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PubMed2005

How to guide patients for online information: focus on chronic disease.

The purpose of this study was to evaluate the accessibility and utility of a common Internet search strategy so physicians might provide this guidance to their patients seeking health information on chronic disease. We selected three common chronic diseases: diabetes, hypertension, and osteoarthritis. We then formulated basic questions from a patient perspective about diagnosis, treatment, and prognosis. A non-medical professional attempted to answer these questions by typing the disease name into the Google search engine. Focusing on the first ten web sites on the Google list was a successful strategy for finding sites that could answer the study questions (average of 61% of the time). The average number of clicks required to answer any question was 1.6. Web sites sponsored by government agencies (89% success) and hospitals (100% success) yielded answers to the questions more often than other sites. In conclusion, despite the multitude of web sites that appear when the name of a chronic disease is entered into a search engine, the top ten results are usually adequate to provide relevant information on common clinical questions to the average patient. Physicians can guide patients to relevant information by instructing them to type the name of the disease itself into a search engine and focusing on government and hospital-sponsored Web sites.

Chronic Disease↗
PubMedDate not supplied

Seroprevalence of HTLV-1 in chronic disease patients in Jamaica.

A high seropositivity rate of human T cell lymphotropic virus type 1 (HTLV-1) infection was found in Jamaican patients with chronic diseases. However, except for tropical spastic paraparesis, polymyositis, adult T cell leukaemia/lymphoma and polyneuropathies of undetermined cause, HTLV-1 seropositivity rates in chronic disease patients were not significantly different from that found in healthy Jamaicans. These results indicate that there is no increased risk of HTLV-1 infection or HTLV-1 associated disease in patients with chronic diseases compared to the general Jamaican population. The association of unclassified polyneuropathies with HTLV-1 reported herein is a novel one which requires further studies to elucidate its nature.

Adult↗
PubMed2003

Active versus passive anti-cytokine antibody therapy against cytokine-associated chronic diseases.

Current therapeutic vaccine trials in major chronic diseases including AIDS, cancer, allergy and autoimmunity, target antigenic pathogens but not the pathogenic stromal cytokines which can be major sources of histopathologic processes. Considering that the limited efficacy of these vaccines has been ascribed to local pathogen-induced cytokine dysfunction, we propose to antagonize pathogenic cytokine(s) by high affinity neutralizing auto-Abs triggered by specific anti-cytokine vaccines. As anticipated by theoretical considerations, animal experiments and initial clinical trials showed that anti-cytokine immunization was safe, well tolerated and triggered transient high titers Abs neutralizing pathogenic cytokines but, in contrast to conventional vaccines, no relevant cellular response was observed. Advantages of active versus passive anti-cytokine Ab therapy, particularly for long-term treatments, as those required in AIDS, cancer, allergy and autoimmunity include greater ease of maintaining high Ab titers, lack of anti-antibody responses and low cost.

Acquired Immunodeficiency Syndrome↗
PubMed2003

Long-standing and limiting long-standing illness in older people: associations with chronic diseases, psychosocial and environmental factors.

OBJECTIVE: to examine the associations between domains of chronic diseases, social, psychological and environmental factors and long-standing and limiting long-standing illness among older people. DESIGN: cross sectional survey. SETTING: national sample living in private households. SUBJECTS: 999 adults aged 65 years and over, mean age 73.2 years. MAIN OUTCOME MEASURES: self-reports of long-standing illness and limiting long-standing illness. RESULTS: the prevalence of long-standing illness was 61.8% (95% CI 58.8, 64.9) and that for limiting long-standing illness was 40.0 (95% CI 38.0, 43.0). Strong associations between long-standing illness and circulatory disease, odds ratio: 2.23 (95% CI 1.63, 3.05) and musculoskeletal disorders, odds ratio: 3.21 (95% CI 2.35, 4.39) were found. In addition associations with other domains were observed. For example, feelings of vulnerability, odds ratio: 1.79 (95% CI, 1.28, 2.51) from the psychological domain and, having close relatives living close by, odds ratio: 1.52 (95% CI 1.11, 2.09) from the social domain. CONCLUSION: the importance of considering a wide range of domains of human experience in the causation of limitations in society is emphasised. The currently dominant disease oriented view is insufficient to explain people's reported long-standing illness and limiting long-standing illness.

Activities of Daily Living↗