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 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Helicobacter pylori (H. pylori) is the most common cause of peptic ulcers, and is considered as carcinogenic with respect to gastric cancer and MALT lymphoma. The role of H. pylori in other gastroduodenal diseases like atrophic gastritis and functional dyspepsia has been investigated in hundreds of works, but little is done about what role H. pylori may play in non gastric diseases. Gastro-esophageal reflux disease does not seem to be related to H. pylori but Barrett's esophagus might be. Inflammatory bowel diseases tend to be reverse correlated with H. pylori. In coronary heart disease some studies have shown a connection, others not. Diabetes is not likely to be H. pylori-associated and nor do liver diseases with exception for cirrhosis, where a correlation is possible. Respiratory diseases are little examined but bronchiectasis might have a correlation with H. pylori. A small series of children, who had died in sudden infant death, showed a high rate of H. pylori infection.
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PMID:Non-gastric effects of H. pylori infection: a literature review with respect to non gastric diseases which might be associated with H. pylori infection. 1002 62

This paper addresses the economic relevance of appropriately staging progression of disease for cost assessment and projection. Illustrations are drawn from two Dutch cost-of-illness studies for Diabetes Mellitus (DM) and AIDS. Our disease-staging specifies a separate late stage to capture terminal high-intensity care for end-stage complications. Data are used from a registration of national hospital resource utilization for DM and from a detailed database on AIDS hospital care and costs. In particular, differences in average length of hospital stay for several potential DM end-stage complications are compared with non-DM patients. Neglecting the separation of a specific late stage is estimated to possibly miscalculate 15-20% of the hospital bed needs for DM and AIDS in the Netherlands. In particular, confidence intervals of future projections for AIDS hospital beds--using respectively staged and non-staged models--do not overlap. AIDS hospital costs are overprojected by almost 11% in the non-staged model. Our estimation of DM hospital bed needs raises the percentage in total Dutch hospital beds from 1.7% (neglecting a specific late stage) to 2.0%. For DM and AIDS an appropriate disease-staging averts structural biases in estimations of bed needs and costs, and therefore benefits the planning of hospital care facilities. Obviously, gathering comparable information and developing similar methodology on other diseases, such as respiratory disease, cardiovascular disease and cancer, is needed and could benefit planning in these fields.
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PMID:Disease-staging for modelling current and future health-care impact of disease: illustrations for diabetes mellitus and AIDS. 1017

A study was done on geriatric residents from three institutions in Metro Manila namely La Verna I and II, a retirement home of Sisters of Franciscan Immaculate Concepcion; Hospicio de San Jose, a catholic welfare institution for the very young as well as for the very old; and Golden Acres, a government institution that takes care of indigent old/elderly people. A total of 176 geriatric residents were examined, majority are from Golden Acres with 121, followed by Hospicio de San Jose with 30 and lastly La Verna I and II with 25. In general, the oral health status of geriatric residents is very poor especially at Golden Acres and Hospicio de San Jose. Since all the resident sisters in La Verna I and II are highly educated, their oral health status is fair to good. The more prevalent medical problems the geriatric residents had are: Cataract (54); Hypertension/Cardiac Disorders (46); Rheumatoid Arthritis (30); Respiratory Diseases (29); Blood Diseases (28); Diabetes Mellitus (14); Skin Diseases (10); Impaired Hearing (13); Neurologic Problems (19); and Psychological Problems (2).
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PMID:Oral health status of institutionalized geriatric residents in Metro Manila. 1020 12

Using data from the Third National Morbidity Study, we have examined annual period prevalence in three large geographical areas of England and Wales--North, Midlands and Wales & South. Standardised persons' consulting ratios (SPCRs) have been obtained by the indirect method using five-year age bands as the basis for standardisation. There were several comparatively small differences between area SPCRs. There was reduced prevalence of diabetes in both sexes in the North; increased prevalence of respiratory disease in the North with the notable exception of asthma: increased prevalence of cardiovascular and cerebrovascular disease in the North which constrasted with increased recognition of hypertension in the South and the Midlands and Wales. There were no area differences in the prevalence of mental disorder; SPCRs for preventive care were relatively high in the North; the SPCR for cervical cytology was low in the Midlands and Wales. Although these differences are statistically significant, they were, in general, of small magnitude and do not suggest any major difference in morbidity between the areas.
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PMID:Geographical variations in persons consulting rates in general practice in England and Wales. 1029 79

To clarify the relationship between long-term prognosis of patients with stroke and their MRI findings, 103 patients with initial cerebral thrombosis, who survived more than three months after the ictus, were studied for five years. The mean age of 98 patients (T group), who were followed up completely, was 73.1 years-old and 65 were men. The age-matched controls consisted of two groups: 65 subjects, who had hypertension and/or diabetes without a history of stroke (R group), and 85 subjects, who had any hypertension, diabetes and stroke (N group). MRI findings were divided into six categories: 1) types of causative lesion, 2) grades of periventricular hyperintensity (none, rims/caps, patchy, diffuse PVH), 3) number of spotty lesions, 4) presence of silent infarction. 5) ventricular dilatation, and 6) extents of brain atrophy. Types of causative lesion were subdivided into 3 subtypes; infarction of the perforating artery territory (P type), infarction of the cortical artery territory (C type), and brainstem infarction (B type). The presence of vascular risks and dementia, and the extent of activity of daily living (ADL) were assessed. The P, C, and B types were identified by MRI in 46, 36, and 16 of the T group, respectively. Motor impairment, dementia, and an ADL status of complete dependence at discharge were also seen in 84, 44, and 22, respectively. In the T group, 33 patients died during five years, which resulted in a cumulative mortality rate of 33.7% and an annual mortality rate of 8.2%. Based on log-rank analysis, the survival rate of the T group revealed was significantly lower than those of the R and N groups. The recurrent rate in the T group (annual stroke recurrence rate was 4.0%) was higher than in the R and N groups, but stroke recurrence was not the cause of death and two thirds of deaths were due to aspiration pneumonia and/or asphyxia. Cox hazard regression analysis for death due to respiratory diseases showed that the hazard ratios of infarction, patchy PVH, and more than 4 spotty lesions were 8.87 (p < .001), 0.31 (p = .058), and 0.44 (p = .098), respectively. Compared to the survival group, rates of complete dependence in ADL, dementia, and brain atrophy were significantly higher in the death group with low incidences of the P type and patchy PVH, which indicated small vessel disease. These findings suggested that in patients with cerebral thrombosis, even in the chronic phase, care should be taken to prevent pneumonia and/or asphyxia due to bulbar palsy. Furthermore, no MRI findings were distinct predictors of long-term prognosis, although infarction based on the small vessel disease had rather good outcome in terms of respiratory disease.
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PMID:[Long-term prognosis of patients with initial cerebral thrombosis and the MRI findings]. 1036 31

In 1973, WHO proposed that "excess mortality" be used for comparative assessment of the severity of influenza epidemics between countries. In this study, analysis of the data for deaths in Japan between 1980-1994 revealed excess mortality, which could be a useful indicator in Japan. There were six influenza epidemics, and statistically significant excess mortality rates were calculated in both deaths from acute respiratory diseases and all causes. The total number of excess deaths from acute respiratory diseases during influenza seasons for the 15 years was 13,931. Statistically significant excess mortality rates were also shown for other diseases, including ischemic heart disease, cerebro-vascular disease, diabetes, nephritis, chronic liver disease, malignant neoplasm, and chronic respiratory disease. Therefore, "excess mortality" is clearly present in recent years in Japan. In analyses of age-specific excess mortality rates, the epidemic was found to be most fatal to the aged. Further, the value of % excess (= excess rate divided by expected rate x 100) suggested that the number of deaths from all causes would be a more useful indicator than that from acute respiratory diseases. It was confirmed that excess mortality was applicable to regional surveillance of epidemic influenza.
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PMID:[Excess mortality from influenza epidemics in Japan, 1980-1994]. 1049 58

This is a prospective cohort comparison study aiming to determine the mortality of patients with peripheral arterial occlusive disease (PAOD) and identify the risk factors affecting their survival. Data regarding demographic and biochemical risk factors, and lower limb disease severity classified by vascular laboratory criteria were collected prospectively from 665 consecutive patients presenting with symptoms of peripheral arterial occlusive disease. The effect of patient and disease risk factors on survival was analyzed by the life-table method and independent significant variables examined by a multivariate Cox regression model. The cumulative survival for all patients at 1, 3, and 5 years were 86.1, 71.2, and 55.8%, respectively, with a median survival of 72.2 months. Female sex, age, smoking, heart disease, renal disease, respiratory disease, stroke, critical ischemia, lowest anklebrachial index, no vascular reconstruction, and major amputation were associated with higher mortality. Lipid and biochemical variables were not significant determinants. Using multivariate Cox regression, age (>70), disease severity, anklebrachial index (<0.5), no vascular reconstruction, diabetes mellitus, and renal and cardiorespiratory diseases were identified as independent risk factors affecting patient survival. The survival of patients with PAOD is poor compared with the general population. Significant patient-related variables were largely coexisting diseases and advanced age, whereas the other risk factors for atherosclerosis are less influential. Disease severity may bear a direct relationship to mortality, and patients with critical ischemia have the worst prognosis. Early disease detection and timely vascular reconstruction may lead to an improvement in overall survival.
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PMID:Survival in patients with chronic lower extremity ischemia: a risk factor analysis. 1074 31

Declining death rates from communicable diseases, together with population aging, leads to a higher incidence and prevalence of noncommunicable diseases (NCDs), such as atherosclerotic disorders, cancers, and chronic respiratory disease. These NCDs gradually become the population's predominant health problems. Evidence indicates that the prevalence of certain NCDs, such as diabetes and hypertension, is increasing rapidly in parts of sub-Saharan Africa. Others, such as asthma and epilepsy, are common, but poorly managed. This paper describes a project funded by the British Government's Department for International Development to provide costed and evaluated treatment packages for use at the primary health care level, methods and materials for evaluating the quality of noncommunicable disease care, and a protocol for assessing national opportunities to prevent hypertension, heart disease, and diabetes. Methods are now being developed and piloted in urban and rural Tanzania and Cameroon.
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PMID:Tackling the emerging pandemic of non-communicable diseases in sub-Saharan Africa: the essential NCD health intervention project. 1091 Apr 12

Use of pneumococcal polysaccharide vaccines remains controversial, even though clinical trials have shown their efficacy in preventing invasive disease caused by vaccine serotypes in immunocompetent adults. Retrospective studies indicate these vaccines have about 50%-80% effectiveness for preventing invasive disease caused by vaccine serotypes, although effectiveness wanes over time and with age. The elderly, people living in institutions and those with chronic cardiac or respiratory disease, alcoholism or diabetes mellitus who are in relatively good health would benefit from vaccination; a polysaccharide vaccine program in the elderly has been shown to be cost-effective. In young children, polysaccharide vaccine should be evaluated as a booster to conjugate pneumococcal vaccines, which are likely to be available soon in industrialised countries. In view of the high rates of hospitalisation and of antimicrobial resistance in pneumococci, every effort should be made to increase coverage by pneumococcal polysaccharide vaccine in Australia, according to guidelines of the National Health and Medical Research Council.
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PMID:Efficacy and effectiveness of pneumococcal polysaccharide vaccines and their use in industrialised countries. 1134 91

We have studied the characteristics of 202 cystic fibrosis adult patients, all with chronic respiratory symptoms, with a median age of 27 yrs (18 to 55 yrs) and a male predominance (56%). At genetic analysis, delta F508 homozygotes were 41%, delta F508 heterozygotes 42% and 17% had no delta F508. The respiratory disease was more severe and complications were more frequent in adults: hemoptysis in 14%, pneumothorax in 15%, lung transplantation in 25 patients. Chronic bronchial colonisation with Pseudomonas aeruginosa, in 76% of patients, contributed to making treatments more severe because of antibiotic i.v. courses and nebulised antibiotics. Respiratory function showed a mean FVC of 62 +/- 22% and a mean FEVI of 48 +/- 94%. External pancreatic insufficiency was found in 83%, diabetes in 14%. Intestinal occlusion syndromes were observed in 11% of patients and hepatic cirrhosis in 8%. In spite of the severity of the respiratory disease, theses patients succeeded in social and occupational insertion; 62% were independent, 18% had children and 77% were working or studying. Analysis of the patients according to age at diagnosis showed that, in 38 patients diagnosed after the age of 18 yrs, the respiratory disease was less severe, pancreatic insufficiency and non-respiratory complications were less frequent (34% had pancreatic insufficiency, 5% had diabetes and none had cirrhosis). This may partly be due to the presence of milder CFTR mutations. In conclusion, cystic fibrosis in adulthood frequently looks like an evolutive form of cystic fibrosis in childhood. Nevertheless, some late diagnosed forms in adults, with better prognosis, have been recently identified.
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PMID:[Characteristics and specificities of cystic fibrosis in adults: evolutive disease of childhood or recently diagnosed disease?]. 1107 85


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