Differences

This shows you the differences between two versions of the page.

--- home:pathogenesis:th1spectrum [02.10.2019] – [Metabolic syndrome] sallieq
+++ home:pathogenesis:th1spectrum [01.13.2024] (current) – [Comorbidity of inflammatory diseases] ron
@@ Line 23: / Line 23: @@
 <blockquote>One of the striking features of a variety of neuropsychiatric diseases (e.g., affective disorders) is their variance, with differences observed across individuals in terms of their susceptibility, in the combination of systems that are disturbed, and in the therapeutic and adverse responses to various medications.... The microbiome [may represent] a source of this observed variance.
-//**A. Gonzalez** et al.//(({{pubmed>long:21485746}}))
+//**A. Gonzalez** et al.//(({{pmid>long:21485746}}))
 </blockquote>
-When the Th1 pathogens compromise the immune response, they make it easier for other types of bacteria in other locations to infect the body as well. This phenomenon is known as comorbidity. Although a comorbid condition is [[http://www.answers.com/comorbidity#Medical_Dictionary|traditionally understood]] to be unrelated to the underlying condition, the sheer number of common comorbidities points to a common pathology. Indeed, a 2012 Dutch analysis of patients showed that disease pairs occurred more frequently than would be expected if diseases had been independent.(({{pubmed>long:22935268}}))
+When the Th1 pathogens compromise the immune response, they make it easier for other types of bacteria in other locations to infect the body as well. This phenomenon is known as comorbidity. Although a comorbid condition is [[https://www.answers.com/comorbidity#Medical_Dictionary|traditionally understood]] to be unrelated to the underlying condition, the sheer number of common comorbidities points to a common pathology. Indeed, a 2012 Dutch analysis of patients showed that disease pairs occurred more frequently than would be expected if diseases had been independent.(({{pmid>long:22935268}}))
 Epidemiological research may have its share of liabilities, but one contribution it has made is in demonstrating the strong connections between seemingly disparate diseases as evidenced by the number of patients who share diagnoses with two or more "unrelated" disease processes.
+<nodisp>
 The following wheel shows how truly related chronic diseases are. Each "spoke" represents a published study which has demonstrated a significant statistical relationship between patients suffering from one disease and the next.
@@ Line 363: / Line 363: @@
          <div id="canvasObj"></div>
 </html>
+The following paragraph contains links to all the studies alluded to in the above chart.
+</nodisp>
+Please note that some of the disease names in the following paragraph are links to articles discussing those diseases in further detail.
+[[home:diseases:allergies_sensitivities|allergies]] (({{pmid>long:9042070}}))
+[[home:diseases:alopecia|alopecia areata]] (({{pmid>long:7883407}})) (({{pmid>long:17582741}}))
+[[home:diseases:alzheimers_dementia|Alzheimer's disease & dementia]] (({{pmid>long:10479741}})) (({{pmid>long:18367704}}))
+[[home:diseases:ankylosing spondylitis|ankylosing spondylitis]] (({{pmid>long:16981296}})) (({{pmid>long:16143148}})) (({{pmid>long:18008072}}))
+[[home:diseases:anorexia_bulimia|anorexia nervosa]] (({{pmid>long:15569892}}))
+anxiety disorders (({{pmid>long:8818377}})) (({{pmid>long:18774427}})) (({{pmid>long:18774427}})) (({{pmid>long:9361174}})) (({{pmid>long:15569892}})) (({{pmid>long:7883407}})) (({{pmid>long:9707157}})) (({{pmid>long:12011605}})) (({{pmid>long:11391746}}))
+arthritis (({{pmid>long:18021889}})) (({{pmid>long:16981296}})) (({{pmid>long:16143122}})) (({{pmid>long:16143148}})) (({{pmid>long:16478843}})) (({{pmid>long:10599323}})) (({{pmid>long:18582390}}))
+[[home:diseases:asthma|asthma]] (({{pmid>long:9042070}})) (({{pmid>long:17437504}})) (({{pmid>long:12011605}})) (({{pmid>long:14706414}})) (({{pmid>long:16491113}})) (({{pmid>long:9856429}})) (({{pmid>long:16143122}})) (({{pmid>long:16143122}})) (({{pmid>long:16143122}})) (({{pmid>long:16478843}})) (({{pmid>long:12720509}})) (({{pmid>long:18582390}}))
+[[home:diseases:bipolar|bipolar disease]] (({{pmid>long:9387083}})) (({{pmid>long:18774427}})) (({{pmid>long:18774427}})) (({{pmid>long:15163249}}))
+[[home:diseases:cancer|cancer]] (({{pmid>long:12361669}})) (({{pmid>long:16393226}})) (({{pmid>long:16478843}})) (({{pmid>long:18582390}}))
+[[home:diseases:cardiovascular|cardiac disease]] (({{pmid>long:16338246}})) (({{pmid>long:15633853}})) (({{pmid>long:11404827}})) (({{pmid>long:18021889}})) (({{pmid>long:18453370}})) (({{pmid>long:17470018}})) (({{pmid>long:12361669}})) (({{pmid>long:16476152}})) (({{pmid>long:17383491}})) (({{pmid>long:16478843}}))
+cardiovascular disease (({{pmid>long:16981296}})) (({{pmid>long:16478843}})) (({{pmid>long:9097215}})) (({{pmid>long:16371403}})) (({{pmid>long:18582390}}))
+[[home:diseases:celiac|celiac disease]] (({{pmid>long:17053448}})) (({{pmid>long:17053448}})) (({{pmid>long:18582390}})) (({{pmid>long:17582741}}))
+[[home:diseases:cfs|chronic fatigue syndrome]] (({{pmid>long:10647761}})) (({{pmid>long:10647761}})) (({{pmid>long:17582741}}))
+chronic obstructive pulmonary disease (({{pmid>long:18453370}}))
+[[home:diseases:depression|depression]] (({{pmid>long:18774427}})) (({{pmid>long:9361174}})) (({{pmid>long:7883407}})) (({{pmid>long:12391767}})) (({{pmid>long:9707157}})) (({{pmid>long:14706414}})) (({{pmid>long:11391746}})) (({{pmid>long:8268331}})) (({{pmid>long:8444530}})) (({{pmid>long:10479741}})) (({{pmid>long:15163249}})) (({{pmid>long:12361669}})) (({{pmid>long:16476152}})) (({{pmid>long:17383491}})) (({{pmid>long:12720509}})) (({{pmid>long:15111522}})) (({{pmid>long:9097215}}))
+[[home:diseases:diabetes2|diabetes]] (({{pmid>long:15745840}})) (({{pmid>long:18453370}})) (({{pmid>long:16478843}})) (({{pmid>long:15111522}})) (({{pmid>long:16371403}})) (({{pmid>long:17206706}})) (({{pmid>long:18582390}}))
+diabetes, type1 (({{pmid>long:9042070}})) (({{pmid>long:17053448}})) (({{pmid>long:17582741}}))
+diabetes, type2 (({{pmid>long:2027060}}))
+[[home:diseases:fibromyalgia|fibromyalgia]] (({{pmid>long:10647761}})) (({{pmid>long:10647761}}))
+Guillain-Barré syndrome (({{pmid>long:11320574}})) (({{pmid>long:17582741}}))
+hypertension (({{pmid>long:15745840}})) (({{pmid>long:18453370}}))
+inflammatory bowel disease ([[home:diseases:ibd|Crohn's disease]] and ulcerative colitis) (({{pmid>long:17437504}})) (({{pmid>long:10647761}})) (({{pmid>long:18021889}})) (({{pmid>long:10943233}})) (({{pmid>long:16143122}})) (({{pmid>long:16143122}})) (({{pmid>long:16143122}})) (({{pmid>long:16143122}})) (({{pmid>long:16143148}})) (({{pmid>long:17206706}})) (({{pmid>long:16393226}})) (({{pmid>long:15247180}})) (({{pmid>long:2923094}})) (({{pmid>long:17582741}}))
+[[home:diseases:lupus|lupus]] (({{pmid>long:16278288}})) (({{pmid>long:10599323}})) (({{pmid>long:8809450}})) (({{pmid>long:11320574}})) (({{pmid>long:17582741}}))
+[[home:diseases:mcs|multiple chemical sensitivity]] (({{pmid>long:12391767}}))
+[[home:diseases:ms|multiple sclerosis]] (({{pmid>long:17437504}})) (({{pmid>long:10943233}})) (({{pmid>long:16280086}})) (({{pmid>long:10489063}})) (({{pmid>long:1565240}})) (({{pmid>long:2136584}})) (({{pmid>long:17582741}}))
+myasthenia gravis (({{pmid>long:17582741}}))
+[[home:diseases:obesity|obesity]] (({{pmid>long:18367704}})) (({{pmid>long:15163249}})) (({{pmid>long:15745840}})) (({{pmid>long:16491113}})) (({{pmid>long:9856429}}))
+[[home:diseases:ocd|obsessive compulsive disorder]] (({{pmid>long:9387083}})) (({{pmid>long:8818377}})) (({{pmid>long:10758256}})) (({{pmid>long:9361174}})) (({{pmid>long:15569892}}))
+[[home:diseases:osteoporosis_osteopenia|osteoporosis]] (({{pmid>long:16278288}})) (({{pmid>long:18453370}})) (({{pmid>long:15247180}})) (({{pmid>long:16478843}}))
+[[home:diseases:parkinsons|Parkinson's disease]] (({{pmid>long:11404827}})) (({{pmid>long:11391746}})) (({{pmid>long:8268331}})) (({{pmid>long:11391746}}))
+[[home:diseases:periodontal|periodontal disease]] (({{pmid>long:2027060}})) (({{pmid>long:17470018}}))
+[[home:diseases:pernicious_anemia|pernicious anemia]] (({{pmid>long:17582741}}))
+[[home:diseases:psoriasis|psoriasis]] (({{pmid>long:17437504}})) (({{pmid>long:18021889}})) (({{pmid>long:8444530}})) (({{pmid>long:15745840}})) (({{pmid>long:17582741}}))
+[[home:diseases:rheumatoid_arthritis|rheumatoid arthritis]] (({{pmid>long:17437504}})) (({{pmid>long:16981296}})) (({{pmid>long:17582741}}))
+[[home:diseases:sarcoidosis|sarcoidosis]] (({{pmid>long:18774427}})) (({{pmid>long:18008072}}))
+[[home:diseases:schizophrenia|schizophrenia]] (({{pmid>long:16338246}})) (({{pmid>long:15633853}})) (({{pmid>long:10758256}}))
+[[home:diseases:scleroderma|scleroderma]] (({{pmid>long:17582741}}))
+Sjogren's syndrome (({{pmid>long:1565240}})) (({{pmid>long:2136584}})) (({{pmid>long:8809450}})) (({{pmid>long:17582741}}))
+thyroiditis ([[home:diseases:graves|Graves' disease]] and [[home:diseases:hashimotos|Hashimoto's thyroiditis]]) (({{pmid>long:9042070}})) (({{pmid>long:17053448}})) (({{pmid>long:16280086}})) (({{pmid>long:10489063}})) (({{pmid>long:10599323}})) (({{pmid>long:8809450}})) (({{pmid>long:17582741}}))
+[[home:diseases:eyes#uveitis|uveitis]] (({{pmid>long:16143148}})) (({{pmid>long:2923094}}))
+vitiligo (({{pmid>long:17582741}}))
+==== Multimorbidity ====
+[{{ :home:pathogenesis:comorbidities.gif|**25% of Americans have more than one chronic condition.**}}]
-The following paragraph contains links to all the studies alluded to in the above chart. Please note that some of the disease names are links to articles discussing those diseases in further detail.
+According to a 2012 //JAMA// paper, the most common chronic condition experienced by adults is multimorbidity, the coexistence of multiple chronic diseases or conditions.(({{pmid>long:22797447}}))  In patients with coronary disease, for example, it is the sole condition in only 17% of cases.(({{pmid>long:17848649}})) Almost 3 in 4 individuals aged 65 years and older have multiple chronic conditions, as do 1 in 4 adults younger than 65 years who receive health care.((Anderson G. (2010). [[https://www.rwjf.org/files/research/50968chronic.care.chartbook.pdf|Chronic care: making the case for ongoing care]]. Princeton, NJ: Robert Wood Johnson Foundation.)) Adults with multiple chronic conditions are the major users of health care services at all adult ages, and account for more than two-thirds of health care spending.((Anderson G. (2010). [[https://www.rwjf.org/files/research/50968chronic.care.chartbook.pdf|Chronic care: making the case for ongoing care]]. Princeton, NJ: Robert Wood Johnson Foundation.))
-<html><div span="fontsize12"></html>
-[[home:diseases:allergies_sensitivities|allergies]] (({{pubmed>long:9042070}}))
-[[home:diseases:alopecia|alopecia areata]] (({{pubmed>long:7883407}})) (({{pubmed>long:17582741}}))
-[[home:diseases:alzheimers_dementia|Alzheimer's disease & dementia]] (({{pubmed>long:10479741}})) (({{pubmed>long:18367704}}))
-[[home:diseases:ankylosing spondylitis|ankylosing spondylitis]] (({{pubmed>long:16981296}})) (({{pubmed>long:16143148}})) (({{pubmed>long:18008072}}))
-[[home:diseases:anorexia_bulimia|anorexia nervosa]] (({{pubmed>long:15569892}}))
-anxiety disorders (({{pubmed>long:8818377}})) (({{pubmed>long:18774427}})) (({{pubmed>long:18774427}})) (({{pubmed>long:9361174}})) (({{pubmed>long:15569892}})) (({{pubmed>long:7883407}})) (({{pubmed>long:9707157}})) (({{pubmed>long:12011605}})) (({{pubmed>long:11391746}}))
-arthritis (({{pubmed>long:18021889}})) (({{pubmed>long:16981296}})) (({{pubmed>long:16143122}})) (({{pubmed>long:16143148}})) (({{pubmed>long:16478843}})) (({{pubmed>long:10599323}})) (({{pubmed>long:18582390}}))
-[[home:diseases:asthma|asthma]] (({{pubmed>long:9042070}})) (({{pubmed>long:17437504}})) (({{pubmed>long:12011605}})) (({{pubmed>long:14706414}})) (({{pubmed>long:16491113}})) (({{pubmed>long:9856429}})) (({{pubmed>long:16143122}})) (({{pubmed>long:16143122}})) (({{pubmed>long:16143122}})) (({{pubmed>long:16478843}})) (({{pubmed>long:12720509}})) (({{pubmed>long:18582390}}))
-[[home:diseases:bipolar|bipolar disease]] (({{pubmed>long:9387083}})) (({{pubmed>long:18774427}})) (({{pubmed>long:18774427}})) (({{pubmed>long:15163249}}))
-[[home:diseases:cancer|cancer]] (({{pubmed>long:12361669}})) (({{pubmed>long:16393226}})) (({{pubmed>long:16478843}})) (({{pubmed>long:18582390}}))
-[[home:diseases:cardiovascular|cardiac disease]] (({{pubmed>long:16338246}})) (({{pubmed>long:15633853}})) (({{pubmed>long:11404827}})) (({{pubmed>long:18021889}})) (({{pubmed>long:18453370}})) (({{pubmed>long:17470018}})) (({{pubmed>long:12361669}})) (({{pubmed>long:16476152}})) (({{pubmed>long:17383491}})) (({{pubmed>long:16478843}}))
-cardiovascular disease (({{pubmed>long:16981296}})) (({{pubmed>long:16478843}})) (({{pubmed>long:9097215}})) (({{pubmed>long:16371403}})) (({{pubmed>long:18582390}}))
-[[home:diseases:celiac|celiac disease]] (({{pubmed>long:17053448}})) (({{pubmed>long:17053448}})) (({{pubmed>long:18582390}})) (({{pubmed>long:17582741}}))
-[[home:diseases:cfs|chronic fatigue syndrome]] (({{pubmed>long:10647761}})) (({{pubmed>long:10647761}})) (({{pubmed>long:17582741}}))
-chronic obstructive pulmonary disease (({{pubmed>long:18453370}}))
-[[home:diseases:depression|depression]] (({{pubmed>long:18774427}})) (({{pubmed>long:9361174}})) (({{pubmed>long:7883407}})) (({{pubmed>long:12391767}})) (({{pubmed>long:9707157}})) (({{pubmed>long:14706414}})) (({{pubmed>long:11391746}})) (({{pubmed>long:8268331}})) (({{pubmed>long:8444530}})) (({{pubmed>long:10479741}})) (({{pubmed>long:15163249}})) (({{pubmed>long:12361669}})) (({{pubmed>long:16476152}})) (({{pubmed>long:17383491}})) (({{pubmed>long:12720509}})) (({{pubmed>long:15111522}})) (({{pubmed>long:9097215}}))
-[[home:diseases:diabetes2|diabetes]] (({{pubmed>long:15745840}})) (({{pubmed>long:18453370}})) (({{pubmed>long:16478843}})) (({{pubmed>long:15111522}})) (({{pubmed>long:16371403}})) (({{pubmed>long:17206706}})) (({{pubmed>long:18582390}}))
-diabetes, type1 (({{pubmed>long:9042070}})) (({{pubmed>long:17053448}})) (({{pubmed>long:17582741}}))
-diabetes, type2 (({{pubmed>long:2027060}}))
-[[home:diseases:fibromyalgia|fibromyalgia]] (({{pubmed>long:10647761}})) (({{pubmed>long:10647761}}))
-Guillain-Barré syndrome (({{pubmed>long:11320574}})) (({{pubmed>long:17582741}}))
-hypertension (({{pubmed>long:15745840}})) (({{pubmed>long:18453370}}))
-inflammatory bowel disease ([[home:diseases:ibd|Crohn's disease]] and ulcerative colitis) (({{pubmed>long:17437504}})) (({{pubmed>long:10647761}})) (({{pubmed>long:18021889}})) (({{pubmed>long:10943233}})) (({{pubmed>long:16143122}})) (({{pubmed>long:16143122}})) (({{pubmed>long:16143122}})) (({{pubmed>long:16143122}})) (({{pubmed>long:16143148}})) (({{pubmed>long:17206706}})) (({{pubmed>long:16393226}})) (({{pubmed>long:15247180}})) (({{pubmed>long:2923094}})) (({{pubmed>long:17582741}}))
-[[home:diseases:lupus|lupus]] (({{pubmed>long:16278288}})) (({{pubmed>long:10599323}})) (({{pubmed>long:8809450}})) (({{pubmed>long:11320574}})) (({{pubmed>long:17582741}}))
-[[home:diseases:mcs|multiple chemical sensitivity]] (({{pubmed>long:12391767}}))
-[[home:diseases:ms|multiple sclerosis]] (({{pubmed>long:17437504}})) (({{pubmed>long:10943233}})) (({{pubmed>long:16280086}})) (({{pubmed>long:10489063}})) (({{pubmed>long:1565240}})) (({{pubmed>long:2136584}})) (({{pubmed>long:17582741}}))
-myasthenia gravis (({{pubmed>long:17582741}}))
-[[home:diseases:obesity|obesity]] (({{pubmed>long:18367704}})) (({{pubmed>long:15163249}})) (({{pubmed>long:15745840}})) (({{pubmed>long:16491113}})) (({{pubmed>long:9856429}}))
-[[home:diseases:ocd|obsessive compulsive disorder]] (({{pubmed>long:9387083}})) (({{pubmed>long:8818377}})) (({{pubmed>long:10758256}})) (({{pubmed>long:9361174}})) (({{pubmed>long:15569892}}))
-[[home:diseases:osteoporosis_osteopenia|osteoporosis]] (({{pubmed>long:16278288}})) (({{pubmed>long:18453370}})) (({{pubmed>long:15247180}})) (({{pubmed>long:16478843}}))
-[[home:diseases:parkinsons|Parkinson's disease]] (({{pubmed>long:11404827}})) (({{pubmed>long:11391746}})) (({{pubmed>long:8268331}})) (({{pubmed>long:11391746}}))
-[[home:diseases:periodontal|periodontal disease]] (({{pubmed>long:2027060}})) (({{pubmed>long:17470018}}))
-[[home:diseases:pernicious_anemia|pernicious anemia]] (({{pubmed>long:17582741}}))
-[[home:diseases:psoriasis|psoriasis]] (({{pubmed>long:17437504}})) (({{pubmed>long:18021889}})) (({{pubmed>long:8444530}})) (({{pubmed>long:15745840}})) (({{pubmed>long:17582741}}))
-[[home:diseases:rheumatoid_arthritis|rheumatoid arthritis]] (({{pubmed>long:17437504}})) (({{pubmed>long:16981296}})) (({{pubmed>long:17582741}}))
-[[home:diseases:sarcoidosis|sarcoidosis]] (({{pubmed>long:18774427}})) (({{pubmed>long:18008072}}))
-[[home:diseases:schizophrenia|schizophrenia]] (({{pubmed>long:16338246}})) (({{pubmed>long:15633853}})) (({{pubmed>long:10758256}}))
-[[home:diseases:scleroderma|scleroderma]] (({{pubmed>long:17582741}}))
-Sjogren's syndrome (({{pubmed>long:1565240}})) (({{pubmed>long:2136584}})) (({{pubmed>long:8809450}})) (({{pubmed>long:17582741}}))
-thyroiditis ([[home:diseases:graves|Graves' disease]] and [[home:diseases:hashimotos|Hashimoto's thyroiditis]]) (({{pubmed>long:9042070}})) (({{pubmed>long:17053448}})) (({{pubmed>long:16280086}})) (({{pubmed>long:10489063}})) (({{pubmed>long:10599323}})) (({{pubmed>long:8809450}})) (({{pubmed>long:17582741}}))
-[[home:diseases:eyes#uveitis|uveitis]] (({{pubmed>long:16143148}})) (({{pubmed>long:2923094}}))
-vitiligo (({{pubmed>long:17582741}}))
+To control for confounding variables, researchers often exclude patients with more than one condition from research studies even though they represent the majority of patients.(({{pmid>long:22935268}})) Jeste //et al// made this observation in patients with schizophrenia(({{pmid>long:8873293}})) and there's no reason to think it's any different with other patient groups.
-<html></div>
-</html>
+A recent survey of Marshall Protocol patients, discussed in [[home:publications:proal_congress_on_autoimmunity_2008|Amy Proal's presentation]] at Congress on Autoimmunity, showed that of those with Hashimoto's thyroiditis, only 8% had been diagnosed with Hashimoto's alone.
+==== Metabolic syndrome ====
-==== Multimorbidity ====
+Impact of 25-hydroxyvitamin D, free and bioavailable fractions of vitamin D, and vitamin D binding protein levels on metabolic syndrome components   (({{pmid>long:28721141}}))
+===== Intestinal barrier =====
-[{{ :home:pathogenesis:comorbidities.gif|**25% of Americans have more than one chronic condition.**}}]
+Zonulin and its regulation of intestinal barrier function: the biological door to inflammation, autoimmunity, and cancer.  (({{pmid>long:    21248165}}))
+The two major triggers of zonulin release that have been described so far are bacteria and gliadin. It is well described that many enteric pathogens are able to produce enterotoxins that affect the intestinal tight junction of the host.   (({{pmid>long:28123927}}))
-According to a 2012 //JAMA// paper, the most common chronic condition experienced by adults is multimorbidity, the coexistence of multiple chronic diseases or conditions.(({{pubmed>long:22797447}}))  In patients with coronary disease, for example, it is the sole condition in only 17% of cases.(({{pubmed>long:17848649}})) Almost 3 in 4 individuals aged 65 years and older have multiple chronic conditions, as do 1 in 4 adults younger than 65 years who receive health care.((Anderson G. (2010). [[http://www.rwjf.org/files/research/50968chronic.care.chartbook.pdf|Chronic care: making the case for ongoing care]]. Princeton, NJ: Robert Wood Johnson Foundation.)) Adults with multiple chronic conditions are the major users of health care services at all adult ages, and account for more than two-thirds of health care spending.((Anderson G. (2010). [[http://www.rwjf.org/files/research/50968chronic.care.chartbook.pdf|Chronic care: making the case for ongoing care]]. Princeton, NJ: Robert Wood Johnson Foundation.))
-To control for confounding variables, researchers often exclude patients with more than one condition from research studies even though they represent the majority of patients.(({{pubmed>long:22935268}})) Jeste //et al// made this observation in patients with schizophrenia(({{pubmed>long:8873293}})) and there's no reason to think it's any different with other patient groups.
-A recent survey of Marshall Protocol patients, discussed in [[home:publications:proal_congress_on_autoimmunity_2008|Amy Proal's presentation]] at Congress on Autoimmunity, showed that of those with Hashimoto's thyroiditis, only 8% had been diagnosed with Hashimoto's alone.
 ===== The challenge of diagnosing diseases caused by bacteria =====
@@ Line 448: / Line 448: @@
 ==== No consistent symptom presentation ====
-Medicine has difficulty diagnosing disorders where there is no consistently identified anatomic abnormality or documented metabolic/physiological dysfunction.(({{pubmed>long:12685682}}))
+Medicine has difficulty diagnosing disorders where there is no consistently identified anatomic abnormality or documented metabolic/physiological dysfunction.(({{pmid>long:12685682}}))
@@ Line 464: / Line 464: @@
 Another challenge relates to how diseases are segmented into categories even when the nature of the diseases themselves don't warrant such fine-graded distinctions.
-One who pores through the articles of a medical textbook could easily form the impression that diseases are discrete, well-defined and mutually exclusive. The reality is that the nature of illness is such that diagnosis is often inexact. Over the past few decades, the [[http://en.wikipedia.org/wiki/Sensitivity_and_specificity|sensitivity and specificity]] of diagnostic tests has, in many cases, increased dramatically. Yet, neither precision nor accuracy is useful when two test results for a patient suggest conflicting diagnoses.
+One who pores through the articles of a medical textbook could easily form the impression that diseases are discrete, well-defined and mutually exclusive. The reality is that the nature of illness is such that diagnosis is often inexact. Over the past few decades, the [[https://en.wikipedia.org/wiki/Sensitivity_and_specificity|sensitivity and specificity]] of diagnostic tests has, in many cases, increased dramatically. Yet, neither precision nor accuracy is useful when two test results for a patient suggest conflicting diagnoses.
 To resolve this ambiguity, epidemiologists have developed a kind of stop-gap measure: rubrics - many of them "evidence-based" - for diagnosing disease. A rubric is a checklist of sorts. Doctors who diagnose according to a rubric look to see if a patient has at least a certain number of classical symptoms - say, eight of the twelve symptoms listed. Given that the vagaries of any one chronic disease are determined by patients' unique [[home:pathogenesis:successive_infection#pea_soup|pea soup]], that is, their particular mix of [[home:pathogenesis:microbiota|Th1 pathogens]], the traditional methods for diagnosis leave something to be desired.
@@ Line 478: / Line 478: @@
 Absolute certainty in diagnosis is unattainable, no matter how much information we gather, how many observations we make, or how many tests we perform. Our task is not to attain certainty, but rather to reduce the level of diagnostic uncertainty enough to make optimal therapeutic decisions.... We continue to test excessively, partly because of our discomfort with uncertainty.
-//**Jerome Kassirer, MD**// (({{pubmed>long:2497349}})) </blockquote>
+//**Jerome Kassirer, MD**// (({{pmid>long:2497349}})) </blockquote>
-In practice, as one approaches diagnostic certainty the useful information returned by diagnostic tests and observations approaches zero.(({{pubmed>long:1901611}}))
+In practice, as one approaches diagnostic certainty the useful information returned by diagnostic tests and observations approaches zero.(({{pmid>long:1901611}}))
 A 2011 article in the Daily Beast showed how some common tests and procedures may do more harm than good.
@@ Line 493: / Line 493: @@
 A corollary of this principle is that attempts to compare one patient's disease with another's may be futile. Certainly there is a great deal of variability in the location and severity of infection and the corresponding symptoms, but ultimately there is no fundamental difference between the origin of patients' disease states and there is, therefore, no significant difference in their ultimate recovery trajectories.
-==== Metabolic syndrome ====
-Impact of 25-hydroxyvitamin D, free and bioavailable fractions of vitamin D, and vitamin D binding protein levels on metabolic syndrome components   (({{pubmed>long:28721141}}))
-===== Intestinal barrier =====
-Zonulin and its regulation of intestinal barrier function: the biological door to inflammation, autoimmunity, and cancer.  (({{pubmed>long:    21248165}}))
-The two major triggers of zonulin release that have been described so far are bacteria and gliadin. It is well described that many enteric pathogens are able to produce enterotoxins that affect the intestinal tight junction of the host.   (({{pubmed>long:28123927}}))
@@ Line 519: / Line 502: @@
 {{tag>Pathogenesis meter picture}}
+<nodisp>
 ===== Notes and comments =====
+ (({{pmid>long:000}}))
 --- //Sallie Q 11.28.2016//removed ~~NOEXPLAIN~~ from start of page edit
@@ Line 532: / Line 519: @@
 Studies to add:
-  * insomnia and cardiac disease: http://jama.ama-assn.org/cgi/content/full/300/24/2859
+  * insomnia and cardiac disease: https://jama.ama-assn.org/cgi/content/full/300/24/2859
-  * [[http://www.reuters.com/article/idUSTRE67P3NX20100826|cardiac disease and allergies]]: http://www.ajconline.org/article/S0002-9149(10)01134-3/abstract
+  * [[https://www.reuters.com/article/idUSTRE67P3NX20100826|cardiac disease and allergies]]: https://www.ajconline.org/article/S0002-9149(10)01134-3/abstract
   *
   *
-  * Where should this go? http://www.cdc.gov/ncidod/EID/vol12no07/06-0037.htm
+  * Where should this go? https://www.cdc.gov/ncidod/EID/vol12no07/06-0037.htm
   * Diseases to add: autism...
   * Legacy content
@@ Line 558: / Line 545: @@
 <blockquote>Integrate into above sections how psychiatry's diagnoses are in a state of turmoil:
-  * [[http://www.newscientist.com/article/mg20427381.300-psychiatrys-civil-war.html|Psychiatry's civil war]]
+  * [[https://www.newscientist.com/article/mg20427381.300-psychiatrys-civil-war.html|Psychiatry's civil war]]
-  * [[http://www.newscientist.com/article/mg20427382.400-times-up-for-psychiatrys-bible.html?full=true&print=true|Time's up for psychiatry's bible]]
+  * [[https://www.newscientist.com/article/mg20427382.400-times-up-for-psychiatrys-bible.html?full=true&print=true|Time's up for psychiatry's bible]]
 </blockquote>
 <blockquote>Links Between Hypertension, Bipolar Disorders Identified
-http://www.sciencedaily.com/releases/2010/06/100610171716.htm
+https://www.sciencedaily.com/releases/2010/06/100610171716.htm
@@ Line 590: / Line 577: @@
 <blockquote>
-http://www.drugs.com/news/autoimmune-disorder-linked-stroke-heart-attack-women-20088.html
+https://www.drugs.com/news/autoimmune-disorder-linked-stroke-heart-attack-women-20088.html
 Lancet Neurol. 2009 Nov;8(11):998-1005. Epub 2009 Sep 25.
@@ Line 618: / Line 605: @@
 The authors noted that their study adds to the literature because it took a novel approach, studying an entire population to examine the association between rheumatologic diseases and neuropsychiatric disorders.
 </blockquote>
-===== References =====
+===== References =====</nodisp>

home/pathogenesis/th1spectrum.1549778913.txt.gz · Last modified: 02.10.2019 by sallieq