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Chest Feb 2017Since initial reports 40 years ago on pediatric OSA syndrome (OSAS) as a distinct and prevalent clinical entity, substantial advances have occurred in the delineation of... (Review)
Review
Since initial reports 40 years ago on pediatric OSA syndrome (OSAS) as a distinct and prevalent clinical entity, substantial advances have occurred in the delineation of diagnostic and treatment approaches. However, despite emerging and compelling evidence that OSAS increases the risk for cognitive, cardiovascular, and metabolic end-organ morbidities, routine assessment of such morbidities is seldom conducted in clinical practice. One of the major reasons for such discrepancies resides in the relatively labor-intensive and onerous steps that would be required to detect the presence of any of such morbidities, further adding to the already elevated cost of diagnosing the disorder. To circumvent these obstacles, the search for biomarker signatures of pediatric OSA and its cognitive and cardiometabolic consequences was launched, and considerable progress has occurred since then. Here, we review the current evidence for the presence of morbidity-related biomarkers among children with OSAS, and explore future opportunities in this promising arena.
Topics: Biomarkers; C-Reactive Protein; Cardiovascular Diseases; Child; Cognitive Dysfunction; Cytokines; Dyslipidemias; Humans; Inflammation; Insulin Resistance; Morbidity; Phenotype; Sleep Apnea, Obstructive
PubMed: 27720883
DOI: 10.1016/j.chest.2016.09.026 -
Behavioural Neurology 2013Tourette syndrome (TS) is often accompanied by other symptoms and syndromes. The two best-known co-morbidities are Attention Deficit Hyperactivity Disorder (ADHD) and... (Review)
Review
Tourette syndrome (TS) is often accompanied by other symptoms and syndromes. The two best-known co-morbidities are Attention Deficit Hyperactivity Disorder (ADHD) and Obsessive Compulsive Disorder (OCD), but also other conditions like rage-attacks, depression, and sleeping disturbances are frequent in persons with TS. Both in clinical cohorts and in population-based cohorts the prevalence of co-morbidities is high. The presence of co-morbid ADHD and/or OCD has an impact on psychosocial, educational, and neuropsychological consequences of TS and it is associated with higher rates of other co-morbid disorders, like rage, anxiety, and conduct disorders. The symptoms of a co-morbid disorder might appear prior to the time that tics reach clinical attention. The TS phenotype probably changes during the course of the disease. The exact aetiology of the co-occurrence of co-morbid disorders and TS is not known, but they probably all are neurotransmitter disorders. European guidelines recommend first-choice pharmacological treatment, but randomised double-blinded trials are needed. Professionals need to be aware of the close relationship between TS and co-morbidities in order to give the patients the right treatment and support.
Topics: Attention Deficit Disorder with Hyperactivity; Comorbidity; Humans; Obsessive-Compulsive Disorder; Prevalence; Tourette Syndrome
PubMed: 23187139
DOI: 10.3233/BEN-120275 -
Clinical & Experimental Optometry Mar 2022Dry Eye Disease (DED) is a complex and multifactorial disorder of tear homoeostasis that results in pain, visual disturbance, and ocular surface damage. It is highly... (Review)
Review
Dry Eye Disease (DED) is a complex and multifactorial disorder of tear homoeostasis that results in pain, visual disturbance, and ocular surface damage. It is highly prevalent around the world and is associated with many co-morbidities that may contribute to or exacerbate symptoms and signs of disease and affect disease phenotype. However, DED is not one disease and can manifest with a variety of symptoms and/or signs. In this review, we discuss relationships between various co-morbidities and DED phenotypes. For example, individuals with immune mediated diseases, like Sjögren's Syndrome and Graft versus Host Disease, often present with aqueous tear deficiency (ADDE) in the setting of lacrimal gland dysfunction. Individuals with disorders that affect the periocular skin, like rosacea and seborrhoeic dermatitis, often present with evaporative dry eye (EDE) in the setting of eyelid and/or meibomian gland abnormalities. Individuals with pain related disorders, such as chronic pain syndrome and migraine, often present with ocular pain out of proportion to tear film abnormalities, often with accompanying corneal nerve hypersensitivity. Individuals with diabetes mellitus often present with an epitheliopathy in the setting of decreased sensation (neurotrophic keratitis). While not absolute, understanding relationships between co-morbidities and DED phenotypes can help tailor a therapeutic plan to the individual patient.
Topics: Dry Eye Syndromes; Humans; Meibomian Glands; Morbidity; Phenotype; Tears
PubMed: 34369296
DOI: 10.1080/08164622.2021.1962210 -
The Spine Journal : Official Journal of... Sep 2021Individuals living with a spinal cord injury (SCI) are at heightened risk for a number of chronic health conditions such as secondary comorbidities that may develop or...
BACKGROUND CONTEXT
Individuals living with a spinal cord injury (SCI) are at heightened risk for a number of chronic health conditions such as secondary comorbidities that may develop or be influenced by the injury, the presence of impairment, and/or the process of aging.
PURPOSE
The objective of this study was to compare the incidence of and adjusted hazards for cardiovascular and metabolic (cardiometabolic) morbidities among adults following SCI compared to adults without SCIs.
STUDY DESIGN/SETTING
Longitudinal cohort from a nationwide insurance claims database.
PATIENT SAMPLE
Privately-insured beneficiaries were included if they had an ICD-9-CM diagnostic code for traumatic SCI (n=9,081). Adults without SCI were also included (n=1,474,232).
OUTCOME MEASURES AND METHODS
Incidence estimates of common cardiometabolic morbidities were compared at 4-years of enrollment. Survival models were used to quantify unadjusted and adjusted hazard ratios for incident cardiometabolic morbidities.
RESULTS
Adults living with traumatic SCIs had a higher 5-year incidence of any cardiometabolic morbidities (56.2% vs. 36.4%) as compared to adults without SCI, and differences were to a clinically meaningful extent. Survival models demonstrated that adults with SCI had a greater hazard for any cardiometabolic morbidity (Hazard Ratio [HR]: 1.67; 95%CI: 1.58, 1.76) and all cardiometabolic disorders; this ranged from HR: 1.45 (1.32, 1.59) for non-alcoholic fatty liver disease to HR: 3.55 (3.36, 3.76) for heart failure.
CONCLUSIONS
Adults with SCIs have a significantly higher incidence of and risk for common cardiometabolic morbidities, as compared to adults without SCIs. Efforts are needed to facilitate the development of improved clinical screening algorithms and early interventions to reduce risk of cardiometabolic disease onset/progression in this vulnerable population.
Topics: Adult; Cohort Studies; Comorbidity; Humans; Incidence; Morbidity; Spinal Cord Injuries
PubMed: 34023517
DOI: 10.1016/j.spinee.2021.05.014 -
BMC Nephrology Jul 2013Uric acid is the end product of purine metabolism in humans. High levels are causative in gout and urolithiasis. Hyperuricaemia has also been implicated in the... (Review)
Review
Uric acid is the end product of purine metabolism in humans. High levels are causative in gout and urolithiasis. Hyperuricaemia has also been implicated in the pathophysiology of hypertension, chronic kidney disease (CKD), congestive heart failure (CHF), the metabolic syndrome, type 2 diabetes mellitus (T2DM), and atherosclerosis, with or without cardiovascular events. This article briefly reviews uric acid metabolism and summarizes the current literature on hyperuricaemia in cardiovascular disease and related co-morbidities, and emerging treatment options.
Topics: Animals; Cardiovascular Diseases; Humans; Hyperuricemia; Morbidity
PubMed: 23895142
DOI: 10.1186/1471-2369-14-164 -
Frontiers in Endocrinology 2023Diabetes is a chronic disease associated with numerous complications including diabetic foot disorders, which are associated with significant morbidity and mortality as... (Review)
Review
Diabetes is a chronic disease associated with numerous complications including diabetic foot disorders, which are associated with significant morbidity and mortality as well as high costs. The costs associated with diabetic foot disorders comprise those linked to care (direct) and loss of productivity and poor quality of life (indirect). Due to the constant increase in diabetes prevalence, it is expected that diabetic foot disorder will require more resources, both in terms of caregivers and economically. We reviewed findings on management, morbidity, mortality, and costs related to diabetic foot disorder.
Topics: Humans; Diabetic Foot; Quality of Life; Cost of Illness; Morbidity; Prevalence; Diabetes Mellitus
PubMed: 38298183
DOI: 10.3389/fendo.2023.1323315 -
BMC Veterinary Research Dec 2022Over the last decades, canines have experienced a marked increase in their lifespan, mirroring human populations. Several authors have pointed out the domestic dog as a...
Over the last decades, canines have experienced a marked increase in their lifespan, mirroring human populations. Several authors have pointed out the domestic dog as a suitable animal model for geropathology translational research. The aim of this study is to assess age-related morbidities and mortality in a population of 269 elderly canines (130 males and 139 females) submitted to necropsy. The organic systems exhibiting the higher number of age-related morbidities were the reproductive, cardiovascular and urinary systems and, in females, also the mammary gland. The prevalence of cardiovascular and urinary disease was significantly higher in males and mammary lesions were exclusively found in females. Urinary disease was more frequent in small breeds dogs, while peritoneum and male genital morbidities were significantly higher in larger breeds. Hyperplastic and degenerative lesions were common morbidities found in this elderly dog population. The main cause of death was neoplasia, which accounted for almost half of the deaths. Cardiovascular and urinary pathology also emerged as a frequent cause of mortality. These findings partially parallel data obtained for human species, displaying cancer and cardiovascular pathology as major causes of disease and death in elderlies. Our data reinforce the potential of the domestic dog for further translational investigations on gerontology, meeting the concept of One Health.
Topics: Humans; Female; Male; Dogs; Animals; Aged; Aging; Neoplasms; Longevity; Prevalence; Dog Diseases
PubMed: 36581919
DOI: 10.1186/s12917-022-03518-8 -
Allergy and Asthma Proceedings 2015Chronic obstructive pulmonary disease (COPD) is a progressive and debilitating respiratory condition that leads to significant burden, both medically and financially. It... (Review)
Review
Chronic obstructive pulmonary disease (COPD) is a progressive and debilitating respiratory condition that leads to significant burden, both medically and financially. It affects millions of people worldwide and causes significant morbidity and mortality. Most detailed information related to its prevalence, morbidity, and mortality comes from high-income countries, but 90% of COPD-related deaths occur in low- and middle-income countries. Cigarette smoking is the main risk factor for developing COPD, but other risk factors do exist and need to be recognized. A majority of morbidity and mortality as well as health care costs occur from acute exacerbations of COPD with a known phenotype of patients being "frequent exacerbators." Health care costs for COPD are not only from treatment of exacerbations, such as hospitalization, but also medication costs for maintenance therapy and outpatient treatment. COPD has been linked with many comorbidities leading to significant burden of disease. The goal of this review is to evaluate the overall burden of disease including prevalence, morbidity, mortality, health care costs, and economic costs.
Topics: Cost of Illness; Disease Progression; Health Care Costs; Hospitalization; Humans; Morbidity; Mortality; Prevalence; Pulmonary Disease, Chronic Obstructive; Risk Factors
PubMed: 25562549
DOI: 10.2500/aap.2015.36.3812 -
International Journal of Environmental... Oct 2022Economic burden issues in SARS-CoV-2 patients with underlying co-morbidities are enormous resources for patient treatment and management. The uncertainty costs for... (Review)
Review
Economic burden issues in SARS-CoV-2 patients with underlying co-morbidities are enormous resources for patient treatment and management. The uncertainty costs for clinical management render the healthcare system catatonic and incurs deficits in national annual budgets. This article focuses on systematic steps towards selecting and evaluating literature to uncover gaps and ways to help healthcare stakeholders optimize resources in treating and managing COVID-19 patients with multi-morbidity. A systematic review of all COVID-19 treatment procedures with co-morbidities or multi-morbidity for the period from 2019 to 2022 was conducted. The search includes studies describing treatment costs associated with multi- or co-morbidity cases for infected patients and, if concurrently reported, determining recurring expenses. Study selection will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Galbraith plots and I statistics will be deployed to assess heterogeneity and to identify potential sources. A backward elimination process will be applied in the regression modelling procedure. Based on the number of studies retrieved and their sample size, the subgroup analysis will be stratified on participant disease category, associated total costs, and degree of freedom in cost estimation. These studies were registered in the PROSPERO registry (ID: CRD42022323071).
Topics: Humans; SARS-CoV-2; COVID-19; Financial Stress; Multimorbidity; Morbidity; Systematic Reviews as Topic
PubMed: 36293741
DOI: 10.3390/ijerph192013157 -
Acta Orthopaedica Oct 2016Background and purpose - Body mass index (BMI) outside the normal range possibly affects the perioperative morbidity and mortality following total hip arthroplasty (THA)... (Observational Study)
Observational Study
Background and purpose - Body mass index (BMI) outside the normal range possibly affects the perioperative morbidity and mortality following total hip arthroplasty (THA) and total knee arthroplasty (TKA) in traditional care programs. We determined perioperative morbidity and mortality in such patients who were operated with the fast-track methodology and compared the levels with those in patients with normal BMI. Patients and methods - This was a prospective observational study involving 13,730 procedures (7,194 THA and 6,536 TKA operations) performed in a standardized fast-track setting. Complete 90-day follow-up was achieved using national registries and review of medical records. Patients were grouped according to BMI as being underweight, of normal weight, overweight, obese, very obese, and morbidly obese. Results - Median length of stay (LOS) was 2 (IQR: 2-3) days in all BMI groups. 30-day re-admission rates were around 6% for both THA (6.1%) and TKA (5.9%), without any statistically significant differences between BMI groups in univariate analysis (p > 0.4), but there was a trend of a protective effect of overweight for both THA (p = 0.1) and TKA (p = 0.06). 90-day re-admission rates increased to 8.6% for THA and 8.3% for TKA, which was similar among BMI groups, but there was a trend of lower rates in overweight and obese TKA patients (p = 0.08 and p = 0.06, respectively). When we adjusted for preoperative comorbidity, high BMI in THA patients (very obese and morbidly obese patients only) was associated with a LOS of >4 days (p = 0.001), but not with re-admission. No such relationship existed for TKA. Interpretation - A fast-track setting resulted in similar length of hospital stay and re-admission rates regardless of BMI, except for very obese and morbidly obese THA patients.
Topics: Aged; Arthroplasty, Replacement, Hip; Arthroplasty, Replacement, Knee; Body Mass Index; Comorbidity; Denmark; Female; Follow-Up Studies; Humans; Length of Stay; Male; Middle Aged; Morbidity; Obesity, Morbid; Osteoarthritis, Hip; Osteoarthritis, Knee; Postoperative Complications; Prognosis; Prospective Studies; Registries
PubMed: 27347785
DOI: 10.1080/17453674.2016.1203477