Multifactorial

It is well accepted that hypertension is a multifactorial disease. Only about 10% of the hypertensive patients have secondary hypertension for which causes, ie, partial coarctation of the renal artery, pheochromacytoma, aldosteronism, hormonal imbalances, etc, are known. The hallmark of hypertension is an abnormally elevated total peripheral resistance. In most patients hypertension produces no serious symptoms particularly in the early phase of the disease. This is why hypertension is called a silent killer. However, prolonged suffering of high arterial blood pressure leads to end organ damage, causing stroke, myocardial infarction, and heart failure, etc. Adequate treatment of hypertension has been proven to decrease the incidence of cardiovascular morbidity and mortaUty and therefore prolong life (176—183). 

The regulation of NHE2 is multifactorial. Chronic exposure to nitric oxide and gamma-interferon decrease NHE2 activity, whereas metabolic acidosis and chronic stimulation with epidermal growth factor (EGF) increase activity. 

Acneiform eruption after deep chemical peel is a common phenomenon appearing immediately after reepithelialization. Its etiology is multifactorial and is related to either exacerbation of previously existing acne or is due to over-greasing of newly formed skin. Short-term systemic antibiotics together with discontinuation of any oily preparations will usually provide satisfactory solution. 

The pathogenesis of rosacea is multifactorial. Vascular hyperactivity is the primary phenomenon that is complicated by inflammatory changes. Endocrine, psychological, pharmacological, immunological, infectious, thermal and alimentary factors contribute to produce vascular instability and tissue damage (Fig. 17.1). The role of Helicobacter pylori is still being discussed. 

Etiology probably multifactorial (i.e., hypersensitivity reactions, pharmacological action of the drug and/or metabolites, infusion-related, altered thermoregulation, idiosyncratic)... 

A decrease in erythrocyte production can be multifactorial. A deficiency in nutrients (such as iron, vitamin B12, and folic acid) is a common cause that often is easily treatable. In addition, patients with cancer and CKD are at risk for developing a hypoproductive anemia. Furthermore, patients with chronic immune-related diseases (such as rheumatoid arthritis and systemic lupus erythematosus) can develop anemia as a complication of their disease. Anemia related to these chronic inflammatory conditions is typically termed anemia of chronic disease. 

The development of sepsis is complex and multifactorial. The normal host response to infection is designed to localize and control bacterial invasion and initiate repair of injured tissue through phagocytic cells and inflammatory mediators.1 Sepsis... 

Electrolytes are involved in many metabolic and homeostatic functions, including enzymatic and biochemical reactions, maintenance of cell membrane structure and function, neurotransmission, hormone function, muscle contraction, cardiovascular function, bone composition, and fluid homeostasis. The causes of electrolyte abnormalities in patients receiving PN may be multifactorial, including altered absorption and distribution excessive or inadequate intake altered hormonal, neurologic, and homeostatic mechanisms altered excretion via gastrointestinal and renal losses changes in fluid status and fluid shifts and medications. 

Magnesium is the second most abundant intracellular cation. Magnesium serves as an essential cofactor for numerous enzymes and in many biochemical reactions, including reactions involving adenosine triphosphate (ATP).17 Magnesium disorders can be multifactorial and can be related to renal function, disease... 

In contrast to common statistical techniques, by modern experimental design influencing factors are studied simultaneously (multifactorial design, MFD). The aim of MFD consists in an arrangement of factors in such a way that their influences can be quantified, compared and separated from random variations. 

Multifactorial experiments are used in analytical chemistry for diverse applications, e.g., checking up significant influences before optimization procedures, recognizing matrix effects, and testing the robustness of analytical procedures (Wegscheider [1996]). 

Plackett RL, Burman JP (1946) The design of optimum multifactorial experiments. Biometrika 33 305... 

Diathesis stress model A multifactorial model of pathogenesis suggesting that schizophrenia is due to the complex interaction between a number of internal and external factors. 

Taken as a whole, these observations show that parasite lines differ in an immune-dependent manner in their infection/expulsion kinetics. Furthermore, there is heritable variation in survival and fecundity in previously exposed hosts and quantitative variation in the immune response that selected parasite lines elicit. Again, taken as a whole, these observations have the necessary corollary that variation in these traits exists not only in laboratory-maintained isolates but also in helminth species in nature. The phenotypes under consideration here (infection/expulsion kinetics, survival, fecundity) are multifactorial life-history traits. Understanding the basis of variation in the components and interplay of these complex, immune-responsive phenotypes must be of crucial relevance to understanding the immunology of infections of parasitic nematodes. This is of particular relevance in view of current attempts to develop immunological methods of nematode control. 

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