Effect Of Chronic Disease Research Articles

Effects of Prebiotic and Synbiotic Supplementation on Glycaemia and Lipid Profile in Type 2 Diabetes: A Meta-Analysis of Randomized Controlled Trials.

Purpose: Diabetes Mellitus (T2DM) as a chronic disease, is on rise in parallel with other non-communicable diseases. Several studies have shown that probiotics and prebiotics might exert beneficial effects in chronic diseases including diabetes. Because of controversial results from different trials, the present study aims to assess the effects of prebiotic/synbiotic consumption on metabolic parameters in patients with type2 diabetes.Methods: A systematic literature search was performed on randomized controlled trial published in PubMed/Medline, SciVerse Scopus, Google scholar, SID and Magiran up to March 2018. Of a total number of 255 studies found in initial literature search, ten randomized controlled trials were included in the meta-analysis. The pooled mean net change were calculated in fasting blood-glucose [FBG], Hemoglobin A1c [HbA1c] and lipid markers (total cholesterol [TC], triglyceride [TG], low-density lipoprotein cholesterol [LDL-C], high density lipoprotein cholesterol [HDL-C]). The meta-analyses was conducted using Revman Software (v5.3).Results: The pooled estimate indicated a significant difference for the mean change in FBG, HbA1c and HDL in treatment group in comparison with control group. Subgroup analysis by intervention showed a significant difference in TG, LDL and HDL (synbiotic group) and in TG, TC, FBG, HDL and HbA1c (prebiotic group) compared with placebo. In another subgroup analysis, high quality studies showed significant reductions in TG, TC, FBG and HbA1c in intervention group compared with placebo group.Conclusion: In summary, diets supplemented with either prebiotics or synbiotics can result in improvements in lipid metabolism and glucose homeostasis in type 2 diabetic patients.

An empirical investigation of chronic diseases: A visualization approach to Medicare in the United States

ABSTRACTThis study explores the condition of chronic diseases and the association with demographics, hospital statistics, and spending. It provides a contemporary view of the current state of chronic diseases and conditions of Medicare beneficiaries in the United States. The data is drawn from the Centers for Medicare & Medicaid Services for the years 2007–2015. Using visualization tools and descriptive analytics, a series of charts are developed to surface and describe the key characteristics and dimensions of chronic conditions across key regions and races in the U.S. The study indicates the wide prevalence of several chronic diseases cutting across race, region, and other indicators. It implies the need to formulate policies for targeted populations. It is important to conduct such studies periodically to understand the nature and effects of chronic diseases. The results inform policymakers whose job it is to evaluate the efficacy of policies and strategies in the management and prevention of chronic diseases.

Predictors of basic self-care and intermediate self-care functional disabilities among older adults in Ghana

The number of older adults in Ghana is growing rapidly. Associated with this growth, is the rise in age-related chronic diseases such as cardiovascular and musculoskeletal conditions. However, there is limited knowledge in the Ghanaian context on the effect of chronic diseases on functional disabilities among older adults. In this study, we examine the association between chronic diseases, socioeconomic status, and functional disabilities. Data from 4107 Ghanaian older adults (persons aged 50 years and above) who participated in the World Health Organization’s Global Ageing and Adult Health survey (SAGE-Wave 1) were used to fit random effect multivariate logistic and complementary log-log regression. Stroke was significantly associated with difficulty in performing both basic self-care functions and intermediate self-care functions. Hypertension and arthritis, on the other hand, were associated with basic self-care functional disability only. Socioeconomically vulnerable groups such as females, those with less education and low-incomes were more likely to have functional disabilities associated with basic self-care and intermediate self-care activities. In order to reduce functional disabilities among older persons in Ghana, efforts should be aimed at reducing chronic conditions as well as improving socioeconomic status.

Identifying the target population for a people-centered, integrated chronic care program: a needs-based approach

Introduction: An estimated 50 million people in Europe suffer from chronic multimorbidity [1]. In the Netherlands, approximately 2 million people (13% of the population) have multiple chronic diseases [2]. Patients with multimorbidity are likely to have relatively high and complex healthcare demands [3]. Internationally, disease management (DM) programs are the norm for chronic care. These programs are based on disease-specific guidelines and tend to be highly standardized, which is often unsuitable for patients suffering from multimorbidity. The interacting effects of chronic diseases and their management require more complex and individualized care than simply the sum of separate, disease-specific guidelines [4]. Therefore, as the number of people with multimorbidity rises, finding disease-transcending solutions becomes increasingly important. One initiative to find such a solution was taken last year by a primary care group (HZD) in the Netherlands. A primary care group is a collective of general practitioners (GPs) similar to Clinical Commissioning Groups in the UK, which supports GPs in the organization and delivery of DM programs. HZD caters to 129 GP-practices in the region, and covers a population of 481,842 patients. In response to GPs’ desire to work more holistically and efficiently - especially for patients suffering from multimorbidity - the care group decided to develop a generic (disease-transcending), people-centered, integrated chronic care program. Unique about the program is that patients’ actual care needs, rather than their specific conditions, are taken as starting point for program development. The aim of this study is to define a suitable target group for the integrated care program, by investigating the characteristics of patients likely to benefit from the program. This is achieved by gaining insight into: (1) the prevalence of chronic diseases and multimorbidity in the population; and (2) the relations between patients’ healthcare use and their personal characteristics. Based on these insights, a relevant target group (including specific subgroups) for the integrated care program will be conceptualized. Methods: The project was designed as a cross-sectional study, using anonymized data from GP information systems. Sixty-six GP practices authorized the use of their data, resulting in a research population of 291,031 patients. Descriptive analyses were performed on data from July 2014 to July 2016, to determine the prevalence of 28 chronic diseases and multimorbidity based on historic GP service use. Relations with healthcare use were analysed for age, sex, type and nature of chronic disease, multimorbidity (number of conditions), and socioeconomic status. Results and discussion: Within the research population, 97,175 patients suffered from one (68% of these patients) or more (32%) chronic diseases, and/or partook in DM programs (43%). These patients had on average 10.7 (SD 9.3) consultations in the GP practice per year. Results showed an association between GP healthcare use and age, sex, number and type of chronic diseases. Moreover, chronic multimorbidity seemed to be associated with a higher overall GP healthcare use, also for non-chronic issues. Detailed results of the study will be presented during the conference.

The Effect Of Chronic Diseases, Financial Hardship And Personality Types In Patient's Medication Adherence

The Effect Of Chronic Diseases, Financial Hardship And Personality Types In Patient's Medication Adherence

Fostering needs assessment and access to medical rehabilitation for patients with chronic disease and endangered work ability: protocol of a multilevel evaluation on the effectiveness and efficacy of a CME intervention for general practitioners

BackgroundStudies show that endangered work ability (EWA) can be maintained or restored through medical rehabilitation (MR). For patients, general practitioners (GP) represent an important point of access to MR in outpatient care. However, many different barriers and shortcomings hinder GPs in both timely detection of the need for MR and the recognition of its potentials for their EWA-patients. These are necessary if GPs are to adequately inform patients about MR options and successfully support applications for MR. This study describes the evaluation of a continuing medical education (CME) module designed to improve rehabilitation-related practical performance of GPs regarding a) subjective satisfaction of GPs with the CME module, b) stability of attitudes and knowledge over time regarding rehabilitation, and c) subjective and objective changes in MR-related competencies needed to support MR applications.MethodsThis study is an open, non-randomised, pre-post-intervention study. The intervention involves a CME module for GPs (n = 1365) in the German state of Saxony-Anhalt on the topic of medical rehabilitation in connection with the federal German pension fund (Deutsche Rentenversicherung). The module will be initially held as regularly scheduled meetings in moderated GP quality circles (QC), and then offered as a written self-study unit. At the end it will be evaluated by the GPs. The study’s primary focus is on the organizational practice as measured by the number of approved MR applications supported by medical reports submitted by the participating GPs in the 6 months before and 6 months after the CME module. Other study aims involve measuring self-perceived competencies of GPs, as well as their attitudes towards and knowledge of rehabilitation (both upon completing the CME and 6 months later). In addition, the level of satisfaction with the CME module will be analysed among participating GPs and QC moderators (as CME facilitators).DiscussionImplementing targeted CME on complex topics such as those involving barriers is possible, even promising, when using QCs and their moderators. Of particular importance is how aware moderating physicians are of the relevance of MR need detection and access.Ethics and disseminationThe ethics committee of the Martin-Luther-Universität Halle-Wittenberg has registered this study under the number 2014–13. The study will be reported on in peer-reviewed journals and at national and international conferences. The results will be available to current and future initiatives aiming to improve detection of MR need and making MR accessible to EWEC patients needing such support to minimize the effects of chronic disease on their livess.Trial registration numberGerman Clinical Trials Register (ID number DRKS00006188) and WHO International Clinical Trials Registry Platform, Universal Trial Number (UTN) U1111–1158-8334.

Poczucie jakości życia a zdrowie lubelskich licealistów

The increasing number of children and young people struggling with chronic diseases and other health problems indicates the need for a closer look at the problem of difficulties in the functioning of psychosocial resulting from ill health. Diagnosing the level of sense of life quality depends on the health of high school students is a necessary procedure in order to identify opportunities for early intervention in countering the negative psychosocial effects of chronic disease. Determining the level of sense of life quality for high school students with health problems compared to healthy peers was conducted. There were examined 251 students in Lublin high schools. Standardized diagnostic questionnaire KIDSCREEN-52 by J. Mazur et al. was used. Results obtained during the analysis of evidence suggest that health-related quality of life of young people with health problems is significantly lower than in healthy peers, both in the case of complete physical, mental and psychosocial functioning in the school environment. Particularly noteworthy are the dimensions of felt emotions, psychological well-being, self-image, and the school environment.

Effect of Chronic Diseases and Multimorbidity on Survival and Functioning in Elderly Adults.

To determine the effect of chronic disorders and their co-occurrence on survival and functioning in community-dwelling older adults. Population-based cohort study. Kungsholmen, Stockholm, Sweden. Individuals aged 78 and older examined by physicians four times over 11 years (N = 1,099). Chronic diseases (grouped according to 10 organ systems according to the International Classification of Diseases, Tenth Revision, code) and multimorbidity (≥2 coexisting chronic diseases) were evaluated in terms of mortality, population attributable risk of death, median years of life lost, and median survival time with and without disability (need of assistance in ≥1 activities of daily living). Approximately one in four deaths were attributable to cardiovascular and one in six to neuropsychiatric diseases. Malignancy was the condition with the shortest survival time (2.5 years). Malignancies and cardiovascular disorders each accounted for approximately 5 years of life lost. In contrast, neurosensorial and neuropsychiatric conditions had the longest median survival time (>6 years), and affected people were disabled for more than half of this time. The most-prevalent and -burdensome condition was multimorbidity, affecting 70.4% of the population, accounting for 69.3% of total deaths, and causing 7.5 years of life lost. Finally, people with multimorbidity lived 81% of their remaining years of life with disability (median 5.2 years). Survival in older adults differs in length and quality depending on specific conditions. The greatest negative effect at the individual (shorter life, greater dependence) and societal (number of attributable deaths, years spent with disability) level was from multimorbidity, which has made multimorbidity a clinical and public health priority.

Hepato- and nephroprotective effects of bradykinin potentiating factor from scorpion (Buthus occitanus) venom on mercuric chloride-treated rats.

Bioactive peptides such as bradykinin potentiating factor (BPF), have, anti-oxidative, anti-inflammatory, immunomodulatory and ameliorative effects in chronic diseases and play a potential role in cancer prevention. It is known that the liver and kidney accumulate inorganic mercury upon exposure, which often leads to mercury intoxication in these organs. In this study, we investigated the effect of bradykinin potentiating factor (BPF), a scorpion venom peptide, on mercuric chloride-induced hepatic and renal toxicity in rats. We used 20 adult male Albino rats divided into four equal groups: the first group was injected with saline (control); the second group was administered daily with mercuric chloride (HgCl2) for 2 weeks; the third group was administered with BPF twice weekly for 2 successive weeks, while the fourth group was exposed to BPF followed by HgCl2. We observed that HgCl2 treated rats had a significant increase in serum ALT, AST, ALP, creatinine and urea levels compared to control. Furthermore, HgCl2 treated rats showed a marked decrease in total proteins, albumin and uric acids compared to control. The previously studied parameters were not significantly changed in BPF pretreated rats compared to control. Moreover, a significant decrease in the activities of glutathione perioxidase (GSH), superoxide dismutase (SOD), and catalase (CAT), in addition to a significant increase in the level of malondialdehyde (MDA) were observed in hepatic and renal tissues of rats after HgCl2 treatment. In contrast, the HgCl2/BPF treated rats showed a significant elevation in the activity of GSH, SOD, and CAT accompanied with a significant regression in the level of MDA compared to the HgCl2 exposed rats. We conclude that treatment with BPF is a promising prophylactic approach for the management of mercuric chloride-induced hepato- and nephro-toxicities.

Prevalence, survival analysis and multimorbidity of chronic diseases in the general veterinarian-attended horse population of the UK

The average age of the global human population is increasing, leading to increased interest in the effects of chronic disease and multimorbidity on health resources and patient welfare. It has been posited that the average age of the general veterinarian-attended horse population of the UK is also increasing, and therefore it could be assumed that chronic diseases and multimorbidity would pose an increasing risk here also. However, evidence for this trend in ageing is very limited, and the current prevalence of many chronic diseases, and of multimorbidity, is unknown. Using text mining of first-opinion electronic medical records from seven veterinary practices around the UK, Kaplan-Meier and Cox proportional hazard modelling, we were able to estimate the apparent prevalence among veterinarian-attended horses of nine chronic diseases, and to assess their relative effects on median life expectancy following diagnosis. With these methods we found evidence of increasing population age. Multimorbidity affected 1.2% of the study population, and had a significant effect upon survival times, with co-occurrence of two diseases, and three or more diseases, leading to 6.6 and 21.3 times the hazard ratio compared to no chronic disease, respectively. Laminitis was involved in 74% of cases of multimorbidity. The population of horses attended by UK veterinarians appears to be aging, and chronic diseases and their co-occurrence are common features, and as such warrant further investigation.

Preconception Care: Improving the Health of Women and Families.

Approximately 50% of the pregnancies in the United States are unintended. Most pregnancies are not diagnosed until after the period of organogenesis. Environmental exposures, chronic and acute illnesses, and ingestion of teratogens that can negatively affect the fetus may occur during these early weeks of pregnancy. Some chronic disease effects and lifestyle behaviors that affect the fetus can be adjusted prior to conception. Because of this, the health of a woman and her partner prior to pregnancy are of utmost importance. The Centers for Disease Control and Prevention and the Preconception Health and Health Care Initiative have established goals and evidence-based guidelines for preconception care. Preconception health care can be threaded into every visit with all women of reproductive age who are not pregnant. The guidelines focus on 3 main areas: screening, health promotion, and interventions. Screening is accomplished with women and couples via a thorough history and assessment of risks including a reproductive life plan; assessment of tobacco, alcohol and drug use; sexually transmitted infection (STI) testing and education; and assessment of environmental or teratogenic risk factors. Health promotion includes making sure the woman is current with regard to recommended vaccines, taking appropriate levels of folic acid, and maintaining a healthy weight and level of physical activity. The health care provider can intervene when indicated with management of chronic and acute illnesses, as well as provide assistance with tobacco, alcohol, and drug cessation as necessary. When a woman and her partner are healthy prior to pregnancy, unintended or planned, the woman and her fetus have a better chance at a healthy gestation and beyond. This article, via the use of case presentations, reviews how preconception health can be integrated into an office visit.

Structural and functional measures of social relationships and quality of life among older adults: does chronic disease status matter?

To evaluate the relative importance of structural and functional social relationships for quality of life (QoL) and the extent to which diagnosed chronic disease modifies these associations. Multivariate linear regression was used to investigate time-lagged associations between structural and functional measures of social relationships and QoL assessed 5 years apart by CASP-19, in 5925 Whitehall II participants (mean age 61, SD 6.0). Chronic disease was clinically verified coronary heart disease, stroke, diabetes or cancer. Social relationships-QoL associations were consistent across disease status (P-values for interaction: 0.15-0.99). Larger friend network (β = 1.9, 95% CI 1.5-2.3), having a partner (β = 1.2, 95% CI 0.5-1.7), higher confiding support (β = 2.2, 95% CI 1.8-2.7) and lower negative aspects of close relationships (β = 3.3, 95% CI 2.8-3.8) were independently related to improved QoL in old age. The estimated difference in QoL due to social relationships was equivalent to up to 0.5 SD of the CASP-19 score and was stronger than the effect of chronic disease (coronary heart disease β = 2.0, 95% CI 1.4-2.6). We found that beneficial aspects of social relationships in relation to QoL were, in order of importance: avoiding negative aspects of close relationships, having confiding support, having a wide network of friends and having a partner. These associations were not modified by chronic disease. Thus, despite inevitable physical deterioration, we may be able to enhance a satisfying late life by optimizing our social relationships.

Le biais de temps immortel dans les études pharmacoépidémiologiques : définition, solutions et exemples

Among the observational studies of drug effects in chronic diseases, many of them have found effects that were exaggerated or wrong. Among bias responsible for these errors, the immortal time bias, concerning the definition of exposure and exposure periods, is relevantly important as it usually tends to wrongly attribute a significant benefit to the study drug (or exaggerate a real benefit). In this article, we define the mechanism of immortal time bias, we present possible solutions and illustrate its consequences through examples of pharmacoepidemiological studies of drug effects.

To evaluate the etiology of erectile dysfunction: What should we know currently?

Erectile dysfunction (ED) is the inability to develop normal erection or an hardening problem at various extent that causes inability to maintain the erection for the sufficient time required for a complete sexual activity. It can be the result of neurologic, psychogenic, vascular, urogenital and hormonal abnormalities. It is reported that it affects 52-67% of men between 40 and 70 years old. Numerous theories and opinions are issued in the literature in order to explain the hemodynamic changea that occur during erection and detumescence. Especially the effects of chronic diseases and psychogenic factors on the pathophysiology of erectile dysfunction are common matters of discussion in recent years. In this review, we will evaluate the current developments in the literature about the etiology of erectile dysfunction.

Contribution of health status and prevalent chronic disease to individual risk for workplace injury in the manufacturing environment

ObjectivesAn ‘information gap’ has been identified regarding the effects of chronic disease on occupational injury risk. We investigated the association of ischaemic heart disease, hypertension, diabetes, depression and asthma with...

The components of self-rated health among adults in Ouagadougou, Burkina Faso

BackgroundAlthough the relationship between self-rated health (SRH) and physical and mental health is well documented in developed countries, very few studies have analyzed this association in the developing world, particularly in Africa. In this study, we examine the associations of SRH with measures of physical and mental health (chronic diseases, functional limitations, and depression) among adults in Ouagadougou, Burkina Faso, and how these associations vary by sex, age, and education level.MethodsThis study was based on 2195 individuals aged 15 years or older who participated in a cross-sectional interviewer-administered health survey conducted in 2010 in areas of the Ouagadougou Health and Demographic Surveillance System. Logistic regression models were used to analyze the associations of poor SRH with chronic diseases, functional limitations, and depression, first in the whole sample and then stratified by sex, age, and education level.ResultsPoor SRH was strongly correlated with chronic diseases and functional limitations, but not with depression, suggesting that in this context, physical health probably makes up most of people’s perceptions of their health status. The effect of functional limitations on poor SRH increased with age, probably because the ability to circumvent or compensate for a disability diminishes with age. The effect of functional limitations was also stronger among the least educated, probably because physical integrity is more important for people who depend on it for their livelihood. In contrast, the effect of chronic diseases appeared to decrease with age. No variation by sex was observed in the associations of SRH with chronic diseases, functional limitations, or depression.ConclusionsOur findings suggest that different subpopulations delineated by age and education level weight the components of health differently in their self-rated health in Ouagadougou, Burkina Faso. In-depth studies are needed to understand why and how these groups do so.

The evaluation of sexual dysfunction in male patients with migraine and tension type headache

BackgroundErectile dysfunction (ED), defined as the inability to achieve or maintain an erection sufficient for satisfactory sexual performance, is a common condition. The psychological, hormonal, neurogenic and arterial pathologies, medications, chronic diseases have been reported in the etiology of the ED. This paper aims to study sexual dysfunction in the male patients with migraine and Tension type headache (TTH).Methods30 migraine cases (Group M), 31 TTH cases (Group T) and 30 control cases (Group C) were included in the study. Patients were evaluated with medical history, physical examination, body mass index (BMI), Beck Depression Inventory, biochemical analysis and hormone profiles. ED was evaluated via International Index of Erectile Function Scale (IIEF). In statistical analysis, variant analysis, post-hoc tukey test, Pearson correlation test, t-test, and fisher's exact chi-square test were used.ResultsThe patients' mean age was 34.96+/−1.30, 35.54+/−1.52 and 32.26+/−1.38 for group M,T and C, respectively. There was no significant difference between the groups in terms of testosterone levels. Mean IIEF scores was 19.83+/−2.2, 20.39+/−1.35 and 27.83+/−0.34 in groups M,T,C. When M and T groups were compared with group C, there were significant differences, and there was no statistical difference when T and M groups were compared to each other. Beck Depression Scores were not significantly different in groups M, T and C.ConclusionIn this study, it was shown that, migraine and TTH affects the sexual functions negatively in male patients. Chronic diseases may cause sexual disorders in patients because of despair, guilt, and fear of death or pain. Our results suggest that, along with the effect of chronic disease and pain, there must be other complicated factors exist causing the development of SD in patients with migraine and TTH.

The effect of chronic diseases on survival and functional status in very old people

The effect of chronic diseases on survival and functional status in very old people

Potentiating exercise training with resveratrol

Potentiating exercise training with resveratrol

Early childhood environment and dementia

Since its inception in 1998, the 10/66 Dementia Research Group has played a crucial part in our understanding of the effect of dementia in the developing world. It has developed, translated, harmonised, and established normative values for assessment instruments in 25 centres in India, China, southeast Asia, Latin America, the Caribbean, and Africa.1 The group has completed prevalence studies in these countries and with time has expanded its range to diagnostic algorithms, the effect of chronic diseases, care management, and health policy.