• International Journal of Advanced Culture Technology
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• 제7권2호
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• pp.13-18
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• 2019

Comorbidity isthe simultaneous presence of two chronic diseases or conditions in a patient. As part of a larger research study, the aims of this study were to explore comorbid conditions in intensive care unit (ICU) patients and to compare the comorbidity across different demographic groups, and to determine what comorbid health problems coexisted in the patients with hospital-acquired pressure injury (HAPI). The average number of comorbid conditions was 6.4 with range from 0-20 in the ICU patients. African American patients had significantly more comorbid health problems than other race/ethnicity groups. Asian and Hispanic female patients showed higher comorbidity than male patients across age. The patients with HAPIs had significantly more comorbid health problems than the patients without HAPIs -- the average numbers were almost two-fold. We found comorbid health problems that existed with HAPI in ICU patients. 'Other diseases of lung' and 'Disorders of fluid, electrolyte, and acid-base balance' were most frequently coexisting health problems in the ICU patients with HAPI. Exploratory plots are helpful to discover patterns or hypotheses relevant to clinical management in critical care. Inclusion of patients' comorbid health problems to ICU HAPI risk assessment may be helpful. Identification of patients at a high risk for the development of HAPI and the early preventative interventions can help reduce length of stay as well as costly complications.

• 디지털융복합연구
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• 제19권8호
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• pp.351-359
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• 2021

본 연구는 유산소운동의 실천과 만성질환이 동반된 관절염의 유병률 및 위험도에 대한 관계를 실증적으로 분석하기 위해 수행되었다. 이 연구를 위해 국민건강영양조사 2017-2019년 자료를 활용하였으며, 연구대상으로 17,356명을 선정하였다. 인구사회학적 특성과 만성질환에 따라 유산소운동의 실천과 관절염의 유병률 및 위험도 관계를 카이제곱 독립성 검정과 Breslow-Day 검정으로 분석하였다. 인구사회학적 특성이 여성, 고연령, 저소득층, 저학력층, 지방거주인 경우 유산소운동 실천률이 낮은 반면 관절염의 유병률과 위험도인 오즈비가 상대적으로 높았다. 그리고 만성질환 양성집단에서 유산소운동 실천을 하는 집단이 실천하지 않는 집단보다 관절염의 유병률과 발병할 위험도가 낮았다. 특히 유산소 운동 실천은 고혈압, 당뇨, 이상지질혈증이 있는 사람들에게 관절염의 유병률과 위험도를 낮추는데 효능이 있는 보완재가 된다. 따라서 인구학적 특성에서 관절염의 유병률이 높은 집단과 만성질환이 동반된 관절염이 있는 사람들이 걷기와 천천히 달리기, 에어로빅 댄스와 같은 일상의 유산소운동을 반드시 실천할 수 있도록 예방의학과 보건의료 차원에서 권장되어야 함을 시사한다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권4호
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• pp.392-399
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• 2019

Wilson disease a rare autosomal recessive inherited disorder of copper metabolism, is characterized by excessive deposition of copper in the liver, brain, and other tissues. Wilson disease is often fatal if it is not recognized early and treated when it is symptomatic. Gitelman syndrome is also an autosomal recessive kidney disorder characterized by low blood levels of potassium and magnesium, decreased excretion of calcium in the urine, and elevated blood pH. Hereditary sensory autonomic neuropathy type IV (HSAN-IV), a very rare condition that presents in infancy, is characterized by anhidrosis, absence of pain sensation, and self-mutilation. It is usually accompanied by developmental delay and mental retardation. We report a case of Wilson disease manifested as fulminant hepatitis, acute pancreatitis, and acute kidney injury in a 15-year-old boy comorbid with HSAN-IV and Gitelman syndrome. Such concurrence of three genetic diseases is an extremely rare case.

• 한국콘텐츠학회논문지
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• 제14권5호
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• pp.190-198
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• 2014

본 연구는 지역사회 거주 노인들의 건강관련 삶의 질에 영향을 미치는 위험요인들을 측정하여 평가 하는 것을 목적으로 하였다. 연구대상은 지역사회 거주노인 총 314명(연령평균:75.8세(5.64))이며 무질병 대상자가 81명, 만성질환자가 233명이며, 2개월 동안 삶의 질에 관한 설문지를 활용하여 상담을 실시하였다. 일상생활활동은 Barthel Index(BI)와 Frenchay Activities Index(FAI)로 평가하였으며 심리상태는 노인우울척도, 건강관련 삶의 질은 한국판 SF-36으로 평가하였다. 조사결과 중복 만성질환 노인은 일상생활동작이 떨어지며, 우울하고, 인지기능의 저하와 건강관련 삶의 질이 낮은 것으로 나타났다. 또한 우울증, 중복 만성질환 및 일상생활활동이 노인의 건강관련 삶의 질을 저하시키는 것으로 나타났다. 본 연구는 중복 만성질환과 낮은 일상생활활동이 우울증과 결합되어 건강관련 삶의 질을 더욱 저하시킬 수 있다는 것을 새롭게 제시하였다.

• Journal of Preventive Medicine and Public Health
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• 제57권1호
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• pp.55-64
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• 2024

Objectives: This study investigated the prevalence and characteristics of comorbid conditions in patients exposed to ionizing radiation and those who were involved in the Soviet-Afghan war. Methods: This study analyzed the frequency and spectrum of morbidity and comorbidity in patients over a long-term period (30-35 years) following exposure to ionizing radiation at the Semipalatinsk nuclear test site or the Chornobyl nuclear power plant, and among participants of the Soviet-Afghan war. A cohort study, both prospective and retrospective, was conducted on 675 patients who underwent comprehensive examinations. Results: Numerical data were analyzed using the Statistica 6 program. The results are presented as the mean±standard deviation, median, and interquartile range (25-75th percentiles). The statistical significance of between-group differences was assessed using the Student t-test and Pearson chi-square test. A p-value of less than 0.05 was considered statistically significant. We found a high prevalence of cardiovascular diseases, including hypertension (55.0%) and cardiac ischemia (32.9%); these rates exceeded the average for this age group in the general population. Conclusions: The cumulative impact of causal occupational, environmental, and ultra-high stress factors in the combat zone in participants of the Soviet-Afghan war, along with common conventional factors, contributed to the formation of a specific comorbidity structure. This necessitates a rational approach to identifying early predictors of cardiovascular events and central nervous system disorders, as well as pathognomonic clinical symptoms in this patient cohort. It also underscores the importance of selecting suitable methods and strategies for implementing treatment and prevention measures.

• Archives of Pharmacal Research
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• 제29권6호
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• pp.431-458
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• 2006

As we approach the completion of the first 25 years of the human immunodeficiency virus(HIV) epidemic, there have been dramatic improvements in the care of patients with HIV infection. These have prolonged life and decreased morbidity. There are twenty currently available antiretrovirals approved in the United States for the treatment of this infection. The medications, including their pharmacokinetic properties, side effects, and dosing are reviewed. In addition, the current approach to the use of these medicines is discussed. We have included a section addressing common comorbid conditions including hepatitis B and C along with tuberculosis.

• Tuberculosis and Respiratory Diseases
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• 제80권2호
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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.

• Journal of Periodontal and Implant Science
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• 제48권2호
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• pp.92-102
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• 2018

Purpose: This study investigated the validity of the Charlson comorbidity index (CCI) as a predictor of periodontal disease (PD) over a 12-year period. Methods: Nationwide representative samples of 149,785 adults aged ${\geq}60$ years with PD (International Classification of Disease, 10th revision [ICD-10], K052-K056) were derived from the National Health Insurance Service-Elderly Cohort during 2002-2013. The degree of comorbidity was measured using the CCI (grade 0-6), including 17 diseases weighted on the basis of their association with mortality, and data were analyzed using multivariate Cox proportional-hazards regression in order to investigate the associations of comorbid diseases (CDs) with PD. Results: The multivariate Cox regression analysis with adjustment for sociodemographic factors (sex, age, household income, insurance status, residence area, and health status) and CDs (acute myocardial infarction, congestive heart failure, peripheral vascular disease, cerebral vascular accident, dementia, pulmonary disease, connective tissue disorders, peptic ulcer, liver disease, diabetes, diabetes complications, paraplegia, renal disease, cancer, metastatic cancer, severe liver disease, and human immunodeficiency virus [HIV]) showed that the CCI in elderly comorbid participants was significantly and positively correlated with the presence of PD (grade 1: hazard ratio [HR], 1.11; P<0.001; grade ${\geq}2$: HR, 1.12, P<0.001). Conclusions: We demonstrated that a higher CCI was a significant predictor of greater risk for PD in the South Korean elderly population.

• 한국산학기술학회논문지
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• 제19권6호
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• pp.447-454
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• 2018

본 연구의 목적은 지역사회건강조사 자료를 이용하여 우리나라 성인 당뇨병 환자에서 인플루엔자 예방접종률과 예방접종 관련요인을 알아보고자 하는 것이다. 본 연구는 2015년 지역사회건강조사 원시자료를 이용하였으며, 만 19세 이상 성인 총 228,261명을 최종 연구대상자로 선정하였다. 인플루엔자 백신 접종 관련요인을 파악하기 위하여 대상자의 인구사회학적 요인(연령, 성별, 교육수준, 가구소득, 거주 지역, 결혼상태 및 직업유무), 건강행태(흡연, 음주 및 건강검진), 질병 이환(비만, 고혈압 및 이상지질혈증) 및 주관적 건강상태를 교차분석 및 로지스틱 회귀분석으로 분석하였다. 본 연구 결과 우리나라 성인 당뇨병 환자의 인플루엔자 백신 접종률은 62.4%로 낮은 수준이다. 인플루엔자 예방접종 여부를 종속변수로 모든 변수가 보정된 상태에서 당뇨군에서는 연령, 성별, 교육수준, 거주 지역, 결혼상태, 직업유무, 흡연, 건강검진 및 동반질환이 유의한 변수로 나타났다(p<0.05). 따라서 당뇨병 환자에서 인플루엔자 백신 접종률을 향상시키기 위해서는 예방접종에 대한 인식증대를 위한 체계적인 교육과 홍보가 필요하며, 무료접종 확대 실시와 같은 국가적 정책도 필요하겠다.

• Tuberculosis and Respiratory Diseases
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• 제81권3호
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• pp.187-197
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• 2018

Chronic obstructive pulmonary disease (COPD) is a frequent comorbid condition associated with increased morbidity and mortality. Pneumonia is the most common infectious disease condition. The purpose of this review is to evaluate the impact of pneumonia in patients with COPD. We will evaluate the epidemiology and factors associated with pneumonia. We are discussing the clinical characteristics of COPD that may favor the development of infections conditions such as pneumonia. Over the last 10 years, there is an increased evidence that COPD patients treated with inhaled corticosteroids are at increased risk to develp pneumonia. We will review the avaialbe information as well as the possible mechanism for this events. We also discuss the impact of influenza and pneumococcal vaccination in the prevention of pneumonia in COPD patients.