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 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The relations between patterns of emotional experience, emotion inhibition, and physical health have been little studied in older adults or ethnically diverse samples. Testing hypotheses derived from work on younger adults, the authors examined the relations between negative affect and emotion inhibition and that of illness (hypertension, respiratory disease, arthritis, and sleep disorder) in a sample (N = 1,118) of community-dwelling older adults from four ethnic groups: U.S.-born African Americans, African Caribbeans, U.S.-born European Americans, and Eastern European immigrants. Participants completed measures of stress, lifestyle risk factors, health, social support, trait negative emotion, and emotion inhibition. As expected, the interaction of ethnicity with emotion inhibition, and, to a lesser extent, negative affect, was significantly related to illness, even when other known risk factors were controlled for. However, the relations among these variables were complex, and the patterns did not hold for all types of illness or operate in the same direction across ethnic groups. Implications for emotion-health relationships in ethnically diverse samples are discussed.
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PMID:Ethnic variation in the impact of negative affect and emotion inhibition on the health of older adults. 1219 98

The Global Initiative for Chronic Obstructive Lung Disease (GOLD) has defined stage I chronic obstructive pulmonary disease (COPD) as forced expiratory volume in one second/forced vital capacity (FEV1/FVC)% <70% and a FEV1% predicted of >80%. Stage 2 has been defined as FEV1/FVC <70% and a FEV1% pred of <80%. The authors examined the extent of COPD misdiagnosis using this definition in healthy, never-smoker, asymptomatic adults aged >70 yrs in Bergen, Norway. A respiratory questionnaire was mailed to a random sample of 2,871 persons aged >70 yrs. In a random, well-defined subgroup of 208 never-smoker respondents with no current respiratory disease and significant dyspnoea or heart disease/hypertension complicated with dyspnoea, 71 were able to perform an acceptable spirometry. Approximately 35% of these healthy, elderly never-smokers had an FEV1/FVC% of <70% and would be classified as having at least a stage 1 COPD. This percentage increased with age and in those aged >80 yrs approximately 50% would be classified as having COPD and approximately one-third would have an FEV1 of <80% pred (stage 2 COPD). The estimated 5th percentile of FEV1 was consistently <80% pred. The Global Initiative for Chronic Obstructive Lung Disease criteria will probably lead to a significant degree of over-diagnosis of chronic obstructive pulmonary disease in those aged >70 yrs. The criteria used to define the various stages of chronic obstructive pulmonary disease need to be age-specific.
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PMID:Risk of over-diagnosis of COPD in asymptomatic elderly never-smokers. 1244 63

Researchers of the St. Petersburg Institute of Bioregulation and Gerontology of the North-Western Branch of the Russian Academy of Medical Sciences and the Research Institute of Gerontology of the Ukrainian Academy of Medical Sciences (Kiev) clinically assessed the geroprotective effects of thymic and epiphyseal peptide bioregulators (Thymalin and Epithalamin, correspondingly) in 266 elderly and older persons during 6-8 years (the bioregulators were applied for the first 2-3 years of observation). The obtained results convincingly confirmed the ability of the bioregulators to normalize the basic functions of the human organism, i.e. to improve the indices of the cardiovascular, endocrine, immune, and nervous systems, homeostasis, and metabolism. The restoration of homeostasis in the patients was accompanied by a 2.0-2.4-fold decrease in acute respiratory disease incidence, reduced incidence ischemic heart disease clinical manifestations, hypertension, deforming osteoarthrosis, and osteoporosis, as compared to the control group. Such a significant improvement in the somatic state of the peptide-treated patients corresponded to a decrease in their mortality rate during the observation period: 2.0-2.1-fold among the Thymalin-treated patients, 1.6-1.8-fold--in the Epithalamin-treated group, and 2.5-fold--in the patients treated with Thymalin combined with Epithalamin, as compared to the control group. A separate group of patients was treated with Thymalin combined with Epithalamin annually for 6 years. We registered a 4.1-fold mortality decrease in this group as compared to the control level. The results of our research confirmed the conclusion on the high geroprotective efficacy of Thymalin and Epithalamin and the expediency of their application in medicine and social care as the means of health maintenance and age-related pathology prevention in persons over 60 years old enabling the prolongation of the active period of their lives.
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PMID:[Geroprotective effect of thymalin and epithalamin]. 1257 95

Asthma is the most frequent respiratory disorder complicating pregnancy. Diagnosis and evaluation of severity of asthma are unchanged by the presence of pregnancy, but the course of asthma varies: asthma may improve, remain stable, or worsen. Conversely, chronically poor control is associated with pregnancy-induced hypertension, preeclampsia, as well as greater rates of cesarian section, preterm delivery, intrauterine growth retardation, low birth weight, and congenital malformation. Highly-motivated women with well-controlled asthma during pregnancy, can achieve pregnancy outcome as good as their non-asthmatic conterparts. Inhalation therapies remain the cornerstone of treatment; most appear to be safe in pregnancy.
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PMID:[Asthma and pregnancy]. 1271 23

The purpose of this study is to determine risk factors associated with mortality in surgical patients with vancomycin-resistant enterococcus (VRE) infections. The hospitalizations of surgical patients with VRE infections from January 1998 to December 2001 were reviewed. Statistical analysis was performed using the Student's t test, chi square, and Fisher's exact test. Thirty-one surgical patients (male:female, 14:17) with a mean age of 51.9 years (range, 21-83 years) developed VRE infection. Infections included bacteremia (12), urinary tract (11), surgical site (seven), and soft tissue (five) infections and intra-abdominal abscess (one). Nine (29.0 per cent) patients received recent outpatient antibiotics and 20 (64.5 per cent) were on steroids. Fifteen (48.4 per cent) patients were treated with intravenous vancomycin before infection. Twelve (38.1 per cent) patients died with a trend toward advanced age (60.7 vs 46.5 years; P = 0.06). The incidence of VRE infection in kidney transplant patients was 1.8 per cent. Six transplant patients (five kidney and one kidney/ pancreas) developed VRE infections with four deaths. Hypertension (P = 0.04), coronary artery disease (P = 0.02), and the need for intra-arterial pressure monitoring (P = 0.04) were associated with mortality. Isolate location, gender, diabetes, renal dysfunction, respiratory disease, liver disease, and serum albumin were not associated with mortality. Kidney transplant patients have a high incidence of VRE infection. Surgical patients with VRE infections have a high mortality rate. Hypertension and coronary artery disease are risk factors for mortality.
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PMID:Clinical characteristics and outcomes of surgical patients with vancomycin-resistant enterococcal infections. 1285 10

The prevalence of chronic respiratory symptoms and of abnormalities in pulmonary function was determined by a survey of persons, aged 25 to 74, residing during May and June 1963 in a rural town, Chilliwack, B.C. Morning phlegm was reported by 26% of men and 13% of women. Chronic bronchitis was considered present in 21.5% of men and 11.3% of women. More serious obstructive lung disease, not related to heart disease, was found in 12.6% of men and 8.7% of women. These prevalences were higher than those found by the authors at Berlin, New Hampshire, U.S.A., in 1961. Demographic factors, such as birthplace, occupational class and measures of social stability, were not related to the prevalence of respiratory disease at Chilliwack. Some observer variation was found after analysis to be the result of non-randomization of respondents among the observers. An incidental observation was a high prevalence at Chilliwack of heart disease and hypertension under treatment.
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PMID:THE CHILLIWACK RESPIRATORY SURVEY, 1963: 3. THE PREVALENCE OF RESPIRATORY DISEASE IN A RURAL CANADIAN TOWN. 1428 55

Obstructive sleep apnea is common and considered to be a risk factor for hypertension, stroke and coronary disease. Accordingly, the presence of sleep apnea is probably a predictor of premature death. Continuous positive airway pressure is an effective treatment of obstructive sleep apnea. It has been demonstrated that such treatment improves daytime sleepiness and quality-of-life. To determine mortality in obstructive sleep apnea patients treated with nasal continuous positive airway pressure, we followed 296 patients given continuous positive airway pressure for 11 years 6 months. At the end of the study 26 of the 296 patients had died, mainly from cardiovascular disease. Mortality was 7% (95% confidence interval: 3%-9%) at 5 years. Three independent factors of death identified by forward stepwise selection were included in a Cox analysis. These factors were 1) smoking as a categorical covariate (>30 pack-years), 2) age and 3) forced expiratory volume in 1 s. When the 52 patients with an associated chronic obstructive pulmonary disease (forced expiratory volume in 1 s/vital capacity<0.65) with obstructive sleep apnea were excluded form analysis, mortality of the 244 remailing patients was 2% at 5 years, a rate observed in the general population. Subsequently, it appears that nasal continuous positive airway pressure corrects for the risk of premature death suspected in obstructive sleep apnea patients. Mortality in obstructive sleep apnea patients treated with continuous positive airway pressure is near to that of the general population, particularly when patients with an associated chronic respiratory disease are excluded.
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PMID:[Mortality in treated sleep apnea syndrome]. 1464 8

Chronic arsenic (As) poisoning has become a worldwide public health issue. Most human As exposure occurs from consumption of drinking water containing high amounts of inorganic As (iAs). In this paper, epidemiological studies conducted on the dose-response relationships between iAs exposure via the drinking water and related adverse health effects are reviewed. Before the review, the methods for evaluation of the individual As exposure are summarized and classified into two types, that is, the methods depending on As concentration of the drinking water and the methods depending on biological monitoring for As exposure; certain methods may be applied as optimum As exposure indexes to study dose-response relationship based on various As exposure situation. Chronic effects of iAs exposure via drinking water include skin lesions, neurological effects, hypertension, peripheral vascular disease, cardiovascular disease, respiratory disease, diabetes mellitus, and malignancies including skin cancer. The skin is quite sensitive to arsenic, and skin lesions are some of the most common and earliest nonmalignant effects related to chronic As exposure. The increase of prevalence in the skin lesions has been observed even at the exposure levels in the range of 0.005-0.01 mg/l As in drinking waters. Skin, lung, bladder, kidney, liver, and uterus are considered as sites As-induced malignancies, and the skin is though to be perhaps the most sensitive site. Prospective studies in large area of endemic As poisoning, like Bangladesh or China, where the rate of malignancies is expected to increase within the next several decades, will help to clarify the dose-response relationship between As exposure levels and adverse health effects with enhanced accuracy.
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PMID:Chronic health effects in people exposed to arsenic via the drinking water: dose-response relationships in review. 1527 3

This study compared health-related outcomes, during a 1-year period, for two groups of frail elders-one that received care coordination via distance monitoring (home-telehealth) and one that received no intervention. A case-control design was employed. The home telehealth intervention group was made up of 111 male veterans who were enrolled in a Veterans Health Administration project. The control group consisted of 115 men who were referred from either senior service agencies or hospital rehabilitation programs, but did not receive home-telehealth. Subjects in both groups had primary diagnoses of hypertension, diabetes, respiratory disease, or heart disease. The two groups were similar in terms of age, race, marital status, and independence in instrumental activities of daily living (IADL) at baseline. A paired t-test was used to study the before-after (baseline to 12-month follow-up) improvements in the outcome measures within each group. Regression models were used to compare the outcome improvements between the two groups. Over 1 year, the intervention group improved 2.2 points more in IADL, 14.4 points more in FIM motor scores, and 2.7 points more in FIM cognitive scores than the control group (p < 0.0001). This evidence supports the use of a specific home-telehealth strategy for care coordination to improve functional independence in non-institutionalized veterans with chronic disease. A randomized controlled trial should be employed to confirm these findings.
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PMID:The association of home-telehealth use and care coordination with improvement of functional and cognitive functioning in frail elderly men. 1531 42

Atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP) are increased in conditions with cardiac ventricular volume and pressure overload. The general physiological and potential therapeutic roles of natriuretic peptides in respiratory disease, right ventricular (RV) dysfunction, and pulmonary arterial hypertension (PAH) are reviewed. BNP levels can be used to differentiate between dyspneic patients with a pure respiratory defect and those with RV dysfunction. BNP levels also correlate with mean pulmonary arterial pressure (mPAP) and pulmonary vascular resistance (PVR) in patients with PAH (atrial septal defect, chronic thromboembolic disease, and scleroderma). BNP is a predictor of mortality in patients with primary pulmonary hypertension (PPH). These are important clinical implications in that a noninvasive blood test may be used to identify high-risk patients for more invasive procedures such as cardiac catheterization. BNP or NT-proBNP measurements may also be used to guide therapy (e.g., pulmonary vasorelaxants) in PAH since upregulation of the natriuretic peptide pathway has been shown to reduce cardiac hypertrophy and PAH. Additionally, there may be therapeutic potential via recombinant BNP or neutral endopeptidase inhibitors in RV dysfunction and PAH.
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PMID:The natriuretic peptides and their role in disorders of right heart dysfunction and pulmonary hypertension. 1536 14


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