• 제목/요약/키워드: comorbid disease

검색결과 57건 처리시간 0.029초

Aortic Stenosis: New Insights in Diagnosis, Treatment, and Prevention

  • Saki Ito;Jae K. Oh
    • Korean Circulation Journal
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    • 제52권10호
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    • pp.721-736
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    • 2022
  • Aortic stenosis (AS) is one of the most common valvular heart diseases and the number of patients with AS is expected to increase globally as the older population is growing fast. Since the majority of patients are elderly, AS is no longer a simple valvular heart disease of left ventricular outflow obstruction but is accompanied by other cardiac and comorbid conditions. Because of the significant variations of the disease, identifying patients at high risk and even earlier detection of patients with AS before developing symptomatic severe AS is becoming increasingly important. With the proven of efficacy and safety of transcatheter aortic valve replacement (TAVR) in the severe AS population, there is a growing interest in applying TAVR in those with less than severe AS. A medical therapy to reduce or prevent the progression in AS is actively investigated by several randomized control trials. In this review, we will summarize the most recent findings in AS and discuss potential future management strategies of patients with AS.

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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    • 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.

Recipient Management before Lung Transplantation

  • Kim, Hyoung Soo;Park, Sunghoon
    • Journal of Chest Surgery
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    • 제55권4호
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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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    • 제13권1호
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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.

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

  • 김종우;정선용;서현욱;정인철;이승기;김보경;김근우;이재혁;김낙형;김태헌;강형원;김세현
    • 동의신경정신과학회지
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    • 제21권2호
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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.

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

  • 김명화
    • 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.

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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    • 제53권1호
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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.

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

  • 전성일;조수철;진태원;남민
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제5권1호
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    • pp.133-140
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    • 1994
  • ICD-10의 진단 기준에 새로이 포함된 과잉운동 품행장애(hyperkinetic conduct disorder)의 내용 타당도를 검증하기 위한 연구를 시행하였다. 이를 위한 구체적 방법으로, 주의력결핍 과잉 운동장애 환자군에서 품행장애가 공존한다는 기존의 연구 결과가 있으므로, 반대로 품행장애 환자군에서 주의력결핍 과잉운동장애가 공존하는 정도를 측정하였다. 대상군은 품행장애로 진단된 29명을 환자군으로 삼았고, 정상 대조군으로 41명을 비교하였으며, 각각에게는 Conners의 부모평가 척도의 DSM-III-R에 의한 부모 평가 척도를 시행하였고 결과는 다음과 같다. 1) 품행장애 환자군에서 대조군에 비하여 Conners의 부모 평가 척도와 DSM-III-R에 의한 부모 평가 척도에서 주의력 결핍 과잉운동장애의 정도가 의미 있게 높은 것으로 나타났다. 2) 품행장애 환자군에서 대조군에 비하여 주의력결핍 과잉운동장애의 공존율이 의미 있게 높았다. 이상의 결과로 미루어 품행장애 환자군에서 주의력결핍 과잉운동장애의 공존이 의미있게 높다는 것을 알 수 있었고, 따라서 과잉운동 품행장애의 내용 타당도가 인정되었다.

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

  • 신은진;이선영
    • 비만대사연구학술지
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    • 제2권2호
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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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    • 제20권4호
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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.