Comorbidity is an important adjustment measure in research focusing on outcomes such as health status and mortality. One recurrent methodological issue concerns the concordance of comorbidity data obtained from different reporting sources. The purpose of these prospectively planned analyses was to examine the concordance of comorbidity data obtained from patient self-report survey interviews and hospital medical record documentation. Comorbidity data were obtained using survey interviews and medical record entries from 525 hospitalized Acute Coronary Syndrome patients. Frequencies and descriptive statistics of individual and composite comorbidity data from both sources were completed. Individual item agreement was evaluated with simple and weighted kappas, Spearman Rho coefficients for composite scores. On average, patients reported more comorbidities during their patient survey interviews (mean = 1.78, SD = 1.99) than providers had documented in medical records (mean = 1.27, SD = 1.43). Higher

TY - JOUR. T1 - Childhood neglect and suicidal behavior. T2 - Findings from the National Comorbidity Survey Replication. AU - Stickley, Andrew. AU - Waldman, Kyle. AU - Ueda, Michiko. AU - Koyanagi, Ai. AU - Sumiyoshi, Tomiki. AU - Narita, Zui. AU - Inoue, Yosuke. AU - DeVylder, Jordan E.. AU - Oh, Hans. PY - 2020/5. Y1 - 2020/5. N2 - Background: Although child neglect is common, there has been comparatively little research on it or its specific forms and their effects on mental health in adulthood. Objective: This study aimed to examine the association between exposure to different forms of childhood neglect and lifetime suicidal behavior among a nationally representative sample of adults in the U.S. general population. Methods: Data were analyzed from 5665 adults that were drawn from the National Comorbidity Survey Replication (NCS-R). Information was obtained on care, supervisory and medical neglect in childhood and lifetime suicidal behavior (ideation, plan, attempt). Lifetime ...

TY - JOUR. T1 - Comparing comorbidity indices to predict post-acute rehabilitation outcomes in older adults. AU - Kumar, Amit. AU - Graham, James E.. AU - Resnik, Linda. AU - Karmarkar, Amol M.. AU - Tan, Alai. AU - Deutsch, Anne. AU - Ottenbacher, Kenneth J.. N1 - Publisher Copyright: © 2016 Wolters Kluwer Health, Inc.. PY - 2016/12/1. Y1 - 2016/12/1. N2 - Objective Compare 5 comorbidity indices to predict community discharge and functional status following post-acute rehabilitation. Design This was a retrospective study of Medicare beneficiaries with stroke, lower-extremity fracture, and joint replacement discharged from inpatient rehabilitation in 2011 (N = 105,275). Community discharge and self-care, mobility, and cognitive function were compared using the Charlson, Elixhauser, Tier, Functional Comorbidity, and Hierarchical Condition Category comorbidity indices. Results Of the patients, 64.4% were female, and 84.6% were non-Hispanic white. Mean age was 79.3 (SD, 7.5) years. Base regression ...

Purpose: The aim of this study is to assess the effect of comorbidities on risk of readmission to an intensive care unit (ICU) and the excess hospital mortality associated with ICU readmissions.. Materials and Methods: A cohort study used clinical data from a 22-bed multidisciplinary ICU in a university hospital and comorbidity data from the Western Australian hospital morbidity database.. Results: From 16 926 consecutive ICU admissions between 1987 and 2002, and 654 (3.9%) of these patients were readmitted to ICU readmissions within the same hospitalization. Patients with readmission were older, more likely to be originally admitted from the operating theatre or hospital ward, had a higher Acute Physiology and Chronic Health Evaluation (APACHE)-predicted mortality, and had more comorbidities when compared with patients without readmission. The number of Charlson comorbidities was significantly associated with late readmission (,72 hours) but not early readmission (≤72 hours) in the ...

1. Global perspectives on mental-physical comorbidity Michael R. Von Korff; Part I. An Epidemiological Map of Mental-Physical Comorbidity: 2. The global burden of chronic physical disease Michael R. Von Korff; 3. The global burden of chronic pain Adley Tsang and Sing Lee; 4. World Mental Health Survey methods for studying mental-physical comorbidity Gemma Vilagut, Kathleen Saunders, and Jordi Alonso; 5. The pattern and nature of mental-physical comorbidity: specific or general Oye Gureje; 6. Age patterns in the prevalence of depressive and anxiety disorders by physical comorbidity status Kate M. Scott; Part II. Risk Factors for Mental-Physical Comorbidity: 7. The development of mental-physical comorbidity Kate M. Scott; 8. Childhood adversity, early-onset mental disorders and adult-onset asthma Kate M. Scott; 9. Childhood adversities, mental disorders and heart disease Huibert Burger; 10. Early childhood adversities and later hypertension Dan Stein, Kate M. Scott, and Michael R. Von Korff; 11. ...

TY - JOUR. T1 - Cumulative traumas and psychosis: an analysis of the National Comorbidity Survey and the British Psychiatric Morbidity Survey. AU - Shevlin, M. AU - Houston, JE. AU - Dorahy, Martin J.. AU - Adamson, Gary. PY - 2008/1. Y1 - 2008/1. N2 - Previous research has shown that traumatic life events are associated with a diagnosis of psychosis. Rather than focus on particular events, this study aimed to estimate the effect of cumulative traumatic experiences on psychosis. The study was based on 2 large community samples (The National Comorbidity Survey [NCS], The British Psychiatric Morbidity Survey [BPMS]). All analyses were conducted using hierarchical binary logistic regression, with psychosis diagnosis as the dependent variable. Background demographic variables were included in the first block, in addition to alcohol/drug dependence and depression. A variable indicating the number of traumas experienced was entered in the second block. Experiencing 2 or more trauma types significantly ...

BACKGROUND: Comorbidities may affect survival and choice of treatment among cancer patients. In fact, comorbidities have been identified as significant determinants of response to therapy in older patients with acute myeloid leukemia, breast cancer, head and neck cancer, and lung cancer. The Charlson comorbidity index and adult comorbidity evaluation-27 are lists of comorbidities with a weight assigned from 1 to 6 for the former and from 0 to 3 for the latter score, derived from relative risk estimates of a proportional hazard regression model using clinical data. DESIGN AND METHODS: We retrospectively evaluated the Charlson index and adult comorbidity evaluation-27 score in a cohort of 125 elderly (, 60 years) patients with chronic phase chronic myeloid leukemia who received dasatinib after showing resistance or intolerance to imatinib with the aim of establishing associations between comorbidities and the development of pleural effusions or compliance with the drug treatment. RESULTS: We found ...

TY - JOUR. T1 - Prevalence of Medical and Psychiatric Comorbidities Following Traumatic Brain Injury. AU - Hammond, Flora M.. AU - Corrigan, John D.. AU - Ketchum, Jessica M.. AU - Malec, James F.. AU - Dams-OConnor, Kristen. AU - Hart, Tessa. AU - Novack, Thomas A.. AU - Bogner, Jennifer. AU - Dahdah, Marie N.. AU - Whiteneck, Gale G.. PY - 2019/7/1. Y1 - 2019/7/1. N2 - Objective: To examine the prevalence of selected medical and psychiatric comorbidities that existed prior to or up to 10 years following traumatic brain injury (TBI) requiring acute rehabilitation. Design: Retrospective cohort. Setting: Six TBI Model Systems (TBIMS) centers. Participants: In total, 404 participants in the TBIMS National Database who experienced TBI 10 years prior. Interventions: Not applicable. Main Outcome Measure: Self-reported medical and psychiatric comorbidities and the onset time of each endorsed comorbidity. Results: At 10 years postinjury, the most common comorbidities developing postinjury, in order, ...

Objectives: little is known about the trends of the cardiovascular comorbidities associated with cardiac arrest in the developing countries and how they affect mortality. This was examined in this study in patients hospitalized alive after out of hospital cardiac arrest in a real-world population in a Middle-Eastern Country.. Methods: Retrospective analysis of prospective registry of all patients hospitalized alive after out of hospital cardiac arrest in Qatar from 1991 through 2010 was made. Rates and trends of cardiac comorbidities and in-hospital mortality were examined.. Results: During the 20-years period 801 patients were hospitalized alive after out of hospital cardiac arrest; 577 men and 224 women. In the latter years of the study there was increase in the prevalence of diabetes mellitus and hypertension when compared to patients hospitalized in the earlier years. Associated ischemic heart disease and heart failure were also trending higher. The study also demonstrated an increasing ...

TY - JOUR. T1 - Psychiatric comorbidities go unrecognized in patients with epilepsy. T2 - You see what you know. AU - Lopez, Maria Raquel. AU - Schachter, Steven C.. AU - Kanner, Andres M.. PY - 2019/9. Y1 - 2019/9. N2 - Patients with epilepsy (PWE) have a significantly higher prevalence of psychiatric comorbid disorders involving depression, anxiety, psychotic, and attention-deficit disorders compared with the general population or patients with other chronic medical conditions. Currently, there is no systematic approach in the evaluation and management of psychiatric comorbidities in these patients. In addition, neurologists are not trained to recognize these disorders, and consequently, they remain undertreated. Despite the high prevalence of psychiatric comorbidities in patients evaluated for epilepsy surgery, most epilepsy centers in North America do not include a psychiatric evaluation as part of the presurgical work-up. Despite the intimate relationship between psychiatric comorbidities ...

Job: Nissenson et al: CURRENT Diagnosis & Treatment: Nephrology and Hypertension back cover copy --0071447873; 9780071447874)[title]CURRENT Diagnosis & Treatment:Nephrology and Hypertension[authors]Edgar V. Lerma, MDJeffrey S. Berns, MDAllen R. Nissenson, MD[Left column]A complete, yet clinically focused guide to managing the full spectrum of kidney diseases and hypertensionIncisive, ready-to-use management protocols and valuable therapeutic guidelines - from authors who are recognized as the fields foremost authoritiesPresented in the consistent, easy-to-follow CURRENT style[Right column][headline]Accessible, concise, and up-to-date CURRENT Diagnosis & Treatment in Nephrology and Hypertension features: One-of-a-kind clinical overview of all major diseases and disorders, from end-stage renal disease to primary and secondary hypertension A practical, learn-as-you-go approach to diagnosing and treating renal disorders and hypertension that combines disease management techniques with the latest ...

The effect of comorbidities on COPD assessment: a pilot study Ulla Møller Weinreich,1–3 Lars Pilegaard Thomsen,2 Barbara Bielaska,4 Vania Helbo Jensen,5,6 Morten Vuust,4 Stephen Edward Rees2 1Department of Respiratory Diseases, Aalborg University Hospital, Aalborg, Denmark; 2Respiratory and Critical Care Group (RCARE), Centre for Model-Based Medical Decision Support Systems, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark; 3The Clinical Institute, Aalborg University Hospital, Aalborg, Denmark; 4Department of Radiology, Vendsyssel Hospital, Hjørring, Denmark; 5Department of Radiology, Horsens Regional Hospital, Horsens, Denmark; 6Department of Radiology, Aalborg University Hospital, Aalborg, Denmark Introduction: Patients with chronic obstructive pulmonary disease (COPD) frequently suffer from comorbidities. COPD severity may be evaluated by the Global initiative for chronic ­Obstructive Lung Disease (GOLD) combined risk assessment score

Erratum: The relative effect of Alzheimers disease and related dementias, disability, and comorbidities on cost of care for elderly persons (Journals of Gerontology - Series B Psychological Sciences and Social (September 2001) 56B (S285-S293))

Background: Few emergency department (ED) studies have examined how psychiatric comorbidity relates to hospitalisation decisions.. Methods: We assessed the relationship of psychiatric comorbidity to hospitalisation decisions among ED patients in the 2004 National Hospital Ambulatory Medical Care Survey.. Results: Patients with psychiatric comorbidity were five times more likely to be hospitalised than patients with a single psychiatric diagnosis. The most frequent psychiatric comorbidities involved substance use disorders (SUDs).. Conclusions: Psychiatric disorders are underdiagnosed among ED patients. We believe that this underdiagnosis may be partly responsible for the high hospitalisation rates of ED patients with SUDs. ...

The National Comorbidity Survey: Baseline (NCS-1) was a collaborative epidemiologic investigation designed to study the prevalence and correlates of DSM III-R disorders and patterns and correlates of service utilization for these disorders. The NCS-1 was the first survey to administer a structured psychiatric interview to a nationally representative sample. The survey was carried out in the early 1990s with a household sample of over 8,000 respondents. Subsamples of the original respondents completed the NCS-1 Part II survey and Tobacco Use Supplement. Diagnoses were based on a modified version of the Composite International Diagnostic Interview (the UM-CIDI), which was developed at the University of Michigan for the NCS-1. Drugs covered by this survey include alcohol, tobacco, sedatives, stimulants, tranquilizers, analgesics, inhalants, marijuana/hashish, cocaine, hallucinogens, heroin, nonmedical use of prescription drugs, and polysubstance use. Other items include demographic characteristics,

Age and comorbidity burden are associated with higher rates of postsurgical mortality and longer lengths of in-hospital stay after atlantoaxial fusion, according to findings from a large retrospective study.

Results: A total of 400 isolates were obtained (93%E. coli and 7%Klebsiella spp). In 2009, 6% of cultures were ESBL-producing E. coliand 7% in 2010. 37% of patients were men and 81% were aged ≥ 60 years. CI was 2.3 ± 1.8 (high comorbidity: 42.8%). 41.5% of strains were susceptible to amoxicillin-clavulanate, 85.8% to fosfomycin and 15.5% to ciprofloxacin. The total number of ESBL E. coli positive urine cultures during hospital admission was 97 and, compared with 103 controls, risk factors for UTI caused by ESBL- E. coli strains in hospitalised patients were nursing home residence (p , 0.001), diabetes (p = 0.032), recurrent UTI (p = 0.032) and high comorbidity (p = 0.002). In addition, these infections were associated with more symptoms (p , 0.001) and longer admission (p = 0.004).. ...

These newly published data includes patient populations that are sometimes excluded from clinical trials, including those with psychiatric comorbidities, specific comorbidities of intellectual disability, or depression.1,11 Adverse events reported during this sub-cut of the Euro-Esli study are consistent with eslicarbazepine acetates safety profile established in Phase III studies.1-5 Adverse events with eslicarbazepine acetate treatment were reported by 43.1% of people with psychiatric comorbidities (n=122/283) and 45.8% of people with intellectual disability (n=49/107). The most common adverse events were dizziness (11.4%; n=31/272), somnolence (8.8%; n=24/272) and fatigue (8.1%; n=22/272) for people with psychiatric comorbidities; and somnolence (10.1%; n=10/99), dizziness (7.1%; n=7/99) and fatigue (6.1%; n=6/99) for people with intellectual disability.1 ...

Kessler RC, Zhao S, Blazer DG, Swartz M. Prevalence, correlates, and course of minor depression and major depression in the National Comorbidity Survey. J Affect Disord. 1997 Aug; 45(1-2):19-30 ...

The Charlson comorbidity index is often used to control for confounding in research based on medical databases. There are few studies of the accuracy of the codes obtained from these databases. We examined the positive predictive value (PPV) of the ICD-10 diagnostic coding in the Danish National Registry of Patients (NRP) for the 19 Charlson conditions. Among all hospitalizations in Northern Denmark between 1 January 1998 and 31 December 2007 with a first-listed diagnosis of a Charlson condition in the NRP, we selected 50 hospital contacts for each condition. We reviewed discharge summaries and medical records to verify the NRP diagnoses, and computed the PPV as the proportion of confirmed diagnoses. A total of 950 records were reviewed. The overall PPV for the 19 Charlson conditions was 98.0% (95% CI; 96.9, 98.8). The PPVs ranged from 82.0% (95% CI; 68.6%, 91.4%) for diabetes with diabetic complications to 100% (one-sided 97.5% CI; 92.9%, 100%) for congestive heart failure, peripheral vascular disease,

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Information on comorbid conditions is essential in routine clinical practice and also for research purposes. We have designed a simple, self-report questionnaire to obtain comorbidity data in patients with advanced kidney failure, receiving treatment by dialysis. The questionnaire-derived comorbidity score - the CSCS - was significantly predictive of short-term survival in this patient group and may have clinical utility.. We found almost perfect or substantial levels of agreement between the prevalence of self-reported diabetes, heart disease and cancer and the prevalence of these conditions derived from the detailed examination of the patients medical records. The level of agreement for liver disease was moderate. For arthritis, lung disease, cerebrovascular disease and depression the levels of agreement were only fair. Whilst lung disease and cerebrovascular disease were under-reported by patients, arthritis and depression were reported more frequently compared to the medical records. There ...

Context The increasing number of people living with multiple chronic conditions in addition to an index condition has become an international healthcare priority. Health education curricula have been developed alongside single condition frameworks in health service policy and practice and need redesigning to incorporate optimal management of multiple conditions. Aim Our aims were to evaluate current teaching and learning about comorbidity care amongst the global population of healthcare students from different disciplines and to develop an International Comorbidity Education Framework (ICEF) for incorporating comorbidity concepts into health education. Methods We surveyed nursing, medical and pharmacy students from England, India, Italy and Sweden to evaluate their understanding of comorbidity care. A list of core comorbidity content was constructed by an international group of higher education academics and clinicians from the same disciplines, by searching current curricula and analysing ...

These data show that both functional outcome at the time of hospital discharge and 1-year mortality rates are associated independently with the number and severity of patients comorbid diseases as reflected in a modified version of the Charlson Index. This analysis specifically extends the usefulness of the Charlson Index as a measure of comorbidity for studies focused on acute ischemic stroke.. There are a variety of parameters that may reflect the validity of a scale. Content validity indicates how well a scale includes domains thought to be relevant to a condition. Convergent validity is demonstrated when scales or items that are thought to measure the same construct have high correlation coefficients. Divergent validity is demonstrated when items or scales thought to measure different constructs have low correlation coefficients. In this case, there is no gold standard measure of aggregate comorbidity for comparison, so these types of validity cannot be assessed. The present study does ...

The Charlson Comorbidity Index (CCI) can be automatically calculated from the International Classification of Disease (ICD) code. However, the feasibility of this transformation has not been acknowledged, particularly in hospitals without a qualified ICD coding system. Here, we investigated the utility of coding-based CCI in China. A multi-center, population-based, retrospective observational study was conducted, using a dataset incorporating 2,464,395 adult subjects from 15 hospitals. CCI was calculated using both ICD-10-based and diagnosis-based method, according to the transformation rule reported previously and to the literal description from discharge diagnosis, respectively. A κ coefficient of variation was used as a measure of agreement between the above two methods for each hospital. The discriminative abilities of the two methods were compared using the receiver-of-operating characteristic curve (ROC) for prediction of in-hospital mortality. Total agreement between the ICD-based and diagnosis

Comorbidity is the rule, not the exception, in bipolar disorder. The most common mental disorders that co-occur with bipolar disorder in community studies include anxiety, substance use, and conduct disorders. Disorders of eating, sexual behavior, attention-deficit/hyperactivity, and impulse control, as well as autism spectrum disorders and Tourettes disorder, co-occur with bipolar disorder in clinical samples. The most common general medical comorbidities are migraine, thyroid illness, obesity, type II diabetes, and cardiovascular disease. Bipolarity is a marker for comorbidity, and comorbid disorders, especially multiple conditions occurring when a patient is young, may be a marker for bipolarity. Relatively few controlled clinical studies have examined the treatment of bipolar disorder in the context of comorbid conditions (i.e., complicated or comorbid bipolar disorder). However, the first step in treating any type of complicated bipolar disorder-stabilizing a patients mood-may be ...

Many breast cancer survivors have coexistent chronic diseases or comorbidities at the time of their cancer diagnosis. The purpose of the study was to evaluate the association of comorbidities on breast cancer survivors quality of life. A prospective design was used to recruit 140 women before cancer surgery, 134 women completed the study. Comorbidities were assessed using self-report and verified by medical record review and the Charlson Comorbidity Index (CCI) before and 12-month after cancer surgery. Quality of life was evaluated using Short-Form Health Survey (SF-36 v2). Descriptive statistics, chi-square tests, t-tests, Fishers exact test, and correlations were performed for data analysis. A total of 28 comorbidities were identified. Among the 134 patients, 73.8% had at least one of the comorbidities, 54.7% had 2-4, and only 7.4% had 5-8. Comorbidities did not change at 12 months after surgery. Numbers of comorbidities by patients self-report and weighted categorization of comorbidities by CCI

How do comorbid psychiatric disorders affect the treatment of OCD? Learn about adjustments in psychotherapy and pharmacotherapy to optimize treatment for your patients with OCD and comorbid depression, bipolar disorder, schizophrenia, or eating disorders.

Our study showed that comorbidities, such as heart failure, diabetes, renal disease or metastatic tumours had a major impact on outcomes in patients hospitalised with ACS and confirmed previous studies that chronic comorbidities are frequently encountered in patients admitted for ACS in daily clinical practice.. The baseline characteristics of the ACS patients differed significantly between the CCI groups and in particular between those with no comorbidities (CCI0) and those patients with CCI1-CCI≥3, as clearly demonstrated by the risk factors hypertension, dyslipidemia and obesity. However, the proportion of current smokers was highest in the CCI0 group but steadily decreased the higher the weighted CCI. The higher the CCI, the longer the delay between symptom onset and admission, symptoms were less typical, there was a higher degree of haemodynamic instability (higher Killip class) and more frequent NSTEMI/UA compared with the patients with lower rates of comorbidities. ACS patients with ...

TY - THES. T1 - The long-term impact of rheumatoid arthritis and comorbidity on functioning and mortality. AU - van den Hoek, Joëlle. PY - 2017/12/15. Y1 - 2017/12/15. M3 - Research external, graduation external. ER - ...

Objectives Comorbid conditions in colorectal cancer patients can influence both clinical eligibility for treatment and survival. We aimed to evaluate the effect of comorbidity on 1 year survival from colorectal cancer, and to assess whether this effect varied with the timing of the comorbidity in relation to the cancer diagnosis.. Study design and setting A population based cohort of 29 563 colorectal cancer patients diagnosed between 1997 and 2004 in the North West of England was evaluated. The excess hazard of death up to 1 year after diagnosis was estimated using deprivation and region specific life tables to adjust for background mortality. Results were adjusted for age and stage at diagnosis.. Results Comorbid conditions diagnosed during the period 18 to 6 months before the diagnosis of colorectal cancer were strongly associated with lower survival at 1 year. Stage and age remained the strongest predictors of cancer related mortality even after adjustment for comorbidity.. Conclusions ...

Methods: We conducted a nationwide population-based cohort study. Using the Danish National Registry of Patients, covering all Danish hospitals, we identified all 219,354 patients with a first-time hospitalization for stroke during 1994-2011. We computed standardized 30-day, 1-year, and 5-year mortality by sex. Comorbidity categories were defined by Charlson Comorbidity Index scores of 0 (none), 1 (moderate), 2 (severe), and 3 or more (very severe). Calendar periods of diagnosis (1994-1998, 1999-2003, 2004-2008, and 2009-2011) and comorbidity categories were compared by means of mortality rate ratios based on Cox regression. Read More. ...

We discuss comorbidity, continuity, and discontinuity of anxiety-related disorders from the perspective of a two-dimensional neuropsychology of fear (threat avoidance) and anxiety (threat approach). Pharmacological dissection of the neurotic disorders justifies both a categorical division between fear and anxiety and a subdivision of each mapped to a hierarchy of neural modules that process different immediacies of threat. It is critical that each module can generate normal responses, symptoms of another syndrome, or syndromal responses. We discuss the resultant possibilities for comorbid dysfunction of these modules both with each other and with some disorders not usually classified as anxiety related. The simplest case is symptomatic fear/anxiety comorbidity, where dysfunction in one module results in excess activity in a second, otherwise normal, module to generate symptoms and apparent comorbidity. More complex is syndromal fear/anxiety comorbidity, where more than one module is ...

TY - JOUR. T1 - Symptom profiles in children with ADHD. T2 - Effects of comorbidity and gender. AU - Newcorn, Jeffrey H.. AU - Halperin, Jeffrey M.. AU - Jensen, Peter S.. AU - Abikoff, Howard B.. AU - Arnold, L. Eugene. AU - Cantwell, Dennis P.. AU - Conners, C. Keith. AU - Elliott, Glen R.. AU - Epstein, Jeffrey N.. AU - Greenhill, Laurence L.. AU - Hechtman, Lily. AU - Hinshaw, Stephen P.. AU - Hoza, Betsy. AU - Kraemer, Helena C.. AU - Pelham, William E.. AU - Severe, Joanne B.. AU - Swanson, James M.. AU - Wells, Karen C.. AU - Wigal, Timothy. AU - Vitiello, Benedetto. PY - 2001/1/1. Y1 - 2001/1/1. N2 - Objective: To examine ratings and objective measures of attention-deficit/hyperactivity disorder (ADHD) symptoms to assess whether ADHD children with add without comorbid conditions have equally high levels of core symptoms and whether symptom profiles differ as a function of comorbidity and gender. Method: Four hundred ninety-eight children from the NIMH Collaborative Multisite Multimodal ...

Comorbidity is an area of increasing interest in MS and evidence has suggested comorbidity is associated with diagnostic delays, misinterpretation of relapses, disability progression, health-related quality of life, and progression of lesion burden on magnetic resonance imaging (MRI). In chronic diseases, it has been shown that comorbidities can affect multiple aspects of treatment.. The aim of this resource guide is to help clinicians recognize and differentiate comorbidities from MS symptoms, understand the impact of comorbidities on individuals, make decisions about treatment in the setting of comorbidities, and manage comorbidities in collaboration with other health care professionals. The general prevalence and impact of comorbidities in MS will be reviewed, with the greatest focus on psychiatric, vascular/metabolic, and autoimmune comorbidities. Conditions defined as comorbidities in this document are those that are chronic in nature and that originate by a mechanism that is distinct from ...

Resumo: O Transplante de Células Tronco Hematopoiéticas (TCTH) Alogênico representa uma possibilidade de cura para pacientes portadores de doenças hematológicas malignas e benignas. Porém, como qualquer modalidade de tratamento, apresenta efeitos adversos que podem ser graves, inclusive causando a morte. Com o intuito de se avaliar a influência que as comorbidades teriam na mortalidade não relacionada à recidiva (MNRR), foi criada uma ferramenta, o Índice de Comorbidade específico do Transplante de Células Tronco Hematopoiéticas (Hematopoietic Cell Transplant Specific Comorbidity Index - HCT-CI). Nossos objetivos, portanto, foram validar o HCT-CI na população de pacientes submetidos a TCTH Alogênico em nossa instituição, no período de 1993 a 2010, e avaliar outros fatores de riscos envolvidos na MNRR e na Sobrevida Global (SG). Os prontuários de 457 pacientes foram revistos e as informações referentes às comorbidades contidas no HCT-CI foram registradas. A maioria dos ...

Results Mean aPWV was 10.3 (SD 2.6) m/s, AIx 27 (10)%, brachial BP 144/82 (18/11) mmHg, central BP 131/82 (18/11) mmHg, CIMT 0.86 (0.4) mm.. BODE correlated with aPWV (p , 0.0001) and this was maintained when adjusted for study site, age, supine heart rate (HR) mean arterial pressure (MAP), years smoked and cardiovascular comorbidities (MI, stroke, diabetes, peripheral vascular disease), p , 0.0001. BODE was also associated with AIx when adjusted for site, age, seated HR and MAP, years smoked and cardiovascular comorbidities, p , 0.01. The constituent variables of BODE did not have the same significant association with both aPWV and AIx, Table 1. ...

The World Health Organization defines health as a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.1 In the past, measures of success in treating medical illness have been thought of in terms of freedom of disease or identifiable quantifiable endpoints, such as serum glucose, systolic blood pressure, or seizures.2 However, recently, there has been an emergence of interest in measuring health-related quality of life (HRQOL), a valid and significant indicator of health in patients with disease. This idea has been studied over the past decade and applied to develop reliable and valid measures of function and well-being for use in patients with epilepsy.3 This concept especially pertains to chronic epilepsy, where though many treating clinicians focus on treating the ictal phenomenon of the disease, namely seizures, the disease itself carries a multitude of clinically relevant interictal comorbidities that affects patients overall HRQOL. ...

Background & Objective: Type 2 diabetes is a complex disease characterized by multiple comorbidities. Depression is one of the most common comorbidities in individuals with diabetes with prevalence rates reaching 30%. Depression complicates diabetes treatment, portends worse outcomes and increases health care costs. One novel approach to managing diabetes with co-morbid depression is a collaborative primary care model involving a multidisciplinary health care team guiding patient-centered care. This model has been tested in the US and showed a significant reduction of depressive symptoms, improved diabetes care and patient-reported outcomes, and saved money. Our aim is to evaluate the implementation of this collaborative care model for type 2 diabetes and comorbid depression within the non-metro Primary Care Network (PCN) setting in Canada.. Intervention: The intervention involves three phases: (1) improving depressive symptoms, (2) improving blood sugar, blood pressure and cholesterol, and (3) ...

Introduction: The impact of comorbidity on overall survival among older women diagnosed with breast cancer has been studied extensively. However, less is known about its impact on overall survival among women diagnosed with breast cancer before age 65 years.. Methods: We followed 4516 (1605 black, 2911 white) women ages 35 to 64 years when diagnosed with incident invasive breast cancer between 1994 and 1998. The pre-diagnosis history of 11 comorbid conditions and whether they had been treated were collected shortly after breast cancer diagnosis. Multivariate Cox regression models were used to examine the impact of these comorbidities on overall survival.. Results: During a median of 8.2 years follow-up, 1052 (524 black, 528 white) women died. The prevalence of comorbidities diagnosed before breast cancer was higher among black women than among white women (61.3% vs. 44.7%). Compared to women without any comorbidities, women were at increased risk of death if they had any treated comorbidity ...

Results 120 patients (53% male, 47% female; age 73 ± 10 years) were included. The stop-go screening tool identified 7 ± 2 co-morbidities per patient requiring no action and 5 ± 2 co-morbidities (could be present, 2 ± 1; unable to assess 3 ± 3) where further action was required. Information from patient records was generally insufficient to screen for anxiety and depression and lacking for around one quarter of patients for atrial fibrillation, diabetes mellitus and cognitive impairment.. During 1 year follow-up, patients developed 0.6 ± 0.9 (range 0-3) new diagnoses from the co-morbidities list. The stop-go tool was most effective at predicting ad hoc diagnosis of hypertension, heart failure and osteoporosis (table) and less effective at predicting atrial fibrillation and ischaemic heart disease. ...

The lifetime prevalence of DSM-III-R alcohol abuse and alcohol dependence and associated patterns of psychiatric comorbidity in the Ontario population aged 15-64 years are estimated from a survey ofa representative household sample using the University of Michigan Composite International Diagnostic Interview UM-CIDI. More than half 55% of all...

Coronavirus disease 2019 (COVID-19) is an infectious disease characterized by cough, fever, and fatigue and 20% of cases will develop into severe conditions resulting from acute lung injury with the manifestation of the acute respiratory distress syndrome (ARDS) that accounts for more than 50% of mortality. Currently, it has been reported that some comorbidities are linked with an increased rate of severity and mortality among COVID-19 patients. To assess the role of comorbidity in COVID-19 progression, we performed a systematic review with a meta-analysis on the relationship of COVID-19 severity with 8 different underlying diseases. PubMed, Web of Science, and CNKI were searched for articles investigating the prevalence of comorbidities in severe and non-severe COVID-19 patients. A total of 41 studies comprising 12,526 patients were included. Prevalence of some commodities was lower than that in general population such as hypertension (19% vs 23.2%), diabetes (9% vs 10.9%), chronic kidney disease (CKD)

Background: Atrial fibrillation (AF) is more frequent in elderly pts and those with underlying cardiac and other comorbidities. The multicenter ENGAGE AF-TIMI 48 trial compared efficacy and safety of edoxaban vs warfarin in 21105 pts with AF over a mean follow up of 2.8 yrs. We hypothesized that despite more adverse events in pts with mod-high comorbidity, the benefits of edoxaban over warfarin would be similar to that seen in pts with less comorbidity.. Methods: Pts were classified using the Charlson Comorbidity Index (CCI) as low comorbidity (CCI ,4, n=15860 pts) or mod-high comorbidity (CCI ≥4, n=5245 pts). Outcomes included study drug discontinuation, serious (non-bleeding) adverse events (SAEs), hepatic events, new neoplasms, and all cause death.. Results: Pts with CCI ,4 were more likely male, with higher BMI, enrolled in NA, and received fewer cardiac co-medications. They had higher CHA2DS2VASc (mean 5.2 vs 4.0) and HASBLED (2.7 vs 2.4) scores, and higher median TTR with warfarin (69 vs ...

BY: Leigh Brosof DATE: 4 August 2017 Comorbidity is when two or more psychiatric disorders co-occur (or happen together) in the same individual, either at the same time or at different times (lifetime comorbidity).1 In individuals with eating disorders, comorbidity is common: with up to 97% of individuals with eating disorders also having another psychiatric…

Figure 2 Correlation structure of the reported coexisting medical conditions (as indicated by PheCodes) associated with higher MS severity scores. As shown in a heat map (A) and in a hierarchical clustering (B) format. The color saturation and the circle size in the heatmap both indicate the strength of (positive or negative) correlation between 2 medical conditions. Reporting criteria were defined as meeting the Bonferroni threshold of statistical significance and having the same direction of effect in both the discovery cohort and the extension cohort. Strength of association −log(p value) from the extension cohort is shown. Refer to table 2 for explanation of each phenotype code (PheCode). ...

Gron KL., Ornbjerg LM., Hetland ML., Aslam F., Khan N., Jacobs JWG., Henrohn D., Rasker H., Kauppi M., Lang HC., Mota L., Aggarwal A., Hisashi Y., Badsha H., Gossec L., Cutolo M., Ferraccioli G., Lee EB., Direskeneli H., Taylor PC., Huisman M., Alten R., Pohl C., Oyoo O., Stropuviene S., Drosos AA., Kerzberg E., Ancuta C., Mofti A., Bergman M., Detert J., Selim ZI., Abda EA., Rexhepi B., Sokka T ...

Assessment of Correlations among Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL) and Cumulative Illness Rating Index (CI) Scores in the Elderly Patients with Femur Fractures: A Prospective Study

Hypertension and bronchial asthma are a major issue for peoples health. As of 2014, approximately one billion adults, or ~ 22% of the world population, have had hypertension. As of 2011, 235-330 million people globally have been affected by asthma and approximately 250,000-345,000 people have died each year from the disease. The development of the effective treatment therapies against these diseases is complicated by their comorbidity features. This is often a major problem in diagnosis and their treatment. Hence, in this study the bioinformatical methodology for the analysis of the comorbidity of these two diseases have been developed. As such, the search for candidate genes related to the comorbid conditions of asthma and hypertension can help in elucidating the molecular mechanisms underlying the comorbid condition of these two diseases, and can also be useful for genotyping and identifying new drug targets. Using ANDSystem, the reconstruction and analysis of gene networks associated with asthma and

This survey identified key areas of improvement in terms of knowledge and development of specific skills for epileptologists regarding management of the psychiatric comorbidities of epilepsy. For the first time, psychiatrists were involved in the process and it was possible to identify specific needs for adult and child neurologists treating patients with epilepsy.. Epileptologists are keen to improve their clinical skills and screening during routine clinical practice seems to be the priority. Most adult neurologists feel inadequate or not skilled enough when dealing with patients with epilepsy and ASD, ADHD, or IDs in general. Child neurologists are historically better trained in these conditions and thus, usually more adept in their management. A prospective community-based study of children and adolescents with active epilepsy showed that up to 40% of patients have IDs, one third have ADHD, and around 20% have ASD (Reilly et al., 2014). In addition, a community-based survey of more than ...