become evident, generating numbness, loss or paralysis of the affected nerve in addition to anhidrosis. The purpose of this work is to carry out an epidemiological study consulting DATASUS, analyzing data from 1999 to 2019 regarding patients who had already been diagnosed on brazilian territory with the chronic infectious disease in question. Based on this information, the number of cases was analyzed according to periodicity, age group, degree of mortality, regionality and sex in order to comprehend the evolution of Hansen`s disease in the last 20 years. Therefore, according to the study, epidemiology in Brazil showed a significant drop in the prevalence rate, reaching, in 2015, the lowest rate in the last 11 years. Even so, it is considered a country with a high burden for the disease, being second in the ranking of countries with the highest number of cases in the world, only behind India. In conclusion, the preventive actions are important in the routine of health services and should be recommended for all patients, through health education and preventive exercises.
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Leprosy is a disease of great antiquity & it still continuous to be a significant health problem in few countries including India. Leprosy is a chronic infectious disease caused by mycobacterium leprae.Of the various mechanism that influences the pathogenesis of leprosy ,oxidative stress is important which occurs due to derangement in the balance between ROS and natural antioxidant.Considering this the study was planned to observe the status of oxidative stress in terms of lipid peroxidation and thiol as antioxidant in leprosy.In present study 50 leprosy patient &50 age and sex matched healthy controls were included.Out of 50 leprosy patient 34 were multibacillary(MB) leprosy patients and16 were paucibacillary(PB)leprosy patients. The level of Malondialdehyde as a marker of lipid peroxidation was found to be significantly increased in leprosy patients than controls. Again the level Malondialdehyde was found to be significantly increasd in multibacillary leprosy patients than paucibacillary leprosy patients.The level of thiolwas found to be significantly decreased in leprosy patients than controls. Again the level thiol was found to be significantly decreasd in multibacillary leprosy patients than paucibacillary leprosy patientsThe negative correlation among Malondialdehyde and thiol was observed among patients.Thus, increaseof lipid peroxidation and decrease in thiol leads protein modifications in leprosy which may be responsible for disease progression.
CHD, particularly its association with diabetes, is a com- mon focus of the CCM [121, 122]. The requirement for life-long adherence to cardiac medications and lifestyle modifications as well as the need for treatment of comorbidities means that the patient-centred CCM provides a useful framework for long-term management of CHD. In the management of TB (and other infec- tions), some components of the CCM may be utilised during the antibiotic treatment phase, but not beyond, despite the potential benefits after microbiological cure. Well-functional TB control programs have specific public health mechanisms to support care and reduce patient default, provide patient education, provide deci- sion support to practitioners through written national TB treatment policies, and good data collection to pro- vide feedback nationally and to the WHO. While these structures are nominally in place internationally, there is always scope for improvement in the quality of imple- mentation, to ensure the desired outcome of ‘informed, activated patients and communities’ and ‘prepared, pro- active practice teams and community partners’ as described in the chronic care model . Two themes of the CCM emphasise the importance of patient and community engagement – the ‘self-management support; and ‘community engagement’ themes. New community- driven approaches to TB control, mentioned above [92, 93] provide informative strategies that could be used to by RHD control programs to address these themes of the CCM.
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late as 22 years of age, of which eight had X-linked dis- ease but residual cytochrome function and three had the AR disease, while nine out of the eleven patients had some residual production of reactive oxygen metabolites, explaining their delayed presentation . In a European cohort study consisting of 429 patients , 67% had X- linked disease and 33% had the AR counterpart. The patient population consisted of 351 males and 78 females . According to retrospective data collected in this series of patients, AR disease was diagnosed later and the mean survival time was significantly better in these patients (49.6 years) than in XL disease (37.8 years), compatible with other reports from the United States and elsewhere. Pulmonary (66% of patients), der- matological (53%), lymphatic (50%), alimentary (48%), and hepatobiliary (32%) complications were the most frequently observed . Staphylococcus aureus, Asper- gillus spp, and Salmonella spp. were the most common cultured pathogens in that order, while Pseudomonas spp. and Burkholderia cepacia were rarely observed. Roughly 3/4 th of the patients received antibiotic prophy- laxis, 1/2 antifungal prophylaxis, and 1/3 rd -received gamma-interferon. Less than 10% of the patients had received stem cell transplantation. Bacterial pneumonia and/or pulmonary abscess, systemic sepsis and brain abscess were the leading causes of death in this series. The differences between the European and United States data/observations are shown in Table 7.
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There are still limitations in this study. The study enrolled patients from single medical center and did not include patients with less severe disease. This may limit generalization of our results to a larger population. Second, the attribution of infectious spondylodiscitis to permanent neurologic outcome was not clear. Patients documented to be bedridden or wheelchair-bound were possibly affected by severe physical de-conditioning during hospitalization rather than a true, significant nerve injury. We could not distinguish these 2 important factors apart. Finally, despite some significant findings, the retrospective study only pro- vides association but not causal relationship.
infections are related to the need of these patients for a vascular access for the performance of Renal Substitutive Therapy. The possibility of NANDA-I/NOC/NIC binding for the patient undergoing central venous catheter for hemodialysis was identified: Risk of infection/Risk control: Infectious process/Care with vascular device, using scientific evidence for justifying such a connection, recognizing the mechanical and infectious risk that the use of the device brings about the patient undergoing hemodialysis and the clinical severity of its complications (Lima Guimarães et al., 2017). As a second major complication, hydroelectrolytic imbalance was found in 49.32% of the patients. With renal injury, the kidneys are unable to perform their homeostatic functions, leading to serious clinical repercussions in the organism, such as altered neurological status or cardiac arrhythmias (Freitas Dutra et al., 2012). The cardiac arrhythmias were also found in this study as an important complication in patients with CKD, corresponding to 36.99% of the records analyzed. Anemia is one of the most frequent clinical manifestations in patients with CKD, identified as one of the complications diagnosed in 35.62% of medical records. A significant portion of CKD patients with anemia were identified in a study, even in the early stages, and iron deficiency was a determining factor in this condition. Thus, correction of this complication is essential, since the scientific evidence suggests that the correction of anemia may decrease the rate of progression of CKD (Canziani et al., 2006). Hemorrhage is shown as a complication in the research (20.55%), corroborating the data of patients with anemia. According to some studies, patients with CKD who undergo hemodialysis
A consecutive series of patients with periodontal disease were referred to the Department of Periodontics in Thai Moogambigai Dental College among which, most of the individuals were a known diabetic case. The survey was taken among the known diabetic individuals, of which 50 individuals participated in the survey. The survey was taken in the form of questionnaire and the questions were framed on the basis of oral infection associated with diabetes and their knowledge about the two way relationship. Ethical commitee approval was obtained from the university. The patient’s were briefd about the study and an Informed consent was obtained from them.
Proposed Method: Four machine learning methods were used to predict the case of Chronic Kidney Disease with the aid of WEKA (Waikato Environment for Knowledge Analysis) software, written in Java, developed at Waikato University (Hall et al., 2009). The work methodology is shown in Figure 1.Figure 1 show which WEKA software was used to perform the classification experiments. The experiments consisted of two steps: training and testing of the classifiers using the respective 90% and 10% databases. After the classifier training phase, the 10-fold cross-validation method was used for (2012), for example, aided diagnostic tool based on ultrasound imaging used to detect and classify different stages (2014), have suggested a distributed approach for the management of alarms related to the monitoring of patients with CKD within the eNefro project. Rosmani et al. (2015), care guidelines for patients with CKD, and implemented a communication channel that assists patients in have developed a system that evaluates in real time the patient's ultrasound images in order to verify the probability of having CKD. Other ) techniques, Singh et used hierarchical methods for assessing CKD and heart failure through high dimensional data. Chiu et al (2012), proposed an intelligent model using artificial neural networks that detects and evaluates the severity of renal disease. obtained high accuracy in the early detection of CKD using Decision Tree as the herefore, it is verified that ML methods are a solution to classification problems such as screening of patients with CKD. For, they offer a more accurate prediction about the health of the individual (Lenart, In the field of health care, this work aims to construct a on model to assist in the early diagnosis of CKD invasive clinical data, low cost and easy application,
Currently, the nephrology referral guidelines for patients with moderate CKD (eGFR 30 to 60 mL/min) in the UK primary care setting rely on determining which patients have pheno- typic features leading physicians to suspect that progressive kidney dysfunction is likely to occur. These features include hypertension which is poorly controlled despite the utilization of several classes of antihypertensive medications, progres- sive decrease in eGFR (5 mL/min/year), the presence of hematuria, significant proteinuria, normochromic anemia, electrolyte imbalances and a significant (15%) fall in eGFR after the introduction of drugs blocking the RAS. These fea- tures are associated with the need for further investigation or specialist treatments; however they do not accurately predict which patients will actually progress to requiring kidney replacement. Epidemiologically such patients are certainly at high risk of cardiovascular morbidity and mortality and this provides an opportunity to study the relationship between cardiovascular and kidney disease at an earlier stage than has previously been examined.
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development, innovative strategies for vector control and vector population monitoring, etc., have to be prom- inently assisted by approaches based on Information Technology (IT). It becomes clear that there is a need for new effective tools that will be able to combine dif- ferent, yet related datasets covering various aspects of disease (e.g. epidemiological and entomological data, intervention efforts, etc.). These tools encompass re- sources such as smart databases (including decision sup- port systems), enhanced bioinformatics software and usage of technologies such as the Internet and mobile telephony for the fast transfer of data. The latter is espe- cially crucial, given that malaria usually strikes the world’s poorest areas, in countries in which general in- frastructures are often under-developed.
Taking into account the results of recent me- ta-analysis, it is considered that administration of probiotics in the case of infectious diarrhea offers modest benefits compared with the control group, including shortening of diarrhea duration on aver- age by 17–30 hours. This effect depends on the type of probiotic strain administered. Documented ac- tivity is shown by Lactobacillus GG and S. boular- dii. The effect of probiotics on the course of acute diarrhea was considered to be clinically relevant in the case of diarrhea of viral etiology and the best results were achieved through the use of supple- ments in the initial stage of the onset of symptoms. Previous observations indicate that more concen- trated dose of probiotics, more than 10 9 –10 11 CFU,
Group 2 patients were selected from those attending the Nephrology department of Stanley Medical College Hospital from April’ 07 to July’ 07. The study subjects were clearly informed of the nature of the study and the samples were collected after getting written informed consent. The samples were analyzed for iron, ferritin, total iron binding capacity (TIBC), transferrin saturation, transferrin, zinc, copper, ceruloplasmin and the results were analyzed based on the data collected.
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respiratory, enteric, skin and soft tissue, urinary or other infection. Independent associations of demographic and child health factors with infectious disease readmission were determined using multiple variable logistic regression. Results: From 2005 to 2011, there were 69,902 infectious disease admissions for 46,657 children less than two years old. Of these 46,657 children, 10,205 (22%) had at least one infectious disease readmission within 12 months of their first admission. The first infectious disease admission was respiratory (54%), enteric (15%), skin or soft tissue (7%), urinary (4%) or other (20%). Risk of infectious disease readmission was increased if the first infectious disease admission was respiratory (OR = 1.87, 95% CI 1.78 – 1.95) but not if it was in any other infectious disease category. Risk factors for respiratory infectious disease readmission were male gender, Pacific or M ā ori ethnicity, greater household deprivation, presence of a complex chronic condition, or a first respiratory infectious disease admission during autumn or of ≥ 3 days duration. Fewer factors (younger age, male gender, presence of a complex chronic condition) were associated with enteric infection readmission. The presence of a complex chronic condition was the only factor associated with urinary tract infection readmission and none of the factors were associated with skin or soft tissue infection readmission.
Cardiovascular disease accounts for over 50% of mortality among patients with chronic kidney disease before reaching end-stage renal disease.The prevalence of chronic kidney disease continues to increase worldwide, and the relationship between renal impairment (RI) and risk of coronary artery disease is well established .Patients with RI typically present with advanced and more complex coronary artery disease compared to patients without RI, as indicated by a higher proportion of multivessel disease, left main disease, ostial lesions, heavily calcified lesions, and lesions located in vein grafts. Percutaneous coronary intervention (PCI) is the most commonly utilized revascularization modality for treatment of CAD both in patients with acute coronary syndromes (ACS) and those with stable ischemic heart disease (SIHD). In patients undergoing coronary revascularization for either stable coronary artery disease or acute myocardial infarction, CKD is one of the strongest risk factors for short- and long term mortality. There is evidence that coronary revascularization reduces the cardiac mortality and improves prognosis compared to medical treatment for CKD patients with CAD. With regard to evidence of best mode of coronary revascularization, percutaneous coronary intervention (PCI) are two alternative methods, but it remains controversial as which one is associated with reduced major adverse cardiac and cerebral events (MACCE), reduced risk of worsening kidney function and need of hemodialysis and reduced in-hospital stay for CKD patients. PCI in patients with CKD is also high-risk due to their increased incidence of worsening kidney function, restenosis, and mortality. To the best of our knowledge, there is paucity of prospective study results
may account for both the destruction of lung tissue and the development of osteoporosis (Jorgensen and Schwarz, 2008). Most patients with COPD are not completely immobilized; however, advanced COPD often is associated with decreased functional status and mobility (Biskobing, 2002; Bourjeily and Rochester, 2000). The decreased exercise tolerance is due to multiple factors, including dyspnea and deconditioning due to respiratory and peripheral skeletal muscle weakness (Bourjeily and Rochester, 2000). Skeletal muscle dysfunction in COPD is probably multifactorial. The reduced mobility due to shortness of breath, the myopathy due to corticosteroid treatments and metabolic factors generate a vicious circle more obvious in patients with severe disease (American Thoracic Society and European Thoracic Society, 1999; Gosselink et al., 1996; Ionescu and Schoon, 2003). Patients with COPD are at risk to develop osteoporosis due to a reduced skeletal muscle mass and strength, both secondary to the disease and due to the natural process of ageing. It remains for future research to assess if training of various skeletal muscle groups improve BMD or prevent the progressive loss of bone mass (Ionescu and Schoon, 2003). It is found that BMI was the strongest predictor of osteoporosis in patients with COPD (Biskobing, 2002). Both the BMI and the mid arm muscle circumference (an index of FFM) were associated with a reduced BMD in patients with COPD (Biskobing, 2002). Such studies support the view that weight loss and mainly the depletion of FFM are factors contributing to the loss of BMD in some patients with COPD. Many patients with end-stage COPD lose weight as the disease progresses due to decreased intake and increased energy requirements (Schols and Wouters, 2000). Iqbal et al., (1999) reported that the lowest BMD was seen in a group of patients with BMI below the normal median and reported an independent correlation between BMI and BMD. Hypogonadism and the reduced availability of sex hormones, either due to ageing or to the effect of corticosteroid treatment, contribute to the development of osteoporosis. Oestrogen deficiency in females increases the bone loss after menopause, and the decline in circulating free oestrogen in elderly males has also been related to a reduction in bone mass (Raisz, 1988; Falahati-Nini et al., 2000; Ionescu and Schoon, 2003; Graat- Verboom et al., 2009; Seeman, 2002). Oestrogen regulates both bone resorption and formation, while testosterone regulates bone formation (Falahati-Nini et al., 2000; Ionescu and Schoon, 2003; Seeman, 2002).
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NO is also known to increase renin, the precursor for the RAAS. The RAAS involves several players: renin is released by juxtaglomerular cells in the kidneys in response to low BP, causing cleavage of angiotensinogen (precursor made in the liver) to angiotensin I. Angiotensin I is, in turn, converted to angiotensin II by ACE in the lungs. Angiotensin II is a vasoconstrictor that accumulates in patients with CKD, and results in a variety of downstream effects causing increased BP. Angiotensin II acts on the zona glomerulosa of the adre- nal cortex to release aldosterone in order to increase water absorption and sodium uptake from the distal convoluted tubule and the collecting duct; 39 alters baroreceptor reflexes
reactance in other peripheral IOS parameters, such as R5, R5–R20, AX, and resonant frequency, although these results were not significant. No difference was observed in inflam- matory biomarkers measured in EBC (Figure 3A) or in clini- cal parameters, ie, C-reactive protein (CRP), CCQ, or MRC scores (Figure 3B). There were no differences in age, sex, smoking status, or oxygen saturation. There was a tendency, albeit not statistically significant, for increased frequency of exacerbation during the study among patients chronically colonized with H. influenzae; seven of ten (70%) chronically colonized patients exacerbated compared with eleven of 21 (52%) non-chronically colonized patients (Figure 4).
with data from the pilot studies, they should be weighed with the limitations that are inherent in identifying adverse events by chart review. While some patients in the COPD or asthma group had documented pulmonary function tests consistent with these diagnoses, self-declaration of COPD or asthma history was alone sufficient to be included in the study group. Furthermore, severity of COPD/asthma was not defined, and adverse outcomes were noted only if they were severe enough to have warranted a documented clinical encounter or death. Though the study cohort was described as comprising unselected, consecutive patients with COPD or asthma undergoing regadenoson stress MPI, these patients were, in effect, preselected by practitioners who deemed their underlying lung disease stable enough for regadenoson to be safely administered.
To analyze the association between respiratory medication and lung cancer risk we stratified patients into ‘non-users’, ‘cur- rent users’, or ‘past users’. Current users were patients who received their last prescription within 180 days prior to the lung cancer diagnosis, and past users were all the patients who had prescriptions for the drugs of interest recorded .180 days prior to the lung cancer diagnosis. We further subdivided ‘cur- rent use’ into ‘current short-term use’ of less then a year (ie, patients have had their first drug prescription within a year prior to the diagnosis), of 1–3 years, or of .3 years. We also divided current and past users into ‘regular’ or ‘intermittent’ user; in order to be a ‘regular user’, patients had to have at least one prescription recorded every 100 days, and if a patient was a current user with less than one prescription every 100 days, the patient was an ‘intermittent user’.
The current study is the ﬁ rst study showing a relationship between PH assessed by echocardiography and radiographic emphysema in COPD patients. In end- stage COPD patients undergoing lung transplant, the patients with PH showed more severe morphological signs of pulmonary emphysema compared to the patients without PH. 39 Common mechanisms linking PH and emphysema induced by cigarette smoking are widely inferred. Increased pulmonary vascular endothelial death and decreased expression of vascular endothelial growth factor (VEGF) have been described in patients with emphysema. 40 In addition, chronic blockade of VEGF receptors induces apoptosis of alveolar cells and emphy- sema in a rat model. 41 Recent reports have shown that the nitric oxide (NO)-cyclic guanosine monophosphate (cGMP) signaling pathway plays an important role in PH and emphysema. 42–44 In tobacco smoke-exposed mice, inducible nitric oxide synthase inhibitor 43 and riociguat, 44 which promotes the NO – cGMP pathway, reversed existing lung emphysema and PH. Further, pulmonary vascular resistance and airway resistance have been shown to decrease in COPD patients with PH treated with riociguat. 44 Our study also showed that the presence of interstitial abnormalities is a risk factor for PH assessed by echocardiography. This result is in line with previous reports demonstrating a high prevalence of PH in patients with combined pulmonary ﬁ brosis and emphysema. 45 The
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