PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “CHRONIC DISEASE”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 235 records · Page 13Linked to original sources
PubMed1990

Depression, self-esteem, and life events in adolescents with chronic diseases.

This study assesses whether nonhospitalized adolescents with chronic diseases differ from their healthy peers on standardized measurements of depression, self-esteem, and life events. The study group consisted of 80 patients (20 with sickle cell disease, 40 with asthma, and 20 with diabetes). All patients had been admitted at least twice in the preceding year, had their disease for at least 2 years, and were between the ages of 12 and 18. The control group consisted of 100 adolescents, matched for age and socioeconomic status, from local schools. All subjects completed a questionnaire compiled from the Beck Depression Inventory (BDI), the Rosenberg Scale of Self-Esteem, and the McCutcheon Life Events Checklist. Adolescents with chronic disease had higher depression scores (p less than 0.001) and lower self-esteem (p less than 0.001) than their healthy age-matched controls. There was no statistically significant difference in life events between the chronic disease and control groups. Depression, self-esteem, and life events did not differ significantly among the three disease groups. These findings suggest a need for intervention strategies to address depression and low self-esteem in adolescents with chronic disease.

Adolescent↗
PubMed2005

Shortchanged? An assessment of chronic disease programming in major US city health departments.

A self-administered survey was distributed to members of The Big Cities Health Coalition, a group of Health Officers/Commissioners from 17 of the largest US metropolitan health departments. The survey asked participants about their chronic disease priorities, data sources, budgets, and funding sources as well as examples of successful chronic disease interventions. Members of the Coalition discussed the survey results in a scheduled conference call. Chronic diseases account for 70% of all deaths nationwide on average, yet the health departments surveyed allocated an average of 1.85% of their budgets to chronic disease. Average chronic disease spending per inhabitant was 2.33 dollars, with a median of 1.56 dollars. Among the group's top chronic disease priorities were asthma, diabetes, tobacco, cancer, and cardiovascular disease (CVD). Nearly half of the group's chronic disease spending was on tobacco. Chronic disease funding sources varied across localities, but direct federal funding was minimal. In 14 cities serving a combined 37 million people (13% of the US population), direct federal chronic disease funding totaled 8.7 million dollars, an average of 0.24 dollars per capita. The group described successful chronic disease interventions, particularly related to tobacco and asthma.

Budgets↗
PubMed1996

Prevention of Alzheimer disease: a perspective based on successes in the prevention of other chronic diseases.

Alzheimer disease, like other common chronic diseases, likely has genetic and environmental risk factors. Prevention of arteriosclerotic vascular disease has occurred based on efforts to reduce risk factors demonstrated in epidemiologic and more basic science research. At present, there are no known risk factors for Alzheimer disease which could form the basis of a preventive strategy. To make progress in the prevention of Alzheimer disease, new findings from epidemiology and basic science will be needed. The current state of the art of epidemiologic studies of dementia is well enough developed to test credible hypotheses. The availability of reliable biomarkers along with cooperative efforts between molecular biologists and clinical epidemiologists should allow us to pursue promising fields in clinical research.

Alzheimer Disease↗
PubMed1992

Use made by patients of chronic disease surveillance consultations in general practice.

A prospective, observational study of chronic disease surveillance consultations over a six-month period was performed in one semi-rural general practice in order to determine the content of the consultations, including incidental items not relevant to the chronic disease. At least one incidental item was recorded during 43% of consultations. There was substantial clinical content in these items: 23% of items required a prescription to be issued and 7% referral to a specialist. It is concluded that chronic disease surveillance consultations in general practice are frequently extended by patients who are anxious to discuss issues which may not be relevant to their chronic diseases. General practitioners must be sensitive to such patient expectations when they instigate chronic disease management clinics.

Adolescent↗
PubMed2006

Emerging infectious determinants of chronic diseases.

Evidence now confirms that noncommunicable chronic diseases can stem from infectious agents. Furthermore, at least 13 of 39 recently described infectious agents induce chronic syndromes. Identifying the relationships can affect health across populations, creating opportunities to reduce the impact of chronic disease by preventing or treating infection. As the concept is progressively accepted, advances in laboratory technology and epidemiology facilitate the detection of noncultivable, novel, and even recognized microbial origins. A spectrum of diverse pathogens and chronic syndromes emerges, with a range of pathways from exposure to chronic illness or disability. Complex systems of changing human behavioral traits superimposed on human, microbial, and environmental factors often determine risk for exposure and chronic outcome. Yet the strength of causal evidence varies widely, and detecting a microbe does not prove causality. Nevertheless, infectious agents likely determine more cancers, immune-mediated syndromes, neurodevelopmental disorders, and other chronic conditions than currently appreciated.

Bacterial Infections↗
PubMed2002

Glucose metabolism in chronic lung disease.

Chronic disease in general induces insulin resistance on glucose metabolism on hepatic and peripheral levels. Hypoxia in healthy subjects, induced by chronic altitude exposure, stimulates glucose production with decreased hepatic insulin sensitivity, but increases peripheral insulin sensitivity. Chronic obstructive lung disease (COPD) is a chronic inflammatory disease characterised by chronic or intermittent hypoxia. Therefore theoretically, COPD can be a chronic disease with unique features in peripheral insulin sensitivity. In this literature review the available data on glucose metabolism in COPD and cystic fibrosis are discussed in relation to this potential unique feature of increased peripheral insulin sensitivity despite the existence of chronic disease. The scarce data do not refute this possibility, but better studies aimed at exploring the influence of the degree of hypoxia on peripheral insulin sensitivity in chronic lung disease are necessary to unravel the role of oxygen in the regulation of peripheral glucose metabolism.

Cystic Fibrosis↗
PubMedDate not supplied

The prevention and control of chronic diseases: reducing unnecessary deaths and disability--a conference report.

Effective, yet underused, preventive measures exist to ameliorate such important public health problems as hypertension, coronary artery disease, and cervical cancer. The First National Conference on Chronic Disease Prevention and Control was convened in September 1986 by the Association of State and Territorial Health Officials and the Centers for Disease Control, Public Health Service, to disseminate information on successful chronic disease programs currently being implemented and to identify barriers to more wide-spread application of state-of-the-art prevention technology. This report briefly summarizes the deliberations of conference working groups (composed primarily of State and Federal public health officials) that addressed these issues. Numerous suggestions for improved surveillance, applied research, and training related to chronic disease prevention and control were offered, as well as ideas on organizing and marketing chronic disease intervention programs. The conference clearly identified a pressing need for a coalition of public health agencies and interested professional and voluntary organizations, as well as a coherent national agenda to combat chronic diseases.

Chronic Disease↗
PubMed2006

Impact of chronic disease on quality of life in the Bella Coola Valley.

INTRODUCTION: North American rural residents have higher rates of chronic disease and they report being ill more frequently compared to their urban counterparts. We recently studied health-related quality in residents living in the isolated, rural community of Bella Coola, Canada. OBJECTIVE: To assess health-related quality of life parameters in adults suffering from chronic disease and living in the rural, remote community of Bella Coola. METHODS: Design, mixed methods: (1) mailed health-related survey; (2) retrospective chart review. STUDY POPULATION: people aged 17 years and older living in the Bella Coola Valley and having a chart at the Bella Coola Medical Clinic as of September 2001 were asked to complete a detailed health-related quality of life survey during the period August to December 2001. MAIN OUTCOME MEASURES: demographics (age, sex, weight [BMI], ethnicity). Health-related quality of life was measured using the MOS 36-item Short Form Health Survey (SF-36), and the US Centers for Disease Control healthy day's items. Chronic diseases studied included diabetes mellitus, hypertension, chronic obstructive lung disease, coronary artery disease, hyperlipidemia, depression/anxiety, cancer, osteoarthritis, inflammatory arthritis and chronic back/neck pain. RESULTS: Response rate to the survey was 38% (675/1770). Compared to total clinic population relatively more female (57% vs 49%), non-Aboriginal (63% vs 57%) and older people (48.9 vs 43.5 years) answered the survey. The most prevalent chronic diseases among the survey respondents were hypertension (17%), depression/anxiety (13%), hyperlipidemia (11%), chronic back/neck pain (11%), and osteoarthritis (9%). Linear regression analysis was performed for each of the SF-36 domains and CDC healthy day items. The presence of chronic disease is associated with significant differences in HRQOL item scores and the greater the number chronic diseases present the worse the HRQOL item scores. CONCLUSION: People living in the rural remote community of Bella Coola who have chronic disease experience significant impairment in their health-related quality of life. The greater the number of coexisting chronic diseases a person has, the more likely that poor HRQOL scores will be reported.

Adolescent↗
PubMed2003

Nonadherence to breast and cervical cancer screening: what are the linkages to chronic disease risk?

BACKGROUND: Several preventive practices that reduce chronic disease risk have been associated with breast and cervical cancer screening, including maintenance of normal weight and avoidance of cigarette smoking. A history of certain chronic illnesses such as diabetes and cardiovascular disease has also been related to cancer screening. Nevertheless, studies that have attempted to identify women who are less likely to have had a recent breast or cervical cancer screening test have infrequently examined the associations of breast and cervical cancer screening with multiple health factors that influence chronic disease risk. METHODS: To clarify relationships between cancer screening and health behaviors and other factors that influence chronic disease risk, we examined the self-reported breast and cervical cancer screening practices of women in the United States by using data from the 1999 Behavioral Risk Factor Surveillance System. The women were described according to their recent use of mammography and the Papanicolaou test, physician visits within the past year, health insurance coverage, and preventive practices that reduce chronic disease risk. RESULTS: Overall, 74.5% (95% CI, 73.9%-75.1%) of the women in this sample aged 40 years or older (n = 56,528) had received a mammogram within the past 2 years. The percentage of women who had been screened for breast cancer, however, varied widely by factors associated with reducing the risk of chronic disease (e.g., cholesterol check in the past 2 years, blood pressure check in the past 2 years, normal weight, avoidance of cigarette smoking) and having access to health care (e.g., health insurance coverage, recent physician visit). Similarly, 84.4% (95% CI, 83.9%-84.9%) of all women aged 18 years or older who had not undergone a hysterectomy (n = 69,113) had received a Papanicolaou test in the past 3 years, and factors associated with reduced chronic disease risk and health care access were related to having had a recent Papanicolaou test. CONCLUSION: The results of this study suggest that underscreened women who are at risk for breast and cervical cancer are likely to benefit from programs that identify and address coexisting prevention needs. The identification of coexisting prevention needs might assist in developing interventions that address multiple risks for chronic disease among women and might subsequently help improve the efficiency and effectiveness of prevention programs.

Adolescent↗
PubMed1994

The etiology of the anemia of chronic disease and infection.

Anemia of infection and chronic disease has traditionally been considered a disorder associated with infections/inflammation. We instead propose that the anemia of infection and chronic disease confers protection from pathogen or neoplastic invasion. There is substantial microbiological and medical research that indicates that the anemia of infection and chronic disease may be a non-specific immunological defense. We suggest it is analogous to fever, which was also originally considered to be a disorder in need of treatment but which is now seen as a positive response of the host to microbial invasion. We suggest that these two non-specific defenses against microorganism proliferation may have evolved together as complementary strategies the body employs to ward off disease.

Anemia↗
PubMed2000

Oral protein calorie supplementation for children with chronic disease.

BACKGROUND: Growth failure and poor nutritional status are common features in children with chronic diseases due to reduced appetite, malabsorption and increased nutritional requirements associated with some diseases. The provision of oral protein calorie supplements is one of a number of interventions used to improve nutritional status in these children. The use of these products, which are expensive, may be associated with a number of adverse effects, for example, they may effect development of normal eating behaviour patterns or lead to unpleasant symptoms such as vomiting and diarrhoea. OBJECTIVES: To examine the evidence that in children with chronic disease, oral protein calorie supplements alter daily nutrient intake, nutritional indices, survival and quality of life and are associated with adverse effects, for example diarrhoea, vomiting, reduced appetite, glucose intolerance, bloating and eating behaviour problems. SEARCH STRATEGY: All publications describing RCTs of the use of oral protein calorie supplements in children with chronic diseases were identified through comprehensive electronic database searches, handsearching relevant journals and handsearching abstract books of conference proceedings. The companies which market oral protein calorie supplements were also contacted. SELECTION CRITERIA: All randomised or quasi-randomised controlled trials comparing use of oral protein calorie supplements for at least one month to increase calorie intake with existing conventional therapy, which may include nutritional advice on how to improve nutritional intake from food or no specific intervention, in children with chronic disease. DATA COLLECTION AND ANALYSIS: The following outcomes were assessed: indices of nutrition and growth, anthropometric measures of body composition, calorie and nutrient intake (total, from oral protein calorie supplements and from food), eating behaviour, compliance, quality of life, specific adverse effects and disease severity scores, and mortality. MAIN RESULTS: Three trials have been identified as being suitable for inclusion in the review and we are awaiting further data from one of these trials. All of these trials were carried out in children with cystic fibrosis. Few statistical differences could be found between the treatment and control groups apart from change in total fat intake at three months (weighted mean difference 69.20 [95% CI 11.05, 127.35]). However, this was based on the results of only one, small study. No trials have been identified which assess the effectiveness of oral protein calorie supplements in children with other chronic diseases. REVIEWER'S CONCLUSIONS: Oral protein calorie supplements are widely used to improve the nutritional status of children with a number of chronic diseases. We have only been able to identify a small number of trials assessing these products in children with cystic fibrosis and have been unable to draw any conclusions based on the limited data extracted from these. We therefore recommend that a series of large, randomised controlled trials are undertaken investigating the use of these products in children with different chronic diseases. Until further data are available, we would suggest that these products are only used with caution.

Adolescent↗
PubMed1988

Chronic problems in addressing chronic diseases.

Because of the elimination of many infectious diseases with vaccines, chronic illnesses account for six of the top ten causes of death. The list of chronic diseases is lengthy, some affecting only a very small percentage of the population. Funding for treatment and prevention is limited, and state and federal programs can only target resources where treatment will benefit the most people.

Chronic Disease↗
PubMed2002

Chronic disease score as a predictor of hospitalization.

BACKGROUND: The Chronic Disease Score is a risk-adjustment metric based on age, gender, and history of dispensed drugs. We compared four versions of the score for their ability to predict hospitalization among members of eight health maintenance organizations nationwide. METHODS: The study included 29,247 women age 45 years and older. Logistic regression models were constructed using rank quintile and rank decile indicators for each of four scores as predictors of hospitalization during the year after 1 October 1995. Discrimination and model fit were compared using several model properties including the C statistic and the odds ratio comparing highest with lowest quantiles. RESULTS: All Chronic Disease Score versions performed similarly, with the version that predicts total healthcare cost, proposed by Clark et al. (Med Care 1995;33:783-795), performing somewhat better than the other three. The overall risk of hospitalization was 12%. Individuals with higher quantile ranks had a higher risk of hospitalization. Among the Chronic Disease Score versions, the risk of hospitalization ranged from 4% for the lowest decile to 27-29% for the highest decile. Odds ratios comparing the highest with the lowest deciles ranged from 8.9 to 10.2. CONCLUSIONS: The Chronic Disease Score predicts hospitalization and therefore may be a useful indicator of baseline comorbidity for control of confounding.

Age Factors↗
PubMed1993

Comorbidity of chronic diseases in general practice.

With the increasing number of elderly people in The Netherlands the prevalence of chronic diseases will rise in the next decades. It is recognized in general practice that many older patients suffer from more than one chronic disease (comorbidity). The aim of this study is to describe the extent of comorbidity for the following diseases: hypertension, chronic ischemic heart disease, diabetes mellitus, chronic nonspecific lung disease, osteoarthritis. In a general practice population of 23,534 persons, 1989 patients have been identified with one or more chronic diseases. Only diseases in agreement with diagnostic criteria were included. In persons of 65 and older 23% suffer from one or more of the chronic diseases under study. Within this group 15% suffer from more than one of the chronic diseases. Osteoarthritis and diabetes mellitus are the diseases with the highest rate of comorbidity. Comorbidity restricts the external validity of results from single-disease intervention studies and complicates the organization of care.

Adolescent↗
PubMed1995

Clinical trials in chronic diseases.

In spite of rather negative publicity on the crossover/self-controlled design for clinical trials in the early 1980s, a fair number of these studies were published in that period. Using these studies as examples, we try to give an overview of major advantages and disadvantages of crossover and parallel group studies. Strengths of the crossover versus the parallel design include: (1) elimination of between-subject variability of symptoms; (2) no need for large samples; (3) fewer ethical problems; and (4) subjects are able to express their preference for one of the compounds being given. Weaknesses include: (1) carryover effect from one treatment period into the other; and (2) time effect due to spontaneously evolving symptoms in a lengthy trial. Although routinely used for all types of therapies in phase I/II studies, the crossover/self-controlled design cannot be used in phase III/IV studies other than for symptomatic treatments of stable disease. Treatments of chronic diseases are directed primarily to the relief of persistent symptoms rather than the cure of a rapidly evolving symptomatology. These very aspects make them particularly suitable for crossover/self-controlled studies. Awareness of the weaknesses of clinical trials is especially important to clinical practitioners, who depend on reported clinical trials when making clinical decisions.

Chronic Disease↗
PubMed2003

Oral protein-energy supplements for children with chronic disease: systematic review.

Growth failure and poor nutritional status are features of children with chronic disease. Oral protein-energy supplements are one of a number of interventions provided with the aim of improving nutritional status in these children. The present paper describes a Cochrane systematic review assessing the efficacy of these products in children with chronic disease. The objective was to examine the evidence that in children with chronic disease oral protein-energy supplements alter nutrient intake, nutritional indices, survival and quality of life. All randomised controlled trials of the use of oral protein-energy supplements in children with chronic disease were identified through searching electronic databases and hand searching the abstract books of nutrition conferences. Studies identified were independently assessed for eligibility and methodological quality, and data on outcomes of interest were combined in a meta-analysis where possible. Two trials were eligible for inclusion in the review, both of which were undertaken with children with cystic fibrosis. No statistical differences could be found between treatment and control groups when data from both studies were combined. Oral protein-energy supplements are widely used to improve the nutritional status of children with chronic disease. No conclusions can be drawn on the efficacy of these products based on the limited data available. Further randomised controlled trials are required to investigate the use of these products in children with chronic disease. Until further data are available, these products should be used with caution.

Adolescent↗
PubMed1970

Pathogenesis of chronic disease associated with persistent lymphocytic choriomeningitis viral infection. II. Relationship of the anti-lymphocytic choriomeningitis immune response to tissue injury in chronic lymphocytic choriomeningitis disease.

Tissue injury (chronic disease) associated with persistent LCM infection is apparently caused by the host immune response to the virus. Employing parabiosis or cell transfer from hyperimmune donors to isologous virus carriers, the tissue injury of chronic disease could be initiated and/or intensified. Furthermore, the transfer of anti-LCM antibody to SWR/J carrier mice results in acute necrotizing inflammatory lesions in regions of viral persistence, followed by chronic mononuclear infiltrates quite similar to those seen after the transfer of immune cells. The pathogenesis of the nonglomerular tissue injury of chronic LCM disease is apparently at least in part related to the interaction of circulating anti-LCM antibody with viral antigen at the tissue site. Trapping of circulating virus-antibody complexes in the glomerular filter is apparently the major cause of the glomerulonephritis.

Animals↗