Comorbidities, multimorbidity and COVID-19

Nature Medicine, Год журнала: 2023, Номер 29(2), С. 334 - 343

Опубликована: Фев. 1, 2023

Язык: Английский

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COPD and multimorbidity: recognising and addressing a syndemic occurrence

The Lancet Respiratory Medicine, Год журнала: 2023, Номер 11(11), С. 1020 - 1034

Опубликована: Сен. 8, 2023

Язык: Английский

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Etiology, effects and management of comorbidities in multiple sclerosis: recent advances

Frontiers in Immunology, Год журнала: 2023, Номер 14

Опубликована: Май 30, 2023

Comorbid conditions commonly affect people with multiple sclerosis (MS). Population-based studies indicate that MS have an increased incidence of ischemic heart disease, cerebrovascular peripheral vascular and psychiatric disorders as compared to without MS. People from underrepresented minority immigrant groups higher comorbidity burdens. Comorbidities exert effects throughout the disease course, symptom onset through diagnosis end life. At individual level, is associated relapse rates, greater physical cognitive impairments, lower health-related quality life, mortality. level health system society, care utilization, costs work impairment. A nascent literature suggests affects outcomes comorbidities. Comorbidity management needs be integrated into care, this would facilitated by determining optimal models care.

Язык: Английский

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Biological and functional multimorbidity—from mechanisms to management

Nature Medicine, Год журнала: 2023, Номер 29(7), С. 1649 - 1657

Опубликована: Июль 1, 2023

Язык: Английский

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Healthcare fragmentation, multimorbidity, potentially inappropriate medication, and mortality: a Danish nationwide cohort study

BMC Medicine, Год журнала: 2023, Номер 21(1)

Опубликована: Авг. 15, 2023

Abstract Background Patients with multimorbidity are frequent users of healthcare, but fragmented care may lead to suboptimal treatment. Yet, this has never been examined across healthcare sectors on a national scale. We aimed quantify fragmentation using various measures and analyze the associations patient outcomes. Methods conducted register-based nationwide cohort study 4.7 million Danish adult citizens. All contacts primary hospitals during 2018 were recorded. Clinical indicators included number contacts, involved providers, provider transitions, hospital trajectories. Formal indices assessed concentration, dispersion, contact sequence. The outcomes potentially inappropriate medication all-cause mortality adjusted for demographics, socioeconomic factors, morbidity level. Results trajectories rose increasing levels. 3 versus 6 conditions had mean 4.0 6.9 providers 6.6 13.7 transitions. proportion patient’s own general practice remained stable High levels associated higher rates increased all after adjusting demographic characteristics, morbidity. strongest found ≥ 20 none (incidence rate ratio 2.83, 95% CI 2.77–2.90) (hazard 10.8, 9.48–12.4), respectively. Having less than 25% your usual was an incidence 1.49 (95% 1.40–1.58) hazard 2.59 2.36–2.84) compared full continuity. For between outcomes, there no clear interactions conditions. Conclusions Several clinical Care even when most important confounders. Frequent provider, fewer better coordination regardless

Язык: Английский

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Prevalence of multimorbidity and polypharmacy among adults and older adults: a systematic review

The Lancet Healthy Longevity, Год журнала: 2024, Номер 5(4), С. e287 - e296

Опубликована: Март 4, 2024

Multimorbidity (multiple conditions) and polypharmacy medications) are increasingly common, yet there is a need to better understand the prevalence of co-occurrence. In this systematic review, we examined multimorbidity among adults (≥18 years) older (≥65 in clinical community settings. Six electronic databases were searched, 87 studies retained after two levels screening. Most focused on 65 years done population-based Although operational definitions varied across studies, consistent cut-points (two or more conditions five used most studies. adult samples, ranged from 4·8% 93·1%, while 2·6% 86·6%. High heterogeneity between indicates for reporting specific lists medications definitions.

Язык: Английский

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The trajectory of very old critically ill patients

Intensive Care Medicine, Год журнала: 2024, Номер 50(2), С. 181 - 194

Опубликована: Янв. 18, 2024

Язык: Английский

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Kombucha Beverages Produced from Fruits, Vegetables, and Plants: A Review on Their Pharmacological Activities and Health Benefits

Foods, Год журнала: 2023, Номер 12(9), С. 1818 - 1818

Опубликована: Апрель 27, 2023

Kombucha is a traditional health beverage produced by fermenting sweetened tea with symbiotic culture of bacteria and yeasts. Consumption kombucha beverages has been growing there commercially available worldwide as one the most famous low-alcohol beverages. have claimed to beneficial effects on human because they contain variety bioactive compounds that possess various functional properties. At present, several kinds raw material (e.g., milk, fruit, vegetables, herbs) fermented consortium consumed Although studies written regarding biological activities materials, however little information characterization their components well from many mixtures. Several pharmacological were reviewed in scientific literature, describing potential implications for health. In addition, adverse toxicity consumption also reviewed. this study, we focused main latest including antioxidant, anti-inflammatory, immunomodulatory, antimicrobial, anticancer, antidiabetic, antihypertensive, antihyperlipidemic vitro vivo studies.

Язык: Английский

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Benefits and Harms of Digital Health Interventions Promoting Physical Activity in People With Chronic Conditions: Systematic Review and Meta-Analysis

Journal of Medical Internet Research, Год журнала: 2023, Номер 25, С. e46439 - e46439

Опубликована: Май 25, 2023

Background Digital health interventions for managing chronic conditions have great potential. However, the benefits and harms are still unclear. Objective This systematic review meta-analysis aimed to investigate of digital in promoting physical activity people with conditions. Methods We searched MEDLINE, Embase, CINAHL, Cochrane Central Register Controlled Trials databases from inception October 2022. Eligible randomized controlled trials were included if they used a component promotion adults ≥1 following conditions: depression or anxiety, ischemic heart disease failure, obstructive pulmonary disease, knee hip osteoarthritis, hypertension, type 2 diabetes. The primary outcomes objectively measured function (eg, walk step tests). random effects model (restricted maximum likelihood) meta-analyses meta-regression analyses assess impact study-level covariates. risk bias was assessed using Risk Bias tool, certainty evidence Grading Recommendations Assessment, Development, Evaluation. Results Of 14,078 hits, 130 included. Compared usual care minimal intervention, increased (end intervention: standardized mean difference [SMD] 0.29, 95% CI 0.21-0.37; follow-up: SMD 0.17, 0.04-0.31) 0.36, 0.12-0.59; 0.01-0.57). secondary also favored subjectively function, depression, health-related quality life at end intervention but only follow-up. nonserious adverse events, not serious higher no seen Conclusions improved across various Effects on observed intervention. events is present during which should be addressed. Future studies focus better reporting, comparing different solutions, investigating how sustained beyond Trial Registration PROSPERO CRD42020189028; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=189028

Язык: Английский

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Aging-Related Comorbidity Burden Among Women and Men With or At-Risk for HIV in the US, 2008-2019

JAMA Network Open, Год журнала: 2023, Номер 6(8), С. e2327584 - e2327584

Опубликована: Авг. 7, 2023

Importance Despite aging-related comorbidities representing a growing threat to quality-of-life and mortality among persons with HIV (PWH), clinical guidance for comorbidity screening prevention is lacking. Understanding distribution severity by sex gender essential informing guidelines promoting healthy aging in adults HIV. Objective To assess the association of human immunodeficiency virus on burden US modern treatment era. Design, Setting, Participants This cross-sectional analysis included data from multisite observational cohort studies women (Women’s Interagency Study) men (Multicenter AIDS Cohort sociodemographically comparable HIV-seronegative individuals. were prospectively followed 2008 2009 (when more than 80% participants reported antiretroviral therapy use) through last observation up until March 2019, at which point outcomes assessed. Data analyzed July 2020 April 2021. Exposures HIV, age, sex. Main Outcomes Measures Comorbidity (the number total out 10 assessed) per participant; secondary individual prevalence. Linear regression assessed status, burden. Results A 5929 individuals (median [IQR] 54 [46-61] years; 3238 [55%]; 2787 Black [47%], 1153 Hispanic or other [19%], 1989 White [34%]). Overall, unadjusted mean was higher vs (3.4 [2.1] 3.2 [1.8]; P = .02). prevalence differed hypertension (2188 [68%] 2026 2691 [75%]), psychiatric illness (1771 [55%] 1565 [58%]), dyslipidemia (1312 [41%] 1728 [64%]), liver (1093 [34%] 1032 [38%]), bone disease (1364 [42%] 512 [19%]), lung (1245 [38%] 259 [10%]), diabetes (763 [24%] 470 [17%]), cardiovascular (493 [15%] 407 [15%]), kidney (444 [14%] 404 [15%]) disease, cancer (219 [7%] 321 [12%]). In an model, estimated difference significantly greater every age strata PWH: under 40 years, 0.33 (95% CI, 0.03-0.63); ages 49 0.37 0.12-0.61); 50 59 0.38 0.20-0.56); 60 69 0.66 0.42-0.90); 70 years older, 0.62 0.07-1.17). However, between sexes varied without HIV: 0.52 0.13 0.92); −0.07 −0.45 0.31); 0.88 1.14); 1.39 1.06 1.72); −0.53 1.19) ( interaction .001). covariate-adjusted findings slightly attenuated but retained statistical significance. Conclusions Relevance this study, overall men, particularly PWH, strategies tailored serostatus may be needed.

Язык: Английский

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