Course of disease

A disease that course manner of diseases can be described by different criteria. In addition, a certain disease can develop differently in different patients . This can be due to a number of factors, such as: B. by differences in the virulence of a pathogen , in the dose of a poison , in the pre-existing health and nutritional status of the sick person, the condition of the immune system or the age of the patient. External factors such as temperature ( heat wave , cold wave ), humidity, dust exposure and drafts can also influence the course of the disease.

Patients can also influence the course of the disease themselves. The better patients are informed about their illness, the higher their health literacy and the better they can contribute to the cure themselves. Studies show that an intact social environment lowers stress, extends life, makes pain less pronounced and helps cancer patients to survive therapy better and with a higher quality of life .

In ancient times, according to the doctor Hippocrates and the disease researcher Georg Sticker, there were four possible forms of development (especially related to fever in febrile diseases):

• rapid increase in symptoms up to the peak and gradual decrease.
  • Examples: fever with smallpox, flu, diphtheria, mumps
• gradual gain from day to day up to the summit and sudden decrease
  • Examples: typhus, paratyphoid, sometimes meningitis
• gradual ascent to the summit, pause and gradual release
  • Examples: typhus in some cases, brucellosis, often meningitis, miliary tuberculosis
• sudden increase, pronounced gait and sudden decrease
  • Examples: pneumonia, erysipelas, typhus, scarlet fever, measles, relapsing fever

With Hippocrates, the natural conclusion of an illness is formed by the decision days (Greek κρίσιμοι ἡμέραι), after which the illness goes into recovery.

Classifications

Classification according to time

According to the course of time, diseases are classified, but occasionally also events in other areas, with different terms:

• acute (from Latin acutus 'sharp', 'pointed') denotes diseases that break out quickly.
• chronic (from the Greek χρόνος chrónos , time ') is usually characterized by slowly developing and long-lasting diseases. The disease progresses for more than four weeks. A disease can be chronic and still have an acute component. Some chronic diseases, such as B. Epilepsy , are characterized by acute attacks (attacks) . In the case of a long-lasting or long-lasting illness, one speaks of a procrastination or a procrastinated illness.

There are modifications of these basic forms for a finer classification:

• perakut is used for very quickly occurring and often fatal diseases (e.g. heart attack , stroke ). It is the shortening of hyperacute .
• subacute is used for less severe clinical symptoms than acute, between acute and chronic .
• Subchronic is a prolonged but even shorter duration of the disease than a chronic course
• Chronic progressive is a long-lasting or permanent illness, in the course of which the symptoms increase or additional symptoms arise.
• prolonged is said to be in the case of an above-average duration of illness or symptoms. In the case of a long-lasting or prolonged illness, one speaks of a procrastination or a procrastinated illness.
• transitory is used for temporary disruptions.

Further properties of time courses are:

• paroxysmal ("attack-like"): are symptoms that appear within a very short time.
• foudroyant ("overwhelming and fast", "suddenly set in"; from French foudroyer "struck by lightning"): z. B. some pulmonary embolism , sepsis . Synonym is also fulminant (from Latin fulminare "flash") used.
• recurrent ("recurring"), the recurrence ("relapse") of an illness, see relapse
  • episodic or phased: symptoms that occur occasionally or more or less often
  • Relapsing: like "episodic" only mostly with permanent deterioration, like in multiple sclerosis
  • intermittent: (also phased, but rather short), v. a. Related to an abnormal heart rhythm or fever
  • cyclic or rhythmic: as with intermittent fever ( malaria ), with a typical course of time
• tardive: a slow or delayed onset of the disease
• progressive (“progressive”, synonym: progressive ): disease that worsens over a longer period of time, see progression
• persistent: a disease or symptom of constant expression
• protracted (“drawn out”) and persistent, but with a tendency to deteriorate.

Classification according to severity of symptoms

• latent is used for "dormant" illnesses in which the patient does not experience any symptoms; However, latent diseases can also become "clinically manifest" (see below) under certain conditions (e.g. with a reduced immune status).
• inapparent ("not appearing") or
• asymptomatic (“without symptoms”) is used for diseases without symptoms (compare Silent Feiung ).
• subclinical means subliminal, not obvious.
• blande applies to rather harmless or weak symptoms
• oligosymptomatic means few clinical symptoms.
• diseases with easily recognizable symptoms are clinically manifest .
• aggravated is used for disease conditions made worse (often by other factors or by exaggeration - see aggravation ).

Classification according to severity or prognosis

• Fatal diseases are referred to as lethal , see Lethality .
• fulminant (fulmen (Latin) = lightning) are very severe disease processes that also progress particularly quickly (analogous to foudroyant ).
• florid (e) ("blooming") are violent, strongly pronounced symptoms.
• remitted or remitting for healing or relieving complaints.
• exacerbates worsening of chronic disease processes (e.g. exacerbation COPD )
• infaust is used for foreseeably hopeless disease courses.

Classification according to pathophysiological damage pattern

• abscessing (melting down, forming an abscess )
• destructive (destructive, especially bone structures)
• necrotizing (causing tissue destruction)
• Consuming for debilitating diseases with so-called B symptoms such as malignant cancers or granulomatous clinical pictures such as tuberculosis or granulomatosis with polyangiitis , sarcoid
• erosive (erosive gastritis )
• generalizing , e.g. B. epileptic seizures that spread to the whole brain
• immobilizing acute medical conditions such as back pain, but also chronic how can rheumatoid arthritis be
• infiltrating (penetration or spread of e.g. pathogens, tumor cells, substances)
• metastatic (forming settlements)
• obstructive , obstructive (closing)
• perforating (breaking through, piercing)
• Septic courses are those with a transition to a state of general blood poisoning
• sclerosing (general: hardening)
• stenosing (constricting)
• systemic (affecting the entire organism)
• ulcerating (forming sores)
• centralized blood circulation in the beginning circulatory shock
• phlegmonous (purulent and diffusely spreading)

Classification according to direction of action

• ascendant (low to high. eg urinary tract infection in the direction of the renal pelvis )
• Descending (descending, e.g. change of floor with inflammation of the nasopharynx, also lateral cord angina )

Classification according to the origin of the disease

• Primary disease , arises directly from the cause that makes the disease , e.g. B. in the organs or tissues, primary hyperaldosteronism or Conn syndrome
• Secondary disease , the disease develops as a result of another disease or injury, e.g. B. Secondary hyperaldosteronism

Individual evidence

1. ^ Health Literacy: A Prescription to End Confusion: Health and Medicine Division. Retrieved March 2, 2017 (English). 
2. ↑ SE Taylor, LC Klein, BP Lewis, TL Gruenewald, RA Gurung: Biobehavioral responses to stress in females: tend-and-befriend, not fight-or-flight . In: Psychological Review . tape 107 , no. 3 , July 1, 2000, ISSN  0033-295X , p. 411-429 , PMID 10941275 .
3. ↑ Lynne C. Giles, Gary FV Glonek, Mary A. Luszcz, Gary R. Andrews: Effect of social networks on 10 year survival in very old Australians: the Australian longitudinal study of aging . In: Journal of Epidemiology and Community Health . tape 59 , no. 7 , July 1, 2005, ISSN  0143-005X , p. 574-579 , doi : 10.1136 / jech.2004.025429 , PMID 15965141 , PMC 1757078 (free full text).
4. ↑ Doctors Zeitung: Relatives can relieve chronic pain - or make it worse. Retrieved March 2, 2017 . 
5. ↑ Martin Pinquart, Paul R. Duberstein: Associations of social networks with cancer mortality: A meta-analysis . In: Critical Reviews in Oncology / Hematology . tape 75 , no. 2 , p. 122-137 , doi : 10.1016 / j.critrevonc.2009.06.003 , PMID 19604706 , PMC 2910231 (free full text).
6. ↑ Candyce H Kroenke, Marilyn L. Kwan, Alfred I. Neugut, Isaac J. Ergas, Jaime D. Wright: Social networks, social support mechanisms, and quality of life after breast cancer diagnosis . In: Breast Cancer Research and Treatment . tape 139 , no. 2 , March 2, 2017, ISSN  0167-6806 , p. 515-527 , doi : 10.1007 / s10549-013-2477-2 , PMID 23657404 , PMC 3906043 (free full text).
7. ↑ Georg Sticker: Hippokrates: The common diseases first and third book (around the year 434-430 BC). Translated, introduced and explained from the Greek. Johann Ambrosius Barth, Leipzig 1923 (= Classics of Medicine. Volume 29); Unchanged reprint: Central antiquariat of the German Democratic Republic, Leipzig 1968, p. 116 f. and 121 f.
8. ^ Hans Günther: Historical explanation of the expressions "acute" and "chronic" illness. In: Sudhoffs Archiv 34, 1941, pp. 105–124.
9. ^ Max Höfler: German book of names of diseases. Piloty & Loehle, Munich 1899 (Reprographic reprint: Olms, Hildesheim and New York 1970 and 1979, ISBN 1-174-35859-9 ), p. 580.
10. ↑ Entry on subchronic in Flexikon , a Wiki of the DocCheck company , accessed on January 10, 2015.
11. ^ Max Höfler: German book of names of diseases. Piloty & Loehle, Munich 1899 (Reprographic reprint: Olms, Hildesheim and New York 1970 and 1979, ISBN 1-174-35859-9 ), p. 580.

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