Journal articles on the topic 'Comorbid condition'
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Roth, Thomas. "Challenges in the comorbid condition." Sleep Medicine 8 (December 2007): S1—S2. http://dx.doi.org/10.1016/s1389-9457(08)70001-7.
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Wright, Anne J. "Nocturnal enuresis: a comorbid condition." Jornal de Pediatria 96, no. 3 (May 2020): 276–78. http://dx.doi.org/10.1016/j.jped.2019.04.002.
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Wright, Anne J. "Nocturnal enuresis: a comorbid condition." Jornal de Pediatria (Versão em Português) 96, no. 3 (May 2020): 276–78. http://dx.doi.org/10.1016/j.jpedp.2019.05.016.
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Roth, Thomas. "Conclusion: Challenges in the comorbid condition." Sleep Medicine 8 (December 2007): S35. http://dx.doi.org/10.1016/s1389-9457(08)70007-8.
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Baweja, Raman, and Debra Byler. "Tourette’s Syndrome and Comorbid Neurological Condition." Current Developmental Disorders Reports 4, no. 3 (June 9, 2017): 61–63. http://dx.doi.org/10.1007/s40474-017-0113-2.
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KALOGIROU, D., G. ANTONIOU, P. KARAKITSOS, O. KALOGIROU, D. ANTONIOU, and G. PROESTAKIS. "Radical Hysterectomy: Is Obesity a Comorbid Condition?" Journal of Gynecologic Surgery 13, no. 1 (January 1997): 7–12. http://dx.doi.org/10.1089/gyn.1997.13.7.
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Vinodhini, Palaniappan, Syeda Aisha, and Chambayil Susheel Swathi. "Central Auditory Processing Disorder: A Comorbid Condition." Otolaryngology – Open Journal SE, no. 1 (April 18, 2019): S5—S9. http://dx.doi.org/10.17140/otloj-se-1-102.
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Swenor, B., B. Munoz, and S. West. "IS VISUAL IMPAIRMENT JUST ANOTHER COMORBID CONDITION?" Innovation in Aging 1, suppl_1 (June 30, 2017): 180. http://dx.doi.org/10.1093/geroni/igx004.693.
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Nair, Uma S., Melanie L. Bell, Nicole P. Yuan, Betsy C. Wertheim, and Cynthia A. Thomson. "Associations Between Comorbid Health Conditions and Quit Outcomes Among Smokers Enrolled in a State Quitline, Arizona, 2011-2016." Public Health Reports 133, no. 2 (March 2018): 200–206. http://dx.doi.org/10.1177/0033354918764903.
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Objective: Smokers with comorbid health conditions have a disproportionate burden of tobacco-related death and disease. A better understanding of differences in quit rates among smokers with comorbid health conditions can guide tailoring of quitline services for subgroups. The objective of this study was to examine self-reported tobacco cessation rates among Arizona Smokers’ Helpline callers with chronic health conditions (CHCs) and/or a mental health condition (MHC). Methods: We analyzed data from quitline telephone callers (n = 39 779) who enrolled in and completed at least 1 behavioral counseling session (ie, coaching call). We categorized callers as CHC only (cardiovascular disease/respiratory-related/cancer; 32%), MHC only (eg, mood/anxiety/substance dependence; 13%), CHC + MHC (25%), or no comorbid condition (30%). We assessed 30-day abstinence at 7-month follow-up for 16 683 clients (41.9%). We used logistic regression analysis to test associations between comorbidity and quit outcomes after controlling for relevant variables (eg, nicotine dependence). Results: Overall quit rates were 45.4% for those with no comorbid condition, 43.3% for those with a CHC only, 37.0% for those with an MHC only, and 33.3% for those with CHC + MHC. Compared with other groups, the CHC + MHC group had the lowest odds of quitting (adjusted odds ratio = 0.60; 95% confidence interval, 0.52-0.69). Conclusion: Having a comorbid condition was associated with lower quit rates, and smokers with co-occurring CHCs and MHCs had the lowest quit rates. Quitlines should evaluate more intensive, evidence-driven, tailored services for smoking cessation among callers with comorbid conditions.
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Ahmad Liaquat, Rabia Naseer, Tahmasub Faraz Tayyab, Muhammad Rashid, Komal Qudsia Sattar, and Javeria Usman. "Frequency of medical comorbidities in patients attending ORM & Maxillofacial Surgery Department at University College of Dentitistry, University of Lahore." Professional Medical Journal 29, no. 03 (February 28, 2022): 377–81. http://dx.doi.org/10.29309/tpmj/2022.29.03.6621.
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Objectives: To find the frequency and type of comorbid conditions in patients presenting with oral diseases. Study Design: Observational study. Setting: Department of Oral and Maxillofacial Surgery, University College of Dentistry, University of Lahore. Period: January 2018 to December 2019. Material & Methods: After approval from the ethical committee, all cases presenting with oral diseases to the oral and maxillofacial surgery department were recruited consecutively. A thorough history and relevant examinations were made. All the previous records of the patient, including laboratory tests and the medical summary, were reviewed for the existence of any comorbid conditions. The data was entered on the spreadsheet. Descriptive statistics were used. Frequencies and percentages were calculated for comorbid conditions. Results: This study included 17155 patients who visited the oral and maxillofacial surgery department for procedures related to oral surgery. Others patients presenting to other departments of dentistry were excluded. Out of these, 4056 patients (24%) had comorbid conditions. Among these patients, 77% had single comorbid condition and 23% had multiple systemic disease. The most common comorbid condition was hypertension (77%), followed by diabetes (33%) and hepatitis (11%). Conclusion: A high prevalence of comorbidities was found in our study. Hypertension, diabetes mellitus, and hepatitis C were the common comorbidities. In addition, a significant number of patients had multiple comorbidities.
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Podmore, Bélène, Andrew Hutchings, Jan van der Meulen, Ajay Aggarwal, and Sujith Konan. "Impact of comorbid conditions on outcomes of hip and knee replacement surgery: a systematic review and meta-analysis." BMJ Open 8, no. 7 (July 2018): e021784. http://dx.doi.org/10.1136/bmjopen-2018-021784.
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ObjectiveTo systematically perform a meta-analysis of the association between different comorbid conditions on safety (short-term outcomes) and effectiveness (long-term outcomes) in patients undergoing hip and knee replacement surgery.DesignSystematic review and meta-analysis.MethodsMedline, Embase and CINAHL Plus were searched up to May 2017. We included all studies that reported data to allow the calculation of a pooled OR for the impact of 11 comorbid conditions on 10 outcomes (including surgical complications, readmissions, mortality, function, health-related quality of life, pain and revision surgery). The quality of included studies was assessed using a modified Newcastle-Ottawa Scale. Continuous outcomes were converted to ORs using the Hasselblad and Hedges approach. Results were combined using a random-effects meta-analysis.OutcomesThe primary outcome was the adjusted OR for the impact of each 11 comorbid condition on each of the 10 outcomes compared with patients without the comorbid condition. Where the adjusted OR was not available the secondary outcome was the crude OR.Results70 studies were included with 16 (23%) reporting on at least 100 000 patients and 9 (13%) were of high quality. We found that comorbidities increased the short-term risk of hospital readmissions (8 of 11 conditions) and mortality (8 of 11 conditions). The impact on surgical complications was inconsistent across comorbid conditions. In the long term, comorbid conditions increased the risk of revision surgery (6 of 11 conditions) and long-term mortality (7 of 11 conditions). The long-term impact on function, quality of life and pain varied across comorbid conditions.ConclusionsThis systematic review shows that comorbidities predominantly have an impact on the safety of hip and knee replacement surgery but little impact on its effectiveness. There is a need for high-quality studies also considering the severity of comorbid conditions.
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Harris, Anthony D., Lisa Pineles, Deverick Anderson, Keith F. Woeltje, William E. Trick, Keith S. Kaye, Deborah S. Yokoe, Ann-Christine Nyquist, David P. Calfee, and Surbhi Leekha. "Which Comorbid Conditions Should We Be Analyzing as Risk Factors for Healthcare-Associated Infections?" Infection Control & Hospital Epidemiology 38, no. 4 (December 29, 2016): 449–54. http://dx.doi.org/10.1017/ice.2016.314.
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OBJECTIVETo determine which comorbid conditions are considered causally related to central-line associated bloodstream infection (CLABSI) and surgical-site infection (SSI) based on expert consensus.DESIGNUsing the Delphi method, we administered an iterative, 2-round survey to 9 infectious disease and infection control experts from the United States.METHODSBased on our selection of components from the Charlson and Elixhauser comorbidity indices, 35 different comorbid conditions were rated from 1 (not at all related) to 5 (strongly related) by each expert separately for CLABSI and SSI, based on perceived relatedness to the outcome. To assign expert consensus on causal relatedness for each comorbid condition, all 3 of the following criteria had to be met at the end of the second round: (1) a majority (>50%) of experts rating the condition at 3 (somewhat related) or higher, (2) interquartile range (IQR)≤1, and (3) standard deviation (SD)≤1.RESULTSFrom round 1 to round 2, the IQR and SD, respectively, decreased for ratings of 21 of 35 (60%) and 33 of 35 (94%) comorbid conditions for CLABSI, and for 17 of 35 (49%) and 32 of 35 (91%) comorbid conditions for SSI, suggesting improvement in consensus among this group of experts. At the end of round 2, 13 of 35 (37%) and 17 of 35 (49%) comorbid conditions were perceived as causally related to CLABSI and SSI, respectively.CONCLUSIONSOur results have produced a list of comorbid conditions that should be analyzed as risk factors for and further explored for risk adjustment of CLABSI and SSI.Infect Control Hosp Epidemiol 2017;38:449–454
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Abbate, S. L. "Hypertension in Diabetes: Controlling a Critical Comorbid Condition." Diabetes Spectrum 19, no. 1 (January 1, 2006): 17. http://dx.doi.org/10.2337/diaspect.19.1.17.
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Durrani, Sandy R., Vincent A. Mukkada, and Theresa W. Guilbert. "Eosinophilic Esophagitis: an Important Comorbid Condition of Asthma?" Clinical Reviews in Allergy & Immunology 55, no. 1 (February 18, 2018): 56–64. http://dx.doi.org/10.1007/s12016-018-8670-7.
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Boyko, V. V., K. Y. Parkhomenko, V. V. Nikonov, O. E. Feskov, and O. E. Gavrikov. "Comorbid pathology in herniology." EMERGENCY MEDICINE 17, no. 1 (April 14, 2021): 14–20. http://dx.doi.org/10.22141/2224-0586.17.1.2021.225709.
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In recent decades, there has been an aging population worldwide with an increasing proportion of the elderly and senile, leading to a significant increase in the prevalence of a variety of pathologies, especially cardiovascular disease, overweight and obesity, diabetes, neoplastic and dysplastic diseases, and diseases that require surgical treatment. The negative impact on health significantly increases in the presence of several diseases, which creates qualitatively new conditions that cannot be explained by the mechanical sum of the impact of individual diseases. The presence of concomitant pathology in surgical diseases, or comorbidity, adversely affects the general condition of the patient, the course of the underlying and concomitant pathology, and from a surgical point of view also the response to surgical aggression, postoperative period, and further rehabilitation of patients. This indicates the need for an individual approach to the organization of the patient’s examination and planning further treatment, which in most cases cannot be standardized. Age factors, overweight, and obesity, chronic obstructive pulmonary disease, chronic heart failure, coronary heart disease are considered the risk factors and predictors of mortality and complications after surgery. Comprehensive assessment of comorbidity and functional status allows optimizing patient care. The Charlson Comorbidity Index is most often used for this purpose. But the attempts to further increase the informativeness of comorbidity scales do not stop and new ones appear, which are used mainly for the administrative evaluation of treatment results. In the context of herniology, a very interesting pathological condition is connective tissue dysplasia, which is characterized by multiorgan and multisystem lesions with extremely diverse clinical manifestations. Connective tissue pathology is associated with many other surgical diseases. These are varicose veins, biliary dyskinesia with the development of gallstones, duodenogastric and gastroesophageal reflux, peptic ulcer of the stomach and duodenum, diverticula of the digestive tract, adhesive disease of the abdominal cavity. Thus, patients with hernias, especially the elderly and senile, have a fairly high incidence of comorbid pathology, which has a significant impact on the incidence of postoperative complications and mortality.
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Santoro, Maya S., Dhwani J. Kothari, Charles Van Liew, and Terry A. Cronan. "Health Care Advocacy." Californian Journal of Health Promotion 12, no. 3 (December 1, 2014): 46–55. http://dx.doi.org/10.32398/cjhp.v12i3.1580.
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Background and Purpose: The U.S. population is living longer; therefore, a relatively large proportion of the population is likely to experience chronic illnesses within their lifetime. An experimental study was conducted to examine factors influencing the likelihood of hiring a Health Care Advocate (HCA). Methods: Survey data were collected from a randomly selected community sample of participants (N = 470) over the age of 18 who were provided with a description of an HCA and a written vignette describing a medical scenario. Participants read one of eight vignettes in which they were asked to imagine they were in a car accident and required medical care. Age, injury (chronic vs. acute), and presence of comorbid chronic condition were manipulated. Results: A significant interaction indicated that when there was no pre-existing chronic health condition, sustaining a chronic injury increased the likelihood of hiring an HCA. In addition, younger adults with comorbid conditions were perceived as having greater need for an HCA than younger adults without comorbid conditions. Older adults were perceived as benefiting from HCAs regardless of comorbid conditions. Conclusion: This study demonstrates the need for patient-centered support for older adults following an injury, and for younger adults when a pre-existing chronic condition exists. Efforts should be made to target services to these populations of interest.
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Williams, Grant Richard, Allison Mary Deal, Jennifer Leigh Lund, YunKyung Chang, Hyman B. Muss, Mackenzi Pergolotti, Emily Jean Guerard, Shlomit S. Shachar, and Hanna Kelly Sanoff. "Patient-reported comorbidity and survival in older adults with cancer." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): 10033. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.10033.
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10033 Background: Our ability to optimize the care of older adults with cancer and comorbid illnesses is insufficient as most clinical trials lack systematic measurement of comorbidities. The primary purpose of this study was to evaluate the prevalence and impact of patient-reported comorbidity on survival using various comorbidity scoring algorithms. Methods: We utilized a unique linkage of the Carolina Senior Registry, an institutional registry (NCT01137825) that contains geriatric assessment data, with the North Carolina Central Cancer Registry to obtain mortality data. Comorbidity was assessed using a patient-reported version of the Older Americans Resources and Services Questionnaire (OARS) Physical Health subscale that includes information regarding 13 specific comorbid conditions and the degree to which each impairs function (“not at all” to “a great deal”). Multivariable Cox proportional hazard regression models were used to evaluate the association between comorbidities and all-cause mortality. Results: 539 patients were successfully linked to mortality data. Median age 72, 72% female, 85% Caucasian, 47% breast cancer, and 12% lung cancer. 92% of participants reported at least one comorbid condition, mean of 2.7 conditions (range 0-10), with arthritis and hypertension the most common (52 and 50%, respectively). 62% of patients with a comorbid illness reported a functional limitation related to comorbidity. Both the presence of 3 or more total comorbidities (hazard ratio (HR) 1.44, CI 1.08-1.92) and 2 or more comorbidities impacting function (HR 1.46, CI 1.09-1.95) increased mortality. After adjusting for age, cancer type, and stage, the risk of death increased 12% for each comorbid condition impacting function (HR 1.12, CI 1.02-1.24), but did not significantly increase for the number of comorbid conditions alone (HR 1.07, CI 0.99-1.15). Conclusions: Comorbid conditions in older adults with cancer are highly prevalent, frequently impair function, and impact survival. Comorbid conditions that impair function have a greater impact on survival than the presence of comorbidity alone. Comorbidity assessment should be incorporated in clinical trials and can be measured via a simple one-page patient-reported questionnaire.
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Hwangbo, Ji Hye, Eun Young Heo, Youn Sil Choo, Jin Young Bae, Mi Ju Kim, and Won Joon Seong. "Colon atresia, a rare comorbid condition in VACTERL association." Korean Journal of Obstetrics & Gynecology 55, no. 9 (2012): 655. http://dx.doi.org/10.5468/kjog.2012.55.9.655.
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Gumus, Aziz, Neslihan Ozcelik, Bilge Yilmaz Kara, Songul Ozyurt, and Unal Sahin. "Thyroid Gland Disease as a Comorbid Condition in COPD." Pulmonary Medicine 2021 (October 29, 2021): 1–6. http://dx.doi.org/10.1155/2021/7479992.
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Introduction. Chronic obstructive pulmonary disease (COPD) is one of the most common causes of morbidity and mortality worldwide. The disease is characterized by progressive airway inflammation, which not only affects the airways but also has systemic effects that are associated with comorbidities. Although comorbid conditions such as hypertension and coronary artery disease are very well-known in COPD patients, diseases of the thyroid gland have not been sufficiently studied. Therefore, thyroid diseases are not considered among the comorbid conditions of COPD. The purpose of this study was to determine the thyroid gland disease (TGD) prevalence in COPD and associated factors. Materials and Method. The study included 309 (297 (96%) male) patients. The patients were subjected to spirometry and thyroid function tests (TFT) in the stable period. The thyroid gland disease they were diagnosed with was recorded after face-to-face meetings and examining their files. Results. The mean age of the patients who were included in the study was 65.9 ± 9.8 (40-90). Thyroid disease was determined in 68 (22%) individuals. There were hypothyroidism in 7 (2%), euthyroidism in 45 (15%), and hyperthyroidism in 16 (%5) patients. No relationship was found between the severity of airflow limitation and the prevalence of TGD. Conclusion. Thyroid abnormalities are commonly observed in COPD. The most frequently encountered TGDs are euthyroid multinodular goiter, euthyroid sick syndrome (ESS), and toxic multinodular goiter.
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Frain, Judy, Horng-Shiuann Wu, and Ling Chen. "Depression as a Comorbid Condition: A Descriptive Comparative Study." Western Journal of Nursing Research 42, no. 12 (June 26, 2020): 1097–103. http://dx.doi.org/10.1177/0193945920937450.
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Studies analyzing depressive symptoms across chronic disease populations are limited. Our descriptive comparison investigation included two studies on life-limiting conditions: Human Immunodeficiency Virus (HIV) and breast cancer. In both, depressive symptoms were assessed using the Center for Epidemiological Studies Depression Scale (CES-D). We found a mean depression score of 18.1 (± 11.8) overall ( N = 243). Over half (54%) reported clinically significant depressive symptoms (CES-D ≥ 16); 26% reported severe depressive symptoms (CES-D > 24). Disease and years of education were predictors of depressive symptoms. Persons living with breast cancer showed significantly worse depressive symptoms than persons living with HIV (p < 0.0001). After adjusting for disease, fewer years of education predicted worse depressive symptoms (p < 0.0001). This study demonstrated common determinants of depressive symptoms in both disease populations, suggesting that underlying conditions known to be predictors of depression could be assessed to identify those at higher risk for depression.
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Snyder, Claire Frances, Kevin D. Frick, Robert J. Herbert, Amanda L. Blackford, Bridget A. Neville, Klaus Lemke, Antonio C. Wolff, Michael Anthony Carducci, and Craig Earle. "Is care coordination associated with improved care quality for comorbid conditions in cancer survivors?" Journal of Clinical Oncology 30, no. 15_suppl (May 20, 2012): 6026. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.6026.
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6026 Background: Many cancer survivors have comorbid conditions, adding complexity to their already complicated care and requiring greater care coordination. We assessed the role of care coordination in comorbid condition care for cancer survivors. Methods: Using SEER-Medicare, we examined 7 published indicators of quality comorbid condition care in survivors of loco-regional breast, prostate, or colorectal cancer who were diagnosed in 2004, in fee-for-service Medicare, and survived ≥3 years. Comorbid condition care was evaluated during the transition from initial cancer treatment to survivorship (i.e. days 366-1095 post-diagnosis). Coordination risk was categorized as Likely, Possible, or Unlikely using an index developed and tested as part of the ACG case-mix adjustment and predictive modeling tool. The index factors in the number of unique providers, number of specialties, the percentage majority source of care, and generalist visits. We tested the hypothesis that lower coordination risk would be associated with better comorbid condition care using logistic regression, adjusting for socio-demographics, cancer type, and comorbidity. Results: The sample included 8661 survivors (53% prostate, 22% breast, 26% colorectal; mean age 75; 65% male, 85% white). Our hypothesis was not supported. Compared to patients with Unlikely coordination issues, patients with Likely coordination issues were more likely to receive appropriate care on 4 indicators and less likely on 1. Possible coordination issues were associated with better care on 1 indicator and worse care on 1 indicator. To explore this finding further, we conducted post-hoc analyses examining the role of each component of the coordination risk index. Having more unique providers was generally associated with better comorbid condition care, in contrast to the calculation of the index which considers more unique providers a greater risk for coordination issues. Conclusions: These findings suggest that traditional metrics of care coordination may not be valid for survivors of cancer. Understanding the role of care coordination in cancer survivorship care requires development and application of alternative coordination measures.
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Zaikov, S. V. "COVID‑19 and comorbid chronic diseases." Infusion & Chemotherapy, no. 3 (October 10, 2020): 5–10. http://dx.doi.org/10.32902/2663-0338-2020-3-5-10.
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ABSTRACT. This literature review includes the latest studies and meta-analyses, dedicated to the problem of comorbidity in coronavirus disease (COVID‑19). The most often comorbid conditions that accompany severe and fatal cases of COVID‑19 include arterial hypertension (AH), diabetes mellitus (DM), ischemic heart disease (IHD), brain infarction, chronic bronchitis /сhronic obstructive lung disease. These diseases share some common features like proinflammatory condition and the deterioration of innate immunity. Mechanisms of unfavorable influence of DM, AH, IHD and chronic obstructive pulmonary disease on the course of COVID‑19 include the imbalance of biochemical cascades of angiotensin-converting enzyme 2 and so-called cytokine storm, induced by glucolipid metabolic disturbances. Revealing of causality between chronic diseases and severe course of COVID‑19 in future studies can help health system providers to find the susceptible population, to estimate the risk of deterioration of clinical condition and to prescribe the preventive measures (for instance, vaccination of high-risk individuals from influenza and, in the future, from COVID‑19). Severe course of COVID‑19 and high mortality in multimorbid patients underline the need in the strict control of their basic biological parameters (arterial pressure, fasting plasma glucose etc.). Apart from that, with the aim of minimization of infection risk these patients need to imply stricter quarantine and shielding measures than the relatively healthy people. Medical workers should also emphasize on telemedicine technologies in management of such patients.
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Enck, Paul, Johannes Leinert, Menno Smid, Thorsten Köhler, and Juliane Schwille-Kiuntke. "Somatic Comorbidity in Chronic Constipation: More Data from the GECCO Study." Gastroenterology Research and Practice 2016 (2016): 1–8. http://dx.doi.org/10.1155/2016/5939238.
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Background. Comorbidity in chronic constipation has rarely been investigated, despite the fact that constipation can occur as one symptom in a number of neurological, systemic, and other nonintestinal and intestinal disorders.Methods. Of 1037 individuals with constipation identified during a telephone survey, 589 returned a postal questionnaire with valid data, asking for sociographic data, clinical symptoms, comorbid conditions, medication intake, and health care behavior related to constipation. Among them, 245 reported some somatic diagnoses and another 120 regular medication intake. They were compared to individuals without comorbid condition and presumed functional constipation (n=215).Results. Individuals reporting a somatic comorbid condition and/or regular medication were significantly older than those with functional constipation (63.8±15.8and43.7±15.5years, resp.,p<0.001) and had lower health and social status (bothp<0.001), but similar general life satisfaction (n.s.). Their quality-of-life was lower for the physical (p<0.001) but not for the mental health domain (n.s.), while among those with functional constipation, the mental health domain distinguished IBS-C individuals from those with functional constipation but without pain (p<0.001).Conclusion. In an unselected population sample with constipated individuals, those with a somatic comorbid condition outnumber those with functional constipation alone and are distinctly different with respect to age and health status.
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Vakhromeeva, P. Yu, E. V. Aranovich, and R. M. Nagaev. "Laparoscopic splenectomy in a comorbid patient in the early recovery period of cerebral infarction on the background of pneumonia COVID-19 etiology." Bulletin of the Medical Institute "REAVIZ" (REHABILITATION, DOCTOR AND HEALTH), no. 6 (December 12, 2021): 79–85. http://dx.doi.org/10.20340/vmi-rvz.2021.6.case.2.
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The article presents a clinical case of urgent surgical treatment, laparoscopic removal of the spleen in a comorbid patient in serious condition. Surgical treatment was carried out according to vital indications, a smooth postoperative period. With dynamic observation, a possible consequence of surgery is the occlusion of large vessels of the brachiocephalic tree. A multidisciplinary approach, which also extends to the conditions for providing medical care to a patient in the "red zone", clinical attentiveness and integration of services made it possible to save the life and achieve good rehabilitation for the patient despite the comorbid aggravation of her condition.
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Grammatico-Guillon, Leslie, Kimberly Shea, S. Reza Jafarzadeh, Ingrid Camelo, Zoha Maakaroun-Vermesse, Marisol Figueira, William G. Adams, and Steve Pelton. "Antibiotic Prescribing in Outpatient Children: A Cohort From a Clinical Data Warehouse." Clinical Pediatrics 58, no. 6 (March 19, 2019): 681–90. http://dx.doi.org/10.1177/0009922819834278.
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Aim. To characterize antibiotic (ab) prescriptions in children. Methods. Evaluation of outpatient ab prescriptions in a 3-year cohort of children in primary care using a data warehouse (Massachusetts Health Disparities Repository) by comorbid conditions, demographics, and clinical indication. Results. A total of 15 208 children with nearly 120 000 outpatient visits were included. About one third had a comorbid condition (most commonly asthma). Among the 30 000 ab prescriptions, first-line penicillins and macrolides represented the most frequent ab (70%), followed by cephalosporins (16%). Comorbid children had 54.3 ab prescriptions/100 child-years versus 38.8 in children without comorbidity; ab prescription was higher in urinary tract infections (>60% of episodes), otitis, lower respiratory tract infections (>50%), especially in comorbid children and children under 2 year old. Ab prescriptions were significantly associated with younger age, emergency room visit, comorbid children, and acute infections. Discussion. A clinical data warehouse could help in designing appropriate antimicrobial stewardship programs and represent a potential assessment tool.
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Petrosyan, Yelena, Kerry Kuluski, Jan Barnsley, Barbara Liu, and Walter P. Wodchis. "Evaluating quality of overall care among older adults with diabetes with comorbidities in Ontario, Canada: a retrospective cohort study." BMJ Open 10, no. 2 (February 2020): e033291. http://dx.doi.org/10.1136/bmjopen-2019-033291.
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ObjectivesThis study aimed to: (1) explore whether the quality of overall care for older people with diabetes is differentially affected by types and number of comorbid conditions and (2) examine the association between process of care measures and the likelihood of all-cause hospitalisations.DesignA population-based, retrospective cohort study.SettingThe province of Ontario, Canada.ParticipantsWe identified 673 197 Ontarians aged 65 years and older who had diabetes comorbid with hypertension, chronic ischaemic heart disease, osteoarthritis or depression on 1 April 2010.Main outcome measuresThe study outcome was the likelihood of having at least one hospital admission in each year, during the study period, from 1 April 2010 to 3 March 2014. Process of care measures specific to older adults with diabetes and these comorbidities, developed by means of a Delphi panel, were used to assess the quality of care. A generalised estimating equations approach was used to examine associations between the process of care measures and the likelihood of hospitalisations.ResultsThe study findings suggest that patients are at risk of suboptimal care with each additional comorbid condition, while the incidence of hospitalisations and number of prescribed drugs markedly increased in patients with 2 versus 1 selected comorbid condition, especially in those with discordant comorbidities. The median continuity of care score was higher among patients with diabetes-concordant conditions compared with those with diabetes-discordant conditions, and it declined with additional comorbid conditions in both groups. Greater continuity of care was associated with lower hospital utilisation for older diabetes patients with both concordant and discordant conditions.ConclusionsThere is a need for focusing on improving continuity of care and prioritising treatment in older adults with diabetes with any multiple conditions but especially in those with diabetes-discordant conditions (eg, depression).
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Baldwin, David S., Emma K. Brandish, and Daniel Meron. "The Overlap of Obsessive-Compulsive Disorder and Social Phobia and its Treatment." CNS Spectrums 13, S14 (2008): 47–53. http://dx.doi.org/10.1017/s1092852900026936.
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AbstractBoth obsessive-compulsive disorder (OCD) and social phobia are common in community and clinical settings, and it should be expected that a proportion of patients with one of these conditions will also fulfill either current or lifetime criteria for the other condition. However, comorbid social phobia is more common among patients with a primary diagnosis of OCD than is comorbid OCD in patients with a primary diagnosis of social phobia. This article explores the extent of the association of OCD and social phobia in epidemiological studies, and examines the possible role of underlying depression and other disorders in mediating the appearance of the comorbid condition. Although there have been no published randomized controlled trials in patients with this particular pattern of co-morbidity, it seems sensible to adopt pharmacologic and psychologic treatment approaches which have been found efficacious in both OCD and social phobia. Pharmacologic management therefore centers on first-line treatment with a selective serotonin reuptake inhibitor. Psychologic intervention should draw on the range of cognitive and behavioral approaches required for optimal outcomes in OCD and social phobia, as discrete conditions.
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Richardson, Lorilei M., Jennifer N. Hill, Bridget M. Smith, Erica Bauer, Frances M. Weaver, Howard S. Gordon, Kevin T. Stroupe, and Timothy P. Hogan. "Patient prioritization of comorbid chronic conditions in the Veteran population: Implications for patient-centered care." SAGE Open Medicine 4 (January 1, 2016): 205031211668094. http://dx.doi.org/10.1177/2050312116680945.
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Objective: Patients with comorbid chronic conditions may prioritize some conditions over others; however, our understanding of factors influencing those prioritizations is limited. In this study, we sought to identify and elaborate a range of factors that influence how and why patients with comorbid chronic conditions prioritize their conditions. Methods: We conducted semi-structured, one-on-one interviews with 33 patients with comorbidities recruited from a single Veterans Health Administration Medical Center. Findings: The diverse factors influencing condition prioritization reflected three overarching themes: (1) the perceived role of a condition in the body, (2) self-management tasks, and (3) pain. In addition to these themes, participants described the rankings that they believed their healthcare providers would assign to their conditions as an influencing factor, although few reported having shared their priorities or explicitly talking with providers about the importance of their conditions. Conclusion: Studies that advance understanding of how and why patients prioritize their various conditions are essential to providing care that is patient-centered, reflecting what matters most to the individual while improving their health. This analysis informs guideline development efforts for the care of patients with comorbid chronic conditions as well as the creation of tools to promote patient–provider communication regarding the importance placed on different conditions.
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Saunders, Ashleigh, and Karen E. Waldie. "Distinguishing autism from co-existing conditions: a behavioural profiling investigation." Advances in Autism 2, no. 1 (January 4, 2016): 41–54. http://dx.doi.org/10.1108/aia-09-2015-0018.
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Purpose – Autism spectrum disorder (ASD) is a lifelong neurodevelopmental condition for which there is no known cure. The rate of psychiatric comorbidity in autism is extremely high, which raises questions about the nature of the co-occurring symptoms. It is unclear whether these additional conditions are true comorbid conditions, or can simply be accounted for through the ASD diagnosis. The paper aims to discuss this issue. Design/methodology/approach – A number of questionnaires and a computer-based task were used in the current study. The authors asked the participants about symptoms of ASD, attention deficit hyperactivity disorder (ADHD) and anxiety, as well as overall adaptive functioning. Findings – The results demonstrate that each condition, in its pure form, can be clearly differentiated from one another (and from neurotypical controls). Further analyses revealed that when ASD occurs together with anxiety, anxiety appears to be a separate condition. In contrast, there is no clear behavioural profile for when ASD and ADHD co-occur. Research limitations/implications – First, due to small sample sizes, some analyses performed were targeted to specific groups (i.e. comparing ADHD, ASD to comorbid ADHD+ASD). Larger sample sizes would have given the statistical power to perform a full scale comparative analysis of all experimental groups when split by their comorbid conditions. Second, males were over-represented in the ASD group and females were over-represented in the anxiety group, due to the uneven gender balance in the prevalence of these conditions. Lastly, the main profiling techniques used were questionnaires. Clinical interviews would have been preferable, as they give a more objective account of behavioural difficulties. Practical implications – The rate of psychiatric comorbidity in autism is extremely high, which raises questions about the nature of the co-occurring symptoms. It is unclear whether these additional conditions are true comorbid conditions, or can simply be accounted for through the ASD diagnosis. Social implications – This information will be important, not only to healthcare practitioners when administering a diagnosis, but also to therapists who need to apply evidence-based treatment to comorbid and stand-alone conditions. Originality/value – This study is the first to investigate the nature of co-existing conditions in ASD in a New Zealand population.
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Wright, Anne J. "Daytime urinary incontinence: a chronic and comorbid condition of childhood." Jornal de Pediatria 92, no. 2 (March 2016): 106–8. http://dx.doi.org/10.1016/j.jped.2016.01.003.
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Wright, Anne J. "Daytime urinary incontinence: a chronic and comorbid condition of childhood." Jornal de Pediatria (Versão em Português) 92, no. 2 (March 2016): 106–8. http://dx.doi.org/10.1016/j.jpedp.2016.01.002.
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El-Refai, Sherif M., Joshua D. Brown, Esther P. Black, and Jeffery C. Talbert. "Immune Checkpoint Inhibition and the Prevalence of Autoimmune Disorders Among Patients With Lung and Renal Cancer." Cancer Informatics 16 (January 1, 2017): 117693511771252. http://dx.doi.org/10.1177/1176935117712520.
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Purpose: Immune checkpoint inhibition reactivates the immune response against cancer cells in multiple tissue types and has been shown to induce durable responses. However, for patients with autoimmune disorders, their conditions can worsen with this reactivation. We sought to identify, among patients with lung and renal cancer, how many harbor a comorbid autoimmune condition and may be at risk of worsening their condition while on immune checkpoint inhibitors such as nivolumab and pembrolizumab. Methods: An administrative health care claims database, Truven MarketScan, was used to identify patients diagnosed with lung and renal cancer from 2010 to 2013. We assessed patients for diagnosis of autoimmune diseases 1 year prior to or after diagnosis of cancer using International Classification of Diseases, Ninth Revision codes for 41 autoimmune diseases. Baseline characteristics and other comorbid conditions were recorded. Results: More than 25% of patients with both lung and renal cancer had a comorbid autoimmune condition between 2010 and 2013 and were more likely to be women, older, and have more baseline comorbidities. Conclusions: This population presents a dilemma to physicians when deciding to treat with immune checkpoint inhibitors and risk immune-related adverse events. Future evaluation of real-world use of immune checkpoint inhibitors in patients with cancer with autoimmune diseases will be needed.
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Freitas, Stephen A., Ross MacKenzie, David N. Wylde, Jason Von Bergen, J. Carl Holowaty, Margaret Beckman, Steven J. Rigatti, and Stacy Gill. "All-Cause Mortality for Life Insurance Applicants with a Family History of Coronary Artery Disease Before 60." Journal of Insurance Medicine 47, no. 3 (January 1, 2018): 159–71. http://dx.doi.org/10.17849/insm-47-03-159-171.1.
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Objective.—To determine the all-cause mortality of life insurance applicants having a family history of coronary artery disease (CAD) before age 60. Background.—Epidemiological studies have shown that a family history of premature CAD is an independent risk factor for CAD events. The strength of the association between family history and CAD is greatest with earlier age of presentation of CAD in the family member and when multiple family members are affected. Despite earlier insurance studies on this relationship, there is sparse current data on the association between family history of CAD and all-cause mortality in life insurance applicants. Methodology.—Life insurance applicants with reported family history of Coronary Artery Disease (CAD) were extracted from data covering United States residents between October 2009 and October 2016. Information about these applicants was matched to the Social Security Death Master (SSDMF) file for deaths occurring from 2009 to 2012 and to another commercially available death source file (Other Death Source, ODS) for deaths occurring from 2009 to 2016 to determine vital status. Actual to Expected (A/E) mortality ratios were calculated using the Society of Actuaries 2015 Valuation Basic Table (2015VBT), select and ultimate table (age last birthday). All expected bases were not smoker distinct. Confidence bands around these mortality ratios were calculated. The variables of interest were applicant age, gender, number of family members with CAD before age 60, and the presence of cardiac or cardiovascular conditions. Results.—Overall, the mortality of applicants with family members with a history of CAD before age 60 was slightly lower than expected mortality based on the 2015 VBT. Applicants with a cardiac or cardiovascular comorbid condition had a significantly higher mortality ratio. For applicants aged 25-54 and 65-75 with cardiac comorbid conditions, the mortality ratio was 2 times that of those without a cardiac comorbid condition. For those aged 55-64 with cardiovascular comorbid conditions, the mortality ratio was 2.9 times that of those without a cardiovascular comorbid condition. Females had a slightly higher mortality ratio for all age groups, number of family members with CAD before age 60, and cardiovascular conditions. Conclusion.—A family history of CAD before the age of 60 in an insurance applicant may be associated with increased all-cause mortality. Overall in this study, life insurance applicants had a mortality slightly lower than the expected mortality based on the 2015 VBT. However, applicants with a positive family history and a cardiac or cardiovascular comorbid condition had a significantly higher mortality ratio.
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Miles, Anna, Kirany Bennett, and Jacqui Allen. "Esophageal Transit Times Vary with Underlying Comorbid Disease." Otolaryngology–Head and Neck Surgery 161, no. 5 (September 3, 2019): 829–34. http://dx.doi.org/10.1177/0194599819874342.
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Objectives Little is known about esophageal transit times (ETT) in relation to underlying comorbid disease or aspiration risk. Our study evaluated liquid ETT in patients relative to underlying comorbid disease and compared this with ETT in healthy adults. We examined whether prolonged ETT was associated with swallow risk. Study Design Prospective observational study. Setting Radiology department. Subjects Patients included those referred to speech pathology for a videofluoroscopic study of swallowing (VFSS) within a tertiary hospital. Methods A total of 617 patients (49% female; mean ± SD age, 77 ± 15 years) and 139 healthy adults (56% female; age, 59 ± 22 years) were included. All patients underwent a standardized VFSS with esophageal screening. Patients were categorized by chief underlying disorder: previous stroke (n = 207), other neurologic condition (n = 188), respiratory conditions (n = 91), or gastroenterology conditions (n = 131). All VFSSs were analyzed with objective measures. ETT and penetration-aspiration scores were compared between groups. Results Advancing age was significantly associated with increased ETT ( P < .05). When controlling for age, mean 20-mL ETT remained significantly different across groups: healthy adults, 11 seconds; stroke, 17 seconds; other neurologic condition, 15 seconds; gastroenterology, 14 seconds; and respiratory, 9 seconds ( P < .001). One-third of patients aspirated; no healthy adults aspirated. Increasing ETT was associated with aspiration events ( P < .001). Conclusions Liquid ETTs differ among patients with different underlying primary diagnoses. Patients following stroke show significantly prolonged ETT and increased risk of aspiration. Prolonged ETT may influence symptom complaint and warrants consideration.
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Harris, Anthony D., Alyssa N. Sbarra, Surbhi Leekha, Sarah S. Jackson, J. Kristie Johnson, Lisa Pineles, and Kerri A. Thom. "Electronically Available Comorbid Conditions for Risk Prediction of Healthcare-Associated Clostridium difficile Infection." Infection Control & Hospital Epidemiology 39, no. 3 (February 5, 2018): 297–301. http://dx.doi.org/10.1017/ice.2018.10.
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OBJECTIVETo analyze whether electronically available comorbid conditions are risk factors for Centers for Disease Control and Prevention (CDC)-defined, hospital-onset Clostridium difficile infection (CDI) after controlling for antibiotic and gastric acid suppression therapy use.PATIENTSPatients aged ≥18 years admitted to the University of Maryland Medical Center between November 7, 2015, and May 31, 2017.METHODSComorbid conditions were assessed using the Elixhauser comorbidity index. The Elixhauser comorbidity index and the comorbid condition components were calculated using the International Classification of Disease, Tenth Revision, Clinical Modification (ICD-10-CM) codes extracted from electronic medical records. Bivariate associations between CDI and potential covariates for multivariable regression, including antibiotic use, gastric acid suppression therapy use, as well as comorbid conditions, were estimated using log binomial multivariable regression.RESULTSAfter controlling for antibiotic use, age, proton-pump inhibitor use, and histamine-blocker use, the Elixhauser comorbidity index was a significant risk factor for predicting CDI. There was an increased risk of 1.26 (95% CI, 1.19–1.32) of having CDI for each additional Elixhauser point added to the total Elixhauser score.CONCLUSIONSAn increase in Elixhauser score is associated with CDI. Our study and other studies have shown that comorbid conditions are important risk factors for CDI. Electronically available comorbid conditions and scores like the Elixhauser index should be considered for risk-adjustment of CDC CDI rates.Infect Control Hosp Epidemiol 2018;39:297–301
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Bagepally, Ravi Shankar. "Management of chronic constipation in comorbid conditions." International Journal of Research in Medical Sciences 10, no. 6 (May 27, 2022): 1382. http://dx.doi.org/10.18203/2320-6012.ijrms20221500.
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Constipation is a common clinical problem in India. It is also a secondary condition in many disorders. This article focused on clinical assessment and evidence-based treatment options for managing chronic constipation in various disorders. A literature search of published medical reports in the English language was performed using PubMed from inception to 2021. The selected articles satisfied the following inclusion criteria: involved human subjects over the age of 18 years and reported at least one of the comorbidities among hypothyroidism, diabetes and hypertension along with chronic constipation. Chronic constipation is one of the most common gastrointestinal symptoms observed in patients with diabetes, hypertension or hyperthyroidism. Constipation in diabetic patients can occur due to several factors such as autonomic dysfunction, dietary habits and medications. The change in the intestinal microbiota because of chronic constipation can also induce cardiovascular events. The association between these changes and increased blood pressure in hypertension had been discussed in this review. Additionally, the link between disturbed gastrointestinal motility and chronic constipation leading to hypothyroidism had also been explored. Furthermore, the pharmacological and non-pharmacological management of chronic constipation in patients with diabetes, hypertension, and hypothyroidism have been discussed. Emphasis has been placed on the changes required in the existing treatment options for diabetes, hypertension and hypothyroidism along with the use of laxatives, dietary fibers, bulking agents, lifestyle changes and other interventions to manage chronic comorbid constipation.
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LONGENECKER, J. CRAIG, JOSEF CORESH, MICHAEL J. KLAG, ANDREW S. LEVEY, ALICE A. MARTIN, NANCY E. FINK, and NEIL R. POWE. "Validation of Comorbid Conditions on the End-Stage Renal Disease Medical Evidence Report." Journal of the American Society of Nephrology 11, no. 3 (March 2000): 520–29. http://dx.doi.org/10.1681/asn.v113520.
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Abstract. Since 1995, the Medical Evidence Report for endstage renal disease (Form 2728) has been used nationally to collect information on comorbid conditions. To date, these data have not been validated. A national cross-sectional study of 1005 incident dialysis patients (734 hemodialysis and 271 peritoneal dialysis) enrolled between October 1995 and June 1998 was conducted using clinical data to validate 17 comorbid conditions on Form 2728. Sensitivity and specificity were calculated for each condition. The relationship between patient characteristics and sensitivity was assessed in multivariate analysis. Sensitivity was fairly high (0.67 to 0.83) for HIV disease, diabetes, and hypertension; intermediate (0.40 to 0.52) for peripheral vascular disease, neoplasm, myocardial infarction, cerebrovascular disease, coronary artery disease, cardiac arrest, and congestive heart failure; and poor (<0.36) for dysrhythmia, ambulation status, pericarditis, chronic obstructive pulmonary disease, and smoking. Sensitivity did not change significantly over calendar time. The sensitivity of Form 2728 averaged across all 17 conditions was 0.59 (95% confidence interval, 0.43 to 0.75). The average sensitivity was 0.10 greater in peritoneal dialysis than hemodialysis patients, 0.11 greater in diabetic patients than nondiabetic patients, and 0.04 less with each added comorbid condition. The specificity was very good for hypertension (0.91) and excellent (>0.95) for the other 16 conditions. Comorbid conditions are significantly underreported on Form 2728, but diagnoses are not falsely attributed to patients. Scientific research, quality of care comparisons, and payment policies that use Form 2728 data should take into account these limitations. Considerable effort should be expended to improve Form 2728 coding if it is to provide accurate estimates of total disease burden in end-stage renal disease patients.
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Jang, Jae-Hwan, and Hi-Joon Park. "Effects of Acupuncture on Neuropathic Pain: Mechanisms in Animal Models." Perspectives on Integrative Medicine 1, no. 1 (October 1, 2022): 17–20. http://dx.doi.org/10.56986/pim.2022.09.004.
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Neuropathic pain is a chronic condition/disease characterized by mechanical and thermal pain. Neuropathic pain can have various comorbidities such as depression, anxiety disorders and cognitive impairment, and as a result, can have a detrimental effect on quality of life. Pain and comorbid symptoms are often complicated, intertwined, affect each other, and present difficulties in treatment. Therefore, it is necessary to improve both pain and comorbid symptoms to treat neuropathic pain. Acupuncture is effective in treating not only pain but other conditions/diseases such as depression, anxiety, and cognitive impairment. Recently, acupuncture was reported to be effective in improving comorbid symptoms in patients with chronic pain. This review aimed to describe the mechanisms of action of acupuncture on the brain with respect to the improvement of comorbid symptoms that appeared in animal models of chronic neuropathic pain. Comorbidity-pain studies were comprehensively reviewed. Both manual acupuncture and electroacupuncture improved not only mechanical and thermal pain but also comorbid symptoms such as depression, anxiety, and cognitive impairment in patients with chronic neuropathic pain. The results of this review suggest that comorbid symptoms can be improved through various mechanisms, including the dopamine system in the brain, glutamate system, inflammation, epigenetic modulation, and mitochondrial function.
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Kido, Ryo, Tadao Akizawa, and Shunichi Fukuhara. "Haemoglobin concentration and survival of haemodialysis patients before and after experiencing cardiovascular disease: a cohort study from Japanese dialysis outcomes and practice pattern study (J-DOPPS)." BMJ Open 9, no. 9 (September 2019): e031476. http://dx.doi.org/10.1136/bmjopen-2019-031476.
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ObjectivesDifferences in the association of haemoglobin concentration with mortality or adverse cardiovascular events in haemodialysis patients before and after experiencing cardiovascular disease are unclear. We aimed to assess the influence of cardiovascular-comorbid condition on the association between haemoglobin concentration and mortality.DesignA prospective cohort study.SettingThe Dialysis Outcomes and Practice Patterns Study Dialysis in phases 2 to 4 (2002 to 2011), including 80 randomly selected dialysis facilities in Japan (J-DOPPS).Participants5515 adult haemodialysis patients.Primary and secondary outcome measuresPrimary outcome was all-cause mortality. Cardiovascular mortality and adverse cardiovascular events were also evaluated. The association of these outcomes with haemoglobin concentration, categorised into six classes by 1.0 g/dL units, and cardiovascular-comorbid condition, treated as a time-dependent variable updated every 4 months, was evaluated. Adjusted hazard ratios (aHRs) were computed using a time-dependent Cox model with interaction test for cardiovascular comorbidity.ResultsOver a median 2.0 years, 847 all-cause and 326 cardiovascular deaths, and 1000 adverse cardiovascular events occurred. Compared with haemoglobin 11.0 to 11.9 g/dL, the aHRs of mortality at the lowest range (<9.0 g/dL) were 1.29 (95% CI 0.95 to 1.76) and 2.11 (95% CI 1.47 to 3.06) in cardiovascular-comorbid and non-cardiovascular-comorbid patients, respectively (p=0.04 for cardiovascular-comorbid interaction), with increased cardiovascular mortality in both groups. At the second-lowest range (9.0 to 9.9 g/dL), mortality was increased only in non-cardiovascular-comorbid patients. Respective risks for mortality and adverse cardiovascular events at the second-highest range (12.0 to 12.9 g/dL) were non-significant but increased in both groups, while adverse cardiovascular events were increased at the highest range (≥13.0 g/dL) in non-cardiovascular-comorbid patients.ConclusionsThe association of low haemoglobin concentration with all-cause mortality differed between haemodialysis patients with and without cardiovascular comorbidity. Cardiovascular-comorbid condition should be considered when the association of haemoglobin concentration with mortality is addressed.
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Hoffart, Asle, and Svenn Torgersen. "Mental Health Locus of Control in First-Degree Relatives of Agoraphobic and Depressed Inpatients." Psychological Reports 71, no. 2 (October 1992): 579–86. http://dx.doi.org/10.2466/pr0.1992.71.2.579.
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Mental health locus of control in 77 first-degree relatives of agoraphobic, agoraphobic and major depressed (comorbid), and depressed inpatients were studied. Relatives of comorbid patients externalized locus of control more to chance than did relatives of agoraphobic and of depressed patients. These results suggest that a tendency to externalize to chance is familially transmitted and may be a vulnerability factor for the development of the comorbid condition of agoraphobia and major depression.
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Buddeke, Josefien, Michiel L. Bots, Ineke van Dis, Frank LJ Visseren, Monika Hollander, François G. Schellevis, and Ilonca Vaartjes. "Comorbidity in patients with cardiovascular disease in primary care: a cohort study with routine healthcare data." British Journal of General Practice 69, no. 683 (May 7, 2019): e398-e406. http://dx.doi.org/10.3399/bjgp19x702725.
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BackgroundComorbidity is a major public health issue, which challenges health care configured around single diseases.AimTo provide an overview of frequent disease combinations of one and two additional chronic diseases and groups among patients with cardiovascular disease (CVD) in general practice.Design and settingMedical record data from the Julius General Practitioners’ Network of 226 670 patients registered in 2015–2016 in Utrecht, the Netherlands, were collected and examined.MethodPrevalences and combinations of one and two comorbid conditions were determined, by age and sex, in four populations of patients with CVD: heart failure, peripheral arterial disease (PAD), coronary heart disease (CHD), or stroke. Using logistic regression analyses, the authors examined whether comorbid conditions were significantly more prevalent in patients with a specific cardiovascular condition compared with those without.ResultsLow vision, diabetes mellitus, back/neck problems, osteoarthritis, chronic obstructive pulmonary disease (COPD), and cancer were the most prevalent non-cardiovascular conditions and ranked in the top five of non-cardiovascular comorbid conditions in the different CVDs studied, irrespective of patient age and sex. Of these, diabetes, COPD, and low vision were statistically significantly more prevalent in all four cardiovascular conditions when compared with patients without the respective disease. Over the life span, the majority of the comorbid conditions were most prevalent in patients with heart failure, directly followed by those with PAD; they were less prevalent in patients with CHD and stroke.ConclusionComorbid conditions are very common in patients with CVD, even in younger age groups. To ensure efficient and effective treatment, organisational adaptations may be required in the healthcare system to accommodate comorbid conditions in patients with CVD.
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Barh, Debmalya, Alaa A. Aljabali, Murtaza M. Tambuwala, Sandeep Tiwari, Ángel Serrano-Aroca, Khalid J. Alzahrani, Bruno Silva Andrade, Vasco Azevedo, Nirmal Kumar Ganguly, and Kenneth Lundstrom. "Predicting COVID-19—Comorbidity Pathway Crosstalk-Based Targets and Drugs: Towards Personalized COVID-19 Management." Biomedicines 9, no. 5 (May 17, 2021): 556. http://dx.doi.org/10.3390/biomedicines9050556.
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It is well established that pre-existing comorbid conditions such as hypertension, diabetes, obesity, cardiovascular diseases (CVDs), chronic kidney diseases (CKDs), cancers, and chronic obstructive pulmonary disease (COPD) are associated with increased severity and fatality of COVID-19. The increased death from COVID-19 is due to the unavailability of a gold standard therapeutic and, more importantly, the lack of understanding of how the comorbid conditions and COVID-19 interact at the molecular level, so that personalized management strategies can be adopted. Here, using multi-omics data sets and bioinformatics strategy, we identified the pathway crosstalk between COVID-19 and diabetes, hypertension, CVDs, CKDs, and cancers. Further, shared pathways and hub gene-based targets for COVID-19 and its associated specific and combination of comorbid conditions are also predicted towards developing personalized management strategies. The approved drugs for most of these identified targets are also provided towards drug repurposing. Literature supports the involvement of our identified shared pathways in pathogenesis of COVID-19 and development of the specific comorbid condition of interest. Similarly, shared pathways- and hub gene-based targets are also found to have potential implementations in managing COVID-19 patients. However, the identified targets and drugs need further careful evaluation for their repurposing towards personalized treatment of COVID-19 cases having pre-existing specific comorbid conditions we have considered in this analysis. The method applied here may also be helpful in identifying common pathway components and targets in other disease-disease interactions too.
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van den Hoek, Joëlle, Leo D. Roorda, Hendriek C. Boshuizen, Gerard J. Tijhuis, Geertrudis A. van den Bos, and Joost Dekker. "Physical and Mental Functioning in Patients with Established Rheumatoid Arthritis over an 11-year Followup Period: The Role of Specific Comorbidities." Journal of Rheumatology 43, no. 2 (January 15, 2016): 307–14. http://dx.doi.org/10.3899/jrheum.150536.
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Objective.To investigate the longterm association of a wide range of comorbidities with physical and mental functioning in patients with rheumatoid arthritis (RA).Methods.Longitudinal data over a period of 11 years were collected from 882 patients with RA. Somatic comorbidity and comorbid depression were measured at baseline, with a questionnaire including 20 chronic diseases and with the Center for Epidemiologic Depression Scale, respectively. Physical functioning was measured at 5 timepoints with a disease-specific measure [Health Assessment Questionnaire (HAQ)] and a generic measure [physical scales of the Medical Outcomes Study Short Form-36 (SF-36)]. Mental functioning was measured with the mental scales of the SF-36. To determine the association of baseline-specific comorbidities with functioning over time, we performed longitudinal analyses.Results.At baseline, 72% percent of the patients were women, mean age ± SD was 59.3 ± 14.8 years, median RA disease duration was 5.0 years, and 68% had ≥ 1 comorbid condition. The effect of comorbid conditions was more apparent when physical functioning was measured with SF-36, a disease-generic measure, compared with the HAQ, a disease-specific measure. Circulatory conditions and depression were associated (p < 0.05) with worse physical functioning according to the HAQ. Respiratory conditions, musculoskeletal conditions, cancer, and depression were associated (p < 0.05) with worse physical functioning according to the SF-36. Respiratory conditions and depression were associated with worse mental functioning.Conclusion.Patients with specific comorbid conditions have an increased risk of low functioning in the long term. Targeted attention for these specific comorbid conditions by clinicians is recommended.
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Porras Segovia, A., C. Carrillo de Albornoz Calahorro, M. Guerrero Jiménez, and J. Cervilla Ballesteros. "Comorbidity between delusional disorder and chronic physical conditions. Results from the Deliranda case register." European Psychiatry 33, S1 (March 2016): S145. http://dx.doi.org/10.1016/j.eurpsy.2016.01.250.
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IntroductionMental disorders are often comorbid with chronic physical conditions. This relationship has been looked into in some mental disorders, such as depression or schizophrenia. However, very few studies have explored this comorbidity in the delusional disorder.ObjectivesThe objective of this study is to establish the prevalence of common chronic medical conditions across delusional disorder.AimsThe aim is to provide useful information regarding this frequent, often disregarded, comorbidity.MethodsOur results proceed from the Andalusian delusional disorder case-register (DelirAnda). We reviewed 1927 clinical histories of patients diagnosed of delusional disorder. Upon having verified the diagnosis following DSM-5 criteria, we recollected data on the prevalence of 10 different medical conditions, which were defined based on clinical diagnosis.ResultsOne thousand four hundred and fifty-two patients matched DSM-5 delusional disorder criteria. Among them, 49.8% of our sample were women. The overall prevalence of medical conditions was 66%. Thirty-one percent of the patients with delusional disorder had only one comorbid physical condition, 20% of them suffered from two conditions, and 15% of them had three or more chronic conditions. The most prevalent physical condition among delusional disorder patients was diabetes, affecting 16% of these patients.ConclusionsChronic physical conditions are highly prevalent among patients with delusional disorder. Comorbid physical conditions may have an important impact on the course of delusional disorder. A correct diagnosis and treatment of this comorbidity should be made to help improve the prognosis and life quality of these patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Bogmat, L. F., V. V. Nikonova, N. S. Shevchenko, and I. M. Bessonova. "Dyslipidemia as a comorbid condition in children with juvenile idiopathic arthritis." CHILD`S HEALTH 15, no. 5 (August 1, 2020): 279–86. http://dx.doi.org/10.22141/2224-0551.15.5.2020.211436.
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Chandra, Saumya. "Arun's Story: A Comorbid Condition of Learning Disability with Bipolar Disorder." Research Journal of Humanities and Social Sciences 9, no. 1 (2018): 29. http://dx.doi.org/10.5958/2321-5828.2018.00006.2.
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Burrows, Graham D., and Trevor R. Norman. "Mood disturbance as a comorbid condition in schizophrenia: Etiology and treatment." Biological Psychiatry 42, no. 1 (July 1997): 266S. http://dx.doi.org/10.1016/s0006-3223(97)88034-1.
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Popa Nedelcu, A., E. Popa Nedelcu, M. Popa Nedelcu, and M. Manea. "1468 – Is depression a more frequent comorbid condition in family practice?" European Psychiatry 28 (January 2013): 1. http://dx.doi.org/10.1016/s0924-9338(13)76496-4.
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Taylor, Simone E., David McD Taylor, Daisy Pisasale, Kyle Booth, and John Lippmann. "Regular medication use by active scuba divers with a declared comorbid medical condition and victims of scuba and snorkelling-related fatalities." Diving and Hyperbaric Medicine Journal 51, no. 3 (September 30, 2021): 264–70. http://dx.doi.org/10.28920/dhm51.3.264-270.
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Introduction: The aim of this study was to describe the nature of regular medications taken by active comorbid scuba divers (having a declared medical comorbidity) and scuba divers and snorkellers who died following a diving incident. Methods: We undertook a retrospective, observational study from July to October, 2020. Data on 268 active comorbid divers were obtained through a 2013 survey of Divers Alert Network Asia-Pacific members. Data on 126 deceased scuba divers and 175 deceased snorkellers were obtained predominantly from 2001–2013 reports to Australian State Coronial Services. Results: The active comorbid divers were significantly older, less likely to be male, and more likely to be taking one or more medications than the two deceased subject groups (P < 0.001). Cardiovascular, endocrine and psychotropic medications accounted for 53.4%, 9.9% and 6.4% of all medications taken, respectively. Almost one tenth of the deceased divers took at least one psychotropic medication, a proportion significantly greater than the other groups (P = 0.01). Conclusions: Medication use among active comorbid divers is common which likely reflects their declared medical condition. Nevertheless, they appear to be diving relatively safely, often with conditions once thought to be absolute contradictions to scuba diving. The deceased divers took significantly more psychotropic medications. It is possible that their underlying psychological/psychiatric conditions rendered them more at risk of a diving incident. Increased vigilance for psychological conditions may need to be considered during diving medical examinations.
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Goodman, Katherine E., Lisa Pineles, Scott Fridkin, Lorraine Kyne, Vivian Loo, Alfredo J. Mena Lora, Eli N. Perencevich, et al. "793. Expert Panel Consensus Ranking of Comorbid Conditions Causally Related to Clostridioides difficile Infection." Open Forum Infectious Diseases 7, Supplement_1 (October 1, 2020): S440. http://dx.doi.org/10.1093/ofid/ofaa439.983.
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Abstract Background Numerous studies have identified comorbidities that are associated with Clostridioides difficile infection (CDI), but current CDC and CMS models for risk adjusting hospital CDI rates do not include patient comorbid conditions. Incorporating patient-level data could improve CDI risk adjustment, but comorbidities would need to be easily electronically available for widescale implementation. Ideally, they would also be causally related to CDI — i.e., true risk factors, not confounders — to facilitate more unbiased inter-hospital comparisons. The current study aimed to determine which comorbid conditions are causally related to CDI based upon expert consensus. Methods We used Delphi methodology to administer an iterative, two-round survey with an intervening teleconference, to eight infectious disease experts. Experts evaluated 40 comorbid conditions included in Charlson and Elixhauser comorbidity indices (and thus validated for electronic capture through administrative data), as well as other comorbidities commonly associated with CDI. Experts rated comorbid conditions from 1 (not at all related) to 5 (strongly related), based upon perceived relatedness with CDI. To assign causal relatedness, the following criteria had to be met at the end of round two: 1) majority (> 50%) of experts rating the condition at 3 (somewhat related) or higher; 2) inter-quartile range (IQR) < = 1; and 3) standard deviation (SD) < = 1. Results 8/40 (20%) comorbid conditions were ranked as causally related to CDI, including patient age, three malignancy comorbidities, two transplant-related comorbidities, HIV/AIDS, and inflammatory bowel disease. A further 18/40 (45%) qualified as indeterminately related, and 14/40 (35%) were ranked as not causally related to CDI (Table). Three of the eight causally related factors were not components of Elixhauser or Charlson indices. Table Conclusion We identified comorbid conditions that may be appropriate candidates to consider for inclusion in patient-level risk adjustment models. Some causal factors did not originate from established comorbidity indices. Thus, future work to validate electronic capture of these conditions could further reduce barriers to risk-adjustment implementation. Disclosures All Authors: No reported disclosures