The presence of co-existing or additional diseases with reference to an initial diagnosis or with reference to the index condition that is the subject of study. Comorbidity may affect the ability of affected individuals to function and also their survival; it may be used as a prognostic indicator for length of hospital stay, cost factors, and outcome or survival.
Diagnostic and Statistical Manual of Mental Disorders
Categorical classification of MENTAL DISORDERS based on criteria sets with defining features. It is produced by the American Psychiatric Association. (DSM-IV, page xxii)
Persistent and disabling ANXIETY.
The total number of cases of a given disease in a specified population at a designated time. It is differentiated from INCIDENCE, which refers to the number of new cases in the population at a given time.
Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.
Age as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or the effect of a circumstance. It is used with human or animal concepts but should be differentiated from AGING, a physiological process, and TIME FACTORS which refers only to the passage of time.
Diagnosis, Dual (Psychiatry)
Severity of Illness Index
Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics.
The use of severity-of-illness measures, such as age, to estimate the risk (measurable or predictable chance of loss, injury or death) to which a patient is subject before receiving some health care intervention. This adjustment allows comparison of performance and quality across organizations, practitioners, and communities. (from JCAHO, Lexikon, 1994)
Psychiatric Status Rating Scales
Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care. (Dictionary of Health Services Management, 2d ed)
Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.
Statistical models which describe the relationship between a qualitative dependent variable (that is, one which can take only certain discrete values, such as the presence or absence of a disease) and an independent variable. A common application is in epidemiology for estimating an individual's risk (probability of a disease) as a function of a given risk factor.
Depressive Disorder, Major
Marked depression appearing in the involution period and characterized by hallucinations, delusions, paranoia, and agitation.
Impulse Control Disorders
Disorders whose essential features are the failure to resist an impulse, drive, or temptation to perform an act that is harmful to the individual or to others. Individuals experience an increased sense of tension prior to the act and pleasure, gratification or release of tension at the time of committing the act.
A primary, chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. The disease is often progressive and fatal. It is characterized by impaired control over drinking, preoccupation with the drug alcohol, use of alcohol despite adverse consequences, and distortions in thinking, most notably denial. Each of these symptoms may be continuous or periodic. (Morse & Flavin for the Joint Commission of the National Council on Alcoholism and Drug Dependence and the American Society of Addiction Medicine to Study the Definition and Criteria for the Diagnosis of Alcoholism: in JAMA 1992;268:1012-4)
Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with LONGITUDINAL STUDIES which are followed over a period of time.
Stress Disorders, Post-Traumatic
A class of traumatic stress disorders with symptoms that last more than one month. There are various forms of post-traumatic stress disorder, depending on the time of onset and the duration of these stress symptoms. In the acute form, the duration of the symptoms is between 1 to 3 months. In the chronic form, symptoms last more than 3 months. With delayed onset, symptoms develop more than 6 months after the traumatic event.
A type of anxiety disorder characterized by unexpected panic attacks that last minutes or, rarely, hours. Panic attacks begin with intense apprehension, fear or terror and, often, a feeling of impending doom. Symptoms experienced during a panic attack include dyspnea or sensations of being smothered; dizziness, loss of balance or faintness; choking sensations; palpitations or accelerated heart rate; shakiness; sweating; nausea or other form of abdominal distress; depersonalization or derealization; paresthesias; hot flashes or chills; chest discomfort or pain; fear of dying and fear of not being in control of oneself or going crazy. Agoraphobia may also develop. Similar to other anxiety disorders, it may be inherited as an autosomal dominant trait.
A repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated. These behaviors include aggressive conduct that causes or threatens physical harm to other people or animals, nonaggressive conduct that causes property loss or damage, deceitfulness or theft, and serious violations of rules. The onset is before age 18. (From DSM-IV, 1994)
A major affective disorder marked by severe mood swings (manic or major depressive episodes) and a tendency to remission and recurrence.
An anxiety disorder characterized by recurrent, persistent obsessions or compulsions. Obsessions are the intrusive ideas, thoughts, or images that are experienced as senseless or repugnant. Compulsions are repetitive and seemingly purposeful behavior which the individual generally recognizes as senseless and from which the individual does not derive pleasure although it may provide a release from tension.
Proportional Hazards Models
Statistical models used in survival analysis that assert that the effect of the study factors on the hazard rate in the study population is multiplicative and does not change over time.
Federal program, created by Public Law 89-97, Title XVIII-Health Insurance for the Aged, a 1965 amendment to the Social Security Act, that provides health insurance benefits to persons over the age of 65 and others eligible for Social Security benefits. It consists of two separate but coordinated programs: hospital insurance (MEDICARE PART A) and supplementary medical insurance (MEDICARE PART B). (Hospital Administration Terminology, AHA, 2d ed and A Discursive Dictionary of Health Care, US House of Representatives, 1976)
The proportion of survivors in a group, e.g., of patients, studied and followed over a period, or the proportion of persons in a specified group alive at the beginning of a time interval who survive to the end of the interval. It is often studied using life table methods.
Attention Deficit Disorder with Hyperactivity
A behavior disorder originating in childhood in which the essential features are signs of developmentally inappropriate inattention, impulsivity, and hyperactivity. Although most individuals have symptoms of both inattention and hyperactivity-impulsivity, one or the other pattern may be predominant. The disorder is more frequent in males than females. Onset is in childhood. Symptoms often attenuate during late adolescence although a minority experience the full complement of symptoms into mid-adulthood. (From DSM-V)
A set of techniques used when variation in several variables has to be studied simultaneously. In statistics, multivariate analysis is interpreted as any analytic method that allows simultaneous study of two or more dependent variables.
Maleness or femaleness as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or effect of a circumstance. It is used with human or animal concepts but should be differentiated from SEX CHARACTERISTICS, anatomical or physiological manifestations of sex, and from SEX DISTRIBUTION, the number of males and females in given circumstances.
A class of statistical procedures for estimating the survival function (function of time, starting with a population 100% well at a given time and providing the percentage of the population still well at later times). The survival analysis is then used for making inferences about the effects of treatments, prognostic factors, exposures, and other covariates on the function.
Quality of Life
Age of Onset
Kidney Failure, Chronic
The end-stage of CHRONIC RENAL INSUFFICIENCY. It is characterized by the severe irreversible kidney damage (as measured by the level of PROTEINURIA) and the reduction in GLOMERULAR FILTRATION RATE to less than 15 ml per min (Kidney Foundation: Kidney Disease Outcome Quality Initiative, 2002). These patients generally require HEMODIALYSIS or KIDNEY TRANSPLANTATION.
Therapy for the insufficient cleansing of the BLOOD by the kidneys based on dialysis and including hemodialysis, PERITONEAL DIALYSIS, and HEMODIAFILTRATION.
International Classification of Diseases
A system of categories to which morbid entries are assigned according to established criteria. Included is the entire range of conditions in a manageable number of categories, grouped to facilitate mortality reporting. It is produced by the World Health Organization (From ICD-10, p1). The Clinical Modifications, produced by the UNITED STATES DEPT. OF HEALTH AND HUMAN SERVICES, are larger extensions used for morbidity and general epidemiological purposes, primarily in the U.S.
Predictive Value of Tests
In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test.
The ratio of two odds. The exposure-odds ratio for case control data is the ratio of the odds in favor of exposure among cases to the odds in favor of exposure among noncases. The disease-odds ratio for a cohort or cross section is the ratio of the odds in favor of disease among the exposed to the odds in favor of disease among the unexposed. The prevalence-odds ratio refers to an odds ratio derived cross-sectionally from studies of prevalent cases.
Procedures for finding the mathematical function which best describes the relationship between a dependent variable and one or more independent variables. In linear regression (see LINEAR MODELS) the relationship is constrained to be a straight line and LEAST-SQUARES ANALYSIS is used to determine the best fit. In logistic regression (see LOGISTIC MODELS) the dependent variable is qualitative rather than continuously variable and LIKELIHOOD FUNCTIONS are used to find the best relationship. In multiple regression, the dependent variable is considered to depend on more than a single independent variable.
Diseases in Twins
Disorders affecting TWINS, one or both, at any age.
Feeling or emotion of dread, apprehension, and impending disaster but not disabling as with ANXIETY DISORDERS.
Outcome Assessment (Health Care)
Research aimed at assessing the quality and effectiveness of health care as measured by the attainment of a specified end result or outcome. Measures include parameters such as improved health, lowered morbidity or mortality, and improvement of abnormal states (such as elevated blood pressure).
Health Status Indicators
Activities of Daily Living
A distribution in which a variable is distributed like the sum of the squares of any given independent random variable, each of which has a normal distribution with mean of zero and variance of one. The chi-square test is a statistical test based on comparison of a test statistic to a chi-square distribution. The oldest of these tests are used to detect whether two or more population distributions differ from one another.
Cause of Death
Disorders having the presence of physical symptoms that suggest a general medical condition but that are not fully explained by a another medical condition, by the direct effects of a substance, or by another mental disorder. The symptoms must cause clinically significant distress or impairment in social, occupational, or other areas of functioning. In contrast to FACTITIOUS DISORDERS and MALINGERING, the physical symptoms are not under voluntary control. (APA, DSM-V)
Attention Deficit and Disruptive Behavior Disorders
A class of disabling primary headache disorders, characterized by recurrent unilateral pulsatile headaches. The two major subtypes are common migraine (without aura) and classic migraine (with aura or neurological symptoms). (International Classification of Headache Disorders, 2nd ed. Cephalalgia 2004: suppl 1)
The number of new cases of a given disease during a given period in a specified population. It also is used for the rate at which new events occur in a defined population. It is differentiated from PREVALENCE, which refers to all cases, new or old, in the population at a given time.
Antisocial Personality Disorder
A personality disorder whose essential feature is a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adolescence and continues into adulthood. The individual must be at least age 18 and must have a history of some symptoms of CONDUCT DISORDER before age 15. (From DSM-IV, 1994)
A cancer registry mandated under the National Cancer Act of 1971 to operate and maintain a population-based cancer reporting system, reporting periodically estimates of cancer incidence and mortality in the United States. The Surveillance, Epidemiology, and End Results (SEER) Program is a continuing project of the National Cancer Institute of the National Institutes of Health. Among its goals, in addition to assembling and reporting cancer statistics, are the monitoring of annual cancer incident trends and the promoting of studies designed to identify factors amenable to cancer control interventions. (From National Cancer Institute, NIH Publication No. 91-3074, October 1990)
United States Department of Veterans Affairs
A legal concept that an accused is not criminally responsible if, at the time of committing the act, the person was laboring under such a defect of reason from disease of the mind as not to know the nature and quality of the act done or if the act was known, to not have known that what was done was wrong. (From Black's Law Dictionary, 6th ed)
Cost of Illness
The personal cost of acute or chronic disease. The cost to the patient may be an economic, social, or psychological cost or personal loss to self, family, or immediate community. The cost of illness may be reflected in absenteeism, productivity, response to treatment, peace of mind, or QUALITY OF LIFE. It differs from HEALTH CARE COSTS, meaning the societal cost of providing services related to the delivery of health care, rather than personal impact on individuals.
Extensive collections, reputedly complete, of facts and data garnered from material of a specialized subject area and made available for analysis and application. The collection can be automated by various contemporary methods for retrieval. The concept should be differentiated from DATABASES, BIBLIOGRAPHIC which is restricted to collections of bibliographic references.
A nonparametric method of compiling LIFE TABLES or survival tables. It combines calculated probabilities of survival and estimates to allow for observations occurring beyond a measurement threshold, which are assumed to occur randomly. Time intervals are defined as ending each time an event occurs and are therefore unequal. (From Last, A Dictionary of Epidemiology, 1995)
A loosely defined grouping of drugs that have effects on psychological function. Here the psychotropic agents include the antidepressive agents, hallucinogens, and tranquilizing agents (including the antipsychotics and anti-anxiety agents).
Hospitals providing medical care to veterans of wars.
Insurance Claim Review
Review of claims by insurance companies to determine liability and amount of payment for various services. The review may also include determination of eligibility of the claimant or beneficiary or of the provider of the benefit; determination that the benefit is covered or not payable under another policy; or determination that the service was necessary and of reasonable cost and quality.
Primary Health Care
An activity distinguished primarily by an element of risk in trying to obtain a desired goal, e.g., playing a game of chance for money.
Renal Replacement Therapy
Mood-stimulating drugs used primarily in the treatment of affective disorders and related conditions. Several MONOAMINE OXIDASE INHIBITORS are useful as antidepressants apparently as a long-term consequence of their modulation of catecholamine levels. The tricyclic compounds useful as antidepressive agents (ANTIDEPRESSIVE AGENTS, TRICYCLIC) also appear to act through brain catecholamine systems. A third group (ANTIDEPRESSIVE AGENTS, SECOND-GENERATION) is a diverse group of drugs including some that act specifically on serotonergic systems.
Studies which start with the identification of persons with a disease of interest and a control (comparison, referent) group without the disease. The relationship of an attribute to the disease is examined by comparing diseased and non-diseased persons with regard to the frequency or levels of the attribute in each group.
Health Care Costs
The actual costs of providing services related to the delivery of health care, including the costs of procedures, therapies, and medications. It is differentiated from HEALTH EXPENDITURES, which refers to the amount of money paid for the services, and from fees, which refers to the amount charged, regardless of cost.
Pulmonary Disease, Chronic Obstructive
European Continental Ancestry Group
Borderline Personality Disorder
A personality disorder marked by a pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts. (DSM-IV)
Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.
Chronically depressed mood that occurs for most of the day more days than not for at least 2 years. The required minimum duration in children to make this diagnosis is 1 year. During periods of depressed mood, at least 2 of the following additional symptoms are present: poor appetite or overeating, insomnia or hypersomnia, low energy or fatigue, low self esteem, poor concentration or difficulty making decisions, and feelings of hopelessness. (DSM-IV)
Various conditions with the symptom of HEADACHE. Headache disorders are classified into major groups, such as PRIMARY HEADACHE DISORDERS (based on characteristics of their headache symptoms) and SECONDARY HEADACHE DISORDERS (based on their etiologies). (International Classification of Headache Disorders, 2nd ed. Cephalalgia 2004: suppl 1)
A system for classifying patient care by relating common characteristics such as diagnosis, treatment, and age to an expected consumption of hospital resources and length of stay. Its purpose is to provide a framework for specifying case mix and to reduce hospital costs and reimbursements and it forms the cornerstone of the prospective payment system.
Persons who receive ambulatory care at an outpatient department or clinic without room and board being provided.
Mental Health Services
Organized services to provide mental health care.
Deaths that occur before LIFE EXPECTANCY is reached within a given population.
Refusal to Treat
The use of multiple drugs administered to the same patient, most commonly seen in elderly patients. It includes also the administration of excessive medication. Since in the United States most drugs are dispensed as single-agent formulations, polypharmacy, though using many drugs administered to the same patient, must be differentiated from DRUG COMBINATIONS, single preparations containing two or more drugs as a fixed dose, and from DRUG THERAPY, COMBINATION, two or more drugs administered separately for a combined effect. (From Segen, Dictionary of Modern Medicine, 1992)
Karnofsky Performance Status
A performance measure for rating the ability of a person to perform usual activities, evaluating a patient's progress after a therapeutic procedure, and determining a patient's suitability for therapy. It is used most commonly in the prognosis of cancer therapy, usually after chemotherapy and customarily administered before and after therapy. It was named for Dr. David A. Karnofsky, an American specialist in cancer chemotherapy.
Health Services for the Aged
Life Change Events
Physician's Practice Patterns
Compulsive Personality Disorder
Disorder characterized by an emotionally constricted manner that is unduly conventional, serious, formal, and stingy, by preoccupation with trivial details, rules, order, organization, schedules, and lists, by stubborn insistence on having things one's own way without regard for the effects on others, by poor interpersonal relationships, and by indecisiveness due to fear of making mistakes.
A disorder characterized by recurrent episodes of paroxysmal brain dysfunction due to a sudden, disorderly, and excessive neuronal discharge. Epilepsy classification systems are generally based upon: (1) clinical features of the seizure episodes (e.g., motor seizure), (2) etiology (e.g., post-traumatic), (3) anatomic site of seizure origin (e.g., frontal lobe seizure), (4) tendency to spread to other structures in the brain, and (5) temporal patterns (e.g., nocturnal epilepsy). (From Adams et al., Principles of Neurology, 6th ed, p313)
Disorders characterized by recurrent TICS that may interfere with speech and other activities. Tics are sudden, rapid, nonrhythmic, stereotyped motor movements or vocalizations which may be exacerbated by stress and are generally attenuated during absorbing activities. Tic disorders are distinguished from conditions which feature other types of abnormal movements that may accompany another another condition. (From DSM-IV, 1994)
Eating an excess amount of food in a short period of time, as seen in the disorder of BULIMIA NERVOSA. It is caused by an abnormal craving for food, or insatiable hunger also known as "ox hunger".
A heterogeneous condition in which the heart is unable to pump out sufficient blood to meet the metabolic need of the body. Heart failure can be caused by structural defects, functional abnormalities (VENTRICULAR DYSFUNCTION), or a sudden overload beyond its capacity. Chronic heart failure is more common than acute heart failure which results from sudden insult to cardiac function, such as MYOCARDIAL INFARCTION.
Tobacco Use Disorder
The behavior of performing an act persistently and repetitively without it leading to reward or pleasure. The act is usually a small, circumscribed behavior, almost ritualistic, yet not pathologically disturbing. Examples of compulsive behavior include twirling of hair, checking something constantly, not wanting pennies in change, straightening tilted pictures, etc.
A province of Canada, lying between the provinces of Alberta and Manitoba. Its capital is Regina. It is entirely a plains region with prairie in the south and wooded country with many lakes and swamps in the north. The name was taken from the Saskatchewan River from the Cree name Kisiskatchewani Sipi, meaning rapid-flowing river. (From Webster's New Geographical Dictionary, 1988, p1083 & Room, Brewer's Dictionary of Names, 1992, p486)
Reproducibility of Results
The statistical reproducibility of measurements (often in a clinical context), including the testing of instrumentation or techniques to obtain reproducible results. The concept includes reproducibility of physiological measurements, which may be used to develop rules to assess probability or prognosis, or response to a stimulus; reproducibility of occurrence of a condition; and reproducibility of experimental results.
Health Services Research
The integration of epidemiologic, sociological, economic, and other analytic sciences in the study of health services. Health services research is usually concerned with relationships between need, demand, supply, use, and outcome of health services. The aim of the research is evaluation, particularly in terms of structure, process, output, and outcome. (From Last, Dictionary of Epidemiology, 2d ed)
A province of Canada, lying between the provinces of Saskatchewan and Ontario. Its capital is Winnipeg. Taking its name from Lake Manitoba, itself named for one of its islands, the name derived from Algonquian Manitou, great spirit. (From Webster's New Geographical Dictionary, 1988, p724 & Room, Brewer's Dictionary of Names, 1992, p332)
Medicare Part A
The compulsory portion of Medicare that is known as the Hospital Insurance Program. All persons 65 years and older who are entitled to benefits under the Old Age, Survivors, Disability and Health Insurance Program or railroad retirement, persons under the age of 65 who have been eligible for disability for more than two years, and insured workers (and their dependents) requiring renal dialysis or kidney transplantation are automatically enrolled in Medicare Part A.
Referral and Consultation
Conditions or pathological processes associated with the disease of diabetes mellitus. Due to the impaired control of BLOOD GLUCOSE level in diabetic patients, pathological processes develop in numerous tissues and organs including the EYE, the KIDNEY, the BLOOD VESSELS, and the NERVE TISSUE.
Diabetes Mellitus, Type 2
A subclass of DIABETES MELLITUS that is not INSULIN-responsive or dependent (NIDDM). It is characterized initially by INSULIN RESISTANCE and HYPERINSULINEMIA; and eventually by GLUCOSE INTOLERANCE; HYPERGLYCEMIA; and overt diabetes. Type II diabetes mellitus is no longer considered a disease exclusively found in adults. Patients seldom develop KETOSIS but often exhibit OBESITY.
Persons living in the United States having origins in any of the black groups of Africa.
Hemodialysis Units, Hospital
Practice Guidelines as Topic
Directions or principles presenting current or future rules of policy for assisting health care practitioners in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery.
Medical Record Linkage
Correlates of sexually transmitted bacterial infections among U.S. women in 1995. (1/12384)CONTEXT: Sexually transmitted diseases (STDs) of bacterial origin such as gonorrhea and chlamydial infection can lead to pelvic inflammatory disease (PID) and infertility. Identifying behaviors and characteristics associated with infection may assist in preventing these often asymptomatic diseases and their sequelae. METHODS: Data from 9,882 sexually active women who participated in the 1995 National Survey of Family Growth describe the characteristics of women who report a history of infection with a bacterial STD or of treatment for PID. Multivariate analysis is used to determine which demographic characteristics and sexual and health-related behaviors affect the likelihood of infection or the occurrence of complications. RESULTS: Overall, 6% of sexually active women reported a history of a bacterial STD, and 8% reported a history of PID. Women who first had sexual intercourse before age 15 were nearly four times as likely to report a bacterial STD, and more than twice as likely to report PID, as were women who first had sex after age 18. Having more than five lifetime sexual partners also was associated with both having an STD and having PID. PID was more common among women reporting a history of a bacterial STD (23%) than among women who reported no such history (7%). In multivariate analyses, age, race, age at first intercourse and lifetime number of sexual partners had a significant effect on the risk of a bacterial STD. Education, age, a history of IUD use, douching and a history of a bacterial STD had a significant impact on the risk of PID, but early onset of intercourse did not, and lifetime number of partners had only a marginal effect. CONCLUSIONS: The pattern of characteristics and behaviors that place women at risk of infection with bacterial STDs is not uniform among groups of women. Further, the level of self-reported PID would suggest higher rates of gonorrhea and chlamydial infection than reported. (+info)
Prevalence and clinical outcome associated with preexisting malnutrition in acute renal failure: a prospective cohort study. (2/12384)Malnutrition is a frequent finding in hospitalized patients and is associated with an increased risk of subsequent in-hospital morbidity and mortality. Both prevalence and prognostic relevance of preexisting malnutrition in patients referred to nephrology wards for acute renal failure (ARF) are still unknown. This study tests the hypothesis that malnutrition is frequent in such clinical setting, and is associated with excess in-hospital morbidity and mortality. A prospective cohort of 309 patients admitted to a renal intermediate care unit during a 42-mo period with ARF diagnosis was studied. Patients with malnutrition were identified at admission by the Subjective Global Assessment of nutritional status method (SGA); nutritional status was also evaluated by anthropometric, biochemical, and immunologic parameters. Outcome measures included in-hospital mortality and morbidity, and use of health care resources. In-hospital mortality was 39% (120 of 309); renal replacement therapies (hemodialysis or continuous hemofiltration) were performed in 67% of patients (206 of 309); APACHE II score was 23.1+/-8.2 (range, 10 to 52). Severe malnutrition by SGA was found in 42% of patients with ARF; anthropometric, biochemical, and immunologic nutritional indexes were significantly reduced in this group compared with patients with normal nutritional status. Severely malnourished patients, as compared to patients with normal nutritional status, had significantly increased morbidity for sepsis (odds ratio [OR] 2.88; 95% confidence interval [CI], 1.53 to 5.42, P < 0.001), septic shock (OR 4.05; 95% CI, 1.46 to 11.28, P < 0.01), hemorrhage (OR 2.98; 95% CI, 1.45 to 6.13, P < 0.01), intestinal occlusion (OR 5.57; 95% CI, 1.57 to 19.74, P < 0.01), cardiac dysrhythmia (OR 2.29; 95% CI, 1.36 to 3.85, P < 0.01), cardiogenic shock (OR 4.39; 95% CI, 1.83 to 10.55, P < .001), and acute respiratory failure with mechanical ventilation need (OR 3.35; 95% CI, 3.35 to 8.74, P < 0.05). Hospital length of stay was significantly increased (P < 0.01), and the presence of severe malnutrition was associated with a significant increase of in-hospital mortality (OR 7.21; 95% CI, 4.08 to 12.73, P < 0.001). Preexisting malnutrition was a statistically significant, independent predictor of in-hospital mortality at multivariable logistic regression analysis both with comorbidities (OR 2.02; 95% CI, 1.50 to 2.71, P < 0.001), and with comorbidities and complications (OR 2.12; 95% CI, 1.61 to 2.89, P < 0.001). Malnutrition is highly prevalent among ARF patients and increases the likelihood of in-hospital death, complications, and use of health care resources. (+info)
Hematocrit level and associated mortality in hemodialysis patients. (3/12384)Although a number of clinical studies have shown that increased hematocrits are associated with improved outcomes in terms of cognitive function, reduced left ventricular hypertrophy, increased exercise tolerance, and improved quality of life, the optimal hematocrit level associated with survival has yet to be determined. The association between hematocrit levels and patient mortality was retrospectively studied in a prevalent Medicare hemodialysis cohort on a national scale. All patients survived a 6-mo entry period during which their hematocrit levels were assessed, from July 1 through December 31, 1993, with follow-up from January 1 through December 31, 1994. Patient comorbid conditions relative to clinical events and severity of disease were determined from Medicare claims data and correlated with the entry period hematocrit level. After adjusting for medical diseases, our results showed that patients with hematocrit levels less than 30% had significantly higher risk of all-cause (12 to 33%) and cause-specific death, compared to patients with hematocrits in the 30% to less than 33% range. Without severity of disease adjustment, patients with hematocrit levels of 33% to less than 36% appear to have the lowest risk for all-cause and cardiac mortality. After adjusting for severity of disease, the impact of hematocrit levels of 33% to less than 36% is vulnerable to the patient sample size but also demonstrates a further 4% reduced risk of death. Overall, these findings suggest that sustained increases in hematocrit levels are associated with improved patient survival. (+info)
A comparison of the use, effectiveness and safety of bezafibrate, gemfibrozil and simvastatin in normal clinical practice using the New Zealand Intensive Medicines Monitoring Programme (IMMP). (4/12384)AIMS: Because of the importance of treating dyslipidaemia in the prevention of ischaemic heart disease and because patient selection criteria and outcomes in clinical trials do not necessarily reflect what happens in normal clinical practice, we compared outcomes from bezafibrate, gemfibrozil and simvastatin therapy under conditions of normal use. METHODS: A random sample of 200 patients was selected from the New Zealand Intensive Medicines Monitoring Programme's (IMMP) patient cohorts for each drug. Questionnaires sent to prescribers requested information on indications, risk factors for ischaemic heart disease, lipid profiles with changes during treatment and reasons for stopping therapy. RESULTS: 80% of prescribers replied and 83% of these contained useful information. The three groups were similar for age, sex and geographical region, but significantly more patients on bezafibrate had diabetes and/or hypertension than those on gemfibrozil or simvastatin. After treatment and taking the initial measure into account, the changes in serum lipid values were consistent with those generally observed, but with gemfibrozil being significantly less effective than expected. More patients (15.8%S) stopped gemfibrozil because of an inadequate response compared with bezafibrate (5.4%) and simvastatin (1.6%). Gemfibrozil treatment was also withdrawn significantly more frequently due to a possible adverse reaction compared with the other two drugs. CONCLUSIONS: In normal clinical practice in New Zealand gemfibrozil appears less effective and more frequently causes adverse effects leading to withdrawal of treatment than either bezafibrate or simvastatin. (+info)
Pulmonary embolism: one-year follow-up with echocardiography doppler and five-year survival analysis. (5/12384)BACKGROUND: The long-term prognosis for patients with pulmonary embolism (PE) is dependent on the underlying disease, degree of pulmonary hypertension (PH), and degree of right ventricular (RV) dysfunction. A precise description of the time course of pulmonary artery pressure (PAsP)/RV function is therefore of importance for the early identification of persistent PH/RV dysfunction in patients treated for acute PE. Other objectives were to identify variables associated with persistent PH/RV dysfunction and to analyze the 5-year survival rate for patients alive 1 month after inclusion. METHODS AND RESULTS: Echocardiography Doppler was performed in 78 patients with acute PE at the time of diagnosis and repeatedly during the next year. A 5-year survival analysis was made. The PAsP decreased exponentially until the beginning of a stable phase, which was 50 mm Hg at the time of diagnosis of acute PE was associated with persistent PH after 1 year. The 5-year mortality rate was associated with underlying disease. Only patients with persistent PH in the stable phase required pulmonary thromboendarterectomy within 5 years. CONCLUSIONS: An echocardiography Doppler investigation performed 6 weeks after diagnosis of acute PE can identify patients with persistent PH/RV dysfunction and may be of value in planning the follow-up and care of these patients. (+info)
Prostatic intraepithelial neoplasia and apoptosis in benign prostatic hyperplasia before and after the Chernobyl accident in Ukraine. (6/12384)The prevalence of prostatic intraepithelial neoplasia (PIN) in men who underwent surgery for benign prostatic hyperplasia (BPH) before and after the Chernobyl nuclear accident was studied. BPH samples were obtained by adenomectomy from 45 patients operated in 1984 before the accident (Group I), and 47 patients from the low contaminated Kiev City (Group II) and 76 from high contaminated area (Group III) operated between 1996 and 1998. Their BPH samples were examined histologically and immunohistochemically. The incidences of prostatic intraepithelial neoplasia (PIN) and high grade PIN (HGPIN) were 15.5 and 11.1% in Group I, 29.8 and 14.9% in Grpoup II, and 35. 5 and 19.7% in Group III. The difference between the incidences of PIN in Group I and III is significant (p<0.02). There was increased apoptosis in areas of PIN in Group II and III as compared to Group I (p<0.001). Since apoptosis has been shown to be associated with ionizing radiation and it is now found to be associated with PIN in patients diagnosed after the Chernobyl nuclear accident, this suggests that long-term low dose internal ionizing radiation potentially may cause prostate cancer. (+info)
The cost of obesity in Canada. (7/12384)BACKGROUND: Almost one-third of adult Canadians are at increased risk of disability, disease and premature death because of being obese. In order to allocate limited health care resources rationally, it is necessary to elucidate the economic burden of obesity. OBJECTIVE: To estimate the direct costs related to the treatment of and research into obesity in Canada in 1997. METHODS: The prevalence of obesity (body mass index of 27 or greater) in Canada was determined using data from the National Population Health Survey, 1994-1995. Ten comorbidities of obesity were identified from the medical literature. A population attributable fraction (PAF) was calculated for each comorbidity with data from large cohort studies to determine the extent to which each comorbidity and its management costs were attributable to obesity. The direct cost of each comorbidity was determined using data from the Canadian Institute of Health Information (for direct expenditure categories) and from Health Canada (for the proportion of expenditure category attributable to the comorbidity). This prevalence-based approach identified the direct costs of hospital care, physician services, services of other health professionals, drugs, other health care and health research. For each comorbidity, the cost attributable to obesity was determined by multiplying the PAF by the total direct cost of the comorbidity. The overall impact of obesity was estimated as the sum of the PAF-weighted costs of treating the comorbidities. A sensitivity analysis was completed on both the estimated costs and the PAFs. RESULTS: The total direct cost of obesity in Canada in 1997 was estimated to be over $1.8 billion. This corresponded to 2.4% of the total health care expenditures for all diseases in Canada in 1997. The sensitivity analysis revealed that the total cost could be as high as $3.5 billion or as low as $829.4 million; this corresponded to 4.6% and 1.1% respectively of the total health care expenditures in 1997. When the contributions of the comorbidities to the total cost were considered, the 3 largest contributors were hypertension ($656.6 million), type 2 diabetes mellitus ($423.2 million) and coronary artery disease ($346.0 million). INTERPRETATION: A considerable proportion of health care dollars is devoted to the treatment and management of obesity-related comorbidities in Canada. Further research into the therapeutic benefits and cost-effectiveness of management strategies for obesity is required. It is anticipated that the prevention and treatment of obesity will have major positive effects on the overall cost of health care. (+info)
Synergistic effects of prothrombotic polymorphisms and atherogenic factors on the risk of myocardial infarction in young males. (8/12384)Several recent studies evaluated a possible effect of the prothrombotic polymorphisms such as 5,10 methylenetetrahydrofolate reductase (MTHFR) nt 677C --> T, factor V (F V) nt 1691G --> A (F V Leiden), and factor II (F II) nt 20210 G --> A on the risk of myocardial infarction. In the present study, we analyzed the effect of these prothrombotic polymorphisms, as well as apolipoprotein (Apo) E4, smoking, hypertension, diabetes mellitus, and hypercholesterolemia, on the risk of myocardial infarction in young males. We conducted a case-control study of 112 young males with first acute myocardial infarction (AMI) before the age of 52 and 187 healthy controls of similar age. The prevalences of heterozygotes for F V G1691A and F II G20210A were not significantly different between cases and controls (6.3% v 6.4% and 5.9% v 3.4% among cases and controls, respectively). In contrast, the prevalence of MTHFR 677T homozygosity and the allele frequency of Apo E4 were significantly higher among patients (24.1% v 10.7% and 9.4% v 5.3% among cases and controls, respectively). Concomitant presence of hypertension, hypercholesterolemia, or diabetes and one or more of the four examined polymorphisms increased the risk by almost ninefold (odds ratio [OR] = 8.66; 95% confidence interval [CI], 3.49 to 21.5) and concomitant smoking by almost 18-fold (OR = 17.6; 95% CI, 6.30 to 48.9). When all atherogenic risk factors were analyzed simultaneously by a logistic model, the combination of prothrombotic and Apo E4 polymorphisms with current smoking increased the risk 25-fold (OR = 24.7; 95% CI, 7.17 to 84.9). The presented data suggest a synergistic effect between atherogenic and thrombogenic risk factors in the pathogenesis of AMI, as was recently found in a similar cohort of women. (+info)
Extra-hepatic comorbidity burden significantly increases 90-day mortality in patients with cirrhosis and high model for...
We examined how extra-hepatic comorbidity burden impacts mortality in patients with cirrhosis referred for liver transplantation (LT). Adults with cirrhosis evaluated for their first LT in 2012 were followed through their clinical course with last follow up in 2019. Extra-hepatic comorbidity burden was measured using the Charlson Comorbidity Index (CCI). The endpoints were 90-day transplant free survival (Cox-Proportional Hazard regression), and overall mortality (competing risk analysis). The study included 340 patients, mean age 56 ± 11, 63% male and MELD-Na 17.2 ± 6.6. The CCI was 0 (no comorbidities) in 44%, 1-2 in 44% and | 2 (highest decile) in 12%, with no differences based on gender but higher CCI in patients with fatty and cryptogenic liver disease. Thirty-three (10%) of 332 patients not receiving LT within 90 days died. Beyond MELD-Na, the CCI was independently associated with 90-day mortality (hazard ratio (HR), 1.32 (95% confidence interval (CI) 1.02-1.72). Ninety-day mortality was
Effects of comorbidity burden and age on brain integrity in HIV. | NNTC
OBJECTIVE: The influence of confounding neurocognitive comorbidities in people living with HIV (PLWH) on neuroimaging has not been systematically evaluated. We determined associations between comorbidity burden and brain integrity and examined the moderating effect of age on these relationships.DESIGN: Observational, cross-sectional substudy of the CNS HIV Antiretroviral Therapy Effects Research cohort.METHODS: A total of 288 PLWH (mean age = 44.2) underwent structural MRI and magnetic resonance spectroscopy as well as neurocognitive and neuromedical assessments. Consistent with Frascati criteria for HIV-associated neurocognitive disorders (HAND), neuromedical and neuropsychiatric comorbidity burden was classified as incidental (mild), contributing (moderate), or confounding (severe-exclusionary) to a diagnosis of HAND. Multiple regression modeling predicted neuroimaging outcomes as a function of comorbidity classification, age, and their interaction.RESULTS: Comorbidity classifications were 176 ...
The Validity of Summary Comorbidity Measures
Prognostic scores, and more specifically comorbidity scores, are important and widely used measures in the health care field and in health services research. A comorbidity is an existing disease an individual has in addition to a primary condition of interest, such as cancer. A comorbidity score is a summary score that can be created from these individual comorbidities for prognostic purposes, as well as for confounding adjustment. Despite their widespread use, the properties of and conditions under which comorbidity scores are valid dimension reduction tools in statistical models is largely unknown. This dissertation explores the use of summary comorbidity measures in statistical models. Three particular aspects are examined. First, it is shown that, under standard conditions, the predictive ability of these summary comorbidity measures remains as accurate as the individual comorbidities in regression models, which can include factors such as treatment variables and additional covariates. ...
The association between internet addiction and psychiatric co-morbidity: a meta-analysis | BMC Psychiatry | Full Text
This study evaluates the association between Internal Addiction (IA) and psychiatric co-morbidity in the literature. Meta-analyses were conducted on cross-sectional, case-control and cohort studies which examined the relationship between IA and psychiatric co-morbidity. Selected studies were extracted from major online databases. The inclusion criteria are as follows: 1) studies conducted on human subjects; 2) IA and psychiatric co-morbidity were assessed by standardised questionnaires; and 3) availability of adequate information to calculate the effect size. Random-effects models were used to calculate the aggregate prevalence and the pooled odds ratios (OR). Eight studies comprising 1641 patients suffering from IA and 11210 controls were included. Our analyses demonstrated a significant and positive association between IA and alcohol abuse (OR = 3.05, 95% CI = 2.14-4.37, z = 6.12, P | 0.001), attention deficit and hyperactivity (OR = 2.85, 95% CI = 2.15-3.77, z = 7.27, P | 0.001), depression (OR = 2
Autoimmune comorbidities are associated with brain injury in multiple sclerosis<...
TY - JOUR. T1 - Autoimmune comorbidities are associated with brain injury in multiple sclerosis. AU - Zivadinov, R.. AU - Raj, B.. AU - Ramanathan, M.. AU - Teter, B.. AU - Durfee, J.. AU - Dwyer, M. G.. AU - Bergsland, N.. AU - Kolb, C.. AU - Hojnacki, D.. AU - Benedict, R. H.. AU - Weinstock-Guttman, B.. PY - 2016/6. Y1 - 2016/6. N2 - BACKGROUND AND PURPOSE: The effect of comorbidities on disease severity in MS has not been extensively characterized. We determined the association of comorbidities with MR imaging disease severity outcomes in MS. MATERIALS AND METHODS: Demographic and clinical history of 9 autoimmune comorbidities confirmed by retrospective chart review and quantitative MR imaging data were obtained in 815 patients with MS. The patients were categorized on the basis of the presence/ absence of total and specific comorbidities. We analyzed the MR imaging findings, adjusting for key covariates and correcting for multiple comparisons. RESULTS: Two hundred forty-one (29.6%) study ...
Comorbidities increase risk of mortality in COP... ( Comorbidities are common among patie...)
Health, ...Comorbidities are common among patients with chronic obstructive pulmo... We followed 1664 COPD patients recruited from five pulmonary clinic...The 12 comorbidities with the strongest association with an increased ... We used these 12 comorbidities to develop a new comorbidity risk inde...,Comorbidities,increase,risk,of,mortality,in,COPD,patients,medicine,medical news today,latest medical news,medical newsletters,current medical news,latest medicine news
Afhandlinger - DOS
Two studies observed that a high comorbidity level prior to surgery has a profound impact on short-term revision risk (study II). A novel finding of this thesis was that high comorbidity also affects the long-term revision risk (study II), which has been confirmed by several recent studies. Due to the increasing burden of a variety of comorbidities in THR patients, their association with revision risk and the underlying mechanisms merit further research. To offer some possible explanations for how comorbidity affects revision risk, this thesis focused in more detail on THR patients with diabetes, which has a high and increasing prevalence in both the general population and the THR population. Diabetes increased the risk of revision due to infection, particularly in patients with diabetes for less than 5 years prior to THR, those with complications due to diabetes, and those with cardiovascular comorbidities prior to surgery (study V). These findings were also confirmed recently. However, the ...
Measurement properties of comorbidity indices in maternal health research: a systematic review | BMC Pregnancy and Childbirth |...
The Elixhauser Comorbidity Index was developed using a California-based population dataset of adult, non-maternal inpatients from 438 acute care hospitals in 1992 . The dataset included 1,779,167 patients and 41 comorbidities were listed. No consensus method was employed for making a list of potential candidates for the comorbidity index. Outcomes were defined as length of stay, charges and in-hospital mortality. Statistically unrelated comorbidities to the outcomes were excluded after a series of univariable and multivariable analyses, leading to a final set of 30 comorbidities (Additional file 1: Appendix D) . The authors did not employ item weighting in the phases of development. The Elixhauser Comorbidity Index was developed mainly for use with administrative data. The index has good face validity as well as content validity as the items are mutually exclusive. Feasibility of using the index was not examined in maternal or related research. In the context of maternal health research, ...
Multimorbidity patterns in the elderly: a prospective cohort study with cluster analysis | BMC Geriatrics | Full Text
We explored multimorbidity patterns and their 6-year evolution in people aged 65 years and older with multimorbidity attended in PHC. The most prevalent chronic diseases, Hypertension, uncomplicated and Lipid disorder, were represented in all clusters in all four groups (i.e., men and women aged 65-79 and ≥80 years). We found 6 clusters per group, 5 of them with a specific pattern related to an organic system: Musculoskeletal, Endocrine-metabolic, Digestive/Digestive-respiratory, Neuropsychiatric and Cardiovascular patterns. We analysed multimorbidity patterns over 6 years and found that they remained quite similar from the beginning to the end of the study period.. We observed a high prevalence of multimorbidity in our population sample, with a higher proportion for women, as in other published studies [5, 8] and described 6 patterns in each study group. In addition, the prevalence of chronic diseases and multimorbidity patterns was similar to previous studies in Catalonia  and in other ...
Rheumatoid Arthritis Comorbidities Are Common, Lead to Premature Death
Learn more about how common certain comorbidities are in people with rheumatoid arthritis and why RA patients need health care to address them.
Comorbidities are associated with poorer outcomes in community patients with rheumatoid arthritis. | RCMAR/UCLA
Ranganath VK, Maranian P, Elashoff DA, Woodworth T, Khanna D, Hahn T, Sarkisian C, Kremer JM, Furst DE, Paulus HE. Comorbidities are associated with poorer outcomes in community patients with rheumatoid arthritis.. Rheumatology (Oxford). Oct 1, 2013; 52: 10: 1809-17: PubMed PMID23813577; PubMed Central PMCID: PMC3775293 ...
Comorbidity burden and health services use in community-living older adults with diabetes mellitus: a retrospective cohort study
Objectives - Diabetes frequently coexists with other conditions, resulting in poorer diabetes self-management and quality of life, higher risk for diabetes-related complications and higher health service use compared to those with diabetes only. Few Canadian studies have undertaken a comprehensive, population-level analysis of comorbidity and health service utilization by older adults with diabetes. This study examined comorbidity and its association with a broad range of health services in a cohort of community-dwelling older adults with diabetes in Ontario, Canada.. Methods - We linked multiple administrative databases to create a cohort of 448,736 older adults with diabetes, described their comorbidities and obtained their 1-year use of health services (physician visits, emergency department visits, inpatient hospital admissions, home care use, nursing home admissions). We examined comorbidity patterns by age and gender and estimated the prevalence of 20 comorbid conditions and the most ...
Factors associated with health literacy in multimorbid patients in primary care: a cross-sectional study in Switzerland | BMJ...
The present study showed that the mean (SD) HL score in our multimorbid primary care patient sample was 2.9 (0.5). In multimorbid patients, a high treatment burden and effects on patients quality of life due to problems with mobility and anxiety/depression were negatively associated with HL. However, our study revealed no association between HL and age. Although several studies have assessed HL, to the best of our knowledge, little is known about which factors are associated with low HL in multimorbid patients in primary care.. The present studys main finding was that the treatment burden facing multimorbid primary care patients was negatively associated with HL. In other words, the lower a multimorbid patients HL, the higher the treatment burden. This is a very interesting finding, and although the β coefficient is small, we believe that this result is clinically relevant and allows us to identify treatment burden as an element to take into account for potentially low literacy in ...
Somatic comorbidity among migrants with posttraumatic stress disorder and depression - a prospective cohort study | BMC...
We found significantly higher rates of somatic comorbidity among migrants with PTSD and depression compared with migrants without a diagnosed psychiatric disorder. Adjusted rates were significantly higher in ten out of the fifteen diagnostic categories being especially high for infectious, neurological and pulmonary diseases. Our results further suggest difference in the rates of somatic comorbidity according to region of origin and according to the legal ground of obtaining residency.. Prior to our study, somatic comorbidity in migrants with PTSD and depression have only received scarce attention in the literature [18-21]. Albeit, diagnosis and treatment of somatic comorbidity may help improve management of mental disorders and vice versa. Further, patients with PTSD and depression suffering from somatic comorbidity will require regular treatment and check-up, such as diabetes may need tailored treatment programmes to ensure they are treated according to need. It is therefore important that ...
Alarmingly High Comorbidity Rates Among HIV+
Background: Patients with HIV infection can present with multiple comorbidities prior to and following the initiation of antiretroviral therapy (ART) including potential risk factors for cardiovascular disease (CVD) and renal impairment and osteoporosis/fracture. Understanding these risk factors can help identify patients at high risk and help optimize HIV treatment. Methods: Adults diagnosed with HIV (ICD-9-CM code: 042.xx, 795.71, V08) in 2002-2013 were selected from MarketScan Commercial, Medicare, and Medicaid databases, which are longitudinal, allowing patients to be observed over multiple years. All patients were continuously enrolled for at least 1 calendar year during 2003-2013. Age and gender entered on the date of the first HIV diagnosis. Comorbid conditions during calendar years 2003-2013 were assessed using diagnosis and procedure codes ...
A Scoring System for Identifying Severe Cases of Influenza-like Illness by Comorbidity and Age - A Nationwide Cohort Analysis
From 2008 to 2010, there were 319,775 ILI inpatient cases, of which 8.82% entered ICU and 3.83% died at hospital discharge. The significant comorbidity attributes varied in each age stratum: heart failure in any age, non-dialyzed renal insufficiency in any age, cancer in school-age children up to mid-age adults, tuberculosis in the elderly, stroke in adults, congenital anomaly in children and adolescents, transplant in school-age up to adolescents, or HIV in young adults. Comorbidity vector was (heart failure, non-dialyzed renal insufficiency, cancer, tuberculosis, stroke, congenital anomaly, transplant, HIV). Age vector was (1, 1, 6<=age<45, 75<=age, 18<=age<65, 0<age<=18, 6<=age<18, 18<=age<45). Comorbidity score, the dot product of comorbidity vector and age vector, showed significant correlation with hospitalization cost (Spearman rho=0.1885, p<0.0001), and with LOS (Spearman rho=0.1717, p<0.0001). Its ROC area-under-curves (AUC) were 0.7454 with death and 0
Comorbidities are a significant concern in people with Type 2 diabetes - Drug Development Technology
Figure 1: 7MM, Diagnosed Prevalent Cases of Type 2 Diabetes with Comorbidity, 2016, Men and Women, Ages ≥20 Years. Source: GlobalData.. Type 2 diabetes (T2D) is a chronic disorder of glucose equilibrium that results from the bodys inability to make use of available insulin along with relative insulin deficiency. Among adults only, T2D is expected to make up at least 95% of all diabetes cases.. It is one of the most common non-communicable diseases and is an escalating public health problem globally, with an estimated 415 million people afflicted. Additionally, poorly managed diabetes leads to serious complications such as heart attack, stroke, kidney failure, leg amputation, vision loss, nerve damage, and other serious complications. Figure 1 presents the most common comorbidities in persons with T2D.. GlobalData Epidemiologists forecast that there were 56,060,328 diagnosed prevalent cases of T2D in the seven major markets (7MM: US, France, Germany, Italy, Spain, UK, and Japan). Additionally, ...
Self-efficacy and health-related quality of life: a cross-sectional study of primary care patients with multi-morbidity |...
Multi-morbidity in chronic long-term conditions is a major concern for health services. Self-management in concert with clinical care forms part of the effective management of multi-morbidity. Self-efficacy is a mechanism through which self-management can be achieved. Quality of life is adversely impacted by multi-morbidity but could be improved by effective self-management. This study examines the relationship between self-efficacy and quality of life in primary care patients with multi-morbidity. A cross-sectional survey was conducted with primary care patients in England. Potential participants were mailed a questionnaire containing quality of life measures (the EQ-5D-5L and the Long-Term Conditions Questionnaire (LTCQ)), the Disease Burden Impact Scale (DBIS) and the Self-efficacy for Managing Chronic Disease Scale. Descriptive statistics, analysis of variance and linear regression analyses were conducted to examine the relationship between quality of life (dependent variable), self-efficacy, and
Multiple comorbidities of 21 psychological disorders and relationships with psychosocial variables: A study of the online...
Background: While research in the area of e-mental health has received considerable attention over the last decade, there are still many areas that have not been addressed. One such area is the comorbidity of psychological disorders in a Web-based sample using online assessment and diagnostic tools, and the relationships between comorbidities and psychosocial variables. Objective: We aimed to identify comorbidities of psychological disorders of an online sample using an online diagnostic tool. Based on diagnoses made by an automated online assessment and diagnostic system administered to a large group of online participants, multiple comorbidities (co-occurrences) of 21 psychological disorders for males and females were identified. We examined the relationships between dyadic comorbidities of anxiety and depressive disorders and the psychosocial variables sex, age, suicidal ideation, social support, and quality of life. Methods: An online complex algorithm based on the criteria of the Diagnostic ...
BR in Patients With CLL With Comorbidities and/or Renal Dysfunction - Tabular View - ClinicalTrials.gov
This is a non-randomized open label dose-ranging study of Bendamustine and Rituximab (BR) in patients with previously untreated or relapsed/refractory CLL who have multiple comorbidities (Cumulative Illness Rating Scale [CIRS]≥7) with or without renal insufficiency (estimated creatinine clearance [CrCL] 15-40 mL/min, but not receiving dialysis).. The study will accrue two independent patient cohorts. Both cohorts will follow a standard 3+3 Phase I design. Once the maximum tolerated dose (MTD) is determined, two expansion cohorts will be enrolled. Dose limiting toxicities (DLT) will be assessed during the 1st cycle of treatment.. Patients with CLL who have significant comorbidities (CIRS≥7; at least one category grade 3-4), with or without minor renal dysfunction (CrCL,40 mL/min) will be accrued onto Cohort 1 of the study. At dose level 1, patients will receive bendamustine 45 mg/m2 in combination with rituximab (375 mg/m2 with cycle 1 and 500 mg/m2 with subsequent cycles). If safe, the dose ...
Younger Smokers More Likely to Suffer Psychiatric Comorbidities on Meducation
Younger smokers are more likely to be dependent on nicotine and have psychiatric and substance use disorders than their older counterparts, new research shows ...
Prevalence and comorbidity of diabetes mellitus among non-institutionalized older adults in Germany - results of the national...
Despite the major public health impact of diabetes, recent population-based data regarding its prevalence and comorbidity are sparse. The prevalence and comorbidity of diabetes mellitus were analyzed in a nationally representative sample (N = 9133) of the non-institutionalized German adult population aged 50 years and older. Information on physician-diagnosed diabetes and 20 other chronic health conditions was collected as part of the national telephone health interview survey German Health Update (GEDA) 2009. Overall, 51.2% of contacted persons participated. Among persons with diabetes, diabetes severity was defined according to the type and number of diabetes-concordant conditions: no diabetes-concordant condition (grade 1); hypertension and/or hyperlipidemia only (grade 2); one comorbidity likely to represent diabetes-related micro- or macrovascular end-organ damage (grade 3); several such comorbidities (grade 4). Determinants of diabetes severity were analyzed by multivariable ordinal regression.
Comorbidity of cardiovascular disease, diabetes and chronic kidney disease in Australia - DRO
This is the first report of a projected series regarding the comorbidity of cardiovascular disease (CVD), diabetes and chronic kidney disease (CKD) in Australia. Comorbidity refers to any two or more of these diseases that occur in one person at the same time. The questions to be answered in this report include: 1. How many Australians have comorbidity of CVD, diabetes and CKD? 2. What is the proportion of hospitalisations with these comorbidities? 3. How much do these comorbidities contribute to deaths? 4. What is the magnitude of comorbidity in the context of each individual disease? 5. Are there differences in the distribution of these comorbidities among age groups and sexes ...
Psych News Alert: Dimensional Measures Show Significant Comorbidity Among Seriously Mentally Ill
Dimensional diagnostic measures, such as those being proposed for use in DSM-5, reveal a more complex symptom profile for public-sector patients with serious mental illness than do categorical diagnoses, said William Narrow, M.D., M.P.H, associate director of APAs Division of Research, at a symposium at APAs Institute on Psychiatric Services last week in San Francisco. Narrow presented a study by the American Psychiatric Institute for Research and Education in which rates of categorical diagnoses and dimensional symptom ratings were examined for patients with schizophrenia, major depressive disorder, PTSD, and substance use disorders. ...
Comorbidities are additional chronic conditions that may compromise the health of people living with HIV. Some comorbid conditions are more common in people with HIV because they have similar risk factors or because the immune changes associated with HIV infection or the side effects of antiretroviral drugs increase a persons risk of developing them. These comorbidities are now the most common causes of death and disability in people living with HIV. Research on comorbidities aims to understand the underlying links between comorbidities and HIV, and to develop treatment strategies and guidelines to reduce their impact on the lives and well-being of people living with HIV.. ...
Cardiovascular comorbidities as predictors for severe COVID-19 infection or death - Forskning - Region Hovedstaden
BACKGROUND: Pre-existing cardiovascular diseases (CVDs) have been proposed to identify patients at higher risk of adverse COVID-19 outcomes, but existing evidence is conflicting. Thus, it is unclear whether pre-existing CVDs are independently important predictors for severe COVID-19.. METHODS AND RESULTS: In a nationwide Danish cohort of hospital-screened COVID-19 patients aged , =40, we investigated if pre-existing CVDs predict the 30-day risk of (1) composite outcome of severe COVID-19 and (2) all-cause mortality. We estimated 30-day risks using a Cox regression model including age, sex, each CVD comorbidity, COPD-asthma, diabetes, and chronic kidney disease. To illustrate CVD comorbidities importance, we evaluated the predicted risks of death and severe infection, for each sex, along ages 40 - 85. 4,090 COVID-19 hospital-screened patients were observed as of August 26, 2020; 22.1% had ≥ 1 CVD, 23.7% had severe infection within 30 days and 12.6% died. Predicted risks of both outcomes at age ...
Pharmacotherapy of cardiovascular comorbidities in osteoporotic postmenopausal women | Izmozherova | Osteoporosis and Bone...
Особенности фармакотерапии коморбидных сердечно-сосудистых заболеваний у женщин с постменопаузальным остеопорозом
Depression With Atypical Features in the National Comorbidity Survey: Classification, Description, and Consequences |...
Underdiagnosing and overdiagnosing psychiatric comorbidities: Insights into common diagnostic oversights<...
TY - JOUR. T1 - Underdiagnosing and overdiagnosing psychiatric comorbidities. T2 - Insights into common diagnostic oversights. AU - Basco, Monica Ramirez. AU - Jacquot, Colette. AU - Thomas, Christina. AU - Knack, Jennifer M.. PY - 2008/10/1. Y1 - 2008/10/1. N2 - There is no substitute for being thorough in conducting a diagnostic evaluation. This includes taking the time to gather information from the patient and significant others, going over prior medical records, and/or observing the patient over time and updating the diagnosis if appropriate. Keep in mind the importance of probing for comorbidities, of not jumping to conclusions about their presence when a patient presents with a few striking symptoms, and of the need to interpret symptoms correctly. Clinicians may be forced to draw quick diagnostic conclusions with limited information in busy practice settings or when patients are acutely ill. In these cases, it is important to follow up after patients have been stabilized, to reevaluate ...
Data was collected between 2006 and 2010 from adults 18 years of age or older in Boston who have a current diagnosis of alcohol dependence and heavy drinking and/or drug dependence and recent drug use.. Specifically, the following inclusion criteria were met at study entry: (1) Male and female subjects must be 18 years of age or older; (2) Must have a current diagnosis of Alcohol dependence and heavy drinking: Alcohol dependence as determined using the (10-items if none skipped) Composite International Diagnostic Interview Short Form (CIDI-SF) that yields a DSM-IV diagnosis and heavy drinking in the past 30 days, defined as greater than or equal to 4 standard drinks for women, greater than or equal to 5 for men at least twice in the past month, or greater than or equal to 22 drinks per week for men or greater than or equal to 15 drinks per week for women in an average week in the past month and/or Drug dependence and recent drug use: Drug dependence (DD) as determined by using the Composite ...
comorbidity - CareThreads
Accountable Care Organizations, which used to be the wave of the future, are the here and now. As groups of doctors, hospitals and other healthcare providers come together to coordinate care, it is essential they include behavioral health providers in the mix. According to a recent National Comorbidity Survey, 17 percent of the adult population had comorbid mental and medical conditions within a 12-month period. Patients with comorbidities require a comprehensive treatment plan to truly bend the cost curve. For…. ...
Can Elderly Patients With DLBCL Tolerate Standard Treatment? | Cancer Network
The OS benefit associated with standard treatment diminished in patients older than 80 with high comorbidity scores, but other age groups fared better.
comoR: a software for disease comorbidity risk assessment | Journal of Clinical Bioinformatics | Full Text
The diagnosis of comorbidities, which refers to the coexistence of different acute and chronic diseases, is difficult due to the modern extreme specialisation of physicians. We envisage that a software dedicated to comorbidity diagnosis could result in an effective aid to the health practice. We have developed an R software comoR to compute novel estimators of the disease comorbidity associations. Starting from an initial diagnosis, genetic and clinical data of a patient the software identifies the risk of disease comorbidity. Then it provides a pipeline with different causal inference packages (e.g. pcalg, qtlnet etc) to predict the causal relationship of diseases. It also provides a pipeline with network regression and survival analysis tools (e.g. Net-Cox, rbsurv etc) to predict more accurate survival probability of patients. The input of this software is the initial diagnosis for a patient and the output provides evidences of disease comorbidity mapping. The functions of the comoR offer flexibility
Background: CVD, AH and DM are common comorbidities in COPD. Their association with the new GOLD 2011 classification has not been evaluated.. Objective:To evaluate the prevalence of CVD, AH and DM in patients admitted to the hospital for COPD exacerbation (AECOPD).. Methods:609 patients admitted for AECOPD were followed-up monthly for one year.. Results:Patients classification according to GOLD 2011 and the prevalence of CVD, AH and DM are shown in Table 1. Comorbid diseases were more common in more severe COPD. Patients without comorbidities had fewer AECOPD in 1 year compared to patients with 1, 2 and 3 comorbidities (0.4±0.5, 1.9±2.5, 3.6±3.3 and 4.6±3.5 respectively, p,0.001) as well as fewer hospitalizations for AECOPD (0.1±0.3, 0.7±1.6, 1.6±1.9 and 2.0±2.6, respectively, p,0.001). Patients in group B with comorbidities had more AECOPD and hospitalizations in 1 year compared to group C (p,0.001). The presence of comorbidities was an independent predictor of AECOPD and ...
The influence of multi-morbidity and self-reported socio-economic standing on the prevalence of depression in an elderly Hong...
Relationship Between Clinical Trial Site Enrollment With Participant Characteristics, Protocol Completion, and Outcomes | JACC:...
In this analysis we demonstrate that, despite strict inclusion and exclusion criteria for eligibility to enroll in a clinical trial, there are significant differences in baseline clinical characteristics among study sites according to enrollment volume. Such variations have been previously reported related to regional differences among participants. To our knowledge, this is the first report that shows significant differences in participants baseline clinical characteristics on the basis of the number of participants enrolled by any individual clinical trial site. These differences spanned demographic and clinical characteristics, comorbidity burden, and laboratory parameters. Participants from the trial sites that enrolled fewer individuals had worse health at baseline. The less prevalent dyspnea and rales coupled with lower blood pressure and worse renal function, and higher use of inotropes all suggest that participants enrolled at lower enrolling sites likely represent a proportion of ...
ADHD Comorbid Conditions: 9 Most Common Related Disorders
This quick-reference chart names the most common comorbid conditions that come with ADHD, plus symptoms, common treatments, and recommended resources for each.
CURRENT Diagnosis & Treatment: Surgery, 14e | AccessMedicine | McGraw-Hill Medical
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CURRENT Diagnosis & Treatment: Surgery, 13e | AccessMedicine | McGraw-Hill Medical
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We are recruiting! | Unitat de Tuberculosi Experimental
We are looking for a PhD student! The PhD fellow will be part of a team working on several projects focused on the immunopathology of tuberculosis and testing drugs and vaccine candidates in several animal models. The PhD student will focus his/her research on understanding how comorbidities are involved in the pathogenesis of tuberculosis while being…
Recent Publications | Health Innovation Program
In a recent study to help inform future interventions for patients who have both diabetes and other comorbid conditions, Dr. Elizabeth Magnan et al. examined how 62 chronic conditions individually related to achievement of diabetes care quality goals. The authors found that the 62 conditions varied in their relationships to diabetes care goal achievement, with congestive heart failure, obesity, mental health conditions, and substance use disorders relating to a lack of achievement in at least one measure. ...
DRG 374: DIGESTIVE MALIGNANCY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) - Market Size, Prevalence, Incidence, Quality...
Research Hospitalization Volume, DRGs, Quality Outcomes, Top Hospitals & Physicians for DRG 374: DIGESTIVE MALIGNANCY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC)
The validity of analyses testing the etiology of comorbidity between two disorders: a review of family studies | CU Experts |...
The validity of analyses testing the etiology of comorbidity between two disorders: a review of family studies Journal Article ...
Definition for comorbidity
comorbidity definition: the clear presence of several conditions (or conditions) as well as a primary illness or condition.; the end result of these extra problems or conditions.; The presence of more…
Multi-label Transduction for Identifying Disease Comorbidity Patterns | SpringerLink
Study of the untoward effects associated with the comorbidity of multiple diseases on brain morphology requires identifying differences across multiple diagnostic groupings. To identify such effects...
Publications Search Results
Swendsen, Joel, Conway, Kevin P., Degenhardt, Louisa, Dierker, Lisa, Glantz, Meyer, Jin, Robert, Merikangas, Kathleen R., Sampson, Nancy, Kessler, Ronald C. Socio-demographic risk factors for alcohol and drug dependence: The 10-year follow-up of the National Comorbidity Survey ...
Cleaner Data Confirm COVID-19 Link to Diabetes, Hypertension
Prevalence rates for either comorbidity are lower than previously reported for hospitalized COVID-19 patients, in a new meta-analysis that worked to overcome sources of bias in earlier reports.
Peter Hatlen - NTNU
Hatlen, Peter; Amundsen, Tore. (2014) Lung cancer - influence of comorbidity on incidence and survival. The Nord-Trøndelag Healt study. 2014. ISBN 978-82-471-4956-0. Doktoravhandlinger ved NTNU (23). ...
Urology-Penile Discharge (Medical Transcription Sample Report)
Penile discharge, infected-looking glans. A 67-year-old male with multiple comorbidities with penile discharge and pale-appearing glans. It seems that the patient has had multiple catheterizations recently and has history of peripheral vascular disease.
This was an ethical problem with a simple solution.
If you have a patient whos been a heavy drinker and heavy smoker (like five 40-ouncers and a couple packs a day) since their teens, and theyre now in their 60s, and they live with family members who are unlikely to stop smoking and drinking just to keep them healthy, and they also live in a food desert and have multiple comorbidities and things generally suck, it is not a dereliction of duty not to suggest that they get their carotid arteries Roto-Rooted in order to restore blood flow to their brain after a minor stroke ...
Ronald C. Kessler
"National Comorbidity Survey (NCS)". Retrieved 2019-09-21. "Mental Health Around the World". Retrieved 2019-09-21. "Hurricane ... Kessler is the principal investigator of the National Comorbidity Survey (NCS). The NCS was the first nationally representative ... Kessler, Ronald (2013). "National Comorbidity Survey: Reinterview, 2001-2002". ICPSR Data Holdings. doi:10.3886/ICPSR30921.v1 ...
Spinocerebellar ataxia type 1
April 2011). "Depression comorbidity in spinocerebellar ataxia". Movement Disorders. 26 (5): 870-6. doi:10.1002/mds.23698. PMID ...
Mixed anxiety-depressive disorder
The high comorbidity of depression and anxiety, as well as the existence of mixed anxiety-depressive disorder suggests that ... The possible causes of anxiety and depression are often similar to one another and the comorbidity of the two disorders is ... "The Comorbidity of Anxiety and Depression". Nami.org. "Mixed Anxiety-Depressive Disorder". Disorders.org - Find Therapists, ... Wittchen, H.-U., Schuster, P., & Lieb, R. (2001). Comorbidity and mixed anxiety-depressive disorder: Clinical curiosity or ...
Fenton WS, Stover ES (2006). "Mood disorders: cardiovascular and diabetes comorbidity". Curr Opin Psychiatry. 19 (4): 421-7. ... Posttraumatic stress disorder Premenstrual dysphoric disorder Social anxiety disorder The following may also be present as co- ...
Diagnosis of schizophrenia
Regier DA, Farmer ME, Rae DS, Locke BZ, Keith SJ, Judd LL, Goodwin FK (November 1990). "Comorbidity of mental disorders with ... Results from the National Comorbidity Survey" (PDF). Archives of General Psychiatry. 51 (1): 8-19. doi:10.1001/archpsyc. ... Bottas A (15 April 2009). "Comorbidity: Schizophrenia With Obsessive-Compulsive Disorder". Psychiatric Times. 26 (4). Archived ... Bottas A (April 15, 2009). "Comorbidity: Schizophrenia With Obsessive-Compulsive Disorder". Psychiatric Times. 26 (4). American ...
Comorbidity treatment. For people who have both atrial fibrillation and obstructive sleep apnea, observational studies ... comorbidities (such as chronic liver or kidney disease), the presence of significant mitral stenosis or mechanical heart valves ...
Generalized anxiety disorder
Comorbidity. GAD and depression. In the National Comorbidity Survey (2005), 58 percent of patients diagnosed with ... Comorbidity and treatment. A study on comorbidity of GAD and other depressive disorders has shown that treatment is not ... and Comorbidity of 12-Month DSM-IV Disorders in the National Comorbidity Survey Replication". Archives of General Psychiatry. ... Impact of Comorbidity on Psychotherapy Outcome and Impact of Psychotherapy on Comorbidity Diagnoses". Behavior Therapy. 41 (1 ...
Procedural sedation and analgesia
Comorbidities. Patient with other serious medical conditions are at greater chance for negative side effects after ... Examples of comorbidities include heart failure, COPD, neuromuscular disease. Use the ASA Classification to predict a patient's ... However, there are some things to consider when administering PSA, such as the patient's age, medical comorbidities, and ... like with older age and other medical comorbidities, but that if there is a complication, it will be hard for the physician to ...
Sensory processing disorder
... is a common comorbidity with autism spectrum disorders and is now ... Other comorbidities. Various conditions can involve SPD, such as obsessive compulsive disorder, schizophrenia,[75 ...
Antisocial personality disorder
Comorbidity. ASPD commonly coexists with the following conditions: *Anxiety disorders ...
Online comorbidity scoring tools. Further reading. *Comorbidity: Addiction and Other Mental Illnesses. Rockville, MD: U.S ... Comorbidity-polypharmacy score (CPS). The comorbidity-polypharmacy score (CPS) is a simple measure that consists of the ... Elixhauser comorbidity measure. The Elixhauser comorbidity measure was developed using administrative data from a ... The comorbidities were not simplified as an index because each comorbidity affected outcomes (length of hospital stay, hospital ...
Comorbidities. Neuropathic pain has profound physiological effects on the brain which can manifest as psychological ... several placebo-controlled double-blind trials proving efficacy in treating neuropathy and various other diabetic comorbidities ...
Avoidant/restrictive food intake disorder
Comorbidity. The determination of the cause of ARFID has been difficult due to the lack of diagnostic criteria and ...
Co-morbidity. A large percentage of children that suffer from PEM also have other co-morbid conditions. The most common ... These co-morbidities tax already malnourished children and may prolong hospital stays initially for PEM and may increase the ... The general explanation of increased infectious comorbidity in malnourished people is that (1) the immune system is what ... co-morbidities are diarrhea (72.2% of a sample of 66 subjects) and malaria (43.3%). However, a variety of other conditions have ...
Sadistic personality disorder
Comorbidity with other personality disorders. Sadistic personality disorder has been found to occur frequently in unison ... Studies have also found that sadistic personality disorder is the personality disorder with the highest level of comorbidity to ... to have a high rate of comorbidity with sadistic personality disorder. ... distinguishing sadistic personality disorder from other forms of personality disorders due to its high level of comorbidity ...
Fear of needles
Comorbidity and triggers. Fear of needles, especially in its more severe forms, is often comorbid with other phobias and ...
Narcissistic personality disorder
Comorbidity. The occurrence of narcissistic personality disorder presents a high rate of comorbidity with other mental ...
Comorbidity. Main article: Conditions comorbid to autism spectrum disorders. Autism spectrum disorders tend to be highly ... Comorbidity may increase with age and may worsen the course of youth with ASDs and make intervention/treatment more difficult. ... Various anxiety disorders tend to co-occur with autism spectrum disorders, with overall comorbidity rates of 7-84%. Rates ... Zafeiriou DI, Ververi A, Vargiami E (June 2007). "Childhood autism and associated comorbidities". Brain & Development. 29 (5): ...
Delayed sleep phase disorder
Comorbidity. Depression. In the DSPD cases reported in the literature, about half of the patients have suffered ... there may be behaviorally-mediated mechanisms for comorbidity between DSPD and depression. For example, the lateness of DSPD ...
Avoidant personality disorder
Comorbidity. Avoidant personality disorder is reported to be especially prevalent in people with anxiety disorders, ... Van Velzen, C. J. M. (2002). Social Phobia and Personality Disorders: Comorbidity and Treatment Issues. Groningen: University ... although estimates of comorbidity vary widely due to differences in (among others) diagnostic instruments. Research suggests ... "Co-morbidity of personality disorders in individuals with substance use disorders". European Psychiatry. 16 (5): 274-282. doi ...
ISBN 978-0-89042-026-3.[page needed] Skodol, Andrew E.; Oldham, John M.; Gallaher, Peggy E. (1999). "Axis II Comorbidity of ... Swendsen, J; Merikangas, KR (2000). "The comorbidity of depression and substance use disorders". Clinical Psychology Review. 20 ... comorbidity, and progression over time". Professional Psychology: Research and Practice. 32 (3): 239-47. doi:10.1037/0735- ...
Studies examining the comorbidity of OCD in subjects with kleptomania have inconsistent results, with some showing a relatively ... Baylé, F.J.; Caci, H.; Millet, B.; Richa, S.; Olié, J.P. (2003). "Psychopathology and comorbidity of psychiatric disorders in ... Grant, J.E. (2003). "Family history and psychiatric comorbidity in persons with kleptomania". Comprehensive Psychiatry. 44 (6 ... clinical features and comorbidity in an Italian sample". Comprehensive Psychiatry. 43 (1): 7-12. doi:10.1053/comp.2002.29851. ...
... there are recognizable clinical courses and patterns of comorbidity; they respond to specific treatments; and they can be ...
Medically unexplained physical symptoms
Kroenke, K. (2003). "Patients presenting with somatic complaints: epidemiology, psychiatric comorbidity and management". ...
Hematopoietic stem cell transplantation
The HCT-CI modifies and adds to a well-validated comorbidity index, the Charlson comorbidity index (CCI) (Charlson, et al.) The ... Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987). "A new method of classifying prognostic comorbidity in longitudinal ... specific comorbidity index: a new tool for risk assessment before allogeneic HCT". Blood. 106 (8): 2912-9. doi:10.1182/blood- ... using the Hematopoietic Cell Transplantation-Specific Comorbidity Index (HCT-CI). The HCT-CI was derived and validated by ...
... co-morbidity). If the symptoms and effects persist, the injured person may become a complainant or plaintiff who initiates ...
Multi-label Transduction for Identifying Disease Comorbidity Patterns | SpringerLink
Study of the untoward effects associated with the comorbidity of multiple diseases on brain morphology requires identifying ... Furthermore, our method identifies patterns specific to each disease and AUD+HIV comorbidity that shows that the comorbidity is ... Parekh, A.K., Barton, M.B.: The challenge of multiple comorbidity for the us health care system. JAMA 303(13), 1303-1304 (2010) ... Justice, A., Sullivan, L., Fiellin, D.: HIV/AIDS, comorbidity, and alcohol: can we make a difference? Alcohol Res. Health 33(3 ...
Alarmingly High Comorbidity Rates Among HIV+
Comorbidity Rates in HIV+ on Medicare in 2013: cardiovascular events 15.9% up from 9.6% in 2003; chronic kidney disease 16% up ... Increasing Comorbidities in HIV+....of note the average age of patients in medicaid in this analysis is only 45 (11.2)..... ... Comorbidities of Patients with Human Immunodeficiency Virus (HIV) in the USA - a Longitudinal Analysis of Prevalent HIV ... "HIV patients are aging and present with a number of comorbidities". Renal Impairment Doubles Among Medicaid & Commercial ...
Comorbidities increase risk of mortality in COP... ( Comorbidities are common among patie...)
We used these 12 comorbidities to develop a new comorbidity risk inde...,Comorbidities,increase,risk,of,mortality,in,COPD, ... The 12 comorbidities with the strongest association with an increased ... ... Comorbidities are common among patients with chronic obstructive pulmo... We followed 1664 COPD patients recruited from five ... "We used these 12 comorbidities to develop a new comorbidity risk index (the COPD specific CO-morbidity Test, or COTE)," Dr. ...
Definition for comorbidity
comorbidity definition: the clear presence of several conditions (or conditions) as well as a primary illness or condition.; ... Definition for "comorbidity"*the clear presence of several conditions (or conditions)… ... How would you define comorbidity?. All the definitions on AZdictionary were written by people just like you. Nows your chance ... Agriculture Dictionary for "comorbidity"*the existence of co-existing or extra… ...
These comorbidities are now the most common causes of death and disability in people living with HIV. Research on comorbidities ... Comorbidities are additional chronic conditions that may compromise the health of people living with HIV. Some "comorbid" ... aims to understand the underlying links between comorbidities and HIV, and to develop treatment strategies and guidelines to ...
Comorbidity - Wikipedia
Online comorbidity scoring tools. Further reading. *Comorbidity: Addiction and Other Mental Illnesses. Rockville, MD: U.S ... Comorbidity-polypharmacy score (CPS). The comorbidity-polypharmacy score (CPS) is a simple measure that consists of the ... Elixhauser comorbidity measure. The Elixhauser comorbidity measure was developed using administrative data from a ... The comorbidities were not simplified as an index because each comorbidity affected outcomes (length of hospital stay, hospital ...
Arthritis Comorbidities | CDC
Comorbidity means more than one disease/condition is present in a person at the same time. Comorbidities are common among ... What does "comorbidity" mean?. Comorbidity means more than one disease or condition is present in the same person at the same ... Comorbidities are common among adults with rheumatic diseases like arthritis.1. CDCs Arthritis Program examines comorbidities ... Comorbidities among people with arthritis. Everyone in this group has arthritis and at least one other chronic condition. ...
Mental Disorders And Medical Comorbidity - RWJF
This synthesis examines the evidence on physical and mental comorbidity including its prevalence, origins and models for ... Key findings include: Comorbidity is the rule rather than the exception. More than 68 percent of adults with a mental disorder ... Comorbidity is associated with elevated symptom burden, functional impairment, decreased length and quality of life and ... The pathways causing comorbidity is complex and bidirectional. Medical disorders may lead to mental disorders, mental ...
Comorbidity in Adults with Epilepsy - United States, 2010
Comorbidities of epilepsy: results from the Epilepsy Comorbidities and Health (EPIC) survey. Epilepsia 2011;52:308-15. ... were more likely to report four or more medical comorbidities and less likely to report no other comorbidities than adults ... were more likely to report four or more medical comorbidities and less likely to report no other comorbidities than adults ... Comorbidity in Adults with Epilepsy - United States, 2010. Epilepsy, a spectrum disorder characterized by recurring seizures, ...
Comorbidity - Wikipedia
The comorbidity between these two disorders can be put down to impulsivity. In medicine, comorbidity describes the effect of ... Online comorbidity scoring tools Comorbidity: Addiction and Other Mental Illnesses. Rockville, MD: U.S. Dept. of Health and ... The comorbidities were not simplified as an index because each comorbidity affected outcomes (length of hospital stay, hospital ... The comorbidities identified by the Elixhauser comorbidity measure are significantly associated with in-hospital mortality and ...
Comorbidity - ADDitude
Since 1998, millions of parents and adults have trusted ADDitudes expert guidance and support for living better with ADHD and its related mental health conditions. Our mission is to be your trusted advisor, an unwavering source of understanding and guidance along the path to wellness.. ...
Comorbidities in Epilepsy | SpringerLink
Comorbidities are additional to epilepsy health and psychosocial problems in a person with epilepsy. Many general medical, ... Psychiatric (depression, anxiety), cognitive and psychosocial comorbidities prevail. The high rate of comorbidities in epilepsy ... Comorbidities are additional to epilepsy health and psychosocial problems in a person with epilepsy. Many general medical, ... Gaitatzis A. The comorbidity of epilepsy: epidemiology, mechanisms and consequences. In: Panayiotopoulos CP, editor. Atlas of ...
Cancer and comorbidity: redefining chronic diseases. - PubMed - NCBI
Cancer and comorbidity: redefining chronic diseases.. Ogle KS1, Swanson GM, Woods N, Azzouz F. ... Comorbidity was present in 68.7% of cancer patients, and 32.6% of these individuals had , or = 2 comorbid conditions. Frequency ... The prevalence of comorbidities has important clinical, health service, and research implications. The disease specific model ... This study was conducted to describe the prevalence of comorbidity in cancer patients and examine its relation with multiple ...
Comorbidity - definition of comorbidity by The Free Dictionary
comorbidity synonyms, comorbidity pronunciation, comorbidity translation, English dictionary definition of comorbidity. adj. ... Comorbidity often arise when a particular disease leads to other complications in patients.. The prevalence of comorbidity and ... The Elixhauser Comorbidity Index was used to measure comorbidity burden.. Variations in Hip Fracture Baseline Patient ... In the comorbidity guideline, the working group examined the therapeutic interventions for psoriasis-related comorbidities such ...
National Comorbidity Survey - Wikipedia
The National Comorbidity Survey Replication (NCS-R) was a study done with 9,282 new participants. And the National Comorbidity ... "NCS Home". National Comorbidity Survey. Harvard Medical School. 2005. "Questions and Answers about the National Comorbidity ... The National Comorbidity Survey: Baseline (NCS-1) was the first large-scale field survey of mental health in the United States ... The National Comorbidity Survey: Reinterview (NCS-2) was a follow up study conducted between 2001 and 2002. The participants in ...
Comorbidity | WPA
The Incremental Inpatient Costs Associated with Marijuana Comorbidity | RAND
In this paper the authors examine the incremental cost of marijuana comorbidity for alcohol, mood and thought diagnoses in ... Marijuana comorbidity is associated with longer length of stays and higher charges for patients suffering from a primary ... In this paper the authors examine the incremental cost of marijuana comorbidity for alcohol, mood and thought diagnoses in ... Findings from this study suggest that a marijuana comorbidity increases the cost of treating patients with alcohol problems and ...
Primary Adrenal Insufficiency Comorbidities
If adrenal failure is caused by tuberculosis, then much less comorbidities are observed owing to the different disease ... The Importance of Recognizing Comorbidities. Adequate recognition of endocrine and other comorbid disorders in patients with ... A plethora of autoimmune comorbidities can be associated with primary adrenal insufficiency - most notably Hashimotos disease ... Primary Adrenal Insufficiency Comorbidities. News-Medical. 22 November 2019. ,https://www.news-medical.net/health/Primary- ...
Clinical Cohort and Comorbidity Research Core | Center for AIDS Research
Neuroplasticity Underlying the Comorbidity of Pain and Depression
Neuroplasticity Underlying the Comorbidity of Pain and Depression. Lisa Doan,1 Toby Manders,1 and Jing Wang1,2 ... M. J. Bair, R. L. Robinson, W. Katon, and K. Kroenke, "Depression and pain comorbidity: a literature review," Archives of ... H. Kim, L. Chen, G. Lim et al., "Brain indoleamine 2,3-dioxygenase contributes to the comorbidity of pain and depression," The ... P. H. Finan and M. T. Smith, "The comorbidity of insomnia, chronic pain, and depression: dopamine as a putative mechanism," ...
Cardiovascular Comorbidity in Inflammatory Rheumatological Conditions (24.03.2017)
The frequency of direct cardiac involvement and/or cardiovascular comorbidities varies... ... Cardiovascular Comorbidity in Inflammatory Rheumatological Conditions. Dtsch Arztebl Int 2017; 114(12): 197-203; DOI: 10.3238/ ... Today, cardiovascular comorbidities are among the leading causes of death in patients with inflammatory rheumatological ... Cardiovascular comorbidity. The risk of major cardiovascular events (all cause caridovascular mortality, myocardial ...
Measuring Comorbidity in Cardiovascular Research: A Systematic Review
Comorbidity, limitations in activ... preview & related info | Mendeley
BACKGROUND: This study aims to contribute to the knowledge of the influence of comorbidity in OA. The objectives of the study ... were (i) to describe the prevalence of comorbidity and (ii) to describe... ... Comorbidity, limitations in activities and pain in patients with osteoarthritis of the hip or knee. *Van Dijk G ... BACKGROUND: This study aims to contribute to the knowledge of the influence of comorbidity in OA. The objectives of the study ...
Department of Health | Implications of comorbidity for management
Comorbidity results in poorer physical and psychiatric outcomes. Comorbidity of substance use and severe mental disorders is ... Collectively, these issues pose considerable demands on interventions for comorbidity. The high comorbidity rates, especially ... Comorbidity is under-serviced. One UK survey estimated that even for psychosis and SUD, only 20% of people were offered ... Comorbidity between substance use and other mental disorders is very common (Degenhardt, Hall, & Lynskey, 2001; Regier et al., ...
Frank Hinton Reads "Comorbidity" from Our October 2009 Issue. Wednesday, June 16th, 2010 Check out Frank Hinton read " ... Tags: Comorbidity, Frank Hinton, Metazen, Orange Alert Podcast. Posted in Audio , 1 Comment » ... "Comorbidity," which first appeared in the October 2009 issue, in Episode Thirteen: Suckers Wear Sunglasses of the Orange Alert ...
Co-morbidity | www.emcdda.europa.eu
Borderline Personality Disorder and Complex Comorbidity
LCSW will discuss Borderline Personality Disorder and comorbidity. ... Borderline Personality Disorder and Complex Comorbidity. Borderline Personality Disorder and Complex Comorbidity Presented by ... Complex comorbidity is a hallmark feature of adult Borderline Personality Disorder (BPD). BPD often presents in a mood disorder ... Comorbidity, Treatment Utilization, and General Functioning. Journal of Personality Disorders, 1-17. doi:10.1521/pedi_2013_27_ ...
Thyroid Disease and Mental Disorders: Cause and Effect or Only Comorbidity?
Development of a comorbidity index using physician claims data. - PubMed - NCBI
Development of a comorbidity index using physician claims data.. Klabunde CN1, Potosky AL, Legler JM, Warren JL. ... Important comorbidities recorded on outpatient claims in administrative datasets may be missed in analyses when only inpatient ... The physician claims index can be used in conjunction with a comorbidity index derived from inpatient hospital claims, or ... Using the comorbid conditions identified by Charlson and colleagues, we developed a comorbidity index that incorporates the ...
Impact of comorbidity and multimorbidity on primary care practice
... Comorbidity and multimorbidity are often defined as the co- ... Comorbidity and multimorbidity have been shown to be associated with adverse health outcomes, such as poor quality of life, ... Comorbidity is common in patients consulting in primary care. Musculoskeletal pain and insomnia each increase the risk of the ... In this context, BMC Family Practice presents our special collection focused on the impact of comorbidity and multimoribidty on ...
... data collection. NCIN work programme , 2009 Co-morbidity workshop. NCIN funded work programme. In October 2010 ... Workshop on co-morbidity data collection (October 2009). Collecting data on co-morbidities in a clinically relevant way poses ... Testing the feasibility of using Adult Co-morbidity Evaluation 27 (ACE 27) as a routine measure of co-morbidity ... To begin to address this issue, and as part of the review of the National Cancer Dataset, NCIN held a workshop on co-morbidity ...
Comorbidity measures for use with administrative data
The comorbidities had independent effects on outcomes and probably should not be simplified as an index because they affect ... Results: A comprehensive set of 30 comorbidity measures was developed. The comorbidities were associated with substantial ... Comorbidity measures for use with administrative data Med Care. 1998 Jan;36(1):8-27. doi: 10.1097/00005650-199801000-00004. ... Conclusions: The comorbidities had independent effects on outcomes and probably should not be simplified as an index because ...
Frontiers | Migraine and Stroke: "Vascular" Comorbidity | Neurology
Several comorbidities are associated to migraine.Recent meta-analyses have consistently demonstrated a relationship between ... Several comorbidities are associated to migraine. Recent meta-analyses have consistently demonstrated a relationship between ... This comorbidity group also had a higher prevalence of cerebrovascular events than the group with only one factor: 4.4 vs. 0.7 ... Citation: Guidetti D, Rota E, Morelli N and Immovilli P (2014) Migraine and stroke: "vascular" comorbidity. Front. Neurol. 5: ...
National Comorbidity SurveyImpact of comorbidityConclusionsSignificant comorbidityPrognosticDiabetes mellitusCharlson Comorbidity IndexChronicPrevalence and ComorbidityPatients With ComorbiditiesDepressionSeverityBurdenCohortCommon comorbiditiesOutcomesDiseasesSignificantlyIncidenceDiagnosisPrevalentDiseaseHypertensionObesitySystematically2017StudyInfection
National Comorbidity Survey1
- According to a recent National Comorbidity Survey, 17 percent of the adult population had comorbid mental and medical conditions within a 12-month period. (ntst.com)
Impact of comorbidity1
- Older age exacerbated the impact of comorbidity burden: to a greater extent in the confounded group, older age was associated with more abnormal white matter (P = 0.017), less total white matter (P = 0.015), and less subcortical gray matter (P = 0.014).CONCLUSION: Neuroimaging in PLWH reveals signatures associated with confounding neurocognitive conditions, emphasizing the importance of evaluating these among individuals with suspected HAND. (nntc.org)
- 01). CONCLUSIONS: The presence of comorbidities in patients with MS is associated with brain injury on MR imaging. (elsevier.com)
- Additionally, the majority of T2D cases were also burdened with a significant comorbidity. (drugdevelopment-technology.com)
- Prognostic scores, and more specifically comorbidity scores, are important and widely used measures in the health care field and in health services research. (temple.edu)
- A comorbidity score is a summary score that can be created from these individual comorbidities for prognostic purposes, as well as for confounding adjustment. (temple.edu)
- The prevalence and comorbidity of diabetes mellitus were analyzed in a nationally representative sample (N = 9133) of the non-institutionalized German adult population aged 50 years and older. (biomedcentral.com)
- Psoriasis, thyroid disease, and type 2 diabetes mellitus comorbidities were associated with more severe nonconventional MR imaging outcomes. (elsevier.com)
Charlson Comorbidity Index3
- Finally, two eligible articles, describing three comorbidity indices appropriate for health administrative data remained: The Maternal comorbidity index, the Charlson comorbidity index and the Elixhauser Comorbidity Index. (biomedcentral.com)
- Extra-hepatic comorbidity burden was measured using the Charlson Comorbidity Index (CCI). (beds.ac.uk)
- The Charlson Comorbidity Index (CCI) is a well described and validated instrument determined by the presence, and in some cases severity, of 16 comorbid conditions, including liver disease [ 5 ]. (beds.ac.uk)
- The diagnosis of comorbidities, which refers to the coexistence of different acute and chronic diseases, is difficult due to the modern extreme specialisation of physicians. (biomedcentral.com)
Prevalence and Comorbidity1
Patients With Comorbidities1
- Patients with comorbidities require a comprehensive treatment plan to truly bend the cost curve. (ntst.com)
- Overall, depression was the most common comorbidity among RA patients, though this condition was also fairly common among the general population (28 percent of RA patients versus 23 percent of those without RA). (creakyjoints.org)
- Migrants with PTSD and depression had a significantly higher rates of somatic comorbidity compared with migrants without a diagnosed psychiatric disorder. (beds.ac.uk)
- Determinants of diabetes severity included age (cumulative odds ratio 1.05, 95% confidence interval 1.03-1.07, per year) and number of discordant comorbidities (1.40, 1.25-1.55). (biomedcentral.com)
- BACKGROUND AND PURPOSE: The effect of comorbidities on disease severity in MS has not been extensively characterized. (elsevier.com)
- We determined the association of comorbidities with MR imaging disease severity outcomes in MS. MATERIALS AND METHODS: Demographic and clinical history of 9 autoimmune comorbidities confirmed by retrospective chart review and quantitative MR imaging data were obtained in 815 patients with MS. The patients were categorized on the basis of the presence/ absence of total and specific comorbidities. (elsevier.com)
- The increasing burden of diabetes globally signifies the importance of implementing preventive programs, awareness programs, and screening programs on a large scale, which would be beneficial in decreasing the economic burden of diabetes and would help to curtail the rising tide of diabetes and associated comorbidity. (drugdevelopment-technology.com)
- Diabetes comorbidities including diabetes-concordant and diabetes-discordant conditions need to be considered in epidemiological studies, in order to monitor disease burden and quality of diabetes care. (biomedcentral.com)
- Effects of comorbidity burden and age on brain integrity in HIV. (nntc.org)
- We determined associations between comorbidity burden and brain integrity and examined the moderating effect of age on these relationships.DESIGN: Observational, cross-sectional substudy of the CNS HIV Antiretroviral Therapy Effects Research cohort.METHODS: A total of 288 PLWH (mean age = 44.2) underwent structural MRI and magnetic resonance spectroscopy as well as neurocognitive and neuromedical assessments. (nntc.org)
- Consistent with Frascati criteria for HIV-associated neurocognitive disorders (HAND), neuromedical and neuropsychiatric comorbidity burden was classified as incidental (mild), contributing (moderate), or confounding (severe-exclusionary) to a diagnosis of HAND. (nntc.org)
- Older age amplifies subcortical and white matter tissue injury, especially in PLWH with severe comorbidity burden, warranting increased attention to this population as it ages. (nntc.org)
- Migrants may differ in disease burden compared with local born, due to both genetics, cultural/life style factors and life course factors [ 23 ] and therefore the most relevant comparison group for assessing excessive somatic comorbidity in migrants with diagnosed PTSD, should be migrants originating from the same areas as the trauma-affected migrants. (beds.ac.uk)
- We examined how extra-hepatic comorbidity burden impacts mortality in patients with cirrhosis referred for liver transplantation (LT). (beds.ac.uk)
- Extra-hepatic comorbidity burden significantly impacts short-term mortality in patients with cirrhosis and high MELD-Na. (beds.ac.uk)
- However, the impact of extra-hepatic comorbidity burden on short-term and overall mortality in patients with advanced cirrhosis referred for LT has not been well-studied or quantified. (beds.ac.uk)
- The assessment of overall comorbidity burden, rather than individual comorbid conditions considered by transplant centers, may provide an aggregate measure of risk posed by the burden of extra-hepatic conditions. (beds.ac.uk)
- In this study we measured the extra-hepatic medical comorbidity burden in a cohort of consecutive patients referred for LT using CCI (excluding the contributions of liver disease and HCC). (beds.ac.uk)
- The aims of the study were to determine the impact of extra-hepatic comorbidity burden on 90-day mortality and overall mortality in the study cohort. (beds.ac.uk)
- Only the Maternal Comorbidity Index was derived and validated specifically from a cohort of pregnant and postpartum women, using an administrative dataset, and had an associated c-statistic of 0.675 (95% Confidence Interval 0.647-0.666) in predicting mortality. (biomedcentral.com)
- Figure 1 presents the most common comorbidities in persons with T2D. (drugdevelopment-technology.com)
- Study of the untoward effects associated with the comorbidity of multiple diseases on brain morphology requires identifying differences across multiple diagnostic groupings. (springer.com)
- The term "comorbidity" refers to the coexistence or presence of multiple diseases or disorders in relation to a primary disease or disorder in a patient [ 1 ]. (biomedcentral.com)
- A comorbidity relationship between two diseases exists whenever they appear simultaneously in a patient more than chance alone. (biomedcentral.com)
- We envisage that a software dedicated to comorbidity diagnosis could result in an effective aid to the health practice. (biomedcentral.com)
- Starting from an initial diagnosis, genetic and clinical data of a patient the software identifies the risk of disease comorbidity. (biomedcentral.com)
- The input of this software is the initial diagnosis for a patient and the output provides evidences of disease comorbidity mapping. (biomedcentral.com)
- Figure 1: 7MM, Diagnosed Prevalent Cases of Type 2 Diabetes with Comorbidity, 2016, Men and Women, Ages ≥20 Years. (drugdevelopment-technology.com)
- Multi-label classifiers, on the other hand, can appropriately model disease comorbidity, as each subject can be assigned to two or more labels. (springer.com)
- Furthermore, our method identifies patterns specific to each disease and AUD+HIV comorbidity that shows that the comorbidity is characterized by a compounding effect of AUD and HIV infection. (springer.com)
- Early and repeated assessment of comorbidities, including respiratory disease, should form part of the routine care of RA patients,' say study authors. (creakyjoints.org)
- A comorbidity is an existing disease an individual has in addition to a primary condition of interest, such as cancer. (temple.edu)
- We have developed an R software comoR to compute novel estimators of the disease comorbidity associations. (biomedcentral.com)
- The functions of the comoR offer flexibility for diagnostic applications to predict disease comorbidities, and can be easily integrated to high-throughput and clinical data analysis pipelines. (biomedcentral.com)
- Population-based disease association is also useful in conjunction with molecular and genetic data to discover the molecular origins of disease and disease comorbidity [ 4 ]. (biomedcentral.com)
- To estimate the correlation starting from disease co-occurrence, we need to quantify the strength of the comorbidity risk. (biomedcentral.com)
- Dyslipidemia was the next most common with just over 50% of persons with T2D having this comorbidity, while CKD and obesity were found in 41% and 46% of cases, respectively. (drugdevelopment-technology.com)
- We sought to systematically review comorbidity indices used in health administrative datasets of pregnant women, in order to critically appraise their measurement properties and recommend optimal tools for clinicians and maternal health researchers. (biomedcentral.com)
- OBJECTIVE: The influence of confounding neurocognitive comorbidities in people living with HIV (PLWH) on neuroimaging has not been systematically evaluated. (nntc.org)
- We conducted a systematic search of MEDLINE and EMBASE to identify studies published from 1946 and 1947, respectively, to May 2017 that describe predictive validity of comorbidity indices using health administrative datasets in the field of maternal health research. (biomedcentral.com)