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PubMed1987

[Comparative characteristics of adenosine triphosphatase activity in the erythrocytes of patients with acute and chronic liver diseases, chronic cholecystitis and in HBs antigen carriers].

A decrease in sodium, potassium and anion (HCO3)-activated erythrocyte ATPases is noted in patients with acute viral hepatitides A and B, chronic persisting hepatitis, liver cirrhosis, chronic cholecystitis and in HBs-antigen carriers, the reduction of HCO8-ATPase being more noticeable. A degree of expression of the above changes depends on the severity of a pathological process in the liver. The most serious changes are noted in liver cirrhosis. In this disease calcium ATPase activity is also on a decrease. Erythrocyte ATPase activity is lowered in chronic cholecystitis to a lesser degree. In patients with chronic persisting hepatitis and liver cirrhosis erythrocyte ATPase activity slightly increases, however it remains significantly lowered as compared to the control level. The determination of erythrocyte ATPase activity can be used for assessment of the status of patients with acute and chronic liver diseases.

Adenosine Triphosphatases↗
PubMed2005

Kidney and kidney related chronic diseases in South Africa and chronic disease intervention program experiences.

The burden of chronic kidney disease (CKD) is rising in the world and the greatest burden is likely in developing countries such as South Africa (SA). This burden is related to the increase of 130% in noncommunicable diseases (NCD) such as diabetes and hypertension. SA has an additional burden of human immunodeficiency virus (HIV), which has infected 19.9% of adults and contributes to 30% of deaths. NCDs remain the major causes of death (37%). Hypertension is considered as a cause of end-stage renal disease (ESRD) in 34.6% of Blacks, 4.3% Whites, 20.9% of mixed race people, and 13.9% of Indians. Diabetes is believed to occur in 10% to 16% of South Africans. These risk factors, together with a high HIV/CKD burden (8%), result in a large burden of CKD. Other nontraditional risk factors, such as low birth weight, must also be considered. Despite rates of ESRD suspected to be about 400 per million population (pmp), only 99 pmp receive renal replacement therapy (RRT). Novel methods have to be established in the developing world to tackle the NCD and communicable disease burden. This article investigates the option of an integrated approach to chronic diseases as an answer to some of this burden. Both an urban-based and a rural-based NCD prevention and treatment program are reviewed.

Humans↗
PubMed2004

Indicators for chronic disease surveillance.

Chronic diseases account for seven of the 10 leading causes of death in the United States, including the three leading causes of preventable death (tobacco use, improper diet and physical inactivity, and alcohol use). Seventy percent of health-care costs in the United States are for chronic diseases. In 1999, to allow public health officials to uniformly define, collect, and report chronic disease data, the Council of State and Territorial Epidemiologists released Indicators for Chronic Disease Surveillance. The report provided standard definitions for 73 indicators developed by epidemiologists and chronic disease program directors at the state and federal level. The indicators were selected because of their importance to public health and the availability of state-level data. This report describes the latest revisions to the chronic disease indicators. The revised set of 92 indicators includes 63 indicators that were unchanged from the first edition, six that have been revised, and 23 that are new. Four indicators from the first edition were deleted. Of the indicators, 24 are for cancer; 15 for cardiovascular disease; 11 for diabetes; seven for alcohol; five each for nutrition and tobacco; three each for oral health, physical activity, and renal disease; and two each for asthma, osteoporosis, and immunizations. The remaining 10 indicators cover such overarching conditions as poverty, education, life expectancy, and health insurance. Additional information regarding the indicators for chronic disease surveillance is available at http://www.cdc.gov/nccdphp/cdi.

Alcohol Drinking↗
PubMed2006

A comparison of symptom prevalence in far advanced cancer, AIDS, heart disease, chronic obstructive pulmonary disease and renal disease.

Little attention has been paid to the symptom management needs of patients with life-threatening diseases other than cancer. In this study, we aimed to determine to what extent patients with progressive chronic diseases have similar symptom profiles. A systematic search of medical databases (MEDLINE, EMBASE, and PsycINFO) and textbooks identified 64 original studies reporting the prevalence of 11 common symptoms among end-stage patients with cancer, acquired immunodeficiency syndrome (AIDS), heart disease, chronic obstructive pulmonary disease, or renal disease. Analyzing the data in a comparative table (a grid), we found that the prevalence of the 11 symptoms was often widely but homogeneously spread across the five diseases. Three symptoms-pain, breathlessness, and fatigue-were found among more than 50% of patients, for all five diseases. There appears to be a common pathway toward death for malignant and nonmalignant diseases. The designs of symptom prevalence studies need to be improved because of methodological disparities in symptom assessment and designs.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Tumor necrosis factor alpha and the anemia of chronic disease: effects of chronic exposure to TNF on erythropoiesis in vivo.

The anemia of chronic disease is associated with conditions in which macrophage activation occurs. Activated marrow macrophages suppress erythropoiesis in vitro, and produce tumor necrosis factor (TNF). Therefore, we tested the effects of chronic in vivo exposure to TNF to determine if it were a candidate for a mediator of the anemia of chronic disease. Nude mice were inoculated with CHO cells expressing the human TNF gene, or with control cells containing the transfection vector alone. The TNF mice promptly became reticulocytopenic, and after 3 weeks their corrected reticulocytes were 2.6 +/- .7% compared to 7.3 +/- 4% in control mice. The hematocrit at 3 weeks was 28.4 +/- 1.7% in TNF mice compared to 46 +/- 8% in control mice. This anemia was also associated with low serum iron and normal iron stores and increased erythropoietin levels. The TNF mice showed an absolute monocytosis with twice the number of circulating monocytes as control mice. The TNF mice also became mildly thrombocytopenic. Marrow CFU-E and BFU-E were profoundly decreased (1.2 +/- 2 x 10(3) vs 8.6 +/- 2 x 10(4) CFU-E per femur, and 6.5 +/- 1 x 10(2) vs 8.5 +/- .2 x 10(4) BFU-E per femur). Splenic CFU-E and BFU-E were similarly depressed. In contrast, marrow CFU-GM and CFU-GEMM were not affected. Administration of recombinant human erythropoietin to these mice failed to reverse the suppressed erythropoiesis in mice bearing TNF producing tumors. These data demonstrated that TNF preferentially inhibits erythropoiesis in vivo, and may be important in the pathogenesis of the anemia of chronic disease.

Anemia↗
PubMed2001

Developing socio-spatial knowledge networks: a qualitative methodology for chronic disease prevention.

Chronic disease is a significant and costly social problem. The burden is even more pronounced in communities with high rates of a particular chronic disease. Assessment of health belief systems and the local geographies of health beliefs can assist community health planners to create cost-effective strategic intervention programs where populations are at high risk for chronic diseases. In this paper, we elaborate the concept of socio-spatial knowledge networks (SSKNs) and demonstrate that SSKNs can be useful in informing the design of health care prevention strategies. In our project, we demonstrate how to identify key socio-spatial information for intervention strategies which will prevent or delay the onset of a particular chronic disease, Type 2 diabetes. Our qualitative framework allows us to determine which sites might be best characterized as socio-spatial knowledge network nodes for sharing diabetes information and which sites might be less suited to such exchange. Our strategy explores cross-cultural similarities, differences, and overlap in a multi-ethnic rural North Carolina context through simple techniques such as mapping social networks and sites in which people share their knowledge and beliefs about diabetes. This geographical analysis allows us to examine exactly where health knowledge coincides with other social support, and where such resources may be improved in a particular community. Knowing precisely what people in a community understand about a chronic disease and its treatment or prevention and knowing where people go to share that information helps to (1) identify strategic locations within a community for future interventions and, (2) evaluate the effectiveness of existing interventions. The geographical approach presented here is one that can serve other communities and health practitioners who hope to improve chronic disease management in diverse local environments.

Aged↗
PubMed1995

Personality change in Parkinson's disease patients: chronic disease and aging.

Parkinson's disease patients (N = 41, mean age = 65 years) were described by themselves and their spouses as they were presently and before their illness using the Adjective Check List. Equivalent self- and spouse descriptions were obtained from the members of a matched community sample (N = 96). Descriptions of patients and their spouses converged, both reporting sharp, pervasive (e.g., on all of the Big Five dimensions), and uniformly negative change in personality. Similar, but much less marked change was found in the community sample. The data as a set suggest that the reported changes in the patients were veridical and that their magnitude was primarily the result of the disease rather than aging. Evidence of continuities in personality (for example, differential stability) was also noted. We argued that the illness accelerated and intensified changes normally expected in later life.

Activities of Daily Living↗
PubMedDate not supplied

[Frequency and structure of chronic diseases of ear, throat and nose among population and their dynamics].

Medical examinations of children and adults have shown that ENT diseases amount to 230 and 190 per 1000, respectively. In terms of types of ENT diseases, chronic tonsilitis (38.4%) and adenoids (23.3%) are most prevalent among children and neurosensory hypoacusis (31.1%) and chronic pharyngitis (19.3%)--among the adult population. Trends in the prevalence and types of chronic ENT diseases have been identified.

Adult↗
PubMed2003

[Malnutrition in chronic diseases].

During chronic diseases, malnutrition is found in approximately 40% of patients. Malnutrition is correlated with complication rates, handicap, need for care as well as mortality. Malnutrition can be related to two mechanisms: insufficient feeding and abnormal nutrient absorption or metabolism. Nutritional assessment of patients with chronic diseases should be helpful for the early detection and management of malnutrition. Nutritional supplementation was shown to improve both nutritional status and survival in selected conditions. Future therapies of malnutrition in chronic diseases rely to the selection of patients susceptible to respond to a new therapeutic approach which, depending on primary disease, may associate nutritional supplementation to rehabilitation and, in some conditions, anabolizing hormones.

Chronic Disease↗
PubMed2002

Is there scientific evidence that suppression of acute diseases in childhood induce chronic diseases in the future?

Seeking to understand the individual in his symptomatic totality has been an aim of homeopathy since its beginning. Throughout its history, homeopaths have been concerned that inadequate treatment of acute diseases in childhood may lead to future chronic diseases. Hahnemann cautioned that by treating acute diseases with allopathic medicine, with strong doses of drugs, or suppressing local symptoms of those diseases, would increase the risk of future chronic diseases. Burnett proposed the theory of vaccinosis and warned of chronic manifestations subsequent to smallpox vaccination. French homeopaths, seeking the physiopathological origin of chronic diseases, correlated it to the abnormal reaction of the reticuloendothelial system (RES). Through the study of experimental pathology, Maffei attributed symptomatic manifestations to the imbalance between the immunological phenomena of allergy and immunity. He termed the sensitizing and pathogenic effects of medications and vaccines, 'metallergy' and 'parallergy', respectively. The hygiene hypothesis is based on evidence that the imbalance of immunological response in childhood, specifically among the Th1 and Th2 lymphocyte subpopulations, is responsible for the development of some allergic and chronic diseases in the future. The deranging factor for the predisposition to future allergic response (Th2) is the obstruction of natural manifestations of infectious diseases (Th1 response) in young children. Homeopathic treatment aims to equilibrate vital reaction, corresponding to an integrative physiological response, it may regulate Th1/Th2 imbalance. However, clinical trials to support this hypothesis are lacking.

Acute Disease↗
PubMed2001

The future of chronic diseases.

Major chronic diseases continue to be the main health scourge of the most developed countries, have only recently been retreating in frequency in the fledgling market economies, and are becoming dominant in many populous areas of the developing world. The descriptive evidence from the developments of the near past strongly suggests that much of the control outcomes have already been achieved with the existent imperfect causative knowledge. The continuation of desirable trends in major chronic diseases in some places like Central & Eastern Europe, is uncertain within the intermediate time range without gaining more etiological clues, among which the role of medical care is worthy of reconsideration. Other factors can grow in importance, like obesity, which may be freed from the suppressive influence of cigarette smoking to trigger major mass pathologies, like type 2 diabetes mellitus, arterial hypertension, some cancers etc. The role of social underpriviledge seems recalcitrant, although the part played by social share of biological risk agents may diminish in response to educational persuasion. The remotest destinies of some chronic diseases may depend on the mixture of external and genetic influences ending as predispositions towards some ailments, antecedents of which might have protected their carriers from dangers of the past unfriendly environment, like obesity (or diabetes) against famine, or hypertension against inefficient defense reaction. The resulting medium-range prediction of well-being for inhabitants of more developed world may not be forbidding, since increasing life expectancy needs not be synonymous with disability, and attaining old age does not require excessive sacrifice, beyond reducing number smoked, or preserving decent respiratory volumes.

Chronic Disease↗
PubMed2000

Quality of care of children with chronic diseases in Alexandria, Egypt: the models of asthma, type I diabetes, epilepsy, and rheumatic heart disease. Egyptian-Italian Collaborative Group on Pediatric Chronic Diseases.

OBJECTIVES: To evaluate the quality of care delivered to children suffering from index chronic diseases using specific indicators of health care delivery and to study the predictors of suboptimal quality of care (SQC) and its outcome on children. DESIGN: Over a 9-month period, guidelines for optimal care were formulated. A specific questionnaire for every studied chronic disease was prepared in collaboration with the clinicians in charge of the diseased children (66% pediatricians and pediatric specialists and 34% adult specialists). The clinicians were asked to write the details of daily practice, ie, how these children were managed on a routine basis as well as in an emergency situation. A cross-sectional study was conducted over a 4-month period and included 953 children suffering from bronchial asthma (BA), childhood epilepsy (CE), type I diabetes mellitus (IDDM), and rheumatic heart disease (RHD). A systematic random sample of children was selected from children visiting the ambulatory settings of all children's hospitals. Every fourth child was selected on 2 randomly chosen days each week, while all diseased children admitted in the hospital settings of the children's hospitals during the study were included. A general form describing the impact of the diseases on the child was prepared. A network of clinicians was created in all children's hospitals; seminars were held during which the content validity of the questionnaire was tested. Items were evaluated for their internal consistency using the Cronbach alpha. According to the degree of adherence to the recent therapeutic guidelines concerning selected indicators of the quality of care specific to every disease, children were categorized as receiving optimal quality of care or SQC. These indicators were: the use of inhaled bronchodilators in acute asthmatic attacks in mild asthma and the use of the prophylactic drugs (inhaled sodium cromoglycate or inhaled beclomethasone) in moderate to severe chronic BA in between acute asthmatic attacks; compliance with antiepileptic drugs in epileptic children; regular performance of self-monitoring of blood glucose and/or urine testing in diabetic children; and compliance with prophylactic antibiotics in children suffering from RHD. The records of the outpatient clinics for ambulatory and hospitalized cases were reviewed to assess the degree of compliance with the prescribed management before the index visit. Sociodemographic characteristics and health care system-related predictors of SQC were analyzed via stepwise logistic regression analysis. The impact of illness on the child was assessed by 7 items which were: dependence on parents in domestic activities, level of activity compared with peers, mood compared with peers, level of socializing, degree of discomfort attributable to illness, level of physical disadvantage, and urinary incontinence. Factor analysis with Varimax rotation was performed on items related to the impact of illness. Parental satisfaction with care was rated as excellent, very good, fair, or poor. Information on school outcome was obtained by asking the caretakers whether the child was able to attend school regularly despite his sickness. Scholastic achievement was also rated as excellent, very good, good, and acceptable. Parents were asked whether the child had ever repeated a grade because of his sickness. SETTING: Ambulatory and hospital settings of all children's hospitals in Alexandria, Egypt. RESULTS: Only 52% of mild asthmatics were given inhaled bronchodilators during acute attacks and 6.84% of moderate to severe asthmatics were taking prophylactic drugs (inhaled sodium cromoglycate and/or inhaled beclomethasone) between acute attacks. Similarly, only 53 of 134 (39.6%) of diabetic children were regularly performing self-monitoring of blood glucose and/or urine testing. In contrast, in epileptic children, 121 of 173 (69.9%) were judged as being compliant by their managing clinicians and more than two

Adolescent↗
PubMed1994

Eicosanoids and essential fatty acid modulation in chronic disease and the chronic fatigue syndrome.

Abnormalities of Essential Fatty Acid (EFA) incorporation into phospholipid are found in chronic diseases. More recently changes in circulating EFA metabolites (EFAM) together with EFAM hypo-responsiveness of immune cells and EFAM production from cells have been found associated with disease. We hypothesize that changes in ratio of EFAMs are the normal physiological responses to stressors, but when stressors are excessive or prolonged, EFAM systems may become unpredictably hypo-responsive owing to factors such as receptor down regulation and substrate depletion. In time, many homeostatic system become deranged and held in that state by minor stressors. Literature review of chronic fatigue syndrome (CFS) shows hyper and hypo-responsiveness in immune function, several Hypothalamo-Pituitary (HP) axes and sympathetic nervous system, all relatable to dysfunctional changes in EFA metabolism. For the first time, we explain chronic immune system activation and hypo-responsive immune function in CFS; through EFAMs. Dietary EFA modulation (DEFA) can alter ratios of both membrane EFAs and produced EFAMs, and if maintained can restore hypo-responsive function. We discuss dietary strategies and relevance in CFS, and a case series of CFS patients applying DEFA with other titrated published managements which saw 90% gaining improvement within 3 months and more than 2/3 fit for full time duties. This hypothesis and DEFA may have relevance in other chronic conditions.

Chronic Disease↗