical conditions. This paper describes the prevalence of heart disease with mental disorders and other chronic physical conditions among the Singapore resident population. Data were from the Singapore Mental Health Study which was a representative, cross-sectional epidemiological survey undertaken with 6616 Singapore residents, between December 2009 and December 2010. The Composite International Diagnostic Interview Version 3.0 was used to establish the diagnosis of mental disorders, while a chronic medical conditions checklist was used to gather information on 15 physical conditions, including various forms of heart disease. Health-related quality of life was measured using the Euro-Quality of Life Scale (EQ-5D). The lifetime prevalence of heart disease was 2.8%. Socio-demographic correlates of heart disease included older age, Indian ethnicity, secondary education (vs. tertiary) and being economically inactive. After adjusting for socio-demographic variables and other comorbid physical and mental disorders, the prevalence of major depressive disorder and bipolar disorder were significantly higher among those with heart disease, as were diabetes, arthritis, kidney failure and lung disease. These findings highlight important associations between heart disease and various socio-demographic correlates, mental disorders and physical conditions. Given the high prevalence of mood disorders among heart disease patients, timely and appropriate screening and treatment of mental disorders among this group is essential. Copyright © 2015 Elsevier B.V. All rights reserved.

  13. Disparities in Confidence to Manage Chronic Diseases in Men

    Directory of Open Access Journals (Sweden)

    Keith Elder

    2014-08-01

    Full Text Available Background: Chronic diseases are highly prevalent among men in the United States and chronic disease management is problematic for men, particularly for racial and ethnic minority men. Objectives: This study examined the association between health information seeking and confidence to manage chronic diseases among men. Methods: Study data were drawn from the 2007 Health Tracking Household Survey and analyzed using multiple binary logistic regressions. The analytical sample included 2,653 men, 18 years and older with a chronic illness. Results: Health information seeking was not associated with confidence to manage chronic illnesses. African-American men had lower odds than White men to agree to take actions to prevent symptoms with their health. Hispanic men had lower odds than White men to agree to tell a doctor concerns they have, even when not asked. Conclusions: Racial and ethnic minority men with a chronic condition appear to be less confident to manage their health compared to white men. Chronic disease management needs greater exploration to understand the best ways to help racial and ethnic minority men successfully manage their chronic condition.

  14. Comparison between urine albumin-to-creatinine ratio and urine protein dipstick testing for prevalence and ability to predict the risk for chronic kidney disease in the general population (Iwate-KENCO study): a prospective community-based cohort study.

    Science.gov (United States)

    Koeda, Yorihiko; Tanaka, Fumitaka; Segawa, Toshie; Ohta, Mutsuko; Ohsawa, Masaki; Tanno, Kozo; Makita, Shinji; Ishibashi, Yasuhiro; Itai, Kazuyoshi; Omama, Shin-Ichi; Onoda, Toshiyuki; Sakata, Kiyomi; Ogasawara, Kuniaki; Okayama, Akira; Nakamura, Motoyuki

    2016-05-12

    This study compared the combination of estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR) vs. eGFR and urine protein reagent strip testing to determine chronic kidney disease (CKD) prevalence, and each method's ability to predict the risk for cardiovascular events in the general Japanese population. Baseline data including eGFR, UACR, and urine dipstick tests were obtained from the general population (n = 22 975). Dipstick test results (negative, trace, positive) were allocated to three levels of UACR (300), respectively. In accordance with Kidney Disease Improving Global Outcomes CKD prognosis heat mapping, the cohort was classified into four risk grades (green: grade 1; yellow: grade 2; orange: grade 3, red: grade 4) based on baseline eGFR and UACR levels or dipstick tests. During the mean follow-up period of 5.6 years, 708 new onset cardiovascular events were recorded. For CKD identified by eGFR and dipstick testing (dipstick test ≥ trace and eGFR urine dipstick testing, the predictive ability for cardiovascular events from UACR-based risk grading was superior to that of dipstick-based risk grading in the general population.

  15. Modeling chronic diseases: the diabetes module. Justification of (new) input data

    NARCIS (Netherlands)

    Baan CA; Bos G; Jacobs-van der Bruggen MAM; Baan CA; Bos G; Jacobs-van der Bruggen MAM; PZO

    2005-01-01

    The RIVM chronic disease model (CDM) is an instrument designed to estimate the effects of changes in the prevalence of risk factors for chronic diseases on disease burden and mortality. To enable the computation of the effects of various diabetes prevention scenarios, the CDM has been updated and

  16. Prevalence and overlap of Disease Management Program diseases in older hospitalized patients

    DEFF Research Database (Denmark)

    Juul-Larsen, Helle Gybel; Petersen, Janne; Sivertsen, Ditte Maria

    2017-01-01

    defined by several ICD-10 codes predefined in the DMPs. Of these patients, 904 (19.4%) had 2 + PDs, and there were 47 different combinations of the six different PDs. The most prevalent pair of PDs was type 2 diabetes with cardiovascular disease in 203 (22.5%) patients, of whom 40.4% had an additional PD......Many countries, like Denmark, have tailored Disease Management Programs (DMPs) based on patients having single chronic diseases [defined institutionally as "program diseases" (PDs)], which can complicate treatment for those with multiple chronic diseases. The aims of this study were (a) to assess...... the prevalence and overlap among acutely hospitalized older medical patients of PDs defined by the DMPs, and (b) to examine transitions between different departments during hospitalization and mortality and readmission within two time intervals among patients with the different PDs. We conducted a registry study...

  17. Chronic kidney disease and 10-year risk of cardiovascular death.

    Science.gov (United States)

    Holzmann, Martin J; Carlsson, Axel C; Hammar, Niklas; Ivert, Torbjörn; Walldius, Göran; Jungner, Ingmar; Wändell, Per; Ärnlöv, Johan

    2016-07-01

    In recent clinical guidelines, individuals with chronic kidney disease are considered to have a similar 10-year absolute risk of cardiovascular death as individuals with diabetes or established cardiovascular disease. There is limited evidence to support this claim. We investigated the 10-year risk for cardiovascular death in individuals with moderate or severe chronic kidney disease (glomerular filtration rate of 30-60 or disease. The inclusion criteria, exposure, study outcome and follow-up period adhered strictly to the definitions of the European Society of Cardiology guidelines. The absolute 10-year risk of cardiovascular death was 3.9% and 14.0% in individuals with moderate and severe chronic kidney disease, respectively, but was substantially lower in women and in younger individuals. The risk in individuals with prevalent diabetes and cardiovascular disease was approximately two and three times higher compared to the risk estimate for moderate chronic kidney disease (hazard ratio (HR) 4.1, 95% confidence interval (CI) 3.8-4.5 and HR 6.2, 95% CI 5.7-6.7 vs. HR 2.3 95% CI 2.0-2.6, respectively) while the risk for individuals with severe chronic kidney disease appeared more congruent to that of diabetes and cardiovascular disease (HR 5.5, 95% CI 3.3-8.9). Although moderate chronic kidney disease is an independent predictor for an increased 10-year risk of cardiovascular death, only those with severe chronic kidney disease had similar risk to those with diabetes or cardiovascular disease. © The European Society of Cardiology 2015.

  18. Screening Fabry's disease in chronic kidney disease patients not on dialysis: a multicenter study.

    Science.gov (United States)

    Yeniçerioğlu, Yavuz; Akdam, Hakan; Dursun, Belda; Alp, Alper; Sağlam Eyiler, Funda; Akın, Davut; Gün, Yelda; Hüddam, Bülent; Batmazoğlu, Mehmet; Gibyeli Genek, Dilek; Pirinççi, Serhat; Ersoy, İsmail Rıfkı; Üzüm, Atilla; Soypaçacı, Zeki; Tanrısev, Mehmet; Çolak, Hülya; Demiral Sezer, Sibel; Bozkurt, Gökay; Akyıldız, Utku Oğan; Akyüz Ünsal, Ayşe İpek; Ünübol, Mustafa; Uslu, Meltem; Eryılmaz, Ufuk; Günel, Ceren; Meteoğlu, İbrahim; Yavaşoğlu, İrfan; Ünsal, Alparslan; Akar, Harun; Okyay, Pınar

    2017-11-01

    Fabry's disease is an X-linked inherited, rare, progressive, lysosomal storage disorder, affecting multiple organs due to the deficient activity of α-galactosidase A (α-Gal A) enzyme. The prevalence has been reported to be 0.15-1% in hemodialysis patients; however, the information on the prevalence in chronic kidney disease not on dialysis is lacking. This study aimed to determine the prevalence of Fabry's disease in chronic kidney disease. The patients older than 18 years, enclosing KDIGO 2012 chronic kidney disease definitions, not on dialysis, were enrolled. Dried blood spots on Guthrie papers were used to analyze α-Gal A enzyme and genetic analysis was performed in individuals with enzyme activity ≤1.2 μmol/L/h. A total of 1453 chronic kidney disease patients not on dialysis from seven clinics in Turkey were screened. The mean age of the study population was 59.3 ± 15.9 years. 45.6% of patients were female. The creatinine clearance of 77.3% of patients was below 60 mL/min/1.73 m 2 , 8.4% had proteinuria, and 2.5% had isolated microscopic hematuria. The mean value of patients' α-Gal A enzyme was detected as 2.93 ± 1.92 μmol/L/h. 152 patients had low levels of α-Gal A enzyme activity (≤1.2 μmol/L/h). In mutation analysis, A143T and D313Y variants were disclosed in three male patients. The prevalence of Fabry's disease in chronic kidney disease not on dialysis was found to be 0.2% (0.4% in male, 0.0% in female). Fabry's disease should be considered in the differential diagnosis of chronic kidney disease with unknown etiology even in the absence of symptoms and signs suggestive of Fabry's disease.

  19. Fisetin and Its Role in Chronic Diseases.

    Science.gov (United States)

    Pal, Harish C; Pearlman, Ross L; Afaq, Farrukh

    2016-01-01

    Chronic inflammation is a prolonged and dysregulated immune response leading to a wide variety of physiological and pathological conditions such as neurological abnormalities, cardiovascular diseases, diabetes, obesity, pulmonary diseases, immunological diseases, cancers, and other life-threatening conditions. Therefore, inhibition of persistent inflammation will reduce the risk of inflammation-associated chronic diseases. Inflammation-related chronic diseases require chronic treatment without side effects. Use of traditional medicines and restricted diet has been utilized by mankind for ages to prevent or treat several chronic diseases. Bioactive dietary agents or "Nutraceuticals" present in several fruits, vegetables, legumes, cereals, fibers, and certain spices have shown potential to inhibit or reverse the inflammatory responses and several chronic diseases related to chronic inflammation. Due to safe, nontoxic, and preventive benefits, the use of nutraceuticals as dietary supplements or functional foods has increased in the Western world. Fisetin (3,3',4',7-tetrahydroxyflavone) is a dietary flavonoid found in various fruits (strawberries, apples, mangoes, persimmons, kiwis, and grapes), vegetables (tomatoes, onions, and cucumbers), nuts, and wine that has shown strong anti-inflammatory, anti-oxidant, anti-tumorigenic, anti-invasive, anti-angiogenic, anti-diabetic, neuroprotective, and cardioprotective effects in cell culture and in animal models relevant to human diseases. In this chapter, we discuss the beneficial pharmacological effects of fisetin against different pathological conditions with special emphasis on diseases related to chronic inflammatory conditions.

  20. Diseases in Chronic Non-infective Diarrhea

    OpenAIRE

    Simadibrata, Marcellus; Rani, Aziz; Daldiyono, Daldiyono; Syam, Ari Fahrial; Tytgat, GNJ; Yuwono, Vera; Lesmana, L A; Ariawan, Iwan

    2004-01-01

    Background: Chronic diarrhea is common in Indonesia. The chronic non-infective diarrhea cases seem to be increasing recently. The aim of this study is to reveal the pattern of diseases that can cause chronic non-infective diarrhea. Methods: We examined all patients suffering from chronic non-infective diarrhea over a six years period. The patients underwent physical examination and performed laboratory tests, colon enema X-ray, colonoscopy, ileoscopy, upper gastrointestnal endoscopy and smal...

  1. Thyroid status in chronic liver diseases in an endemic area

    International Nuclear Information System (INIS)

    Ryabchikov, A.V.

    1989-01-01

    Iodine absorptive thyroid function, the levels of T 3 , T 4 and TSH by means of radioimmunoassay and thyroid scanning were determined and performed in 132 patients with chronic liver diseases. All patients lived in a goiterendemic area with higher prevalence of liver diseases. Functional thyroid disorders were revealed in all the patients: hypofunction in 85.6 %, hyperfunction in 14.4 %. Structural and morphological and anatomic thyroid changes were detected in 91.6 %

  2. Fruit and vegetable consumption and prevalence of diet-related chronic non-communicable diseases in Zanzibar, Tanzania: a mixed methods study

    DEFF Research Database (Denmark)

    Keller, Amélie; de Courten, Max; Dræbel, Tania

    2012-01-01

    and 22 (2·2%) versus 46 (2·8%) had diabetes. The prevalence of diabetes, hypertension, and obesity was higher in urban sites than in rural sites. People from rural areas earned on average 4·5 times less than did those in urban areas (mean annual income 83 708 Tanzanian shillings vs 383 065 Tanzanian...... consumption of fruit and vegetables is associated with NCDs. In Zanzibar, the incidence of diabetes has increased from 252 new cases in 2006, to 373 in 2008, in an adult population of just over a million people and hypertension is the second commonest cause of death. We explored the association between fruit......=2800, age 25–65 years, done from June to July, 2011). We calculated frequency, percentage, and 95% CIs for age, sex, marital status, level of education, income, tobacco use, alcohol use, obesity (body mass index), hypertension (systolic and diastolic blood pressure), and diabetes (fasting blood glucose...

  3. The prevalence of chronic conditions associated with modifiable ...

    African Journals Online (AJOL)

    The Sunday Times Discovery Healthiest Company Index Survey collected a dataset of 13 578 responses from corporate employees in 101 companies. This dataset has been used to assess the prevalence of self-reported modifiable health-risk factors and the association with chronic conditions. The analysis indicates that ...

  4. Prevalence of genetic renal disease in children.

    Science.gov (United States)

    Fletcher, Jeffery; McDonald, Stephen; Alexander, Stephen I

    2013-02-01

    Genetic etiology comprises a significant proportion of renal disease in childhood. Completion of the Human Genome Project and increased genetic testing has assisted with the increased recognition of a genetic basis to many renal disorders. Australia and New Zealand have a relatively stable but diverse population, with eight major pediatric nephrology referral centers, which allow ascertainment of disease frequency. To determine prevalence, pediatric nephrologists at the eight centers in Australia and New Zealand were surveyed on their estimated number of patients with renal disease of genetic etiology over a 10-year period. Disease prevalence was calculated using combined national population data. The overall prevalence of genetic kidney disease in children in Australia and New Zealand is 70.6 children per million age-representative population. Congenital anomalies of the kidney and urinary tract (CAKUT) and steroid-resistant nephrotic syndrome (SRNS) are the most frequent, with a prevalence of 16.3 and 10.7, respectively, per million children. We find a similar prevalence of genetic renal disorders in Australia and New Zealand to those reported in other countries. This is likely to be due to inclusion of children with all forms of renal disease rather than being limited to those with renal impairment.

  5. Hypertension in Chronic Kidney Disease.

    Science.gov (United States)

    Hamrahian, Seyed Mehrdad; Falkner, Bonita

    2017-01-01

    Hypertension, a global public health problem, is currently the leading factor in the global burden of disease. It is the major modifiable risk factor for heart disease, stroke and kidney failure. Chronic kidney disease (CKD) is both a common cause of hypertension and CKD is also a complication of uncontrolled hypertension. The interaction between hypertension and CKD is complex and increases the risk of adverse cardiovascular and cerebrovascular outcomes. This is particularly significant in the setting of resistant hypertension commonly seen in patient with CKD. The pathophysiology of CKD associated hypertension is multi-factorial with different mechanisms contributing to hypertension. These pathogenic mechanisms include sodium dysregulation, increased sympathetic nervous system and alterations in renin angiotensin aldosterone system activity. Standardized blood pressure (BP) measurement is essential in establishing the diagnosis and management of hypertension in CKD. Use of ambulatory blood pressure monitoring provides an additional assessment of diurnal variation in BP commonly seen in CKD patients. The optimal BP target in the treatment of hypertension in general and CKD population remains a matter of debate and controversial despite recent guidelines and clinical trial data. Medical therapy of patients with CKD associated hypertension can be difficult and challenging. Additional evaluation by a hypertension specialist may be required in the setting of treatment resistant hypertension by excluding pseudo-resistance and treatable secondary causes. Treatment with a combination of antihypertensive drugs, including appropriate diuretic choice, based on estimated glomerular filtration rate, is a key component of hypertension management in CKD patients. In addition to drug treatment non-pharmacological approaches including life style modification, most important of which is dietary salt restriction, should be included in the management of hypertension in CKD patients.

  6. Chronic diseases among older cancer patients.

    NARCIS (Netherlands)

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

    2011-01-01

    Introduction: With the growing number of older cancer patients, the burden of chronic diseases among older cancer patients will become increasingly important. Chronic diseases often interfere with treatment decisions and prognosis for cancer patients. However, little is known about the occurrence of

  7. Osteoporosis in chronic obstructive pulmonary disease patients

    DEFF Research Database (Denmark)

    Jørgensen, Niklas Rye; Schwarz, Peter

    2008-01-01

    The purpose of this review is to examine the state of knowledge and clinical practice in the association of chronic obstructive pulmonary disease to osteoporosis and fracture incidence.......The purpose of this review is to examine the state of knowledge and clinical practice in the association of chronic obstructive pulmonary disease to osteoporosis and fracture incidence....

  8. Danish Register of chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Lange, Peter; Tøttenborg, Sandra Søgaard; Sorknæs, Anne Dichmann

    2016-01-01

    AIM OF DATABASE: The Danish Register of Chronic Obstructive Pulmonary Disease (DrCOPD) is a nationwide database aiming to describe the quality of treatment of all patients with chronic obstructive pulmonary disease (COPD) in Denmark. STUDY POPULATION: DrCOPD comprises data on all patients...

  9. Prevalence of gastroduodenal lesions in chronic nonsteroidal anti ...

    African Journals Online (AJOL)

    At endoscopy, only 10 (13.9%) patients had normal gastroduodenal mucosa. Gastritis was the most prevalent lesion occurring in 50% of the patients. Peptic ulcer disease had a point prevalence of 30.5% (duodenal ulcers 22.2%, and gastric ulcers 8.3%). Other lesions at endoscopy were duodenitis 16.7%, gastric erosions ...

  10. Chronic obstructive pulmonary disease and peripheral neuropathy

    Directory of Open Access Journals (Sweden)

    Gupta Prem

    2006-01-01

    Full Text Available Chronic obstructive pulmonary disease (COPD is the fourth leading cause of death world-wide and a further increase in the prevalence as well as mortality of the disease is predicted for coming decades. There is now an increased appreciation for the need to build awareness regarding COPD and to help the thousands of people who suffer from this disease and die prematurely from COPD or its associated complication(s. Peripheral neuropathy in COPD has received scanty attention despite the fact that very often clinicians come across COPD patients having clinical features suggestive of peripheral neuropathy. Electrophysiological tests like nerve conduction studies are required to distinguish between axonal and demyelinating type of disorder that cannot be analyzed by clinical examination alone. However, various studies addressing peripheral neuropathy in COPD carried out so far have included patients with COPD having markedly varying baseline characteristics like severe hypoxemia, elderly patients, those with long duration of illness, etc. that are not uniform across the studies and make it difficult to interpret the results to a consistent conclusion. Almost one-third of COPD patients have clinical evidence of peripheral neuropathy and two-thirds have electrophysiological abnormalities. Some patients with no clinical indication of peripheral neuropathy do have electrophysiological deficit suggestive of peripheral neuropathy. The more frequent presentation consists of a polyneuropathy that is subclinical or with predominantly sensory signs, and the neurophysiological and pathological features of predominantly axonal neuropathy. The presumed etiopathogenic factors are multiple: chronic hypoxia, tobacco smoke, alcoholism, malnutrition and adverse effects of certain drugs.

  11. Fibromyalgia and chronic widespread pain in autoimmune thyroid disease.

    Science.gov (United States)

    Ahmad, Jowairiyya; Tagoe, Clement E

    2014-07-01

    Fibromyalgia and chronic widespread pain syndromes are among the commonest diseases seen in rheumatology practice. Despite advances in the management of these conditions, they remain significant causes of morbidity and disability. Autoimmune thyroid disease is the most prevalent autoimmune disorder, affecting about 10 % of the population, and is a recognized cause of fibromyalgia and chronic widespread pain. Recent reports are shedding light on the mechanisms of pain generation in autoimmune thyroid disease-associated pain syndromes including the role of inflammatory mediators, small-fiber polyneuropathy, and central sensitization. The gradual elucidation of these pain pathways is allowing the rational use of pharmacotherapy in the management of chronic widespread pain in autoimmune thyroid disease. This review looks at the current understanding of the prevalence of pain syndromes in autoimmune thyroid disease, their likely causes, present appreciation of the pathogenesis of chronic widespread pain, and how our knowledge can be used to find lasting and effective treatments for the pain syndromes associated with autoimmune thyroid disease.

  12. Secondary hyperparathyroidism prevalence and profile, between diabetic and non-diabetic patients with stage 3 to 4 chronic kidney disease attended in internal medicine wards. MiPTH study.

    Science.gov (United States)

    Arévalo-Lorido, José Carlos; Carretero-Gómez, Juana; García-Sánchez, Francisco; Maciá-Botejara, Enrique; Ramiro-Lozano, José Manuel; Masero-Carretero, Antonio; Robles, Nicolás Roberto; Bureo-Dacal, Juan Carlos

    2016-01-01

    Secondary hyperparathyroidism (SHPTH) is a leading cause of renal osteodystrophy, and an independent risk factor for all-cause and cardiovascular mortality. Our aim is to establish differences in prevalence and profile of SHPTH, regarding diabetics or non-diabetics with chronic kidney disease (CKD). Cross-sectional multicenter study which included patients with stages 3 to 4 CKD. SHPTH was considered when the intact PTH levels (iPTH) were equal or higher than 70pg/ml. We divided the sample into two groups (diabetics and non-diabetics). We used robust statistical methods. 409 patients (214 diabetics) were studied. HPTH was found in 60.4% of diabetics vs 65% of non-diabetics (P=0.42). Diabetics with HPTH were younger (79.5 vs 82.3 years-old, P=0.005), and had more hypertension (P=0.0014), dyslipidemia (P=0.0001) and comorbidities. In multivariate analysis, we found a significant relationship in case of diabetics, with age (OR: 1.04, 95%CI 1.005-1.09 P=0.02 ), and with statins treatment (OR 2.3, 95%CI 1.17-4.54, P=0.01). The prevalence of SHPTH between the groups was similar, however, diabetics had more presence of hypertension and dyslipidemia, and SHPTH in this case was also related with moderate microalbuminuria and lower levels of vitamin D. An association with statins was also found in this group. Copyright © 2016 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  13. Caregiver Burden in Chronic Diseases

    Directory of Open Access Journals (Sweden)

    Murat Ilhan Atagun

    2011-09-01

    Full Text Available Duration of human life has been substantially increased in the last fifty years. Survivals of diseases have been prolonged through the advances in medicine. Together with these gratifying consequences, there appeared novel difficulties to cope with. Furthermore developments including globalization, industrialization and transition from rural to urban life occurred during the last century; so family units became smaller and numbers of members on employment in family units increased. As a result numbers of family members to undertake the responsibility of care decreased. As a concept, caregiver burden expresses physical, psychosocial and financial reactions during the course of care providing. Distinct factors including structures of social, cultural and family units and health care systems may affect conditions of care. Caregiver’s age, gender, ethnicity, education, relationship with the patient, attitude towards providing care, financial situation, coping abilities, her own health, beliefs, social support and cultural pattern are the personal factors that are related to perception of caregiver burden. Burden of care giving is geared to differential aspects of care needs. For instance care needs of physically disabled and medical care requiring patients with spinal cord injuries may differ from care needs of chronic psychiatric disorders, demented patients in advanced age of their lives or cancer patients in terminal periods. Strain due to care giving may differ as a result of properties of care demands. It is aimed to review the burden of caregivers in different medical and psychiatric care requiring conditions and to introduce differential aspects of caregiver burden in these different conditions.

  14. Relevance of Chronic Lyme Disease to Family Medicine as a Complex Multidimensional Chronic Disease Construct: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Liesbeth Borgermans

    2014-01-01

    Full Text Available Lyme disease has become a global public health problem and a prototype of an emerging infection. Both treatment-refractory infection and symptoms that are related to Borrelia burgdorferi infection remain subject to controversy. Because of the absence of solid evidence on prevalence, causes, diagnostic criteria, tools and treatment options, the role of autoimmunity to residual or persisting antigens, and the role of a toxin or other bacterial-associated products that are responsible for the symptoms and signs, chronic Lyme disease (CLD remains a relatively poorly understood chronic disease construct. The role and performance of family medicine in the detection, integrative treatment, and follow-up of CLD are not well studied either. The purpose of this paper is to describe insights into the complexity of CLD as a multidimensional chronic disease construct and its relevance to family medicine by means of a systematic literature review.

  15. Nurses' knowledge of chronic disease management

    African Journals Online (AJOL)

    2014-11-21

    Nov 21, 2014 ... violence and accidents, cardiac diseases, diarrhoeal diseases, lower respiratory tract infections and poverty-related disease such as protein-energy malnutrition are estimated to account for approximately 90% of the premature mortality in. South Africa (Harrison 2009). Chronic diseases of lifestyle are ...

  16. Sleep disorders in chronic liver disease.

    Science.gov (United States)

    De Cruz, Sharon; Espiritu, Joseph Roland D; Zeidler, Michelle; Wang, Tisha S

    2012-02-01

    Sleep-related complaints and disturbances are increasingly recognized in the setting of chronic liver disease and have recently been shown to be an important prognostic factor in patients with advanced chronic liver disease. This article reviews the literature surrounding sleep disturbances and disorders in a variety of types of chronic liver disease. This includes the association of sleep disturbances with hepatitis C and antiviral therapy, primary biliary cirrhosis, and Wilson disease as well as the circadian rhythm abnormalities present in cirrhosis and hepatic encephalopathy. The association between chronic liver disease, particularly nonalcoholic fatty liver disease, and sleep-disordered breathing is also reviewed in detail. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  17. A etiological factors of chronic liver disease in children

    International Nuclear Information System (INIS)

    Tahir, A.; Malik, F.R.; Akhtar, P.

    2011-01-01

    Background: Chronicity of liver disease is determined either by duration of liver disease or by evidence of either severe liver disease or physical stigmata of chronic liver disease. Chronic liver disease may be caused commonly by persistent viral infections, metabolic diseases, drugs, autoimmune hepatitis, or unknown factors. The objective of this study was to find out the aetiology of chronic liver disease (CLD) in children. Methodology: It was a descriptive, prospective study which used a structured proforma designed to collect data of cases of CLD from both indoor and outdoor Paediatrics units of Fauji Foundation Hospital, Rawalpindi, and Children Hospital, Pakistan Institute of Medical Sciences, Islamabad. All children under 12 years having either clinical or biochemical evidence of liver disease and/or elevated liver enzymes for more than 3 months were included in this study. Results: Sixty cases of CLD were enrolled from indoor and outdoor units from January 2010 to July 201. Thirty nine (65%) cases were male and 21 (35%) were female. Eleven children were less than 1 year, 18 were 1-5 years old and 31 were 5-12 years of age. Viral hepatitis was the most common cause found in 22 (36.7%) cases. Out of these 22 patients with viral aetiology 19 (31.66%) patients had Hepatitis C and 3 (5%) had Hepatitis B. Glycogen storage disease was seen in 8.3% cases, and biliary atresia and Wilson disease in 6.7% each. Other less commonly found cases were autoimmune hepatitis, TORCH infections, hepatoma and drug induced hepatitis (1.7% each). Cause couldn't be established in 35% cases which remained idiopathic. Conclusion: Viral hepatitis is the leading cause of chronic liver disease in children, with the highest incidence of chronic Hepatitis C followed by metabolic disorders (glycogen storage disease and Wilson disease) and biliary atresia. Chronic viral hepatitis was most prevalent between 11 months to 12 years of age. Wilson disease was common in 3-7 years age group, and

  18. Features of chronic renal disease in children.

    Science.gov (United States)

    Ivanova, Olga N; Savvina, Natalia A; Egorova, Victoria E

    chronic renal disease (CKD) is the inevitable outcome of many chronic diseases of the kidneys, which not all survive. The number of patients with chronic renal diseases is constantly growing. Aim to study the level osteocalcin and calcitonin and parathyroid hormone and immunological features in patients with chronic renal diseases. Materials and method The study involved 10 children with chronic renal failure at the age from 7 to 14 years in the initial stage - GFR 60-40 ml/min, creatinine blood increased to 180 μmol/l, and 20 healthy patients as a control group. in the studies there was significant increase in the level of calcitonin , osteocalcin, parathyroid hormone in patients with chronic renal failure. In patients with chronic renal disease decreased indices of cellular and humoral immunity. In children with chronic renal disease significantly increased CIK and decreased the content of IFN-γ, FNO-α in comparison with the group of healthy children. revealed that at all stages of CKD patients there is a change of level calcitonin, osteocalcin and parathyroid hormone. All patients with CKD, there was a reduction of humoral and cellular immunity.

  19. K/DOQI Clinical Practice Guidelines on Hypertension and Antihypertensive Agents in Chronic Kidney Disease

    NARCIS (Netherlands)

    Levey, Andrew S.; Rocco, Michael V.; Anderson, Sharon; Andreoli, Sharon P.; Bailie, George R.; Bakris, George L.; Callahan, Mary Beth; Greene, Jane H.; Johnson, Cynda Ann; Lash, James P.; McCullough, Peter A.; Miller III, Edgar R.; Nally, Joseph V.; Pirsch, John D.; Portman, Ronald J.; Sevick, Mary Ann; Sica, Domenic; Wesson, Donald E.; Agodoa, Lawrence; Bolton, Kline; Cutler, Jeffrey A.; Hostetter, Tom; Lau, Joseph; Uhlig, Katrin; Chew, Priscilla; Kausz, Annamaria; Kupelnick, Bruce; Raman, Gowri; Sarnak, Mark; Wang, Chenchen; Astor, Brad C.; Eknoyan, Garabed; Levin, Adeera; Levin, Nathan; Bailie, George; Becker, Bryan; Becker, Gavin; Burrowes, Jerrilynn; Carrera, Fernando; Churchill, David; Collins, Allan; Crooks, Peter W.; de Zeeuw, Dick; Golper, Thomas; Gotch, Frank; Gotto, Antonio; Greenwood, Roger; Greer, Joel W.; Grimm Jr., Richard; Haley, William E.; Hogg, Ronald; Hull, Alan R.; Hunsicker, Lawrence; Klag, Michael; Klahr, Saulo; Lameire, Norbert; Locatelli, Francesco; McCulloch, Sally; Michael, Maureen; Newmann, John M.; Nissenson, Allen; Norris, Keith; Obrador, Gregorio; Owen Jr., William; Patel, Thakor G.; Payne, Glenda; Ronco, Claudio; Rivera-Mizzoni, Rosa A.; Schoolwerth, Anton C.; Star, Robert; Steffes, Michael; Steinman, Theodore; Wauters, John-Pierre; Wenger, Nanette; Briggs, Josephine; Burrows-Hudson, Sally; Latos, Derrick; Mapes, Donna; Oberley, Edith; Pereira, Brian J.G.; Willis, Kerry; Gucciardo, Anthony; Fingerhut, Donna; Klette, Margaret; Schachne, Elicia

    2004-01-01

    INTRODUCTION: CHRONIC KIDNEY disease (CKD) is a worldwide public health issue. In the United States, there is a rising incidence and prevalence of kidney failure (Fig 1), with poor outcomes and high cost. The prevalence of earlier stages of CKD is approximately 100 times greater than the prevalence

  20. Prevalence of periodontal disease, its association with systemic diseases and prevention

    Science.gov (United States)

    Nazir, Muhammad Ashraf

    2017-01-01

    Periodontal diseases are prevalent both in developed and developing countries and affect about 20-50% of global population. High prevalence of periodontal disease in adolescents, adults, and older individuals makes it a public health concern. Several risk factors such as smoking, poor oral hygiene, diabetes, medication, age, hereditary, and stress are related to periodontal diseases. Robust evidence shows the association of periodontal diseases with systemic diseases such as cardiovascular disease, diabetes, and adverse pregnancy outcomes. Periodontal disease is likely to cause 19% increase in the risk of cardiovascular disease, and this increase in relative risk reaches to 44% among individuals aged 65 years and over. Type 2 diabetic individuals with severe form of periodontal disease have 3.2 times greater mortality risk compared with individuals with no or mild periodontitis. Periodontal therapy has been shown to improve glycemic control in type 2 diabetic subjects. Periodontitis is related to maternal infection, preterm birth, low birth weight, and preeclampsia. Oral disease prevention strategies should be incorporated in chronic systemic disease preventive initiatives to curtail the burden of disease in populations. The reduction in the incidence and prevalence of periodontal disease can reduce its associated systemic diseases and can also minimize their financial impact on the health-care systems. It is hoped that medical, dental practitioners, and other health-care professionals will get familiar with perio-systemic link and risk factors, and need to refer to the specialized dental or periodontal care. PMID:28539867

  1. Prevalence of periodontal disease, its association with systemic diseases and prevention.

    Science.gov (United States)

    Nazir, Muhammad Ashraf

    2017-01-01

    Periodontal diseases are prevalent both in developed and developing countries and affect about 20-50% of global population. High prevalence of periodontal disease in adolescents, adults, and older individuals makes it a public health concern. Several risk factors such as smoking, poor oral hygiene, diabetes, medication, age, hereditary, and stress are related to periodontal diseases. Robust evidence shows the association of periodontal diseases with systemic diseases such as cardiovascular disease, diabetes, and adverse pregnancy outcomes. Periodontal disease is likely to cause 19% increase in the risk of cardiovascular disease, and this increase in relative risk reaches to 44% among individuals aged 65 years and over. Type 2 diabetic individuals with severe form of periodontal disease have 3.2 times greater mortality risk compared with individuals with no or mild periodontitis. Periodontal therapy has been shown to improve glycemic control in type 2 diabetic subjects. Periodontitis is related to maternal infection, preterm birth, low birth weight, and preeclampsia. Oral disease prevention strategies should be incorporated in chronic systemic disease preventive initiatives to curtail the burden of disease in populations. The reduction in the incidence and prevalence of periodontal disease can reduce its associated systemic diseases and can also minimize their financial impact on the health-care systems. It is hoped that medical, dental practitioners, and other health-care professionals will get familiar with perio-systemic link and risk factors, and need to refer to the specialized dental or periodontal care.

  2. Prevalence of herpesviruses in gingivitis and chronic periodontitis: relationship to clinical parameters and effect of treatment

    Directory of Open Access Journals (Sweden)

    Rucha Shah

    2016-01-01

    Full Text Available Background: Assess the prevalence of herpesviruses in healthy subjects, gingivitis, and chronic periodontitis patients, to assess the relationship between the prevalence of herpesviruses and periodontal clinical parameters, and to evaluate the effect of phase-I therapy on the level of viral detection. Materials and Methods: Hundred patients consisting of 20 healthy subjects, 40 gingivitis, and 40 chronic periodontitis were included in the study. Clinical parameters recorded included plaque index, gingival index, sulcus bleeding index, probing depth, and clinical attachment level. The gingivitis and chronic periodontitis patients received phase-I periodontal therapy including oral hygiene instructions, full mouth scaling for gingivitis patients and scaling and root planing for chronic periodontitis patients. Gingival crevicular fluid (GCF was collected, and the presence of herpes simplex virus-1 (HSV-1, HSV-2, cytomegalovirus, and Epstein–Barr virus (EBV was analyzed using polymerase chain reaction (PCR. Recording of periodontal parameters as well as GCF collection was performed at baseline and 6 weeks postphase-I therapy. Results: At baseline, the levels of HSV-1 and EBV detection were lower in healthy controls as compared to gingivitis (P < 0.05 and chronic periodontitis cases (P < 0.001. Phase-I therapy led to reduction in the amount of HSV-1 and EBV in gingivitis patients (P < 0.05 and for HSV-1, human cytomegalovirus and EBV in chronic periodontitis patients (P < 0.05 in comparison to baseline. The prevalence of EBV in chronic periodontitis patients was positively associated with increased gingival index, probing depth and loss of clinical attachment (P < 0.05. Conclusions: Higher prevalence of HSV-1 and EBV viruses in GCF of gingivitis and chronic periodontitis suggests a strong association between these viruses and periodontal diseases and periodontal therapy can lead to a reduction in herpesviruses at infected sites.

  3. Prevalence and social distribution of risk factors for chronic noncommunicable diseases in Brazil Prevalencia y distribución social de los factores de riesgo de enfermedades crónicas no transmisibles en Brasil

    Directory of Open Access Journals (Sweden)

    Erly Catarina Moura

    2009-07-01

    Full Text Available OBJECTIVE: To assess risk factors for chronic noncommunicable disease (CND and to identity social inequalities in their distribution among the adult Brazilian population. METHODS: Study of CND risk factors (including tobacco use, overweight and obesity, low fruit and vegetable intake (LFVI, insufficient leisure-time physical activity (LTPA, sedentary lifestyle, and alcohol abuse, among other risks in a probabilistic sample of 54369 individuals from Brazil's 26 state capitals and Federal District, in 2006, using the Surveillance System of Risk and Protective Factors for Chronic Non-Communicable Diseases through Telephone Interviews (VIGITEL, a computer-assisted telephone interviewing (CATI survey system, and calculated age-adjusted prevalence ratios for trends in education levels using Poisson regression with linear models. RESULTS: Men reported higher tobacco use, overweight, LFVI, sedentary lifestyle, and alcohol abuse versus women, but lower insufficient LTPA. In men, education was associated with increased overweight and sedentary lifestyle, but decreased tobacco use, LFVI, and insufficient LTPA. Among women, education was associated with decreased tobacco use, overweight, obesity, LFVI, and insufficient LTPA, but increased sedentary lifestyle. CONCLUSION: In Brazil, prevalence of CND risk factors (except insufficient LTPA is higher in men. For both sexes, the CND risk factor prevalence ratio is influenced by level of education.OBJETIVOS: Evaluar los factores de riesgo de enfermedades crónicas no transmisibles (ECNT e identificar las desigualdades sociales relacionadas con su distribución en la población adulta brasileña. MÉTODOS: Se estudiaron los factores de riesgo de ECNT (entre ellos el consumo de tabaco, el sobrepeso y la obesidad, el bajo consumo de frutas y vegetales [BCFV], la insuficiente actividad física en el tiempo de ocio [IAFTO], el estilo de vida sedentario y el consumo excesivo de alcohol en una muestra probabil

  4. Chronic Kidney Disease: What Does It Mean for Me?

    Science.gov (United States)

    ... Cysts Solitary Kidney Your Kidneys & How They Work Chronic Kidney Disease (CKD) View or Print All Sections ​​What Is Chronic Kidney Disease? Chronic kidney disease (CKD) means your kidneys are ...

  5. Nutrition for Advanced Chronic Kidney Disease in Adults

    Science.gov (United States)

    ... Chronic Kidney Disease in Adults Nutrition for Advanced Chronic Kidney Disease in Adults Why is nutrition important for someone with advanced chronic kidney disease? A person may prevent or delay some health ...

  6. Prevalence of multiple chronic conditions in the United States' Medicare population

    Directory of Open Access Journals (Sweden)

    Dean Debbie

    2009-09-01

    Full Text Available Abstract In 2006, the Centers for Medicare & Medicaid Services, which administers the Medicare program in the United States, launched the Chronic Condition Data Warehouse (CCW. The CCW contains all Medicare fee-for-service (FFS institutional and non-institutional claims, nursing home and home health assessment data, and enrollment/eligibility information from January 1, 1999 forward for a random 5% sample of Medicare beneficiaries (and 100% of the Medicare population from 2000 forward. Twenty-one predefined chronic condition indicator variables are coded within the CCW, to facilitate research on chronic conditions. The current article describes this new data source, and the authors demonstrate the utility of the CCW in describing the extent of chronic disease among Medicare beneficiaries. Medicare claims were analyzed to determine the prevalence, utilization, and Medicare program costs for some common and high cost chronic conditions in the Medicare FFS population in 2005. Chronic conditions explored include diabetes, chronic obstructive pulmonary disease (COPD, heart failure, cancer, chronic kidney disease (CKD, and depression. Fifty percent of Medicare FFS beneficiaries were receiving care for one or more of these chronic conditions. The highest prevalence is observed for diabetes, with nearly one-fourth of the Medicare FFS study cohort receiving treatment for this condition (24.3 percent. The annual number of inpatient days during 2005 is highest for CKD (9.51 days and COPD (8.18 days. As the number of chronic conditions increases, the average per beneficiary Medicare payment amount increases dramatically. The annual Medicare payment amounts for a beneficiary with only one of the chronic conditions is $7,172. For those with two conditions, payment jumps to $14,931, and for those with three or more conditions, the annual Medicare payments per beneficiary is $32,498. The CCW data files have tremendous value for health services research. The

  7. The global burden of chronic respiratory disease in adults.

    Science.gov (United States)

    Burney, P; Jarvis, D; Perez-Padilla, R

    2015-01-01

    With an aging global population, chronic respiratory diseases are becoming a more prominent cause of death and disability. Age-standardised death rates from chronic obstructive pulmonary disease (COPD) are highest in low-income regions of the world, particularly South Asia and sub-Saharan Africa, although airflow obstruction is relatively uncommon in these areas. Airflow obstruction is, by contrast, more common in regions with a high prevalence of cigarette smoking. COPD mortality is much more closely related to the prevalence of a low forced vital capacity which is, in turn, associated with poverty. Mortality from asthma is less common than mortality from COPD, but it is also relatively more common in poorer areas, particularly Oceania, South and South-East Asia, the Middle East and Africa. Again this contrasts with the asthma prevalence among adults, which is highest in high-income regions. In high-income areas, mortality due to asthma, which is predominantly an adult problem, has fallen substantially in recent decades with the spread of new guidelines for treatment that emphasise the use of inhaled steroids to control the disease. Although mortality rates have been falling, the prevalence of atopy has been increasing between generations in Western Europe. Changes in the prevalence of wheeze among adults has been more varied and may have been influenced by the reduction in smoking and the increase in the use of inhaled steroids.

  8. Hepatitis C Infection and Risk of Chronic Liver Disease in Lagos ...

    African Journals Online (AJOL)

    Objectives: This case-control study sets out to investigate the prevalence of antibodies to hepatitis C virus (anti-HCV) and its association with the presence of hepatitis B surface antigen (HBsAg) in Nigerians with chronic liver disease. Method: Seventy-four (74) biopsy proven cases of chronic liver disease and 74 age and ...

  9. Inclusion of methods for early detection of chronic kidney disease in ...

    African Journals Online (AJOL)

    Background The burden and magnitude of chronic kidney disease (CKD) are enormous. The incidence and prevalence of chronic kidney disease are rising all over the world. Thus, there is the urgent and pressing need for methods of early detection of CKD, to be included in guidelines for management of noncommunicable ...

  10. An audit of chronic kidney disease risk factors in type 2 diabetic ...

    African Journals Online (AJOL)

    An audit of chronic kidney disease risk factors in type 2 diabetic patients in a tertiary hospital in Southern Nigeria. ... highly prevalent in type 2 diabetics in this study. Measures aimed at reducing these risks should be instituted to delay the onset and progression of CKD. Keywords: diabetes mellitus, chronic kidney disease, ...

  11. Chronic renal disease: the mother's experience.

    Science.gov (United States)

    MacDonald, H

    1995-01-01

    In a qualitative study, mothers (N = 4) of children with chronic renal disease were asked to share the meaning they assigned to their child's illness. The central theme of "uncertainty" emerged from the data and was described in three phases: (a) finding out, (b) learning to live with chronic illness, and (c) worries and dreams about the future. In this article phase three, labeled "learning to live with chronic illness," is presented.

  12. HIV/AIDS, chronic diseases and globalisation

    Directory of Open Access Journals (Sweden)

    Colvin Christopher J

    2011-08-01

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

  13. HIV/AIDS, chronic diseases and globalisation.

    Science.gov (United States)

    Colvin, Christopher J

    2011-08-26

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

  14. Prevalence of vernal keratoconjunctivitis: a rare disease?

    Science.gov (United States)

    Bremond-Gignac, D; Donadieu, J; Leonardi, A; Pouliquen, P; Doan, S; Chiambarretta, F; Montan, P; Milazzo, S; Hoang-Xuan, T; Baudouin, C; Aymé, S

    2008-08-01

    To determine the prevalence of vernal keratoconjuntivitis (VKC) in Europe. A cross-sectional survey was mailed to 3003 ophthalmologists from six countries (Finland, France, Italy, The Netherlands, Norway and Sweden) representing 151.9 million inhabitants. Results were analysed per country, and VKC prevalence for the 15 European member states in 2002 was extrapolated. Six hypotheses were used: disease duration (4 or 8 years) combined with three prevalence hypotheses for non-responding ophthalmologists. The response rate to the survey was 29.5%. The estimates of VKC prevalence in Western Europe (per 10,000 inhabitants) ranged from 1.16 to 10.55. The prevalence of VKC with corneal complications ranged from 0.30 to 2.26. The VKC prevalences per country were in the following ranges: Italy 2.4-27.8, Finland, 0.7-8.4, Sweden 1.2-8.7, The Netherlands 0.6-4.6, France 0.7-3.3 and Norway 0.3-1.9. VKC with corneal complications were: Italy 0.4-4.8, Sweden 0.3-2.4, Finland 0.2-2.8, The Netherlands 0.2-1.6, France 0.3-1.4 and Norway 0.1-1.0. Based on the most likely hypotheses concerning disease duration and non-responding ophthalmologists' VKC case rate, the best estimate of VKC prevalence in Western Europe is 3.2/10,000 inhabitants. The prevalence of VKC with corneal complications is 0.8/10,000 inhabitants.

  15. Prevalence and Risk of Inflammatory Bowel Disease in Patients with Hidradenitis Suppurativa

    DEFF Research Database (Denmark)

    Egeberg, Alexander; Jemec, Gregor B.E.; Kimball, Alexa B.

    2017-01-01

    Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease. In small studies, inflammatory bowel disease has been associated with the increased prevalence of HS, but the data on the concurrence of inflammatory bowel disease in patients with HS are limited. We therefore investigated the ...

  16. Airway distensibility in Chronic Obstructive Airway Disease

    DEFF Research Database (Denmark)

    Winkler Wille, Mathilde Marie; Pedersen, Jesper Holst; Dirksen, Asger

    2013-01-01

    Rationale – Chronic Obstructive Pulmonary Disease (COPD) is a combination of chronic bronchitis and emphysema, which both may lead to airway obstruction. Under normal circumstances, airway dimensions vary as a function of inspiration level. We aim to study the influence of COPD and emphysema on t...... in causing airway narrowing, the latter most likely due to loss of elastic recoil of surrounding tissue....

  17. Chronic Obstructive Pulmonary Disease in Women

    Directory of Open Access Journals (Sweden)

    Louis Laviolette

    2007-01-01

    Full Text Available BACKGROUND: Little is known about the comparative impact of chronic obstructive pulmonary disease (COPD between women and men and about women’s response to pulmonary rehabilitation.

  18. Percutaneous Nephrolithotomy and Chronic Kidney Disease

    DEFF Research Database (Denmark)

    Sairam, Krish; Scoffone, Cesare M; Alken, Peter

    2012-01-01

    by glomerular filtration rate, including chronic kidney disease stages 0/I/II-greater than 60, stage III-30 to 59 and stages IV/V-less than 30 ml/minute/1.73 m(2). Patient characteristics, operative characteristics, outcomes and morbidity were assessed. RESULTS: Estimated glomerular filtration rate data were...... available on 5,644 patients, including 4,436 with chronic kidney disease stages 0/I/II, 994 with stage III and 214 with stages IV/V. A clinically significant minority of patients with nephrolithiasis presented with severe chronic kidney disease. A greater number of patients with stages IV/V previously...... underwent percutaneous nephrolithotomy, ureteroscopy or nephrostomy and had positive urine cultures than less severely affected patients, consistent with the higher incidence of staghorn stones in these patients. Patients with chronic kidney disease stages IV/V had statistically significantly worse...

  19. Chronic Disease Control Research Fellowship Program (Guatemala ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    of-sale advertising in rural Guatemala : appendix A. 52022. Journal articles. Clinical preventive services in Guatemala : a cross-sectional survey of internal medicine physicians. Download PDF. Reports. Final technical report / Chronic Disease ...

  20. Chronic periodontitis prevalence and the inflammatory burden in a sample population from South India

    Directory of Open Access Journals (Sweden)

    S K Balaji

    2018-01-01

    Full Text Available Context: Periodontal diseases are among the most prevalent oral diseases in the world. Apart from repercussions in the oral cavity, there is evidence that periodontitis contributes to systemic damage in chronic diseases such as cardiovascular disease, diabetes, and preterm low birth weight. Aims: The aims of this study were to estimate the prevalence of chronic periodontitis in a sample urban population (<18 years in Tamil Nadu and to estimate the inflammatory burden posed by chronic periodontitis by calculating the periodontal inflammatory surface area. Settings and Design: This was a population-based study and cross-sectional design. Subjects and Methods: A total of 1000 individuals (<18 years were selected and screened for their periodontal status, oral hygiene status (OHI, and the periodontal inflamed surface area (PISA in an outreach center located in Chennai, India. Statistical Analysis Used: The proportion of individuals with different periodontal states (health, gingivitis, and periodontitis was determined. A multivariate logistic regression analysis was performed to assess the influence of the individual risk factors such as habits (tobacco use, systemic conditions (diabetes, and oral hygiene maintenance on periodontitis prevalence in the sample population. Results: A high prevalence of periodontal disease was observed in the study population (42.3%. Among the urban participants, age, cigarette smoking, pan chewing, decayed, missing, and filled teeth scores, OHI scores, and PISA scores were found to be significantly associated with periodontitis (P < 0.05. Conclusions: Periodontitis prevalence appears to be high even in areas with adequate access to oral health care and an inflammatory burden risk exists in a definitive manner.

  1. Prevalence of archaea in chronic periodontitis patients in an Indian population

    Directory of Open Access Journals (Sweden)

    Nipun Ashok

    2013-01-01

    Full Text Available Aim: The aim of this study was to investigate the prevalence of archaea in the subgingival crevices of patients with chronic periodontitis in an Indian population. Materials and Methods: Thirty four chronic periodontitis patients and 16 healthy subjects were included in the study. Thirty four subgingival plaque samples were collected from chronic periodontitis patients, of which 17 samples were from deep pockets and 17 were from shallow pockets. Sixteen subgingival plaque samples were collected from healthy subjects. The presence of archaea in plaque samples was detected by polymerase chain reaction. Results: Prevalence of archaea in chronic periodontitis patients was 29.4% and in healthy subjects was 11.8%, which was not a statistically significant difference. However, prevalence of archaea, in deep periodontal pockets was 47.1%, in shallow periodontal pockets was 11.8% and in healthy sulcus was 12.5%, respectively. Thus, showing a statistically significant difference between prevalence of archaea in deep periodontal pockets (47.1% and healthy sulcus (12.5% and also between deep periodontal pockets (47.1% and shallow pockets (11.8%, respectively. Conclusion: Archaea were detected commonly in severe periodontitis suggesting that these microorganisms might be involved in the pathogenesis of periodontal diseases.

  2. Interrelationship of canonical and non-canonical Wnt signalling pathways in chronic metabolic diseases.

    Science.gov (United States)

    Ackers, Ian; Malgor, Ramiro

    2018-01-01

    Chronic diseases account for approximately 45% of all deaths in developed countries and are particularly prevalent in countries with the most sophisticated and robust public health systems. Chronic metabolic diseases, specifically lifestyle-related diseases pertaining to diet and exercise, continue to be difficult to treat clinically. The most prevalent of these chronic metabolic diseases include obesity, diabetes, non-alcoholic fatty liver disease, chronic kidney disease and cardiovascular disease and will be the focus of this review. Wnt proteins are highly conserved glycoproteins best known for their role in development and homeostasis of tissues. Given the importance of Wnt signalling in homeostasis, aberrant Wnt signalling likely regulates metabolic processes and may contribute to the development of chronic metabolic diseases. Expression of Wnt proteins and dysfunctional Wnt signalling has been reported in multiple chronic diseases. It is interesting to speculate about an interrelationship between the Wnt signalling pathways as a potential pathological mechanism in chronic metabolic diseases. The aim of this review is to summarize reported findings on the contrasting roles of Wnt signalling in lifestyle-related chronic metabolic diseases; specifically, the contribution of Wnt signalling to lipid accumulation, fibrosis and chronic low-grade inflammation.

  3. Genetic influences on Chronic Obstructive Pulmonary Disease

    DEFF Research Database (Denmark)

    Ingebrigtsen, Truls; Thomsen, Simon F; Vestbo, Jørgen

    2010-01-01

    Genes that contribute to the risk of developing Chronic Obstructive Pulmonary Disease (COPD) have been identified, but an attempt to accurately quantify the total genetic contribution to COPD has to our knowledge never been conducted.......Genes that contribute to the risk of developing Chronic Obstructive Pulmonary Disease (COPD) have been identified, but an attempt to accurately quantify the total genetic contribution to COPD has to our knowledge never been conducted....

  4. Pulmonary hypertension in chronic obstructive and interstitial lung diseases

    DEFF Research Database (Denmark)

    Andersen, Charlotte U; Mellemkjær, Søren; Nielsen-Kudsk, Jens Erik

    2013-01-01

    , and is considered one of the most frequent types of PH. However, the prevalence of PH among patients with COPD and ILD is not clear. The diagnosis of PH in chronic lung disease is often established by echocardiographic screening, but definitive diagnosis requires right heart catheterization, which...... treatment with existent drugs effective in pulmonary arterial hypertension (PAH) is beneficial in lung disease related PH. Studies investigating existing PAH drugs in animal models of lung disease related PH have indicated a positive effect, and so have case reports and open label studies. However...

  5. Global, regional, and national deaths, prevalence, disability-adjusted life years, and years lived with disability for chronic obstructive pulmonary disease and asthma, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015 : a systematic analysis for the Global Burden of Disease Study 2015

    NARCIS (Netherlands)

    Soriano, Joan B.; Abajobir, Amanuel Alemu; Abate, Kalkidan Hassen; Abera, Semaw Ferede; Agrawal, Anurag; Ahmed, Muktar Beshir; Aichour, Amani Nidhal; Aichour, Ibtihel; Aichour, Miloud Taki Eddine; Alam, Khurshid; Alam, Noore; Alkaabi, Juma M.; Al-Maskari, Fatma; Alvis-Guzman, Nelson; Amberbir, Alemayehu; Amoako, Yaw Ampem; Ansha, Mustafa Geleto; Anto, Josep M.; Asayesh, Hamid; Atey, Tesfay Mehari; Avokpaho, Euripide Frinel G. Arthur; Barac, Aleksandra; Basu, Sanjay; Bedi, Neeraj; Bensenor, Isabela M.; Berhane, Adugnaw; Beyene, Addisu Shunu; Bhutta, Zulfiqar A.; Biryukov, Stan; Boneya, Dube Jara; Brauer, Michael; Carpenter, David O.; Casey, Daniel; Christopher, Devasahayam Jesudas; Dandona, Lalit; Dandona, Rakhi; Dharmaratne, Samath D.; Huyen Phuc Do,; Fischer, Florian; Geleto, Ayele; Ghoshal, Aloke Gopal; Gillum, Richard F.; Ginawi, Ibrahim Abdelmageem Mohamed; Gupta, Vipin; Hay, Simon I.; Hedayati, Mohammad T.; Horita, Nobuyuki; Hosgood, H. Dean; Jakovljevic, Mihajlo (Michael) B.; van Boven, Job F. M.

    2017-01-01

    Background Chronic obstructive pulmonary disease (COPD) and asthma are common diseases with a heterogeneous distribution worldwide. Here, we present methods and disease and risk estimates for COPD and asthma from the Global Burden of Diseases, Injuries, and Risk Factors (GBD) 2015 study. The GBD

  6. Chronic disease burden associated with overweight and obesity in Ireland: the effects of a small BMI reduction at population level

    OpenAIRE

    Kearns, Karen; Dee, Anne; Fitzgerald, Anthony P; Doherty, Edel; Perry, Ivan J

    2014-01-01

    Background: Overweight and obesity prevalence has risen dramatically in recent decades. While it is known that overweight and obesity is associated with a wide range of chronic diseases, the cumulative burden of chronic disease in the population associated with overweight and obesity is not well quantified. The aims of this paper were to examine the associations between BMI and chronic disease prevalence; to calculate Population Attributable Fractions (PAFs) associated with overweight and obe...

  7. Nutrition Therapy in Elderly with Chronic Obstructive Pulmonary Disease (COPD

    Directory of Open Access Journals (Sweden)

    Minidian Fasitasari

    2013-06-01

    Full Text Available Nutrition is an important health element for elderly people and influence aging process. Malnutrition prevalence is increasing in this population. Chronic Obstructive Pulmonary Disease (COPD is one of the chronic diseases in elderly that is related to malnutrition. The association between malnutrition and pulmonary disease (including COPD has been known for a long time. Malnutrition has negative impacts on pulmonary structure, elasticity, and function, strength and endurance of respiratory muscles, pulmonary immunity defense mechanism, and breath control. Inversely, pulmonary disease (including COPD will increase energy need and may reduce dietary intake. Nutrition intervention in COPD patient is intended for regulating anorexia, improving pulmonary function, and controlling weight loss. Nutrient requirements will be calculated according to the results of nutrition assessment. This article will discuss about nutrition therapy in elderly with COPD. It describes respiratory system in aging, association COPD and nutrition, and nutrition assessment, as well as nutrition intervention in elderly people with COPD.

  8. Diet in chronic kidney disease in a Mediterranean African country.

    Science.gov (United States)

    Kammoun, Khawla; Chaker, Hanen; Mahfoudh, Hichem; Makhlouf, Nouha; Jarraya, Faical; Hachicha, Jamil

    2017-01-23

    Mediterranean diet is characterized by low to moderate consumption of animal protein and high consumption of fruits, vegetables, bread, beans, nuts, seeds and other cereals. It has been associated with reduced risk of cardiovascular disease. However, it is not suitable for chronic kidney disease because of high potassium intake. Tunisia is an emerging Mediterranean country with limited resources, a high prevalence of chronic hemodialysis treatment and high dialysis expenditures. In order to limit dialysis cost, primary and secondary prevention of chronic renal disease are of paramount importance. In addition to drugs, secondary prevention includes diet measures (e.g. salt diet, protein diet). The aims of diet practice in chronic kidney disease are to slow chronic renal failure progression and to prevent its complications like hyperphosphatemia and hyperkaliemiae. A few decades ago, a Tunisian diet was exclusively Mediterranean, and protein consumption was not excessive. However, today, protein consumption is more comparable to western countries. Salt consumption is also excessive. Some Tunisian diets still include food with high potassium intake, which are not suitable for patients with chronic kidney disease. Therefore, the role of the dietician is extremely important to help calculate and create a dietary regimen tailored to each of our patients. Advice about diets should be adapted to both the patient and population habits to improve adherence rate. As such, the purpose of this article is to provide our own experience regarding medical nutrition therapy in patients with chronic kidney disease in Tunisia, with some changes in food habits. Prevention is far better than treatment. In this perspective, dietary measures must be at the core of our intervention.

  9. Prevalência e distribuição dos fatores de risco para doenças crônicas não transmissíveis entre adultos da cidade de Lages (SC, sul do Brasil, 2007 Prevalence and distribution of risk factors for non-communicable chronic diseases among adults from Lages city, south of Brazil, 2007

    Directory of Open Access Journals (Sweden)

    Giana Zarbato Longo

    2011-12-01

    diseases among adults from Lages, Santa Catarina, Brazil. METHODS: Probabilistic sample of adult urban population, of both genders and aged from 20 to 59 years old was interviewed (n=2022. The sample process was made through conglomerates. It was applied a structured questionnaire with questions related to demographical, socio-economical, and behavior and self-referred diseases. In this study the following informations, related to the risk/protection factors for non-communicable chronic diseases, were used: gender, age, school background, body mass index, waist circumference, smoking, physical activity, pressure levels, self-referred mellitus diabetes and feeding characteristics. Prevalence for risk/protection factors for non-communicable chronic diseases, in the total population and according to gender and school background, was calculated. RESULTS: The studied population is prone to non-communicable chronic diseases, presenting substantial proportions of hypertension (33.78%, overweight individuals (33.46%, obesity (23.46% and abdominal obesity (43.81%. In relation to feeding characteristics, women presented higher prevalence of behaviors considered as protection factors, relative to men. It was found less than 30.0% of physically inactive individuals and 45.9% of smokers or ex-smokers. CONCLUSION: Descriptive studies such as this could be the basis for the development of public policies specific to the adult population of Lages, in order to guide the organization, planning and quality improvement of health assistance services, aiming the reduction in the occurrence and in the impact of non-communicable chronic diseases.

  10. Pulmonary comorbidities associated with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Fabrizio Luppi

    2012-12-01

    Full Text Available Introduction Chronic obstructive pulmonary disease (COPD is characterized by a relatively irreversible airflow limitation caused by chronic inflammation, in most cases tobacco-related. The impact of COPD on morbidity and mortality at the single-patient level depends upon the severity of COPD symptoms and the existence of other types of systemic and/or pulmonary disease, also known as co-morbid conditions.Materials and methods This review examines the pulmonary diseases commonly associated with COPD, in terms of their prevalence, clinical features, pathogenic mechanisms, prognoses, and implications for management of COPD.Results The incidence and prevalence of various pulmonary diseases are significantly increased in patients with COPD. These conditions include symptomatic bronchiectasis, combined pulmonary fibrosis and emphysema, lung cancer, sleep-related respiratory disorders, and pulmonary embolism. Some of these concomitant respiratory diseases have an independent negative impact on the prognosis of COPD patients, and their presence has important implications for treatment of these patients.Conclusions Physicians treating patients with COPD need to be aware of these coexisting pulmonary diseases. All patients with COPD should be carefully evaluated to identify pulmonary comorbidities, since they not only influence the prognosis but also have an impact on disease management. The treatment of COPD is no longer restricted exclusively to inhaled therapy. The therapeutic approach to this disease is becoming increasingly multidimensional in view of the fact that successful management of comorbidities might positively affect the course of COPD itself.

  11. Cerebral Small Vessel Disease and Chronic Kidney Disease

    OpenAIRE

    Toyoda, Kazunori

    2015-01-01

    Chronic kidney disease, defined by a decreased glomerular filtration rate or albuminuria, is recognized as a major global health burden, mainly because it is an established risk factor for cardiovascular and cerebrovascular diseases. The magnitude of the effect of chronic kidney disease on incident stroke seems to be higher in persons of Asian ethnicity. Since the kidney and brain share unique susceptibilities to vascular injury due to similar anatomical and functional features of small arter...

  12. Cholesterol Crystal Embolism and Chronic Kidney Disease.

    Science.gov (United States)

    Li, Xuezhu; Bayliss, George; Zhuang, Shougang

    2017-05-24

    Renal disease caused by cholesterol crystal embolism (CCE) occurs when cholesterol crystals become lodged in small renal arteries after small pieces of atheromatous plaques break off from the aorta or renal arteries and shower the downstream vascular bed. CCE is a multisystemic disease but kidneys are particularly vulnerable to atheroembolic disease, which can cause an acute, subacute, or chronic decline in renal function. This life-threatening disease may be underdiagnosed and overlooked as a cause of chronic kidney disease (CKD) among patients with advanced atherosclerosis. CCE can result from vascular surgery, angiography, or administration of anticoagulants. Atheroembolic renal disease has various clinical features that resemble those found in other kidney disorders and systemic diseases. It is commonly misdiagnosed in clinic, but confirmed by characteristic renal biopsy findings. Therapeutic options are limited, and prognosis is considered to be poor. Expanding knowledge of atheroembolic renal disease due to CCE opens perspectives for recognition, diagnosis, and treatment of this cause of progressive renal insufficiency.

  13. Prevalence and pattern of cystic kidney diseases in Ilorin, Nigeria

    Directory of Open Access Journals (Sweden)

    Chijioke Adindu

    2010-01-01

    Full Text Available Cystic kidney disease is an important cause of chronic renal failure. Since the utili-zation of imaging techniques in the diagnosis of diseases has become widespread, cystic kidney disease is now being increasingly diagnosed. This study is designed to determine the prevalence and pattern of cystic kidney disease at the Nephrology Unit of University of Ilorin Teaching Hospital (UITH, Ilorin. All consecutive adult patients seen in the Nephrology Unit of UITH during a ten-year period (January 1999-December 2008 were studied for the presence of cystic kidney disease. The results were analyzed with specific reference to age, gender, annual inci-dence, type of cystic disease, location of cyst, mode of presentation, complications and prognosis. A total of 67 out of 436 renal patients (15.4% studied had cystic kidney disease. A progressive annual increase in the number of cases was noticed. The age-range was 20-83 years with a mean of 47.4 +/- 16.2 years and the peak incidence was in the third and sixth decades with male to female ratio of 1.3:1. The types of cystic kidney disease identified in the study were: 26 simple cysts (38.8%, 35 polycystic kidney disease (53.3% and six multicystic kidney disease (8.9%. The most common mode of presentation was abdominal pain followed by hypertension, urinary tract infection, chronic renal failure and palpable abdominal mass, in decreasing order. Our study indicates that cystic kidney disease is not an uncommon problem among our renal patients and the incidence is on the increase. Although, routine screening of family members with cystic kidney disease still remains a contentious issue because the knowledge may evoke anxiety in terms of employment and insurance, screening of symptomatic cases or those that develop hypertension, hematuria and proteinuria is strongly recommended.

  14. Chronic traumatic encephalopathy: The unknown disease.

    Science.gov (United States)

    Martínez-Pérez, R; Paredes, I; Munarriz, P M; Paredes, B; Alén, J F

    2017-04-01

    Chronic traumatic encephalopathy is a neurodegenerative disease produced by accumulated minor traumatic brain injuries; no definitive premortem diagnosis and no treatments are available for chronic traumatic encephalopathy. Risk factors associated with chronic traumatic encephalopathy include playing contact sports, presence of the apolipoprotein E4, and old age. Although it shares certain histopathological findings with Alzheimer disease, chronic traumatic encephalopathy has a more specific presentation (hyperphosphorylated tau protein deposited as neurofibrillary tangles, associated with neuropil threads and sometimes with beta-amyloid plaques). Its clinical presentation is insidious; patients show mild cognitive and emotional symptoms before progressing to parkinsonian motor signs and finally dementia. Results from new experimental diagnostic tools are promising, but these tools are not yet available. The mainstay of managing this disease is prevention and early detection of its first symptoms. Copyright © 2014 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Overlap Syndrome in Respiratory Medicine: Asthma and Chronic Obstructive Pulmonary Disease

    OpenAIRE

    Alexandru Corlateanu; Valeria Pripa; Gloria Montanari; Victor Botnaru

    2014-01-01

    Asthma and chronic obstructive pulmonary disease (COPD) are highly prevalent chronic diseases in the general population. Both are characterized by similar mechanisms: airway inflammation, airway obstruction, and airway hyperresponsiveness. However, the distinction between the two obstructive diseases is not always clear. Multiple epidemiological studies demonstrate that in elderly people with obstructive airway disease, as many as half or more may have overlapping diagnoses of asthma and COPD...

  16. Elevada prevalência de fatores de risco para doenças crônicas entre universitários = High prevalence of risk factors for chronic diseases among university students

    Directory of Open Access Journals (Sweden)

    Crepaldi, Barbara Virginia Caixeta

    2016-01-01

    Full Text Available Objetivo: Este estudo avaliou a prevalência de fatores de risco compartilhados e modificáveis para doenças crônicas não transmissíveis entre estudantes de uma universidade pública brasileira. Materiais e Métodos: Participaram do estudo 379 alunos de diferentes áreas de conhecimento e períodos. Os dados foram coletados por meio de questionário autoaplicável, contendo questões sobre o âmbito acadêmico, dados socioeconômicos, estado nutricional e estilo de vida. Resultados: No total, 95,4% dos estudantes apresentaram pelo menos três fatores de risco, sendo os mais comuns o baixo consumo de frutas, hortaliças e leite, o consumo de carnes com excesso de gordura, a ingestão de bebidas alcoólicas, a ausência/carência de exercícios físicos e o gasto excessivo de tempo com eletrônicos. Observaram-se diferenças significativas de comportamento em relação a gênero, área de conhecimento e período. Conclusão: Os resultados evidenciam um perfil preocupante entre os universitários e demonstram a necessidade de implementação de programas educativos no âmbito acadêmico, a fim de reduzir a exposição dos alunos aos fatores de risco para doenças crônicas não transmissíveis

  17. Prevalence and breed distribution of chronic pancreatitis at post-mortem examination in first-opinion dogs.

    Science.gov (United States)

    Watson, P J; Roulois, A J A; Scase, T; Johnston, P E J; Thompson, H; Herrtage, M E

    2007-11-01

    To assess the prevalence of canine chronic pancreatitis in first-opinion practice and identify breed associations or other risk factors. Three sections of pancreas were taken from 200 unselected canine post-mortem examinations from first-opinion practices. Sections were graded for inflammation, fibrosis and other lesions. Prevalence and relative risks of chronic pancreatitis and other pancreatic diseases were calculated. The prevalence of chronic pancreatitis was 34 per cent omitting the autolysed cases. Cavalier King Charles spaniels, collies and boxers had increased relative risks of chronic pancreatitis; cocker spaniels had an increased relative risks of acute and chronic pancreatitis combined. Fifty-seven per cent of cases of chronic pancreatitis were classified histologically as moderate or marked. Forty-one per cent of cases involved all three sections. Dogs with chronic pancreatitis were more commonly female and overweight, but neither factor increased the relative risk of chronic pancreatitis. There were breed differences in histological appearances and 24.5 per cent of cases were too autolysed to interpret with an increased relative risk of autolysis in a number of large breeds. Chronic pancreatitis is a common, under-estimated disease in the first-opinion dog population with distinctive breed risks and histological appearances.

  18. The disease burden of chronic obstructive pulmonary disease in Greece

    Directory of Open Access Journals (Sweden)

    Kourlaba G

    2016-09-01

    Full Text Available Georgia Kourlaba,1 Georgios Hillas,2 Theodoros Vassilakopoulos,2 Nikos Maniadakis3 1Evroston LP, 2Department of Critical Care of Evangelismos Hospital, Medical School of National & Kapodistrian University of Athens, 3Department of Health Services Organization and Management, National School of Public Health, Athens, Greece Background: The objective of the study was to estimate the self-reported prevalence of chronic obstructive pulmonary disease (COPD in Greece and to quantify its burden on patients’ daily activities, productivity, and psychological status. Methods: A population-based, random digit-dialed telephone nationwide survey was conducted between July 10, 2015 and July 31, 2015 in order to recruit patients with COPD in Greece. Among the 11,471 persons contacted, 3,414 met the inclusion criterion of age ≥40 years and completed the screening questions regarding COPD. Of the 362 subjects who reported that they had been diagnosed with COPD, 351 completed the survey. Data on demographic and lifestyle characteristics, comorbidities, disease history, perceived disease severity, breathlessness severity, symptoms severity, limitations in daily activities, psychological distress, and productivity were collected. All data were collected through the telephone interview method using a structured questionnaire. Results: The overall self-reported COPD prevalence was 10.6%. Among 351 participants, only 9% reported that they suffered from severe breathlessness. The mean COPD assessment test score was 19.0, with 84% of participants having a COPD assessment test score ≥10. As for the perceived severity of COPD, the majority of subjects considered that their respiratory condition was of moderate (34.2% or mild severity (33.9%. Overall, the participants reported a significant impact of COPD on their daily life. For instance, 61.5% of them reported that their respiratory condition has affected their sports activities. Moreover, 73% of subjects

  19. Thyroid gland in chronic obstructive pulmonary disease.

    Science.gov (United States)

    Miłkowska-Dymanowska, Joanna; Białas, Adam J; Laskowska, Paulina; Górski, Paweł; Piotrowski, Wojciech J

    2017-01-01

    The risk of chronic obstructive pulmonary disease (COPD), as well as thyroid diseases increases with age. COPD is a common systemic disease associated with chronic inflammation. Many endocrinological disorders, including thyroid gland diseases are related to systemic inflammation. Epidemiological studies suggest that patients with COPD are at higher risk of thyroid disorders. These associations are not well-studied and thyroid gland diseases are not included on the broadly acknowledged list of COPD comorbidities. They may seriously handicap quality of life of COPD patients. Unfortunately, the diagnosis may be difficult, as many signs are masked by the symptoms of the index disease. The comprehension of the correlation between thyroid gland disorders and COPD may contribute to better care of patients. In this review, we attempt to revise available literature describing existing links between COPD and thyroid diseases.

  20. The chronic gastrointestinal manifestations of Chagas disease

    Directory of Open Access Journals (Sweden)

    Nilce Mitiko Matsuda

    2009-01-01

    Full Text Available Chagas disease is an infectious disease caused by the protozoan Trypanosoma cruzi. The disease mainly affects the nervous system, digestive system and heart. The objective of this review is to revise the literature and summarize the main chronic gastrointestinal manifestations of Chagas disease. The chronic gastrointestinal manifestations of Chagas disease are mainly a result of enteric nervous system impairment caused by T. cruzi infection. The anatomical locations most commonly described to be affected by Chagas disease are salivary glands, esophagus, lower esophageal sphincter, stomach, small intestine, colon, gallbladder and biliary tree. Chagas disease has also been studied in association with Helicobacter pylori infection, interstitial cells of Cajal and the incidence of gastrointestinal cancer.

  1. Monitoring the prevalence of chronic conditions: which data should we use?

    Directory of Open Access Journals (Sweden)

    Orueta Juan F

    2012-10-01

    Full Text Available Abstract Background Chronic diseases are an increasing threat to people’s health and to the sustainability of health organisations. Despite the need for routine monitoring systems to assess the impact of chronicity in the population and its evolution over time, currently no single source of information has been identified as suitable for this purpose. Our objective was to describe the prevalence of various chronic conditions estimated using routine data recorded by health professionals: diagnoses on hospital discharge abstracts, and primary care prescriptions and diagnoses. Methods The ICD-9-CM codes for diagnoses and Anatomical Therapeutic Chemical (ATC codes for prescriptions were collected for all patients in the Basque Country over 14 years of age (n=1,964,337 for a 12-month period. We employed a range of different inputs: hospital diagnoses, primary care diagnoses, primary care prescriptions and combinations thereof. Data were collapsed into the morbidity groups specified by the Johns Hopkins Adjusted Clinical Groups (ACGs Case-Mix System. We estimated the prevalence of 12 chronic conditions, comparing the results obtained using the different data sources with each other and also with those of the Basque Health Interview Survey (ESCAV. Using the different combinations of inputs, Standardized Morbidity Ratios (SMRs for the considered diseases were calculated for the list of patients of each general practitioner. The variances of the SMRs were used as a measure of the dispersion of the data and were compared using the Brown-Forsythe test. Results The prevalences calculated using prescription data were higher than those obtained from diagnoses and those from the ESCAV, with two exceptions: malignant neoplasm and migraine. The variances of the SMRs obtained from the combination of all the data sources (hospital diagnoses, and primary care prescriptions and diagnoses were significantly lower than those using only diagnoses. Conclusions The

  2. Clinical aspects of chronic kidney disease

    African Journals Online (AJOL)

    Clinical course of chronic kidney disease. Although patients with kidney disease may present with symptoms such as oedema (nephritic or nephrotic syndrome) and changes in urine composition, histological and functional renal decompensation can often not be diagnosed owing to a lack of symptoms. Undetected loss.

  3. Epidemiology of chronic kidney disease in children

    NARCIS (Netherlands)

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

    2012-01-01

    In the past 30 years there have been major improvements in the care of children with chronic kidney disease (CKD). However, most of the available epidemiological data stem from end-stage renal disease (ESRD) registries and information on the earlier stages of pediatric CKD is still limited. The

  4. Chronic diarrhoea in HIV patients: Prevalence of coccidian parasites

    Directory of Open Access Journals (Sweden)

    Gupta S

    2008-01-01

    Full Text Available The purpose of this study was to determine the prevalence of intestinal parasites in HIV patients with or without diarrhoea and to see an association between diarrhoea and the coccidian parasites in our setting. Stool samples from 113 HIV patients, 34 chronic diarrhoea and 79 without any history of diarrhoea were collected and examined for enteric parasites by microscopy. One hundred and thirteen control samples from HIV negative patients complaining of prolonged diarrhoea were also collected and analysed. Prevalence of coccidian parasites in HIV and non-HIV patients; with and without diarrhoea was compared using chi-square tests. Enteric parasites were detected in 55.8% HIV patients with diarrhoea compared to 16.4% in patients without diarrhoea ( P < 0.001. Isospora belli was found in 41.1% (14/34 of chronic diarrhoea and 6.3% (5/79 in non-diarrhoeal cases ( P < 0.001. Cryptosporidium was detected in 20.6% (7/34 of chronic diarrhoea and 2.5% (2/79 in non-diarrhoeal cases ( P < 0.01. Cyclospora cayetanensis associated diarrhoea was detected in only one case of chronic diarrhoea (2.9%. CD4+ T-cell count was lower (180 cells/μl0 in diarrhoeal HIV patients as compared to non-diarrhoeal patients. Coccidian parasites were seen at a mean CD4+ T-cell count of 186.3 cells/μL. This study concluded that Isospora belli was the predominant parasite followed by Cryptosporidium spp. and both were strongly associated with diarrhoea among HIV patients.

  5. [Etiology, prevalence of chronic renal failure and growth retardation in Lithuanian children].

    Science.gov (United States)

    Pundziene, Birute; Masalskiene, Jūrate; Jankauskiene, Augustina; Cerkauskiene, Rimante; Aleksyniene, Vilte; Dobiliene, Diana; Rudaitis, Sarūnas

    2007-01-01

    The aim of the study was to evaluate the causes, prevalence, and grades of chronic renal failure in Lithuanian children and to assess its influence on children's growth. The study was performed in Vilnius University Children's Hospital and Clinic of Children's Diseases, Kaunas University of Medicine. By March 31, 2006, 65 children with chronic renal failure had been registered. The prevalence was 88.3 cases per million children. The mean age was 10.8+/-4.9 years. The leading causes of chronic renal failure were congenital diseases (37%) and obstruction with interstitial nephritis (33.8%). At presentation, 23 (35.40%) children had mild, 17 (26.15%) had moderate, 9 (23.85%) had severe renal failure, and 16 (24.6%) had end-stage renal disease. Fourteen (21.54%) children were below the third percentile in height for their age. Growth failure was observed in one (4.35%) child with Grade 1 renal failure. The deterioration of renal function had a significant influence on growth impairment, and 13 (30.95%) children with glomerular filtration rate of less than 60 mL/min/1.73 m2 and 7 (43.75%) with end-stage renal disease had a height below the third percentile. Growth retardation as one of the symptoms of impairment of children's physical development depends on the severity of renal function.

  6. Framing international trade and chronic disease

    Science.gov (United States)

    2011-01-01

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

  7. Framing international trade and chronic disease

    Directory of Open Access Journals (Sweden)

    Mohindra Katia S

    2011-07-01

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

  8. Framing international trade and chronic disease.

    Science.gov (United States)

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

    2011-07-04

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

  9. Sexuality and Chronic Kidney Disease

    Science.gov (United States)

    ... Events Advocacy Donate A to Z Health Guide Sexuality and Kidney Disease Tweet Share Print Email Can ... It's something everyone needs. Many people think that sexuality refers only to sexual intercourse. But sexuality includes ...

  10. REJUVENATING CHRONIC DISEASE MANAGEMENT IN MALAYSIAN PRIVATE GENERAL PRACTICE

    Directory of Open Access Journals (Sweden)

    PITERMAN L

    2010-01-01

    Full Text Available Rapid epidemiological transition globally has witnessed a rising prevalence of major chronic diseases such as hypertension, diabetes, hyperlipidaemia, obesity, chronic respiratory diseases and cancers over the past 30 years. In Malaysia, these conditions are commonly managed in primary care and published evidence has consistently shown suboptimal management and poor disease control. This in turn, has led to the massive burden of treating complications in secondary care, burden tothe patients and their families with regards to morbidity and premature death, and burden to the country with regards to premature loss of human capital. The crushing burden and escalating health care costs in managing chronic diseases pose a daunting challenge to our primary care system, as we remain traditionally oriented to care for acute, episodic illnesses. This paper re-examines the current evidence supporting the implementation of Wagner Chronic Care Model in primary careglobally; analyses the barriers of implementation of this model in the Malaysian private general practice through SWOT(strengths, weaknesses, opportunities and threats analysis; and discusses fundamental solutions needed to bridge the gap to achieve better outcomes.

  11. Chronic Disease Cost not Transferable: Colombian Reality

    Directory of Open Access Journals (Sweden)

    Karina Gallardo Solarte

    2016-01-01

    Full Text Available Objective: The aim is to reflect on the social and economic costs of chronic non-communicable disease (NCD in Colombia to display a charging indicator of these pathologies. Material and methods: In a review of 50 studies, 27 were selected since these met the inclusion criteria, like chronical disease, studies conducted between 2002 and 2011 related to costs, chronic disease, and being Colombian. Results: This is a review study of chronic diseases vs. their costs, being here cardiovascular diseases part of the group of high cost and higher incidence diseases, thus repre­senting a great risk to the financial stability of healthcare companies. There are few studies that address the costs generated by the treatment of ncds patients that show the economic impact experienced by public and private institutions providing and promoting health services. Most of them forget the economic, family and social costs the affected population must suffer. Conclu­sions: ncds represent a burden to the health service system for their very high costs, untimely intervention and reduced significant benefit for this population and their families.

  12. Management of Pruritus in Chronic Liver Disease

    Directory of Open Access Journals (Sweden)

    Angeline Bhalerao

    2015-01-01

    Full Text Available Background. There continues to be uncertainty on the ideal treatment of pruritus in chronic liver disease. The aim of this study was to gather the latest information on the evidence-based management of pruritus in chronic liver disease. Methodology. A literature search for pruritus in chronic liver disease was conducted using Pubmed and Embase database systems using the MeSH terms “pruritus,” “chronic liver disease,” “cholestatic liver disease,” and “treatment.” Results. The current understanding of the pathophysiology of pruritus is described in addition to detailing research into contemporary treatment options of the condition. These medical treatments range from bile salts, rifampicin, and opioid receptor antagonists to antihistamines. Conclusion. The burden of pruritus in liver disease patients persists and, although it is a common symptom, it can be difficult to manage. In recent years there has been greater study into the etiology and treatment of the condition. Nonetheless, pruritus remains poorly understood and many patients continue to suffer, reiterating the need for further research to improve our understanding of the etiology and treatment for the condition.

  13. SECRETED KLOTHO AND CHRONIC KIDNEY DISEASE

    Science.gov (United States)

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

    2013-01-01

    Soluble Klotho (sKl) in the circulation can be generated directly by alterative splicing of the Klotho transcript or the extracellular domain of membrane Klotho can be released from membrane-anchored Klotho on the cell surface. Unlike membrane Klotho which functions as a coreceptor for fibroblast growth factor-23 (FGF23), sKl, acts as hormonal factor and plays important roles in anti-aging, anti-oxidation, modulation of ion transport, and Wnt signaling. Emerging evidence reveals that Klotho deficiency is an early biomarker for chronic kidney diseases as well as a pathogenic factor. Klotho deficiency is associated with progression and chronic complications in chronic kidney disease including vascular calcification, cardiac hypertrophy, and secondary hyperparathyroidism. In multiple experimental models, replacement of sKl, or manipulated up-regulation of endogenous Klotho protect the kidney from renal insults, preserve kidney function, and suppress renal fibrosis, in chronic kidney disease. Klotho is a highly promising candidate on the horizon as an early biomarker, and as a novel therapeutic agent for chronic kidney disease. PMID:22396167

  14. Chronic kidney disease in children with unilateral renal tumor.

    Science.gov (United States)

    Cozzi, Denis A; Ceccanti, Silvia; Frediani, Simone; Schiavetti, Amalia; Cozzi, Francesco

    2012-05-01

    In patients who have undergone nephrectomy lower stage chronic kidney disease may develop, which is an independent risk factor for cardiovascular disease and overall mortality. We investigated whether the prevalence of lower stage chronic kidney disease is related to the amount of renal parenchyma excised in children with unilateral renal tumor. A total of 15 patients treated with nephrectomy and 10 treated with nephron sparing surgery were enrolled at a single academic center. The Kidney Disease Outcomes Quality Initiative guidelines were used to classify patients by chronic kidney disease stage based on estimated glomerular filtration rate values. The Modification of Diet in Renal Disease study equation and Schwartz equation were used in patients older and younger than 17 years, respectively. At a mean followup of more than 12 years 8 patients who had undergone nephrectomy and 1 treated with bilateral nephron sparing surgery presented with stage II chronic kidney disease (estimated glomerular filtration rate 60 to 89 ml/min/1.73 m(2)). Sequential measurements from diagnosis to 12 to 17 years postoperatively showed that stage II chronic kidney disease in patients who had undergone nephrectomy manifested as a negligible postoperative increase in mean ± SD estimated glomerular filtration rate (75.7 ± 25.5 vs 79.4 ± 3.9 ml/min/1.73 m(2), p = 0.6). Five of the 8 patients presented with stage II chronic kidney disease even before nephrectomy. The other 7 patients who had undergone nephrectomy and those treated with nephron sparing surgery presented with a significant postoperative increase in mean ± SD estimated glomerular filtration rate (81.1 ± 24 vs 102.3 ± 3 ml/min/1.73 m(2), p = 0.02, and 88.7 ± 2 vs 107.4 ± 14 ml/min/1.73 m(2), p = 0.005, respectively). A subset of children with unilateral renal tumor presents before and/or after nephrectomy, and not after nephron sparing surgery, with stage II chronic kidney disease, probably due to a reduced renal

  15. Chronic kidney disease and cardiovascular disease

    African Journals Online (AJOL)

    2007-08-16

    stage renal disease (ESRD) worldwide and accounts for approximately 30 - 50% of all deaths. It is a sobering fact that the risk for premature CVD in a 30-year-old patient with. ESRD is similar to that of a 70 - 80-year-old without ...

  16. CHRONIC THROMBOEMBOLIC PULMONARY HYPERTENSION AND PROBLEMS OF RARE AND INTERDISCIPLINARY DISEASE

    Directory of Open Access Journals (Sweden)

    N. A. Shostak

    2014-01-01

    Full Text Available Chronic thromboembolic pulmonary hypertension (CTEPH is a rare life-threatening disease with a prevalence of 2 cases per 100000 population. CTEPH is a chronic, progressive disease characterized by high disability and mortality rates in young and middle-aged people, often with underlying genetic and autoimmune thrombophilic disorders. The need for pathogenetic therapy with orphan drugs that can slow the progression of the disease is supported.

  17. Prevalence rate of chronic overuse pain in taekwondo athletes.

    Science.gov (United States)

    Koh, Jae-Ok

    2017-10-01

    The aim of this study was to estimate the prevalence of chronic overuse pain (COP) and to identify possible risk factors of COP in sport poomsae taekwondo. This is a cross-sectional survey. A total of 263 sport-poomsae competitors (112 females; 151 males; aged between 12-44 years), who competed at the 2014 sport poomsae taekwondo competition, participated in this study. The prevalence rate of COP and possible risk factors associated with COP were analyzed by using Chi-square tests and independent t-tests. A total of 173 athletes reported that they experienced COP (65.8%; 95% confidence interval [CI]: 60.5-71.5). Female athletes showed a higher prevalence rate than their male counterparts (75.9% vs. 58.3%). Lower body (61.5%) and knee joints (26.4%) were the two primarily injured body part. A total of 101 athletes reported that they injured in the previous year. Among those, 81.2% were suffered from COP. The technique that caused pain most frequently was side-kick among females and front-kick among males. Prevalence rates of COP were significantly different by sex, education level, training hour, and a history of injury. The prevalence of COP is high among sport poomsae taekwondo athletes. Competitors who are female, have a history of injury, and train for extended hours were more likely to experience COP. To identify other potential risk factors of COP in sport poomsae taekwondo, more research is needed to build upon the findings.

  18. Subclinical cerebral abnormalities in chronic kidney disease.

    Science.gov (United States)

    Yao, Hiroshi; Takashima, Yuki; Hashimoto, Manabu; Uchino, Akira; Yuzuriha, Takefumi

    2013-01-01

    Impaired kidney function or chronic kidney disease (CKD), as measured by estimated glomerular filtration rate (eGFR), is associated with incident stroke risk. However, few studies have examined the relationship between CKD and subclinical cerebral abnormalities. We examined 675 elderly subjects (mean age 69.9 years), who were living independently at home without apparent dementia, using magnetic resonance imaging. Serum creatinine values, measured by the enzymatic method, were used for the Japanese equation of eGFR. Subclinical lacunar infarction, deep white matter lesions, and periventricular hyperintensities were detected in 88 (13.0%), 240 (35.6%) and 158 (23.4%) of the 675 participants, respectively. In the forward stepwise method of logistic analysis, age (OR 2.081/10, 95% CI 1.541-2.810), hypertension (OR 3.656, 95% CI 2.184-6.119), diabetes mellitus (OR 1.961, 95% CI 1.007-3.820), alcohol intake (OR 2.130, 95% CI 1.283-3.535), and eGFR <45 ml/min/1.73 m(2) were significant factors concerning subclinical lacunar infarction. CKD defined as eGFR <60 ml/min/1.73 m(2) was not significantly associated with subclinical lacunar infarction. Decreased eGFR was not a significant factor associated with white matter lesions (WMLs). Age (OR 2.781/10, 95% CI 2.252-3.435), hypertension (OR 1.746, 95% CI 1.231-2.477), diabetes mellitus (OR 1.854, 95% CI 1.070-3.213), but not eGFR were significant factors concerning WMLs. The present study showed that community-dwelling elderly subjects with late stage 3 CKD were at high risk for prevalent subclinical lacunar infarction. The identification of CKD-specific modifiable risk factors for SBI and WMLs is of increased importance for prevention of subclinical brain ischemic lesions. Copyright © 2013 S. Karger AG, Basel.

  19. Comorbidity in patients with chronic obstructive pulmonary disease in family practice: a cross sectional study

    Directory of Open Access Journals (Sweden)

    García-Olmos Luis

    2013-01-01

    Full Text Available Abstract Background Chronic obstructive pulmonary disease (COPD is frequent and often coexists with other diseases. The aim of this study was to quantify the prevalence of COPD and related chronic comorbidity among patients aged over 40 years visiting family practices in an area of Madrid. Methods An observational, descriptive, cross-sectional study was conducted in a health area of the Madrid Autonomous Region (Comunidad Autónoma de Madrid. The practice population totalled 198,670 persons attended by 129 Family Physicians (FPs, and the study population was made up of persons over the age of 40 years drawn from this practice population. Patients were deemed to have COPD if this diagnosis appeared on their clinical histories. Prevalence of COPD; prevalence of a further 25 chronic diseases in patients with COPD; and standardised prevalence ratios, were calculated. Results Prevalence of COPD in family medicine was 3.2% (95% CI 3.0–3.3 overall, 5.3% among men and 1.4% among women; 90% of patients presented with comorbidity, with a mean of 4 ± 2.04 chronic diseases per patient, with the most prevalent related diseases being arterial hypertension (52%, disorders of lipid metabolism (34%, obesity (25%, diabetes (20% and arrhythmia (15%. After controlling for age and sex, the observed prevalence of the following ten chronic diseases was higher than expected: heart failure; chronic liver disease; asthma; generalised artherosclerosis; osteoporosis; ischaemic heart disease; thyroid disease; anxiety/depression; arrhythmia; and obesity. Conclusions Patients with COPD, who are frequent in family practice, have a complex profile and pose a clinical and organisational challenge to FPs.

  20. Prevalence of Celiac Disease in Children with Autoimmune Hepatitis and vice versa

    OpenAIRE

    Najafi, Mehri; Sadjadei, Nooshin; Eftekhari, Kambiz; Khodadad, Ahmad; Motamed, Farzaneh; Fallahi, Gholam-Hossain; Farahmand, Fatemeh

    2014-01-01

    Objective: Celiac disease is an autoimmune disorder in which the risk of autoimmune liver disease is high. Autoimmune hepatitis is a chronic and progressive entity and the risk of its being associated with other autoimmune disorders such as celiac disease is high also. The aim of this study was to determine the prevalence of celiac disease in patients with autoimmune hepatitis and vice versa. Methods: In a cross-sectional study children with autoimmune hepatitis underwent serological screenin...

  1. Pulmonary hypertension in chronic obstructive pulmonary disease

    International Nuclear Information System (INIS)

    Aguirre F, Carlos E; Torres D, Carlos A.

    2010-01-01

    Pulmonary hypertension (PH) is a relatively common complication of chronic obstructive pulmonary disease (COPD). Its appearance during the course of COPD is associated with a worsened prognosis, due to reduced life expectancy and greater use of health care resources. Although a well-defined lineal relationship has not been shown, the prevalence of PH in patients with COPD is higher in cases characterized by greater obstruction and severity. PH is infrequent in cases of mild and moderate COPD. In cases of COPD, PH is generally mild or moderate, and seldom impairs right ventricular function. In many cases it is not apparent during rest, and manifests itself during exercise. PH can be severe or out of proportion with the severity of COPD. In this situation, the possibility of associated conditions should be explored, although COPD might be the only final explanation. There is scarce knowledge about the prevalence and behavior of PH in patients with COPD residing at intermediate and high altitudes (>2.500 meters above sea level), which is a common situation in Latin America and Asia. PH in COPD is not exclusively related with hypoxia/hypoxaemia and hypercapnia. The mechanical disturbances related with COPD (hyper inflation and high alveolar pressure) and inflammation may prevail as causes of endothelial injury and remodeling of pulmonary circulation, which contribute to increased pulmonary vascular pressure and resistance. The appearance of signs of cor p ulmonale indicates advanced PH. This condition should therefore be suspected early when dyspnoea, hypoxaemia, and impairment of diffusion are not in keeping with the degree of obstruction. PH is confirmed by Doppler echocardiography. Right heart catheterization may be justified in selected cases. Long-term oxygen therapy is the only intervention proven to be temporarily useful. Conventional vasodilators do not produce medium- or long-term improvement and can be detrimental to the ventilation-perfusion relation

  2. Pneumococcal vaccination and chronic respiratory diseases

    Directory of Open Access Journals (Sweden)

    Froes F

    2017-12-01

    Full Text Available Filipe Froes,1 Nicolas Roche,2 Francesco Blasi3,4 1Chest Department, Hospital Pulido Valente, North Lisbon Hospital Center, Lisbon, Portugal; 2Department of Respiratory and Intensive Care Medicine, Cochin Hospital, Paris Descartes University, Paris, France; 3Department of Pathophysiology and Transplantation, University of Milan, 4Internal Medicine Department, Respiratory Unit and Adult Cystic Fibrosis Center, Fondazione IRCCS ca Granda Ospedale Maggiore Policlinico, Milan, Italy Abstract: Patients with COPD and other chronic respiratory diseases are especially vulnerable to viral and bacterial pulmonary infections, which are major causes of exacerbations, hospitalization, disease progression, and mortality in COPD patients. Effective vaccines could reduce the burden of respiratory infections and acute exacerbations in COPD patients, but what is the evidence for this? This article reviews and discusses the existing evidence for pneumococcal vaccination efficacy and its changing role in patients with chronic respiratory diseases, especially COPD. Specifically, the recent Community-Acquired Pneumonia Immunization Trial in Adults (CAPITA showed the efficacy of pneumococcal conjugate vaccine in older adults, many of whom had additional risk factors for pneumococcal disease, including chronic lung diseases. Taken together, the evidence suggests that pneumococcal and influenza vaccinations can prevent community-acquired pneumonia and acute exacerbations in COPD patients, while pneumococcal vaccination early in the course of COPD could help maintain stable health status. Despite the need to prevent pulmonary infections in patients with chronic respiratory diseases and evidence for the efficacy of pneumococcal conjugate vaccine, pneumococcal vaccine coverage and awareness are low and need to be improved. Respiratory physicians need to communicate the benefits of vaccination more effectively to their patients who suffer from chronic respiratory diseases

  3. Transgenic Mouse Model of Chronic Beryllium Disease

    Energy Technology Data Exchange (ETDEWEB)

    Gordon, Terry

    2009-05-26

    Animal models provide powerful tools for dissecting dose-response relationships and pathogenic mechanisms and for testing new treatment paradigms. Mechanistic research on beryllium exposure-disease relationships is severely limited by a general inability to develop a sufficient chronic beryllium disease animal model. Discovery of the Human Leukocyte Antigen (HLA) - DPB1Glu69 genetic susceptibility component of chronic beryllium disease permitted the addition of this human beryllium antigen presentation molecule to an animal genome which may permit development of a better animal model for chronic beryllium disease. Using FVB/N inbred mice, Drs. Rubin and Zhu, successfully produced three strains of HLA-DPB1 Glu 69 transgenic mice. Each mouse strain contains a haplotype of the HLA-DPB1 Glu 69 gene that confers a different magnitude of odds ratio (OR) of risk for chronic beryllium disease: HLA-DPB1*0401 (OR = 0.2), HLA-DPB1*0201 (OR = 15), HLA-DPB1*1701 (OR = 240). In addition, Drs. Rubin and Zhu developed transgenic mice with the human CD4 gene to permit better transmission of signals between T cells and antigen presenting cells. This project has maintained the colonies of these transgenic mice and tested the functionality of the human transgenes.

  4. When Your Child Has a Chronic Kidney Disease

    Science.gov (United States)

    ... Search English Español When Your Child Has a Chronic Kidney Disease KidsHealth / For Parents / When Your Child Has a Chronic Kidney Disease What's in this article? Treating Kidney Diseases Dialysis ...

  5. Endometriosis: a high-risk population for major chronic diseases?

    Science.gov (United States)

    Kvaskoff, Marina; Mu, Fan; Terry, Kathryn L.; Harris, Holly R.; Poole, Elizabeth M.; Farland, Leslie; Missmer, Stacey A.

    2015-01-01

    BACKGROUND Despite an estimated prevalence of 10% in women, the etiology of endometriosis remains poorly understood. Over recent decades, endometriosis has been associated with risk of several chronic diseases, such as cancer, autoimmune diseases, asthma/atopic diseases and cardiovascular diseases. A deeper understanding of these associations is needed as they may provide new leads into the causes or consequences of endometriosis. This review summarizes the available epidemiological findings on the associations between endometriosis and other chronic diseases and discusses hypotheses for underlying mechanisms, potential sources of bias and methodological complexities. METHODS We performed a comprehensive search of the PubMed/Medline and ISI Web of Knowledge databases for all studies reporting on the associations between endometriosis and other diseases published in English through to May 2014, using numerous search terms. We additionally examined the reference lists of all identified papers to capture any additional articles that were not identified through computer searches. RESULTS We identified 21 studies on the associations between endometriosis and ovarian cancer, 14 for breast cancer, 8 for endometrial cancer, 4 for cervical cancer, 12 for cutaneous melanoma and 3 for non-Hodgkin's lymphoma, as well as 9 on the links between endometriosis and autoimmune diseases, 6 on the links with asthma and atopic diseases, and 4 on the links with cardiovascular diseases. Endometriosis patients were reported to be at higher risk of ovarian and breast cancers, cutaneous melanoma, asthma, and some autoimmune, cardiovascular and atopic diseases, and at decreased risk of cervical cancer. CONCLUSIONS Increasing evidence suggests that endometriosis patients are at higher risk of several chronic diseases. Although the underlying mechanisms are not yet understood, the available data to date suggest that endometriosis is not harmless with respects to women's long-term health. If

  6. [Type 2 diabetes mellitus and chronic kidney disease].

    Science.gov (United States)

    Ponťuch, Peter

    The number of type 2 diabetic patients is increasing world-wide and a prediction of prevalence of chronic kidney disease up to 2025 in European diabetic population is alarming. Albuminuria and estimated glomerular filtration rate are cardinal biochemical parameters in diagnostics of diabetic nephropathy. Following diagnostic methods are also used: renal ultrasonography, ophthalmoscopy and in not clarified cases renal biopsy. Long-term optimal glycemic control, efficient antihypertensive treatment by angiotensin converting enzyme inhibitor, or angiotensin receptor blocker and recommended protein intake is a cornerstone of therapy. The research is presently focused on new pathophysiological mechanisms, as analysis of genome, microRNA, kidney injury biomarkers and proteomes.Key words: chronic kidney disease - type 2 diabetes mellitus.

  7. Innovative Approaches in Chronic Disease Management: Health Literacy Solutions and Opportunities for Research Validation.

    Science.gov (United States)

    Villaire, Michael; Gonzalez, Diana Peña; Johnson, Kirby L

    2017-01-01

    This chapter discusses the need for innovative health literacy solutions to combat extensive chronic disease prevalence and costs. The authors explore the intersection of chronic disease management and health literacy. They provide specific examples of successful health literacy interventions for managing several highly prevalent chronic diseases. This is followed by suggestions on pairing research and practice to support effective disease management programs. In addition, the authors discuss strategies for collection and dissemination of knowledge gained from collaborations between researchers and practitioners. They identify current challenges specific to disseminating information from the health literacy field and offer potential solutions. The chapter concludes with a brief look at future directions and organizational opportunities to integrate health literacy practices to address the need for effective chronic disease management.

  8. Src family kinases in chronic kidney disease.

    Science.gov (United States)

    Wang, Jun; Zhuang, Shougang

    2017-09-01

    Src family kinases (SFKs) belong to nonreceptor protein tyrosine kinases and have been implicated in the regulation of numerous cellular processes, including cell proliferation, differentiation, migration and invasion, and angiogenesis. The role and mechanisms of SFKs in tumorgenesis have been extensively investigated, and some SFK inhibitors are currently under clinical trials for tumor treatment. Recent studies have also demonstrated the importance of SFKs in regulating the development of various fibrosis-related chronic diseases (e.g., idiopathic pulmonary fibrosis, liver fibrosis, renal fibrosis, and systemic sclerosis). In this article, we summarize the roles of SFKs in various chronic kidney diseases, including glomerulonephritis, diabetic nephropathy, human immunodeficiency virus-associated nephropathy, autosomal dominant form of polycystic kidney disease, and obesity-associated kidney disease, and discuss the mechanisms involved. Copyright © 2017 the American Physiological Society.

  9. Prevalence and overlap of Disease Management Program diseases in older hospitalized patients.

    Science.gov (United States)

    Juul-Larsen, Helle Gybel; Petersen, Janne; Sivertsen, Ditte Maria; Andersen, Ove

    2017-09-01

    Many countries, like Denmark, have tailored Disease Management Programs (DMPs) based on patients having single chronic diseases [defined institutionally as "program diseases" (PDs)], which can complicate treatment for those with multiple chronic diseases. The aims of this study were (a) to assess the prevalence and overlap among acutely hospitalized older medical patients of PDs defined by the DMPs, and (b) to examine transitions between different departments during hospitalization and mortality and readmission within two time intervals among patients with the different PDs. We conducted a registry study of 4649 acutely hospitalized medical patients ≥65 years admitted to Copenhagen University Hospital, Hvidovre, Denmark, in 2012, and divided patients into six PD groups (type 2 diabetes, chronic obstructive pulmonary disease, cardiovascular disease, musculoskeletal disease, dementia and cancer), each defined by several ICD-10 codes predefined in the DMPs. Of these patients, 904 (19.4%) had 2 + PDs, and there were 47 different combinations of the six different PDs. The most prevalent pair of PDs was type 2 diabetes with cardiovascular disease in 203 (22.5%) patients, of whom 40.4% had an additional PD. The range of the cumulative incidence of being readmitted within 90 days was between 28.8% for patients without a PD and 46.6% for patients with more than one PD. PDs overlapped in many combinations, and all patients had a high probability of being readmitted. Hence, developing strategies to create a new generation of DMPs applicable to older patients with comorbidities could help clinicians organize treatment across DMPs.

  10. An Update on Coronary Artery Disease and Chronic Kidney Disease

    Directory of Open Access Journals (Sweden)

    Baris Afsar

    2014-01-01

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

  11. Increased risk of chronic liver disease in patients with bipolar disorder: A population-based study.

    Science.gov (United States)

    Hsu, Jer-Hwa; Chien, I-Chia; Lin, Ching-Heng

    2016-01-01

    This study aimed to investigate the prevalence and incidence of chronic liver disease in patients with bipolar disorder. We used a random sample of 766,427 subjects aged ≥18 years from the National Health Research Institute database in the year 2005. Subjects with at least one primary diagnosis of bipolar disorder in 2005 were identified. Patients with a primary or secondary diagnosis of chronic liver disease were also defined. We compared the prevalence and associated factors of chronic liver disease between patients with bipolar disorder and the general population in 2005. We also compared the incidence of chronic liver disease in patients with bipolar disorder and the general population from 2006 to 2010. The prevalence of chronic liver disease in patients with bipolar disorder (13.9%) was 2.68 times higher than that of the general population (5.8%) in 2005. The average annual incidence of chronic liver disease in patients with bipolar disorder from 2006 to 2010 was also higher than that of the general population (2.95% vs. 1.73%; risk ratio: 1.71; 95% confidence interval: 1.46-2.01). Patients with bipolar disorder had a significantly higher prevalence and incidence of chronic liver disease than those in the general population, and younger patients with bipolar disorder have a much higher prevalence and incidence than those in the general population. Male sex, second-generation antipsychotic or antidepressant use, and hyperlipidemia were associated factors for chronic liver disease in patients with bipolar disorder. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Prevalence of disability according to multimorbidity and disease clustering: a population-based study

    Directory of Open Access Journals (Sweden)

    Alessandra Marengoni

    2011-12-01

    Full Text Available Background: The prevalence of chronic diseases has increased with population ageing, and research has attempted to elucidate the correlation between chronic diseases and disability. However, most studies in older populations have focused on the effect of single disabling conditions, even though most older adults have more than one chronic disease (multimorbidity. Objective: The aims of this study were to evaluate the association of disability with disease, in terms of multimorbidity and specified pairs of diseases, in a population-based study of older adults. Materials and Methods: Using the Kungsholmen Project, we estimated the prevalence of disability by the number of chronic diseases, disease status by organ systems, and in specific pairs of chronic conditions, in a Swedish population (n=1,099; ≥77 years. Disability was defined as need of assistance in at least one activity of daily living (Katz index. Results: Functional disability was seen in 17.9% of participants. It increased as the number of chronic diseases increased. The prevalence of disability varied greatly amongst specific pairs of diseases: from 6.7% in persons affected by hypertension and atrial fibrillation to 82.4% in persons affected by dementia and hip fracture. In multivariate logistic regression models, the disease pairs that were significantly associated with the highest increased relative odds of disability contained dementia (dementia–hip fracture, dementia–CVD, and dementia–depression. Conclusions: Our findings suggest specific pairs of diseases are much more highly associated with disability than others, particularly diseases coupled with dementia. This knowledge may improve prevention of disablement and planning of resource distribution.

  13. Case Management of Adolescents with Chronic Disease.

    Science.gov (United States)

    Lankard, Bettina A.

    This training guide presents a model for optimum delivery of the primary duties, tasks, and steps required in the comprehensive case management of adolescents with chronic disease. Using a team approach to coordinated health care, the guide involves the patient and family as key members of the care team along with the physician, nurse, dietitian,…

  14. Nurses' knowledge of chronic disease management

    African Journals Online (AJOL)

    2014-11-21

    Nov 21, 2014 ... Intervention clinic nurses were also surveyed immediately after training and three months post-training. Data were analysed using SPSS version 19 (SPSS Inc., Chicago, IL).Total mean knowledge percentage scores were calculated for each chronic disease. Mean knowledge percentage score changes.

  15. Chronic obstructive pulmonary disease and genetics

    DEFF Research Database (Denmark)

    Ingebrigtsen, T.; Thomsen, S.F.; Vestbo, J.

    2008-01-01

    Chronic obstructive pulmonary disease (COPD) is characterised by airflow limitation and is associated with an inflammatory response of the lungs primarily caused by cigarette smoking. Cigarette smoking is by far the most important environmental risk factor for COPD, but less than half of all heavy...

  16. Chronic obstructive pulmonary disease in Denmark

    DEFF Research Database (Denmark)

    Lykkegaard, Jesper; Kristensen, Gustav N

    2016-01-01

    BACKGROUND: During the 80s and 90s the mortality and number of hospitalisations due to chronic obstructive pulmonary disease (COPD) in the country of Denmark almost doubled. Since then there has been a plateau. OBJECTIVE: To analyse age, period, and cohort effects on rates of deaths and first...

  17. Biomarkers in chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Sin, Don D; Vestbo, Jørgen

    2009-01-01

    Currently, with exception of lung function tests, there are no well validated biomarkers or surrogate endpoints that can be used to establish efficacy of novel drugs for chronic obstructive pulmonary disease (COPD). However, the lung function test is not an ideal surrogate for short-term drug...

  18. Occult Metabolic Bone Disease in Chronic Pancreatitis

    African Journals Online (AJOL)

    2017-10-26

    Oct 26, 2017 ... Background: Chronic pancreatitis (CP) leads to malabsorption and metabolic bone disease (MBD). Alcoholic CP (ACP) and tropical CP (TCP) are the two common types of CP. Objective: We investigated the presence of occult. MBD in patients with CP and compared the same between ACP and TCP.

  19. Dyselectrolytemia in Chronic Obstructive Pulmonary Diseases with ...

    African Journals Online (AJOL)

    Summary: Chronic Obstructive Pulmonary Disease (COPD) is one of the leading causes of mortality and morbidity world wide. Due to lack of awareness about the precipitating factors and predictors of prognosis, cases of acute exacerbation of COPD often suffer the fatal outcomes. In our study we assessed the levels of ...

  20. Nurses' knowledge of chronic disease management

    African Journals Online (AJOL)

    2014-11-21

    Nov 21, 2014 ... Objective: This study's objective was to evaluate the impact of the 'Primary Care 101' chronic disease management ... on management of tuberculosis, human immunodeficiency virus infection, mental health, epilepsy ... Conclusion: The improvements in nurses' knowledge can ensure improved patient.

  1. Arterial hypertension and chronic liver disease

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik Sahl; Møller, S

    2005-01-01

    This review looks at the alterations in the systemic haemodynamics of patients with chronic liver disease (cirrhosis) in relation to essential hypertension and arterial hypertension of renal origin. Characteristic findings in patients with cirrhosis are vasodilatation with low overall systemic va...

  2. Chronic obstructive pulmonary disease and cancer risk

    DEFF Research Database (Denmark)

    Kornum, Jette Brommann; Sværke, Claus; Thomsen, Reimar Wernich

    2012-01-01

    Little is known about the risk of cancer in patients with chronic obstructive pulmonary disease (COPD), including which cancer sites are most affected. We examined the short- and long-term risk of lung and extrapulmonary cancer in a nationwide cohort of COPD patients....

  3. Chronic Disease Risks From Exposure to Long-Hour Work Schedules Over a 32-Year Period.

    Science.gov (United States)

    Dembe, Allard E; Yao, Xiaoxi

    2016-09-01

    This study aims at evaluating the chronic disease risk related to prolonged work in long-hour schedules for eight major chronic diseases: heart disease, non-skin cancer, arthritis, diabetes, chronic lung disease, asthma, chronic depression, and hypertension. The study used data from the National Longitudinal Survey of Youth, 1979 covering 32 years of job history (1978 to 2009) for 7492 respondents. Logistic regression analyses were performed to test the relationship between average weekly work hours, and the reported prevalence of those conditions for each individual. Regularly working long hours over 32 years was significantly associated with elevated risks of heart disease, non-skin cancer, arthritis, and diabetes. The observed risk was much larger among women than among men. Working long-hour schedules over many years increases the risk for some specific chronic diseases, especially for women.

  4. Sleep disorders in pediatric chronic kidney disease patients.

    Science.gov (United States)

    Stabouli, Stella; Papadimitriou, Eleni; Printza, Nikoleta; Dotis, John; Papachristou, Fotios

    2016-08-01

    The prevalence of sleep disorders during childhood has been estimated to range from 25 to 43 %. The aim of this review is to determine the prevalence of sleep disorders and possible associations with chronic kidney disease (CKD)-related factors and health-related quality of life (HRQOL) in children with CKD. An electronic systematic literature search for sleep disorders in children with CKD in Pubmed, Embase and the Cochrane Library Databases identified seven relevant articles for review, all of which reported an increased prevalence of sleep disorders in children with CKD. Five studies included children with CKD undergoing dialysis, and two studies included only non-dialysis patients. In all studies the presence of sleep disturbances was assessed by questionnaires; only one study compared the results of a validated questionnaire with laboratory-based polysomnography. The prevalence of any sleep disorder ranged from 77 to 85 % in dialysis patients, to 32-50 % in transplanted patients and 40-50 % in non-dialysis patients. The most commonly studied disorder was restless legs syndrome, which presented at a prevalence of 10-35 %. Three studies showed significant associations between presence of sleep disorders and HRQOL. We found consistent evidence of an increased prevalence of sleep disturbances in children with CKD, and these seemed to play a critical role in HRQOL.

  5. Chronic obstructive pulmonary disease: the impact of gender.

    Science.gov (United States)

    Raghavan, Deepa; Varkey, Anita; Bartter, Thaddeus

    2017-03-01

    Chronic obstructive pulmonary disease (COPD) is a widely prevalent and potentially preventable cause of death worldwide. The purpose of this review is to summarize the influence of gender on various attributes of this disease, which will help physicians provide more personalized care to COPD patients. Cultural trends in smoking have morphed the epidemiology of this traditionally male disease. There is an increasing 'disease burden' among women with COPD as suggested by the higher prevalence and slower decline in death rates as compared with men. Biologic differences between the genders account for some, but not all of these differences. In women, distinct features need to be considered to boost success of therapeutic interventions such as smoking cessation, addressing comorbidities, and attendance to pulmonary rehabilitation. COPD in women is distinct from that in men with respect to phenotype, symptom burden, and comorbidities. Women are more predisposed to develop chronic bronchitis, have more dyspnea, and suffer more frequently from coexistent anxiety or depression. They may be more subject than men to misdiagnoses and/or underdiagnoses of COPD, often as a result of physician bias. Knowledge of these gender differences can lead to more effective tailored care of the COPD patient.

  6. The increasing financial impact of chronic kidney disease in australia.

    Science.gov (United States)

    Tucker, Patrick S; Kingsley, Michael I; Morton, R Hugh; Scanlan, Aaron T; Dalbo, Vincent J

    2014-01-01

    The aim of this investigation was to determine and compare current and projected expenditure associated with chronic kidney disease (CKD), renal replacement therapy (RRT), and cardiovascular disease (CVD) in Australia. Data published by Australia and New Zealand Dialysis and Transplant Registry, Australian Institute of Health and Welfare, and World Bank were used to compare CKD-, RRT-, and CVD-related expenditure and prevalence rates. Prevalence and expenditure predictions were made using a linear regression model. Direct statistical comparisons of rates of annual increase utilised indicator variables in combined regressions. Statistical significance was set at P Dollar amounts were adjusted for inflation prior to analysis. Between 2012 and 2020, prevalence, per-patient expenditure, and total disease expenditure associated with CKD and RRT are estimated to increase significantly more rapidly than CVD. RRT prevalence is estimated to increase by 29%, compared to 7% in CVD. Average annual RRT per-patient expenditure is estimated to increase by 16%, compared to 8% in CVD. Total CKD- and RRT-related expenditure had been estimated to increase by 37%, compared to 14% in CVD. Per-patient, CKD produces a considerably greater financial impact on Australia's healthcare system, compared to CVD. Research focusing on novel preventative/therapeutic interventions is warranted.

  7. Stroke and cerebrovascular diseases in patients with chronic kidney disease.

    Science.gov (United States)

    Toyoda, Kazunori; Ninomiya, Toshiharu

    2014-08-01

    Chronic kidney disease, defined as a reduced glomerular filtration rate or increased urinary albumin excretion, is recognised as a rapidly growing global health burden, and increasing evidence suggests that it contributes to the risk and severity of cerebrovascular diseases. In particular, chronic kidney disease is an established risk factor for stroke and is also strongly associated with subclinical cerebrovascular abnormalities and cognitive impairment, partly because it shares several traditional and non-traditional risk factors, and sometimes uraemia-related and dialysis-related factors, with cerebrovascular diseases. The effect of chronic kidney disease on incident stroke differs among regions and races and is greater in Asian than in non-Asian people. Chronic kidney disease seems to be predictive of severe neurological deficits and poor vital and functional outcomes after both ischaemic and haemorrhagic strokes, which is partly due to the limitations of pharmacotherapies, including limited use and effects of novel oral anticoagulants, other antithrombotic treatments, and reperfusion treatment for hyperacute ischaemic stroke. In view of the strong two-way association between stroke and kidney disease, the pathophysiological interactions between the brain and kidney should be the subject of intensive study. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Recent Developments in Epigenetics of Acute and Chronic Kidney Diseases

    Science.gov (United States)

    Reddy, Marpadga A.; Natarajan, Rama

    2015-01-01

    The growing epidemic of obesity and diabetes, the aging population as well as prevalence of drug abuse has led to significant increases in the rates of the closely associated acute and chronic kidney diseases, including diabetic nephropathy. Furthermore, evidence shows that parental behavior and diet can affect the phenotype of subsequent generations via epigenetic transmission mechanisms. These data suggest a strong influence of the environment on disease susceptibility and that, apart from genetic susceptibility, epigenetic mechanisms need to be evaluated to gain critical new information about kidney diseases. Epigenetics is the study of processes that control gene expression and phenotype without alterations in the underlying DNA sequence. Epigenetic modifications, including cytosine DNA methylation and covalent post translational modifications of histones in chromatin are part of the epigenome, the interface between the stable genome and the variable environment. This dynamic epigenetic layer responds to external environmental cues to influence the expression of genes associated with disease states. The field of epigenetics has seen remarkable growth in the past few years with significant advances in basic biology, contributions to human disease, as well as epigenomics technologies. Further understanding of how the renal cell epigenome is altered by metabolic and other stimuli can yield novel new insights into the pathogenesis of kidney diseases. In this review, we have discussed the current knowledge on the role of epigenetic mechanisms (primarily DNA me and histone modifications) in acute and chronic kidney diseases, and their translational potential to identify much needed new therapies. PMID:25993323

  9. Recent developments in epigenetics of acute and chronic kidney diseases.

    Science.gov (United States)

    Reddy, Marpadga A; Natarajan, Rama

    2015-08-01

    The growing epidemic of obesity and diabetes, the aging population as well as prevalence of drug abuse has led to significant increases in the rates of the closely associated acute and chronic kidney diseases, including diabetic nephropathy. Furthermore, evidence shows that parental behavior and diet can affect the phenotype of subsequent generations via epigenetic transmission mechanisms. These data suggest a strong influence of the environment on disease susceptibility and that, apart from genetic susceptibility, epigenetic mechanisms need to be evaluated to gain critical new information about kidney diseases. Epigenetics is the study of processes that control gene expression and phenotype without alterations in the underlying DNA sequence. Epigenetic modifications, including cytosine DNA methylation and covalent post-translational modifications of histones in chromatin, are part of the epigenome, the interface between the stable genome and the variable environment. This dynamic epigenetic layer responds to external environmental cues to influence the expression of genes associated with disease states. The field of epigenetics has seen remarkable growth in the past few years with significant advances in basic biology, contributions to human disease, as well as epigenomics technologies. Further understanding of how the renal cell epigenome is altered by metabolic and other stimuli can yield novel new insights into the pathogenesis of kidney diseases. In this review, we have discussed the current knowledge on the role of epigenetic mechanisms (primarily DNAme and histone modifications) in acute and chronic kidney diseases, and their translational potential to identify much needed new therapies.

  10. Prevalence of Chronic Erythematous Candidiasis in Lebanese Denture Wearers: a Clinico-microbiological Study.

    Science.gov (United States)

    Aoun, Georges; Berberi, Antoine

    2017-03-01

    Chronic erythematous candidiasis also known as denture-related stomatitis refers to inflammatory changes of the denture-bearing mucosa. The aim of this study was to evaluate the prevalence of chronic erythematous candidiasis in a Lebanese population using clinical and microbiological examinations. Ninety-eight patients wearing full acrylic maxillary denture (50 women and 48 men) were included in this study. A clinical oral assessment and a microbiological exam using swab samples collected from the palate of these patients were performed and the data obtained were analyzed statistically. Sixty-nine point thirty-eight per cent (69.38%) of the patients examined, (68 out of 98; 25 men and 43 women), presented chronic erythematous candidiasis. The statistical analysis showed that patient's gender was a significant predictor of the disease while no statistically significant relationship with the patient's age was found. Within the limits of this study, the prevalence of chronic erythematous candidiasis is estimated to be high in Lebanon. Women were more affected than men.

  11. A multilevel model for cardiovascular disease prevalence in the US and its application to micro area prevalence estimates

    Directory of Open Access Journals (Sweden)

    Congdon Peter

    2009-01-01

    Full Text Available Abstract Background Estimates of disease prevalence for small areas are increasingly required for the allocation of health funds according to local need. Both individual level and geographic risk factors are likely to be relevant to explaining prevalence variations, and in turn relevant to the procedure for small area prevalence estimation. Prevalence estimates are of particular importance for major chronic illnesses such as cardiovascular disease. Methods A multilevel prevalence model for cardiovascular outcomes is proposed that incorporates both survey information on patient risk factors and the effects of geographic location. The model is applied to derive micro area prevalence estimates, specifically estimates of cardiovascular disease for Zip Code Tabulation Areas in the USA. The model incorporates prevalence differentials by age, sex, ethnicity and educational attainment from the 2005 Behavioral Risk Factor Surveillance System survey. Influences of geographic context are modelled at both county and state level, with the county effects relating to poverty and urbanity. State level influences are modelled using a random effects approach that allows both for spatial correlation and spatial isolates. Results To assess the importance of geographic variables, three types of model are compared: a model with person level variables only; a model with geographic effects that do not interact with person attributes; and a full model, allowing for state level random effects that differ by ethnicity. There is clear evidence that geographic effects improve statistical fit. Conclusion Geographic variations in disease prevalence partly reflect the demographic composition of area populations. However, prevalence variations may also show distinct geographic 'contextual' effects. The present study demonstrates by formal modelling methods that improved explanation is obtained by allowing for distinct geographic effects (for counties and states and for

  12. Prevalence of undiagnosed acute and chronic HIV in a lower-prevalence urban emergency department.

    Science.gov (United States)

    Moschella, Phillip C; Hart, Kimberly W; Ruffner, Andrew H; Lindsell, Christopher J; Wayne, D Beth; Sperling, Matthew I; Trott, Alexander T; Fichtenbaum, Carl J; Lyons, Michael S

    2014-09-01

    We estimated the seroprevalence of both acute and chronic HIV infection by using a random sample of emergency department (ED) patients from a region of the United States with low-to-moderate HIV prevalence. This cross-sectional seroprevalence study consecutively enrolled patients aged 18 to 64 years within randomly selected sampling blocks in a Midwestern urban ED in a region of lower HIV prevalence in 2008 to 2009. Participants were compensated for providing a blood sample and health information. After de-identification, we assayed samples for HIV antibody and nucleic acid. There were 926 participants who consented and enrolled. Overall, prevalence of undiagnosed HIV was 0.76% (95% confidence interval [CI] = 0.30%, 1.56%). Three participants (0.32%; 95% CI = 0.09%, 0.86%) were nucleic acid-positive but antibody-negative and 4 (0.43%; 95% CI = 0.15%, 1.02%) were antibody-positive. Even when the absolute prevalence is low, a considerable proportion of undetected HIV cases in an ED population are acute. Identification of acute HIV in ED settings should receive increased priority.

  13. Prevalence of Undiagnosed Acute and Chronic HIV in a Lower-Prevalence Urban Emergency Department

    Science.gov (United States)

    Moschella, Phillip C.; Hart, Kimberly W.; Ruffner, Andrew H.; Lindsell, Christopher J.; Wayne, D. Beth; Sperling, Matthew I.; Trott, Alexander T.; Fichtenbaum, Carl J.

    2014-01-01

    Objectives. We estimated the seroprevalence of both acute and chronic HIV infection by using a random sample of emergency department (ED) patients from a region of the United States with low-to-moderate HIV prevalence. Methods. This cross-sectional seroprevalence study consecutively enrolled patients aged 18 to 64 years within randomly selected sampling blocks in a Midwestern urban ED in a region of lower HIV prevalence in 2008 to 2009. Participants were compensated for providing a blood sample and health information. After de-identification, we assayed samples for HIV antibody and nucleic acid. Results. There were 926 participants who consented and enrolled. Overall, prevalence of undiagnosed HIV was 0.76% (95% confidence interval [CI] = 0.30%, 1.56%). Three participants (0.32%; 95% CI = 0.09%, 0.86%) were nucleic acid–positive but antibody-negative and 4 (0.43%; 95% CI = 0.15%, 1.02%) were antibody-positive. Conclusions. Even when the absolute prevalence is low, a considerable proportion of undetected HIV cases in an ED population are acute. Identification of acute HIV in ED settings should receive increased priority. PMID:25033145

  14. Lung disease with chronic obstruction in opium smokers in Singapore

    Science.gov (United States)

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

    1971-01-01

    Fifty-four opium smokers with chronic obstructive lung disease were studied for two-and-a-half years. Forty-eight patients had a cough for at least two years before the onset of inappropriate exertional dyspnoea. Fine, bubbling adventitious sounds suggesting small airway disease were heard on auscultation over the middle and lower lobes in 38 patients. The prevalence of inflammatory lung disease and chronic respiratory failure in this series is suggested as the main cause for the frequent finding of right ventricular hypertrophy and congestive heart failure. Physiological studies revealed moderate to severe airways obstruction with gross over-inflation and, in 32 patients, an additional restrictive defect probably due to peribronchiolar fibrosis. Radiological evidence of chronic bronchitis and bronchiolitis was observed in 45 patients, `pure' chronic bronchiolitis in six patients, and `widespread' emphysema in 25 patients respectively. Necropsy examinations in nine patients, however, showed destructive emphysema of variable severity in all. Chronic bronchiolitis often associated with striking bronchiolectasis was present in six cases. More severe bronchiolar rather than bronchial inflammation was noted. The heavy opium smokers had characteristic nodular shadows on chest radiography, sometimes associated with a striking reticular pattern not seen in `pure' cigarette smokers. This was due to gross pigmented dust (presumably carbon) deposition in relation to blood vessels, lymphatics, and bronchioles, and also within the alveoli. It is speculated that the initial lesion is an acquired bronchiolitis. Opium smoking induces an irritative bronchopathy favouring repeated attacks of acute bronchiolitis and eventually resulting in obliterative bronchiolitis, peribronchiolar fibrosis, chronic bronchitis, and destructive emphysema. Images PMID:5134057

  15. Chronic Diseases, Lack of Medications, and Depression Among Syrian Refugees in Jordan, 2013–2014

    Science.gov (United States)

    Al-Smadi, Ahmed Mohammad; Tawalbeh, Loai Issa; Khoury, Laurice Sami

    2015-01-01

    Introduction Studying mental and physical health problems in refugees facilitates providing suitable health care, thus improving their quality of life. We studied depression tendency in Syrian refugees in Jordan in the light of chronic diseases and medication availability. Also, depression prevalence and depression comorbidity with chronic diseases were identified. Methods In this multicenter cross-sectional survey, data from Syrian refugees attending Caritas centers in 6 Jordanian cities from November 2013 through June 2014 were analyzed. Participants’ demographics, depression, previously diagnosed chronic diseases, and newly diagnosed chronic diseases and the availability of medications were studied. Logistic regression was used to examine predictors for depression. Results Of 765 refugees who participated, about one-third demonstrated significant depression as measured by the Beck Depression Inventory. Descriptive analyses showed that depression was comorbid in 35% of participants with previously diagnosed chronic diseases and in 40% of participants with newly diagnosed chronic diseases. Newly diagnosed chronic diseases and lack of medications significantly contributed to depression, but the regression model as a whole explained less than 5% of the variance. Conclusion Because the regression model showed low effect size, we concluded that newly diagnosed chronic diseases and medication shortages could not predict depression in Syrian refugees residing in Jordan. Therefore, further studies of additional factors are recommended. Prompt measures have to be taken to prevent the spread of chronic diseases and improve mental health in this fragile population. PMID:25633485

  16. Chronic diseases, lack of medications, and depression among Syrian refugees in Jordan, 2013-2014.

    Science.gov (United States)

    Gammouh, Omar Salem; Al-Smadi, Ahmed Mohammad; Tawalbeh, Loai Issa; Khoury, Laurice Sami

    2015-01-29

    Studying mental and physical health problems in refugees facilitates providing suitable health care, thus improving their quality of life. We studied depression tendency in Syrian refugees in Jordan in the light of chronic diseases and medication availability. Also, depression prevalence and depression comorbidity with chronic diseases were identified. In this multicenter cross-sectional survey, data from Syrian refugees attending Caritas centers in 6 Jordanian cities from November 2013 through June 2014 were analyzed. Participants' demographics, depression, previously diagnosed chronic diseases, and newly diagnosed chronic diseases and the availability of medications were studied. Logistic regression was used to examine predictors for depression. Of 765 refugees who participated, about one-third demonstrated significant depression as measured by the Beck Depression Inventory. Descriptive analyses showed that depression was comorbid in 35% of participants with previously diagnosed chronic diseases and in 40% of participants with newly diagnosed chronic diseases. Newly diagnosed chronic diseases and lack of medications significantly contributed to depression, but the regression model as a whole explained less than 5% of the variance. Because the regression model showed low effect size, we concluded that newly diagnosed chronic diseases and medication shortages could not predict depression in Syrian refugees residing in Jordan. Therefore, further studies of additional factors are recommended. Prompt measures have to be taken to prevent the spread of chronic diseases and improve mental health in this fragile population.

  17. 28 CFR 79.57 - Proof of chronic renal disease.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Proof of chronic renal disease. 79.57... disease. (a) In determining whether a claimant developed chronic renal disease following pertinent... conclusion that a claimant developed chronic renal disease must be supported by medical documentation. (b) A...

  18. 28 CFR 79.67 - Proof of chronic renal disease.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Proof of chronic renal disease. 79.67... renal disease. (a) In determining whether a claimant developed chronic renal disease following pertinent... claimant. A conclusion that a claimant developed chronic renal disease must be supported by medical...

  19. Sarcopenia and frailty in chronic respiratory disease.

    Science.gov (United States)

    Bone, Anna E; Hepgul, Nilay; Kon, Samantha; Maddocks, Matthew

    2017-02-01

    Sarcopenia and frailty are geriatric syndromes characterized by multisystem decline, which are related to and reflected by markers of skeletal muscle dysfunction. In older people, sarcopenia and frailty have been used for risk stratification, to predict adverse outcomes and to prompt intervention aimed at preventing decline in those at greatest risk. In this review, we examine sarcopenia and frailty in the context of chronic respiratory disease, providing an overview of the common assessments tools and studies to date in the field. We contrast assessments of sarcopenia, which consider muscle mass and function, with assessments of frailty, which often additionally consider social, cognitive and psychological domains. Frailty is emerging as an important syndrome in respiratory disease, being strongly associated with poor outcome. We also unpick the relationship between sarcopenia, frailty and skeletal muscle dysfunction in chronic respiratory disease and reveal these as interlinked but distinct clinical phenotypes. Suggested areas for future work include the application of sarcopenia and frailty models to restrictive diseases and population-based samples, prospective prognostic assessments of sarcopenia and frailty in relation to common multidimensional indices, plus the investigation of exercise, nutritional and pharmacological strategies to prevent or treat sarcopenia and frailty in chronic respiratory disease.

  20. Contraception for adolescents with chronic rheumatic diseases

    Directory of Open Access Journals (Sweden)

    Benito Lourenço

    Full Text Available ABSTRACT Contraception is an important issue and should be a matter of concern in every medical visit of adolescent and young patients with chronic rheumatic diseases. This narrative review discusses contraception methods in adolescents with juvenile systemic lupus erythematosus (JSLE, antiphospholipid syndrome (APS, juvenile idiopathic arthritis (JIA and juvenile dermatomyositis (JDM. Barrier methods are safe and their use should be encouraged for all adolescents with chronic rheumatic diseases. Combined oral contraceptives (COC are strictly prohibited for JSLE and APS patients with positive antiphospholipid antibodies. Reversible long-acting contraception can be encouraged and offered routinely to the JSLE adolescent patient and other rheumatic diseases. Progestin-only pills are safe in the majority of rheumatic diseases, although the main concern related to its use by adolescents is poor adherence due to menstrual irregularity. Depot medroxyprogesterone acetate injections every three months is a highly effective contraception strategy, although its long-term use is associated with decreased bone mineral density. COC or other combined hormonal contraceptive may be options for JIA and JDM patients. Oral levonorgestrel should be considered as an emergency contraception method for all adolescents with chronic rheumatic diseases, including patients with contraindication to COC.

  1. Psychosocial interventions for patients with chronic disease

    Directory of Open Access Journals (Sweden)

    Deter Hans-Christian

    2012-01-01

    Full Text Available Abstract Treatment of patients with chronic diseases will be one of the main challenges of medicine in the future. This paper presents an overview of different origins, mechanism, and symptoms necessary for understanding new and different interventions that include a psychosomatic view. In a psychosomatic therapeutic intervention there are very different targets, such as psychological symptoms, personality traits, attitudes toward disease and life, risk behaviour, and social isolation and as biological targets the change of autonomic imbalance and of the effects of the psycho-endocrinological or psycho-immunological stress responses. And there are also different psychosomatic measures that influence the individual biological, psychological and sociological targets. There is a need to give different answer to different questions in the field of psychosomatic and behavioral medicine. Comparative effectiveness research is an important strategy for solving some methodological issues. What is the target of treatment for different diseases: Symptom reduction, healing, or limiting progression to the worst case - the death of patients. We know that, the patient-physician relationship is important for every medical/therapeutic action for patients with chronic diseases. This volume of BioPsychoSocial Medicine will present four different psychosomatic treatment studies from the clinical field in the sense of phase 2 studies: Reports of patients with obesity, anorexia nervosa, chronic somatoform pain and coronary artery disease were presented

  2. Can we use the pharmacy data to estimate the prevalence of chronic conditions? a comparison of multiple data sources

    Directory of Open Access Journals (Sweden)

    Borgia Piero

    2011-09-01

    Full Text Available Abstract Background The estimate of the prevalence of the most common chronic conditions (CCs is calculated using direct methods such as prevalence surveys but also indirect methods using health administrative databases. The aim of this study is to provide estimates prevalence of CCs in Lazio region of Italy (including Rome, using the drug prescription's database and to compare these estimates with those obtained using other health administrative databases. Methods Prevalence of CCs was estimated using pharmacy data (PD using the Anathomical Therapeutic Chemical Classification System (ATC. Prevalences estimate were compared with those estimated by hospital information system (HIS using list of ICD9-CM diagnosis coding, registry of exempt patients from health care cost for pathology (REP and national health survey performed by the Italian bureau of census (ISTAT. Results From the PD we identified 20 CCs. About one fourth of the population received a drug for treating a cardiovascular disease, 9% for treating a rheumatologic conditions. The estimated prevalences using the PD were usually higher that those obtained with one of the other sources. Regarding the comparison with the ISTAT survey there was a good agreement for cardiovascular disease, diabetes and thyroid disorder whereas for rheumatologic conditions, chronic respiratory illnesses, migraine and Alzheimer's disease, the prevalence estimates were lower than those estimated by ISTAT survey. Estimates of prevalences derived by the HIS and by the REP were usually lower than those of the PD (but malignancies, chronic renal diseases. Conclusion Our study showed that PD can be used to provide reliable prevalence estimates of several CCs in the general population.

  3. Neurohumoral fluid regulation in chronic liver disease

    DEFF Research Database (Denmark)

    Møller, Søren; Henriksen, Jens Henrik

    1998-01-01

    Impaired homeostasis of the blood volume, with increased fluid and sodium retention, is a prevailing element in the deranged systemic and splanchnic haemodynamics in patients with liver disease. In this review, some basic elements of the circulatory changes that take place and of neurohumoral fluid...... regulation are outlined in order to provide an update of recent investigations on the neuroendocrine compensation of circulatory and volume dysfunction in chronic liver disease. The underlying pathophysiology is a systemic vasodilatation in which newly described potent vasoactive substances such as nitric...... and lungs. It is still an enigma why patients with chronic liver disease are at the same time overloaded and functional hypovolaemic with a hyperdynamic, hyporeactive circulation. Further research is needed to find the solution to this apparent haemodynamic conflict concerning the abnormal neurohumoral...

  4. Alcoholic Beverage Consumption and Chronic Diseases

    Directory of Open Access Journals (Sweden)

    Yue Zhou

    2016-05-01

    Full Text Available Epidemiological and experimental studies have consistently linked alcoholic beverage consumption with the development of several chronic disorders, such as cancer, cardiovascular diseases, diabetes mellitus and obesity. The impact of drinking is usually dose-dependent, and light to moderate drinking tends to lower risks of certain diseases, while heavy drinking tends to increase the risks. Besides, other factors such as drinking frequency, genetic susceptibility, smoking, diet, and hormone status can modify the association. The amount of ethanol in alcoholic beverages is the determining factor in most cases, and beverage types could also make an influence. This review summarizes recent studies on alcoholic beverage consumption and several chronic diseases, trying to assess the effects of different drinking patterns, beverage types, interaction with other risk factors, and provide mechanistic explanations.

  5. Mediterranean Diet in Prevention of Chronic Diseases

    Directory of Open Access Journals (Sweden)

    Pelin Meryem

    2017-07-01

    Full Text Available Bad eating habits lead to the emergence of chronic health problems such as coronary artery diseases, hypertension, dyslipidaemia, cancer and obesity and the relationship between diet and diseases is emphasized and the relationship between them is clearly revealed in studies conducted over many years. The Mediterranean diet, which is first described by Angel Keys at the beginning of the 1960’s, is not a specific diet but a natural way of eating in olive-growing region. With the properties such as the use of vegetable oils such as olive oil in particular, and the consumption of fish instead of red meat, the diet constitutes a health-protective nutrition. So, this review conducted the relationship between Mediterranean diet and chronic diseases.

  6. Direct renin inhibition in chronic kidney disease

    DEFF Research Database (Denmark)

    Persson, Frederik; Rossing, Peter; Parving, Hans-Henrik

    2013-01-01

    that renin inhibition could hold potential for improved treatment in patients with chronic kidney disease, with diabetic nephropathy as an obvious group of patients to investigate, as the activity of the renin-angiotensin-aldosterone system is enhanced in these patients and as there is an unmet need...... early as a beneficial effect was unlikely and there was an increased frequency of side effects. Also in non-diabetic kidney disease a few intervention studies have been carried out, but there is no ongoing hard outcome study. In this review we provide the current evidence for renin inhibition in chronic...... kidney disease by reporting of the studies published so far as well as perspective on the future possibilites....

  7. Prevalence of chronic cerebrospinal venous insufficiency in multiple sclerosis: a blinded sonographic evaluation.

    Science.gov (United States)

    Tromba, L; Blasi, S; Vestri, A; Kiltzanidi, D; Tartaglia, F; Redler, A

    2015-02-01

    To verify the prevalence of chronic cerebrospinal venous insufficiency in patients affected by different clinical forms of multiple sclerosis and in healthy subjects using the Zamboni ultrasound protocol combined with M-mode ultrasound examination. We enrolled 112 patients with multiple sclerosis and 67 healthy subjects from 20 to 67 years of age. All the patients underwent Duplex and color-Doppler sonography of the neck vessels, transcranial colour duplex sonography, M-mode study of the valve system and of venous abnormalities. Subjects were positive for chronic cerebrospinal venous insufficiency when at least two of five hemodynamic criteria of the Zamboni protocol were fulfilled. Chronic cerebrospinal venous insufficiency condition was further analyzed by a multivariate analysis including age, sex, disease duration, subtypes of multiple sclerosis and expanded disability status scale score as independent variables. No healthy subjects was positive for chronic cerebrospinal venous insufficiency, while in the sample of patients affected by multiple sclerosis the diagnosis was made in 59.8% of cases (p multiple sclerosis and chronic cerebrospinal venous insufficiency (respectively 54.4% and 76.1%, p present in healthy subjects but were detected in patients with multiple sclerosis. The positivity of the second criterion was associated with diagnosis of chronic cerebrospinal venous insufficiency in 100% of cases. The third criterion had a prevalence of 52.2% in the subgroup of chronic cerebrospinal venous insufficiency patients. It was positive in 36 multiple sclerosis patients and was associated with chronic cerebrospinal venous insufficiency diagnosis in all cases except one. The multivariate analysis showed that age, disease duration, sex, subtypes of multiple sclerosis and expanded disability status scale score were not considered predictors of this haemodynamic condition. Chronic cerebrospinal venous insufficiency is a haemodynamic condition strongly

  8. Inhaled Antibiotic Therapy in Chronic Respiratory Diseases

    Directory of Open Access Journals (Sweden)

    Diego J. Maselli

    2017-05-01

    Full Text Available The management of patients with chronic respiratory diseases affected by difficult to treat infections has become a challenge in clinical practice. Conditions such as cystic fibrosis (CF and non-CF bronchiectasis require extensive treatment strategies to deal with multidrug resistant pathogens that include Pseudomonas aeruginosa, Methicillin-resistant Staphylococcus aureus, Burkholderia species and non-tuberculous Mycobacteria (NTM. These challenges prompted scientists to deliver antimicrobial agents through the pulmonary system by using inhaled, aerosolized or nebulized antibiotics. Subsequent research advances focused on the development of antibiotic agents able to achieve high tissue concentrations capable of reducing the bacterial load of difficult-to-treat organisms in hosts with chronic respiratory conditions. In this review, we focus on the evidence regarding the use of antibiotic therapies administered through the respiratory system via inhalation, nebulization or aerosolization, specifically in patients with chronic respiratory diseases that include CF, non-CF bronchiectasis and NTM. However, further research is required to address the potential benefits, mechanisms of action and applications of inhaled antibiotics for the management of difficult-to-treat infections in patients with chronic respiratory diseases.

  9. [Disease management for chronic heart failure patient].

    Science.gov (United States)

    Bläuer, Cornelia; Pfister, Otmar; Bächtold, Christa; Junker, Therese; Spirig, Rebecca

    2011-02-01

    Patients with chronic heart failure (HF) are limited in their quality of life, have a poor prognosis and face frequent hospitalisations. Patient self-management was shown to improve quality of life, reduce rehospitalisations and costs in patients with chronic HF. Comprehensive disease management programmes are critical to foster patient self-management. The chronic care model developed by the WHO serves as the basis of such programmes. In order to develop self-management skills a needs orientated training concept is mandatory, as patients need both knowledge of the illness and the ability to use the information to make appropriate decisions according to their individual situation. Switzerland has no established system for the care of patients with chronic diseases in particular those with HF. For this reason a group of Swiss experts for HF designed a model for disease management for HF patients in Switzerland. Since 2009 the Swiss Heart Foundation offers an education programme based on this model. The aim of this programme is to offer education and support for practitioners, patients and families. An initial pilot evaluation of the program showed mixed acceptance by practitioners, whereas patient assessed the program as supportive and in line with their requirements.

  10. [Probable Mental Health Disorders Prevalence in Children With Chronic Conditions. Results From the National Mental Health Survey of Colombia 2015].

    Science.gov (United States)

    Gómez-Restrepo, Carlos; Ramirez, Sandra; Tamayo Martínez, Nathalie; Rodriguez, Maria Nelcy; Rodríguez, Andrea; Rengifo, Henrey

    2016-12-01

    The prevalence of chronic conditions is increasing globally and this phenomenon covers pediatric populations. There is a relationship between chronic conditions and mental health problems, which has been insufficiently studied in the case of children. To measure the frequency of problems and mental disorders in the Colombian population between 7 and 11 years, depending on the presence or absence of chronic conditions. The information pertains to the National Survey of Mental Health of Colombia 2015, an observational cross-sectional nationally representative for the group between 7 and 11 years old. Mental problems where measure with the Reporting Questionnaire for Children (RQC), the 12 month prevalence of seven mental disorders were assessed using the Diagnostic Interview Schedule for Children Version parents (DISC-P) and a list of chronic conditions. Univariate and stratification analysis of the data were performed. 41.6% of the children with no chronic conditions, 56.7% of the children with 1 chronic condition and 70.8% in those with 2 or more have at least one RQC symptom; the highest prevalence of mental health symptoms are those with chronic inflammatory lung disease, followed by diabetes mellitus and allergies. The prevalence of one or more mental disorders in children without chronic conditions is 3.1% while those with at least 1 is 13.8%. A higher prevalence of mental disorders in children and its association with chronic conditions justifies further studies that address this issue and develop strategies with multidisciplinary interventions. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  11. [Self-perception of disease in patients with chronic diseases].

    Science.gov (United States)

    Adrián-Arrieta, L; Casas-Fernández de Tejerina, J M

    2017-11-18

    The aim of this study is to assess the self-perception of disease by patients with chronic diseases and determine factors related to their perception of disease. Cross-sectional descriptive study performed between September 2014 and April 2015 in nine (6 urban and 3 rural) Health Centres of Navarra, Spain. The participants were recruited by convenience sampling of 196 patients aged over 65 years with at least one chronic disease. The outcome variable was: Perception of disease evaluated through The Brief Illness Perception Questionnaire (9 items. Assessment of the cognitive and emotional representation of the disease. A higher total score indicates a greater threat of disease to the patient). Explanatory variables: Evaluation of the care received through the Patient Assessment of Chronic Illness Care, Katz index, Gijon's socio-family evaluation scale and quality of life using the EQ5D questionnaire. Other variables studied were: gender, age, education, Charlson index, and number of chronic diseases. The association between the total The Brief Illness Perception Questionnaire value and the rest of the variables was calculated. The self-perception of disease is more negative for a larger number of diseases (rho: 0.242; p=.001), greater patient dependence (rho: -0.193; P=.007), and a poorer self-perceived quality of life (EQ VAS rho: -0.484; Pdisease worsens as their diseases and their dependence increase, and also worsens their quality of life. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  12. Male Sexual Dysfunction and Chronic Kidney Disease

    Science.gov (United States)

    Edey, Matthew M.

    2017-01-01

    Male sexual dysfunction is common in chronic kidney disease (CKD), particularly in end-stage renal disease. Historically, this cause of considerable morbidity has been under-reported and under-recognized. The ideal approach to diagnosis and management remains unclear due to a paucity of good quality data, but an understanding of the pathophysiology is necessary in order to address the burden of this important complication of CKD. This paper will review the endocrine dysfunction that occurs in renal disease, particularly the hypothalamic–pituitary–gonadal axis, discuss the causes of erectile dysfunction, infertility, and altered body image and libido in these patients and suggest appropriate treatment interventions. PMID:28382300

  13. Nutritional management and growth in children with chronic kidney disease.

    Science.gov (United States)

    Rees, Lesley; Jones, Helen

    2013-04-01

    Despite continuing improvements in our understanding of the causes of poor growth in chronic kidney disease, many unanswered questions remain: why do some patients maintain a good appetite whereas others have profound anorexia at a similar level of renal function? Why do some, but not all, patients respond to increased nutritional intake? Is feed delivery by gastrostomy superior to oral and nasogastric routes? Do children who are no longer in the 'infancy' stage of growth benefit from enteral feeding? Do patients with protein energy wasting benefit from increased nutritional input? How do we prevent obesity, which is becoming so prevalent in the developed world? This review will address these issues.

  14. Mediterranean dietary pattern and chronic diseases.

    Science.gov (United States)

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

    2014-01-01

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

  15. MRI for chronic inflammatory bowel disease

    International Nuclear Information System (INIS)

    Hansmann, H.J.; Hess, T.; Hahmann, M.; Erb, G.; Richter, G.M.; Duex, M.; Elsing, C.

    2001-01-01

    Chronic inflammatory bowel disease is diagnosed and monitored by the combination of colonoscopy and small bowel enteroklysis. Magnetic resonance imaging has become the gold standard for the imaging of perirectal and pelvic fistulas. With the advent of ultrafast MRI small and large bowel imaging has become highly attractive and is being advocated more and more in the diagnostic work up of inflammatory bowel disease. Imaging protocols include fast T 1 -weighted gradient echo and T 2 -weighted TSE sequences and oral or rectal bowel distension. Furthermore, dedicated imaging protocols are based on breath-hold imaging under pharmacological bowel paralysis and gastrointestinal MR contrast agents (Hydro-MRI). High diagnostic accuracy can be achieved in Crohn's disease with special reference to the pattern of disease, depth of inflammation, mesenteric reaction, sinus tract depiction and formation of abscess. In ulcerative colitis, the mucosa-related inflammation causes significantly less bowel wall thickening compared to Crohn's disease. Therefore with MRI, the extent of inflammatory changes is always underestimated compared to colonoscopy. According to our experience in more than 200 patients as well as the results in other centers, Hydro-MRI possesses the potential to replace enteroklysis in the diagnosis of chronic inflammatory bowel disease and most of the follow-up colonoscopies in Crohn's disease. Further technical improvements in 3D imaging will allow interactive postprocessing of the MR data. (orig.) [de

  16. [Prevalence of anosognosia in Alzheimer's disease].

    Science.gov (United States)

    Turró-Garriga, Oriol; Conde-Sala, Josep Lluís; Reñé-Ramírez, Ramón; López-Pousa, Secundino; Gascón-Bayarri, Jordi; Garre-Olmo, Josep

    2014-07-07

    Anosognosia is a disorder that affects the clinical presentation of Alzheimer's disease (AD), increasing in frequency with the evolution of AD. The objective was to determine the prevalence of anosognosia and analyze the associated factors and predictors. Multicenter transversal and observational study of 345 AD patients. Anosognosia was assessed by Anosognosia Questionnaire-Dementia and the evolutionary stage with the Global Deterioration Scale (GDS). Tests used were Mini-Mental State Examination, Disability Assessment for Dementia and Neuropsychiatric Inventory to assess cognition, functional status and neuropsychiatric symptoms, respectively. We adjusted linear regression models to determine the associated variables and binary logistic regression (RLog) to identify predictors of anosognosia. The overall prevalence of anosognosia was 46.7% (95% confidence interval [95% CI] 41.3 to 52.1). The prevalence in stages was 28.4% (GDS 4), 64.6% (GDS 5) and 91.4% (GDS 6). The RLog identified as predictors older age (odds ratio [OR] 1.04; 95% CI 1.01-1.09), lower functional capacity (OR 0.96; 95% CI 0.93-0.98), lower cognitive level (OR 0.9; 95% CI 0.88-0.99), and greater apathy (OR 1.1; 95% CI 1.03-1.18), disinhibition (OR 1.2; 95% CI 1.09-1.50), irritability (OR 1.1; 95% CI 1.09-1.50) and motor disorders (OR 1.2; 95% CI 1.09-1.50). Anosognosia increases with further deterioration. In patients with a mild impairment, predictor variables were apathy, disinhibition and motor disorders. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  17. Chronic kidney disease of unknown etiology in Sri Lanka.

    Science.gov (United States)

    Rajapakse, Senaka; Shivanthan, Mitrakrishnan Chrishan; Selvarajah, Mathu

    2016-07-01

    In the last two decades, chronic kidney disease of unknown etiology (CKDu) has emerged as a significant contributor to the burden of chronic kidney disease (CKD) in rural Sri Lanka. It is characterized by the absence of identified causes for CKD. The prevalence of CKDu is 15.1-22.9% in some Sri Lankan districts, and previous research has found an association with farming occupations. A systematic literature review in Pubmed, Embase, Scopus, and Lilacs databases identified 46 eligible peer-reviewed articles and one conference abstract. Geographical mapping indicates a relationship between CKDu and agricultural irrigation water sources. Health mapping studies, human biological studies, and environment-based studies have explored possible causative agents. Most studies focused on likely causative agents related to agricultural practices, geographical distribution based on the prevalence and incidence of CKDu, and contaminants identified in drinking water. Nonetheless, the link between agrochemicals or heavy metals and CKDu remains to be established. No definitive cause for CKDu has been identified. Evidence to date suggests that the disease is related to one or more environmental agents, however pinpointing a definite cause for CKDu is challenging. It is plausible that CKDu is multifactorial. No specific guidelines or recommendations exist for treatment of CKDu, and standard management protocols for CKD apply. Changes in agricultural practices, provision of safe drinking water, and occupational safety precautions are recommended by the World Health Organization.

  18. Pathophysiology of Pulmonary Hypertension in Chronic Parenchymal Lung Disease.

    Science.gov (United States)

    Singh, Inderjit; Ma, Kevin Cong; Berlin, David Adam

    2016-04-01

    Pulmonary hypertension commonly complicates chronic obstructive pulmonary disease and interstitial lung disease. The association of chronic lung disease and pulmonary hypertension portends a worse prognosis. The pathophysiology of pulmonary hypertension differs in the presence or absence of lung disease. We describe the physiological determinants of the normal pulmonary circulation to better understand the pathophysiological factors implicated in chronic parenchymal lung disease-associated pulmonary hypertension. This review will focus on the pathophysiology of 3 forms of chronic lung disease-associated pulmonary hypertension: idiopathic pulmonary fibrosis, chronic obstructive pulmonary disease, and sarcoidosis. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Prevalence of Fabry disease in dialysis patients: Japan Fabry disease screening study (J-FAST).

    Science.gov (United States)

    Saito, Osamu; Kusano, Eiji; Akimoto, Tetsu; Asano, Yasushi; Kitagawa, Teruo; Suzuki, Ken; Ishige, Nobuyuki; Akiba, Takashi; Saito, Akira; Ishimura, Eiji; Hattori, Motoshi; Hishida, Akira; Guili, Chu; Maruyama, Hiroki; Kobayashi, Masahisa; Ohashi, Touya; Matsuda, Ichiro; Eto, Yoshikatsu

    2016-04-01

    In Fabry disease, progressive glycolipid accumulation leads to damage in kidney and other organs. This study was designed to determine the prevalence rate of Fabry disease in Japanese dialysis patients. All dialysis patients agreeing to Japan Fabry disease screening study (J-FAST) with informed consent were selected except for Fabry disease. The screening was performed by a method of measuring plasma and/or leukocytes lysosomal α-galactosidase A protein level and α-galactosidase A activity. If positive, genetic analysis was carried out upon patient's agreement. J-FAST dealt with 8547 patients (male 5408, female 3139). At the tertiary examination, 26 out of 8547 patients were found to be positive. Six out of 26 patients could not accept genetic analysis because of death. Remaining 20 patients agreed with genetic analysis; then 2 patients (male 2, female 0) had a variation of the α-Gal gene and 11 patients showed E66Q variations. Therefore, the frequency of Fabry disease in J-FAST was 0.04 % (2/5408) in males and 0 % (0/3139) in females, and then 0.02 % (2/8547) in all patients. The presumptive clinical diagnoses of end-stage kidney disease (ESKD) were 10 chronic glomerulonephritis, 7 diabetic nephropathy, 3 unknown etiology, 3 nephrosclerosis, 1 gouty nephropathy, 1 autosomal dominant polycystic kidney disease and 1 renal tuberculosis among 26 tertiary positive patients. Two male Fabry patients were initially diagnosed as nephrosclerosis and chronic glomerulonephritis. The prevalence rate of Fabry disease in J-FAST was 0.02 %. Moreover, Fabry disease could not be ruled out as the clinical diagnosis of ESKD.

  20. Chronic heart disease caused by irradiation

    International Nuclear Information System (INIS)

    Horimoto, Masashi; Matsuhashi, Hironobu; Nakano, Hiroshi; Honda, Hajime; Sekiguchi, Morie.

    1988-01-01

    An analysis was made of 5 patients who had chronic heart disease 18 months to 13 years after radiation therapy for breast cancer or rib osteoblastoma. A total dose of X-ray or electron beam was ≥50 Gy for each patient. Computed tomography of the chest and cardiac catheterization led to the diagnosis of constrictive pericarditis with chronic pericardial effusion in one patient and chronic effusive pericarditis in the other three patients. Complete or incomplete right bundle branch block was observed on ECG in 3 patients. Endomyocardial biopsy of the right ventricle for 4 patients revealed nonspecific pathological findings, such as hypertrophy, disarray of cardiac muscle cells, various sized cell nuclei, rarefaction of myofibrils, and slight interstitial fibrosis with infrequent cellular infiltration. The results may implicate radiation-induced myocardial disturbance. Long-term follow-up is mandatory for the management of patients treated with radiation. (Namekawa, K.)

  1. Allopurinol Against Progression of Chronic Kidney Disease.

    Science.gov (United States)

    Golmohammadi, Sima; Almasi, Afshin; Manouchehri, M; Omrani, Hamid Reza; Zandkarimi, Mohammad Reza

    2017-07-01

    Hyperuricemia is common in approximately 50% of patients with kidney failure due to decreased uric acid excretion, and it has been recently known as an independent factor in the progression of renal insufficiency. Allopurinol inhibits the production of uric acid. The aim of this study was to evaluate the effect of allopurinol on chronic kidney disease progression. In a clinical trial, patients with stages 3 and 4 of chronic kidney disease were divided into two groups to receive allopurinol, 100 mg, daily and placebo for 12 months. Patients' kidney function and serum uric acid levels were assessed at baseline and 3, 6, and 12 months after initial administration. Subgroups of patients with severe and mild glomerular filtration rate (GFR) impairment (GFR, 15 mL/min/1.73 m2 to 30 mL/min/1.73 m2 and 30 mL/min/1.73 m2 to 60 mL/min/1.73 m2, respectively), were compared between the groups. Serum uric acid levels decreased significantly during after 12 months of allopurinol administration (P = .004). In patients with severe GFR impairment, serum creatinine levels did not decrease significantly and there was no significant increase in GFR, but in those with mild GFR impairment, serum creatinine levels decreased and GFR increase significantly (P chronic kidney disease progression and could be administered with other effective medications for controlling the kidney disease.

  2. Erectile dysfunction in patients with liver disease related to chronic hepatitis B

    OpenAIRE

    Kim, Min; Kim, Seul Young; Rou, Woo Sun; Hwang, Se Woong; Lee, Byung Seok

    2015-01-01

    Background/Aims Despite sexual function making an important contribution to the quality of life, data on erectile function are relatively scant in patients with chronic liver disease. We evaluated the prevalence of and risk factors for erectile dysfunction (ED) in patients with liver disease related to hepatitis B, especially among those with chronic hepatitis B (CHB) or early-stage cirrhosis. Methods In total, 69 patients (35 with CHB and 34 with hepatitis-B-related liver cirrhosis [HBV-LC])...

  3. The prevalence of severe fatigue in rheumatic diseases: an international study.

    Science.gov (United States)

    Overman, Cécile L; Kool, Marianne B; Da Silva, José A P; Geenen, Rinie

    2016-02-01

    Fatigue is a common, disabling, and difficult-to-manage problem in rheumatic diseases. Prevalence estimates of fatigue within rheumatic diseases vary considerably. Data on the prevalence of severe fatigue across multiple rheumatic diseases using a similar instrument is missing. Our aim was to provide an overview of the prevalence of severe fatigue across a broad range of rheumatic diseases and to examine its association with clinical and demographic variables. Online questionnaires were filled out by an international sample of 6120 patients (88 % female, mean age 47) encompassing 30 different rheumatic diseases. Fatigue was measured with the RAND(SF)-36 Vitality scale. A score of ≤35 was taken as representing severe fatigue (90 % sensitivity and 81 % specificity for chronic fatigue syndrome). Severe fatigue was present in 41 to 57 % of patients with a single inflammatory rheumatic disease such as rheumatoid arthritis, systemic lupus erythematosus, ankylosing spondylitis, Sjögren's syndrome, psoriatic arthritis, and scleroderma. Severe fatigue was least prevalent in patients with osteoarthritis (35 %) and most prevalent in patients with fibromyalgia (82 %). In logistic regression analysis, severe fatigue was associated with having fibromyalgia, having multiple rheumatic diseases without fibromyalgia, younger age, lower education, and language (French: highest prevalence; Dutch: lowest prevalence). In conclusion, one out of every two patients with a rheumatic disease is severely fatigued. As severe fatigue is detrimental to the patient, the near environment, and society at large, unraveling the underlying mechanisms of fatigue and developing optimal treatment should be top priorities in rheumatologic research and practice.

  4. The prevalence of chronic fatigue syndrome/ myalgic encephalomyelitis: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Johnston S

    2013-03-01

    Full Text Available Samantha Johnston,1 Ekua W Brenu,1 Donald Staines,1,2 Sonya Marshall-Gradisnik1 1Griffith Health Institute, School of Medical Sciences, National Centre for Neuroimmunology and Emerging Diseases, Griffith University, Parklands, QLD, Australia; 2Gold Coast Public Health Unit, Queensland Health, Robina, QLD, Australia Purpose: To perform a meta-analysis to examine variability among prevalence estimates for CFS/ME, according to the method of assessment used. Methods: Databases were systematically searched for studies on CFS/ME prevalence in adults that applied the 1994 Centers for Disease Control (CDC case definition.1 Estimates were categorized into two methods of assessment: self-reporting of symptoms versus clinical assessment of symptoms. Meta-analysis was performed to pool prevalences by assessment using random effects modeling. This was stratified by sample setting (community or primary care and heterogeneity was examined using the I2 statistic. Results: Of 216 records found, 14 studies were considered suitable for inclusion. The pooled prevalence for self-reporting assessment was 3.28% (95% CI: 2.24–4.33 and 0.76% (95% CI: 0.23–1.29 for clinical assessment. High variability was observed among self-reported estimates, while clinically assessed estimates showed greater consistency. Conclusion: The observed heterogeneity in CFS/ME prevalence may be due to differences in method of assessment. Stakeholders should be cautious of prevalence determined by the self-reporting of symptoms alone. The 1994 CDC case definition appeared to be the most reliable clinical assessment tool available at the time of these studies. Improving clinical case definitions and their adoption internationally will enable better comparisons of findings and inform health systems about the true burden of CFS/ME. Keywords: chronic fatigue syndrome, myalgic encephalomyelitis, prevalence, meta-analysis

  5. Prevalence of celiac disease in siblings of Iranian patients with celiac disease

    Directory of Open Access Journals (Sweden)

    Bashir Chomeili

    2011-06-01

    Full Text Available CONTEXT: Celiac disease, one of the best-known autoimmune human leukocyte antigen-dependent disorders, has a relatively increased prevalence in first-degree relatives. OBJECTIVE: To determine the prevalence of celiac disease in siblings of patients with confirmed celiac disease. METHODS: Siblings of confirmed celiac disease patients in our center were identified and enrolled in this study. Their serum immunoglobulin A and tissue transglutaminase antibody-enzyme-linked immunosorbent assay (anti-tissue transglutaminase, immunoglobulin A, and immunoglobulin G were measured and multiple endoscopic duodenal biopsy specimens were obtained with parental consensus. Celiac disease was confirmed by observation of characteristic histological changes. RESULTS: A total of 49 children (male, 29; female, 20; age, 2-16 years with confirmed celiac disease in a pediatric gastroenterology ward were studied from 1999 to 2006. We found 30 siblings (female, 16 all shared in both parents. The only measurement available was for immunoglobulin A tissue transglutaminase antibody. A duodenal biopsy was performed in all 30 siblings. Clinical findings such as abdominal pain, fatigue, growth retardation and diarrhea were found in 53.3% of the completely studied siblings, and positive serology without histological changes was identified in four cases. Both serology and biopsy (confirmed new cases were positive in 2 of the 30 siblings. CONCLUSION: High prevalence of celiac disease among siblings of patients with confirmed celiac disease necessitates serologic screening (and confirmatory biopsy if indicated in families having celiac disease. It is advantageous to diagnose the disease as soon as possible because early diagnosis and diet intervention may prevent serious complications such as growth retardation, short stature, chronic diarrhea, and malignancy.

  6. Children with Chronic Kidney Disease: Tips for Parents

    Science.gov (United States)

    ... Donate A to Z Health Guide Children With Chronic Kidney Disease: Tips for Parents Print Email If your child has been diagnosed with chronic kidney disease, you are no doubt feeling distressed and bewildered. ...

  7. Unmet needs in severe chronic upper airway disease (SCUAD)

    NARCIS (Netherlands)

    Bousquet, Jean; Bachert, Claus; Canonica, Giorgio W.; Casale, Thomas B.; Cruz, Alvaro A.; Lockey, Richard J.; Zuberbier, Torsten; Akdis, C. A.; Baena-Cagnani, C.; Bateman, E. D.; Bonini, S.; Boulet, L. P.; Bousquet, P. J.; Burney, P. G.; Cardell, L. O.; Carlsen, K. H.; Carsten-Jensens, B.; Chen, Y.; Chkhartishvili, E.; Chuchalin, A.; Cox, L.; Custovic, A.; Dahl, R.; Delgado, L.; Demoly, P.; Denburg, J.; Dolen, W. K.; Dubakiene, R.; El-Gamal, Y.; Fokkens, W. J.; Fukuda, T.; Gerth van Wiijk, R.; Gjomarkaj, M.; Haahtela, T.; Hamelmann, E.; Holgate, S. T.; Howarth, P.; Ivancevich, J. C.; Jensen-Jarolim, E.; Kalayci, O.; Kaliner, M.; Kim, Y. Y.; Kowalski, M. L.; Le, L.; Lee, B. W.; Leynaert, B.; Lodrup-Carlsen, K.; Meltzer, E. O.; Mohammad, Y.; Morais-Almeida, M.; Mullol, J.; Nizankowska-Mogilnicka, E.; O'Hehir, R. E.; Ohta, K.; Okamoto, Y.; Papadopoulos, N.; Park, H. S.; Passalacqua, G.; Pawankar, R.; Popov, T.; Potter, P.; Price, D.; Rabe, K. F.; Rodriguez Perez, N.; Romano, A.; Rosenwasser, L.; Ryan, D.; Salapatas, M.; Sanchez-Borges, M.; Scadding, G.; Schmid-Grendelmeier, P. D.; Simons, F. E. R.; Todo-Bom, A.; Toskala, E.; Valovirta, E.; van Cauwenberge, P.; van Weel, C.; Vandenplas, O.; Vichyanond, P.; Wang, D. Y.; Wickman, M.; Yorgancioglu, A.; Yusuf, O.; Zar, H.; Zhong, N.; Zitt, M.; Zock, P.

    2009-01-01

    Although the majority of patients with chronic upper airway diseases have controlled symptoms during treatment, many patients have severe chronic upper airway diseases (SCUADs). SCUAD defines those patients whose symptoms are inadequately controlled despite adequate (ie, effective, safe, and

  8. Ghana's Burden of Chronic Non-Communicable Diseases: Future Directions in Research, Practice and Policy

    NARCIS (Netherlands)

    de-Graft Aikins, A.; Addo, J.; Ofei, F.; Bosu, Wk; Agyemang, C.

    2012-01-01

    The prevalence of major chronic non-communicable diseases and their risk factors has increased over time and contributes significantly to the Ghana's disease burden. Conditions like hypertension, stroke and diabetes affect young and old, urban and rural, and wealthy and poor communities. The high

  9. Immunization with synthetic peptide vaccine fails to protect mule deer (Odocoileus hemionus) from chronic wasting disease

    Science.gov (United States)

    Chronic wasting disease (CWD) is a transmissible spongiform encephalopathy of deer and elk. The disorder is characterized by accumulation of an abnormally folded isoform of the normal cellular prion protein. Disease prevalence in farmed herds of white tailed deer can exceed 80%. Attempts to control ...

  10. Physical training in chronic respiratory disease

    Directory of Open Access Journals (Sweden)

    Olga Cecilia Vargas

    2003-12-01

    Full Text Available Title: Exercise Training in Chronic RespiratoryDisease.Patients with chronic pulmonary disease havean inactive lifestyle with a progressive viciouscycle of physical inactivity, deconditioning andmore dyspnea. Physical Therapy attempts toimprove cardiopulmonary function andphysical conditioning. In PulmonaryRehabilitation, exercise training is consideredthe most important aspect because improvesaerobic exercise capacity and skeletal muscle function, and reduces breathlessness. Endurancetraining can include lower extremity trainingwith treadmill or cycle ergometer and upperlimbs exercises specialy in patients that haveproblems with arms movement. The use of highintensity training has showed better results,including less dyspnea and more functionalcapacity.Complementary therapies include ventilatoryassistance with pressure support or proportionalventilatory assistance during training, anabolichormones, nutritional support and functionalelectric stimulation.

  11. Lactate metabolism in chronic liver disease

    DEFF Research Database (Denmark)

    Jeppesen, Johanne B; Mortensen, Christian; Bendtsen, Flemming

    2013-01-01

    Background. In the healthy liver there is a splanchnic net-uptake of lactate caused by gluconeogenesis. It has previously been shown that patients with acute liver failure in contrast have a splanchnic release of lactate caused by a combination of accelerated glycolysis in the splanchnic region...... and a reduction in hepatic gluconeogenesis. Aims. The aims of the present study were to investigate lactate metabolism and kinetics in patients with chronic liver disease compared with a control group with normal liver function. Methods. A total of 142 patients with chronic liver disease and 14 healthy controls...... underwent a liver vein catheterization. Blood samples from the femoral artery and the hepatic and renal veins were simultaneously collected before and after stimulation with galactose. Results. The fasting lactate levels, both in the hepatic vein and in the femoral artery, were higher in the patients than...

  12. Physical Inactivity, Sedentary Behavior and Chronic Diseases

    OpenAIRE

    Gonz?lez, Karim?; Fuentes, Jorge; M?rquez, Jos? Luis

    2017-01-01

    New research into physical activity suggests that it is no longer sufficient just to meet minimum levels recommended by health guidelines in order to reduce cardiovascular risk. Both physical inactivity and sedentary behavior have their own health hazards and need to be addressed separately, in order to explore their different deleterious mechanisms. The aim of this review was to define and to characterize both concepts, and their relationship with major non-communicable chronic diseases. A P...

  13. The nature and prevalence of chronic pain in homeless persons: an observational study.

    Science.gov (United States)

    Fisher, Rebecca; Ewing, Judith; Garrett, Alice; Harrison, E Katherine; Lwin, Kimberly Kt; Wheeler, Daniel W

    2013-01-01

    Homeless people are known to suffer disproportionately with health problems that reduce physical functioning and quality of life, and shorten life expectancy. They suffer from a wide range of diseases that are known to be painful, but little information is available about the nature and prevalence of chronic pain in this vulnerable group. This study aimed to estimate the prevalence of chronic pain among homeless people, and to examine its location, effect on activities of daily living, and relationship with alcohol and drugs. We conducted face-to-face interviews with users of homeless shelters in four major cities in the United Kingdom, in the winters of 2009-11. Participants completed the Brief Pain Inventory, Short Form McGill Pain questionnaire, Leeds Assessment of Neuropathic Symptoms and Signs, and detailed their intake of prescribed and unprescribed medications and alcohol. We also recorded each participant's reasons for homelessness, and whether they slept rough or in shelters. Of 168 shelter users approached, 150 (89.3%) participated: 93 participants (63%) reported experiencing pain lasting longer than three months; the mean duration of pain experienced was 82.2 months. The lower limbs were most frequently affected. Opioids appeared to afford a degree of analgesia for some, but whilst many reported symptoms suggestive of neuropathic pain, very few were taking anti-neuropathic drugs. The prevalence of chronic pain in the homeless appears to be substantially higher than the general population, is poorly controlled, and adversely affects general activity, walking and sleeping. It is hard to discern whether chronic pain is a cause or effect of homelessness, or both. Pain is a symptom, but in this challenging group it might not always be possible to treat the underlying cause. Exploring the diagnosis and treatment of neuropathic pain may offer a means of improving the quality of these vulnerable people's lives.

  14. Pediatric kidney diseases in an African country: Prevalence, spectrum and outcome

    Directory of Open Access Journals (Sweden)

    Taiwo A Ladapo

    2014-01-01

    Full Text Available Insufficient data to guide the authorities responsible for resource allocation and a focus on communicable diseases increase the challenges of care of children with kidney disease in resource-constrained settings like ours. This study was performed with the aim to describe the current spectrum of pediatric nephrology disease in a tertiary hospital in Sub-Saharan Africa and highlight the challenges encountered in their care. A 4-year retrospective review of pediatric renal admissions was carried out and the overall prevalence, disease-specific prevalence and mortality rates were determined. Results were compared with nationwide data. Kidney diseases accounted for 8.9% of pediatric admissions with a prevalence of 22.3 admissions per 1000 child-admissions per year. Nephrotic syndrome, acute kidney injury and nephroblastoma accounted for almost 70% of admissions. The overall mortality was 14.4% with acute kidney injury accounting for 36% of this. Chronic kidney disease was also associated with poor outcome. The spectrum of disease nationwide is similar with a wide variation in disease-specific prevalence between geographic regions. The prevalence of genetic and hereditary conditions was low. The prevalence of pediatric renal disease in our environment is on the increase and associated with significant morbidity and mortality. Late presentation and high treatment costs were limitations to care. Preventive nephrology, training of pediatric nephrologists and strengthening of health insurance schemes are advocated.

  15. Obstructive sleep apnea in chronic obstructive pulmonary disease patients.

    LENUS (Irish Health Repository)

    Lee, Ruth

    2012-02-01

    PURPOSE OF REVIEW: Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) represent two of the most prevalent chronic respiratory disorders and cardiovascular diseases are major co-morbidities in both. Co-existence of both disorders (overlap syndrome) occurs in 1% of adults and overlap patients have worse nocturnal hypoxemia and hypercapnia than COPD and OSA patients alone. The present review discusses recent data concerning the pathophysiological and clinical significance of the overlap syndrome. RECENT FINDINGS: The severity of obstructive ventilatory impairment and hyperinflation, especially the inspiratory capacity to total lung capacity (TLC) ratio, correlates with the severity of sleep-related breathing disturbances.