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One Disease (one + disease)
Selected AbstractsAcquired thrombotic thrombocytopenic purpura as the presenting symptom of systemic lupus erythematosus.EUROPEAN JOURNAL OF HAEMATOLOGY, Issue 5 2005Successful treatment with plasma exchange, immunosuppression, report of two cases Abstract:, Thrombotic thrombocytopenic purpura (TTP) is a rare but life-threatening syndrome characterized by platelet aggregation causing occlusive microangiopathy. It has been described as a complication in systemic lupus erythematosus (SLE). Recent research indicated that genetic or autoantibody-induced deficiency of the metalloprotease ADAMTS13 plays a key role in the pathogenesis of TTP. Here we report two uncommon cases of TTP as the first presenting symptom of SLE. Both patients were treated with combined plasma exchange and immunosuppressive therapy, and recovered completely. Although TTP and SLE have several clinical findings in common, and both disorders may coexist more frequently than we currently assume, features of one disease should not mislead to reject the alternative disorder. [source] Personality variable differences between disease clustersEUROPEAN JOURNAL OF PERSONALITY, Issue 2 2003G. Matthews Previous studies of personality and health have focused mainly on the influence of psychological factors on single diseases such as cancer and coronary heart disease (CHD), thereby neglecting the problem of comorbidity (i.e. the combination of different diseases). The main focus of the present study was the discrimination between single- and multiple-disease conditions on the basis of personality traits. An extensive battery of personality scales implicated in health was administered to a sample of n=5133 individuals of both genders between the ages of 40 and 65. Subjects also reported their health or illness status. A factor analysis of the personality scales yielded five dimensions clearly interpretable as "Emotional Lability", "Type A Behaviour", "Behavioural Control", "Locus of Control over Diseases", and "Psychoticism". Hierarchical cluster analyses of the subsample of participants who reported suffering from more than one disease led to eight clusters representing individuals with different combinations of diseases. Generally, there were very few significant differences between healthy and single-disease participants with regard to personality. However, mean factor scores calculated for "Emotional Lability" were higher across the multiple-disease groups than in the healthy and single-disease groups. No other personality factor showed this trend. In general the results reported here show the important role negative affectivity (e.g. Emotional Lability, Neuroticism, Depression) plays in differentiating between single and multiple diseases. Copyright © 2003 John Wiley & Sons, Ltd. [source] The impact of chronic multimorbidity and disability on functional decline and survival in elderly persons.JOURNAL OF INTERNAL MEDICINE, Issue 2 2009A community-based, longitudinal study Abstract. Objective., We aimed to disentangle the effect of chronic multimorbidity and disability on 3-year functional decline and survival in the elderly. Design., Prospective cohort study with a mean of follow-up of 2.8 years. Setting., Swedish elderly persons from the Kungsholmen Project (1987,2000). Subjects., A total of 1099 subjects, 77,100 years old, living in the community and institutions. Main outcome measurements., Medical diagnoses (based on clinical examination, drug use, medical records and blood tests), and functional assessment (according to Katz Index) at baseline were investigated in relation to functional decline and death occurring during follow-up. Results., At baseline, 12.1% of participants had disability, and 52.3% were affected by multimorbidity. During follow-up, 363 persons died and 85 worsened in functioning. The number of chronic conditions incrementally increased the risk of functional decline [hazard ratio (HR) increased from 1.5 in subjects with one disease to 6.2 in persons with 4+ diseases]. However, this was not the case for mortality, as the HR of death was the same for people with one disease as well as 4+ diseases (HR = 2.3). Baseline disability had the highest impact on survival, independently of number of diseases [HR = 8.1; 95% confidence interval (CI) = 4.8,13.7 in subjects with one disease and HR = 7.7; 95% CI = 4.7,12.6 in those with 2+ diseases]. Conclusions., In the elderly subjects, chronic disability rather than multimorbidity emerged as the strongest negative prognostic factor for functionality and survival. [source] Response to IL-1-Receptor Antagonist in a Child with Familial Cold Autoinflammatory SyndromePEDIATRIC DERMATOLOGY, Issue 1 2007Susan M. O'Connell M.R.C.P.I. They appear to represent a continuum of one disease characterized by IL-1-mediated inflammation. Until recently, these conditions have been difficult to treat; however, with the advent of IL-1-receptor antagonist therapy, many reports of successful treatment of patients with these autoinflammatory diseases have emerged in the past 2 years. We describe an 8-year-old girl, diagnosed with Familial cold auto-inflammatory syndrome, confirmed by presence of a novel CIAS1 mutation, who was refractory to symptomatic treatment. As frequent attacks of urticaria and associated arthralgia had a debilitating effect on the child's lifestyle, a trial of IL-1-receptor antagonist (anakinra) was instituted. Dramatic sustained clinical improvement was evident within days and serum amyloid and C-reactive protein levels normalized within a month. Although several authors have reported successful use of this agent in children with chronic infantile neurologic, cutaneous, articular syndrome, we believe ours is the first report of successful treatment with anakinra in a young child with familial cold auto-inflammatory syndrome. [source] Strategies for the endodontic management of concurrent endodontic and periodontal diseasesAUSTRALIAN DENTAL JOURNAL, Issue 2009PV Abbott Abstract Endodontic and periodontal diseases can provide many diagnostic and management challenges to clinicians, particularly when they occur concurrently. As with all diseases, a thorough history combined with comprehensive clinical and radiographic examinations are all required so an accurate diagnosis can be made. This is essential since the diagnosis will determine the type and sequence of treatment required. This paper reviews the relevant literature and proposes a new classification for concurrent endodontic and periodontal diseases. This classification is a simple one that will help clinicians to formulate management plans for when these diseases occur concurrently. The key aspects are to determine whether both types of diseases are present, rather than just having manifestations of one disease in the alternate tissue. Once it is established that both diseases are present and that they are as a result of infections of each tissue, then the clinician must determine whether the two diseases communicate via the periodontal pocket so that appropriate management can be provided using the guidelines outlined. In general, if the root canal system is infected, endodontic treatment should be commenced prior to any periodontal therapy in order to remove the intracanal infection before any cementum is removed. This avoids several complications and provides a more favourable environment for periodontal repair. The endodontic treatment can be completed before periodontal treatment is provided when there is no communication between the disease processes. However, when there is communication between the two disease processes, then the root canals should be medicated until the periodontal treatment has been completed and the overall prognosis of the tooth has been reassessed as being favourable. The use of non-toxic intracanal therapeutic medicaments is essential to destroy bacteria and to help encourage tissue repair. [source] The expression of Bcl-2 family proteins differs between nonsmall cell lung carcinoma subtypesCANCER, Issue 7 2005Helen K. Berrieman Ph.D. Abstract BACKGROUND Proteins of the Bcl-2 family play a key role in the control of apoptosis and carry out both proapoptotic and antiapoptotic functions. However, with the exception of Bcl-2 itself, little is known about the expression of these potentially critical proteins in nonsmall cell lung carcinoma. METHODS Immunohistochemistry was used to study the expression of Bcl-2 and 6 other Bcl-2 family proteins in a pilot series of 41 archival nonsmall cell lung carcinoma specimens (19 adenocarcinomas and 22 squamous cell carcinomas). RESULTS Overexpression of the apoptosis inhibitors Bcl-2 and Bcl-XL was observed in 10 of 41 samples (24%) and in 11 of 41 samples (27%), respectively. Loss of expression of proapoptotic proteins was observed as follows: Bak, 24 of 41 samples (59%); Bad, 21 of 41 samples (51%); Bid, 20 of 41 samples (49%); Bax, 14 of 41 samples (34%); and Bim/Bod, 2 of 41 samples (5%). Statistically significant differences in expression between adenocarcinoma samples and squamous cell carcinoma samples were observed for Bcl-XL (overexpression in 11 of 19 adenocarcinomas [58%] vs. 0 of 22 squamous cell carcinomas [0%]; P < 0.001) and for Bad (loss of expression in 5 of 19 adenocarcinomas [26%] vs. 16 of 22 squamous cell carcinomas [73%]; P = 0.004). CONCLUSIONS Although this was only a pilot study, the results revealed significant differences in the expression of apoptosis-related proteins both between individual samples of nonsmall cell lung carcinoma and between the two main histologic subtypes. Such differences may play a role in the development of lung tumors; and, if it is found that these differences are of clinical importance, then it may be required to regard nonsmall cell lung carcinoma subtypes as separate entities rather than as one disease. Cancer 2005. © 2005 American Cancer Society. [source] The genetics of autoimmune endocrine diseaseCLINICAL ENDOCRINOLOGY, Issue 1 2003Karen F. Tait Summary The common autoimmune endocrinopathies result from an interaction between environmental factors and genetic predisposition. Several chromosomal gene regions have been shown to contribute to more than one disease, supporting the clinical observation that the autoimmune endocrine diseases cluster within individuals and families. Genetic studies have implicated the major histocompatability complex (MHC)-human leucocyte antigen (HLA) genes on chromosome 6p21, although this chromosomal region does not explain all of the genetic contribution to the various disorders. Non-MHC-HLA genes, including disease-specific loci, are beginning to be identified and the publication of the draft sequence of the human genome will undoubtedly expediate future discoveries. Combined with the establishment of large cohorts of subjects with disease and the development of technology capable of performing high-throughput genotyping, genetic studies are likely to impact on the future treatment and prevention of the common autoimmune endocrine diseases. [source] | ||||||||||