Multifactorial therapy

Fig. 10.14 Multifactorial therapy in Alzheimer s disease (AD). Apolipoprotein E APOE)-ve aieA therapeutic response. (Adapted from refs. 13-16 aaA 18-20.)...

ACii-Related Cognitive Performance in Response to a Multifactorial Therapy in Alzheimer s Disease... 

Because atherogenesis is multifactorial, therapy should be directed toward all the modifiable risk... 

Fig. 9 APOE-related cognitive performance in response to a multifactorial therapy in patients with dementia. Tb Basal MMSE score prior to treatment Tt MMSE score after 3 months of treatment in the total sample. E2/3b Basal MMSE score in APOE-2/3 carriers E2/3t MMSE score after treatment in APOE-2/3 carriers E2/4b Basal MMSE score in APOE-2/4 carriers E2/4t MMSE score after treatment in APOE-2/4 carriers E3/3b Basal MMSE score in APOE-3/3 carriers E3/3t MMSE score after treatment in APOE-3/3 carriers E3/4b Basal MMSE score in APOE-3/4 carriers E3/4t MMSE score after treatment in APOE-3/4 carriers E4/4b Basal MMSE score in APOE-4/4 carriers E4/4 MMSE score after treatment in APOE-4/4 carriers. (Adapted from ref. 15)...

Fig. 10 APOE-related cognitive response rate in patients with dementia treated with a multifactorial therapy...

The mechanism of anemia in heart failure is multifactorial. Cytokines have been implicated in the process, specifically TNFo . TNF-a has been shown to blunt the production and proliferation of ery-throid progenitors [48]. The drug therapies used for heart failure also may contribute to anemia. ACE inhibitors and ARBs have been shown to result in a decrease in angioitensin-II receptor mediated activity [49, 50]. This relationship is further augmented by evidence of communication by the same second messenger system, Jak STAT [51, 52]. 

It is becoming clear that Alzheimer s disease is a multifactorial syndrome and that unraveling its causes may be difficult. However, as knowledge of the mechanisms of degeneration are elucidated, this knowledge can be applied to the development of therapies to alleviate the symptoms and hopefully to prevent the disease or inhibit its progression. 

Ponepal, V., U. Spielberger, G. Riedel-Caspari, and F. W. Schmidt. Use of Coffea-arabica-wasta extract in propyl-axis and therapy of multifactorial infectious diseases in newborn calves. Dtsch Tieraerztl Wochenschr 1996 ... 

Kita T, Yokoyama K, Higuchi T, Kinuya S, Taki J, Nakajima K, Michigishi T, Tonami N. Multifactorial analysis on the short-term side effects occurring within 96 hours after radioiodine-131 therapy for differentiated thyroid carcinoma. Ann Nucl Med 2004 18(4) 345-9. 

Metabolic disturbances are frequent in patients with HIV infection and represent a multifactorial condition related both to the underlying disease and to the antiviral treatment. HIV infection itself appears to cause hyperlipidemia and insulin resistance in some patients. Protease inhibitor therapy is a major contributor to fat accumulation, hyperlipidemia, and insulin resistance. NNRTIs contribute mainly through augmentation of lipid concentrations and NRTIs to the development of lipid-associated toxicity. NRTIs can cause mitochondrial dysfunction. 

Perhaps the role of cognitive-behavioral treatments ought to be tested, as both depression and chronic pain tend to be responsive to cognitive and behavioral interventions. To our knowledge, very few, if any, treatments have studied the combined effects of pharmacotherapy and behavioral or physical therapies. Given the complex nature of FM, a multifactorial approach may be the most effective (40) and an important area to explore with more scientific rigor. 

As with other organ systems, the consideration of using gene therapy in the airways has generally begun with simple Mendelian disorders, like CF. However, asthma is a much more prevalent multifactorial... 

---