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PubMedDate not supplied

[Relations between the problem-oriented education of patients and quality of treatment and efficiency of rehabilitation of children with chronic diseases].

Research aimed at development and introduction of effective forms of organization and methods of health improvement, compensation, and rehabilitation of patients with chronic diseases acquire special significance today. However, the actual economic and social conditions in the Russian Federation dictate the development and introduction of the least expensive and at the same time sufficiently effective methods for treatment and rehabilitation. Topical training of chronic patients is such a method. One more aspect necessitating such research is essential increase in the prevalence of chronic diseases and disability among children. Special attention is paid to insulin-dependent diabetes mellitus, asthma, and chronic gastrointestinal diseases, often leading to stable (sometimes for life) disability; treatment, rehabilitation, and follow-up of such patients are very expensive, which makes the problem a pressing one.

Adolescent↗
PubMed2005

Chronic diseases in self-employed French workers.

OBJECTIVE: The objective of this study was to evaluate occupations associated with a high risk of specific chronic diseases in self-employed workers. METHODS: For each occupational category and gender, the observed and expected numbers of prevalent cases for each chronic disease leading to exemption from copayments by the French National Health Insurance System in 2001 were compared using the age-specific self-employed population rates as a reference. RESULTS: Dramatic discrepancies were observed depending on occupational categories, specifically for diabetes mellitus, cardiovascular diseases, mental health disorders, chronic respiratory insufficiency, severe liver disorders, and connective tissue diseases. CONCLUSIONS: Based on this extremely large dataset, several known associations between occupations and specific diseases were confirmed; other potential associations observed require future investigation.

Adult↗
PubMed1996

Choosing chronic disease measures for HEDIS: conceptual framework and review of seven clinical areas.

Few quality measures are available today that assess care for chronic conditions. Concern has been expressed by the developers of the Health Plan Employer Data and Information Set (HEDIS) that the current system may not capture the critical dimensions of quality for chronic diseases. This article provides a conceptual framework for selecting chronic diseases for which measures of quality should be developed, reviews the literature on the effectiveness of interventions for the diseases that meet the criteria, and recommends possible areas for the development of quality measures.

Adolescent↗
PubMed2003

Reforming medical education to enhance the management of chronic disease.

Medical education must adapt to change if it is to remain relevant to the needs of doctors, patients and society. Ideally, it should anticipate and lead change. Undergraduate education remains rooted in urban medical schools where the focus is on acute disease, while most graduates spend their working lives in the community, dealing mainly with chronic health problems. Medical graduates need to acquire specific knowledge, skills and attitudes if they are to effectively manage people with chronic disease. Strategies that create a better balance between education in acute and chronic disease are being developed. These include a transfer of clinical teaching to community and nursing home settings and the development of interdisciplinary teaching.

Aged↗
PubMed1987

Completeness of chronic disease registration in general practice.

The completeness of chronic disease registration in four general practices was assessed by referring to the Hospital Activity Analysis. Overall, just over half (56%) of the 695 patients who had been discharged from hospital with a diagnosis of diabetes, cancer, myocardial infarction, epilepsy, hypertension, or thyroid disease were identified on the practice disease registers. Patients with diabetes were most likely to be identified (72%), and those who had had a myocardial infarct least likely (43%). If the standard of registration is to be improved general practitioners must be convinced of its value. The Hospital Activity Analysis might be used widely to audit and improve practice registers.

Chronic Disease↗
PubMed2026

Low-carbohydrate diet score subtypes and all-cause mortality in general and chronic disease populations: a systematic review and meta-analysis of prospective cohort studies.

OBJECTIVES: To examine associations of overall, healthy and unhealthy low-carbohydrate diet (LCD) scores with all-cause mortality in general and chronic disease populations. Healthy and unhealthy subtypes were compared with assess whether the observed associations depend on macronutrient quality rather than carbohydrate restriction alone. DESIGN: Systematic review and pairwise category meta-analysis. DATA SOURCES: PubMed, MEDLINE, ProQuest Medical Database and Web of Science Core Collection were searched from inception to 12 May 2026. ELIGIBILITY CRITERIA: Prospective cohort studies of adults assessing LCD adherence using a validated three-macronutrient composite score and reporting HRs for all-cause mortality were eligible. DATA EXTRACTION AND SYNTHESIS: Two reviewers independently extracted data and assessed study quality using the Newcastle-Ottawa Scale (NOS). Random-effects meta-analyses compared each higher reported LCD category with the lowest category, stratified by LCD score subtype and population type. Certainty of evidence was assessed using NutriGrade. RESULTS: 18 prospective cohort studies included 779 158 participants and 219 457 deaths; all scored 7-9/9 on the NOS. In chronic disease populations, the highest healthy LCD category was associated with lower mortality than the lowest category (HR 0.72, 95% CI 0.69 to 0.76; I²=0%; high certainty), as was the highest overall LCD category (HR 0.85, 95% CI 0.75 to 0.96; I²=68%; high certainty). In the general population, the highest healthy LCD category was not associated with lower mortality than the lowest category (HR 0.93, 95% CI 0.85 to 1.01; I²=69%; moderate certainty), and neither was the highest overall LCD category (HR 0.96, 95% CI 0.90 to 1.03; I²=87%; low certainty). Unhealthy LCD scores were not associated with mortality in either population. CONCLUSIONS: Healthy LCD adherence was associated with lower all-cause mortality, particularly among individuals with chronic diseases. Unhealthy LCD scores were not associated with mortality in either population, suggesting that macronutrient quality and source may matter more than carbohydrate reduction alone.

Humans↗
PubMed1998

The association between chronic diseases and depressive symptomatology in older Mexican Americans.

BACKGROUND: Among the elderly population, the risk for psychological distress increases with the number of chronic diseases and accompanying functional disability. The prevalence of chronic medical conditions and functional disability varies substantially across ethnocultural groups, however. Using data from the Hispanic EPESE, we previously reported that among older Mexican Americans, the total number of chronic medical conditions and the presence of functional impairment are strong predictors of depressive symptoms. METHODS: Using multiple regression, we examined the association between specific chronic diseases, individual functional disabilities, and depressive symptoms in this group of ethnic elders. RESULTS: Multiple regression models indicated that diabetes (OR = 1.25, 95% CI = 1.03-1.56), arthritis (OR = 1.42, 95% CI = 1.17-1.72), urinary incontinence (OR = 1.94, 95% CI = 1.46-2.59), bowel incontinence (OR = 2.28, 95% CI = 1.15-4.55), kidney disease (OR = 3.11, 95% CI = 1.13-8.58), and ulcers (OR = 2.56, 95% CI = 1.23-5.29) were predictive of high levels of depressive symptoms. Hip fracture, although recognized as having a substantial impact on functional status, was not found to be associated with depressive symptoms. History of stroke was not significantly associated with depressive symptoms in bivariate or multivariate analyses, but history of stroke with residual speech problems was predictive (OR = 2.16, 95% CI = 1.01-4.79). Among specific activities of daily living, only impaired ability to walk across a room (OR = 1.65, 95% CI = 1.04-2.73) or to bathe oneself (OR = 1.87, 95% CI = 1.12-3.12) proved to be predictive in multivariate analyses. CONCLUSIONS: This constellation of chronic medical conditions and functional disabilities is very different from those reported to be associated with depressive symptoms in older non-Hispanic White and African Americans, and appears to comprise those conditions most associated with substantial physical impairment, pain, and discomfort.

Aged↗
PubMed1994

Prevalence of chronic diseases and impairments among US farmers, 1986-1990.

Farmers in the United States suffer disproportionately from certain chronic diseases and impairments. This analysis estimated the prevalence of selected diseases among farmers and compared these rates with those for other US workers. Five years (1986-1990) of National Health Interview Survey data on white male workers were combined to provide a basis for estimating the prevalence of selected conditions and impairments among this subgroup. Crude prevalence rates were significantly elevated for farmers compared with other workers for cardiovascular diseases, arthritis, skin cancer, hearing loss, and amputations. These elevations persisted when farmers were compared with blue-collar workers. The crude prevalence of orthopedic impairments and chronic respiratory diseases was not elevated among farmers, but the age-adjusted prevalence ratios for cardiovascular diseases, arthritis, and amputations were significantly elevated for farmers as compared with other workers. The prevalence of hearing loss was significantly higher only for farmers older than 65 years. This method of pooling data holds promise for studying disease rates in other small segments of the US population.

Accidents, Occupational↗
PubMed2007

Chronic disease self-management education programs: challenges ahead.

Chronic disease self-management education programs aim to empower patients through providing information and teaching skills and techniques to improve self-care and doctor-patient interaction, with the ultimate goal of improving quality of life. The recent 2006-07 federal budget allocated an unprecedented $515 million over 5 years for activation of patient self-management activities, commencing this financial year. Previous attempts in other countries to incorporate self-management education activities into the health care sector have faced setbacks because of inadequate integration into primary care. Engagement of health care professionals and their endorsement of self-management activities is critical to success.

Australia↗
PubMedDate not supplied

[Characteristics of tick-borne encephalitis virus strains isolated from patients with chronic diseases of the central nervous system].

Two groups of tick-borne encephalitis (TBE) virus strains were studied: Group 1, 5 strains isolated from patients with chronic TBE with progressive course, Group 2, 13 strains isolated from residents of an endemic locality, with chronic diseases of the CNS (amiotrophic lateral sclerosis, epidemic encephalitis, polyoencephalomyelitis, syringomyelia, etc.). Strains of both groups belong to two serotypes of TBE virus: mid-Siberian and Transbaikal (synonym Aina/1448) and eastern. Group 1 strains were heterogeneous in their virulence, immunogenic and surface properties of the virions. The latter characteristic was demonstrated in studies of elution from macropore glass and sensitivity of hemagglutinin to the effect of detergents (Bridge-96, Tween-80). Eight of 13 Group 2 patients had concurrent diseases (tuberculosis, toxoplasmosis, tumors, etc.). Streptomycin was demonstrated to activate asymptomatic infection with TBE virus in hamsters. It is assumed that isolation of TBE virus from Group 2 patients could be due to activation of persistent infection under the effect of concurrent diseases and drugs.

Animals↗
PubMedDate not supplied

[Social and hygienic characteristics of families of schoolchildren with chronic diseases].

Comparative analysis of families of schoolchildren in Vladikavkaz demonstrated the social and hygienic characteristics of families with schoolchildren suffering from chronic diseases, necessitating the formation of a special priority group with a complex of specific medical and social requirements, in order to develop prophylactic recommendations. The role of a family in prevention of diseases of schoolchildren should be increased and special recommendations should be developed for families with schoolchildren suffering from chronic diseases.

Adolescent↗
PubMed1987

Coping with chronic disease, dying and death--a contribution to competence in old age.

This article reports empirical studies investigating coping with chronic disease, dying and death in the later years. The coping process is seen as a characteristic of "competence" in old age, as the investigations demonstrate that old people are very often able to adjust to crises and restrictions caused by disease, and at the same time maintain a stable perspective. The studies show that coping with chronic disease, dying and death are highly influenced by biography, by subjective evaluation of the past, present and future, and by access to a supportive intra- and extrafamilial network. This article discusses central concepts, such as "competence", "cognitive representation", "future perspective" and "coping", followed by a summary of empirical studies conducted by the author and investigates different groups of patients.

Adaptation, Psychological↗
PubMed1993

Autonomic dysfunction in chronic liver disease.

Chronic liver disease is accompanied by a number of circulatory changes including impairment of cardiovascular autonomic reflexes. This occurs irrespective of the aetiology of liver disease, increases in prevalence and severity with worsening hepatic function, and is related at least in part to an autonomic neuropathy. Parasympathetic abnormalities predominate and, although largely subclinical, they may play a role in the altered fluid homeostasis and neurohumoral disturbances associated with cirrhosis. On prospective follow up, the presence of autonomic impairment was associated with a five-fold increased mortality, largely from sepsis and variceal haemorrhage. Defective responses to such stressful events as a result of an afferent defect could possibly explain these findings. Further studies are required to evaluate the natural history of this complication, and determine if it is reversible with improvement in hepatic function or after liver transplantation.

Autonomic Nervous System Diseases↗
PubMed2002

Exacerbation of HIV viral load simultaneous with asymptomatic reactivation of chronic Chagas' disease.

Chronic Trypanosoma cruzi infection can reactivate in patients with immunosuppression related to human immunodeficiency virus (HIV) infection, resulting in severe meningoencephalitis or myocarditis and high parasitemia. The effects of T. cruzi on HIV infection are unknown. We describe an HIV-infected patient with chronic Chagas' disease who experienced an asymptomatic T. cruzi reactivation characterized by the finding of the parasite in direct microscopic examination of blood. The patient's HIV viral load had increased simultaneously with the exacerbation of T. cruzi parasitemia and decreased to previous levels after successful antiparasitic treatment. This otherwise unexplained finding suggests that T. cruzi infection might up-regulate HIV replication, which may affect HIV disease progression. Asymptomatic reactivation of Chagas' disease has not been reported before. This could mean that the severe clinical manifestations related to the reactivation of trypanosomiasis are just the tip of the iceberg.

Adult↗
PubMed2001

Impact of overweight on the risk of developing common chronic diseases during a 10-year period.

BACKGROUND: Overweight adults are at an increased risk of developing numerous chronic diseases. METHODS: Ten-year follow-up (1986-1996) of middle-aged women in the Nurses' Health Study and men in the Health Professionals Follow-up Study to assess the health risks associated with overweight. RESULTS: The risk of developing diabetes, gallstones, hypertension, heart disease, and stroke increased with severity of overweight among both women and men. Compared with their same-sex peers with a body mass index (BMI) (calculated as weight in kilograms divided by the square of height in meters) between 18.5 and 24.9, those with BMI of 35.0 or more were approximately 20 times more likely to develop diabetes (relative risk [RR], 17.0; 95% confidence interval [CI], 14.2-20.5 for women; RR, 23.4; 95% CI, 19.4-33.2 for men). Women who were overweight but not obese (ie, BMI between 25.0 and 29.9) were also significantly more likely than their leaner peers to develop gallstones (RR, 1.9), hypertension (RR, 1.7), high cholesterol level (RR, 1.1), and heart disease (RR, 1.4). The results were similar in men. CONCLUSIONS: During 10 years of follow-up, the incidence of diabetes, gallstones, hypertension, heart disease, colon cancer, and stroke (men only) increased with degree of overweight in both men and women. Adults who were overweight but not obese (ie, 25.0 < or = BMI < or = 29.9) were at significantly increased risk of developing numerous health conditions. Moreover, the dose-response relationship between BMI and the risk of developing chronic diseases was evident even among adults in the upper half of the healthy weight range (ie, BMI of 22.0-24.9), suggesting that adults should try to maintain a BMI between 18.5 and 21.9 to minimize their risk of disease.

Body Mass Index↗
PubMed2003

[Multifocal osteomyelitis as the first manifestation of chronic granulomatous disease].

Chronic granulomatous disease is a rare immune disease related to an anomaly in phagocytes NADPH oxidase. The characteristic clinical feature is early recurrent and sometimes serious infection. We report the case of a 22-month-old child who developed multifocal osteomyelitis, an unusual inaugural manifestation of chronic granulomatous disease. Septic chronic granulomatous disease is an uncommon differential diagnosis in children who develop recurrent infections. Diagnosis is established with specific blood tests: reduction of tetrazolium nitroblue, chemoluminescence test, molecular analysis. Therapeutic management must be undertaken as early as possible in order to preserve the long-term prognosis. No curative treatment is currently available. Aggressive treatment of each infectious focus with an adapted antibiotic regimen and in certain cases surgical debridement is required in addition to long-term antibiotic prophylaxis.

Consanguinity↗
PubMed1997

The relation of chronic diseases to all-cause mortality risk--the Seven Countries Study.

The relation of chronic conditions on all-cause mortality in population samples was studied based on observations from the Seven Countries Study. The objective of this work was to study the risk of death during a 15-year follow-up of middle-aged men in relation to six chronic diseases. Fifteen cohorts of men aged 50-69, totalling 8122 subjects, were examined around 1970 in seven countries: Finland, The Netherlands, Italy, Croatia (former Yugoslavia), Serbia (former Yugoslavia), Greece and Japan. Clinical diagnoses findings were made for coronary heart disease (CHD), 'other heart diseases' (OTH), peripheral arterial disease (PAD), stroke (STR), chronic obstructive pulmonary disease (COPD), and diabetes mellitus (DIAB). All-cause mortality was assessed in the subsequent 15 years. Death rates and relative risks were estimated from crude data, and in proportional hazards models after adjustment for age, systolic blood pressure and serum cholesterol level, cigarette smoking and body mass index. Large regional differences were found in the prevalence of the six conditions. Weak relations were found between population prevalence of each disease and population death rates for that disease. Among cohorts the relative risk of death in 15 years from any cause, adjusted for other risk factors, showed little variation among countries. Pooled relative risks, adjusted by the inverse of variance (with 95% CI) were: for CHD, 1.81 (1.60-2.06); for OTH, 1.47 (1.28-1.69); for PAD, 1.64 (1.39-1.93); for STR, 1.56 (1.23-1.98); for COPD, 1.67 (1.48-1.88); and for DIAB, 1.75 (1.43-2.15). The smallest variability of prognosis among countries was found for CHD, OTH and DIAB; the largest for PAD, STR and COPD. Despite simple clinical diagnostic procedures and large differences in prevalence, the relation of established prevalent conditions to subsequent all-cause mortality is relatively uniform among countries and across these conditions, with a relative risk of dying in 15 years usually ranging between 1.5 and 2.0.

Aged↗