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Verma VK, Yadav R, Beevi SS, Mohod AS, Mancharla S, Damodar N, Darapuneni RC, Reddy SG, Upendram P, Salt MN, Kulkarni P, Sahu S, Bollineni BR. Differential host responses to COVID-19: Unraveling the complexity. Diagn Microbiol Infect Dis 2024; 109:116281. [PMID: 38537507 DOI: 10.1016/j.diagmicrobio.2024.116281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 03/20/2024] [Accepted: 03/21/2024] [Indexed: 04/30/2024]
Abstract
These diverse outcomes of Covid-19 are influenced by various factors including age, gender, underlying health conditions, immune responses, viral variants, external factors, and overall quality of life. Demographic analysis of patients aged 0-18 years experienced mild to moderate cases, above 55 years with co-morbidities, were more severely affected.COVID-19 incidence was higher in males (58 %) & (42 %) in females. The reduced expression of Toll-like receptors (TLR) in severe and critical patients is a crucial determinant. This reduced TLR expression is primarily attributed to the dominance of the PLpro viral protein of COVID-19. Disease enrichment analysis highlights the long-term impact of COVID-19, which can lead to post-recovery complications such as hypertension, diabetes, cardiac diseases, and brain ischemia in Covid-19 patients. In conclusion, a comprehensive strategy targeting key factors like PLpro, TLR, and inflammatory cytokines such as IL-1 and IL-6 could offer an effective approach to mitigate the devastating effects of COVID-19.
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Affiliation(s)
- Vinod Kumar Verma
- KIMS Foundation and Research Centre, KIMS Hospital, Minister Road, Secunderabad, Telangana, India.
| | - Rahul Yadav
- KIMS Foundation and Research Centre, KIMS Hospital, Minister Road, Secunderabad, Telangana, India
| | - Syed Sultan Beevi
- KIMS Foundation and Research Centre, KIMS Hospital, Minister Road, Secunderabad, Telangana, India.
| | - Annie S Mohod
- KIMS Foundation and Research Centre, KIMS Hospital, Minister Road, Secunderabad, Telangana, India
| | - Shravya Mancharla
- KIMS Foundation and Research Centre, KIMS Hospital, Minister Road, Secunderabad, Telangana, India
| | - Neha Damodar
- KIMS Foundation and Research Centre, KIMS Hospital, Minister Road, Secunderabad, Telangana, India
| | | | - Sukurtha Gopal Reddy
- Diagnostics Division, Krishna Institute of Medical Sciences, Minister Road, Secunderabad, Telangana, India
| | - Pavani Upendram
- Department of Genetics, Krishna Institute of Medical Sciences, Minister Road, Secunderabad, Telangana, India
| | - Mohammad Nawaz Salt
- Department of Pulmonology, Krishna Institute of Medical Sciences, Minister Road, Secunderabad, Telangana, India
| | - Praveen Kulkarni
- Department of Internal Medicine, Krishna Institute of Medical Sciences, Minister Road, Secunderabad, Telangana, India
| | - Sambit Sahu
- Department of Critical care, Krishna Institute of Medical Sciences, Minister Road, Secunderabad, Telangana, India
| | - Bhaskar Rao Bollineni
- KIMS Foundation and Research Centre, KIMS Hospital, Minister Road, Secunderabad, Telangana, India
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Le BK, Hoang M. Prevalence of obstructive sleep apnea in patients with chronic obstructive pulmonary disease in Vietnam. Sleep Breath 2024:10.1007/s11325-024-03035-y. [PMID: 38662313 DOI: 10.1007/s11325-024-03035-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 03/11/2024] [Accepted: 04/08/2024] [Indexed: 04/26/2024]
Abstract
PURPOSE Chronic obstructive pulmonary disease and obstructive sleep apnea are two common respiratory diseases. Chronic obstructive pulmonary disease patients co-morbid with obstructive sleep apnea are associated with increased cardiovascular adverse events, frequent acute exacerbations, and higher mortality. Only a few studies on obstructive sleep apnea among patients with chronic obstructive pulmonary disease are available in Vietnam. The study aims to determine the prevalence of obstructive sleep apnea in patients with chronic obstructive pulmonary disease in Vietnam. METHODS This is a cross-sectional study in patients with chronic obstructive pulmonary disease at multi-sites in Vietnam: the People's Hospital of Gia Dinh, Bach Mai Hospital, Phoi Viet Clinics, and Lam Dong Medical College using type 3 sleep monitoring device at sleep labs to diagnose obstructive sleep apnea in all study participants. RESULTS Two hundred seventy-eight patients with chronic obstructive pulmonary disease were enrolled. Among the patients, 93.2% were male, with an average age of 66.9 ± 9.3 and a BMI of 21.9 ± 3.8 kg/m2; 82.0% were symptomatic including 44.6% in group B and 37.4% in group D with average post-FEV1 of 49.8 ± 18.3% predicted values. One hundred seventeen patients (42.1%) with chronic obstructive pulmonary disease presented obstructive sleep apnea defined by AHI ≥ 15 events/h. CONCLUSIONS The prevalence of obstructive sleep apnea in patients with chronic obstructive pulmonary disease in Vietnam was 42.1% for an AHI of ≥ 15 events/h.
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Affiliation(s)
- Bao Khac Le
- Ho Chi Minh City Association of Sleep Medicine, Ho Chi Minh, Viet Nam
- Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Việt Nam
| | - Minh Hoang
- Ho Chi Minh City Association of Sleep Medicine, Ho Chi Minh, Viet Nam.
- Medical Education Center, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Việt Nam.
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Chuang ML, Wang YH, Lin IF. The contribution of estimated dead space fraction to mortality prediction in patients with chronic obstructive pulmonary disease-a new proposal. PeerJ 2024; 12:e17081. [PMID: 38560478 PMCID: PMC10981412 DOI: 10.7717/peerj.17081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 02/19/2024] [Indexed: 04/04/2024] Open
Abstract
Background Mortality due to chronic obstructive pulmonary disease (COPD) is increasing. However, dead space fractions at rest (VD/VTrest) and peak exercise (VD/VTpeak) and variables affecting survival have not been evaluated. This study aimed to investigate these issues. Methods This retrospective observational cohort study was conducted from 2010-2020. Patients with COPD who smoked, met the Global Initiatives for Chronic Lung Diseases (GOLD) criteria, had available demographic, complete lung function test (CLFT), medication, acute exacerbation of COPD (AECOPD), Charlson Comorbidity Index, and survival data were enrolled. VD/VTrest and VD/VTpeak were estimated (estVD/VTrest and estVD/VTpeak). Univariate and multivariable Cox regression with stepwise variable selection were performed to estimate hazard ratios of all-cause mortality. Results Overall, 14,910 patients with COPD were obtained from the hospital database, and 456 were analyzed after excluding those without CLFT or meeting the lung function criteria during the follow-up period (median (IQR) 597 (331-934.5) days). Of the 456 subjects, 81% had GOLD stages 2 and 3, highly elevated dead space fractions, mild air-trapping and diffusion impairment. The hospitalized AECOPD rate was 0.60 ± 2.84/person/year. Forty-eight subjects (10.5%) died, including 30 with advanced cancer. The incidence density of death was 6.03 per 100 person-years. The crude risk factors for mortality were elevated estVD/VTrest, estVD/VTpeak, ≥2 hospitalizations for AECOPD, advanced age, body mass index (BMI) <18.5 kg/m2, and cancer (hazard ratios (95% C.I.) from 1.03 [1.00-1.06] to 5.45 [3.04-9.79]). The protective factors were high peak expiratory flow%, adjusted diffusing capacity%, alveolar volume%, and BMI 24-26.9 kg/m2. In stepwise Cox regression analysis, after adjusting for all selected factors except cancer, estVD/VTrest and BMI <18.5 kg/m2 were risk factors, whereas BMI 24-26.9 kg/m2 was protective. Cancer was the main cause of all-cause mortality in this study; however, estVD/VTrest and BMI were independent prognostic factors for COPD after excluding cancer. Conclusions The predictive formula for dead space fraction enables the estimation of VD/VTrest, and the mortality probability formula facilitates the estimation of COPD mortality. However, the clinical implications should be approached with caution until these formulas have been validated.
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Affiliation(s)
- Ming-Lung Chuang
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Div. Pulmonary Medicine, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yu Hsun Wang
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - I-Feng Lin
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Bailey GA, Rawlings A, Torabi F, Pickrell WO, Peall KJ. Prevalence and temporal relationship of clinical co-morbidities in idiopathic dystonia: a UK linkage-based study. J Neurol 2024:10.1007/s00415-024-12284-6. [PMID: 38512523 DOI: 10.1007/s00415-024-12284-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 02/26/2024] [Accepted: 02/28/2024] [Indexed: 03/23/2024]
Abstract
While motor and psychiatric phenotypes in idiopathic dystonia are increasingly well understood, a few studies have examined the rate, type, and temporal pattern of other clinical co-morbidities in dystonia. Here, we determine the rates of clinical diagnoses across 13 broad systems-based diagnostic groups, comparing an overall idiopathic dystonia cohort, and sub-cohorts of cervical dystonia, blepharospasm, and dystonic tremor, to a matched-control cohort. Using the SAIL databank, we undertook a longitudinal population-based cohort study (January 1st 1994-December 31st 2017) using anonymised electronic healthcare records for individuals living in Wales (UK), identifying those diagnosed with dystonia through use of a previously validated algorithm. Clinical co-morbid diagnoses were identified from primary health care records, with a 10% prevalence threshold required for onward analysis. Using this approach, 54,166 dystonia cases were identified together with 216,574 matched controls. Within this cohort, ten of the main ICD-10 diagnostic codes exceeded the 10% prevalence threshold over the 20-year period (infection, neurological, respiratory, gastrointestinal, genitourinary, dermatological, musculoskeletal, circulatory, neoplastic, and endocrinological). In the overall dystonia cohort, musculoskeletal (aOR: 1.89, aHR: 1.74), respiratory (aOR: 1.84; aHR: 1.65), and gastrointestinal (aOR: 1.72; aHR: 1.6) disorders had the strongest associations both pre- and post-dystonia diagnosis. However, variation in the rate of association of individual clinical co-morbidities was observed across the cervical, blepharospasm, and tremor dystonia groups. This study suggests an increased rate of specific co-morbid clinical disorders both pre- and post-dystonia diagnosis which should be considered during clinical assessment of those with dystonia to enable optimum symptomatic management.
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Affiliation(s)
- Grace A Bailey
- Neuroscience and Mental Health Research Institute, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Hadyn Ellis Building, Maindy Road, Cardiff, CF24 4HQ, UK
| | - Anna Rawlings
- Swansea University Medical School, Singleton Park, Swansea, UK
| | - Fatemeh Torabi
- Swansea University Medical School, Singleton Park, Swansea, UK
- Health Data Research UK, Swansea, UK
| | - W Owen Pickrell
- Swansea University Medical School, Singleton Park, Swansea, UK
- Department of Neurology, Morriston Hospital, Swansea Bay University Health Board, Swansea, UK
| | - Kathryn J Peall
- Neuroscience and Mental Health Research Institute, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Hadyn Ellis Building, Maindy Road, Cardiff, CF24 4HQ, UK.
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de Bejczy A, Addolorato G, Aubin HJ, Guiraud J, Korpi ER, John Nutt D, Witkiewitz K, Söderpalm B. AUD in perspective. Int Rev Neurobiol 2024; 175:1-19. [PMID: 38555113 DOI: 10.1016/bs.irn.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
Alcohol is a major cause of pre-mature death and individual suffering worldwide, and the importance of diagnosing and treating AUD cannot be overstated. Given the global burden and the high attributable factor of alcohol in a vast number of diseases, the need for additional interventions and the development of new medicines is considered a priority by the World Health Organization (WHO). As of today, AUD is severely under-treated with a treatment gap nearing 90%, strikingly higher than that for other psychiatric disorders. Patients often seek treatment late in the progress of the disease and even among those who seek treatment only a minority receive medication, mirroring the still-prevailing stigma of the disease, and a lack of access to effective treatments, as well as a reluctance to total abstinence. To increase adherence, treatment goals should focus not only on maintaining abstinence, but also on harm reduction and psychosocial functioning. A personalised approach to AUD treatment, with a holistic view, and tailored therapy has the potential to improve AUD treatment outcomes by targeting the heterogeneity in genetics and pathophysiology, as well as reason for, and reaction to drinking. Also, the psychiatric co-morbidity rates are high in AUD and dual diagnosis can worsen symptoms and influence treatment response and should be considered in the treatment strategies.
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Affiliation(s)
- Andrea de Bejczy
- Addiction Biology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Addiction and Dependency, Sahlgrenska University Hospital, Gothenburg, Sweden.
| | - Giovanni Addolorato
- Department of Medical and Surgical Sciences, Università Cattolica di Roma, Rome, Italy; Internal Medicine and Alcohol Related Disease Unit, Columbus-Gemelli Hospital, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Henri-Jean Aubin
- Université Paris-Saclay, Inserm, CESP, Villejuif, France; AP-HP, Université Paris Saclay, Villejuif, France
| | - Julien Guiraud
- Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands; Vergio, Clichy, France
| | - Esa R Korpi
- Department of Pharmacology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - David John Nutt
- Imperial College London and GABA Labs, London, United Kingdom
| | - Katie Witkiewitz
- Department of Psychology and Center on Alcohol, Substance Use, and Addictions, University of New Mexico, Albuquerque, New Mexico, United States
| | - Bo Söderpalm
- Addiction Biology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Addiction and Dependency, Sahlgrenska University Hospital, Gothenburg, Sweden
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Sabatini S, Martyr A, Hunt A, Gamble LD, Matthews FE, Thom JM, Jones RW, Allan L, Knapp M, Quinn C, Victor C, Pentecost C, Rusted JM, Morris RG, Clare L. Health conditions in spousal caregivers of people with dementia and their relationships with stress, caregiving experiences, and social networks: longitudinal findings from the IDEAL programme. BMC Geriatr 2024; 24:171. [PMID: 38373905 PMCID: PMC10875834 DOI: 10.1186/s12877-024-04707-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 01/13/2024] [Indexed: 02/21/2024] Open
Abstract
OBJECTIVES Longitudinal evidence documenting health conditions in spousal caregivers of people with dementia and whether these influence caregivers' outcomes is scarce. This study explores type and number of health conditions over two years in caregivers of people with dementia and subgroups based on age, sex, education, hours of care, informant-rated functional ability, neuropsychiatric symptoms, cognition of the person with dementia, and length of diagnosis in the person with dementia. It also explores whether over time the number of health conditions is associated with caregivers' stress, positive experiences of caregiving, and social networks METHODS: Longitudinal data from the IDEAL (Improving the experience of Dementia and Enhancing Active Life) cohort were used. Participants comprised spousal caregivers (n = 977) of people with dementia. Self-reported health conditions using the Charlson Comorbidity Index, stress, positive experiences of caregiving, and social network were assessed over two years. Mixed effect models were used RESULTS: On average participants had 1.5 health conditions at baseline; increasing to 2.1 conditions over two years. More health conditions were reported by caregivers who were older, had no formal education, provided 10 + hours of care per day, and/or cared for a person with more neuropsychiatric symptoms at baseline. More baseline health conditions were associated with greater stress at baseline but not with stress over time. Over two years, when caregivers' health conditions increased, their stress increased whereas their social network diminished DISCUSSION: Findings highlight that most caregivers have their own health problems which require management to avoid increased stress and shrinking of social networks.
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Affiliation(s)
- Serena Sabatini
- Institute of Mental Health, School of Medicine, University of Nottingham, Nottingham, UK
| | - Anthony Martyr
- University of Exeter Medical School, University of Exeter, Exeter, UK.
- Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School, Exeter, UK.
| | - Anna Hunt
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Laura D Gamble
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Fiona E Matthews
- Institute for Clinical and Applied Health Research, Hull York Medical School, University of Hull, Hull, UK
| | - Jeanette M Thom
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Roy W Jones
- Research Institute for the Care of Older People (RICE), Bath, UK
| | - Louise Allan
- University of Exeter Medical School, University of Exeter, Exeter, UK
- NIHR Applied Research Collaboration South-West Peninsula, Exeter, UK
| | - Martin Knapp
- London School of Economics and Political Science, London, UK
| | - Catherine Quinn
- Centre for Applied Dementia Studies, Bradford University, Bradford, UK
- Wolfson Centre for Applied Health Research, Bradford, UK
| | - Christina Victor
- College of Health, Medicine and Life Sciences, Department of Health Sciences, Brunel University London, London, UK
| | - Claire Pentecost
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | | | - Robin G Morris
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Linda Clare
- University of Exeter Medical School, University of Exeter, Exeter, UK
- NIHR Applied Research Collaboration South-West Peninsula, Exeter, UK
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Laflamme L, Lindholm E, Möller J. Repeated hospital admission for intentional poisonings among older adults - a Swedish national register-based study. BMC Geriatr 2024; 24:157. [PMID: 38360600 PMCID: PMC10870539 DOI: 10.1186/s12877-024-04717-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 01/17/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Poisoning injuries is an increasing concern among older people, and so is the repetition of intentional poisonings. To date, few studies have documented the pattern and individual risk factors for repeated poisonings. This national study aims to shed light on the burden, pattern, and health-related risk factors of repeated intentional poisoning leading to hospitalization or death among older Swedish adults (50 years and older), with a focus on the year following a first event. METHODS We conducted a nationwide register-based cohort study of people aged 50-100, hospitalized for intentional poisoning (ICD10: X60-69) during 2006-2016 (n = 15,219) and re-hospitalized by poisoning of any intent within a year (n = 1710), i.e., up to the end of 2017. We considered in turn, the distribution of the second poisoning in 30-day intervals stratified by intent; poisoning lethality within a month and a year; and the sex-specific association between health conditions and being re-hospitalized for intentional poisoning within one year as compared to being hospitalized only once using logistic regression (odds ratios (OR) with 95% confidence intervals (95% CI)). RESULTS Following an intentional poisoning, re-hospitalization within a year was predominantly for a new intentional poisoning (89.7%) and occurred most typically within a month (median 4 days). Death within 30 days occurred in similar proportion for the first and second poisoning (2.3% vs. 2.1% respectively). Among both men and women, comorbidity of psychiatric illness was strongly associated with re-hospitalization for intentional poisoning (adjusted ORs = 1.70; 95% CI = 1.45-2.01 and 1.89 (95% CI = 1.60-2.19) respectively). CONCLUSION Most re-hospitalizations within a year after intentional poisoning are also for intentional poisoning and occur most typically within days. Re-hospitalization is associated with several conditions that are characteristic of poor mental health and there are more similarities than differences between men and women in that respect.
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Affiliation(s)
- L Laflamme
- Department of Global Public Health , Karolinska Institutet, Widerströmska huset Tomtebodavägen 18A, 17177, Stockholm, Sweden
| | - E Lindholm
- Department of Global Public Health , Karolinska Institutet, Widerströmska huset Tomtebodavägen 18A, 17177, Stockholm, Sweden
| | - Jette Möller
- Department of Global Public Health , Karolinska Institutet, Widerströmska huset Tomtebodavägen 18A, 17177, Stockholm, Sweden.
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Park JH, Park DJ, Kim H, Park H, Nam H, Lee B, Kim J, Cho YS, Kong SH, Lee HJ, Yang HK. Long-term impact of weight loss in people with class II obesity on the overall burden of disease: evidence from the national health screening cohort in Korea. Surg Obes Relat Dis 2024:S1550-7289(24)00039-X. [PMID: 38418337 DOI: 10.1016/j.soard.2024.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 01/06/2024] [Accepted: 01/21/2024] [Indexed: 03/01/2024]
Abstract
BACKGROUND Obesity is known to increase overall disease burden but does obesity management actually help reduce disease burden? OBJECTIVES To investigate the effects of weight loss on disease burden in people with obesity using the National Health Insurance Service-Health Screening Cohort (NHIS-HEALS) in Korea. SETTING Pure longitudinal observational study using Nationwide cohort database. METHODS Out of 514,866 NHIS-HEALS cohort, participants with class II obesity in Asia-Pacific region (30 ≤ body mass index [BMI] < 35) who underwent health check-up provided by NHIS during 2003-2004 (index date) were included. All final participants continued to receive a total of 5 biennial health check-ups over the next 10 years without missing. A group-based trajectory model (GBTM) was used to categorize subjects based on 10-year BMI change patterns. The changes of co-morbidities, healthcare resource utilization, and medical cost were analyzed. RESULTS The final study subjects (9857) were categorized into 3 trajectory clusters based on the pattern of BMI (kg/m2) change: maintenance (57.35%) with an average change of -.02 ± .06, loss (38.65%) with -.04 ± .08, and substantial loss (4.0%) with -.10 ± .18. The annual increases in the number of co-morbidities per subject in each cluster were .18, .18, and .16 (all P < .001), respectively. The increase of healthcare resource utilization over time was lowest for the substantial loss compared to maintenance and loss. With each passing year, the average annual total healthcare cost increased by ₩21,200 ($16.48, P = .034) and ₩10,500 ($8.16, P = .498) in the maintenance and loss, respectively, but decreased by ₩62,500 ($48.59, P = .032) in the substantial loss. CONCLUSIONS Weight loss in people with obesity was associated with a reduced burden of disease, as evidenced by lower co-morbidity, healthcare resource utilization rate, and decreased medical costs. This study highlights the potential positive long-term impact on Korean society when actively managing weight in individuals with obesity.
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Affiliation(s)
- Ji-Hyeon Park
- Department of Surgery, Seoul National University Hospital, Seoul, Korea; Department of Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Do Joong Park
- Department of Surgery, Seoul National University Hospital, Seoul, Korea; Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
| | - Hyesung Kim
- Health Economics & Market Access, Johnson & Johnson MedTech Korea, Seoul, Republic of Korea
| | - Hyejin Park
- Health Economics & Market Access, Johnson & Johnson MedTech Korea, Seoul, Republic of Korea
| | | | - Bora Lee
- RexSoft Corp., Seoul, South Korea; Institute of Health & Environment, Seoul National University, Seoul, Republic of Korea
| | - Jeesun Kim
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
| | - Yo-Seok Cho
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
| | - Seong-Ho Kong
- Department of Surgery, Seoul National University Hospital, Seoul, Korea; Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Hyuk-Joon Lee
- Department of Surgery, Seoul National University Hospital, Seoul, Korea; Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Han-Kwang Yang
- Department of Surgery, Seoul National University Hospital, Seoul, Korea; Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
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Veisi H, Malakian A, Fakhar M, Sharifpour A, Nakhaei M, Soleymani M, Mosave SR, Ahangar N, Seyedpour SH. First Molecular Evidence of Emerging Lophomonas Pathogen Among Patients Suspected of Having Pulmonary Tuberculosis in Mazandaran Province, Northern Iran. Acta Parasitol 2023:10.1007/s11686-023-00729-3. [PMID: 38110641 DOI: 10.1007/s11686-023-00729-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 10/12/2023] [Indexed: 12/20/2023]
Abstract
PURPOSE Lophomoniasis is a chronic protozoan respiratory disease in humans with main clinical symptoms such as chronic cough, productive sputum, breath shortness, and occasionally hemoptysis. Differentiation diagnosis of lophomoniasis from tuberculosis (TB) and asthma is crucial. METHODS In this study, 210 participants with suspected TB referred to tuberculosis laboratories in Mazandaran province, northeastern Iran, were enrolled during 2021. All patients showed low grade fever, chronic cough or sputum on referral. Sputum specimens were collected from the participants, and Lophomonas DNA was detected through a conventional genus-specific polymerase chain reaction (PCR). RESULTS Out of 210 participants, 67 (31.9%) had Lophomonas spp., infection, 38 (18.1%) had TB (Smear and culture-positive), and 20 (9.5%) had both TB and Lophomonas co-infection. CONCLUSION Based on our results, a relatively high occurrence of Lophomonas infection was found among patients suspected of having TB. Accordingly, due to the high similarity of clinical symptoms between both pulmonary diseases, it is highly recommended to accurately and early diagnose the parasite in the sputum specimen.
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Affiliation(s)
- Hossein Veisi
- Iranian National Registry Center for Lophomoniasis (INRCL), Imam Khomeini Hospital, Mazandaran University of Medical Sciences, P.O Box 48166-33131, Sari, Iran
| | - Abdollah Malakian
- Department of Emergency Medicine, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Mahdi Fakhar
- Iranian National Registry Center for Lophomoniasis (INRCL), Imam Khomeini Hospital, Mazandaran University of Medical Sciences, P.O Box 48166-33131, Sari, Iran.
| | - Ali Sharifpour
- Iranian National Registry Center for Lophomoniasis (INRCL), Imam Khomeini Hospital, Mazandaran University of Medical Sciences, P.O Box 48166-33131, Sari, Iran
- Pulmonary and Critical Care Division, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Maryam Nakhaei
- Iranian National Registry Center for Lophomoniasis (INRCL), Imam Khomeini Hospital, Mazandaran University of Medical Sciences, P.O Box 48166-33131, Sari, Iran
| | - Mostafa Soleymani
- Iranian National Registry Center for Lophomoniasis (INRCL), Imam Khomeini Hospital, Mazandaran University of Medical Sciences, P.O Box 48166-33131, Sari, Iran
| | - Seyed Reza Mosave
- Provincial Health Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Nader Ahangar
- Provincial Health Center, Mazandaran University of Medical Sciences, Sari, Iran
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Yarbakhsh E, van der Sterren A, Bowles D. Screening and Treatment for Co-occurring Gambling and Substance Use: A Scoping Review. J Gambl Stud 2023; 39:1699-1721. [PMID: 37493839 PMCID: PMC10628029 DOI: 10.1007/s10899-023-10240-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2023] [Indexed: 07/27/2023]
Abstract
There is a high prevalence of gambling harms co-occurring with substance use harms. Where harms are co-occurring, they may be experienced as more severe. However, there is little evidence that services are systematically screening for such co-occurring harms in treatment-seeking populations. Furthermore, treatment modalities remain relatively under-developed, with treatment usually addressing only one source of harm.This scoping review looks at the current literature on screening and therapeutic interventions for co-occurring gambling and substance use harms to understand how co-occurring harms may be managed in a treatment setting. It draws together available data on the intersections of substance use harms and gambling related harms, in a treatment context.This research identifies a range of potentially useful validated tools for clinicians in substance use treatment settings to screen for gambling harms. For workers in gambling treatment settings who are seeking validated tools to screen for co-occurring substance use harms, the literature provides less guidance.The validated toolbox of therapeutic interventions for those experiencing co-occurring substance use and gambling harms is relatively sparse. Psychosocial interventions appear to offer the best outcomes on gambling measures for those experiencing co-occurring substance use harms. Further research is needed to establish the benefits of different combinations of treatment and treatment types in achieving reductions across both substance use and gambling harms, when these harms are experienced concurrently.
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Affiliation(s)
- Elisabeth Yarbakhsh
- Alcohol, Tobacco and Other Drug Association, ACT (ATODA), Canberra, Australia.
- College of Arts and Social Sciences, Australian National University, Canberra, Australia.
| | - Anke van der Sterren
- Alcohol, Tobacco and Other Drug Association, ACT (ATODA), Canberra, Australia
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Devin Bowles
- ACT Council of Social Service (ACTCOSS), Canberra, Australia
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Alqahtani AR, Alqahtani O, Amro N, Al Qahtani A, Elahmedi M, Abdurabu H, Boutros A, Abdo N, Ebishi A, Awil A, Aldarwish A. Long-term outcomes of laparoscopic sleeve gastrectomy in those with class I obesity: safety, efficacy, and quality of life. Surg Obes Relat Dis 2023; 19:1135-1141. [PMID: 37076319 DOI: 10.1016/j.soard.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 02/19/2023] [Accepted: 03/02/2023] [Indexed: 03/16/2023]
Abstract
BACKGROUND Class I obesity carries significant morbidity and mortality risk similar to higher grades of obesity, and persons with class I obesity have a high risk of progression to class II and III obesity. While bariatric surgery has made strides in safety and efficacy, it remains inaccessible for persons with class I obesity (body mass index [BMI] of 30-35 kg/m2). OBJECTIVES To assess safety, weight loss durability, co-morbidity resolution, and quality of life after laparoscopic sleeve gastrectomy (LSG) in persons with class I obesity. SETTING Multidisciplinary medical center that specializes in obesity management. METHODS A longitudinal prospective single-surgeon registry was queried for data pertaining to persons with class I obesity who underwent primary LSG. Primary endpoint was weight loss. Secondary endpoints included change in obesity-related co-morbidities, adverse events, and post hoc analysis of symptoms of gastroesophageal reflux disease (GERD) and Bariatric Analysis and Reporting Outcome System results. Follow-up was divided into short- (1-3 yr), intermediate- (4-7 yr), and long-term (8-12 yr). We evaluated percent excess weight loss (%EWL) using linear mixed models adjusting for age, sex, years since operation, and baseline BMI. Least-squares means estimates and 95% confidence intervals (CI) were generated. RESULTS Of 13,863 bariatric procedures, a total of 1851 patients were included. Mean baseline BMI, age, and male:female ratio were 32.6 ± 2.1 kg/m2, 33.7 ± 9.2 years, and 1:5, respectively. Adjusted mean %EWL (95% CI) at short-, intermediate-, and long-term follow-up were 111% (95% CI, 91%-131%), 110% (95% CI, 89%-131%), and 141% (95% CI, 57%-225%), respectively. Of 195 patients with type 2 diabetes, 59% experienced complete remission, and of 168 patients with hypertension, 43% experienced complete remission. Being on oral antidiabetes medication was a significant predictor of sustained remission compared with being on insulin or combination therapy (P < .001). Sixty-nine patients had symptoms of GERD before surgery, which improved in 55 (79.7%). Thirty-three patients developed de novo symptoms of GERD. The average Bariatric Analysis and Reporting Outcome System score was 4.5 ± 1.7, with 83% of participants rating their quality of life after surgery as good, very good, or excellent. CONCLUSION Those with class I obesity who undergo LSG experience normalization of weight, sustained remission of co-morbidity, and good quality of life without significant risk of morbidity or mortality.
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Affiliation(s)
| | - Omar Alqahtani
- Department of Surgery, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Nizar Amro
- New You Medical Center, Riyadh, Saudi Arabia
| | - Awadh Al Qahtani
- Department of Surgery, King Saud University, Riyadh, Saudi Arabia
| | | | | | | | - Nael Abdo
- New You Medical Center, Riyadh, Saudi Arabia
| | | | - Amal Awil
- New You Medical Center, Riyadh, Saudi Arabia
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12
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Idolor O, Edigin E, Hino C, He E, Rao J, Ugoh AC, Onobraigho P, Omoike E, Okpujie V, Ezeafulukwe CJ, Eseaton PO, Manadan A, Downey C. Polymyositis/dermatomyositis readmissions: analysis of the nationwide readmission database. Clin Rheumatol 2023; 42:2833-2839. [PMID: 37407906 DOI: 10.1007/s10067-023-06690-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 06/13/2023] [Accepted: 06/28/2023] [Indexed: 07/07/2023]
Abstract
BACKGROUND There is a scarcity of national population-based studies on polymyositis (PM)/dermatomyositis (DM) readmissions in the USA. In this study, we aim to describe the rates, reasons for readmissions, and characteristics of readmissions for adults hospitalized for PM/DM in the USA. METHODS We analyzed the 2018 Nationwide Readmissions Database (NRD). We included index hospitalizations for all adult DM/PM patients with a principal diagnosis of PM/DM using ICD-10 codes. We excluded elective and traumatic readmissions. Using a "rank" command in STATA, the most common specific principal diagnosis of readmissions was outlined. Chi-square tests were used to compare baseline characteristics between readmissions and index hospitalizations. STATA 16 was used for analysis. RESULTS A total of 1610, 1286, and 842 index hospitalizations with a principal diagnosis of PM/DM, that were discharged alive, were included in the 30-, 90-, and 180-day readmission analysis, respectively. Among these, 193 (12%), 276 (21.5%), and 240 (28.5%) were readmitted within 30, 90, and 180 days, respectively. PM and sepsis were the most common reasons for reasons across the 3 timeframes. 30-day readmissions were responsible for an aggregate of 4.1 million US dollars in total hospital cost and 1518 hospital days in 2018. Compared to index hospitalizations, 30-day readmissions have higher Charlson Comorbidity Index scores, severe-extreme loss of function, obesity, and deep venous thrombosis. CONCLUSION About a third of PM/DM hospitalized patients are readmitted within 180 days. Readmissions constitute a significant economic burden to the health care system. PM and sepsis are the main reasons for readmissions. Key points • About a third of polymyositis (PM)/dermatomyositis (DM) hospitalized patients are readmitted within 180 days • PM and sepsis are the main reasons for readmissions. • Readmissions of PM/DM Patients constitute a significant economic burden to the health care system. • Compared to index hospitalizations, 30-day readmissions have higher Charlson comorbidity index scores, severe-extreme loss of function, obesity, and deep venous thrombosis.
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Affiliation(s)
- Osahon Idolor
- Department of Internal Medicine, Piedmont Athens Regional, Athens, GA, USA
| | - Ehizogie Edigin
- Division of Rheumatology, Loma Linda University Health, Loma Linda, USA.
| | - Christopher Hino
- Department of Internal Medicine, Loma Linda University Health, Loma Linda, CA, USA
| | - Emily He
- Department of Internal Medicine, Loma Linda University Health, Loma Linda, CA, USA
| | - Janhavi Rao
- Department of Internal Medicine, Riverside University Medical Center, Riverside, CA, USA
| | - Amaka Cynthia Ugoh
- Department of Family Medicine, University of Benin Teaching Hospital, Benin, Nigeria
| | - Precious Onobraigho
- Department of Internal Medicine, University of Benin Teaching Hospital, Benin, Nigeria
| | - Eugene Omoike
- Department of Internal Medicine, University of Benin Teaching Hospital, Benin, Nigeria
| | - Victory Okpujie
- Department of Internal Medicine, University of Benin Teaching Hospital, Benin, Nigeria
| | | | - Precious Obehi Eseaton
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Augustine Manadan
- Division of Rheumatology, Rush University Medical Center, Chicago, IL, USA
| | - Christina Downey
- Division of Rheumatology, Loma Linda University Health, Loma Linda, USA
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Oliveira Hashiguchi L, Cox SE, Edwards T, Castro MC, Khan M, Liverani M. How can tuberculosis services better support patients with a diabetes co-morbidity? A mixed methods study in the Philippines. BMC Health Serv Res 2023; 23:1027. [PMID: 37749519 PMCID: PMC10519082 DOI: 10.1186/s12913-023-10015-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 09/08/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND People with diabetes mellitus (DM) have an estimated two- to three-times greater risk of adverse tuberculosis (TB) treatment outcomes compared to those without DM. Blood glucose control is a primary aim of managing DM during TB treatment, yet TB programmes are not generally adapted to provide DM services. The purpose of this study was to understand perceptions and the lived experiences of diabetic patients in TB treatment in the Philippines, with a view to informing the development of disease co-management strategies. METHODS This mixed methods study was conducted within a prospective cohort of adults newly-starting treatment for drug-sensitive and drug-resistant TB at 13 public TB clinics in three regions of the Philippines. Within the subset of 189 diabetic persons who self-reported a prior DM diagnosis, or were diagnosed by screenings conducted through the TB clinic, longitudinal blood glucose data were used to ascertain individuals' glycaemic control (controlled or uncontrolled). Univariable logistic regression analyses exploring associations between uncontrolled glycaemia and demographic and clinical factors informed purposive sampling of 31 people to participate in semi-structured interviews. All audio-recorded data were transcribed and thematic analysis performed. RESULTS Participants - both with controlled and uncontrolled blood glucose - were knowledgeable about diabetes and its management. However, a minority of participants were aware of the impact of DM on TB treatment and outcomes. Many participants newly-diagnosed with DM at enrolment in TB treatment had not perceived any diabetic symptoms prior and would have likely not sought clinical consult otherwise. Access to free glucose-lowering medications through TB clinics was a key enabling resource. However, participants expressed fear of side effects and interrupted access to glucose-lowering medications, and a preference for phytotherapy. Many participants felt that physical and financial impacts of TB and its treatment were challenges to DM management. CONCLUSIONS AND RECOMMENDATIONS Results of this study indicate that public TB clinics can provide diabetic patients with additional health care resources and education to address co-morbidity. TB programmes might consider identifying patients with complicated DM, and offering diabetic monitoring and management, as DM and diabetic complications may compound the burden of TB and its treatment.
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Affiliation(s)
- Lauren Oliveira Hashiguchi
- National Institute of Nursing Research, National Institutes of Health, 31 Center Drive, Bethesda, MD, 20892-2178, USA.
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, Keppel St, London, WC1E 7HT, UK.
- School of Tropical Medicine & Global Health, Nagasaki University, 1 Chome-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
| | - Sharon E Cox
- School of Tropical Medicine & Global Health, Nagasaki University, 1 Chome-12-4 Sakamoto, Nagasaki, 852-8523, Japan
- Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, Keppel St, London, WC1E 7HT, UK
- United Kingdom Health Security Agency, 61 Colindale Avenue London NW9 5EQ, Collindale, UK
| | - Tansy Edwards
- School of Tropical Medicine & Global Health, Nagasaki University, 1 Chome-12-4 Sakamoto, Nagasaki, 852-8523, Japan
- MRC International Statistics and Epidemiology Group, London School of Hygiene & Tropical Medicine, Keppel St, London, WC1E 7HT, UK
| | - Mary C Castro
- Nutrition Center Philippines, Muntinlupa City, Manila, Philippines
| | - Mishal Khan
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, Keppel St, London, WC1E 7HT, UK
- Aga Khan University, National Stadium Road, Karachi, 74800, Pakistan
| | - Marco Liverani
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, Keppel St, London, WC1E 7HT, UK
- School of Tropical Medicine & Global Health, Nagasaki University, 1 Chome-12-4 Sakamoto, Nagasaki, 852-8523, Japan
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Joundi RA, King JA, Stang J, Nicol D, Hill MD, Quan H, Faris P, Yu AYX, Kapral MK, Smith EE. Association of co-morbidity with acute stroke mortality by age and time since stroke: A population-based study. J Stroke Cerebrovasc Dis 2023; 32:107236. [PMID: 37429113 DOI: 10.1016/j.jstrokecerebrovasdis.2023.107236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 06/12/2023] [Accepted: 06/26/2023] [Indexed: 07/12/2023] Open
Abstract
OBJECTIVE To examine whether the association of co-morbidity with mortality after acute stroke is influenced by stroke type, age, sex, or time since stroke. MATERIALS AND METHODS We conducted a province-wide population-based study using linked administrative databases to identify all admissions for acute stroke between 2007-2018 in Alberta, Canada. We used Cox proportional hazard models to determine the association of severe co-morbidity based on the Charlson Co-morbidity Index with 1-year mortality after stroke, assessing for effect modification by stroke type, age, and sex, and with adjustment for estimated stroke severity, comprehensive stroke centre care, hypertension, atrial fibrillation, and year of study. We used a piecewise model to analyze the impact of co-morbidity across four time periods. RESULTS We had 28,672 patients in our final cohort (87.8% ischemic stroke). The hazard of mortality with severe co-morbidity was higher for individuals with ischemic stroke (adjusted hazard ratio [aHR] 2.20, 95% CI 2.07-2.32) compared to those with intracerebral hemorrhage (aHR 1.70, 95% CI 1.51-1.92; pint<0.001), and higher in individuals under age 75 (aHR 3.20, 95% CI 2.90-3.53) compared to age ≥75 (aHR 1.93, 95% CI 1.82-2.05, pint<0.001). There was no interaction by sex. The hazard ratio increased in a graded fashion at younger ages and was higher after the first 30 days of acute stroke. CONCLUSION There was a stronger association between co-morbidity and mortality at younger age and in the subacute phase of stroke. Further research is needed to determine the reason for these findings and identify ways to improve outcomes among those with stroke and co-morbid conditions at young age.
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Affiliation(s)
- Raed A Joundi
- Division of Neurology, Hamilton Health Sciences, McMaster University & Population Health Research Institute, Hamilton, ON, Canada; Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Canada.
| | - James A King
- Alberta Strategy for Patient Oriented Research Support Unit Data Platform; Provincial Research Data Services, Alberta Health Services
| | - Jillian Stang
- Data and Analytics (DnA), Alberta Health Services, Alberta, Canada
| | - Dana Nicol
- Data and Analytics (DnA), Alberta Health Services, Alberta, Canada
| | - Michael D Hill
- Alberta Strategy for Patient Oriented Research Support Unit Data Platform; Provincial Research Data Services, Alberta Health Services
| | - Hude Quan
- Department of Community Health Sciences, University of Calgary, Alberta Canada; Centre for Health Informatics, Calgary, Alberta Canada
| | - Peter Faris
- The O'Brien Institute for Public Health, University of Calgary, Health Services Statistical and Analytic Methods, Data and Analytics (DnA), Alberta Health Services, Foothills Medical Centre, Calgary, AB Canada
| | - Amy Y X Yu
- ICES, Department of Medicine (Neurology), University of Toronto, Sunnybrook Health Sciences Centre, ON, Canada
| | - Moira K Kapral
- Department of Medicine (General Internal Medicine), University of Toronto-University Health Network, ON, Canada
| | - Eric E Smith
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Canada; Department of Community Health Sciences, University of Calgary, Alberta Canada; Centre for Health Informatics, Calgary, Alberta Canada
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Zhang X, Han L, Lu C, McIntyre RS, Teopiz KM, Wang Y, Chen H, Cao B. Brain structural and functional alterations in individuals with combined overweight/obesity and mood disorders: A systematic review of neuroimaging studies. J Affect Disord 2023; 334:166-179. [PMID: 37149050 DOI: 10.1016/j.jad.2023.04.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 04/11/2023] [Accepted: 04/29/2023] [Indexed: 05/08/2023]
Abstract
Growing evidence suggests there is a bidirectional relationship between depression and obesity, which are associated with structural and functional brain abnormalities. However, the underlying neurobiological mechanisms subserving the foregoing associations have yet to be characterized. It is necessary to summarize the neuroplastic brain changes in relation to depression and obesity. We systematically searched articles from 1990 to November 2022 on databases including MEDLINE/PubMed, Web of Science, PsycINFO. Only neuroimaging studies within the scope of potential differences in brain function and structure in individuals with depression and obesity/ BMI changes were included. Twenty-four eligible studies were included in the review herein, consisting of 17 studies reporting changes in brain structure, 4 studies reporting abnormal brain function, and 3 studies reporting both changes in brain structure and function. Results indicated an interaction between depression and obesity on brain functions, and their influence on brain structure is both extensive and specific. Overall, reduced whole brain, intracranial, and gray matter volume (e.g. frontal, temporal gyri, thalamic, and hippocampal) and impaired white matter integrity was observed in persons with depression and obesity comorbidity. Additional evidence on resting state fMRI reveals select brain regions associated with cognitive control, emotion regulation, and reward functions. Due to the diversity of tasks in task fMRI, the distinct neural activation patterns are revealed separately. The bidirectional relationship between depression and obesity reflects different characteristics in brain structure and function. Longitudinal designs should be reinforced in follow-up studies.
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Affiliation(s)
- Xinhe Zhang
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing 400715, PR China; National Demonstration Center for Experimental Psychology Education, Southwest University, Chongqing 400715, PR China
| | - Lin Han
- The First Affiliated Hospital of Xi'an Medical University, Xi'an, PR China
| | - Chenxuan Lu
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing 400715, PR China
| | - Roger S McIntyre
- Department of Psychiatry and Pharmacology, University of Toronto, Toronto, Ontario, Canada; Brain and Cognition Discovery Foundation, Toronto, Ontario, Canada
| | - Kayla M Teopiz
- Brain and Cognition Discovery Foundation, Toronto, Ontario, Canada
| | - Yiyi Wang
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing 400715, PR China
| | - Hong Chen
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing 400715, PR China; National Demonstration Center for Experimental Psychology Education, Southwest University, Chongqing 400715, PR China.
| | - Bing Cao
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing 400715, PR China; National Demonstration Center for Experimental Psychology Education, Southwest University, Chongqing 400715, PR China.
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Tschopp R, König RS, Rejmer P, Paris DH. Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): A preliminary survey among patients in Switzerland. Heliyon 2023; 9:e15595. [PMID: 37131449 PMCID: PMC10149204 DOI: 10.1016/j.heliyon.2023.e15595] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 03/07/2023] [Accepted: 04/13/2023] [Indexed: 05/04/2023] Open
Abstract
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a multi-factorial systemic chronic debilitating disease of poorly understood etiology and limited systematic evidence. The questionnaire and interview-based survey included 169 ME/CFS patients from the Swiss ME/CFS association. The majority of patients were females (72.2%), single (55.7%) and without children (62.5%). Only one third were working (full/part-time). The mean onset of ME/CFS was 31.6 years of age with 15% of patients being symptomatic before their 18th birthday. In this cohort, patients had documented ME/CFS for a mean 13.7 years, whereby half (50.3%) stated their condition was progressively worsening. Triggering events and times of disease onset were recalled by 90% of the participants. An infectious disease was associated with a singular or part of multiple events by 72.9% and 80.6%, respectively. Prior to disease onset, a third of the patients reported respiratory infections; followed by gastro-intestinal infections (15.4%) and tick-borne diseases (16.2%). Viral infections were recalled by 77.8% of the respondents, with Epstein Barr Virus being the most commonly reported agent. Patients self-reported an average number of 13 different symptoms, all described specific triggers of symptoms exacerbation and 82.2% suffered from co-morbidities. This study collated clinically relevant information on ME/CFS patients in Switzerland, highlighting the extent of disease severity, the associated factors negatively affecting daily life activities and work status as well as potential socio-economic impact.
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Affiliation(s)
- Rea Tschopp
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland
- University of University of Basel, Switzerland
- Armauer Hansen Research Institute, Jimma Road, PO Box 1005, Addis Ababa, Ethiopia
- Corresponding author. Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland.
| | - Rahel S. König
- Faculty of Medicine, University of Basel, Klingelbergstrasse 61, 4056 Basel, Switzerland
| | - Protazy Rejmer
- Seegarten Clinic, Seestrasse 155A, 8802 Kilchberg ZH, Switzerland
| | - Daniel H. Paris
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland
- University of University of Basel, Switzerland
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Ndetei DM, Mutiso V, Momanyi R, Nyamai P, Musyimi C, Mamah D. The co-morbidity of DSM-V Gambling with DSM-V mental disorders and substance abuse in a Kenyan context of high risk schizophrenia. BMC Psychiatry 2023; 23:239. [PMID: 37038149 PMCID: PMC10084586 DOI: 10.1186/s12888-023-04738-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 03/31/2023] [Indexed: 04/12/2023] Open
Abstract
INTRODUCTION There is evidence that gambling disorder shares similarities with other types of addictive behavior, such as occurs in substance abuse. In addition, co-morbidity of gambling with mental disorders has been established in school-going students. AIM This study aimed at determining the comorbidity of DSM-V gambling disorder with DSM-V mental disorders and substance abuse in high school, college and university students in Kenya. METHODS This was a cross-sectional study among 536 high school, college and university students. We collected data on socio-demographic characteristics, economic indicators, DSM-V diagnosis including DSM-V gambling disorder and substance use disorders using the WHO ASSIST tool. Descriptive and inferential analyses were done. RESULTS A total of 536 students participated in the study, of which 11.4% (61 out of 536) had DSM-V gambling disorder. Male gender (AOR = 12.0, 95% CI: 4.99-34.3), antisocial personality disorder (AOR = 3.42, 95% CI: 1.34-8.54), tobacco use (AOR = 4.42, 95% CI: 1.15-18.3) and conduct disorder (AOR = 7.56, 95% CI: 2.34-25.1) were predictors of gambling disorder. CONCLUSION Gambling is highly prevalent in Kenya learning institutions at 11.4% and is associated with mental disorders and substance use. There is a need for public awareness of gambling among Kenyan youths.
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Affiliation(s)
- David M Ndetei
- Department of Psychiatry, University of Nairobi, Nairobi, Kenya.
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya.
- World Psychiatric Association Collaborating Centre for Research and Training, Nairobi, Kenya.
| | - Victoria Mutiso
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya
- World Psychiatric Association Collaborating Centre for Research and Training, Nairobi, Kenya
| | - Reinpeter Momanyi
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya
- World Psychiatric Association Collaborating Centre for Research and Training, Nairobi, Kenya
| | - Pascalyne Nyamai
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya
- World Psychiatric Association Collaborating Centre for Research and Training, Nairobi, Kenya
| | - Christine Musyimi
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya
- World Psychiatric Association Collaborating Centre for Research and Training, Nairobi, Kenya
| | - Daniel Mamah
- Department of Psychiatry, Washington University Medical School, St. Louis, MO, USA
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18
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Lin A, Farhat LC, Flores JM, Levine JLS, Fernandez TV, Bloch MH, Olfson E. Characteristics of trichotillomania and excoriation disorder across the lifespan. Psychiatry Res 2023; 322:115120. [PMID: 36842397 PMCID: PMC10023474 DOI: 10.1016/j.psychres.2023.115120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 01/31/2023] [Accepted: 02/18/2023] [Indexed: 02/23/2023]
Abstract
Trichotillomania (hair-pulling disorder) and excoriation (skin-picking) disorder are body-focused repetitive behaviors, which often first present in adolescence and cause distress and impairment into adulthood. Few studies have examined the clinical characteristics of the co-occurrence of these conditions across the lifespan. We examined cross-sectional survey responses collected from April 2018-February 2020 to evaluate the relationship between trichotillomania, excoriation disorder, and their co-occurrence. Responses from individuals with trichotillomania (n = 50), excoriation disorder (n = 52), and both conditions (n = 50) ages 4-67 years old were compared for co-occurring conditions and current symptoms. Self-report measures of hair-pulling and skin-picking severity and subtypes were assessed. Gender, race, and co-occurring conditions were generally similarly distributed across the three groups with high rates of self-reported anxiety (63-82%), depression (34-50%), obsessive-compulsive disorder (16-29%), and attention-deficit/hyperactivity disorder (12-32%). Among individuals with both trichotillomania and excoriation disorder, significant positive correlations were observed between hair-pulling and skin-picking severity scores as well as hair-pulling and skin-picking subtypes. Hair-pulling and skin-picking severity peaked at the transition from adolescence to adulthood and hair-pulling/skin-picking styles appeared to shift across the lifespan. Our results support several similarities between trichotillomania and excoriation disorder, providing new insight into the clinical characteristics of these conditions.
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Affiliation(s)
- Ashley Lin
- Child Study Center, Yale University School of Medicine, 230 S. Frontage Rd., New Haven CT, United States
| | - Luis C Farhat
- Child Study Center, Yale University School of Medicine, 230 S. Frontage Rd., New Haven CT, United States; Department of Psychiatry, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - José M Flores
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Jessica L S Levine
- Child Study Center, Yale University School of Medicine, 230 S. Frontage Rd., New Haven CT, United States
| | - Thomas V Fernandez
- Child Study Center, Yale University School of Medicine, 230 S. Frontage Rd., New Haven CT, United States; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Michael H Bloch
- Child Study Center, Yale University School of Medicine, 230 S. Frontage Rd., New Haven CT, United States; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Emily Olfson
- Child Study Center, Yale University School of Medicine, 230 S. Frontage Rd., New Haven CT, United States.
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Maruf FA, Ucheokoye DM. Positive impacts of leisure-time physical activity on cardiorespiratory fitness, co-morbidity level, cardiovascular health and quality of life among midlife adults: a cross-sectional study of a Nigerian population. BMC Sports Sci Med Rehabil 2023; 15:25. [PMID: 36879328 PMCID: PMC9987118 DOI: 10.1186/s13102-023-00622-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 01/27/2023] [Indexed: 03/08/2023]
Abstract
BACKGROUND Regular physical activity (PA) improves general health and quality of life (QoL) of the general population. It is however not known if leisure-time PA (LTPA) behaviour will reduce co-morbidity and adiposity, and improve cardiorespiratory fitness and QoL in midlife men. This study explored the impacts of regular LTPA behaviour on co-morbidity, adiposity, cardiorespiratory fitness and QoL among male midlife sports club members in a Nigerian population. METHODS This cross-sectional study involved 174 age-matched male midlife adults: 87 engaging in LTPA (LTPA group) and 87 not engaging in LTPA (non-LTPA group). Information on age, body mass index (BMI), waist circumference (WC), maximal oxygen uptake (VO2max), resting heart rate (RHR), QoL and co-morbidity level was collected using standardized procedures. Data were summarized using mean and standard deviation, and explored using frequency and proportion. Independent t-test, Chi Square and Mann-Whitney U test were employed to determine the impacts of LTPA at 0.05 significance level. RESULTS The LTPA group had lower co-morbidity score (p = 0.05) and RHR (p = 0.004), and higher QoL (p = 0.01) and VO2max (p = 0.003) than non-LTPA group. While heart disease (χ2 = 10.99; p = 0.01) and hypertension (χ2 = 15.24; p = 0.004) severity levels were associated with LTPA behaviour, hypertension (p = 0.01) was the only co-morbid condition that had a significantly lower score in the LTPA group than in the non-LTPA group. CONCLUSIONS Regular LTPA improves cardiovascular health, physical work capacity and QoL in the sample of Nigerian mid-life men. Regular LTPA behaviour is recommended for cardiovascular health promotion, and improved physical work capacity and life satisfaction in midlife men.
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Affiliation(s)
- Fatai Adesina Maruf
- Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, Nnamdi Azikiwe University, Nnewi Campus, Nnewi, Nigeria.
| | - Demelum Marylyn Ucheokoye
- Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, Nnamdi Azikiwe University, Nnewi Campus, Nnewi, Nigeria
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Soegiarto G, Purnomosari D, Wulandari L, Mahdi BA, Fahmita KD, Hadmoko ST, Gautama HI, Prasetyo ME, Prasetyaningtyas D, Negoro PP, Arafah N, Sigit Prakoeswa CR, Endaryanto A, Agung Suprabawati DG, Tinduh D, Rachmad EB, Triyono EA, Wahyuhadi J, Keswardiono CB, Wardani FE, Mayorita F, Kristiani N, Baskoro A, Fetarayani D, Nurani WK, Oceandy D. Incidence of SARS-CoV-2 infection in hospital workers before and after vaccination programme in East Java, Indonesia-A retrospective cohort study. Lancet Reg Health Southeast Asia 2023; 10:100130. [PMID: 36531927 PMCID: PMC9742226 DOI: 10.1016/j.lansea.2022.100130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 10/11/2022] [Accepted: 12/01/2022] [Indexed: 12/14/2022]
Abstract
Background The incidence of the Coronavirus Disease 2019 (COVID-19) among healthcare workers (HCWs) is widespread. It is important to understand COVID-19 characteristics among HCWs before and after vaccination. We evaluated the incidence of COVID-19 among HCWs in East Java, Indonesia comparing the characteristics of the disease between the pre- vs post-vaccination periods. Methods A retrospective observational study was conducted among HCWs in two major hospitals in East Java, Indonesia, between April 01, 2020, and Oct 31, 2021. All HCWs were offered vaccination with inactivated viral vaccine (CoronaVac) from Jan 15, 2021. Therefore, we divided the time of the study into the pre-vaccination period (between April 01, 2020, and Jan 14, 2021) and post-vaccination period (between Jan 15 and Oct 31, 2021). We then compared the pattern of COVID-19 infections, and hospitalisations between these periods. Findings A total of 434 (15.1%) and 649 (22.6%) SARS-CoV-2 infections were reported among study participants (n = 2878) during the pre-vaccination and post-vaccination periods, respectively. The vaccine effectiveness was 73.3% during the first 3-4 months after vaccination but this decreased to 17.6% at 6-7 months after vaccination, which coincided with the emergence of the delta variant. The overall hospitalisation rate was reduced from 23.5% in the pre-vaccination period to 14.3% in the post-vaccination period. Hypertension appeared to be the strongest risk factor affecting hospitalisation in the pre-vaccination period. However, the risk due to hypertension was reduced in the post-vaccination period. Interpretation The risk to contract COVID-19 remains high among HCWs in East Java, Indonesia. Vaccination is important to reduce infection and hospitalisation. It is essentially important to evaluate the characteristics of COVID-19 infection, hospitalisation, the impact of co-morbidities and vaccine effectiveness in order to improve the measures applied in protecting HCWs during the pandemic. Funding Mandate Research Grant No:1043/UN3.15/PT/2021, Universitas Airlangga, Indonesia.
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Affiliation(s)
- Gatot Soegiarto
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia,Corresponding author. Division of Allergy and Clinical Immunology, Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga and Dr. Soetomo General Academic Hospital, Surabaya, Indonesia, Jl. Mayjen. Prof. Dr. Moestopo no. 6-8, Surabaya, 60286, East Java, Indonesia
| | - Dewajani Purnomosari
- Department of Histology and Cell Biology, Faculty of Medicine Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Laksmi Wulandari
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Bagus Aulia Mahdi
- Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Karin Dhia Fahmita
- Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Satrio Tri Hadmoko
- Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Hendra Ikhwan Gautama
- Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Muhammad Edwin Prasetyo
- Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Dewi Prasetyaningtyas
- Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Pujo Prawiro Negoro
- Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Nur Arafah
- Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Cita Rosita Sigit Prakoeswa
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Anang Endaryanto
- Department of Child Health, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Desak Gede Agung Suprabawati
- Division of Oncology, Department of Surgery, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Damayanti Tinduh
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Eka Basuki Rachmad
- Medical Service Bureau, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Erwin Astha Triyono
- Division of Tropical Disease and Infection, Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Joni Wahyuhadi
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga – Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | | | | | - Fitriyah Mayorita
- Syarifah Ambami Rato Ebu Hospital, Bangkalan, Madura, East Java, Indonesia
| | - Nunuk Kristiani
- Syarifah Ambami Rato Ebu Hospital, Bangkalan, Madura, East Java, Indonesia
| | - Ari Baskoro
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Deasy Fetarayani
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Wita Kartika Nurani
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Delvac Oceandy
- Division of Cardiovascular Sciences Faculty of Biology Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom,Department of Biomedical Science, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia,Corresponding author. Division of Cardiovascular Sciences Faculty of Biology Medicine and Health, The University of Manchester, Oxford Rd, Manchester, M13 9PL, UK
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Mmerem JI, Unigwe US, Iroezindu MO, Chukwu KS, Ezenwosu IL, Okorie GO, Chika-Igwenyi NM, Nwatu CB, Onodugo OD. Demographic characteristics, clinical presentation and in-hospital outcome among patients with Covid-19 in a Nigerian tertiary hospital. Malawi Med J 2023; 35:43-57. [PMID: 38124701 PMCID: PMC10645895 DOI: 10.4314/mmj.v35i1.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
Background We described the demographic/clinical characteristics and in-hospital outcome of patients with COVID-19 at the University of Nigeria Teaching Hospital (UNTH) during the first wave to inform evidence-based responses during subsequent waves in Africa. Methodology We conducted retrospective cohort analyses of adult patients ≥18 years with PCR or GeneXpert-confirmed SARS-CoV-2 infection. Data was extracted from patients' medical records from 1st May to 30th September 2020. Based on disease severity, patients were either hospitalized (82) or managed at home (90). Logistic regression and cox-proportional hazard models were used to determine predictors of severe COVID-19 disease and in-hospital mortality, respectively. Results Of 172 cases, 113 (65.7%) were males, and the mean age was 45 ± 19 years. The majority were urban dwellers (72.1%), 19.8% had a positive history of contact with a confirmed/suspected case, 15.7% were healthcare workers while 68 (39.5%) had co-morbidities. Symptomatic patients comprised 73.3% of cases. Fever (p=0.02) and breathlessness (p=0.03) were commoner in males while diarrhoea (p<0.01) was predominant in females. On multivariate analysis, severe COVID-19 was predicted by the presence of co-morbidity (AOR= 14.44, 95% C.I= 4.79- 43.58, p <0.001)and prior antibiotic/antimalarial use (AOR= 6.35, 95% C.I= 2.24- 18.05, p =0.001) while being a non-healthcare worker (AOR= 0.18, 95% C.I= 0.04-0.78, p=0.02) was protective. However, none of the variables assessed predicted in-hospital mortality. Conclusion Our findings underscore the contributions of demographic variables in COVID-19 transmission and gender differences in clinical presentation. Underlying comorbidity likewise prior antimicrobial use increased the likelihood of severe COVID-19. The absence of mortality predictors in our study may be related to the relatively small number of deaths. Further studies are recommended to unravel the predominance of severe disease in healthcare workers.
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Affiliation(s)
- Juliet I Mmerem
- Department of Medicine, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Enugu State, Nigeria
- Department of Internal Medicine, Federal Medical Centre, Owerri, Imo State, Nigeria
| | - Uche S Unigwe
- Department of Medicine, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Enugu State, Nigeria
- Department of Internal Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
| | - Michael O Iroezindu
- Department of Medicine, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Enugu State, Nigeria
| | - Kyrian S Chukwu
- Department of Medicine, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Enugu State, Nigeria
- Department of Internal Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
| | - Ifeyinwa L Ezenwosu
- Department of Community Medicine, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Enugu State, Nigeria
| | - Geofrey O Okorie
- Department of Medicine, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Enugu State, Nigeria
- Department of Internal Medicine, Enugu State University Teaching Hospital, Parklane, Enugu, Enugu State, Nigeria
| | - Nneka M Chika-Igwenyi
- Department of Medicine, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Enugu State, Nigeria
- Department of Internal Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
| | - Chidinma B Nwatu
- Department of Medicine, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Enugu State, Nigeria
| | - Obinna D Onodugo
- Department of Medicine, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Enugu State, Nigeria
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22
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Alhallak I, Quick CM, Graham GL, Simmen RCM. A Pilot Study on the Co-existence of Diabetes and Endometriosis in Reproductive-Age Women: Potential for Endometriosis Progression. Reprod Sci 2023:10.1007/s43032-023-01190-3. [PMID: 36788175 DOI: 10.1007/s43032-023-01190-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 02/02/2023] [Indexed: 02/16/2023]
Abstract
Endometriosis (ENDO) is a chronic estrogen-dependent gynecological condition that affects reproductive-age women, causing pelvic pain, infertility, and increased risk for ovarian cancer. Diabetes mellitus (DM) is a metabolic disease with significant morbidity and mortality and rising incidence worldwide. The occurrence of DM among ENDO patients remains understudied, despite commonalities in these conditions' immune, inflammatory, and metabolic dysfunctions. This pilot study evaluated whether a subset of women with ENDO manifests DM co-morbidity and if so, whether DM promotes ENDO status. Archived ectopic lesions obtained at ENDO surgery from non-diabetic (ENDO-N; n = 11) and diabetic (ENDO-DM; n = 15) patients were identified by a search of an electronic health database. Retrieved samples were analyzed by immunohistochemistry for markers of proliferation (Ki67, PTEN), steroid receptor signaling (ESR, PGR) and macrophage infiltration (CD68). Immunostaining data were expressed as percentages of immune-positive cells in lesion stroma and epithelium. In lesion stroma, the percentages of nuclear immune-positive cells were higher for ESR2 and lower for PGR-T, in ENDO-DM than ENDO-N patients. The percentages of nuclear immune-positive cells for ESR1 and PTEN tended to be higher and lower, respectively, in ENDO-DM than ENDO-N groups. In lesion glandular epithelium, the percentages of nuclear immune-positive cells were higher for ESR1 and ESR2, in ENDO-DM than ENDO-N groups. ENDO-N lesions had lower percentages of stromal CD68 immune-positive cells than ENDO-DM Type 1 lesions. Findings demonstrate DM in a subset of women with ENDO, which was associated with significant changes in lesion stromal and epithelial nuclear steroid hormone receptor levels, suggestive of disease progression.
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Affiliation(s)
- Iad Alhallak
- Department of Physiology & Cell Biology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Charles M Quick
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Garrett L Graham
- Department of Physiology & Cell Biology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Rosalia C M Simmen
- Department of Physiology & Cell Biology, University of Arkansas for Medical Sciences, Little Rock, AR, USA. .,The Winthrop P Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
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23
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Alexandre F, Lapergola A, Vannucci M, Pizzicannella M, D'Urso A, Saviano A, Mutter D, Vix M, Perretta S. Endoscopic management of obesity: Impact of endoscopic sleeve gastroplasty on weight loss and co-morbidities at six months and one year. J Visc Surg 2023:S1878-7886(22)00177-1. [PMID: 36725451 DOI: 10.1016/j.jviscsurg.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Endoscopic sleeve gastroplasty (ESG) is one of the new minimally invasive endoscopic treatments aimed at inducing weight loss. Its effectiveness in terms of weight loss is proven. Gastric volume reduction and delayed gastric emptying are the mechanisms that drive weight loss. However, potential benefits for co-morbidities in relation to weight loss after ESG are still being investigated. This study aims to evaluate the effect of ESG procedures on major obesity-associated co-morbidities, and on some biological parameters. PATIENTS AND METHODS This is a series of consecutive cases from a prospective observational study carried out in a specialized center that follows a standardized care pathway for the multimodal management of obesity. Patients who have undergone ESG with endoscopic and laboratory follow-up at six and twelve months after this intervention were included in the study. Prospectively recorded data on weight loss, co-morbidities and laboratory parameters at six and twelve months after surgery was analyzed retrospectively. Changes in body mass index (BMI), absolute weight loss (AWL), percent of excess weight loss (%EWL) and percent total weight loss (%TWL) were assessed at six and twelve months. Reduction in various obesity-related co-morbidities (arterial hypertension [AHT], type 2 diabetes mellitus [T2DM], gastroesophageal reflux disease [GERD], obstructive sleep apnea syndrome [OSAS] and dyslipidemia was also evaluated at six and twelve months. Changes in blood glucose, liver function tests and lipid blood tests were also analyzed at six and twelve months. RESULTS From October 2016 to July 2021, 99 of the 227 patients who underwent ESG in our unit (43.6%) subsequently underwent a complete endoscopic and laboratory follow-up at six and twelve months. The initial BMI was 42.7±7.8kg/m2 and age was 45±12.7 years. Seventy-four patients (74.8%) were female. Total weight loss (%TWL) and excess weight loss (%EWL) were 16.6±7.4% and 43.3±21.2%, respectively, at six months, 16.6±9.6% and 42.9±25.6%, respectively, at one year. At six and twelve month follow-up, a statistically significant reduction was observed for the rates of T2DM (30.8 and 32.7%), hypertension (18.4 and 22.1%), GERD (28 and 25.7%), OSAS (15.8 and 25.5%) and dyslipidemia (69.2 and 77.2%) (P<0.001). A statistically significant difference was found in the reduction in blood glucose between the pre-operative period and six months post-operatively (P<0.01) and between the pre-operative period and twelve months post-operatively (P<0.01). The reduction in triglycerides and total cholesterol between the pre-operative values and at six months was statistically significant (P<0.01) as was the reduction at twelve months (P<0.01) (P=0.017). For liver function tests, the reduction in AST was statistically significant at six and twelve months after ESG (P=0.048) (P=0.048) as was ALT (P<0.01) (P<0.01) respectively. From October 2016 to July 2021, of the 227 patients who underwent ESG, 99 (43.6%) had follow-up gastro-duodenoscopy at 6 and 12 months. %TWL and %EWL were respectively 16.6±7.4% and 43.3%±21.2 at 6 months, 16.6±9.6% and 42.9±25.6% at one year. Statistically significant reduction rates at 6 and 12 months were observed in T2DM (30.8 and 32.7%), AHT (18.4 and 22.1%), GERD (28 and 25.7%), OSAS (15.8 and 25.5%) and dyslipidemia (69.2 and 77.2%) (P<0.001). Moreover, glycemic levels were statistically significantly reduced between the pre-operative period and 6 months post-operative (1.11±0.22mg/L vs. 1.01±0.17mg/L, P<0.01), and between the pre-operative period and 12 months post-operative (1.11±0.22mg/L vs. 1.06±0.32mg/L, P<0.01). A statistically significant reduction was also observed in triglycerides and total cholesterol levels at 6 months (1.52±0.74mmol/L vs. 1.14±0.52mmol/L, P<0.01) (1.94±0.4mmol/L vs. 1.85±0.36mmol/L, P<0.01) and at 12 months (1.52±0.74mmol/L vs. 1.18±0.67mmol/L, P<0.01) (1.94±0.4mmol/L vs. 1.82±0.39mmol/L, P=0.017) and in AST (27.2±11.7 IU/L vs. 23.7 IU/L; P=0.048) (27.2±11.7 IU/L vs. 24.7±14.65 IU/L, P=0.048) and ALAT levels (34±21.32 IU/L vs. 22.3±10.4 IU/L, P<0.01 and 34±21.32 IU/L vs. 27.07±25 IU/L, P<0.01) at 6 and 12 months after ESG, respectively. CONCLUSION ESG is a well-tolerated and safe surgical procedure that is effective in terms of weight loss and reduction of obesity-related co-morbidities at six months and one year. This procedure could thus be adopted on a broader clinical scale and be more widely promoted as an effective treatment for morbid obesity.
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Lu V, Tennyson M, Zhang J, Thahir A, Zhou A, Krkovic M. Ankle fusion with tibiotalocalcaneal retrograde nail for fragility ankle fractures: outcomes at a major trauma centre. Eur J Orthop Surg Traumatol 2023; 33:125-133. [PMID: 34820741 PMCID: PMC8612118 DOI: 10.1007/s00590-021-03171-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 11/15/2021] [Indexed: 01/07/2023]
Abstract
PURPOSE Fragility ankles fractures in the geriatric population are challenging to manage, due to fracture instability, soft tissue compromise, and patient co-morbidities. Traditional management options include open reduction internal fixation, or conservative treatment, both of which are fraught with high complication rates. We aimed to present functional outcomes of elderly patients with fragility ankle fractures treated with retrograde ankle fusion nails. METHODS A retrospective observational study was performed on patients who underwent intramedullary nailing with a tibiotalocalcaneal nail. Twenty patients met the inclusion criteria of being over sixty and having multiple co-morbidities. Patient demographics, AO/OTA fracture classification, intra-operative and post-operative complications, time to mobilisation and union, AOFAS and Olerud-Molander scores, and patient mobility were recorded. RESULTS There were seven males and thirteen females, with a mean age of 77.82 years old, five of whom are type 2 diabetics. Thirteen patients returned to their pre-operative mobility state, and the average Charlson Co-morbidity Index (CCI) was 5.05. Patients with a low CCI are more likely to return to pre-operative mobility status (p = 0.16; OR = 4.00). All patients achieved radiographical union, taking on average between 92.5 days and 144.6 days. The mean post-operative AOFAS and Olerud-Molander scores were 53.0 and 50.9, respectively. There were four cases of superficial infection, four cases of broken or loose distal locking screws. There were no deep infections, periprosthetic fractures, nail breakages, or non-unions. CONCLUSION Tibiotalocalcaneal nailing is an effective and safe option for managing unstable ankle fractures in the elderly. This technique leads to lower complication rates and earlier mobilisation than traditional fixation methods.
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Affiliation(s)
- Victor Lu
- School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0SP UK ,Christ’s College, St. Andrew’s Street, Cambridge, CB2 3BU UK
| | - Maria Tennyson
- Department of Trauma and Orthopaedics, Addenbrooke’s Hospital, Cambridge, CB2 0QQ UK
| | - James Zhang
- School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0SP UK
| | - Azeem Thahir
- Department of Trauma and Orthopaedics, Addenbrooke’s Hospital, Cambridge, CB2 0QQ UK
| | - Andrew Zhou
- School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0SP UK
| | - Matija Krkovic
- Department of Trauma and Orthopaedics, Addenbrooke’s Hospital, Cambridge, CB2 0QQ UK
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Panda PK, Varkey RS, Ranjan P, Meher AK, Panda S. COVID 19 fatalities burden in Asian countries: An analysis of pattern and determinants. Soc Sci Humanit Open 2023; 7:100378. [PMID: 36466378 PMCID: PMC9708635 DOI: 10.1016/j.ssaho.2022.100378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 10/18/2022] [Accepted: 11/18/2022] [Indexed: 12/03/2022]
Abstract
Covid 19 pandemic has severe implications on health and life of people. Asia being the most populous region has higher fatalities burden. Health infrastructure, stringent preventive measures by the government and public participation through adhering to social distancing have influence to check on fatalities' burden. The level of Social capital as well as voters' participation in a particular country can have influence on containment of COVID cases and fatalities. In this context, the main objectives of this study are to analyse pattern and trend of death burden for 45 Asian countries and impact of stringency measures by government, and voters' turnout ratio on death burden. However, for regression analysis only 32 countries are taken into account considering the availability of data for all variables. Multiple linear regression analysis is employed in a cross-sectional framework and Ordinary least square estimation technique with heteroscedastic adjusted standard errors have been used for estimation of coefficients. The results show that southern Asia contributes the highest share of fatality cases in total fatality cases of Asia with 71.43% share. It also has the highest share of confirmed cases in total confirmed cases of Asia with 71.72%. However, when we take the population into account, Western Asia leads in the share of confirmed COVID-19 cases and its associated fatality cases per million populations in Asia as compared to other Asian regions. The factors like health infrastructure and voters' turnover ratio are found to be significant and potential in reducing the new deaths per million populations. Though the coefficient of Stringency index has been negative and it did not emerge to be significant in Asian countries. The COVID related fatalities in Asian region are urban centric and urbanization proxy is found to be positive and significant. Diabetes prevalence rate has some heterogeneous result and in the present study its coefficient is not in the hypothesized direction. . The Countries should ramp up health infrastructure and necessary preparedness to deal with the subsequent waves and COVID related fatalities. Importance need to be given people's participation and their shared responsibilities in dealing with COVID cases and checking on fatalities. The realisation of social responsibility among the masses can lead to community participation and adhering to the protocols imposed by the government and helps in checking on spread of virus and associated death.
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Affiliation(s)
- Prasant Kumar Panda
- Department of Economics, Pondicherry University, Puducherry, 605014, India,Corresponding author
| | - Rittu Susan Varkey
- Department of Economics, CHRIST (Deemed to be University), Bengaluru, 560029, India
| | - Priya Ranjan
- Department of Economics, Pondicherry University, Puducherry, 605014, India
| | - Ashish Kumar Meher
- Department of Economics, Central University of Tamil Nadu, Thiruvarur, Tamil Nadu, 610101, India
| | - Soumyaranjan Panda
- Department of Computer Science and Information Technology, Mahatma Gandhi Central University, Motihari, Bihar, 845401, India
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Busse W, Bartels C, Rosenkranz M. Brain-Airway Interactions in Asthma. Adv Exp Med Biol 2023; 1426:185-214. [PMID: 37464122 DOI: 10.1007/978-3-031-32259-4_9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
Asthma and brain interactions have long been appreciated and initially centered on increased anxiety and depression. Epidemiology studies have shown that early life stressors and situational disadvantages are risk factors for asthma. Conversely, the presence of asthma is a risk for mood and anxiety disorders, thus indicating a bidirectional effect between asthma and brain-related health. To substantiate asthma-brain interactions, validated instruments indicate and elucidate that communication likely exists between asthma and the brain. For example, provocation of an asthmatic response with an allergen challenge modulates how the brain responds to emotion-laden information. As detected by imaging studies, emotion-related brain activation is associated with generating airway inflammation. However, the specific mediators and processes mediating airway communication with the brain have yet to be established.Systemic inflammation is also associated with asthma and can affect other organ systems such as the cardiovascular system and the brain. Epidemiology studies have shown that asthma is a risk factor for dementia and Alzheimer's disease. In support of the importance of asthma as a risk factor for impaired cognitive function, imaging studies have shown changes to the white matter of the brain in asthma patients that resemble neuroinflammation changes seen in Alzheimer's disease and other neurodegenerative diseases. Therefore, bidirectional links between asthma and the brain exist with an important next research step to define asthma-brain interactions linked to neurodegeneration and dementia and explore whether treatments directed toward asthma-related inflammation can prevent the deleterious effects of asthma on brain health.
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Affiliation(s)
- William Busse
- Department of Medicine, Division of Allergy Pulmonary and Critical Care Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
| | - Christie Bartels
- Department of Medicine, Division of Rheumatology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Melissa Rosenkranz
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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Mir SA, Noor M, Manzar MD, Alshehri B, Alaidarous M, Dukhyil AAB, Banawas S, Madkhali Y, Jahan S, Kashoo FZ, Iqbal D, Zia Q, Alsagaby SA, ALDosari S. Prevalence of rheumatoid arthritis and diagnostic validity of a prediction score, in patients visiting orthropedic clinics in the Madinah region of Saudi Arabia: a retrospective cross-sectional study. PeerJ 2022; 10:e14362. [PMID: 36405025 PMCID: PMC9673770 DOI: 10.7717/peerj.14362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 10/18/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction In Saudi Arabia, the epidemiology of rheumatoid arthritis (RA) is not well studied and is marked by inconsistencies in clinical diagnosis. Therefore, in this study, we explored the prevalence, clinical characteristics, and diagnostic validity of a prediction score based upon disease markers in orthropedic clinics' patients in the Madinah region of Saudi Arabia. Method The clinical data for this retrospective cross-sectional study were retrieved from the database registry of orthopedic clinics in selected hospitals of the Medinah province of Saudi Arabia. Sociodemographic features, disease markers and the clinical characteristics were collected for a period of 6 months, from December 1, 2020, to May 31, 2021. The prediction score was generated from the sum of disease markers, coded as dichotomous variables. Results The total sample size of our study was 401. The prevalence of RA in the study subjects (n = 401) was 14.46% (n = 58). Among RA patients, the majority were females (60.3%). Painful joints (69%) and swollen joints (51.7%) were the most common clinical complaints among RA patients. RA patients suffered from arthritis (51.7%) and experienced fatigue (46.6%), weight loss (44.8%), and loss of appetite (41.4%). Diabetes (55.2%) was the most common comorbidity in the RA patients. The sensitivity and specificity of the prediction score at the criterion score of 2.5 were 67.3% and 63.0%, respectively. The area under the curve was 0.69 (95% CI [0.62-0.76]). Conclusion There was a moderately high prevalence of RA in patients visiting the orthropedic clinics of the selected hospitals of Madinah region of Saudi Arabia. The diagnostic validity of the prediction score, though promising, was slightly lower than the acceptable range.
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Affiliation(s)
- Shabir Ahmad Mir
- Department of Medical Laboratory Science, College of Applied Medical Science, Majmaah University, Al Majmaah, Riyadh, Saudi Arabia
| | - Mamdooh Noor
- Department of Medical Laboratory Science, College of Applied Medical Science, Majmaah University, Al Majmaah, Riyadh, Saudi Arabia
| | - Md Dilshad Manzar
- Department of Nursing, College of Applied Medical Science, Majmaah University, Al Majmaah, Riyadh, Saudi Arabia
| | - Bader Alshehri
- Department of Medical Laboratory Science, College of Applied Medical Science, Majmaah University, Al Majmaah, Riyadh, Saudi Arabia
| | - Mohammed Alaidarous
- Department of Medical Laboratory Science, College of Applied Medical Science, Majmaah University, Al Majmaah, Riyadh, Saudi Arabia,Health and Basic Sciences Research Center, Majmaah University, Al Majmaah, Riyadh, Saudi Arabia
| | - Abdul Aziz Bin Dukhyil
- Department of Medical Laboratory Science, College of Applied Medical Science, Majmaah University, Al Majmaah, Riyadh, Saudi Arabia
| | - Saeed Banawas
- Department of Medical Laboratory Science, College of Applied Medical Science, Majmaah University, Al Majmaah, Riyadh, Saudi Arabia,Health and Basic Sciences Research Center, Majmaah University, Al Majmaah, Riyadh, Saudi Arabia,Department of Biomedical Sciences, Oregon State University, Corvallis, Oregon, United States
| | - Yahya Madkhali
- Department of Medical Laboratory Science, College of Applied Medical Science, Majmaah University, Al Majmaah, Riyadh, Saudi Arabia
| | - Sadaf Jahan
- Department of Medical Laboratory Science, College of Applied Medical Science, Majmaah University, Al Majmaah, Riyadh, Saudi Arabia
| | - Faizan Z. Kashoo
- Department of Physical Therapy and Rehabilitation, College of Applied Medical Science, Majmaah University, Al Majmaah, Riyadh, Saudi Arabia
| | - Danish Iqbal
- Department of Medical Laboratory Science, College of Applied Medical Science, Majmaah University, Al Majmaah, Riyadh, Saudi Arabia
| | - Qamar Zia
- Department of Medical Laboratory Science, College of Applied Medical Science, Majmaah University, Al Majmaah, Riyadh, Saudi Arabia,Health and Basic Sciences Research Center, Majmaah University, Al Majmaah, Riyadh, Saudi Arabia
| | - Suliman A. Alsagaby
- Department of Medical Laboratory Science, College of Applied Medical Science, Majmaah University, Al Majmaah, Riyadh, Saudi Arabia
| | - Sahar ALDosari
- Department of Medical Laboratory Science, College of Applied Medical Science, Majmaah University, Al Majmaah, Riyadh, Saudi Arabia
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Mersha AG, Tollosa DN, Bagade T, Eftekhari P. A bidirectional relationship between diabetes mellitus and anxiety: A systematic review and meta-analysis. J Psychosom Res 2022; 162:110991. [PMID: 36081182 DOI: 10.1016/j.jpsychores.2022.110991] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 07/11/2022] [Accepted: 07/13/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND Due to the existence of inconsistencies in the evidence regarding the direction and extent of association between diabetes and anxiety disorders, the anxiety-diabetes comorbidity remains an issue of debate. AIM To estimate the proportion and risk of diabetes among individuals with anxiety disorder and vice versa. METHODS A systematic review was conducted using studies retrieved from databases and grey literature, with the last database search being conducted on April 15, 2021. The methodological rigor of studies was assessed using the National Institute of Health quality assessment tool. Prevalence and effect size (ES) estimates were pooled using a random effect model. Heterogeneity was assessed using the Higgins' I2 statistical test, and subgroup analysis conducted. RESULTS We included 68 studies presenting data from 2,128,029 participants. The prevalence of anxiety disorders in diabetic patients was 28% (95% CI: 26%, 31%); however, subgroup analysis showed significant differences based on type of anxiety assessment scales, study location, and type of diabetes. The prevalence of diabetes among patients with anxiety disorders was 12% (95% CI: 9%, 16%). Patients with anxiety disorders were found to have a 19% higher risk of diabetes (pooled effect size (ES) = 1.19, 95% CI: 1.13, 1.26). Diabetic patients were found to have a 41% higher risk of developing anxiety disorders (ES = 1.41, 95% CI: 1.19, 1.62). CONCLUSIONS There is a higher risk of anxiety disorders in patients with diabetes mellitus and vice versa. It is recommended to screen diabetic patients for anxiety at initial diagnosis and follow-up visits. Similarly, patients with anxiety disorders should have regular screening for diabetes. REVIEW REGISTRATION PROSPERO registration number CRD42021252475.
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Affiliation(s)
- Amanual Getnet Mersha
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, Newcastle 2308, New South Wales, Australia.
| | - Daniel Nigusse Tollosa
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, Newcastle 2308, New South Wales, Australia.
| | - Tanmay Bagade
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, Newcastle 2308, New South Wales, Australia; Hunter Medical Research Institute, Lot 1, Kookaburra Circuit, New Lambton Heights, Newcastle 2305, NSW, Australia.
| | - Parivash Eftekhari
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, Newcastle 2308, New South Wales, Australia; Hunter Medical Research Institute, Lot 1, Kookaburra Circuit, New Lambton Heights, Newcastle 2305, NSW, Australia.
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Akosile W, Adewuyi E. Genetic correlation and causality assessment between post-traumatic stress disorder and coronary artery disease-related traits. Gene X 2022; 842:146802. [PMID: 35961436 DOI: 10.1016/j.gene.2022.146802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 07/29/2022] [Accepted: 08/05/2022] [Indexed: 11/16/2022] Open
Abstract
Consistent evidence from observational studies supports a risk-increasing association between post-traumatic stress disorder (PTSD) and coronary artery disease (CAD); however, the mechanisms underlying their relationship remain poorly understood. This study assesses the genetic correlation and potential causal relationship between PTSD and CAD-related traits. We analysed genome-wide associated study summary data of PTSD (cases = 23,212, controls = 151,447) with CAD-related traits (sample size up to 408,458 individuals) to achieve our study objectives. Findings revealed a significant and positive genetic correlation between PTSD and CAD (rG = 0.19, p = 3.47 × 10-2), and between PTSD and CAD traits of ischemic heart disease (genetic correlation [rG] = 0.42, p = 5.17 × 10-10), coronary arteriosclerosis (rG = 0.32, p = 3.78 × 10-7), and angina pectoris (rG = 0.48, p = 1.14 × 10-9). However, Mendelian randomisation (MR) analysis found no evidence for a significant causal association between PTSD and CAD traits, regardless of analysis direction (PTSD or CAD traits as the exposure or outcome variable). Findings from MR sensitivity analyses were consistent, suggesting that genetic liability to PTSD has no causal influence on any CAD trait and vice versa. In summary, our study provides evidence implicating a positive genetic correlation between PTSD with CAD-related traits, supporting evidence of a risk-increasing but non-causal association between them.
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Affiliation(s)
- Wole Akosile
- School of Medicine, University of Queensland, Australia.
| | - Emmanuel Adewuyi
- Edith Cowan University, School of Medical and Health Sciences, Australia.
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Boake M, Mash R. Diabetes in the Western Cape, South Africa: A secondary analysis of the diabetes cascade database 2015 - 2020. Prim Care Diabetes 2022; 16:555-561. [PMID: 35672227 DOI: 10.1016/j.pcd.2022.05.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 05/27/2022] [Indexed: 10/18/2022]
Abstract
AIM The aim was to describe the demographics, comorbidities and outcomes of care for patients with diabetes at primary care facilities in the Western Cape, South Africa, between 2015 and 2020. METHODS This was a secondary analysis of the diabetes cascade database. RESULTS The database included 116726 patients with mean age of 61.4 years and 63.8 % were female. The mean age at death was 66.0 years. Co-morbidities included hypertension (69.5 %), mental health disorders (16.2 %), HIV (6.4 %) and previous TB (8.2 %). Sixty-three percent had at least one previous hospital admission and 20.2 % of all admissions were attributed to cardiovascular diseases. Coronavirus was the third highest reason for admission over a 10-year period. Up to 70% were not receiving an annual HbA1c test. The mean value for the last HBA1c taken was 9.0%. Three-quarters (75.5 %) of patients had poor glycaemic control (HbA1c >7 %) and a third (33.7 %) were very poorly controlled (HbA1c>10 %). Glycaemic control was significantly different between urban sub-districts and rural areas. Renal disease was prevalent in 25.5 %. CONCLUSION Diabetes was poorly controlled with high morbidity and mortality. There was poor compliance with guidelines for HbA1c and eGFR measurement. At least 7% of diabetic patients were being admitted for complications annually.
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Affiliation(s)
- Megan Boake
- Division of Family Medicine and Primary Care, Stellenbosch University, Box241, Cape Town 8000, South Africa
| | - Robert Mash
- Division of Family Medicine and Primary Care, Stellenbosch University, Box241, Cape Town 8000, South Africa.
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31
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Wang N, Chung MC, Zhang J, Fang S. Network analysis on the relationship between posttraumatic stress disorder, psychiatric co-morbidity and posttraumatic growth among Chinese adolescents. J Affect Disord 2022; 309:461-470. [PMID: 35513114 DOI: 10.1016/j.jad.2022.04.148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 08/14/2021] [Accepted: 04/25/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND This study investigated the association between posttraumatic stress disorder (PTSD), psychiatric co-morbidity and posttraumatic growth (PTG) among Chinese adolescents using network analysis. METHODS 867 Chinese adolescents (male = 424, female = 443) were recruited from three secondary schools. They completed the Posttraumatic Stress Disorder Checklist for DSM-5, the Posttraumatic Growth Inventory, and the General Health Questionnaire-28. RESULTS Domains of each construct mainly clustered within their respective communities with several bridging edges identified. The prominent roles of bridging nodes and edges (positive and negative) were highlighted. Key bridging nodes were negative alterations in cognitions and mood for PTSD, anxiety and insomnia for psychiatric co-morbidity and appreciation of life for PTG. LIMITATIONS The cross-sectional nature of the present study may preclude the identification of real causal relationships between nodes. CONCLUSIONS Following a trauma, adolescents displayed posttraumatic stress along with general psychological disorder symptoms. These distress reactions could affect the way they appreciated life and their motivation to seek future life possibilities. Findings from the current study may provide some clue for the facilitation of posttraumatic growth among clinical patients.
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Affiliation(s)
- Na Wang
- Department of Educational Psychology, The Chinese University of Hong Kong, Hong Kong
| | - Man Cheung Chung
- Department of Psychology, Zayed University, Dubai, United Arab Emirates
| | - Jieting Zhang
- College of Psychology, Shenzhen University, Shenzhen, China
| | - Siqi Fang
- Department of Social and Behavioral Sciences, City University of Hong Kong, Hong Kong.
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32
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Briley PM, Webster L, Boutry C, Cottam WJ, Auer DP, Liddle PF, Morriss R. Resting-state functional connectivity correlates of anxiety co-morbidity in major depressive disorder. Neurosci Biobehav Rev 2022; 138:104701. [PMID: 35598819 DOI: 10.1016/j.neubiorev.2022.104701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 04/17/2022] [Accepted: 05/13/2022] [Indexed: 10/18/2022]
Abstract
Major depressive disorder (MDD) is frequently co-morbid with anxiety disorders. The co-morbid state has poorer functional outcomes and greater resistance to first line treatments, highlighting the need for novel treatment targets. This systematic review examined differences in resting-state brain connectivity associated with anxiety comorbidity in young- and middle-aged adults with MDD, with the aim of identifying novel targets for neuromodulation treatments, as these treatments are thought to work partly by altering dysfunctional connectivity pathways. Twenty-one studies met inclusion criteria, including a total of 1292 people with MDD. Only two studies included people with MDD and formally diagnosed co-morbid anxiety disorders; the remainder included people with MDD with dimensional anxiety measurement. The quality of most studies was judged as fair. Results were heterogeneous, partly due to a focus on a small set of connectivity relationships within individual studies. There was evidence for dysconnectivity between the amygdala and other brain networks in co-morbid anxiety, and an indication that abnormalities of default mode network connectivity may play an underappreciated role in this condition.
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Affiliation(s)
- P M Briley
- Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK; Institute of Mental Health, School of Medicine, University of Nottingham, Nottingham, UK.
| | - L Webster
- Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
| | - C Boutry
- Institute of Mental Health, School of Medicine, University of Nottingham, Nottingham, UK
| | - W J Cottam
- NIHR Nottingham Biomedical Research Centre, Queen's Medical Centre, University of Nottingham, Nottingham, UK; Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, UK; Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
| | - D P Auer
- NIHR Nottingham Biomedical Research Centre, Queen's Medical Centre, University of Nottingham, Nottingham, UK; Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, UK; Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
| | - P F Liddle
- Institute of Mental Health, School of Medicine, University of Nottingham, Nottingham, UK
| | - R Morriss
- Institute of Mental Health, School of Medicine, University of Nottingham, Nottingham, UK; NIHR Nottingham Biomedical Research Centre, Queen's Medical Centre, University of Nottingham, Nottingham, UK
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Hesse M, Thylstrup B, Skogen JC. Commentary on Chai et al: Drug use, self-harm, suicide, and use of registry data in epidemiological research. Addiction 2022; 117:1950-1951. [PMID: 35475588 PMCID: PMC9320798 DOI: 10.1111/add.15901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 04/07/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Morten Hesse
- Centre for Alcohol and Drug Research, School of Business and Social Sciences, Department of Psychology and Behavioural SciencesAarhus UniversityDenmark
| | - Birgitte Thylstrup
- Centre for Alcohol and Drug Research, School of Business and Social Sciences, Department of Psychology and Behavioural SciencesAarhus UniversityDenmark
| | - Jens C. Skogen
- Department of Health PromotionNorwegian Institute of Public HealthBergenNorway,Alcohol and Drug Research Western NorwayStavanger University HospitalStavangerNorway
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Despotov K, Klivényi P, Nagy I, Pálvölgyi A, Vécsei L, Rajda C. Rare co-occurrence of multiple sclerosis and Wilson's disease - case report. BMC Neurol 2022; 22:178. [PMID: 35578211 PMCID: PMC9109366 DOI: 10.1186/s12883-022-02691-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 04/28/2022] [Indexed: 11/25/2022] Open
Abstract
Background Wilson’s disease is a hereditary disorder of copper metabolism resulting mainly in hepatic, neurological, and psychiatric symptoms. Multiple sclerosis (MS) is an immune-mediated demyelinating disease affecting the central nervous system (CNS). The co-occurrence of these two, although not unheard of in literature, is still considered to be very rare and can give rise to diagnostic difficulties. Also, comorbidity in MS highly influences quality of life and disease progression, which makes the timely diagnosis and treatment of these conditions essential. Case presentation The aim of this study is to present a patient exhibiting symptoms of both MS and Wilson’s disease, as well as to conduct a detailed review of previously reported cases. The patient’s neurological symptoms (sensory disorder) as well as MRI and CSF findings were characteristic for MS. The diagnosis of MS preceded that of Wilson’s disease and was relatively mild in course. Currently, the patient receives cladribine as an immunomodulatory treatment after escalation from glatiramer acetate therapy. Apart from one episode of acute hepatic decompensation, during which transfusion, albumin supplementation and diuretic treatment was necessary, Wilson’s disease manifested as chronic impairment of liver function. The diagnosis of Wilson’s disease was established by the analysis of serum coeruloplasmin levels, histological examination and genetic findings. Continuous oral penicillamine therapy led to the slow normalization of hepatic function and significant amelioration of the patient’s symptoms. Correlating with cases previously reported, the course of MS was relatively mild, and like in three out of four other known cases, the symptoms of Wilson’s disease were mostly restricted to hepatic dysfunction. Conclusion The case presented in our report is similar to those reported before. The co-occurrence of the two diseases seems to be more a coincidence than a sharing of common factors in their pathogenesis; however, they are considered to influence one another. Regarding rare co-occurrences such as this one, every new case is of high importance, as it enables a better evaluation and understanding of the clinical presentations that are more characteristic of these cases, thus aiding the estimation of disease course as well as possible therapeutic choices.
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Affiliation(s)
- Katalin Despotov
- Department of Neurology, University of Szeged, Faculty of Medicine, Szeged, Hungary
| | - Péter Klivényi
- Department of Neurology, University of Szeged, Faculty of Medicine, Szeged, Hungary
| | - István Nagy
- Faculty of Medicine, Department of Internal Medicine I, University of Szeged, Szeged, Hungary
| | - Attila Pálvölgyi
- Faculty of Medicine, Department of Internal Medicine I, University of Szeged, Szeged, Hungary
| | - László Vécsei
- Department of Neurology, University of Szeged, Faculty of Medicine, Szeged, Hungary.,MTA-SZTE Neuroscience Research Group, Szeged, Hungary.,Faculty of Medicine, Interdisciplinary Excellence Center, University of Szeged, Szeged, Hungary
| | - Cecília Rajda
- Department of Neurology, University of Szeged, Faculty of Medicine, Szeged, Hungary.
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35
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Saha AK, Podder CN, Niger AM. Dynamics of novel COVID-19 in the presence of Co-morbidity. Infect Dis Model 2022; 7:138-160. [PMID: 35530528 PMCID: PMC9065686 DOI: 10.1016/j.idm.2022.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 04/27/2022] [Accepted: 04/27/2022] [Indexed: 12/14/2022] Open
Abstract
A novel coronavirus (COVID-19) has emerged as a global serious public health issue from December 2019. People having a weak immune system are more susceptible to coronavirus infection. It is a double challenge for people of any age with certain underlying medical conditions including cardiovascular disease, diabetes, high blood pressure and cancer etc. Co-morbidity increases the probability of COVID-19 complication. In this paper a deterministic compartmental model is formulated to understand the transmission dynamics of COVID-19. Rigorous mathematical analysis of the model shows that it exhibits backward bifurcation phenomenon when the basic reproduction number is less than unity. For the case of no re-infection it is shown that having the reproduction number less than one is necessary and sufficient for the effective control of COVID-19, that is, the disease free equilibrium is globally asymptotically stable when the reproduction threshold is less than unity. Furthermore, in the absence of reinfection, a unique endemic equilibrium of the model exists which is globally asymptotically stable whenever the reproduction number is greater than unity. Numerical simulations of the model, using data relevant to COVID-19 transmission dynamics, show that the use of efficacious face masks publicly could lead to the elimination of COVID-19 up to a satisfactory level. The study also shows that in the presence of co-morbidity, the disease increases significantly.
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Davies J, Glinn L, Osborne LA, Reed P. Exploratory Study of Parenting Differences for Autism Spectrum Disorder and Attachment Disorder. J Autism Dev Disord 2022; 53:2143-2152. [PMID: 35353334 DOI: 10.1007/s10803-022-05531-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2022] [Indexed: 11/28/2022]
Abstract
The current study explored similarities and differences in parenting stress (PSI) and behaviours in parent reports of autism spectrum disorder (ASD) and attachment disorder (AD). 155 parents whose children had developmental delays and disorders completed the social communication questionnaire, Randolph attachment questionnaire, strengths and difficulties questionnaire, PSI, and parent-child relationship inventory. Parents of children with AD reported greater levels of PSI than parents of children with ASD. Parents of children reaching criteria for both disorders reported the greatest levels of PSI. Limit setting was poorest in parents of children with both classifications, followed by parents of children with AD, and then ASD. Limit setting mediated the relationship between PSI and child behaviour problems for parents of children with ASD < but not for parents of children with AD. These findings suggest different areas of difficulty for parents of children with these conditions, which may be of help in designing interventions.
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Affiliation(s)
- Joanna Davies
- Department of Psychology, Swansea University, Singleton Park, Swansea, SA2 8PP, UK.
| | - Laura Glinn
- Department of Psychology, Swansea University, Singleton Park, Swansea, SA2 8PP, UK
| | - Lisa A Osborne
- Swansea Bay University Health Board, Port Talbot, UK.,The Open University, Milton Keynes, UK
| | - Phil Reed
- Department of Psychology, Swansea University, Singleton Park, Swansea, SA2 8PP, UK
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Lord S, Teh R, Gibson R, Smith M, Wrapson W, Thomson M, Rolleston A, Neville S, McBain L, Del Din S, Taylor L, Kayes N, Kingston A, Abey-Nesbit R, Kerse N. Optimising function and well-being in older adults: protocol for an integrated research programme in Aotearoa/New Zealand. BMC Geriatr 2022; 22:215. [PMID: 35296250 PMCID: PMC8925165 DOI: 10.1186/s12877-022-02845-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 02/15/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Maintaining independence is of key importance to older people. Ways to enable health strategies, strengthen and support whanāu (family) at the community level are needed. The Ageing Well through Eating, Sleeping, Socialising and Mobility (AWESSOM) programme in Aotearoa/New Zealand (NZ) delivers five integrated studies across different ethnicities and ages to optimise well-being and to reverse the trajectory of functional decline and dependence associated with ageing. METHODS Well-being, independence and the trajectory of dependence are constructs viewed differently according to ethnicity, age, and socio-cultural circumstance. For each AWESSoM study these constructs are defined and guide study development through collaboration with a wide range of stakeholders, and with reference to current evidence. The Compression of Functional Decline model (CFD) underpins aspects of the programme. Interventions vary to optimise engagement and include a co-developed whānau (family) centred initiative (Ngā Pou o Rongo), the use of a novel LifeCurve™App to support behavioural change, development of health and social initiatives to support Pacific elders, and the use of a comprehensive oral health and cognitive stimulation programme for cohorts in aged residential care. Running parallel to these interventions is analysis of large data sets from primary care providers and national health databases to understand complex multi-morbidities and identify those at risk of adverse outcomes. Themes or target areas of sleep, physical activity, oral health, and social connectedness complement social capital and community integration in a balanced programme involving older people across the ability spectrum. DISCUSSION AWESSoM delivers a programme of bespoke yet integrated studies. Outcomes and process analysis from this research will inform about novel approaches to implement relevant, socio-cultural interventions to optimise well-being and health, and to reverse the trajectory of decline experienced with age. TRIAL REGISTRATION The At-risk cohort study was registered by the Australian New Zealand Clinical Trials registry on 08/12/2021 (Registration number ACTRN 12621001679875 ).
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Affiliation(s)
- Sue Lord
- School of Clinical Sciences, Faculty of Health & Environmental Sciences, Auckland University of Technology, Akoranga Drive, Northcote, Auckland, 0627, New Zealand.
| | - Ruth Teh
- School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Rosie Gibson
- School of Health Sciences, Massey University, Wellington, New Zealand
| | - Moira Smith
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Wendy Wrapson
- AUT Public Health and Mental Health Research Institute, Auckland University of Technology, Auckland, New Zealand
| | - Murray Thomson
- Department of Oral Sciences, University of Otago, Dunedin, New Zealand
| | | | - Stephen Neville
- School of Clinical Sciences, Faculty of Health & Environmental Sciences, Auckland University of Technology, Akoranga Drive, Northcote, Auckland, 0627, New Zealand
| | | | - Silvia Del Din
- Clinical Ageing Research Unit, Newcastle University, Newcastle Upon Tyne, UK
| | - Lynne Taylor
- School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Nicola Kayes
- School of Clinical Sciences, Faculty of Health & Environmental Sciences, Auckland University of Technology, Akoranga Drive, Northcote, Auckland, 0627, New Zealand
| | - Andrew Kingston
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Rebecca Abey-Nesbit
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK.,Department of Medicine, Canterbury District Health Board, Christchurch, New Zealand
| | - Ngaire Kerse
- School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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Nakhaei M, Fakhar M, Sharifpour A, Banimostafavi ES, Zakariaei Z, Mehravaran H, Saberi R, Safanavaei S, Abedi S, Aliyali M, Soleimani M. First Co-morbidity of Lophomonas blattarum and COVID-19 Infections: Confirmed Using Molecular Approach. Acta Parasitol 2022; 67:535-538. [PMID: 34677797 PMCID: PMC8531884 DOI: 10.1007/s11686-021-00468-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 09/10/2021] [Indexed: 12/19/2022]
Abstract
Introduction Lophomoniasis is caused by Lophomonas spp., a new emerging protozoan, which commonly affects the human lower respiratory tract. The Lophomonas parasite mostly lives commensally in the hindgut of cockroaches. Case Presentation We present the case of a 33-year-old woman, 30 weeks pregnant, who had severe COVID-19. She was intubated upon admission and began the routine COVID-19 treatment. To rule out possible super infection dual with COVID-19, microscopic examination of the patient's mini-bronchoalveolar lavage (mini-BAL) specimen, revealed L. blattarum, which was identified by the SSU rRNA-PCR and sequencing approaches (accession number: MZ093069). According to that, the patient was treated successfully with metronidazole. Conclusion To prevent serious complications, lophomoniasis should be listed in co-morbidity cases of COVID-19 infection during the COVID-19 pandemic worldwide. To the best of our knowledge, this is the first co-infection of Lophomonas blattarum and COVID-19 in the world which has been confirmed using a molecular approach.
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Affiliation(s)
- Maryam Nakhaei
- Toxoplasmosis Research Center, School of Medicine, Communicable Diseases Institute, Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Mazandaran University of Medical Sciences, Km 18, Farah-Abad Road, PO Box 48471-91971, Sari, Iran
| | - Mahdi Fakhar
- Toxoplasmosis Research Center, School of Medicine, Communicable Diseases Institute, Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Mazandaran University of Medical Sciences, Km 18, Farah-Abad Road, PO Box 48471-91971, Sari, Iran.
| | - Ali Sharifpour
- Toxoplasmosis Research Center, School of Medicine, Communicable Diseases Institute, Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Mazandaran University of Medical Sciences, Km 18, Farah-Abad Road, PO Box 48471-91971, Sari, Iran.
- Pulmonary and Critical Care Division, Imam Khomeini Hospital, Iranian National Registry Center for Lophomoniasis (INRCL), Mazandaran University of Medical Sciences, PO Box 48166-33131, Sari, Iran.
| | - Elham Sadat Banimostafavi
- Toxoplasmosis Research Center, School of Medicine, Communicable Diseases Institute, Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Mazandaran University of Medical Sciences, Km 18, Farah-Abad Road, PO Box 48471-91971, Sari, Iran
- Department of Radiology, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Zakaria Zakariaei
- Toxoplasmosis Research Center, School of Medicine, Communicable Diseases Institute, Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Mazandaran University of Medical Sciences, Km 18, Farah-Abad Road, PO Box 48471-91971, Sari, Iran
- Toxicology and Forensic Medicine Division, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hossein Mehravaran
- Toxoplasmosis Research Center, School of Medicine, Communicable Diseases Institute, Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Mazandaran University of Medical Sciences, Km 18, Farah-Abad Road, PO Box 48471-91971, Sari, Iran
- Pulmonary and Critical Care Division, Imam Khomeini Hospital, Iranian National Registry Center for Lophomoniasis (INRCL), Mazandaran University of Medical Sciences, PO Box 48166-33131, Sari, Iran
| | - Reza Saberi
- Toxoplasmosis Research Center, School of Medicine, Communicable Diseases Institute, Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Mazandaran University of Medical Sciences, Km 18, Farah-Abad Road, PO Box 48471-91971, Sari, Iran
| | - Sepideh Safanavaei
- Toxoplasmosis Research Center, School of Medicine, Communicable Diseases Institute, Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Mazandaran University of Medical Sciences, Km 18, Farah-Abad Road, PO Box 48471-91971, Sari, Iran
- Pulmonary and Critical Care Division, Imam Khomeini Hospital, Iranian National Registry Center for Lophomoniasis (INRCL), Mazandaran University of Medical Sciences, PO Box 48166-33131, Sari, Iran
| | - Siavash Abedi
- Toxoplasmosis Research Center, School of Medicine, Communicable Diseases Institute, Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Mazandaran University of Medical Sciences, Km 18, Farah-Abad Road, PO Box 48471-91971, Sari, Iran
- Pulmonary and Critical Care Division, Imam Khomeini Hospital, Iranian National Registry Center for Lophomoniasis (INRCL), Mazandaran University of Medical Sciences, PO Box 48166-33131, Sari, Iran
| | - Masoud Aliyali
- Toxoplasmosis Research Center, School of Medicine, Communicable Diseases Institute, Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Mazandaran University of Medical Sciences, Km 18, Farah-Abad Road, PO Box 48471-91971, Sari, Iran
- Pulmonary and Critical Care Division, Imam Khomeini Hospital, Iranian National Registry Center for Lophomoniasis (INRCL), Mazandaran University of Medical Sciences, PO Box 48166-33131, Sari, Iran
| | - Mostafa Soleimani
- Toxoplasmosis Research Center, School of Medicine, Communicable Diseases Institute, Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Mazandaran University of Medical Sciences, Km 18, Farah-Abad Road, PO Box 48471-91971, Sari, Iran
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Esperanza RA, Evans A, Tucker D, Paranjothy S, Hurt L. Hospital admissions in infants with Down syndrome: a record-linked population-based cohort study in Wales. J Intellect Disabil Res 2022; 66:225-239. [PMID: 34859911 PMCID: PMC9376940 DOI: 10.1111/jir.12903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 10/26/2021] [Accepted: 10/29/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Despite recent advances, mortality in children with Down syndrome remains five times higher than in the general population. This study aims to describe the burden, patterns and causes of hospital admissions in infants with Down syndrome, and compare this with infants without Down syndrome in a population-based cohort. METHODS This study used data from the Wales Electronic Cohort for Children, a cohort of all children born in Wales between 1990 and 2012. The cohort was generated from routine administrative data, linked to create an anonymised data set within the Secure Anonymised Information Linkage databank. This analysis is based on all infants born between January 2003 and January 2012 who were followed to their first birthday, a move out of Wales, death, or until 31 October 2012 (end of follow-up). Infants with Down syndrome were identified using the Congenital Anomaly Register and Information Service in Wales. Multivariable Cox regression was used to compare the time to first hospital admission. Admission codes were used to identify the commonest indications for hospitalisation and to determine the presence of other congenital anomalies. RESULTS We included 324 060 children, 356 of whom had Down syndrome. Of infants with Down syndrome, 80.3% had at least one hospital inpatient admission during the first year of life, compared with 32.9% of infants without Down syndrome. These first admissions were earlier [median of 6 days interquartile range (IQR) (3, 72) compared with 45 days [IQR 6, 166)] and longer [median of 4 days (IQR 1, 15) compared with 1 day (IQR 0, 3)] than in infants without Down syndrome. The most common causes of admissions were congenital abnormalities, respiratory diseases, conditions originating in the perinatal period and infectious diseases. The presence of other congenital abnormalities increased hospitalisations in all infants, but more so in infants with Down syndrome who spent a median of 21 days in hospital (IQR 11, 47) during their first year of life. CONCLUSION Infants with Down syndrome are at high risk for early, more frequent and longer hospital admissions. Congenital heart disease and respiratory infections remain a major burden in this population. More research is needed to understand how to better manage these conditions particularly in the first month of life when most admissions occur.
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Affiliation(s)
- R. A. Esperanza
- School of MedicineCardiff UniversityCardiffUK
- Cwm Taf Morgannwg University Health BoardMerthyr TydfilUK
| | - A. Evans
- Division of Population Medicine, School of MedicineCardiff UniversityCardiffUK
| | - D. Tucker
- Congenital Anomaly Register and Information ServicePublic Health WalesSwanseaUK
| | - S. Paranjothy
- Division of Population Medicine, School of MedicineCardiff UniversityCardiffUK
- Centre for Health Data ScienceUniversity of AberdeenAberdeenUK
| | - L. Hurt
- Division of Population Medicine, School of MedicineCardiff UniversityCardiffUK
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Adegbite BR, Edoa JR, Agbo Achimi Abdul JBP, Epola M, Mevyann C, Dejon-Agobé JC, Zinsou JF, Honkpehedji YJ, Mpagama SG, Alabi AS, Kremsner PG, Klipstein-Grobusch K, Adegnika AA, Grobusch MP. Non-communicable disease co-morbidity and associated factors in tuberculosis patients: A cross-sectional study in Gabon. EClinicalMedicine 2022; 45:101316. [PMID: 35243277 PMCID: PMC8885570 DOI: 10.1016/j.eclinm.2022.101316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 01/31/2022] [Accepted: 02/09/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND There are only limited data from resource-limited settings available on the prevalence of non-communicable diseases and associated risk factors of tuberculosis patients. This study investigated non-communicable disease co-morbidity in tuberculosis patients from Moyen Ogooué Province, Gabon. METHODS All patients aged 18 years or older consulting for tuberculosis (TB) symptoms in Gabon's Moyen Ogooué province and neighbouring provinces from November 2018 to November 2020 were screened for diabetes mellitus, hypertension, and risk factors thereof (obesity, dyslipidaemia, smoking and alcohol consumption). Logistic regression was performed to identify factors associated with TB-diabetes and TB-hypertension co-morbidities. FINDINGS Of 583 patients included, 227 (39%) were diagnosed with tuberculosis. In tuberculosis-confirmed patients, the prevalences of hypertension and diabetes were 16·3% and 12·8%, respectively. The prevalence of diabetes was twice as high in tuberculosis patients compared to non-tuberculosis patients. Factors independently associated with hypertension-tuberculosis co-morbidity were age >55 years (aOR=8·5, 95% CI 2·43, 32·6), age 45-54 years (aOR=4.9, 95%CI 1.3-19.8), and moderate alcohol consumption (aOR=2·4; 95% CI 1·02- 5·9), respectively. For diabetes-tuberculosis co-morbidity, age >55 years was positively (aOR=9·13; 95% CI 2·4-39·15), and moderate alcohol consumption inversely associated (aOR=0·26, 95% CI 0·08- 0·73). One-hundred-and-four (46%) of the tuberculosis patients had at least either dyslipidaemia, hypertension, diabetes, or obesity with a majority of newly-diagnosed hypertension and diabetes. INTERPRETATION Integration of screening of non-communicable diseases and their risk factors during TB assessment for early diagnosis, treatment initiation and chronic care management for better health outcomes should be implemented in all tuberculosis healthcare facilities. FUNDING This study was supported by WHO AFRO/TDR/EDCTP (2019/893,805) and Deutsches Zentrum für Infektiologie (DZIF/ TTU 02.812).
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Affiliation(s)
- BR Adegbite
- German Center for Infection Research, Centre de Recherches Médicales de Lambaréné and African Partner Institution, Lambaréné, Gabon
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, location AMC, Amsterdam Public Health, Amsterdam Infection and Immunity, University of Amsterdam, Amsterdam University Medical Centers, location AMC, Meibergdreef 9, Amsterdam 1105 AZ, the Netherlands
- Universität Tübingen and German Center for Infection Research, Institut für Tropenmedizin, Tübingen, Germany
| | - JR Edoa
- German Center for Infection Research, Centre de Recherches Médicales de Lambaréné and African Partner Institution, Lambaréné, Gabon
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, location AMC, Amsterdam Public Health, Amsterdam Infection and Immunity, University of Amsterdam, Amsterdam University Medical Centers, location AMC, Meibergdreef 9, Amsterdam 1105 AZ, the Netherlands
- Universität Tübingen and German Center for Infection Research, Institut für Tropenmedizin, Tübingen, Germany
| | - JBP Agbo Achimi Abdul
- German Center for Infection Research, Centre de Recherches Médicales de Lambaréné and African Partner Institution, Lambaréné, Gabon
| | - M Epola
- German Center for Infection Research, Centre de Recherches Médicales de Lambaréné and African Partner Institution, Lambaréné, Gabon
| | - C Mevyann
- German Center for Infection Research, Centre de Recherches Médicales de Lambaréné and African Partner Institution, Lambaréné, Gabon
| | - JC Dejon-Agobé
- German Center for Infection Research, Centre de Recherches Médicales de Lambaréné and African Partner Institution, Lambaréné, Gabon
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, location AMC, Amsterdam Public Health, Amsterdam Infection and Immunity, University of Amsterdam, Amsterdam University Medical Centers, location AMC, Meibergdreef 9, Amsterdam 1105 AZ, the Netherlands
- Universität Tübingen and German Center for Infection Research, Institut für Tropenmedizin, Tübingen, Germany
| | - JF Zinsou
- German Center for Infection Research, Centre de Recherches Médicales de Lambaréné and African Partner Institution, Lambaréné, Gabon
- Universität Tübingen and German Center for Infection Research, Institut für Tropenmedizin, Tübingen, Germany
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
| | - YJ Honkpehedji
- German Center for Infection Research, Centre de Recherches Médicales de Lambaréné and African Partner Institution, Lambaréné, Gabon
- Universität Tübingen and German Center for Infection Research, Institut für Tropenmedizin, Tübingen, Germany
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
| | - SG Mpagama
- Kibong'oto Infectious Diseases Hospital - Sanya Juu Siha/Kilimanjaro Clinical Research Institute Kilimanjaro Tanzania, Mae Street, Lomakaa Road, Siha Kilimanjaro, Tanzania
| | - AS Alabi
- German Center for Infection Research, Centre de Recherches Médicales de Lambaréné and African Partner Institution, Lambaréné, Gabon
- Universität Tübingen and German Center for Infection Research, Institut für Tropenmedizin, Tübingen, Germany
| | - PG Kremsner
- German Center for Infection Research, Centre de Recherches Médicales de Lambaréné and African Partner Institution, Lambaréné, Gabon
- Universität Tübingen and German Center for Infection Research, Institut für Tropenmedizin, Tübingen, Germany
| | - K Klipstein-Grobusch
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - AA Adegnika
- German Center for Infection Research, Centre de Recherches Médicales de Lambaréné and African Partner Institution, Lambaréné, Gabon
- Universität Tübingen and German Center for Infection Research, Institut für Tropenmedizin, Tübingen, Germany
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
| | - MP Grobusch
- German Center for Infection Research, Centre de Recherches Médicales de Lambaréné and African Partner Institution, Lambaréné, Gabon
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, location AMC, Amsterdam Public Health, Amsterdam Infection and Immunity, University of Amsterdam, Amsterdam University Medical Centers, location AMC, Meibergdreef 9, Amsterdam 1105 AZ, the Netherlands
- Universität Tübingen and German Center for Infection Research, Institut für Tropenmedizin, Tübingen, Germany
- Masanga Medical Research Unit (MMRU), Masanga, Sierra Leone
- Institute of Infectious Diseases and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa
- Corresponding author at: Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, location AMC, Amsterdam Public Health, Amsterdam Infection and Immunity, University of Amsterdam, Amsterdam University Medical Centers, location AMC, Meibergdreef 9, Amsterdam 1105 AZ, the Netherlands.
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Mutiso VN, Ndetei DM, N Muia E, K Alietsi R, Onsinyo L, Kameti F, Masake M, Musyimi C, Mamah D. The prevalance of binge eating disorder and associated psychiatric and substance use disorders in a student population in Kenya - towards a public health approach. BMC Psychiatry 2022; 22:122. [PMID: 35172765 PMCID: PMC8848944 DOI: 10.1186/s12888-022-03761-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 09/15/2021] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION Kenya in particular and Africa in general lack data on Binge Eating Disorder (BED). The overarching objective of this study is to fill that gap. Kenyans may not be aware that BED exists when a "very good" appetite is considered a sign of good health, especially if food is available either at home, in fast food shops or when communally eating together, a very common cultural practice. On the other hand where there is relatively insufficient food, it is not expected that one could be having a problem of eating too much. METHOD We administered the following tools and measurements to 9742 participants (high school, college and university students): 1) Researcher designed socio-demographic and economic indicator questionnaire; 2) An instrument documenting DSM-IV diagnostic criteria for BED and its various symptoms; 3) An instrument to determine DSM-IV psychiatric disorders and substance abuse;4) An instrument measuring high risk for psychosis ,affectivity and stress; 5) A WHO designed instrument measuring the severity of substance abuse for specific substances. We used descriptive and inferential analysis to determine the prevalence and association of the different variables. Independent predictors of BED were generated from a generalized linear model (p<0.05). RESULTS We found a prevalence of 3.2% of BED and a wide range of prevalence for BED and BED related symptoms (8.1% to 19%). The least prevalent was "To prevent weight gain from eating binge did you force yourself to vomit, or used laxatives?". The most common was "Did you often go on eating binges (eating a very large amount of food very quickly over a short period of time)." Major depression, obsessive compulsive disorder, panic disorder, agoraphobia, generalized anxiety disorder ,a positive stress screen and drug abuse were independent predictors of BED (p<0.05). CONCLUSION Our findings on the prevalence of BED and significant associations with various psychiatric disorders and substance use disorders are similar to those obtained in High Income Countries (HIC) using similar large-scale samples in non-clinical populations. Our findings suggest the need fora public health approach to enhance awareness of BED and to promote health-seeking behaviour towards management of BED.
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Affiliation(s)
- Victoria N. Mutiso
- grid.490737.eAfrica Mental Health Research and Training Foundation, Mawensi Road, Off Elgon road, Mawensi Garden, P.O. Box 48423-00100, Nairobi, Kenya
| | - David M. Ndetei
- grid.490737.eAfrica Mental Health Research and Training Foundation, Mawensi Road, Off Elgon road, Mawensi Garden, P.O. Box 48423-00100, Nairobi, Kenya ,grid.10604.330000 0001 2019 0495Department of Psychiatry, University of Nairobi, Mawensi Road, Off Elgon road, Mawensi Garden, P.O. Box 48423-00100, Nairobi, Kenya
| | - Esther N Muia
- grid.493101.e0000 0004 4660 9348Department of Public and Community Health, Machakos University, Machakos, Kenya
| | - Rita K Alietsi
- grid.490737.eAfrica Mental Health Research and Training Foundation, Mawensi Road, Off Elgon road, Mawensi Garden, P.O. Box 48423-00100, Nairobi, Kenya
| | - Lydia Onsinyo
- grid.490737.eAfrica Mental Health Research and Training Foundation, Mawensi Road, Off Elgon road, Mawensi Garden, P.O. Box 48423-00100, Nairobi, Kenya
| | - Frida Kameti
- grid.490737.eAfrica Mental Health Research and Training Foundation, Mawensi Road, Off Elgon road, Mawensi Garden, P.O. Box 48423-00100, Nairobi, Kenya
| | - Monicah Masake
- grid.493101.e0000 0004 4660 9348Department of Public and Community Health, Machakos University, Machakos, Kenya
| | - Christine Musyimi
- grid.490737.eAfrica Mental Health Research and Training Foundation, Mawensi Road, Off Elgon road, Mawensi Garden, P.O. Box 48423-00100, Nairobi, Kenya
| | - Daniel Mamah
- grid.4367.60000 0001 2355 7002Department of Psychiatry, Washington University Medical School, St. Louis, Missouri USA
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Farooqi A, Gillies C, Sathanapally H, Abner S, Seidu S, Davies MJ, Polonsky WH, Khunti K. A systematic review and meta-analysis to compare the prevalence of depression between people with and without Type 1 and Type 2 diabetes. Prim Care Diabetes 2022; 16:1-10. [PMID: 34810141 DOI: 10.1016/j.pcd.2021.11.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 10/12/2021] [Accepted: 11/07/2021] [Indexed: 01/21/2023]
Abstract
AIMS Diabetes can significantly impact quality of life and mental health. However, inconsistencies have been reported in the prevalence of depression in those with Type 1 and Type 2 diabetes, and those without. Systematic reviews also included studies without adequate control subjects. We update existing literature, by comparing depression prevalence between individuals with and without Type 1 and Type 2 diabetes. METHODS A systematic review and meta-analysis. We searched MEDLINE, EMBASE and PSYCHINFO, from January 1985 to August 2021. Studies were excluded if they failed to have an adequate control group, specified type of diabetes, or reported depression prevalence by type of diabetes. RESULTS 44 studies were selected for inclusion. The prevalence of depression was significantly higher in people with Type 1 (22% vs 13%, OR = 2.10 (95% CI: 1.23, 3.52)), or Type 2 diabetes (19% vs 11%, OR = 1.76 (1.55, 2.01)) compared to those without diabetes. There was no association between study effect size and mean age or gender. Findings did not significantly differ between methods of depression assessment. Prevalence of depression in people with diabetes was higher in studies carried out in specialist care (36%, OR = 3.14 (2.12, 4.63)) compared to those in community or primary care (12%, OR = 1.51 (1.35, 1.70) and in low- and middle-income countries (OR = 2.58 (1.91, 3.50) compared to countries with high income economies (OR = 1.59 (1.39, 1.82)). CONCLUSIONS Depression prevalence remains significant in those with type 1 and type 2 diabetes. Effective chronic disease management in people with diabetes is important, particularly screening and managing depression and diabetes distress in specialist care settings.
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Affiliation(s)
- Aaisha Farooqi
- Department of Psychology, Birmingham City University, UK.
| | - Clare Gillies
- Leicester Real World Evidence Unit, University of Leicester, UK
| | | | - Sophia Abner
- Leicester Real World Evidence Unit, University of Leicester, UK
| | - Sam Seidu
- Leicester Real World Evidence Unit, University of Leicester, UK; Diabetes Research Centre, University of Leicester, UK
| | - Melanie J Davies
- Diabetes Research Centre, University of Leicester, UK; NIHR Leicester Biomedical Research Centre, Leicester General Hospital, UK
| | | | - Kamlesh Khunti
- Leicester Real World Evidence Unit, University of Leicester, UK; Diabetes Research Centre, University of Leicester, UK
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Soji DJ, Lordson J, Mini GK. Multimorbidity patterns among rural adults with Type-2 diabetes mellitus: A cross-sectional study in Kerala, India. WHO South East Asia J Public Health 2022; 10:32-36. [PMID: 35046156 DOI: 10.4103/who-seajph.who-seajph_73_21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives The study evaluated the prevalence and pattern of multi-morbidity among rural adults with type-2 diabetes mellitus and explored the factors associated with multi-morbidity among 400 adult diabetic patients from rural areas of Thiruvananthapuram district in the Kerala state of India. Materials and Methods The presence of multi-morbidity was assessed using a semi-structured interview schedule based on the physician's confirmation. The reported chronic diseases were classified as concordant (conditions with a similar pathophysiologic risk profile as diabetes) and discordant (conditions whose treatments are not directly related to the pathogenesis for diabetes) co-morbidity. Multivariate analysis was done to find the factors associated with multi-morbidity. Results Prevalence of multi-morbidity among diabetic patients was 74% (95% Confidence Interval (CI): 69-77), around 66% reported at least one concordant co-morbidity, 30% reported at least one discordant co-morbidity and 21% reported both concordant and discordant co-morbidity with diabetes. Hypertension (59%) was the most frequent co-morbidity. Older adults (above 60 years of age) [Odds Ratio (OR):3.42, 95% CI:1.97-5.94] and women (OR:2.16, CI:1.13-3.51) were more likely to have multi-morbidity compared to their counterparts. Those using insulin and/or oral medication were more likely to have multi-morbidity compared to those using oral medication only (OR: 2.19, CI: 1.07-4.09). Conclusion Multi-morbidity among diabetic patients needs to be addressed by a comprehensive and integrated approach rather than a diabetes specific approach.
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Affiliation(s)
- D J Soji
- Global Institute of Public Health, Ananthapuri Hospitals and Research Institute, Thiruvananthapuram, Kerala, India
| | - J Lordson
- Global Institute of Public Health, Ananthapuri Hospitals and Research Institute, Thiruvananthapuram, Kerala, India
| | - G K Mini
- Global Institute of Public Health, Ananthapuri Hospitals and Research Institute; Women's Institute for Social and Health Studies, Women's Social and Health Studies Foundation, Thiruvananthapuram, Kerala, India
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Datta D, Podder I, De A, Das S. Psoriatic Arthritis: A Comprehensive Update for Dermatologists with Review of Literature. Indian J Dermatol 2022; 67:381-386. [PMID: 36578730 PMCID: PMC9792016 DOI: 10.4103/ijd.ijd_571_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Psoriatic arthritis (PsA), an inflammatory seronegative spondyloarthropathy is the most common co-morbidity of psoriasis (PsO), in almost 30% of cases. Delayed diagnosis and treatment of PsA may result in irreversible joint damage, significant morbidity, impaired quality of life, and several cardiometabolic and cerebrovascular co-morbidities. Dermatologists are uniquely privileged to be able to diagnose latent PsA at an early stage, as almost 80% of these patients present with pre-existing cutaneous PsO. This review provides a detailed overview of PsA along with its salient clinical features, classification criteria, screening tools, simple physical examination maneuvers, imaging findings, and therapeutic options to acquaint dermatologists and other clinicians with this morbid musculoskeletal disorder. We hope to generate awareness about this condition among dermatologists to enable proactive screening of all PsO patients for early diagnosis, initiation of appropriate treatment, and prompt referral to a rheumatologist; thus, helping to arrest PsA disease progression, irreversible joint damage, and subsequent permanent disability.
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Affiliation(s)
- Debatri Datta
- From the Consultant Dermatologist, Oliva Skin Clinic, Kolkata, West Bengal, India
| | - Indrashis Podder
- Department of Dermatology, Venereology and Leprosy, College of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal, India,Address for correspondence: Dr. Indrashis Podder, Department of Dermatology, Venereology and Leprosy, College of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal, India. E-mail:
| | - Abhishek De
- Department of Dermatology, Calcutta National Medical College, Kolkata, West Bengal, India
| | - Sudip Das
- Department of Dermatology, Calcutta National Medical College, Kolkata, West Bengal, India
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Rani R, Tegta GR, Verma GK, Sharma DD, Gupta M, Negi A. A Clinicoepidemiological Study of Psychiatric Co-Morbidity in Hansen's Disease. Indian Dermatol Online J 2021; 12:847-851. [PMID: 34934720 PMCID: PMC8653717 DOI: 10.4103/idoj.idoj_141_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 04/11/2021] [Accepted: 08/07/2021] [Indexed: 11/04/2022] Open
Abstract
Introduction Leprosy is a chronic disease caused by mycobacterium leprae. Chronicity of the disease leads to various psychiatric co-morbidities, which are often undiagnosed and untreated. The main objectives of this study were to evaluate the frequency and nature of psychiatric co-morbidity in patients of Hansen's disease. Materials and Methods Seventy confirmed cases of Hansen's disease between the ages of 18 and 60 years attending the department of dermatology of Indira Gandhi Medical College and Hospital, Shimla were evaluated for various manifestations of Hansen's disease and screened for psychiatric co-morbidity using GHQ-12 and diagnosed using ICD-10 checklist. Severity of depression and anxiety was assessed with HAM-D and HAM-A scales, respectively. Results The prevalence of psychiatric co-morbidity was found in 27.14% of enrolled patients. Depression was most prevalent in (20%) mental disorder; followed by anxiety disorder (7.14%). Moderate depressive episode was the commonest seen in 11.42% patients whereas 5.71% patients had mild depression. Generalized anxiety disorder was seen in 1.42% whereas 5.71% patients had mixed anxiety disorder. Patients with higher education status, positive family history of leprosy, lepromatous leprosy, and hand deformities were significantly associated with higher psychiatric co-morbidity. Conclusion Patients suffering from Hansen's disease have significantly high prevalence of psychiatric co-morbidity complicating the Hansen's disease. High index of suspicion is required to diagnose and treat it.
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Affiliation(s)
- Ritu Rani
- Department of Dermatology, Venereology and Leprosy, IGMC, Shimla, Himachal Pradesh, India
| | - Gita R Tegta
- Department of Dermatology, Venereology and Leprosy, IGMC, Shimla, Himachal Pradesh, India
| | - Ghanshyam K Verma
- Department of Dermatology, Venereology and Leprosy, IGMC, Shimla, Himachal Pradesh, India
| | - Dinesh D Sharma
- Department of Psychiatry, IGMC, Shimla, Himachal Pradesh, India
| | - Mudita Gupta
- Department of Dermatology, Venereology and Leprosy, IGMC, Shimla, Himachal Pradesh, India
| | - Ajeet Negi
- Department of Dermatology, Venereology and Leprosy, IGMC, Shimla, Himachal Pradesh, India
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Beasley JM, Ho JC, Conderino S, Thorpe LE, Shah M, Gujral UP, Zanowiak J, Islam N. Diabetes and hypertension among South Asians in New York and Atlanta leveraging hospital electronic health records. Diabetol Metab Syndr 2021; 13:146. [PMID: 34922618 PMCID: PMC8684279 DOI: 10.1186/s13098-021-00766-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 11/30/2021] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Diabetes and hypertension disparities are pronounced among South Asians. There is regional variation in the prevalence of diabetes and hypertension in the US, but it is unknown whether there is variation among South Asians living in the US. The objective of this study was to compare the burden of diabetes and hypertension between South Asian patients receiving care in the health systems of two US cities. METHODS Cross-sectional analyses were performed using electronic health records (EHR) for 90,137 South Asians receiving care at New York University Langone in New York City (NYC) and 28,868 South Asians receiving care at Emory University (Atlanta). Diabetes was defined as having 2 + encounters with a diagnosis of diabetes, having a diabetes medication prescribed (excluding Acarbose/Metformin), or having 2 + abnormal A1C levels (≥ 6.5%) and 1 + encounter with a diagnosis of diabetes. Hypertension was defined as having 3 + BP readings of systolic BP ≥ 130 mmHg or diastolic BP ≥ 80 mmHg, 2 + encounters with a diagnosis of hypertension, or having an anti-hypertensive medication prescribed. RESULTS Among South Asian patients at these two large, private health systems, age-adjusted diabetes burden was 10.7% in NYC compared to 6.7% in Atlanta. Age-adjusted hypertension burden was 20.9% in NYC compared to 24.7% in Atlanta. In Atlanta, 75.6% of those with diabetes had comorbid hypertension compared to 46.2% in NYC. CONCLUSIONS These findings suggest differences by region and sex in diabetes and hypertension risk. Additionally, these results call for better characterization of race/ethnicity in EHRs to identify ethnic subgroup variation, as well as intervention studies to reduce lifestyle exposures that underlie the elevated risk for type 2 diabetes and hypertension development in South Asians.
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Affiliation(s)
- Jeannette M Beasley
- Department of Medicine, NYU Grossman School of Medicine, 462 First Avenue CD 673, New York, NY, 10016, USA.
| | - Joyce C Ho
- Department of Mathematics and Computer Science, Emory University, Atlanta, USA
| | - Sarah Conderino
- Department of Population Health, NYU Grossman School of Medicine, New York, USA
| | - Lorna E Thorpe
- Department of Population Health, NYU Grossman School of Medicine, New York, USA
| | - Megha Shah
- Department of Family and Preventive Medicine, Emory University School of Medicine, Atlanta, USA
| | - Unjali P Gujral
- Department of Global Health, Emory University Rollins School of Public Health, Atlanta, USA
| | - Jennifer Zanowiak
- Department of Population Health, NYU Grossman School of Medicine, New York, USA
| | - Nadia Islam
- Department of Population Health, NYU Grossman School of Medicine, New York, USA
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Joseph K, Wong J, Abraham A, Zebak J, Patel A, Jones Thachuthara A, Iqbal U, Pham TM, Menon A, Ghosh S, Warkentin H, Walker J, Jha N, Faruqi S, Salopek TG, Smylie M. Patterns and predictors of relapse in Merkel cell carcinoma: Results from a population-based study. Radiother Oncol 2021; 166:110-117. [PMID: 34838888 DOI: 10.1016/j.radonc.2021.11.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 11/02/2021] [Accepted: 11/17/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND PURPOSE Prospective data evaluating the role of adjuvant radiotherapy (RT) for Merkel Cell Carcinoma(MCC) is lacking. To better understand the efficacy of adjuvant RT, a population-based patterns of failure study was conducted. METHODS We identified MCC patients treated from 1988 to 2018.Primary outcome measures were recurrence-free survival (RFS), overall survival (OS) and MCC-specific survival (MCC-SS). Charlson Co-morbidity Index (CCI) was also calculated. RESULTS 217 patients with mean age 79 (range: 33-96) were analyzed. The median follow-up was 40 months. Treatments were: surgery(S) alone (n = 101, 45%) or S + RT(n = 116, 55%).Local recurrence (LR) was low in stage I (n = 6, 6.5%) with clear margin of ≥1 cm, negative sentinel lymph node biopsy (SLNB) without high-risk factors, irrespective of adjuvant RT. Tumor size ≥ 2 cm (HR:2.95; p = 0.024) and immunosuppression(HR:3.98; p = 0.001) were associated with high risk of nodal failure. Adjuvant RT was associated with significant reduction in regional failure (HR:0.36; p = 0.002). Distant metastases (DM) were infrequent in stage I (4/90) and stage II (4/34), compared to stage III (32/93). Adjuvant RT improvedRFS but did not influence MCC-SS and OS. CCI was a significant predictor of OS. CONCLUSIONS Adjuvant RT improvedRFS, withoutimpact on MCC-SS and OS. Co-morbidity rather than RT influenced OS. Adjuvant RT may be avoided instage I patients with negative SLNB and no associated high-risk factors. Prophylactic RNI could be considered in stage II with high risk features, inspite of negative SLNB. Stage III patients benefited from adjuvant RNI, but no impact on prevention of DM.
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Affiliation(s)
- Kurian Joseph
- Division of Radiation Oncology, Department of Oncology, University of Alberta & Cross Cancer Institute, Edmonton, Canada.
| | - Justina Wong
- School of Radiation Therapy, University of Alberta, Canada
| | - Aswin Abraham
- Division of Radiation Oncology, Department of Oncology, University of Alberta & Cross Cancer Institute, Edmonton, Canada
| | - Julia Zebak
- Division of Radiation Oncology, Department of Oncology, University of Alberta & Cross Cancer Institute, Edmonton, Canada
| | - Anushree Patel
- Division of Radiation Oncology, Department of Oncology, University of Alberta & Cross Cancer Institute, Edmonton, Canada
| | | | - Umar Iqbal
- Cancer Research & Analytics, Alberta Health Services, Edmonton, Canada
| | - Truong-Minh Pham
- Cancer Research & Analytics, Alberta Health Services, Edmonton, Canada
| | - Anjali Menon
- Division of Radiation Oncology, Department of Oncology, University of Alberta & Cross Cancer Institute, Edmonton, Canada
| | - Sunita Ghosh
- Division of Medical Oncology, Department of Oncology, University of Alberta, & Cross Cancer Institute, Edmonton, Canada
| | - Heather Warkentin
- Department of Medical Physics, University of Alberta, & Cross Cancer Institute, Edmonton, Canada
| | - John Walker
- Division of Medical Oncology, Department of Oncology, University of Alberta, & Cross Cancer Institute, Edmonton, Canada
| | - Naresh Jha
- Division of Radiation Oncology, Department of Oncology, University of Alberta & Cross Cancer Institute, Edmonton, Canada
| | - Salman Faruqi
- Department of Radiation Oncology, Tom Baker Cancer Centre, University of Calgary, Canada
| | - Thomas G Salopek
- Division of Dermatology, Department of Medicine, University of Alberta, Edmonton, Canada
| | - Michael Smylie
- Division of Medical Oncology, Department of Oncology, University of Alberta, & Cross Cancer Institute, Edmonton, Canada
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Uotila J, Gyllenberg D, Korhonen L, Hinkka-Yli-Salomäki S, Heinonen E, Chudal R, Gissler M, Sourander A. Incidence and comorbidities of disruptive behavior disorders diagnosed in Finnish specialist psychiatric services. Soc Psychiatry Psychiatr Epidemiol 2021; 56:2063-72. [PMID: 33398496 DOI: 10.1007/s00127-020-02015-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 12/07/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE Disruptive behavior disorders (DBD), including oppositional defiant disorder (ODD) and conduct disorder (CD), are some of the most common psychiatric conditions in childhood. Despite this, there has been limited research on DBDs. We examined the incidence, comorbidity and gender differences of DBDs diagnosed by specialist services. METHOD This was a nationwide register study of 570,815 children and adolescents born in 1996-2005. The 7050 individuals diagnosed with DBD by specialist healthcare services were matched to 26,804 controls. RESULTS By the age of 15, the cumulative incidence of diagnosed DBDs was 3.5% for boys and 1.4% for girls. The yearly incidence rate increased for girls after 13 years of age, while the incidence for boys was relatively stable between 8 and 15 years of age. When we compared subjects born between 1996-1998 and 1999-2001, we found that by the age of 12, the cumulative incidence per 100 people had increased from 0.56 to 0.68 among girls and from 2.3 to 2.6 among boys. This indicated a minor increase in treated incidence. The parents of children diagnosed with DBDs had lower educational levels than the parents of controls. Children with DBD were also more likely to have been diagnosed with other psychiatric disorders. CONCLUSION Although DBDs were 3.5 times more common among boys during the whole follow-up period, the yearly incidence during adolescence was fairly similar between boys and girls. DBD existed alongside various psychiatric disorders at a relatively young age and only a minor increase in treated incidence was found during childhood.
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An Y, Shi J, Chuan-Peng H, Wu X. The symptom structure of posttraumatic stress disorder and co-morbid depression among college students with childhood abuse experience: A network analysis. J Affect Disord 2021; 293:466-475. [PMID: 34256208 DOI: 10.1016/j.jad.2021.06.065] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 06/24/2021] [Accepted: 06/27/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) and depression are highly co-morbid among individuals with childhood abuse history, while the mechanism of the co-morbidity is highly debated. This study sought to extent the work among college students with network analysis, which is a novel method that sees the co-morbidity from a symptom interacting perspective. METHODS Data was collected from 476 college students who were assessed to have childhood abuse history, PTSD and depression at the same time, using Childhood Trauma Questionnaire- Short Form, PTSD Checklist for DSM-5 and The Center for Epidemiological Studies Depression. We created a Graphical Gaussian Model (GGM) network to show associations between symptom pairs and a Directed Acyclic Graph (DAG) to estimate potential casual relationships among symptoms. RESULTS The GGM network was reliably stable, feeling sad (Depression) and trouble experiencing positive feelings (PTSD) were the most central nodes. Trouble experiencing positive feelings and several negative affect symptoms, sleep problems and difficulty in concentrating were acting as important bridging nodes. The DAG network suggested the key triggering roles of exaggerated startle (PTSD) and several re-experiencing symptoms. LIMITATIONS The study used cross-sectional data and self-reported measures. Results from network analysis could be affected by scale factors and contain spurious correlations. CONCLUSIONS In the childhood-abuse-related co-morbid structure, several negative affect symptoms both in PTSD and depression have pivotal roles, hyper-arousal symptoms and re-experiencing symptoms could trigger the co-morbid structure. Illustrating the strength and limitations of network analysis, this study help target the potentially influential symptoms for better clinical intervention.
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Affiliation(s)
- Yuanyuan An
- School of Psychology, Nanjing Normal University, 122 Ninghai Road, Gulou Distinct, Nanjing, PR China
| | - Junyi Shi
- School of Psychology, Nanjing Normal University, 122 Ninghai Road, Gulou Distinct, Nanjing, PR China
| | - Hu Chuan-Peng
- Leibniz Institute for Resilience Research, 55131 Mainz, Germany
| | - Xinchun Wu
- Faculty of Psychology, Beijing Normal University, No.19 Xinjiekou Wai Street, Beijing, PR China; Beijing Key Laboratory of Applied Experimental Psychology, Beijing Normal University, No.19 Xinjiekou Wai Street, Beijing, PR China.
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Wallhed Finn S, Lundin A, Sjöqvist H, Danielsson AK. Pharmacotherapy for alcohol use disorders - Unequal provision across sociodemographic factors and co-morbid conditions. A cohort study of the total population in Sweden. Drug Alcohol Depend 2021; 227:108964. [PMID: 34518028 DOI: 10.1016/j.drugalcdep.2021.108964] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/20/2021] [Accepted: 07/25/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Pharmacotherapy for alcohol use disorders (AUD) is effective. However, knowledge about utilization of, and patient characteristics associated with prescriptions is scarce. The aim is to investigate prescriptions of pharmacotherapy for AUD in Sweden across time, sociodemographics, domicile and comorbid conditions. METHOD This is a national cohort study, comprising 132 733 adult patients with AUD diagnosis between 2007 and 2015. The exposure variables were age, sex, income, education, family constellation, domicile, origin, concurrent psychiatric and somatic co-morbid diagnoses. Logistic regression analyses were used to obtain odds ratios (OR) for any filled prescription of AUD pharmacotherapy; Acamprosate, Disulfiram, Naltrexone or Nalmefene during 12 months after AUD diagnosis. RESULTS During the study period, the proportion of individuals who received pharmacotherapy ranged between 22.80 and 23.94 % (χ2(64) = 72.00, p = .23). Female sex, age 31-45, higher education and income, living in a big city, co-habiting and born in Sweden, bar Norway, Denmark and Iceland, were associated with higher odds of pharmacotherapy. Concurrent somatic diagnosis was associated with lower odds of pharmacotherapy but psychiatric diagnosis higher (aOR = 0.61 95 % CI 0.59-0.63 and aOR = 1.61 95 % CI 1.57-1.66 respectively). CONCLUSIONS Pharmacotherapy for AUD is underutilized. The proportion of individuals with a prescription did not change between 2007 and 2015. Provision of treatment is unequal across different groups in society, where especially older age, lower income and education, and co-morbid somatic diagnosis were associated with lower odds of prescription. There is a need to develop treatment provision, particularly for individuals with co-morbid somatic conditions.
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Affiliation(s)
- Sara Wallhed Finn
- Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden; Mottagningen För alkohol och hälsa, Stockholm Center for Dependency Disorders, Health Care Services, Riddargatan 1, 114 35, Stockholm, Sweden.
| | - Andreas Lundin
- Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden; Centre for Epidemiology and Community Medicine, Stockholm Region, Sweden
| | - Hugo Sjöqvist
- Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Anna-Karin Danielsson
- Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden
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