Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Hypertension is a primary risk factor for heart disease and stroke, the first and third most common causes of death in the United States. The National Health and Nutrition Examination Survey (NHANES) revealed an increase in awareness of hypertension from 51% to 73%, and, among persons with hypertension, the treatment rate has increased from 31% to 55% (from 1976-1980 vs 1988-1991). Of importance, the rate of those achieving goal blood pressure (< 140/90 mm Hg) has only improved from 10% in NHANES-II (1976-1980) to 29% in NHANES-III (1988-1991). Thus, more than 70% of persons with hypertension in whom good blood pressure control has not been achieved are termed "difficult hypertensives." Failure to achieve treatment blood pressure goals of less than 140/90 mm Hg is usually attributed to the presence of resistant hypertension, a resistant physician, secondary causes of hypertension such as renovascular disease, medication adverse effects, or a nonadherent patient. A practical understanding of the pathophysiology of resistant hypertension, appropriate screening techniques for secondary forms of hypertension, and alternative management strategies for a chronic disease such as hypertension can result in treatment goals being achieved in most difficult hypertensives.
 ...
PMID:Management of difficult-to-control hypertension. 1085 31

Diabetes is a chronic disease of metabolic dysfunction that is increasing world-wide. The hyperglycemia associated with diabetes causes significant protein alterations and an oxidative stress. In the heart, all cell types are affected by diabetes: the myocyte, the vasculature and the blood cells. Four out of five diabetics die from ischemic heart disease and stroke, suggesting that the diabetic is quite vulnerable to ischemic injury. It is important to understand the pathophysiologic challenges that occur in the diabetic heart in order to develop thoughtful treatments to limit this serious complication. This review focuses on the anatomical and functional alterations that occur in the diabetic circulation of the heart, with emphasis on the coronary microcirculation. Coronary microvascular dysfunction combined with blood cellular alterations are presented to explain the amplified oxidative stress that occurs in the diabetic heart under ischemic conditions.
 ...
PMID:Microvascular perfusion and transport in the diabetic heart. 1090 96

The last decade has seen significant progress in reduction of mortality rates from many chronic diseases on both a state and national level. Moreover, in general, Wisconsin has achieved levels below the United States for mortality. However, as suggested by Figures 1 and 2, preventive efforts in stroke and prostate cancer should become high priorities in this state. Additionally, it will be important to monitor the stabilization of death rates due to diabetes. Turning Point, anti-tobacco efforts by the Tobacco Control Board and the Thomas T. Melvin Program, and the upcoming Minority Health Report should reveal additional areas for DHFS and its statewide partners to address in the arena of chronic disease. Programs such as the Wisconsin Diabetes Control Program and the Wisconsin Well Woman Program will also continue to contribute significantly to other community and clinical efforts to control chronic diseases.
 ...
PMID:A decade of improvement in areas of chronic disease. Where do we go from here? 1092 75

Re-thinking stroke rehabilitation: the Corbin and Strauss chronic illness trajectory framework The dramatic effects of a stroke can have far-reaching implications for patients and carers. Effective recovery involves a considerable array of coping strategies that facilitate and promote engagement in the social world. Their development is a long-term process that requires considerable effort, motivation and enterprise on the part of patients and their families. Traditional approaches to the provision of stroke rehabilitation services, however, appear to be underpinned by frameworks that are short-term in outlook. As a consequence, nursing interventions often focus on the progression of the patient through the care system, rather than on facilitating future recovery. Much of the work of stroke recovery is consequently done by patients and their families at home, with little provision of ongoing professional help and advice. This paper explores the application of the Corbin and Strauss Chronic Illness Trajectory Framework for stroke. In particular, the major concepts of the framework are applied to a vignette derived from a longitudinal study of patients' experiences of recovery. The trajectory framework is shown to be a useful structure that has the potential to enhance the appropriateness of nursing interventions for stroke patients. However, the validity of the framework can only be established through its application and evaluation in clinical practice. The purpose of this paper is to contribute to a debate that encourages consideration of the framework's utility for nurses to enhance the stroke rehabilitation experience.
 ...
PMID:Re-thinking stroke rehabilitation: the Corbin and Strauss chronic illness trajectory framework. 1101 1

Atrial fibrillation is a chronic disorder, which significantly increases the risk of stroke. The risk of stroke largely depends on cardiac failure, age, sex, the presence of hypertension and a history of previousthromboembolism. In low risk patients with atrial fibrillation stroke can effectively be prevented with acetylsalicylic acid (100-200 mg/day). With increasing stroke risk coumarin derivatives are more effective than acetylsalicylic acid and its use has an acceptable bleeding risk. The target international normalized ratio (INR) should be between 2.0 and 3.0.
 ...
PMID:[Acetylsalicylic acid versus coumarin derivatives in atrial fibrillation]. 1213 79

The increasing prevalence of obesity worldwide has prompted the World Health Organization (WHO) to classify it as a global epidemic. Around the globe, more than a half billion people are overweight, and the chronic disease of obesity represents a major threat to health care systems in developed and developing countries. The major health hazards associated with obesity are the risks of developing diabetes, cardiovascular disease, stroke, osteoarthritis and some forms of cancer. In this paper, we review the prevalence of obesity and its cost to health care systems and present the relative contribution of environmental conditions and genetic makeup to the development of obesity in people. We also discuss the concept of "essential" obesity in an "obesigenic" environment. Though weight gain results from a sustained imbalance between energy intake and energy expenditure, it is only recently that studies have identified important new mechanisms involved in the regulation of body weight. The etiology of the disease is presented as a feedback model in which afferent signals inform the central controllers in the brain as to the state of the external and internal environment and elicit responses related to the regulation of food intake and energy metabolism. Pharmaceutical agents may intervene at different levels of this feedback model, i.e., reinforce the afferent signals from the periphery, target the central pathways involved in the regulation of food intake and energy expenditure, and increase peripheral energy expenditure and fat oxidation directly. Since obesity results from genetic predisposition, combined with the proactive environmental situation, we discuss new potential targets for generation of drugs that may assist people in gaining control over appetite as well as increasing total energy expenditure and fat oxidation.
 ...
PMID:Human genomics and obesity: finding appropriate drug targets. 1113 65

Diabetes mellitus is a chronic disease that leads to complications including heart disease, stroke, kidney failure, blindness and nerve damage. Type 2 diabetes, characterized by target-tissue resistance to insulin, is epidemic in industrialized societies and is strongly associated with obesity; however, the mechanism by which increased adiposity causes insulin resistance is unclear. Here we show that adipocytes secrete a unique signalling molecule, which we have named resistin (for resistance to insulin). Circulating resistin levels are decreased by the anti-diabetic drug rosiglitazone, and increased in diet-induced and genetic forms of obesity. Administration of anti-resistin antibody improves blood sugar and insulin action in mice with diet-induced obesity. Moreover, treatment of normal mice with recombinant resistin impairs glucose tolerance and insulin action. Insulin-stimulated glucose uptake by adipocytes is enhanced by neutralization of resistin and is reduced by resistin treatment. Resistin is thus a hormone that potentially links obesity to diabetes.
 ...
PMID:The hormone resistin links obesity to diabetes. 1120 21

In a recent prospective study, whole grain intake was associated with a reduced risk of ischemic stroke. Refined grain, however, did not elicit such protection. Given the potential health benefits associated with whole grain diets, further exploration on the effects of whole grains on health and risk of chronic disease is warranted.
 ...
PMID:Whole grain intake and risk of ischemic stroke in women. 1139 95

Older males are known to carry, more likely than younger people, one or more chronic diseases with an expected impact on mortality. This study was aimed at identifying the relationship of prevalent chronic diseases in elderly populations of different countries with all-cause mortality. Men aged 65-84 from defined areas were enrolled in Finland (N=716), the Netherlands (N=887) and Italy (N=682). They were survivors of cohorts studied for 25 years within the Seven Countries Study. Major chronic diseases were diagnosed at entry. Ten-year follow-up for mortality was completed. Entry prevalence of selected chronic diseases was higher in Finland (56%) than in Italy (51%) and the Netherlands (44%). Ten-year age-adjusted death rates from all causes were higher in Finland (565 per 1000) and lower in the Netherlands (478 per 1000) and Italy (445 per 1000). The absolute risk of death related to chronic disease was high in the three countries, but was higher in Finland than in the Netherlands and Italy. The most lethal condition was stroke, with 10-year death rates of 806 per 1000 in Finland and 707 and 729 per 1000 in the Netherlands and Italy, respectively. The relative risk of all-cause mortality for a set of seven chronic diseases (coronary heart disease, heart failure, claudicatio intermittens, cerebrovascular accidents, diabetes, COPD and cancer) adjusted by age, other diseases and cohort was less than two for each condition, except cerebrovascular accidents in the Netherlands (RR 2.20). In general, relative risk was higher in Finland, intermediate in the Netherlands and lower in Italy, where only cerebrovascular accidents, intermittent claudication, diabetes and the presence of any chronic condition had a significant relative risk. About one third of men had one chronic disease, and between 10% and 15% had two diseases. The coexistence of any two or three chronic conditions was associated with a relative risk of 2 or more in Finland and the Netherlands and less than 2 in Italy. In these elderly men prevalent morbidity and comorbidity was relatively common and it explained a large proportion of excess in all-cause mortality in 10 years of follow-up.
 ...
PMID:Prevalence of morbidity and multimorbidity in elderly male populations and their impact on 10-year all-cause mortality: The FINE study (Finland, Italy, Netherlands, Elderly). 1143 8

Protein-energy malnutrition (PEM) is common in connection with chronic disease and is associated with increased morbidity and mortality. Because the risk of PEM is related to the degree of illness, the causal connections between malnutrition and a poorer prognosis are complex. It cannot automatically be inferred that nutritional support will improve the clinical course of patients with wasting disorders. We reviewed studies of the treatment of PEM in cases of chronic obstructive pulmonary disease, chronic heart failure, stroke, dementia, rehabilitation after hip fracture, chronic renal failure, rheumatoid arthritis, and multiple disorders in the elderly. Several methodologic problems are associated with nutrition treatment studies in chronically ill patients. These problems include no generally accepted definition of PEM, uncertain patient compliance with supplementation, and a wide range of outcome variables. Avail-able treatment studies indicate that dietary supplements, either alone or in combination with hormonal treatment, may have positive effects when given to patients with manifest PEM or to patients at risk of developing PEM. In chronic obstructive pulmonary disease, nutritional treatment may improve respiratory function. Nutritional therapy of elderly women after hip fractures may speed up the rehabilitation process. When administered to elderly patients with multiple disorders, diet therapy may improve functional capacity. The data regarding nutritional treatment of the conditions mentioned above is still inconclusive. There is still a great need for randomized controlled long-term studies of the effects of defined nutritional intervention programs in chronically ill and frail elderly with a focus on determining clinically relevant outcomes.
 ...
PMID:Treatment of protein-energy malnutrition in chronic nonmalignant disorders. 1272 Jun 5


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>