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 739 records · Page 41Linked to original sources
PubMed2000

Blood glutathione decreases in chronic diseases.

Previously a high blood glutathione level was correlated with long life span in the mouse and rat and in healthy elderly human beings. This raised the question of whether low glutathione levels occur in unhealthy subjects. To this end, 74 consecutive patients newly admitted to the hospital, with ages ranging from 21 to 89 years and diagnosed with chronic diseases, were studied along with 32 healthy control subjects. Blood samples were analyzed for reduced (GSH) and oxidized (GSSG) glutathione with a high-performance liquid chromatography-dual electrochemical method. The data were integrated with the clinical diagnoses and statistically analyzed. Marked total glutathione decreases from the control levels occurred in over 36% of the patients with chronic diseases including cancer and genitourinary, gastrointestinal, cardiovascular, and musculoskeletal diseases (P < .001). The deficit was due to low GSH concentrations and not to GSSG, which was the same as that in the control subjects. The conclusion is that a decrease in GSH is a risk factor for chronic diseases that may be used to monitor the severity and progress of the diseases. Future work is necessary to elucidate the mechanism of action.

Adult↗
PubMed1999

Development and estimation of a pediatric chronic disease score using automated pharmacy data.

BACKGROUND: Although risk assessment models for specific adult populations such as the elderly have been developed, little work has focused on developing pediatric-specific models. The lack of pediatric models may result in incorrect estimates of relative disease severity among children, in reduced reimbursement for health plans and providers, and in inadequate health care for chronically ill children. OBJECTIVES: To develop and to evaluate a pediatric risk assessment model using automated pharmacy data. DESIGN: Retrospective, case-cohort study using automated data. SUBJECTS: All children continuously enrolled in Group Health Cooperative of Puget Sound during 1992 and 1993. MEASURES: The Pediatric Chronic Disease Score (PCDS), an algorithm that classified children into chronic disease categories by prescription drug fills, was compared with the ICD-9-CM-based Ambulatory Care Groups (ACG) model and a demographic model for prediction of total, ambulatory, or primary care costs and primary care visits. Forecast models were estimated using linear regression and they were evaluated with R2, mean prediction error, mean squared prediction error, and Mincer-Zarnowitz tests. RESULTS: The pharmacy-based PCDS performed significantly better on each of the four forecasting accuracy tests than did a demographic model (eg, R2s averaging fourfold higher). Compared with the ACG model, the PCDS model performed similarly on mean squared prediction error tests; however, the ACG generally had higher validation R2 values. CONCLUSIONS: A pharmacy-based pediatric risk assessment model performs better than a demographic model and represents a viable alternative to ICD-9-CM-based models. Further research is necessary to determine if children must be considered separately from adults when conducting population-based risk assessments.

Adolescent↗
PubMedDate not supplied

[Antibodies to the structural proteins of the measles virus studied in some chronic diseases].

The qualitative and quantitative analysis of antibodies to measles virus (MV) structural proteins (SP) in sera from patients with chronic glomerulonephritis (CGN), chronic active hepatitis (CAH), and liver cirrhosis (LC) was done. The patients were shown to have neutralizing antibody titres (NAT) higher than those in healthy subjects. An analysis of antibodies to SP was carried out by the radioimmunoprecipitation assay. Antibodies were detected to hemagglutinin, nucleoprotein (NP), fusion protein and to matrix protein (M) both in sera from the patients with these chronic diseases, healthy subjects, and patients with active measles. (The two latter groups were selected for comparison). However, some patients with CAH and LC had no antibodies to M protein in spite of very high NAT. The quantitative analysis of MV antibodies to SP was done only for NP because this antibody had the least individual variations. The quantity of anti-NP antibodies was higher in most sera from patients with chronic diseases than in those from healthy subjects, and reached the level of that in patients with active measles. The presence of MV genome in the peripheral blood lymphocytes from patients CAH, CGN, and LC had been shown earlier. So it is assumed that MV persists in lymphoid tissue where the expression of all SP genes is realized.

Antibodies, Viral↗
PubMed2006

The causes of skin damage and leg ulceration in chronic venous disease.

Chronic venous disease with skin changes of the leg is a common condition affecting up to 1 in 20 people in westernized countries. The causes of this problem are not fully understood, although research in recent years has revealed a number of important mechanisms that contribute to the disease process. Patients with chronic venous disease suffer persistently raised pressures in their deep and superficial veins in the lower limb. Leucocytes become "trapped" in the circulation of the leg during periods of venous hyper-tension produced by sitting or standing. Studies of the plasma levels of neutrophil granule enzymes shows that these are increased during periods of venous hypertension, suggesting that this causes activation of the neutrophils. Investigation of the leucocyte surface ligands CD11b and CD62L shows that the more activated neutrophils and monocytes are sequestered during venous hypertension. Measurement of plasma levels of the soluble parts of the endothelial adhesion molecules VCAM, ICAM, and ELAM show that these are all elevated in patients with chronic venous disease compared to controls. Following 30 minutes of venous hypertension produced by standing, these levels are further increased. These data suggest that venous hypertension causes neutrophil and monocyte activation, which in turn causes injury to the endothelium. Chronic injury to the endothelium leads to a chronic inflammatory condition of the skin that we know clinically as lipodermatosclerosis. This is mediated by perivascular inflammatory cells, principally macrophages, in the skin microcirculation. These stimulate fibroblasts in the skin leading to tissue remodeling and laying down of fibrous tissue. Vascular endothelial growth factor stimulates proliferation of capillaries within the skin. Skin in this state has the potential to ulcerate in response to minor injury.

Chronic Disease↗
PubMed2006

Validity of screening tests for Sjögren's syndrome in ambulatory patients with chronic diseases.

OBJECTIVE: To determine the validity of screening tests for Sjogren's syndrome (SS) in ambulatory patients with chronic diseases. METHODS: Three hundred randomly selected patients from the rheumatology and internal medicine clinics of a tertiary care center were assessed for SS according to the American-European Consensus Group criteria. During the screening phase, an interview, the European questionnaire for sicca symptoms, Schirmer-I test, and the wafer test were carried out in all patients. Patients with positive screening had confirmatory tests including fluorescein staining test, nonstimulated whole salivary flow, and autoantibody testing. Confirmatory tests were also done in 13 patients with negative screening. During the last phase, lip biopsy was proposed to patients who met preestablished criteria. RESULTS: Women made up 79% of the study population. Mean age of subjects was 42.8+/-15.7 years. Two hundred twenty patients (73%) had positive screening. The distribution of positive test results was: xerophthalmia 118 (39%), xerostomia 103 (34%), Schirmer-I test 101 (34%), and wafer test 187 (62%) patients. Forty (13%) patients met criteria for SS. All screening tests were useful for identifying patients with SS; however, the model composed of at least one positive response to the European questionnaire (EQ1), Schirmer-I test, and wafer test showed the best performance. CONCLUSION: Use of the European questionnaire, Schirmer-I test, and wafer test in parallel was useful for identifying patients with SS among ambulatory patients with chronic diseases.

Adult↗
PubMed2004

Prevalence of chronic diseases in adults exposed to arsenic-contaminated drinking water.

Inorganic arsenic is naturally occurring in groundwaters throughout the United States. This study investigated arsenic exposure and self-report of 9 chronic diseases. We received private well-water samples and questionnaires from 1185 people who reported drinking their water for 20 or more years. Respondents with arsenic levels of 2 microg/L or greater were statistically more likely to report a history of depression, high blood pressure, circulatory problems, and bypass surgery than were respondents with arsenic concentrations less than 2 microg/L.

Adult↗
PubMed2005

Paternal involvement in the management of pediatric chronic diseases: associations with adherence, quality of life, and health status.

OBJECTIVES: This article reports associations among paternal involvement in pediatric chronic disease management and child outcomes. METHODS: The Dads' Active Disease Support scale (DADS) and measures of treatment adherence, quality of life, health status, and health care utilization were obtained for youths with six chronic diseases, with complete data sets obtained from 190 couples. RESULTS: Paternal involvement was not associated with these outcomes among younger children. Among adolescents, mother-reported and father-reported DADS scores indicating more paternal involvement were associated with maintenance, rather than deterioration, of treatment adherence and more favorable quality of life. Youths' health status and health care utilization were not related significantly to paternal involvement. CONCLUSIONS: More paternal involvement was associated with more favorable adherence and quality of life among adolescents but not associated with health status or health care utilization. Longitudinal studies could verify whether paternal involvement merits clinical intervention.

Adaptation, Psychological↗
PubMed1995

Menopause: its epidemiology and potential association with chronic diseases.

While there are weak indications that the decline in estradiol levels with menopause has ramifications for the expression of overt disease in women, the associations are not clearly characterized with the exception of osteoporosis. The lack of well-characterized associations is undoubtedly due to the same limitations previously described: difficulty in defining the menopausal stages and difficulty in doing serum hormone sampling. Added to these limitations are other impediments. Chronic diseases will not be expressed within a few short months of the menopause, so the temporal sequence of hormone change with clinical disease expression is difficult to establish. Furthermore, it is likely that menopause is an "enabling" state that allows for the subsequent disease in women with other risk factors. Until sufficient data are available to explore the menopause as both an effect modifier and confounder, inconclusive results are likely to be reported. Future studies of the association between chronic diseases and the menopause need to consider issues similar to those that have arisen relative to studies in symptomatology. There needs to be a more concise definition of menopausal status. Potential confounders, including race/ethnicity, body size, and socioeconomic status, must be considered in both design and analysis. Studies need to be designed to separate the effects of age from those of menopause. Finally, women with medically induced menopause should be evaluated separately from those with natural menopause.

Age Factors↗
PubMed1990

Creative policy-making. Strategies for working with the healthy chronically diseased employee.

As society ages and employees remain in the workplace longer, business managers must develop policies for maintaining the healthy chronically diseased employee in the workplace. With continuing increases in health care insurance costs, business should begin to look at chronic conditions which require repeat visits as well as "big ticket items." Based on an employee perspective approach, a model which presents three categories of healthy chronically diseased employees is utilized in teaching self care activities to insure a productive outcome for the employee. Self-care activities are a key component of the health promotion model, of which four aspects are included: information giving and seeking, encouraging self-responsibility, decision-making, and continued support and follow up.

Chronic Disease↗
PubMed2001

Avoiding pitfalls in chronic disease quality measurement: a case for the next generation of technical quality measures.

The true utility of quality measurement lies in its ability to inspire quality improvement, with resultant enhancements in the processes and outcomes of care. Because quality measurement is expensive, it is difficult to justify using measures that are not likely to lead to important improvements in health. Many current measures of chronic disease technical quality, however, have one or more pitfalls that prevent them from motivating quality improvement reactions. These pitfalls include that: (1) measured processes of care lack strong links to outcomes; (2) actionable processes of care are not measured; (3) measures do not target those at highest risk; (4) measures do not allow for patient exceptions; and (5) intermediate outcome measures are not severity adjusted. To exemplify recent advancements and current pitfalls in chronic disease quality measurement, we examine the evolution of quality measures for diabetes mellitus and discuss the limitations of many currently used diabetes mellitus care measures. We then propose more clinically meaningful "tightly linked" measures that examine clinical processes directly linked to outcomes, target populations with specific diagnoses or intermediate disease outcomes that contribute to risk for poor downstream health outcomes, and explicitly incorporate exceptions. We believe that using more tightly linked measures in quality assessment will identify important quality of care problems and is more likely to produce improved outcomes for those with chronic diseases.

Chronic Disease↗
PubMedDate not supplied

[The interferon-inducing and immunomodulating action of bonafton in chronic diseases of the oral mucosa].

The immunocorrective activity of bonaphthon, an antiviral agent, was studied in 27 patients with chronic diseases of the buccal mucosa (recurrent aphthous stomatitis, lichen ruber planus, Melkersson-Rosenthal's syndrome). Bonaphthon therapy resulted in quite a number of patients in elevation of serum interferon titer and of the titer of specific antiherpetic antibodies. These results evidence that, besides the antiviral effect, bonaphthon is characterized by an immunomodulating effect and is conducive to fortification of the defense potential of the body in patients with stubborn chronic diseases of the buccal mucosa.

Adjuvants, Immunologic↗
PubMed1993

Preventable mortality in Missouri: excess deaths from nine chronic diseases, 1979-1991.

For the period 1979-1991, 54% of the 644,045 deaths in Missouri were attributed to nine chronic diseases--cancers of the breast, uterine cervix, lung, colon/rectum; coronary heart disease; stroke; diabetes; chronic obstructive pulmonary disease; hepatic diseases/cirrhosis. Elimination of risk factors and screening have been shown to reduce the mortality caused by these diseases. To evaluate the range in excess mortality in the state, we calculated excess mortality by county and correlated these rates with three sociodemographic variables. Based on these analyses, an estimated 100,000 deaths may have been prevented through prevention and early detection activities.

Adult↗
PubMed2005

A 12-month follow-up study of self-management training for people with chronic disease: are changes maintained over time?

OBJECTIVE: A previous study reported some improved outcomes at 4-month follow-up after attendance on a lay-led, chronic disease self-management course (CDSMC). The purpose of this study was to determine whether changes were maintained over time (i.e. at 12 months) and to describe participants' current use of self-management techniques. DESIGN: The study was a 12-month follow-up of a sample of 171 participants who attended a CDSMC in the UK. METHOD: Data were collected by self-administered questionnaires mailed to participants 12 months after they commenced a CDSMC and via telephone interviews with a sub-sample. RESULTS: The sample had a mean age of 54 years, mean disease duration of 16 years, 73% were women, and chronic diseases included endometriosis, depression, diabetes, myalgic encephalomyelitis, osteoporosis and polio. The significant improvements in outcomes identified at 4 months (i.e. cognitive symptom management, self-efficacy, communication with physician, fatigue, anxious and depressed moods and health distress) were sustained at 12 months. No significant changes between 4- and 12-month assessments were found on any study variables. Interview data confirmed that participants continued to use some of the self-management techniques learned on the course. CONCLUSION: Attendance on the CDSMC may lead to longer-term changes in key outcomes such as self-efficacy, use of some self-management behaviours and some aspects of health status (e.g. fatigue, depressed mood).

Activities of Daily Living↗
PubMed2004

Association of obesity and smoking with chronic diseases among Oklahoma adults.

Obesity and smoking are the two modifiable risk factors that contribute the most for many chronic diseases. Obesity has nearly doubled in Oklahoma and in the US since 1990 while Oklahoma adult smoking rates have remained above 25%. The purpose of this study was to utilize the Behavioral Risk Factor Surveillance System (BRFSS) to describe the associations between overweight, obesity, and cigarette smoking with selected chronic diseases among Oklahoma adults. The BRFSS is an ongoing, state-based, random-digit dialing telephone survey of the non-institutionalized adult population ages 18 years and older designed to collect various kinds of health-related information. Descriptive statistics were obtained for high blood pressure, high cholesterol, diabetes, asthma, and arthritis by BMI status (i.e. not overweight, overweight, obese) and smoking status (i.e., current, former, never). Logistic regression was performed to test for associations between BMI status or smoking status and these diseases. Self-reported diabetes, arthritis, and lifetime high blood pressure and high cholesterol rates were higher among those who were overweight and highest among those who were obese, while asthma rates were higher among obese adults than those who were not obese. Asthma rates were higher for those who currently smoke than former smokers and never smokers. Former smokers had significantly higher rates of high blood pressure, high cholesterol, diabetes, and arthritis compared to never smokers or current smokers.

Adolescent↗
PubMed1995

The epidemiologic transition to chronic diseases in developing countries: cardiovascular mortality, morbidity, and risk factors in Seychelles (Indian Ocean). Investigators of the Seychelles Heart Study.

The occurrence of cardiovascular diseases (CVD) and related risk factors was evaluated in Seychelles, a middle level income country, as accumulating evidence supports increasing rates of CVD in developing countries. CVD mortality was obtained from vital statistics for two periods, 1984-5 and 1991-3. CVD morbidity was estimated by retrospective review of discharge diagnoses for all admissions to medical wards in 1990-1992. Levels of CVD risk factors in the population were assessed in 1989 through a population-based survey. In 1991-93, standardized mortality rates were in males and females respectively, 80.9 and 38.8 for cerebrovascular disease and 92.9 and 47.0 for ischemic heart disease. CVD accounted for 25.2% of all admissions to medical wards. Among the general population aged 35-64, 30% had high blood pressure, 52% of males smoked, and 28% of females were obese. These findings substantiate the current health transition to CVD in Seychelles. More generally, epidemiologic data on CVD mortality, morbidity, and related risk factors, as well as similar indicators for other chronic diseases, should more consistently appear in national and international reports of human development to help emphasize, in the health policy making scene, the current transition to chronic diseases in developing countries and the subsequent need for appropriate control and prevention programs.

Adult↗