• Title/Summary/Keyword: comorbid disease

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Asthma and the Risk of Rheumatoid Arthritis: An Insight into the Heterogeneity and Phenotypes of Asthma

  • Rolfes, Mary Claire;Juhn, Young Jun;Wi, Chung-Il;Sheen, Youn Ho
    • Tuberculosis and Respiratory Diseases
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    • v.80 no.2
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    • pp.113-135
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    • 2017
  • Asthma is traditionally regarded as a chronic airway disease, and recent literature proves its heterogeneity, based on distinctive clusters or phenotypes of asthma. In defining such asthma clusters, the nature of comorbidity among patients with asthma is poorly understood, by assuming no causal relationship between asthma and other comorbid conditions, including both communicable and noncommunicable diseases. However, emerging evidence suggests that the status of asthma significantly affects the increased susceptibility of the patient to both communicable and noncommunicable diseases. Specifically, the impact of asthma on susceptibility to noncommunicable diseases such as chronic systemic inflammatory diseases (e.g., rheumatoid arthritis), may provide an important insight into asthma as a disease with systemic inflammatory features, a conceptual understanding between asthma and asthma-related comorbidity, and the potential implications on the therapeutic and preventive interventions for patients with asthma. This review discusses the currently under-recognized clinical and immunological phenotypes of asthma; specifically, a higher risk of developing a systemic inflammatory disease such as rheumatoid arthritis and their implications, on the conceptual understanding and management of asthma. Our discussion is divided into three parts: literature summary on the relationship between asthma and the risk of rheumatoid arthritis; potential mechanisms underlying the association; and implications on asthma management and research.

Recipient Management before Lung Transplantation

  • Kim, Hyoung Soo;Park, Sunghoon
    • Journal of Chest Surgery
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    • v.55 no.4
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    • pp.265-273
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    • 2022
  • Lung transplantation is considered a viable treatment option for patients with end-stage lung disease. Recent decades have seen a gradual increase in the number of lung transplantation patients worldwide, and in South Korea, the case number has increased at least 3-fold during the last decade. Furthermore, the waiting list time is becoming longer, and more elderly patients (>65 years) are undergoing lung transplantation; that is, the patients placed on the waiting list are older and sicker than in the past. Hence, proper management during the pre-transplantation period, as well as careful selection of candidates, is a key factor for transplant success and patient survival. Although referring and transplant centers should address many issues, the main areas of focus should be the timing of referral, nutrition, pulmonary rehabilitation, critical care (including mechanical ventilation and extracorporeal membrane oxygenation), psychological support, and the management of preexisting comorbid conditions (coronary artery disease, diabetes mellitus, gastroesophageal reflux disease, osteoporosis, malignancy, viral infections, and chronic infections). In this context, the present article reviews and summarizes the pre-transplantation management strategies for adult patients listed for lung transplantation.

Effectiveness of BBV152 vaccine and ChAdOx1-S vaccine in preventing severe disease among vaccinated patients admitted to a designated COVID-19 hospital in India

  • Rajaraman Nivetha;Ramesh Anshul;Subbarayan Sarojini;Chinnaian Sivagurunathan;Chandrasekar Janaganbose Maikandaan
    • Clinical and Experimental Vaccine Research
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    • v.13 no.1
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    • pp.28-34
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    • 2024
  • Purpose: Coronavirus disease 2019 (COVID-19) is a highly formidable disease. Globally, multiple vaccines have been developed to prevent and manage this disease. However, the periodic mutations of severe acute respiratory syndrome coronavirus 2 variants cast doubt on the effectiveness of commonly used vaccines in mitigating severe disease in the Indian population. This study aimed to assess the effectiveness of the BBV152 vaccine and ChAdOx1-S vaccine in preventing severe forms of the disease. Materials and Methods: This retrospective study, based on hospital records, was conducted on 204 vaccinated COVID-19 patients using a consecutive sampling approach. Data on their vaccination status, comorbidities, and high-resolution computed tomography lung reports' computed tomography severity scores were extracted from their medical records. Fisher's exact test and binomial logistic regression analysis were employed to assess the independent associations of various factors with the dependent variables. Results: Of the 204 records, 57.9% represented males, with a mean age of 61.5±9.8 years. Both vaccines demonstrated effective protection against severe illness (90.2%), with BBV152 offering slightly better protection compared to ChAdOx1-S. Male gender, partial vaccination, comorbid conditions, and the type of vaccine were identified as independent predictors of severe lung involvement. Conclusion: This study indicates that both vaccines were highly effective (90%) in preventing severe forms of the disease in fully vaccinated individuals. When comparing the two vaccines, BBV152 was slightly more effective than ChAdOx1-S in preventing severe COVID-19.

The Characteristics of Hwa-byung Patients Based on Hwa-byung Epidemiologic Data (화병역학연구 자료를 기반으로 한 화병 환자의 특성)

  • Kim, Jong-Woo;Chung, Sun-Yong;Suh, Hyun-Uk;Jung, In-Chul;Lee, Seung-Gi;Kim, Bo-Kyoung;Kim, Geun-Woo;Lee, Jae-Hyuk;Kim, Lak-Hyung;Kim, Tae-Heon;Kang, Hyung-Won;Kim, Se-Hyun
    • Journal of Oriental Neuropsychiatry
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    • v.21 no.2
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    • pp.157-169
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    • 2010
  • Objectives : The aim of this study was to investigate the characteristics of Hwa-Byung(HB) patients, draw the clinical key issue of HB, and provide the data as the basis for development of Clinical Guideline of HB. Methods : The study participants included 151 subjects who thought they have HB in 9 site. For all patients, we used HB epidemiologic study protocol, which include the Korean version of the Structured Clinical Interview for the DSM-IV Diagnosis (SCID-1), diagnostic criteria of HB, symptoms check list, pattern identification tool, psychiastric psychological questionaires, and Framingham coronary risk score(FRS). Results : 1. For all participants, 62 % of subjects were diagnosed with HB. These patients had comorbid DSM-IV diagnoses with depression (65%) and anxiety (27%). But 22% of these patients had only HB. 2. HB patients had various physical symptoms when visiting, were diagnosed as various disease, and undergone medical treatments in the past. Among the diagonsed illness, Gastronitestinal diseases (51.6%), psychiatric disorders(40.9%), endocrine diseases(39.8%) were being the most frequent. The frequent physical symptoms of HB patients reported were chest discomfort, head ache, pallpitation, frequent sigh, amnesia, shoulder pain, dry mouth, eye fatigue etc. 3. HB patients had high scores in psychologic questionares, CES-D, STAI, and STAXI. It means that HB patients might be low-level emotional stability. 4. Participant had negative opinion about the treatment of HB that it would be difficult or impossible (65.7%), but they neglect the need of medical treatment. Conclusions : This result shows that HB is comorbid with various psychiatric disease, but it has different physio-psychological symptoms from others and there were only HB patients. so we identify HB is independent disease. Moreover, there were the wrong perception of HB which blocking treatments. These problems support that the neccesity of development of Clinical Guideline of HB.

Impact of Depression, Comorbid Chronic Diseases, and ADL on Health-Related Quality of Life Among Community-Dwelling Elderly People in Korea (한국의 지역사회 거주노인들에게 있어서 우울증, 만성질환, 일상생활활동이 삶의 질에 미치는 영향)

  • Kim, Myung-Wha
    • The Journal of the Korea Contents Association
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    • v.14 no.5
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    • pp.190-198
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    • 2014
  • The purpose of study was evaluated associations among risk factors to have influence on HRQOL of community dwelling Elderly People. Total 314 community dwelling elderly persons(age:$75.80{\pm}5.64$[$mean{\pm}SD$]) who had no disease(n=81) and more than two chronic diseases (n=233) were interviewed based on the QOL questionnaires. During two months. The activities of daily living were evaluated using BI and FAI. Neuropsychological status was evaluated using GDS. Health related QOL was evaluated using the SF-36. The results emphasize the importance of preventing and controlling depression, chronic diseases, and low basic activities of daily living in order to reduce their impact on HRQOL among community dwelling elderly people.

Comorbid Gastric Adenocarcinoma and Gastric and Duodenal Strongyloides stercoralis Infection: A Case Report

  • Seo, An Na;Goo, Youn-Kyoung;Chung, Dong-Il;Hong, Yeonchul;Kwon, Ohkyoung;Bae, Han-Ik
    • Parasites, Hosts and Diseases
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    • v.53 no.1
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    • pp.95-99
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    • 2015
  • Strongyloides stercoralis can cause systemic infection, termed strongyloidiasis, and gastrointestinal ulcer disease in immunocompromised patients. However, to our knowledge, there are no reported cases of comorbid gastric adenocarcinoma and S. stercoralis infection. Here, we report a case of an 81-year-old Korean man who presented with S. stercoralis infection coexisting with early gastric adenocarcinoma (T1aN0M0). S. stercoralis eggs, rhabditiform larvae, and adult females were observed in normal gastric and duodenal crypts. They were also observed in atypical glands representative of adenocarcinoma and adenoma. Preliminary laboratory tests revealed mild neutrophilic and eosinophilic leukocytosis. A routine stool test failed to detect rhabditiform larvae in the patient's fecal sample; however, S. stercoralis was identified by PCR amplification and 18S rRNA sequencing using genomic DNA extracted from formalin-fixed paraffin-embedded tissues. Postoperatively, the patient had a persistent fever and was treated with albendazole for 7 days, which alleviated the fever. The patient was followed-up by monitoring and laboratory testing for 4 months postoperatively, and no abnormalities were observed thus far. The fact that S. stercoralis infection may be fatal in immunocompromised patients should be kept in mind when assessing high-risk patients.

A STUDY OF THE CONTENT VALIDITY IN HYPERKINETIC CONDUCT DISORDER (과잉운동 품행장애의 내용 타당도에 관한 연구)

  • Jeon, Seong-Ill;Cho, Soo-Churl;Jin, Tae-Won;Nam, Min
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.5 no.1
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    • pp.133-140
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    • 1994
  • Conduct disorder is a heterogenous disorder of various etiology affecting 4-10% of school-age children. There is suggestive evidence that the comorbid group of conduct disorder and attention deficit hyperactivity disorder is different from these two separated diseases groups. There findings suggest that this comorbid group may present a meaningful subgroup. This study is conducted to examine the content validity of hyperkinetic conduct disorder that accepted first in International Classification of Disease 10th edition. The results are summarized as follows : 1) Using Conners Parenting Rating Scale, Parent Rating Scale Form for DSM-III-R, the mean scores of attention deficit hyperactivity disorder in conduct disorder were significantly higher compared with those of normal controls. 2) 72.4% of conduct disorder and 41.5% of normal control groups showed simultaneous attention deficit hyperactivity disorder. The diffenence between conduct disorder and normal control groups was significant. There were many previous informations that children with attention deficit hyperactivity disorder had conduct disorder as comorbid disorder and these result show that children with conduct disorder also significantly had attention attention deficit hyperactivity disorder reversibly. Then these show that hyperkinetic conduct disorder-diagnosis used when both the overall criteria for hyperkinetic disorders and the overall criteria for conduct disorders are met-have satisfactory content validity. Biological, familial or long term studies are needed to further validate this diagnostic category.

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A Case of Morbid Obese Patient with Comorbidities: Why a Lifestyle Modification is Important (동반 질환을 가진 고도 비만 환자의 증례: 생활습관 교정이 왜 중요한가?)

  • Eunjin Shin;Seon Yeong Lee
    • Archives of Obesity and Metabolism
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    • v.2 no.2
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    • pp.64-70
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    • 2023
  • Obesity is a complex multifactorial disease that is associated with various complications, including cardiovascular diseases. The prevalence of obesity among young adult males has increased, and this has increased the prevalence of several comorbidities. This trend was closely linked to lifestyle factors, including heavy drinking, smoking cigarettes, and an imbalanced diet. This emphasized the necessity of lifestyle improvements for effective obesity management. In this case, the comprehensive lifestyle changes and adjuvant medication resulted in weight loss and improvement in several comorbid conditions in a young adult male. The case highlighted the importance of a comprehensive approach to managing obesity. Furthermore, it emphasized the importance of a healthy lifestyle in addressing obesity and its complications.

Carotid Arterial Calcium Scoring Using Upper Airway Computed Tomography in Patients with Obstructive Sleep Apnea: Efficacy as a Clinical Predictor of Cerebrocardiovascular Disease

  • Jae Hoon Lee;Eun-Ju Kang;Woo Yong Bae;Jong Kuk Kim;Jae Hyung Choi;Chul Hoon Kim;Sang Joon Kim;Kyoo Sang Jo;Moon Sung Kim;Tae Kyung Koh
    • Korean Journal of Radiology
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    • v.20 no.4
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    • pp.631-640
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    • 2019
  • Objective: To evaluate the value of airway computed tomography (CT) in patients with obstructive sleep apnea (OSA) as a predictor of cerebrocardiovascular disease (CCVD) clinically, by quantitatively analyzing carotid arterial calcification (CarAC). Materials and Methods: This study included 287 patients aged 40-80 years, who had undergone both polysomnography (PSG) and airway CT between March 2011 and October 2015. The carotid arterial calcium score (CarACS) was quantified using the modified Agatston method on each upper airway CT. The OSA severity was categorized as normal, mild, moderate, and severe using the PSG results. Clinical characteristics, comorbid diseases, and lipid profiles of all patients were analyzed, and the prevalence of CCVDs was investigated during the follow up period (52.2 ± 16.0 months). Results: CCVD occurred in 27 patients (9.3%) at the end of follow-up, and the CCVD-present groups showed a significantly older mean age (57.5 years vs. 54.2 years), higher prevalence of hypertension (59% vs. 34%) and CarAC (51.9% vs. 20.8%), whereas sex, other comorbid diseases, and severity of OSA were not significantly different from the CCVD-absent group. A univariate analysis showed that age, hypertension, incidence of CarAC, and CarACS were risk factors for the occurrence of CCVD events. In a multivariate analysis, the incidence of CarAC was the only independent risk factor for CCVD. Conclusion: CarAC is an independent risk factor for CCVD, whereas the severity of OSA is not a contributory risk factor in patients with OSA. Therefore, additional analysis of CarACS based on airway CT scans may be useful for predicting CCVD.

Prognostic Factors, Treatment and Outcome in a Turkish Population with Endometrial Stromal Sarcoma

  • Donertas, Ayla;Nayki, Umit;Nayki, Cenk;Ulug, Pasa;Gultekin, Emre;Yildirim, Yusuf
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.3
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    • pp.881-887
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    • 2015
  • Purpose: To analyze treatment modalities and prognostic factors in patients with Stage I-II endometrial stromal sarcoma (ESS). Materials and Methods: Twenty four patients (nineteen with low-grade ESS [LGESS] and five with high-grade ESS [HGESS]) were assessed retrospectively in terms of general characteristics, prognostic factors, treatment methods and survival. Results: Twenty patients were at Stage I and three were at Stage II. The stage of one patient could not be determined. With respect to age and comorbidity, no statistically significant difference was found among disease-free survival (DFS) (p=0.990; p=0.995). However, DFS was significantly shorter in Stage II than Stage I patients (p=0.002). It was also significantly shorter in HGESS patients than in LGESS patients (p=0.000). There was no statistically significant differences among the overall survival (OVS) times of patients with respect to age at diagnosis and comorbid disease (p=0.905; p=0.979) but OVS was significantly shorter in patients with HGESS (p=0.00) and Stage II disease (p=0.001). No statistically significant difference was found with respect to OVS between patients who received radiotherapy (RT) and those who did not receive RT (p=0.055). It was not statistically possible to include other treatment modalities in the analysis because of the small sample size. Conclusions: Grade and stage of a tumour were found to be the most important prognostic factors. It was not possible to determine the optimal surgical method and the effect of adjuvant treatment since the number of cases was insufficient.