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Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
Myalgic encephalomyelitis (ME) and chronic fatigue syndrome (CFS) are serious, debilitating conditions that affect millions of people in the United States and around the world. ME/CFS can cause significant impairment and disability. Despite substantial efforts by researchers to better understand ME/CFS, there is no known cause or effective treatment. Diagnosing the disease remains a challenge, and patients often struggle with their illness for years before an identification is made. Some health care providers have been skeptical about the serious physiological - rather than psychological - nature of the illness. Once diagnosed, patients often complain of receiving hostility from their health care provider as well as being subjected to treatment strategies that exacerbate their symptoms.
Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome proposes new diagnostic clinical criteria for ME/CFS and a new term for the illness - systemic exertion intolerance disease(SEID). According to this report, the term myalgic encephalomyelitis does not accurately describe this illness, and the term chronic fatigue syndrome can result in trivialization and stigmatization for patients afflicted with this illness. Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome stresses that SEID is a medical - not a psychiatric or psychological - illness. This report lists the major symptoms of SEID and recommends a diagnostic process.One of the report's most important conclusions is that a thorough history, physical examination, and targeted work-up are necessary and often sufficient for diagnosis. The new criteria will allow a large percentage of undiagnosed patients to receive an accurate diagnosis and appropriate care.
Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome will be a valuable resource to promote the prompt diagnosis of patients with this complex, multisystem, and often devastating disorder; enhance public understanding; and provide a firm foundation for future improvements in diagnosis and treatment.
eBook
Long-term benefits and risks of frontline nilotinib vs imatinib for chronic myeloid leukemia in chronic phase: 5-year update of the randomized ENESTnd trial
In the phase 3 Evaluating Nilotinib Efficacy and Safety in Clinical Trials–Newly Diagnosed Patients (ENESTnd) study, nilotinib resulted in earlier and higher response rates and a lower risk of progression to accelerated phase/blast crisis (AP/BC) than imatinib in patients with newly diagnosed chronic myeloid leukemia in chronic phase (CML-CP). Here, patients’ long-term outcomes in ENESTnd are evaluated after a minimum follow-up of 5 years. By 5 years, more than half of all patients in each nilotinib arm (300 mg twice daily, 54%; 400 mg twice daily, 52%) achieved a molecular response 4.5 (MR
4.5
;
BCR-ABL
⩽0.0032% on the International Scale) compared with 31% of patients in the imatinib arm. A benefit of nilotinib was observed across all Sokal risk groups. Overall, safety results remained consistent with those from previous reports. Numerically more cardiovascular events (CVEs) occurred in patients receiving nilotinib vs imatinib, and elevations in blood cholesterol and glucose levels were also more frequent with nilotinib. In contrast to the high mortality rate associated with CML progression, few deaths in any arm were associated with CVEs, infections or pulmonary diseases. These long-term results support the positive benefit-risk profile of frontline nilotinib 300 mg twice daily in patients with CML-CP.
Journal Article
The brain and pain : breakthroughs in neuroscience
\"Pain is an inevitable part of existence, but severe debilitating or chronic pain is a pathological condition that diminishes the quality of life. The Brain and Pain explores the present and future of pain management, providing a comprehensive understanding based on the latest discoveries from many branches of neuroscience. Richard Ambron-the former director of a neuroscience lab that conducted leading research in this field-explains the science of how and why we feel pain. He describes how the nervous system and brain process information that leads to the experience of pain, detailing the cellular and molecular functions that are responsible for the initial perceptions of an injury. He discusses how pharmacological agents such as opiates affect the duration and intensity of pain. Ambron examines new evidence showing that discrete circuits in the brain modulate the experience of pain in response to a placebo, fear, anxiety, belief, or other circumstances, as well as how pain can be relieved by activating these circuits using mindfulness training and other nonpharmacological treatments. The book also evaluates the prospects of procedures such as deep brain stimulation and optogenetics. Current and thorough, The Brain and Pain will be invaluable for a range of people seeking to understand their options for treatment as well as students in neuroscience and medicine\"-- Provided by publisher.
Book
European LeukemiaNet 2020 recommendations for treating chronic myeloid leukemia
The therapeutic landscape of chronic myeloid leukemia (CML) has profoundly changed over the past 7 years. Most patients with chronic phase (CP) now have a normal life expectancy. Another goal is achieving a stable deep molecular response (DMR) and discontinuing medication for treatment-free remission (TFR). The European LeukemiaNet convened an expert panel to critically evaluate and update the evidence to achieve these goals since its previous recommendations. First-line treatment is a tyrosine kinase inhibitor (TKI; imatinib brand or generic, dasatinib, nilotinib, and bosutinib are available first-line). Generic imatinib is the cost-effective initial treatment in CP. Various contraindications and side-effects of all TKIs should be considered. Patient risk status at diagnosis should be assessed with the new EUTOS long-term survival (ELTS)-score. Monitoring of response should be done by quantitative polymerase chain reaction whenever possible. A change of treatment is recommended when intolerance cannot be ameliorated or when molecular milestones are not reached. Greater than 10% BCR-ABL1 at 3 months indicates treatment failure when confirmed. Allogeneic transplantation continues to be a therapeutic option particularly for advanced phase CML. TKI treatment should be withheld during pregnancy. Treatment discontinuation may be considered in patients with durable DMR with the goal of achieving TFR.
Journal Article
The Perrin technique : how to beat chronic fatigue syndrome/ME
After many years of careful study coupled with practical hands-on experience, Perrin has arrived at the firm conclusion that M.E. is a structural disorder with definite diagnosable physical signs. This technique gives you the chance to take charge of your own structural health and rid yourself of years of toxin build-up.
Book
Multifactorial intervention with nurse practitioners does not change cardiovascular outcomes in patients with chronic kidney disease
Strict implementation of guidelines directed at multiple targets reduces vascular risk in diabetic patients. Whether this also applies to patients with chronic kidney disease (CKD) is uncertain. To evaluate this, the MASTERPLAN Study randomized 788 patients with CKD (estimated GFR 20–70ml/min) to receive additional intensive nurse practitioner support (the intervention group) or nephrologist care (the control group). The primary end point was a composite of myocardial infarction, stroke, or cardiovascular death. During a mean follow-up of 4.62 years, modest but significant decreases were found for blood pressure, LDL cholesterol, anemia, proteinuria along with the increased use of active vitamin D or analogs, aspirin and statins in the intervention group compared to the controls. No differences were found in the rate of smoking cessation, weight reduction, sodium excretion, physical activity, or glycemic control. Intensive control did not reduce the rate of the composite end point (21.3/1000 person-years in the intervention group compared to 23.8/1000 person-years in the controls (hazard ratio 0.90)). No differences were found in the secondary outcomes of vascular interventions, all-cause mortality or end-stage renal disease. Thus, the addition of intensive support by nurse practitioner care in patients with CKD improved some risk factor levels, but did not significantly reduce the rate of the primary or secondary end points.
Journal Article
The effect of muscle energy technique on pain, kinesiophobia, and quality of life in patients with COPD with chronic pain
Patients with Chronic Obstructive Pulmonary Disease (COPD) experience pain both as a symptom and comorbid condition. This study aimed to investigate the effect of the Muscle Energy Technique (MET) on pain, kinesiophobia, and quality of life in patients with chronic pain and COPD. 52 patients with moderate COPD and pain complaints were included in this randomized controlled trial and longitudinal study and were divided into two groups. The intervention group received MET 3 times a week for 4 weeks, while the control group was given a home exercise program. Both groups participated in a home-based exercise program. Pain, fear of movement, and health-related quality of life were assessed at baseline, the end of the 4-week intervention, and at the 6-week follow-up. Significant improvements were observed in both groups; however, the intervention group showed more pronounced reductions in pain and kinesiophobia as well as improvements in quality of life (p < 0.05), and the effectiveness decreased over time. This study highlights the potential benefits of MET for pain, kinesiophobia, and quality of life in patients with chronic pain and COPD. Therefore, MET interventions should be considered in the treatment of chronic pain in patients with COPD.
Trial registration
: NCT04874571.
Journal Article