-
Journal of Obstetrics and Gynaecology :... Dec 2023A comparative cross-sectional study was conducted among 991 pregnant and 674 non-pregnant women of reproductive age attending healthcare facilities in Ibadan, Nigeria...
A comparative cross-sectional study was conducted among 991 pregnant and 674 non-pregnant women of reproductive age attending healthcare facilities in Ibadan, Nigeria using the General Health Questionnaire-12 (GHQ), and WHO self-reporting questionnaire (SRQ). Logistic regression analysis was conducted to identify predictors of psychiatric morbidity at < 0.05. A significantly higher proportion of pregnant women experienced psychological distress on the GHQ (51.8%) and psychiatric morbidity on SRQ (33.3%) compared with 28.6% and 18.2% of non-pregnant women, respectively. Predictors of psychiatric morbidity among pregnant women were the type of facility, poor satisfaction and communication with partners, the experience of violence in the home, previous abortions, and previous history of depression. Psychiatric morbidity among non-pregnant women was predicted by younger age, previous history of depression, poor satisfaction and communication with partners. There is a need for early identification of psychiatric morbidity among women of reproductive age, to ensure early interventions and prevent long-term disability.Impact statement Psychiatric morbidity has immense effects on a woman's quality of life, social functioning, obstetric outcome, and economic productivity. Psychiatric morbidity among women of reproductive age is high. Pregnant women when compared to non-pregnant women had significantly higher rates of psychiatric morbidity. This high prevalence of psychiatric morbidity in both groups was predicted by poor satisfaction and communication with partners, and a previous history of depression. Simple screening for women of reproductive age attending healthcare facilities may help with the early identification of psychiatric morbidity leading to prompt interventions, and preventing long-term disability.
Topics: Pregnancy; Female; Humans; Nigeria; Cross-Sectional Studies; Quality of Life; Pregnant Women; Morbidity; Prevalence
PubMed: 37140084
DOI: 10.1080/01443615.2023.2205503 -
Current Diabetes Reports Aug 2023Multiple studies report an increased incidence of diabetes following SARS-CoV-2 infection. Given the potential increased global burden of diabetes, understanding the... (Review)
Review
PURPOSE OF REVIEW
Multiple studies report an increased incidence of diabetes following SARS-CoV-2 infection. Given the potential increased global burden of diabetes, understanding the effect of SARS-CoV-2 in the epidemiology of diabetes is important. Our aim was to review the evidence pertaining to the risk of incident diabetes after COVID-19 infection.
RECENT FINDINGS
Incident diabetes risk increased by approximately 60% compared to patients without SARS-CoV-2 infection. Risk also increased compared to non-COVID-19 respiratory infections, suggesting SARS-CoV-2-mediated mechanisms rather than general morbidity after respiratory illness. Evidence is mixed regarding the association between SARS-CoV-2 infection and T1D. SARS-CoV-2 infection is associated with an elevated risk of T2D, but it is unclear whether the incident diabetes is persistent over time or differs in severity over time. SARS-CoV-2 infection is associated with an increased risk of incident diabetes. Future studies should evaluate vaccination, viral variant, and patient- and treatment-related factors that influence risk.
Topics: Humans; COVID-19; SARS-CoV-2; Diabetes Mellitus; Incidence
PubMed: 37284921
DOI: 10.1007/s11892-023-01515-1 -
Perioperative Morbidity and Long-term Outcomes of Bariatric Surgery in Patients with Severe Obesity.The Israel Medical Association Journal... Sep 2023Long-term outcome data for bariatric surgery in patients with severe obesity (SO) (body mass index [BMI] 50 kg/m2) are scarce.
BACKGROUND
Long-term outcome data for bariatric surgery in patients with severe obesity (SO) (body mass index [BMI] 50 kg/m2) are scarce.
OBJECTIVES
To compare perioperative morbidity and long-term outcomes between patients with SO and non-SO (NSO).
METHODS
Patients with SO who underwent primary bariatric surgery with a follow-up 5 years were age- and gender-matched with NSO patients in a retrospective, case-control study. Data included demographics, BMI, co-morbidities, early outcomes, current and nadir weight, co-morbidity status, and general satisfaction.
RESULTS
Of 178 patients, 49.4% were male, mean age 44.5 ± 14 years. Mean preoperative BMI was 54.7 ± 3.6 and 41.8 ± 3.8 kg/m2 in SO and NSO, respectively (P = 0.02). Groups were similar in preoperative characteristics. Depression/anxiety was more prevalent in NSO (12.4% vs. 3.4%, P = 0.03). Obstructive sleep apnea was higher in SO (21.3% vs. 10.1%, P = 0.04). Sleeve gastrectomy was performed most often (80.9%), with a tendency toward bypass in SO (P = 0.05). Early complication rates were: 13.5% in SO and 12.4% in NSO (P = 0.82). Mean follow-up was 80.4 ± 13.3 months. BMI reduction was higher in SO (31.8 ± 5.9 vs. 26.8 ± 4.2 kg/m2, P < 0.001) and time to nadir weight was longer (22.1 ± 21.3 vs. 13.0 ± 12.0 months, P = 0.001). Co-morbidity improvement and satisfaction were similar.
CONCLUSIONS
Patients with SO benefited from bariatric surgery with reduced BMI and fewer co-morbidities. No added risk of operative complications was found compared to patients with NSO.
Topics: Humans; Male; Adult; Middle Aged; Female; Obesity, Morbid; Case-Control Studies; Retrospective Studies; Bariatric Surgery; Morbidity; Weight Loss
PubMed: 37698312
DOI: No ID Found -
Journal of Dairy Science Aug 2023Currently, mortality and morbidity rates for preweaning calves in the US dairy industry are high, with the major cause being digestive disorders and respiratory... (Review)
Review
Graduate Student Literature Review: Reducing mortality and morbidity in transported preweaning dairy calves: Colostrum management and pretransport nonsteroidal anti-inflammatory drug administration.
Currently, mortality and morbidity rates for preweaning calves in the US dairy industry are high, with the major cause being digestive disorders and respiratory diseases. One of the most important management practices that can reduce calf mortalities and morbidities is the feeding of colostrum, provided its quantity, quality, and cleanliness, and timing of feeding are according to recommendations. However, other management practices similar to transportation, can also compromise calf health and production performance. When preweaning calves are transported, stressors similar to physical restraint, commingling, dehydration, bruising, and pain may lead to an inflammatory response and immunosuppression, which has been seen in older cattle, and could increase susceptibility to digestive disorders and respiratory diseases. One strategy that could potentially reduce transport-related negative outcomes is the pretransport administration of nonsteroidal anti-inflammatory drugs, such as meloxicam. This review provides a brief background on preweaning mortality and morbidity, colostrum management, transport-related stress, use of nonsteroidal anti-inflammatory drugs in transported calves, and highlights some of the current knowledge gaps.
Topics: Pregnancy; Female; Animals; Cattle; Colostrum; Weaning; Anti-Inflammatory Agents, Non-Steroidal; Meloxicam; Morbidity; Animals, Newborn
PubMed: 37414600
DOI: 10.3168/jds.2022-22707 -
Sleep Sep 2023
Topics: Sleep; Morbidity
PubMed: 37523675
DOI: 10.1093/sleep/zsad075 -
Cancer Medicine Oct 2023Thoracotomy is considered the standard surgical approach for the management of pulmonary metastases in osteosarcoma (OST). Several studies have identified the advantages... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Thoracotomy is considered the standard surgical approach for the management of pulmonary metastases in osteosarcoma (OST). Several studies have identified the advantages of a thoracoscopic approach, however, the clinical significance of thoracotomy compared to thoracoscopy is yet to be evaluated in a randomized trial.
AIMS
The primary aim was to determine the survival outcomes in OST patients based on surgical approach for pulmonary metastasectomy (PM) and secondary aim was to assess the post-operative morbidities of OST PM through various surgical approaches.
MATERIALS AND METHODS
We conducted a single institution retrospective study to compare survival outcomes and surgical morbidity according to the surgical approach of the management of pulmonary metastases in patients with OST.
RESULTS
Sixty-one patients with OST underwent PM. Twenty-one patients were metastatic at diagnosis and underwent PM during primary treatment; nine had thoracotomy, six thoracoscopy, and six combined thoracoscopy with thoracotomy (CTT). Forty-three patients with first pulmonary relapse or progression underwent PM; 18 had thoracotomy, 16 thoracoscopy and nine CTT. There was no difference in survival between surgical approaches. There were significantly more postoperative morbidities associated with thoracotomy for initial PM (pain and postoperative chest tube placement), and for PM at first relapse (pneumothoraces, pain, Foley catheter use and prolonged hospitalizations).
CONCLUSION
Our study demonstrates that patients with OST pulmonary metastases have comparable poor outcomes despite varying surgical approaches for PM. There were significantly more postoperative morbidities associated with thoracotomy for PM. Surgical bias and other competing risks could not be assessed given the limitations of a retrospective study and may be addressed in a prospective trial evaluating surgical approach for PM in OST.
Topics: Humans; Child; Adolescent; Young Adult; Metastasectomy; Retrospective Studies; Prospective Studies; Lung Neoplasms; Osteosarcoma; Bone Neoplasms; Morbidity; Pain; Recurrence; Thoracotomy
PubMed: 37800658
DOI: 10.1002/cam4.6491 -
Archives of Orthopaedic and Trauma... Nov 2023The POSSUM model has been widely used to predict morbidity and mortality after general surgery. Modified versions known as O-POSSUM and P-POSSUM have been used... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The POSSUM model has been widely used to predict morbidity and mortality after general surgery. Modified versions known as O-POSSUM and P-POSSUM have been used extensively in orthopedic surgery, but their accuracy is unclear. This systematic review evaluated the predictive value of these models in older patients with hip fractures.
METHODS
This study was performed and reported based on the "Preferred reporting items for systematic reviews and meta-analyses" guidelines. PubMed, Cochrane, EMBASE, and Web of Science were comprehensively searched for relevant studies, whose methodological quality was evaluated according to the "Methodological index for non-randomized studies" scale. Revman 5 was used to calculate weighted ratios of observed to expected morbidity or mortality.
RESULTS
The meta-analysis included 10 studies, of which nine (2549 patients) assessed the ability of O-POSSUM to predict postoperative morbidity, nine (3649 patients) assessed the ability of O-POSSUM to predict postoperative mortality, and four (1794 patients) assessed the ability of P-POSSUM to predict postoperative mortality. The corresponding weighted ratios of observed to expected morbidity or mortality were 0.84 (95% CI 0.70-1.00), 0.68 (95% CI 0.49-0.95), and 0.61 (95% CI 0.16-2.38).
CONCLUSIONS
While O-POSSUM shows reasonable accuracy in predicting postoperative morbidity in older patients with hip fractures, both P-POSSUM and O-POSSUM substantially overestimate postoperative mortality. The POSSUM model should be optimized further for this patient population.
Topics: Humans; Aged; Risk Assessment; Severity of Illness Index; Hip Fractures; Morbidity; Postoperative Complications
PubMed: 37162574
DOI: 10.1007/s00402-023-04897-9 -
Alcohol and Alcoholism (Oxford,... Sep 2023Alcohol use is a major risk factor for the burden of mortality and morbidity. Alcoholic cirrhosis (AC) and alcoholic liver cancer (ALC) are most important and severe...
Alcohol use is a major risk factor for the burden of mortality and morbidity. Alcoholic cirrhosis (AC) and alcoholic liver cancer (ALC) are most important and severe liver disease outcomes caused by alcohol use. The objectives of the current study were to investigate the global prevalence and burden of disease in disability-adjusted life years (DALYs) for AC and ALC, based on data from the Global Burden of Disease (GBD). Incidence, prevalence, death, and DALYs for GBDs in different locations, years, sex, and age groups were estimated using DisMod-MR 2.1 and a generic Cause of Death Ensemble Modeling approach. The correlations between the age-standardized incidence rate or age-standardized death rate and gender, sociodemographic index (SDI), and alcohol usage were conducted by Generalized Linear Models. Globally, the changes of age-standardized rates of indicators were not much significant over the 30-year period. However, the changes varied widely across regions. Central Asia and East Europe contributed the highest age-standardized incidence, prevalence, death, and DALYs and increased sharply by past 30 years. Generalized Linear Models (GLMs) showed male gender as a risk factor of AC, with the relative risk of incidence of 1.521 and relative risk of death of 1.503. Globally, there were improvements in overall health with regard to GBDs over the 30 years. However, the prevention of AC and ALC should be promoted in middle and middle-high SDI regions, especially Central Asia and East Europe, whereas more medical resources should be provided to improve treatment levels in low SDI region.
Topics: Humans; Male; Adult; Global Burden of Disease; Quality-Adjusted Life Years; Risk Factors; Liver Diseases, Alcoholic; Prevalence; Incidence; Liver Cirrhosis, Alcoholic; Global Health
PubMed: 37452498
DOI: 10.1093/alcalc/agad046 -
Indian Journal of Ophthalmology Jun 2024
Topics: Humans; Vitreoretinal Surgery; Morbidity; Global Health
PubMed: 38804794
DOI: 10.4103/IJO.IJO_1154_24 -
Minerva Obstetrics and Gynecology Dec 2023The increased risks of various obstetric, maternal and fetal comorbidities of monochorionic twin pregnancies are widely known. However, despite its high prevalence and... (Review)
Review
The increased risks of various obstetric, maternal and fetal comorbidities of monochorionic twin pregnancies are widely known. However, despite its high prevalence and significance, the assessment of neurological morbidity as more commonly in selective fetal growth restriction (sFGR) is concerned with more health care. This literature review aims to provide more information about such an assessment. To this end, retrospective cases of sFGR were studied in monochorionic twins, already diagnosed, classified and who had the recommended management, published between 2001 and 2018 in 17 scientific articles. In the assessment of fetal mortality, the highest risk of death of the restricted fetus was found in type 3 of sFGR, while type 2 sFGR was responsible for the highest death rates of both fetuses and also the lowest mean gestational age at delivery, 30.9 weeks. Regarding neurological morbidity, however, studies have shown a higher risk of brain damage in the habitually growing twin compared to the restricted one in the case of sFGR. This may be due to prematurity or intermittent diastolic flow on Doppler in type 2 and 3 of sFGR, however, statements about its pathophysiology still lack further studies.
Topics: Female; Humans; Pregnancy; Fetal Growth Retardation; Morbidity; Pregnancy, Twin; Retrospective Studies
PubMed: 35758094
DOI: 10.23736/S2724-606X.22.05068-0