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Prognosis of Diseases means how we are expected to do after a disease is diagnosed. It is based on many things, including stage of disease, kind of disease, response to treatment, and our general state of health.
1. HIV/AIDS:
The first drugs used to treat HIV, such as AZT (zidovudine) and ddI (didanosine), have reduced the numbers of opportunistic infections and increased the life expectancy of people with AIDS, and combinations of these drugs produce even better results. Newer nucleoside drugs, such as d4T and 3TC, and HIV protease inhibitors (such as indinavir, saquinavir, ritonavir) and non-nucleoside reverse transcriptase inhibitor (such as efavirenz, nevirapine) are even more potent. In some, with effective combination treatment, the amount of virus in the blood (viral load) will decrease even to an undetectable level. Cures, however, have not been proven.
2. Small-Cell Lung Cancer:
An all-oral regimen of etoposide and cyclophosphamide is developed for use in prognosis of this extensive disease.
3. Coronary Artery Disease:
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Early diagnosis and treatment can improve the prognosis for people with coronary artery disease. For angina or a minor blockage, medications and the lifestyle changes may limit further damage. In serious conditions, surgical treatment such as angioplasty and stents that open the artery can help the blood flow more freely. Coronary bypass surgery can create a bypass for the artery that allows blood to flow to the heart.
4. Lyme Disease:
For early cases, prompt treatment is usually curative. However, the severity and treatment of Lyme disease may be complicated due to late diagnosis, failure of antibiotic treatment, and simultaneous infection with other tick-borne diseases (co-infections) including ehrlichiosis, babesiosis, and bartonella, and immune suppression in the patient. If aggressive antibiotic therapy is given early, and the patient cooperates fully and sticks to the medication schedule, recovery should be complete.
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Only a small percentage of Lyme disease patients fail to respond or relapse (have recurring episodes). Most long-term effects of the disease result when diagnosis and treatment are delayed or missed. Co-infection with other infectious organisms spread by ticks in the same areas as Bb (babesiosis and ehrlichiosis, for instance) may be responsible for treatment failures or more severe symptoms.
5. Hepatitis A:
Hepatitis A is the least serious of the common hepatitis viruses. It only has an acute (short term) form that can last from several weeks to up to 6 months. It does not have a chronic form. Most people who have hepatitis A recover completely. Once people recover, they are immune to the hepatitis A virus. In very rare cases, hepatitis A can cause liver failure (fulminant hepatic failure) but this usually occurs in people who already have other chronic liver diseases, such as hepatitis B or C.
6. Hepatitis B:
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Hepatitis B can have an acute or chronic form. The majorities (95%) of people who are infected with hepatitis B recover within 6 months and develop immunity to the virus. People who develop immunity arc- not infectious and cannot pass the virus on to others. Still, blood banks will not accept donations from people who test positive for the presence of HBV antibodies.
About 5% of people develop a chronic form of hepatitis B. People who have chronic hepatitis B remain infectious and are considered carriers of the disease, even if they do not have any symptoms. Chronic hepatitis B infection significantly increases the risk for liver damage, including cirrhosis and liver cancer. In fact, hepatitis B is the leading cause of liver cancer worldwide. Liver disease, especially liver cancer, is the main cause of death in people with chronic hepatitis B.
7. Hepatitis C:
Hepatitis C has an acute and chronic form but most people (75-85%) who are infected with the virus develop chronic hepatitis C. Chronic hepatitis C poses a risk for cirrhosis, liver cancer, or both. About 60-70% of patients with chronic hepatitis C eventually develop chronic liver disease. About 5-20% of patients with chronic hepatitis C develop cirrhosis over a period of 20-30 years.
The longer the patient has had the infection, the greater the risk. Patients who have had hepatitis C for more than 60 years have a 70% chance of developing cirrhosis. Of these patients, about 4% eventually develop liver cancer. (Liver cancer rarely develops without cirrhosis first being present.) About 1-5% of people with chronic hepatitis C eventually die from cirrhosis or liver cancer.
8. Malaria:
Infections with P. falciparum cause cerebral malaria resulting in mental confusion, convulsions, and coma. This prognosis is worse, and without treatment death can occur as quickly as within 24 hours.
9. Hepatocellular Carcinoma:
The classifications of hepatocellular carcinoma (HCC) currently used are based on prognostic factors obtained from studies performed years ago when most tumors were diagnosed at advanced stages and the survival rates were substantially poor. The Barcelona Clinic Liver Cancer (BCLC) staging classification comprises four stages that select the best candidates for the best therapies currently available.
(A) Early stage includes patients with asymptomatic early tumors suitable for radical therapies-resection, transplantation or percutaneous treatments.
(B) Intermediate stage comprises patients with asymptomatic multinodular HCC.
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(C) Advanced stage includes patients with symptomatic tumors and/or an invasive tumoral pattern (vascular invasion/extrahepatic spread). Stage B and C patients may receive palliative treatments/new agents in the setting of phase II investigations or randomized controlled trials, and
(D) End-stage disease contains patients with extremely grim prognosis (Okuda stage III or PST 3-4) that should merely receive symptomatic treatment.
10. Anemia:
If iron-deficiency anemia is treated by stopping the source of the blood loss, the anemia should resolve once the iron stores are repleted, and should not reoccur unless another site of bleeding arises. Pernicious anemia, caused by B12 deficiency, generally must be treated life-long with B12 injections, and will reoccur if the B12 treatment is stopped. Inherited anemias, such as thalassemia, are lifelong conditions as well.
11. Sickle Cell Anemia:
Several factors aside from genetic inheritance determine the prognosis for affected individuals. Therefore, predicting the course of the disorder based solely on genes is not possible. In general, given proper medical care, individuals with sickle cell anemia are in fairly good health most of the time. The life expectancy for these individuals has increased over the last 30 years, and many survive well into their 40s or beyond. In the United States, the average life span for men with sickle cell anemia is 40-44 years; for women, it is 46-50 years.
