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complex chronic condition

Stefanie C Vuotto, Kevin R Krull, Chenghong Li, Kevin C Oeffinger, Daniel M Green, Sunita K Patel, Deokumar Srivastava, Marilyn Stovall, Kirsten K Ness, Gregory T Armstrong, Leslie L Robison, Tara M Brinkman
BACKGROUND: The current study was performed to examine associations between childhood cancer therapies, chronic health conditions, and symptoms of emotional distress in adult survivors of childhood cancer. METHODS: Participants included 5021 adult survivors of childhood cancer (mean age, 32.0 years [standard deviation, 7.6 years] with a time since diagnosis of 23.2 years [standard deviation, 4.5 years]) who completed measures assessing symptoms of anxiety, depression, and posttraumatic stress...
October 20, 2016: Cancer
Shasha Li, Hao Hu, Zhiheng He, Deguang Liang, Rui Sun, Ke Lan
Kaposi's sarcoma (KS)-associated herpesvirus (KSHV) is an oncogenic pathogen that displays latent and lytic life cycles. In KS lesions, infiltrated immune cells, secreted viral and/or cellular cytokines, and hypoxia orchestrate a chronic pro-lytic microenvironment that can promote KSHV reactivation. However, only a small subset of viruses spontaneously undergoes lytic replication in this pro-lytic microenvironment while the majority remains in latency. Here, we show that the expression of the Notch ligand JAG1 is induced by KSHV-encoded replication and transcription activator (RTA) during reactivation...
October 2016: PLoS Pathogens
Marlen Vitales-Noyola, Rita Martínez-Martínez, Juan P Loyola-Rodríguez, Lourdes Baranda, Perla Niño-Moreno, Roberto González-Amaro
BACKGROUND: Periodontal disease is chronic inflammatory process that affects the attachment structures of the teeth and constitutes a significant cause of tooth loss in adults. Although different bacteria play an important role in the triggering of this condition, the progression and severity of the disease are strongly affected by the host immune response, which is under the control of different immune-regulatory mechanisms, including T regulatory (Treg) cells. The aim of this study was to assess the frequency and function of CD69(+) Treg lymphocytes in patients with chronic periodontal disease...
October 19, 2016: Journal of Oral Pathology & Medicine
Rosemary Fama, Edith V Sullivan, Stephanie A Sassoon, Adolf Pfefferbaum, Natalie M Zahr
BACKGROUND: Executive functioning and episodic memory impairment occur in HIV infection (HIV) and chronic alcoholism (ALC). Comorbidity of these conditions (HIV + ALC) is prevalent and heightens risk of vulnerability to separate and compounded deficits. Age and disease-related variables can also serve as mediators of cognitive impairment and should be considered, given the extended longevity of HIV-infected individuals in this era of improved pharmacological therapy. METHODS: HIV, ALC, HIV + ALC, and normal controls (NC) were administered traditional and computerized tests of executive function and episodic memory...
October 19, 2016: Alcoholism, Clinical and Experimental Research
K S Rock, R J Quinnell, G F Medley, O Courtenay
The leishmaniases comprise a complex of diseases characterized by clinical outcomes that range from self-limiting to chronic, and disfiguring and stigmatizing to life threatening. Diagnostic methods, treatments, and vector and reservoir control options exist, but deciding the most effective interventions requires a quantitative understanding of the population level infection and disease dynamics. The effectiveness of any set of interventions has to be determined within the context of operational conditions, including economic and political commitment...
2016: Advances in Parasitology
Rebecca DeVries, David Kriebel, Susan Sama
BACKGROUND: Exacerbations of chronic obstructive pulmonary disease (COPD) contribute greatly to increased morbidity, mortality and diminished quality of life. Recent studies report moderately strong positive associations between exposures to several air pollutants and COPD-related emergency department (ED) visits and hospital admissions (HA). Studies that use clinically defined exacerbations rather than counting ED visits and HA may be more sensitive to environmental triggers like air pollution, but very few such studies exist...
October 18, 2016: Environmental Health: a Global Access Science Source
David G Reuter, Yuk Law, Wayne C Levy, Stephen P Seslar, R Eugene Zierler, Mark Ferguson, James Chattra, Tim McQuinn, Lenna L Liu, Mark Terry, Patricia S Coffey, Jane A Dimer, Coral Hanevold, Joseph T Flynn, F Bruder Stapleton
The morbidity and mortality associated with preeclampsia is staggering. The physiology of the Page kidney, a condition in which increased intrarenal pressure causes hypertension, appears to provide a unifying framework to explain the complex pathophysiology. Page kidney hypertension is renin-mediated acutely and ischemia-mediated chronically. Renal venous outflow obstruction also causes a Page kidney phenomenon, providing a hypothesis for the increased vulnerability of a subset of women who have what we are hypothesizing is a "renal compartment syndrome" due to inadequate ipsilateral collateral renal venous circulation consistent with well-known variation in normal venous anatomy...
September 15, 2016: Journal of the American Society of Hypertension: JASH
Enrico Bellato, Roberto Rotini, Alessandro Marinelli, Enrico Guerra, Shawn W O'Driscoll
BACKGROUND: Chronic coronoid deficiency can occur subsequent to coronoid fracture malunion/nonunion or to coronoid hypoplasia or dysplasia resulting from injury during development. Several surgical options have been described to treat this difficult condition, but results are equivocal. We hypothesized that a modified coronoid reconstruction using a radial head osteochondral graft could restore elbow stability and congruity and that a technique involving rigid internal fixation would promote graft union...
October 14, 2016: Journal of Shoulder and Elbow Surgery
Chung Eui You, Seok Hoon Moon, Kwang Hoon Lee, Kyu Han Kim, Chun Wook Park, Seong Joon Seo, Sang Hyun Cho
BACKGROUND: Atopic dermatitis (AD) is a common, complex disease that follows a chronic relapsing course and significantly affects the quality of life of patients. Skin barrier dysfunction and inflammatory processes induce and aggravate this skin condition. Proper use of an emollient for hydration is a keystone of AD treatment. Bee venom is known to have anti-inflammatory effects and has been widely used in traditional medicine to treat various inflammatory disorders. OBJECTIVE: To find out the beneficial effect of an emollient containing bee venom in the treatment of patients with AD...
October 2016: Annals of Dermatology
Giuseppe Lanza, Cornelius G Bachmann, Imad Ghorayeb, Yuping Wang, Raffale Ferri, Walter Paulus
Neurophysiological techniques have been applied in restless legs syndrome (RLS) to obtain direct and indirect measures of central and peripheral nervous system excitability, as well as to probe different neurotransmission pathways. Data converge on the hypothesis that, from a pure electrophysiological perspective, RLS should be regarded as a complex sensorimotor disorder in which cortical, subcortical, spinal cord, and peripheral nerve generators are all involved in a network disorder, resulting in an enhanced excitability and/or decreased inhibition...
August 27, 2016: Sleep Medicine
Zachary A Marcum, Nakia A Duncan, Una E Makris
Pharmacologic management of chronic pain in older adults is one component of the multimodal, interdisciplinary management of this complex condition. In this article, we summarize several of the key barriers to effective pharmacologic management in older adults and review the existing (albeit limited) evidence for its effectiveness and safety, especially in a medically complex population with multimorbidity. This review covers topical formulations, acetaminophen, oral nonsteroidal antiinflammatory drugs, and adjuvant therapies...
November 2016: Clinics in Geriatric Medicine
JoAnn Trial, Lawrence A Potempa, Mark L Entman
The participation of C-reactive protein (CRP) in host defense against microorganisms has been well described. More controversial has been its role in chronic conditions such as cardiovascular disease. Our recent publications explain the reasons for some of the confusion concerning CRP as a risk factor for disease and whether it is pro-inflammatory or anti-inflammatory. We found that two isoforms of CRP, pentameric (pCRP) and monomeric (mCRP), on microparticles (MPs), were not measureable by standard clinical assays...
2016: Inflammation and Cell Signaling
Sarah Sallon, Yahav Dory, Yazeed Barghouti, Tsewang Tamdin, Rigzin Sangmo, Jamyang Tashi, Sonam Yangdon, Tenzin Yeshi, Tsetan Sadutshang, Michal Rotenburg, Elinor Cohen, Yehudit Harlavan, Galit Sharabi, Tali Bdolah-Abram
Mercury an important therapeutic substance in Tibetan Medicine undergoes complex "detoxification" prior to inclusion in multi-ingredient formulas. In an initial cross-sectional study, patients taking Tibetan Medicine for various conditions were evaluated for mercury toxicity. Two groups were identified: Group 1, patients taking " TSOTHEL: " the most important detoxified mercury preparation and Group 2, patients taking other mercury preparations or mercury free Tibetan Medicine. Atomic fluorescence spectrometry of Tibetan Medicine showed mercury consumption 130 µg/kg/day (Group 1) and 30 µg/kg/day (Group 2) (P ≤ 0...
October 13, 2016: Experimental Biology and Medicine
Antonio G Zippo, Maurizio Valente, Gian Carlo Caramenti, Gabriele E M Biella
Chronic pain (CP) is a condition with a large repertory of clinical signs and symptoms with diverse expressions. Though widely analyzed, an appraisal at the level of single neuron and neuronal networks in CP is however missing. The present research proposes an empirical and theoretic framework which identifies a complex network correlate nested in the somatosensory thalamocortical (TC) circuit in diverse CP models. In vivo simultaneous extracellular neuronal electrophysiological high-density recordings have been performed from the TC circuit in rats...
October 13, 2016: Scientific Reports
Sheena Derry, Cathy Stannard, Peter Cole, Philip J Wiffen, Roger Knaggs, Dominic Aldington, R Andrew Moore
BACKGROUND: Opioid drugs, including fentanyl, are commonly used to treat neuropathic pain, and are considered effective by some professionals. Most reviews have examined all opioids together. This review sought evidence specifically for fentanyl, at any dose, and by any route of administration. Other opioids are considered in separate reviews. OBJECTIVES: To assess the analgesic efficacy of fentanyl for chronic neuropathic pain in adults, and the adverse events associated with its use in clinical trials...
October 11, 2016: Cochrane Database of Systematic Reviews
Tarek M Hegazi, Jeffrey A Belair, Eoghan J McCarthy, Johannes B Roedl, William B Morrison
Injuries of the hip and surrounding structures represent a complex and commonly encountered scenario in athletes, with improper diagnosis serving as a cause of delayed return to play or progression to a more serious injury. As such, radiologists play an essential role in guiding management of athletic injuries. Familiarity with hip anatomy and the advantages and limitations of various imaging modalities is of paramount importance for accurate and timely diagnosis. Magnetic resonance (MR) imaging is often the modality of choice for evaluating many of the injuries discussed, although preliminary evaluation with conventional radiography and use of other imaging modalities such as ultrasonography (US), computed tomography, and bone scintigraphy may be supplementary or preferred in certain situations...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
William L Hasler
Chronic unexplained nausea and vomiting (CUNV) refers to a symptom complex defined by nausea and/or vomiting with normal diagnostic testing, including anatomic assessments (including upper endoscopy) and measures of upper gut function (e.g., gastric emptying testing). Nausea and vomiting in this condition are postulated to result from aberrant peripheral or central neurohumoral activity. A substantial subset of patients satisfies this diagnosis as more than half of individuals referred for scintigraphic testing exhibit normal gastric emptying rates...
October 10, 2016: Current Treatment Options in Gastroenterology
Janine Margarita Dizon, Karen Grimmer, Shingai Machingaidze, Pam McLaren, Quinette Louw
BACKGROUND: Little is known about allied health (AH) clinical practice guideline (CPG) activity in South Africa, and particularly in relation to primary health care (PHC). This paper reports on a scoping study undertaken to establish a reference framework, from which a comprehensive maximum variation sample could be selected. This was required to underpin robust sampling for a qualitative study aimed at understanding South African primary care AH therapy CPG activities. This paper builds on findings from the South African Guidelines Evaluation (Project SAGE) Flagship grant...
October 10, 2016: Health Research Policy and Systems
J Koudy Williams, Gopal Badlani, Ashley Dean, Shannon Lankford, Kimberly Poppante, Tracy Criswell, Karl-Erik Andersson
BACKGROUND: Many factors may influence the efficacy of cell therapy for intrinsic urinary sphincter deficiency (ISD), including the route of administration of the cells and the condition of the sphincter. The goal of this study was to compare local versus intravenous administration of autologous skeletal muscle precursor cells (skMPCs) when administered to nonhuman primates (NHPs) with either acute or chronic ISD. METHODS: Thirty-two adult female monkeys were divided into eight groups (n = 4/group): (1) control; (2) surgically induced ISD/no treatment; (3) acute ISD (6-week duration)/local vehicle only; (4) acute ISD/local skMPC injection; (5) acute ISD/systemic skMPC; (6) chronic ISD (6-month duration)/local vehicle; (7) chronic ISD/local skMPC; (8) chronic ISD/systemic skMPC...
October 7, 2016: Stem Cell Research & Therapy
Meredith Greene, Amy C Justice, Kenneth E Covinsky
: As the number of older adults living with HIV continues to increase, understanding how to incorporate geriatric assessments within HIV care will be critical. Assessment of geriatric syndromes and physical function can be useful tools for HIV clinicians and researchers to help identify the most vulnerable older adults and to better understand the aging process in PLWH. This review focuses on the assessment of falls, frailty and physical function, first in the general population of older adults and includes a specific focus on use of these assessments in older adults living with HIV...
October 7, 2016: Virulence
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