Cardiovascular disease, including coronary heart disease, strokes and diseases of other arteries, is a major
cause of early death and disability. For many years the major markers of disease risk have been well recognised:
these include high blood cholesterol levels and smoking. But it has also been recognised that these markers do
not account for all cardiovascular risk. Furthermore, treatments that are highly effective in altering these
markers, for instance the ‘statin’ drugs used to lower cholesterol, do not remove risk entirely: typically they
reduce it by about 30% or less.
Diagnosis and Treatment by Clinical State
The disease continuum—from the appearance of a preneoplastic and invasive lesion localized to the prostate, to a metastatic lesion that results in symptoms and, ultimately, mortality from prostate cancer—can span decades. Management at all points is centered on competing risks that are defined by considering the disease as a series of clinical states (Fig. 91-1).
From HIV to influenza, the battle between infectious agents and the immune system is at the heart of disease. Knowledge of how and why parasites vary to escape recognition by the immune system is central to vaccine design, the control of epidemics, and our fundamental understanding of parasite ecology and evolution. As the first comprehensive synthesis of parasite variation at the molecular, population, and evolutionary levels, this book is essential reading for students and researchers throughout biology and biomedicine....
Chapter 123. Clostridium difficile–Associated Disease, Including Pseudomembranous Colitis (Part 1)
Harrison's Internal Medicine Chapter 123. Clostridium difficile– Associated Disease, Including Pseudomembranous Colitis
Etiology and Epidemiology C. difficile is an obligately anaerobic, gram-positive, spore-forming bacillus whose spores are found widely in nature, particularly in the environment of hospitals and chronic-care facilities. CDAD occurs most frequently in hospitals and nursing homes where the level of antimicrobial use is high and the environment is contaminated by C.
It is clear that most retirement communities have some level of disaster plans that tend to be based on two driving forces. The first force driving the creation of plans is as a response to regulations or laws that exist in their area or state. These tend to be drills rather than the more valuable exercises that bring all of the involved parties together to discuss interactions during a disaster response. The second driving force is what history suggests to be the most likely disaster. Although important and valuable in creation of disaster plans, this approach neglects the changing natural...
Nonsteroidal antiandrogens such as flutamide, bicalutamide, and nilutamide block the binding of androgens to the receptor. When an antiandrogen is given alone, testosterone levels remain the same or increase. Compared to testosteronelowering therapies, antiandrogens cause fewer hot flashes, less of an effect on libido, less muscle wasting, fewer personality changes, and less bone loss. Gynecomastia remains a significant problem but can be alleviated in part by tamoxifen.
When PV presents with erythrocytosis in combination with leukocytosis, thrombocytosis, or both, the diagnosis is apparent. However, when patients present with an elevated hemoglobin or hematocrit alone, or with thrombocytosis alone, the diagnostic evaluation is more complex because of the many diagnostic possibilities (Table 103-2). Furthermore, unless the hemoglobin level is ≥20 gm% (hematocrit ≥60%), it is not possible to distinguish PV from disorders causing plasma volume contraction.
Most patients with trichotillomania, pressure-induced alopecia.
The most common causes of nonscarring alopecia include telogen effluvium, androgenetic alopecia, alopecia areata, tinea capitis, and some cases of traumatic alopecia (Table 54-5). In women with androgenetic alopecia, an elevation in circulating levels of androgens may be seen as a result of ovarian or adrenal gland dysfunction. When there are signs of virilization, such as a deepened voice and enlarged clitoris, the possibility of an ovarian or adrenal gland tumor should be considered.
Previous trials have demonstrated that lowering low-density lipoprotein (LDL) cholesterol
levels below currently recommended levels is beneficial in patients with acute coronary
syndromes. We prospectively assessed the efficacy and safety of lowering LDL
cholesterol levels below 100 mg per deciliter (2.6 mmol per liter) in patients with stable
coronary heart disease (CHD).
Tham khảo sách 'mineral requirements for military personnel: levels needed for cognitive and physical performance during garrison training', khoa học tự nhiên, vật lý phục vụ nhu cầu học tập, nghiên cứu và làm việc hiệu quả
Chronic Idiopathic Myelofibrosis: Treatment
No specific therapy exists for chronic IMF. Anemia may be due to gastrointestinal blood loss and exacerbated by folic acid deficiency, and in rare instances, pyridoxine therapy has been effective. However, anemia is more often due to ineffective erythropoiesis uncompensated by extramedullary hematopoiesis in the spleen and liver. Neither recombinant erythropoietin nor androgens, such as Danazol, have proved consistently effective as therapy for anemia.
High-density lipoprotein (HDL) cholesterol levels are a strong inverse predictor of
cardiovascular events. However, it is not clear whether this association is maintained
at very low levels of low-density lipoprotein (LDL) cholesterol.
A post hoc analysis of the recently completed Treating to New Targets (TNT) study
assessed the predictive value of HDL cholesterol levels in 9770 patients.
Previous World Health Organization studies have examined the aggregate
disease burden attributed to key environmental risks globally and
regionally, quantifying the amount of death and disease caused by factors
such as unsafe drinking-water and sanitation, and indoor and outdoor air
Building from that experience, this present study examines how specific
diseases and injuries are impacted by environmental risks, and which
regions and populations are most vulnerable to environmentally-mediated
diseases and injuries.
These health problems are more or less same in the majority of Asian countries. The
lack of financial and human resources has become a major constraint for many poor countries
in the Afro-Asian region, posing a serious obstacle to the promotion of public health,
particularly in the context of achieving health-related Millennium Development Goals by
2015. Countries in South Asia and Sub-Saharan Africa have failed to scale up interventions
to address the significant burden of diseases.
I am a clinical psychologist. The guiding training model for clinical
psychology is called "scientist-practitioner" which demands that any
Ph.D. clinical psychologist must be trained both as a scientist and
practitioner. Since receiving my Ph.D.
The activity of matrix metalloproteinases (MMPs) is regulated at several
levels, including enzyme activation, inhibition, complex formation and
compartmentalization. Regulation at the transcriptional level is also impor-tant, although this is not a subject of the present minireview.
During 1993–2003, incidence of tuberculosis (TB) in the United States decreased 44% and is now occurring at a historic low
level (14,874 cases in 2003). The Advisory Council for the Elimination of Tuberculosis has called for a renewed commitment to
eliminating TB in the United States, and the Institute of Medicine has published a detailed plan for achieving that goal.
Few studies have simultaneously investigated the role of soluble tumor necrosis factor
) receptors types 1 and 2 (sTNF-R1 and sTNF-R2), C-reactive protein, and
interleukin-6 as predictors of cardiovascular events. The value of these inflammatory
markers as independent predictors remains controversial.
The maintenance of correct protein homeostasis (‘proteostasis’) is an essen-tial activity of mammalian cells to preserve their vital properties and func-tions. Because of its importance, correct proteostasis is achieved by the cell
in several ways and at several levels of each gene expression pathway.
Research objectives: Describe the clinical and subclinical characteristics in patients with Graves’ disease. Evaluation of Graves' disease treatment in children by anti-thyroid drug methimazole group synthesis. Survey and evaluate change TRAb levels and some clinical parameters, subclinical concerning treatment outcome and recurrence in children with Graves’ disease.