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Multi morbidity

Parminder Raina, Anne Gilsing, Heinz Freisling, Edwin van den Heuvel, Nazmul Sohel, Mazda Jenab, Pietro Ferrari, Anne Tjønneland, Vassiliki Benetou, Susan Picavet, Sture Eriksson, Ben Schöttker, Hermann Brenner, Kai-Uwe Saum, Laura Perna, Tom Wilsgaard, Antonia Trichopoulou, Paolo Boffetta, Lauren E Griffith
Background: The number of older people living with cancer and cardio-metabolic conditions is increasing but little is known about how specific combinations of these conditions impact mortality. Methods: A total of 22,692 participants aged 65 years and older from four international cohorts were followed-up for mortality for an average of 10 years (8,596 deaths). Data were harmonized across cohorts and mutually exclusive groups of disease combinations were created for cancer, MI, stroke, and diabetes at baseline...
March 19, 2018: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
Sonali Bose, Karina Romero, Kevin J Psoter, Frank C Curriero, Chen Chen, Caroline M Johnson, Deepak Kaji, Patrick N Breysse, D'Ann L Williams, Murugappan Ramanathan, William Checkley, Nadia N Hansel
BACKGROUND: Air pollution exposure may contribute to rhinoconjunctivitis morbidity in children with underlying airways disease. Prior studies have not assessed rhinoconjunctivitis-related quality of life (QOL) in children with asthma chronically exposed to air pollution. METHODS: Children ages 9-19 years with asthma from peri-urban Peru, self-reporting rhinoconjunctivitis symptoms (n = 484), were administered the Rhinoconjunctivitis QOL Questionnaire (RQLQ) at repeated intervals over one year, with scores dichotomized into bothered (>0) and not bothered (= 0)...
2018: PloS One
Yasmin van Kasteren, Jill Freyne, M Sazzad Hussain
BACKGROUND: The growth in patient-centered care delivery combined with the rising costs of health care have perhaps not unsurprisingly been matched by a proliferation of patient-centered technology. This paper takes a multistakeholder approach to explore how digital technology can support the cocreation of value between patients and their care teams in the delivery of total knee replacement (TKR) surgery, an increasingly common procedure to return mobility and relieve pain for people suffering from osteoarthritis...
March 20, 2018: Journal of Medical Internet Research
Ana M Lenz, Elena Andion, Silvina Ruvinsky, Clarisa Aguirre, Julieta Alvarez Parma, Facundo Jorro, Gabriela López Cruz, Martín Pascutto, Matías Penazzi, Silvia Santos, Marcela Zuázaga, Norma Aquino, Juan C Vassallo, Guillermo Moreno, Ricardo Magliola, Aldo Haimovich, Luis Landry, Rosa Bologna
INTRODUCTION: Catheter-related infections (CRIs) cause a high level of morbidity and mortality with the increasing use of hospital resources. OBJECTIVE: To describe the outcomes of a program implemented to reduce the rate of CRIs in pediatric intensive care units in Argentina. POPULATION AND METHODS: Collaborative, multi center, clinical-epidemiological, quasiexperimental, before-and-after intervention study. Children who had a central venous catheter during hospitalization in 9 pediatric intensive care units in the Autonomous City of Buenos Aires, Greater Buenos Aires, and other provinces between June 2011 and April 2012 were included...
April 1, 2018: Archivos Argentinos de Pediatría
Dogus Hemsinli, Gokalp Altun, Safiye Tuba Kaplan, Furkan Yildirim, Gamze Cebi
INTRODUCTION: Wounds refractory to standard treatment in patients with thromboangiitis obliterans (TAO, Buerger's disease) are associated with amputation, other morbidity and mortality. The purpose of this study was to investigate the effect of hyperbaric oxygen treatment (HBOT) in patients with TAO. MATERIALS AND METHODS: Ninety-seven patients with TAO with ischaemic wounds treated between January 2007 and July 2016 were included in this dual-centre, non-randomised, retrospective study...
March 31, 2018: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
Hilmi Alnsasra, Binyamin Ben-Avraham, Shmuel Gottlieb, Merav Ben-Avraham, Ran Kronowski, Zaza Iakobishvili, Ilan Goldenberg, Boris Strasberg, Moti Haim
High-grade atrioventricular block (HAVB) is a frequent complication of acute myocardial infarction (AMI) and is associated with increased morbidity and mortality. We aimed to evaluate the incidence, predictors, and prognostic significance of HAVB in a contemporary cohort of patients with AMI, in the recent era of early reperfusion. Patients with acute coronary syndromes (n=11,487) during the years 2000-2010 were included. Patients were divided into two groups: with HAVB (n=308, 2.7%) and without HAVB (n=11,179, 97...
March 7, 2018: Journal of Electrocardiology
Christine A DeForest, Virginia Blackman, John E Alex, Lauren Reeves, Alejandra Mora, Crystal Perez, Joseph Maddry, Domenique Selby, Benjamin Walrath
Introduction: Military prehospital and en route care (ERC) directly impacts patient morbidity and mortality. Provider knowledge and skills are critical variables in the effectiveness of ERC. No Navy doctrine defines provider choice for patient transport or requires standardized provider training. Frequently, Search and Rescue Medical Technicians (SMTs) and Navy Nurses (ERC RNs) are tasked with this mission though physicians have also been used. Navy ERC provider training varies greatly by professional role...
March 14, 2018: Military Medicine
Lucie Cluver, Franziska Meinck, Elona Toska, F Mark Orkin, Rebecca J Hodes, Lorraine Sherr
OBJECTIVE(S): HIV-positive adolescents have low ART-adherence, with consequent increased risks of mortality, morbidity and viral resistance. Despite high rates of violence against children in the Africa region, no known studies have tested impacts on HIV-positive adolescents. We examine associations of ART-adherence with adolescent violence victimisation by caregivers, teachers, peers, community members, and healthcare providers. DESIGN AND METHODS: HIV-positive adolescents were interviewed (n = 1060), and clinic biomarker data collected...
March 15, 2018: AIDS
David P Darrow, Coridon Quinn, Huy T Donguyen, Matthew Hunt, Stephen Haines
INTRODUCTION: External ventricular drains can pose a serious source of morbidity and mortality. Interventions proven to reduce the risk of infections are lacking. Single center studies limit the study of procedures that mitigate infection, but bundled protocols have demonstrated utility. A collaborative EVD registry was designed to facilitate local quality improvement projects to be implemented at any location using standardized data collection instruments through resident collaboration to reduce and study EVD infection and prevention...
March 12, 2018: World Neurosurgery
Efrat L Amitay, Agne Krilaviciute, Hermann Brenner
Colorectal cancer (CRC) is a leading cause of cancer morbidity and mortality. Dysbiosis in the gut microbiota may be associated with CRC. This systematic review focuses on differences in gut microbial community between people diagnosed with CRC or adenoma and healthy individuals using fecal samples, emphasizing non-invasive fecal microbiome models for CRC early diagnosis. Nineteen studies were identified in a systematic literature search of Pubmed, Web of Science and ScienceDirect. Several bacteria were reported to differ in abundance between CRC and adenoma cases and healthy controls, with Fusobacterium the most common...
March 15, 2018: Gut Microbes
Tagbo Oguonu, Ijeoma N Obumneme-Anyim, Joy N Eze, Adaeze C Ayuk, Chinyere V Okoli, Ikenna K Ndu
Background Biofuels and other cooking fuels are used in households in low- and middle-income countries. Aim To investigate the impact of cooking fuels on lung function in children in urban and rural households in South-East Nigeria. Methods The multi-stage sampling method was used to enroll children exposed to cooking fuel in the communities. Lung function values FEV1, FVC and the FEV1/FVC ratio, were measured with ndd EasyOneR spirometer. Airflow limitation was determined with FEV1/FVC Z-score values at -1...
March 15, 2018: Paediatrics and International Child Health
Daniel Geh, Caroline Gordon
Systemic lupus erythematosus (SLE) is a multi-system autoimmune disease. There are three drugs licensed for the treatment of lupus: corticosteroids, hydroxychloroquine and belimumab. Immunosuppressants such as azathioprine, methotrexate and mycophenolate are also used. Despite these treatments there is still considerable morbidity. New treatments are needed for the management of active lupus. Epratuzumab a humanized IgG1 monoclonal antibody that targets CD22 resulting in selective B cell modulation that has been considered a potential treatment for SLE...
March 15, 2018: Expert Review of Clinical Immunology
Sarosh Khan, Maria Ribeiro, Diogo Fernandes, Colin Reid
72 year old man with known systolic & diastolic heart failure presented with congestive cardiac failure symptoms over a period of 6 weeks. Successful resection of left upper lobe lung adenocarcinoma 4 years prior. Poor response to optimal medical therapy and IV diuresis. Repeat echocardiogram elicited rare images (Videos 1, 2 and 3) of a significant invasive pericardial tumour involving myocardium and endocardium (Figure 1). Comparative CT thorax images are also provided (Figure 2a & Figure 2b). The importance of cardiac silhouette evaluation on CXR's for interval change is highlighted with 6 month retrospective review in this case (Figure 3)...
March 14, 2018: Echo Research and Practice
Endrias Markos Woldesemayat, Andargachew Kassa, Taye Gari, Mesay Hailu Dangisso
BACKGROUND: Non-communicable chronic diseases (NCCDs) multi-morbidity is becoming one of the public health problems in Ethiopia. The objective of this study was to describe the prevalence of NCCDs and multi-morbidity among adult patients at Hawassa University Comprehensive Specialized Hospital (HUCSH). METHODS: Between January and February 2016, a cross-sectional study was carried out among patients aged ⩾ 18 years attending the outpatient department of the hospital...
March 14, 2018: BMC Public Health
Rangarirai Matima, Katherine Murphy, Naomi S Levitt, Rhonda BeLue, Tolu Oni
BACKGROUND: Current South African health policy for chronic disease management proposes integration of chronic services for better outcomes for chronic conditions; that is based on the Integrated Chronic Disease Model (ICDM). However, scant data exist on how patients with chronic multimorbidities currently experience the (re)-organisation of health services and what their perceived needs are in order to enhance the management of their conditions. METHODS: A qualitative study was conducted in a community health centre treating both HIV and diabetes patients in Cape Town...
2018: PloS One
Balagangadhar R Totapally, Ashish H Shah, Toba Niazi
OBJECTIVE: Posterior fossa tumor surgery in children poses a significant morbidity and mortality. Large multi-institutional datasets characterizing the epidemiology and morbidity of children undergoing posterior fossa tumor surgery are lacking. The objective of this study is to describe the epidemiology and short term surgical outcomes of children presenting with cerebellar tumors. PATIENTS AND METHODS: A retrospective review of the Kids Inpatient Database (KID) for all hospital discharges in 2012 with a diagnosis of cerebellar tumor (ICD-9 diagnosis code 191...
February 26, 2018: Clinical Neurology and Neurosurgery
A Dunham, D Kinnear, L Allan, E Smiley, S-A Cooper
BACKGROUND: People with intellectual disabilities face a much greater burden and earlier onset of physical and mental ill-health than the general adult population. Physical-mental comorbidity has been shown to result in poorer outcomes in the general population, but little is known about this relationship in adults with intellectual disabilities. AIMS: To identify whether physical ill-health is associated with mental ill-health in adults with intellectual disabilities and whether the extent of physical multi-morbidity can predict the likelihood of mental ill-health...
March 12, 2018: Journal of Intellectual Disability Research: JIDR
Yang Xiao, Wei Li, Haifeng Wan, Yifei Tan, Hong Wu
BACKGROUND: Both central hepatectomy (CH) and major hepatectomy (MH) are suggested surgical treatments for patients with centrally located hepatocellular carcinoma (CL-HCC). However, no consensus has been reached regarding which method is superior for managing these patients. This meta-analysis was conducted to compare the short- and long-term outcomes of CH and MH in patients with CL-HCC. METHODS: An electronic search for studies published in all years up to July 2017 in PubMed (Medline), EMBASE, Cochrane Library and Web of Science was performed...
March 9, 2018: International Journal of Surgery
Sonia de Castro, María-José Camarasa
HIV infection still has a serious health and socio-economical impact and is one of the primary causes of morbidity and mortality all over the world. HIV infection and the AIDS pandemic are still matters of great concern, especially in less developed countries where the access to highly active antiretroviral therapy (HAART) is limited. Patient compliance is another serious drawback. Nowadays, HAART is the treatment of choice although it is not the panacea. Despite the fact that it suppresses viral replication at undetectable viral loads and prevents progression of HIV infection into AIDS HAART has several pitfalls, namely, long-term side-effects, drug resistance development, emergence of drug-resistant viruses, low compliance and the intolerance of some patients to these drugs...
March 5, 2018: European Journal of Medicinal Chemistry
Sarinnapha M Vasunilashorn, Long H Ngo, Noel Y Chan, Wenxiao Zhou, Simon T Dillon, Hasan H Otu, Sharon K Inouye, Iris Wyrobnik, George A Kuchel, Janet E McElhaney, Zhongcong Xie, David C Alsop, Richard N Jones, Towia A Libermann, Edward R Marcantonio
Background: Delirium is common, morbid, and costly, yet its biology is poorly understood. We aimed to develop a multi-protein signature of delirium by identifying proteins associated with delirium from unbiased proteomics and combining them with delirium biomarkers identified in our prior work (interleukin [IL]-6 and IL-2). Methods: We used the Successful Aging after Elective Surgery (SAGES) Study of adults age ≥70 undergoing major non-cardiac surgery (N=560; 24% delirium)...
February 24, 2018: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
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