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Disease trajectories

Ming-Ching Wen, Hannah S E Heng, Samuel Y E Ng, Louis C S Tan, Ling Ling Chan, Eng King Tan
Parkinson's disease (PD) is a debilitating neurodegenerative disorder. Findings on specific white matter (WM) alterations in PD have been inconsistent. We hypothesized that WM changes occur in early PD patients and unbiased whole-brain analysis may provide additional evidence of pathological WM changes in PD. In this study, we examined various indexes of WM microstructure in newly diagnosed PD patients at the whole-brain level. 64 PDs with Hoehn &Yahr stage 1 (HY1PDs), 87 PDs with Hoehn &Yahr stage 2 (HYPD2s), and 60 controls (HCs) were recruited...
October 20, 2016: Scientific Reports
Jan-Marie Kozicky, Alexander McGirr, David J Bond, Marjorie Gonzalez, Leonardo E Silveira, Kamyar Keramatian, Ivan J Torres, Raymond W Lam, Lakshmi N Yatham
OBJECTIVES: Bipolar I disorder (BD-I) is associated with gray matter volume (GMV) alterations in neural regions important for emotional regulation. Reductions found in patients with multiple episodes are not seen at illness onset, suggesting that changes occur with illness progression, although no prospective studies to date have examined this. In the present study, we assessed GMV at baseline and one year following a first manic episode, examining the impact of episode recurrence on the trajectory of change...
September 2016: Bipolar Disorders
Anika Sparla, Sebastian Flach-Vorgang, Matthias Villalobos, Katja Krug, Martina Kamradt, Kadiatou Coulibaly, Joachim Szecsenyi, Michael Thomas, Sinikka Gusset-Bährer, Dominik Ose
PURPOSE: Lung cancer is a disease with a high percentage of patients diagnosed in an advanced stage. In a situation of palliative treatment, both patients and their relatives experience diverse types of distress and burden. Little research has been done to identify the individual difficulties and resources for patients with advanced lung cancer and their relatives. Especially, standardized questionnaire-based exploration may not assess the specific distressing issues that pertain to each individual on a personal level...
2016: Patient Preference and Adherence
Emma Aarnio, Janne Martikainen, Aaron N Winn, Risto Huupponen, Jussi Vahtera, Maarit J Korhonen
BACKGROUND: Previous research shows that low socioeconomic position (SEP; especially low income) is associated with statin nonadherence. We investigated the relationship between SEP and statin adherence in a country with universal coverage using group-based trajectory modeling in addition to the proportion of days covered. METHODS AND RESULTS: Using data from Finnish healthcare registers, we identified 116 846 individuals, aged 45 to 75 years, who initiated statin therapy for primary prevention of cardiovascular disease...
October 18, 2016: Circulation. Cardiovascular Quality and Outcomes
Kelsey M Flint, Sarah J Schmiege, Larry A Allen, Timothy J Fendler, John Rumsfeld, David Bekelman
CONTEXT: Health status (i.e., symptoms, function, and quality of life) is an important palliative care outcome in patients with heart failure, however patterns of health status over time (i.e. trajectories) are not well described. OBJECTIVES: To identify health status trajectories in outpatients with heart failure, and assess whether depression, symptom burden, or sense of peace predict health status trajectory. METHODS: Observational study utilizing data from the Patient-Centered Disease Management for Heart Failure trial...
October 15, 2016: Journal of Pain and Symptom Management
Eun-Jung Shim, Jee Eun Park, Myungsun Yi, Dooyoung Jung, Kwang-Min Lee, Bong-Jin Hahm
BACKGROUND: Doctor-patient communication is a crucial aspect of patient care. This study explored the communication experience of patients in a cancer consultation over the course of the cancer continuum. METHODS: In-depth interviews with seven breast cancer patients were carried out. RESULTS: Themes related to communication experiences across the five phases of cancer consultation, from diagnosis to recurrence, were identified. The most salient issue is that patients also perceived cancer as 'a disease of the mind', which is not adequately cared for in consultation...
October 18, 2016: BMC Women's Health
Katherine Clark, Lawrence T Lam, Nicholas J Talley, Jane L Phillips, David C Currow
OBJECTIVE: The aim of this work was to investigate whether variables identified as likely to impact the experience of constipation in other clinical settings similarly affected the experiences of constipated palliative care patients. BACKGROUND: The majority of palliative care patients with cancer are likely to be bothered by constipation symptoms at some point in their disease trajectory. Despite this, it remains unclear as to which factors predict more severe problems...
October 18, 2016: Journal of Palliative Medicine
Abhik Bhattacharya, Bhavana B Rao, Ioannis E Koutroubakis, Benjamin Click, Eric J Vargas, Miguel Regueiro, Marc Schwartz, Jason M Swoger, Dmitriy Babichenko, Douglas Hartmann, Claudia R Rivers, Arthur Barrie, Jana G Hashash, Michael A Dunn, David G Binion
BACKGROUND: Patients with Crohn's disease (CD) in clinical remission with elevated C-reactive protein (CRP) have been labeled "silent CD" and have increased 2-year hospitalization rates when compared with asymptomatic patients with no biochemical evidence of inflammation. The risk of cumulative bowel damage in patients with silent CD is unknown. METHODS: Observational study of patients with CD prospectively followed in a tertiary referral natural history registry...
November 2016: Inflammatory Bowel Diseases
Siddharth Ramanan, Maxime Bertoux, Emma Flanagan, Muireann Irish, Olivier Piguet, John R Hodges, Michael Hornberger
OBJECTIVES: With comparable baseline performance on executive functions (EF) and memory between Alzheimer's disease (AD) and behavioral-variant frontotemporal dementia (bvFTD), it is currently unclear if both diseases can be distinguished longitudinally on these measures reliably. METHODS: A total of 111 participants (33 AD, 31 bvFTD, and 47 controls) were followed-up annually over a 4-year period and tested on measures of EF, memory, and orientation. Linear mixed-effect models were constructed using disease severity as a nuisance variable to examine profiles of neuropsychological performance decline...
October 18, 2016: Journal of the International Neuropsychological Society: JINS
Yong Yu, Jason C H Tsang, Cui Wang, Simon Clare, Juexuan Wang, Xi Chen, Cordelia Brandt, Leanne Kane, Lia S Campos, Liming Lu, Gabrielle T Belz, Andrew N J McKenzie, Sarah A Teichmann, Gordon Dougan, Pentao Liu
Innate lymphoid cells (ILCs) functionally resemble T lymphocytes in cytotoxicity and cytokine production but lack antigen-specific receptors, and are important regulators in immune response and tissue homeostasis(1, 2). ILCs are generated from common lymphoid progenitors (CLPs), which are subsequently committed to innate lymphoid lineages in the α lymphoid progenitor (αLP), early innate lymphoid progenitor (EILP), common helper innate lymphoid progenitor (CHILP) and innate lymphoid cell progenitor (ILCP) compartments(3, 4, 5, 6, 7, 8)...
September 29, 2016: Nature
Aaron J Quyn, Michael J Solomon, Peter M Lee, Tim Badgery-Parker, Lindy M Masya, Jane M Young
BACKGROUND: Locally advanced pelvic malignancy can be associated with disabling symptoms and reduced quality of life. If resectable with clear margins, a pelvic exenteration can offer long-term survival and improved quality of life. Its role in the palliation of symptoms has been described; however, the clinical outcomes and surgical indication are poorly defined. OBJECTIVE: This study describes the clinical and quality-of-life outcomes after palliative pelvic exenteration for advanced pelvic malignancy...
November 2016: Diseases of the Colon and Rectum
Paolo T Pianosi, Zhen Zhang, Paul Hernandez, Marianne Huebner
BACKGROUND: Dyspnea or perceived exertion during exercise is most commonly measured using Borg or visual analog scales, created for use in adults. In contrast, pictorial scales have been promoted for children due to skepticism concerning applicability of the said scales in pediatrics. We sought to validate our newly created, pictorial Dalhousie Dyspnea and Perceived Exertion Scales in adult populations and compare ratings with the Borg scale. METHODS: Dyspnea and perceived exertion ratings obtained with both modified Borg CR-10 and Dalhousie scales during maximal cycle exercise were compared in 24 healthy adults and 17 with various pulmonary disorders...
December 2016: Sports Medicine—Open
Adam Ralph, Martin Somers, Jonathan Cowman, Bruno Voisin, Emma Hogan, Hannah Dunne, Eimear Dunne, Barry Byrne, Nigel Kent, Antonio J Ricco, Dermot Kenny, Simon Wong
The imaging of shear-mediated dynamic platelet behavior interacting with surface-immobilized von Willebrand factor (vWF) has tremendous potential in characterizing changes in platelet function for clinical diagnostics purposes. However, the imaging output, a series of images representing platelets adhering and rolling on the surface, poses unique, non-trivial challenges for software algorithms that reconstruct the positional trajectories of platelets. We report on an algorithm that tracks platelets using the output of such flow run experiments, taking into account common artifacts encountered by previously-published methods, and we derive seven key metrics of platelet dynamics that can be used to characterize platelet function...
October 14, 2016: Cardiovascular Engineering and Technology
Hongmei Xia, Yinxiang Xu, Zhiqing Cheng, Yongfeng Cheng
Tetramethylpyrazine (TMP) was extracted from Ligusticum chuanxiong hort. The compound is known to have a variety of medicinal functions; in particular, it is used for the treatment of cerebral ischemic diseases. TMP-loaded hydrogels offer an excellent preparation with the capacity to bypass the blood-brain barrier, allowing treatment of the brain through intranasal administration. We prepared TMP-loaded hydrogels using carbomer 940 and evaluated the release of TMP from the hydrogel. We determined the release rate using Franz-type diffusion cell experiments with a subcutaneous-mucous-membrane model and also by a molecular dynamics (MD) simulation...
October 14, 2016: AAPS PharmSciTech
Alireza Karbalayghareh, Ulisses Braga-Neto, Jianping Hua, Edward R Dougherty
Gene-expression-based phenotype classification is used for disease diagnosis and prognosis relating to treatment strategies. The present paper considers classification based on sequential measurements of multiple genes using gene regulatory network (GRN) modeling. There are two networks, original and mutated, and observations consist of trajectories of network states. The problem is to classify an observation trajectory as coming from either the original or mutated network. GRNs are modeled via probabilistic Boolean networks, which incorporate stochasticity at both the gene and network levels...
October 11, 2016: IEEE/ACM Transactions on Computational Biology and Bioinformatics
O M S Fredheim, S Brelin, M J Hjermstad, J H Loge, N Aass, T B Johannesen, S Skurtveit
BACKGROUND: Even though validation studies of the WHO analgesic ladder have indicated that the simple approach of the analgesic ladder can provide adequate pain control in most patients, prevalence studies have documented a high prevalence of pain in cancer patients. Little is known about how analgesics are actually prescribed for cancer pain. The aim of the study was to study prescriptions of analgesics during the entire disease trajectory in patients dying from cancer within five years of diagnosis...
October 14, 2016: European Journal of Pain: EJP
Robert-Paul Juster, Jennifer J Russell, Daniel Almeida, Martin Picard
Stress-related pathophysiology drives comorbid trajectories that elude precise prediction. Allostatic load algorithms that quantify biological "wear and tear" represent a comprehensive approach to detect multisystemic disease processes of the mind and body. However, the multiple morbidities directly or indirectly related to stress physiology remain enigmatic. Our aim in this article is to propose that biological comorbidities represent discrete pathophysiological processes captured by measuring allostatic load...
November 2016: Development and Psychopathology
Eleanor Hall, Norma Graciela Cuellar
INTRODUCTION: Immigrants have a negative health trajectory due to interactions between immigration policies and the totality of the immigration experience. Despite the enactment of the Patient Protection and Affordable Care Act in 2010, an association with the sociopolitical environment and its influence on chronic disease prevalence remains. The purpose of this review was to provide evidence for existing health disparities among immigrants based on ethnicity, immigration status, country of origin, duration in the United States...
November 2016: Journal of Transcultural Nursing: Official Journal of the Transcultural Nursing Society
Venkatesh L Murthy, Siddique A Abbasi, Juned Siddique, Laura A Colangelo, Jared Reis, Bharath A Venkatesh, J Jeffrey Carr, James G Terry, Sarah M Camhi, Michael Jerosch-Herold, Sarah de Ferranti, Saumya Das, Jane Freedman, Mercedes R Carnethon, Cora E Lewis, Joao A C Lima, Ravi V Shah
BACKGROUND: Despite evidence suggesting that early metabolic dysfunction impacts cardiovascular disease risk, current guidelines focus on risk assessments later in life, missing early transitions in metabolic risk that may represent opportunities for averting the development of cardiovascular disease. METHODS AND RESULTS: In 4420 young adults in the Coronary Artery Risk Development in Young Adults (CARDIA) study, we defined a "metabolic" risk score based on components of the Third Report of the Adult Treatment Panel's definition of metabolic syndrome...
October 13, 2016: Journal of the American Heart Association
Gabrielle Martel, Charles-André Couture, Guillaume Gilbert, Stéphane Bancelin, Hélène Richard, Thomas Moser, Sabrina Kiss, François Légaré, Sheila Laverty
Osteochondrosis is an ischemic chondronecrosis of epiphyseal growth cartilage that results in focal failure of endochondral ossification and osteochondritis dissecans at specific sites in the epiphyses of humans and animals, including horses. The upstream events leading to the focal ischemia remain unknown. The epiphyseal growth cartilage matrix is composed of proteoglycan and collagen macromolecules and encases its vascular tree in canals. The matrix undergoes major dynamic changes in early life that could weaken it biomechanically and predispose it to focal trauma and vascular failure...
October 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
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