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At least 469 records · Page 26Linked to original sources
PubMed1978

Air quality correlates of chronic disease mortality: Harris County, Texas 1969--1971.

Air quality correlates of chronic disease mortality in 180 census tracts of Harris County, Texas, were studied using 3 years mortality for 1969--1971. This study was designed to test with a different data base the universality of several study results which have reported significant correlations between heart disease and air pollutants. Air quality data (suspended particulates, benzene solubles, sulfur dioxide, and metals associated with particulates: copper, mercury, manganese, lead, nickel, zinc, chromium, and cadmium) were related to both sex and age adjusted crude death rates, and cause-specific death rates for age cohorts for 7 categories of heart disease, and pneumonia, asthma, cancer, tuberculosis, and accident deaths. The results of the study were in agreement with the findings of the other researchers who used national data. Suspended particulates and cadmium concentrations were found to be correlated (r=.38, .36; P less than .001) with ischemic heart disease (IHD). Many other significant correlations are reported but are not cause-specific. Socio-economic indicators were also correlated with IHD, thus confounding the issue. Further work is planned using more sophisticated statistical techniques to disentangle the relative contribution of each of these highly intercorrelated factors. No causality can be assigned at this stage, although this study, with the other cited, points to possible risk factors for IHD which need further evaluation.

Adult↗
PubMed2006

Fundamental questions about genes, inactivity, and chronic diseases.

Currently our society is faced with the challenge of understanding the biological basis for the epidemics of obesity and many chronic diseases, including Type 2 diabetes. Physical inactivity increases the relative risk of coronary artery disease by 45%, stroke by 60%, hypertension by 30%, and osteoporosis by 59%. Moreover, physical inactivity is cited as an actual cause of chronic disease by the US Centers of Disease Control. Physical activity was obligatory for survival for the Homo genus for hundreds of thousands of years. This review will present evidence that suggests that metabolic pathways selected during the evolution of the human genome are inevitably linked to physical activity. Furthermore, as with many other environmental interactions, cycles of physical activity and inactivity interact with genes resulting in a functional outcome appropriate for the environment. However, as humans are less physically active, there is a maladaptive response that leads to metabolic dysfunction and many chronic diseases. How and why these interactions occur are fundamental questions in biology. Finally, a perspective to future research in physical inactivity-gene interaction is presented. This information is necessary to provide the molecular evidence required to further promote the primary prevention of chronic diseases through physical activity, identify those molecules that will allow early disease detection, and provide society with the molecular information needed to counter the current strategy of adding physical inactivity into our lives.

Adaptation, Physiological↗
PubMed2005

Using histamine (H1) antagonists, in particular atypical antipsychotics, to treat anemia of chronic disease via interleukin-6 suppression.

Anemia of chronic disease (ACD) is a condition of decreased red cell mass secondary to some other chronic inflammatory condition. In ACD total body iron stores are normal, though serum iron is typically low secondary to iron sequestration by macrophages, and often iron supplementation is not an effective treatment for ACD for the same reason. The pathogenesis of ACD had been poorly understood, but recently there has been important progress: upregulation of interleukin-6 (Il-6) secondary to the underlying chronic inflammatory disease upregulates expression of the protein hepcidin. Upregulation of hepcidin causes anemia by a number of mechanisms: decreased intestinal absorption of iron from the duodenum, increased sequestration of iron by macrophages. Thus, downregulation of Il-6 may represent a most important treatment avenue for ACD. Anti-Il-6 antibodies might be a way to lower Il-6 levels, but such antibodies besides being expensive would have to be given intravenously or intramuscularly, and such large immunogenic molecules may not be appropriate in patients already with a chronic inflammatory condition. Here, we note that an immediately available and potentially effective treatment for ACD is to decrease Il-6 levels by histamine (H1) receptor antagonism, given that histamine acting through the H1 receptor is known to be a potent positive regulator of Il-6. Among the classes of medications that are H1 antagonists we point out that atypical antipsychotic medications such as olanzapine and quetiapine are among the most potent H1 antagonists, and can have simple daily dosing schedules and thus may be particularly useful in ACD.

Anemia↗
PubMed2004

A transitional care service for elderly chronic disease patients at risk of readmission.

BACKGROUND: Multiple hospital admissions, especially those related to chronic disease, represent a particular challenge to the acute health care sector in Australia. OBJECTIVE: To determine whether a nurse-led chronic disease management model of transitional care reduced readmissions to acute care. DESIGN: A quasi-experimental controlled trial. SETTING: A large tertiary metropolitan teaching hospital. PARTICIPANTS: 166 general medical patients aged > or = 65 years with either a history of readmissions to acute care or multiple medical comorbidities. INTERVENTION: Implementation of a chronic disease management model of transitional care aimed at improving patient management and reducing readmissions to acute care. MAIN OUTCOME MEASURES: Readmission rates and emergency department presentation rates at 3-and 6-month follow up. Secondary outcome measures include quality of life, discharge destination, and primary health care service utilisation. RESULTS: There was no difference in readmission rates, emergency department presentation rates, quality of life, discharge destination or primary health care service utilisation. The difficulties inherent in evaluating this type of multifactorial intervention are discussed and consideration is given to patient factors, the difficulty of influencing readmission rates, and local system issues. CONCLUSION: The outcomes of this study reflect the tension that exists between implementing multifaceted integrated health service programs and attempting to evaluate them within complex and changing environments using robust research methodologies.

Aged↗
PubMed1982

Residential mobility and urban-rural residence within life stages related to health risk and chronic disease in Tecumseh, Michigan.

Residential history, diagnosis of three chronic diseases, five clinical measurements and histories of smoking and drinking were obtained from a sample of 615 women and 529 men, aged 35-69, randomly selected from respondents of the Tecumseh Community Health Study. Two measures of residential mobility and one of urban-rural residence, during early life stages and over the entire lifetime, were related to subsequent adult health traits. Greater residential mobility, particularly in childhood but also in later life, was significantly associated with greater prevalence of hypertension and higher mean diastolic blood pressure in older persons. Greater duration of urban residence was associated with greater prevalence of chronic bronchitis. Both residential traits were associated with greater prevalence of CHD, and with behavior patterns, namely cigarette smoking and drinking, that are risk factors for certain chronic diseases.

Adult↗
PubMed2005

[Influence of smoking on the prevalence of chronic diseases among people with different income levels].

OBJECTIVE: To explore the influence of smoking on chronic diseases among people with various income levels in China. METHODS: Cross-sectional study on smoking behavior, chronic disease and income level was performed using database of the Second National Health Service Study (1998) provided by the Ministry of Health in China. RESULTS: Compared to never-smokers, smokers (including current smokers and former smokers) had a higher rate of having chronic diseases, after adjusted in age, income, educational level, employment status and type of jobs with corresponding countryside (OR = 1.185, 95% CI: 1.121 - 1.253 and town OR = 1.083, 95% CI: 1.010 - 1.161). Smoking had a more serious effect on having chronic illness in males from the countryside (former-smoker OR = 2.764, 95% CI: 2.471 - 3.092) than in town (former-smoker OR = 2.112, 95% CI: 1.844 - 2.419). Smokers at the lowest income level had a higher possibility of having chronic illness (town OR = 2.076, 95% CI: 1.551 - 2.780; countryside OR = 2.903, 95% CI: 2.248 - 3.749) than those at the highest income level (town OR = 1.785, 95% CI: 1.285 - 2.479 in the countryside OR = 2.466, 95% CI: 1.941 - 3.134). CONCLUSION: Smoking might cause more serious health problems to people at lower income level in China.

China↗
PubMed2026

Chronic disease in a 15th-century skeleton from the first European settlement of the Canary Islands: Early evidence in the colonial Atlantic expansion (San Marcial de Rubicón, Lanzarote).

OBJECTIVE: This study seeks to evaluate morphological changes in a skeleton recovered from San Marcial de Rubicón, the earliest permanent European settlement in the Canary Islands. MATERIALS: The individual derives from a primary inhumation dated to the early fifteenth century. METHODS: Macroscopic observation was combined with conventional radiography, computed tomography, and mitochondrial DNA analysis. A systematic differential diagnosis considered metabolic, infectious, inflammatory, neoplastic, and degenerative conditions. RESULTS: The individual under investigation is an adult male with evidence of diffuse cortical thickening, periosteal new bone formation, heterogeneous radiodensity, cranial diploic expansion, long-bone bowing, severe degenerative joint disease, sacroiliac ankylosis, and elongated thoracic vertebral defects. Mitochondrial DNA analysis identified haplogroup X2c1, consistent with European maternal ancestry. CONCLUSIONS: The overall pattern is most consistent with polyostotic Paget disease of bone, although coexisting axial ankylosis and vertebral defects complicate the interpretation. These additional lesions are insufficient to support an alternative primary diagnosis. SIGNIFICANCE: This case provides an early extra-European archaeological example of Paget disease in the context of Atlantic colonial expansion. Rather than simply extending the geographic record of the disease, it shows how chronic skeletal conditions with strong European clinical and archaeological associations may be identified in frontier populations formed through mobility, settlement and colonial interaction. LIMITATIONS: The diagnosis is based on a single individual, and nuclear DNA data were insufficient to assess genetic susceptibility. SUGGESTIONS FOR FURTHER RESEARCH: Further radiological, genomic, and isotopic analyses of early colonial skeletal assemblages are needed to evaluate chronic disease, mobility, and biological diversity in Atlantic frontier populations.

Male↗
PubMed2006

Information system support as a critical success factor for chronic disease management: Necessary but not sufficient.

UNLABELLED: Improvement of chronic disease management in primary care entails monitoring indicators of quality over time and across patients and practices. Informatics tools are needed, yet implementing them remains challenging. OBJECTIVE: To identify critical success factors enabling the translation of clinical and operational knowledge about effective and efficient chronic care management into primary care practice. DESIGN: A prospective case study of positive deviants using key informant interviews, process observation, and document review. SETTING: A chronic disease management (CDM) collaborative of primary care physicians with documented improvement in adherence to clinical practice guidelines using a web-based patient registry system with CDM guideline-based flow sheet. PARTICIPANTS: Thirty community-based physician participants using predominantly paper records, plus a project management team including the physician lead, project manager, evaluator and support team. ANALYSIS: A critical success factor (CSF) analysis of necessary and sufficient pathways to the translation of knowledge into clinical practice. RESULTS: A web-based CDM 'toolkit' was found to be a direct CSF that allowed this group of physicians to improve their practice by tracking patient care processes using evidence-based clinical practice guideline-based flow sheets. Moreover, the information and communication technology 'factor' was sufficient for success only as part of a set of seven direct CSF components including: health delivery system enhancements, organizational partnerships, funding mechanisms, project management, practice models, and formal knowledge translation practices. Indirect factors that orchestrated success through the direct factor components were also identified. A central insight of this analysis is that a comprehensive quality improvement model was the CSF that drew this set of factors into a functional framework for successful knowledge translation. CONCLUSIONS: In complex primary care settings environment where physicians have low adoption rates of electronic tools to support the care of patients with chronic conditions, successful implementation may require a set of interrelated system and technology factors.

British Columbia↗
PubMed1999

Lifestyle factors and chronic diseases: application of a composite risk index.

BACKGROUND: Assessing a combination of modifiable lifestyle practices may be a practical tool to modify patients' health behavior in counseling. Therefore, we developed a chronic disease risk index (CDRI) and investigated its relation with chronic disease in a multiethnic cohort. METHODS: A total of 15,693 men and 16,007 women in Hawaii who reported their diet and other lifestyle behaviors between 1975 and 1980 were followed until 1994. A semi-quantitative composite CDRI with scores ranging from 1 to 10 included the rankings for smoking, alcohol use, body mass index, fat intake, and fruit and vegetable consumption. Cox's proportional hazards regression was used to estimate the relative risk for chronic diseases. RESULTS: When comparing the highest to the lowest CDRI category, the respective relative risks (RRs) for total mortality were 2.9 (95% CI 2.3-3.8) and 3.8 (95% CI 2.9-5.0) for men and women. With higher CDRIs, the RRs for cancer incidence, mortality from cancer, coronary heart disease, and stroke increased significantly. Among the five components of the CDRI, smoking had the greatest influence on chronic disease risk, followed by body mass index. CONCLUSIONS: Positive health behavior reflected by the CDRI is associated with a lower risk of cancer and with greater longevity.

Adult↗
PubMedDate not supplied

Quality of life in chronic diseases of the aged: the importance of cognitive deterioration.

The interference of a chronic disease on the aging process reduces patients efficiency in confronting everyday life events and their Quality of Life (QOL). The purpose of this study was to examine the interaction between cognitive problems and emotional difficulties as related to several chronic diseases commonly present among aged patients in contributing to their QOL reduction. Diseases considered were: chronic cerebro-vascular disorders non-insulin dependent diabetes mellitus and hypertension. Memory characteristics and subjective evaluation of several areas of daily living where problems could be present were assessed. Severity of cognitive and behavioral deterioration emerged as a major component independent from type of disease, contributing to reduction of QOL. Disease type determined the different risk of presence of an objective reduction of memory efficiency. The QOL of aged patients was identified as a multidimensional array of different components among which cognitive deterioration assumes a primary role. These results, together with analogous findings from previous studies, underline the importance of considering cognitive efficiency in aged patients even with chronic diseases not directly affecting CNS in order to evaluate their needs.

Journal Article↗
PubMed1997

Patterns of health risk behaviors for chronic disease: a comparison between adolescent and adult American Indians living on or near reservations in Montana.

PURPOSE: To compare the chronic disease health risk behavior patterns of adolescents and adults among American Indians living on or near reservations in Montana. METHODS: We analyzed data from the 1993 Youth Risk Behavior Survey of American Indians in Grades 9-12 living on or near Montana reservations. Risk factors included tobacco use, low physical activity, attempted weight loss, and low consumption of fruits, vegetables, and green salad. Similar data were analyzed from a 1994 Behavioral Risk Factor Survey of American Indian adults living on or near reservations in Montana. RESULTS: The prevalence of most adolescent health risk behaviors was high, especially cigarette smoking (45% for males, 57% for females), smokeless tobacco use (44% for males, 30% for females), and infrequent consumption of salad or vegetables (59-76%). With the exception of daily cigarette smoking and inadequate fruit consumption among adolescents of both genders and physical inactivity among adolescent males, the prevalence of chronic disease health risk behaviors among adolescents was similar to or higher than the prevalence of the same risk behaviors among adults. CONCLUSIONS: Many health risk behaviors for chronic diseases are common by the time this group of American Indians in Montana has reached adolescence. Possible reasons may include modeling of familial behaviors, peer pressure, advertising, or age cohort effects. If these risk behavior patterns continue into adulthood, morbidity and mortality from chronic diseases are likely to remain high. Substantial efforts are needed to prevent or reduce health risk behaviors among adolescents and adults in this population.

Adolescent↗
PubMed2006

How do teens view the physical and social impact of asthma compared to other chronic diseases?

We surveyed cognitively normal teens with and without chronic illness regarding the perceived physical and social impact of various chronic diseases including asthma. The overall physical impact of asthma was perceived equivalently to diabetes and arthritis, but less than epilepsy, Down's syndrome, leukemia, and human immunodeficiency virus infection. However, asthma was rated to more commonly cause physical disability (p < 0.001) and restrict activities (p < 0.0005). The social impact of asthma was perceived equivalently to diabetes, but more favorably than the other chronic diseases surveyed. Specifically, teens with asthma were perceived as having fewer behavior problems, being more honest, popular, and fun to be around, but less adept at sports. Only 6 of 149 (4%) teens surveyed expressed any degree of reluctance to befriend peers with asthma.

Adolescent↗
PubMed2000

A decade of improvement in areas of chronic disease. Where do we go from here?

The last decade has seen significant progress in reduction of mortality rates from many chronic diseases on both a state and national level. Moreover, in general, Wisconsin has achieved levels below the United States for mortality. However, as suggested by Figures 1 and 2, preventive efforts in stroke and prostate cancer should become high priorities in this state. Additionally, it will be important to monitor the stabilization of death rates due to diabetes. Turning Point, anti-tobacco efforts by the Tobacco Control Board and the Thomas T. Melvin Program, and the upcoming Minority Health Report should reveal additional areas for DHFS and its statewide partners to address in the arena of chronic disease. Programs such as the Wisconsin Diabetes Control Program and the Wisconsin Well Woman Program will also continue to contribute significantly to other community and clinical efforts to control chronic diseases.

Cardiovascular Diseases↗
PubMed2002

Optimism and adaptation to chronic disease: The role of optimism in relation to self-care options of type 1 diabetes mellitus, rheumatoid arthritis and multiple sclerosis.

OBJECTIVES: To determine the role of optimistic beliefs in adaptation processes of three chronic diseases different in controllability by self-care. It was expected that optimism towards the future would relate to adaptation independently of the controllability of disease. Optimism regarding one's coping ability should be beneficial in controllable diseases. Unrealistic optimism was expected to be beneficial in uncontrollable disease. DESIGN: The cross-sectional design involved 104 patients with type 1 diabetes, 95 patients with rheumatoid arthritis and 98 patients with multiple sclerosis, recruited via their physician at the out-patient department of five hospitals. METHOD: Confirmatory Factor Analysis (LISREL) was employed to confirm a three-dimensional approach of optimism: outcome expectancies, efficacy expectancies and unrealistic thinking. Multi-sample analysis by path modelling was used to examine whether the relationship of the three optimistic beliefs with coping (CISS-21), depression and anxiety (HADS), and physical functioning (SF-36) differs with the controllability based on the self-care options of chronic disease. RESULTS: These show that when chronic disease must be controlled by self-care, physical health depends more strongly on positive efficacy expectancies. In contrast, when self-care options for controlling chronic disease are limited, physical health depends more strongly on positive unrealistic thinking and relates negatively to positive efficacy expectancies. The impact of the three optimistic beliefs on mental health is independent of the controllability by self-care. CONCLUSION: Optimistic beliefs are differently beneficial for physical health dependent on the controllability of chronic disease. Unrealistic beliefs are helpful when patients are confronted with moderately to largely uncontrollable disease where self-care options are limited, in contrast to positive efficacy expectancies that are helpful when patients deal with largely controllable disease where self-care is required.

Journal Article↗
PubMed2002

The impact of chronic disease on the family.

Haemophilia is a chronic disease, affecting patients and their families. The impact of such a disease upon each family is dependent upon family type and characteristics and adjustment to it varies with time, in concordance with the family's lifecycle. In the National Hemophilia Center in Israel we lead a special support system and conduct group therapy from the very early stage of haemophilia diagnosis throughout the lifetime of patients. The general definitions of a family's lifecycle, the effect of the disease and the required adjustment to it are described in this paper. We refer to special difficulties associated with haemophilia as a chronic, genetic disease and describe ways to cope, discussing the support systems that have been established in our centre.

Chronic Disease↗
PubMed1996

Chronic disease mortality in Maine: assessing the targets for prevention.

From 1982 through 1991, nine chronic diseases accounted for over 55 percent of deaths in Maine. Using the lowest age-specific death rates as theoretically achievable rates, there were over 8,000 excess deaths. Over 25,000 deaths could be attributed to preventable causes over the 10-year period. Cigarette smoking was the single largest contributor to chronic disease mortality, accounting for 17,688 deaths, followed by physical inactivity, high blood pressure, and diet. This assessment provides a measure of the size of the chronic disease prevention target in Maine and is a first step in assessing the potential impact of prevention programs.

Adolescent↗
PubMed2002

Vitamins for chronic disease prevention in adults: scientific review.

CONTEXT: Although vitamin deficiency is encountered infrequently in developed countries, inadequate intake of several vitamins is associated with chronic disease. OBJECTIVE: To review the clinically important vitamins with regard to their biological effects, food sources, deficiency syndromes, potential for toxicity, and relationship to chronic disease. DATA SOURCES AND STUDY SELECTION: We searched MEDLINE for English-language articles about vitamins in relation to chronic diseases and their references published from 1966 through January 11, 2002. DATA EXTRACTION: We reviewed articles jointly for the most clinically important information, emphasizing randomized trials where available. DATA SYNTHESIS: Our review of 9 vitamins showed that elderly people, vegans, alcohol-dependent individuals, and patients with malabsorption are at higher risk of inadequate intake or absorption of several vitamins. Excessive doses of vitamin A during early pregnancy and fat-soluble vitamins taken anytime may result in adverse outcomes. Inadequate folate status is associated with neural tube defect and some cancers. Folate and vitamins B(6) and B(12) are required for homocysteine metabolism and are associated with coronary heart disease risk. Vitamin E and lycopene may decrease the risk of prostate cancer. Vitamin D is associated with decreased occurrence of fractures when taken with calcium. CONCLUSIONS: Some groups of patients are at higher risk for vitamin deficiency and suboptimal vitamin status. Many physicians may be unaware of common food sources of vitamins or unsure which vitamins they should recommend for their patients. Vitamin excess is possible with supplementation, particularly for fat-soluble vitamins. Inadequate intake of several vitamins has been linked to chronic diseases, including coronary heart disease, cancer, and osteoporosis

Ascorbic Acid↗