Search

Copyright of Revista Española de Quimioterapia is the property of Sociedad Espanola de Quimioterapia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Adaptive behavior (AB) concerns skills that enable individuals to be independent. It may be affected by different diagnoses, including Autism Spectrum Disorder (ASD). This study's objective was to investigate AB differences between children and adolescents aged 4 to 21 with ASD only, ASD with other health conditions, and those with typical development and to verify the effects of sociodemographic variables on AB outcomes among individuals with ASD. The sample comprised the caregivers of 309 children and adolescents aged 4 to 21 assigned to a non-clinical group (n = 181) and two clinical subgroups: one for ASD only (n = 47) a nd t he o ther f or A SD w ith c omorbidities (n = 81). ANOVA and T-tests were performed, followed by a bootstrap process to ensure the normality and homogeneity of results. Significant deficits were found in the individuals diagnosed with ASD in all three domains of AB. A significant difference was found in the practical domain between the clinical subgroups. The respondents' educational level and the type of school children and adolescents attended affected the conceptual domain. Sex, on the other hand, only showed an effect in the practical domain. The conclusion is that individuals with ASD present differences in the three domains of adaptive behavior, and sociodemographic characteristics also play a role. However, further studies considering other variables that may influence the findings are needed, to ensure greater reliability of the results. [ABSTRACT FROM AUTHOR]

Introduction. Bariatric and metabolic surgery (BMS) has shown its efficacy in achieving short-term weight loss. However, there is limited evidence regarding long-term clinical and metabolic outcomes. Methods. Retrospective longitudinal study with patients who underwent laparoscopic Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) interventions in Bogotá, Colombia, between 2013 and 2021. Weight change, comorbidity control, and metabolic outcomes were collected at the onset, 3-, 6-, and 12-month post-surgery, and annually up to the fifth year. Comorbidity control rates were assessed using the Kaplan-Meier test. A Cox proportional hazards model was used to evaluate the effect of covariates on weight regain. Results. Of 1092 patients with BMS (71.4% SG and 28.6% RYGB), 67% were women, with a median age of 48 years, BMI 35.5 kg/m². After five years of follow-up, the control rate in diabetes mellitus was 65.5%, in hypertension 56.6%, and dyslipidemia 43.6%. The weight regain rate was 28% with no differences between SG vs RYGB (p=0.482). The mean time to nadir weight was 14 months. Age at the time of BMS was the best independent predictor of weight regain (HR=1.02, 95%CI: 1.01-1.04), but with a modest clinical effect. Conclusion. BMS is safe and shows long-term benefits in weight loss and control of comorbidities in Colombian population. [ABSTRACT FROM AUTHOR]

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

OBJECTIVE: To define the frequency of isolated infectious agents and associated comorbidities in deep neck abscesses at a third level center. MATERIALS AND METHODS: An observational, retrospective, and descriptive study was conducted, reviewing medical records of Hospital Español de México from 2017 to 2022. The results were compared with studies conducted in 1990 and 2009. RESULTS: A total of 44 patients with complete records and microbiology reports were included. It was found that the submandibular space was most frequently affected, and the most common comorbidity was type 2 diabetes mellitus. Microbiology analysis revealed that Staphylococcus epidermidis was the pathogen present in most patients. CONCLUSIONS: Associated comorbidities, the odontogenic origin of the infection, and the involved spaces have not changed over time; however, the microbiology is different, and this should be considered in the medical management of these patients. [ABSTRACT FROM AUTHOR]

Copyright of Medicina (Buenos Aires) is the property of Medicina (Buenos Aires) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Hidradenitis suppurativa (HS) is a chronic autoinflammatory skin disorder that involves dysfunction of the follicular infundibulum and an abnormal immune response. It has a peak incidence between the second and third decades of life, and clinically presents as painful, chronic, and recurrent suppurative lesions in the intertriginous areas, which evolve into sinuous tracts and deforming scar bands with a remarkable impact on quality of life. This article is a comprehensive review of the state of the art of HS. This first part includes epidemiology, risk factors, comorbidities, and pathophysiology. Materials and methods: For this narrative review, a complete literature search was carried out in three databases (PubMed®, Science Direct®, and EMBASE®), from 2001 to 2023, including articles published both in English and Spanish. Results: A total of 107 articles published from 2001 to 2023 were included and reviewed in full text. Conclusion: Hidradenitis suppurativa is a complex dermatological disease with a significant prevalence worldwide. The risk factors and associated comorbidities are diverse and deserve full attention for a comprehensive approach. Advances in the understanding of its pathogenesis are relevant to achieving a greater comprehension of the disease. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To analyze the atopic march of atopic dermatitis in both children and adults and to identify the risk factors associated with persistent clinical symptoms and atopic comorbidities. MATERIALS AND METHODS: A retrospective observational study of patients with a confirmed diagnosis of atopic dermatitis from a dermatology reference center in Bogota, Colombia was done from 2011 to 2022. Patients were followed from the first care in the dermatological center (index date) up to the last care received at the center. Data on patient characteristics, treatment, comorbidities, and relapses were analyzed. RESULTS: A total of 208 patients were included with a mean age of 25 years, 64% were female, with a mean time of 17 years since diagnosis, 119 (57.2%) patients were classified as mild atopic dermatitis, 40 (19.2%) as moderate and 49 (23.5%) as severe. Main atopic comorbidities were allergic rhinitis (55.3%) and asthma (22.1%). One hundred twenty patients presented lesions in the facial area (57.7%), followed by folds in the upper extremities (111 cases). Most patients (93.7%) received topical corticosteroids and 63% had received topical calcineurin inhibitors. A total of 75.9% of the patients relapsed during the study period, the mean time to first relapse after index date for patients was 1.57 years (95% CI 1.30-2.25). CONCLUSIONS: Results showed the heterogeneous nature of the disease and high variability of treatment trajectories of patients with atopic dermatitis within clinical practice. [ABSTRACT FROM AUTHOR]

Copyright of Revista Família, Ciclos de Vida e Saúde no Contexto Social (REFACS) is the property of Universidade Federal do Triangulo Mineiro, Instituto de Ciencias da Saude and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Panamerican Journal of Neuropsychology / Cuadernos de Neuropsicología is the property of Cuadernos de Neuropsicologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Adicciones is the property of Sociedad Cientifica Espanola de Estudios sobre el Alcohol and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Lan Harremanak - Revista Relaciones Laborales is the property of Lan Harremanak and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Multimorbidity is an increasing global public health challenge, however, most existing research focuses on high‐income countries, with limited evidence from low‐ and middle‐income countries. This paper aims to estimate the prevalence of multimorbidity in South Africa and analyse the associations between multimorbidity and social determinants of health in the adult population. Multimorbidity will be defined as the coexistence of two or more chronic diseases in an individual throughout this paper. Data from the South African National Income Dynamics Survey of 2017 was used with a total sample of 20,833. A binary logistic regression was performed to analyse the associations between multimorbidity and several social determinants of health indicators based on the Commission on Social Determinants of Health Framework. Multimorbidity was prevalent in 5.4% of the South African adult population surveyed, with 71.35% of those with multimorbidity being female. Hypertension was the most common NCD and the highest contributor to multimorbidity. Multimorbidity was found to have statistically significant associations with age, obesity, being female, being of Colored or Asian/Indian ethnicity, being in employment, and having no schooling. This study highlights the importance of analysing the associations between multimorbidity and the social determinants of health. Further research on multimorbidity is required in low‐ and middle‐income countries to understand the specific challenges not identifiable in the existing research predominately based in high‐income nations. Key Points: Prevalence of multimorbidity was 5.4% in South Africa's adult populationThe prevalance of multimorbidity was found to be higher in women.Hypertension was the most common non‐communicable disease and the highest contributor to multimorbidity.A positive association was found between age, obesity, female, being of Colored or Asian/Indian ethnicity, employment, and no schooling status and experiencing multimorbidity. [ABSTRACT FROM AUTHOR]

Copyright of Biomédica: Revista del Instituto Nacional de Salud is the property of Instituto Nacional de Salud of Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Foundation: the study of the clinical characteristics of people infected with COVID-19 has shown that factors such as advanced age, male gender and the presence of comorbidities are associated with the clinical variability of this disease.Objective: to determine the comorbidities related to the severity of COVID-19 infections.Methods: research carried out at the San Vicente de Paul Hospital, which includes 200 patients admitted for COVID-19. The collection of information was carried out through the medical records and the degree of severity of COVID-19 was categorized. Pearson's Chi square was used with a significance level of 95%, p≤ 0.005 and the Odds Ratio test for risk estimation.Results: 53% of the patients belong to the male sex and 61.5% presented at least one comorbidity, and arterial hypertension was the most reported (35%); 70% predominated with a serious disease and 2.5% died. Furthermore, chronic obstructive pulmonary disease was associated with an increased risk of developing mild to moderate illness from COVID-19.Conclusions: the study favors monitoring the association between comorbidities as the pandemic progressed and using the information as a prognostic factor to guide early intervention and an appropriate therapeutic approach.

Resumen Objetivo: Analizar la diferencia entre mujeres menores y mayores de 75 años en relación con la fragilidad multidimensional y la calidad de vida, controlando por variables determinantes del curso de la vida, aspectos de salud, valoración geriátrica integral y comorbilidad. Metodología: Estudio descriptivo, analítico y transversal en 356 mujeres mayores que se atienden en los centros de salud familiar de las comunas de la Pintana y Puente Alto en Santiago de Chile. La recolección de datos se llevó a cabo por los asistentes de investigación capacitados previamente. Se recolectaron los siguientes datos: determinantes del curso de la vida, aspectos de salud, valoración geriátrica integral, comorbilidad, fragilidad multidimensional y calidad de vida. El análisis de datos fue descriptivo, correlacional y de regresión lineal. Resultados: Ser mayor de 75 años implica que a un intervalo de confianza del 95% se tiene una calidad de vida de 17,09 puntos más alta con relación a las mujeres adultas menores de 75 años. Conclusiones: La fragilidad multidimensional, en lo físico, incide en las mujeres menores de 75 años en sentirse físicamente saludables, mientras que lo social influye en las mujeres mayores de 75 años y la psicológica en ambos grupos. Por otra parte, la calidad de vida incide de manera positiva en las mujeres mayores de 75 años.

Introducción: Escasos reportes sobre asma existen en la literatura nacional. El objetivo del estudio es describir ciertas características clínicas, las comorbilidades y el riesgo para apnea obstructiva del sueño (AOS) en este colectivo. Material y métodos: Mediante un estudio observacional tipo caso-control, se incluyeron pacientes portadores de asma de ambos sexos y un grupo control pareado por sexo y edad. Se consignaron datos demográficos, características de la enfermedad, datos relativos al control del asma y espirometría, comorbilidades y riesgo de apnea de sueño medido por el cuestionario STOP-BANG durante una entrevista estructurada. Resultados: Se incluyeron 132 individuos en el grupo caso y 132 en el grupo control. Entre los asmáticos, se consignaron 38,63% de formas no controladas y 9% severas. También se constató mayor frecuencia de hipertensión arterial, obesidad, rinitis alérgica y trastornos de la memoria. Riesgo mayor para AOS, aunque no significativo, se consignó en el grupo de casos. En el subgrupo de asmáticos con obesidad o en adultos mayores, la diferencia fue estadísticamente significativa- Discusión: Aun disponiendo de medicamentos preventivos, la tasa de control de los asmáticos en esta muestra es llamativa y merece estudios sistemáticos. Es extremadamente importante tener en cuenta algunas comorbilidades para el manejo de este grupo de pacientes, incluyendo la estratificación de riesgo para AOS.

Introducción. La cirugía bariátrica y metabólica (CBM) es efectiva en lograr pérdida de peso a corto plazo. Sin embargo, existe evidencia limitada en desenlaces clínicos y metabólicos a largo plazo. Métodos. Estudio longitudinal retrospectivo con pacientes llevados a baipás gástrico en Y de Roux (BGYR) o gastrectomía en manga (MG) por laparoscopia en Bogotá, D.C., Colombia, entre 2013 y 2021. El cambio de peso, control de comorbilidades y resultados metabólicos se recopilaron al inicio del estudio, 3, 6 y 12 meses después de cirugía, y anualmente hasta el quinto año. Las tasas de control de comorbilidades se evaluaron mediante la prueba Kaplan-Meier. Se utilizó un modelo de riesgos proporcionales de Cox para evaluar el efecto de covariables en la reganancia de peso. Resultados. De 1092 pacientes con CBM (71,4 % MG y 28,6 % BGYR), 67 % eran mujeres, con mediana de edad 48 años e índice de masa corporal de 35,5 Kg/m2. Después de cinco años de seguimiento, la tasa de control en diabetes mellitus fue 65,5 %, en hipertensión 56,6 % y en dislipidemia 43,6 %. La tasa de reganancia de peso fue 28 %, sin diferencias entre MG vs BGYR (p=0,482). El tiempo promedio hasta peso nadir fue 14 meses. La edad al momento de CBM fue el mejor predictor independiente de reganancia (HR=1,02, IC95% 1,01-1,04), pero con efecto clínico modesto. Conclusión. La CBM es segura y muestra beneficios a largo plazo en la pérdida de peso y control de comorbilidades en población colombiana.

Introduction: The term frailty was conceptualized as: risk of "breaking down", increased risk of dying, unusual susceptibility to become ill, loss of strength and endurance. Objective: To design an instrument for the diagnosis of frailty in hospitalized elderly. Material and Methods: An observational, analytical, and ambispective study was carried out in the internal medicine services of the "Dr. Carlos J Finlay" and "Dr. Luis Díaz Soto" Hospitals from January 2020 to January 2022. The universe was constituted by 1950 adult patients. The sample consisted of 204 subjects in the estimation group and 199 in the validation group. Each subject underwent a comprehensive geriatric evaluation. The basic steps known for the construction and validation of scales were followed. Results: The instrument constructed was called the Frailty Index for Hospitalized Elderly People. It consisted of the following variables: black skin color, depression, cognitive impairment, suicidal ideation, disability, ischemic heart disease, and cerebrovascular disease. The area under the ROC curve was 0.982 95% CI: (0.967-0.997). The intraclass correlation coefficient was equal to 0.948. Conclusions: The frailty index proposed in this research is a simple clinical instrument, which is balanced, useful, easy to apply and feasible in the hospital care setting.

La epilepsia es una enfermedad caracterizada por crisis epilépticas recurrentes debido a actividad neuronal anormal o excesiva a nivel cerebral. Dichas crisis están asociadas a un aumento en comorbilidad cardiaca. En primer lugar, se ha evidenciado una relación de la epilepsia con arritmias cardiacas, siendo la más prevalente la taquicardia sinusal. Además, entidades como bloqueos AV o incluso asistolia se han visto asociados. Diversos mecanismos se han estudiado como los causantes, entre los que destacan alteraciones a nivel de canales iónicos, los cuales en muchos casos están asociados con alteraciones genéticas en canales que se encuentran tanto a nivel cerebral como cardiaco. Otro aspecto importante es la presencia de cambios estructurales, así como cambios moleculares a nivel cardiaco entre lo que se ha evidenciado disfunción sistólica y diastólica, además de hipertrofia ventricular. Asimismo, se ha encontrado la asociación de epilepsia con aumento en la prevalencia de factores de riesgo cardiovasculares y la afectación directa por medicamentos. En esta revisión bibliográfica se evidencia que todos estos factores cumplen un papel en el riesgo cardiovascular, sin embargo, no en todos se ha encontrado una relación estadísticamente significativa, principalmente por problemas al diferenciar la relación directa con la mortalidad cardiovascular.

Introducción: la migraña y el trastorno depresivo son patologías altamente prevalentes e incapacitantes, las cuales presentan relaciones bidireccionales de comorbilidad. En la literatura se han descrito factores de riesgo y mecanismos fisiopatológicos comunes para ambas enfermedades, así como asociaciones entre estas y su presentación clínica. Métodos: el presente texto es una revisión narrativa de la literatura. La búsqueda del material bibliográfico se hizo mediante distintas bases de datos especializadas en el área de la salud. Resultados: algunos factores de riesgo están asociados con ambas patologías, y ambas comparten factores patogénicos, incluidos cambios funcionales, estructurales, genéticos, epigenéticos y hormonales, entre otros. Varios de los tratamientos preventivos que han demostrado eficacia en el tratamiento de la migraña son medicamentos o medidas con efecto antidepresivo. Discusión: si se consideran las asociaciones y los factores comunes descritos en la literatura, se hace evidente que en el enfoque de pacientes diagnosticados con alguna de estas patologías es necesario tener en cuenta una posible comorbilidad entre migraña y depresión. Conclusión: es importante promover el tamizaje de estas dos condiciones en pacientes diagnosticados con alguna de ellas, pues esto puede tener implicaciones terapéuticas e impacto en la calidad de vida.

OBJECTIVE: To identify the associated factors to death in COVID-19 positive patients in Tamaulipas, Mexico. MATERIALS AND METHODS: Retrospective, descriptive, cross-sectional and observational study that used information obtained from the Single Epidemiological Surveillance Information System (SINOLAVE) from January 2020 to January 2022 of the Mexican Social Security Institute. A hypothesis test of difference of proportions for independent samples based on the z statistic and a logistic regression model was used. RESULTS: The sample used was 12,704 positive patients. Arterial hypertension (61.2%), diabetes mellitus (50.6%) and obesity (30.2%) were the main comorbidities, but chronic kidney disease was the major contributor to the probability of death. In addition, lethality increased significantly after the age of 55 years. CONCLUSIONS: The behavior of lethality and the causes that contribute to increase the probability of death by SARS-CoV-2 virus infection depend on the characteristics of each population, for example, sex, age, presence of comorbidities such as arterial hypertension, diabetes mellitus, obesity or chronic kidney disease, among others. This reflects the current lifestyles that are professed in each place and that have undoubtedly shown the public health problems of the country. [ABSTRACT FROM AUTHOR]

Background: Post-traumatic stress disorder (PTSD) and substance use disorder (SUD) are often comorbid and difficult to treat. The availability of evidence-based treatment guidelines is very limited and there is significant uncertainty about what best practice looks like. Objective: This paper describes the methodology used to develop expert recommendations for the assessment and psychological treatment of PTSD and comorbid SUD and presents the final recommendations. Methodology: A small committee of experts in the field of PTSD and SUD was formed on behalf of the European Society for Traumatic Stress Studies (ESTSS) Board. The committee developed recommendations based on a two-stage process. In the first stage a systematic review of randomised controlled trials of psychological interventions aimed at treating PTSD-SUD comorbidity was completed, and other recent relevant reviews systematic were also considered. To complement the recommendations based on systematic review, the second stage involved the review and collation of existing guidance, good practice and consensus recommendations made in methodologically rigorous clinical practice guidelines. Results: The two-stage process resulted in 9 recommendations related to assessment and 21 recommendations related to treatment planning and delivery. Conclusions: To our knowledge, this is the first attempt to provide expert recommendations based on a systematic review of the literature and through collation of guidance provided in other authoritative and reliable sources. These expert recommendations will provide helpful guidance to clinicians and service providers in both addiction and mental health settings about appropriate clinical care for those with PTSD SUD comorbidity. This project aimed to develop expert recommendations for the assessment and psychological treatment of PTSD and comorbid substance use disorder. Trauma-focused psychological intervention combined with treatment for SUD is the most effective treatment for PTSD symptoms and for alcohol use disorder treatment benefits appear to be strongest when combined with alcohol targeted pharmacotherapy. The presence of co-occurring SUD should not prevent or exclude individuals from receiving established evidence-based treatments for PTSD and readiness to engage in evidence-based treatment should be evaluated on an individual basis. [ABSTRACT FROM AUTHOR]

Background: There are two primary phenotypic models of comorbidity between post-traumatic stress disorder (PTSD) and drug use disorder (DUD), i.e. self-medication (PTSD precedes and causes DUD) and susceptibility (DUD precedes and causes PTSD). We sought to clarify the longitudinal relationship between PTSD and DUD, while examining sex differences. Method: We used approximately 23 years of longitudinal data from Swedish population registries to conduct two complementary statistical models: Cox proportional hazard models (N ≈ 1.5 million) and a cross-lagged panel model (N ≈ 3.8 million). Results: Cox proportional hazards models, adjusting for cohort and socioeconomic status, found strong evidence for the self-medication hypothesis, as PTSD predicted increased risk for DUD among both women [hazard ratio (HR) = 5.34, 95% confidence interval (CI) 5.18, 5.51] and men (HR = 3.65, 95% CI 3.54, 3.77), and moreover, that the PTSD to DUD association was significantly higher among women (interaction term 0.68, 95% CI 0.65, 0.71). The results of the susceptibility model were significant, but not as strong as the self-medication model. DUD predicted risk for PTSD among both women (HR = 2.43, 95% CI 2.38, 2.50) and men (HR = 2.55, 95% CI 2.50, 2.60), and HR was significantly higher in men (interaction term 1.05, 95% CI 1.02, 1.08). Investigating the pathways simultaneously in the cross-lagged model yielded support for both pathways of risk. The cross-paths instantiating the susceptibility model (0.10–0.22 in females, 0.12–0.19 in males) were mostly larger than those capturing the self-medication model (0.01–0.16 in females, 0.04–0.22 in males). Conclusions: We demonstrate that the relationship between PTSD and DUD is bidirectional, with evidence that future research should prioritize examining specific pathways of risk that may differ between men and women. Post-traumatic stress disorder (PTSD) and drug use disorder (DUD) are highly comorbid, and few large population-based longitudinal studies have been conducted to better understand why these disorders co-occur at a rate far greater than chance. We used approximately 23 years of longitudinal data from the Swedish National Registries, in a sample of over 1.5 million people, to look at the prospective relationships between PTSD and DUD, and vice versa. We found evidence for bidirectional risk such that having one disorder increased the future risk for the other disorder, although the effect sizes were higher for PTSD's risk on future DUD, and some patterns differed by sex. [ABSTRACT FROM AUTHOR]

Background: There is evidence to suggest that the experience of complex post-traumatic stress disorder (C-PTSD) may be commonly associated with elevated risk for several mental ill-health comorbidities. Objective: The current study seeks to contribute to the growing literature on C-PTSD comorbidity by examining the relationship between C-PTSD and other mental health disorders in a UK Armed Forces veteran sample. Method: This study used data from the Northern Ireland Veterans' Health and Wellbeing Study (NIVHWS). The effective sample consisted of 638 veterans (90.0% male). Tetrachoric correlations examined the relationship between C-PTSD caseness and other mental health outcomes. Latent class analysis was then conducted, determining the optimal number and nature of classes in the sample in relation to C-PTSD, depression, anxiety, and suicidality. Results: C-PTSD caseness (i.e. probable diagnosis) was found to be significantly associated with positive caseness of depression, anxiety, and suicidality. Overall, four latent classes emerged, with each of these classes characterized by varying degrees of comorbidity: a 'Resilient/Low Comorbidity' class, a 'Lifetime Suicidal' class, a 'PTSD Polymorbid' class, and a 'C-PTSD Polymorbid' class. Conclusions These findings support and extend previous results indicating the highly comorbid nature of C-PTSD. C-PTSD may be considered a highly polymorbid condition, increasing the risk for multiple mental health pathologies concurrently. The results showed that probable complex PTSD was associated with depression, anxiety, and suicidality in this military veteran sample. Latent class analysis revealed that probable complex PTSD was associated with multiple conditions concurrently, suggesting that complex PTSD is not only highly comorbid but polymorbid. The findings highlight the importance of screening for multiple pathologies, particularly in cases of probable complex PTSD. [ABSTRACT FROM AUTHOR]

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Neurológica Colombiana is the property of Colombian Association of Neurology / Asociacion Colombiana de Neurologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Foundation: the study of the clinical characteristics of people infected with COVID-19 has shown that factors such as advanced age, male gender and the presence of comorbidities are associated with the clinical variability of this disease. Objective: to determine the comorbidities related to the severity of COVID-19 infections. Methods: research carried out at the San Vicente de Paul Hospital, which includes 200 patients admitted for COVID-19. The collection of information was carried out through the medical records and the degree of severity of COVID-19 was categorized. Pearson's Chi square was used with a significance level of 95%, p= 0.005 and the Odds Ratio test for risk estimation. Results: 53% of the patients belong to the male sex and 61.5% presented at least one comorbidity, and arterial hypertension was the most reported (35%); 70% predominated with a serious disease and 2.5% died. Furthermore, chronic obstructive pulmonary disease was associated with an increased risk of developing mild to moderate illness from COVID-19. Conclusions: the study favors monitoring the association between comorbidities as the pandemic progressed and using the information as a prognostic factor to guide early intervention and an appropriate therapeutic approach. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Investigación en Salud VIVE is the property of Revista de Investigacion en Salud VIVE and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Although the results of kidney transplantation (KT) have improved substantially in recent years, a chronic and inexorable loss of grafts mainly due to the death of the patient and chronic dysfunction of the KT, continues to be observed. The objectives, thus, to optimize this situation in the next decade are fundamentally focused on minimizing the rate of kidney graft loss, improving patient survival, increasing the rate of organ procurement and its distribution, promoting research and training in health professionals and the development of scientific registries providing clinical and reliable information that allow us to optimize our clinical practice in the field of KT. With this perspective, this review will deep into: (1) strategies to avoid chronic dysfunction and graft loss in the medium and long term; (2) to prolong patient survival; (3) strategies to increase the donation, maintenance and allocation of organs; (4) promote clinical and basic research and training activity in KT; and (5) the analysis of the results in KT by optimizing and merging scientific registries. Resumen: Aunque los resultados del trasplante renal (TR) han mejorado sustancialmente en los últimos años, continúa observándose una pérdida crónica e inexorable de los injertos debido principalmente a la muerte del paciente y a la disfunción crónica del TR. Por tanto, los objetivos para optimizar esta situación en la próxima década se centran fundamentalmente en minimizar la tasa de pérdida de injertos renales, mejorar la supervivencia de los pacientes, incrementar la tasa de obtención de órganos y su distribución, fomentar la investigación y la formación de los profesionales sanitarios y la elaboración de registros científicos que proporcionen una información clínica y fiable que nos permita optimizar nuestra práctica clínica en el campo del TR. Con esta perspectiva, esta revisión profundizará en: 1) estrategias para evitar la disfunción crónica y la pérdida del injerto a medio y largo plazo; 2) prolongar la supervivencia del paciente; 3) estrategias para incrementar la donación, mantenimiento y distribución de órganos; 4) promocionar la investigación clínica y básica y la actividad formativa en TR; y 5) el análisis de los resultados en TR mediante la optimización y fusión de los registros.

Objetivos: Describir las características clínicas de pacientes con CO-VID-19 en Reynosa, Tamaulipas en el 2020 e identificar factores de riesgo para mortalidad. Material y métodos: Los casos COVID-19 registrados de marzo a no-viembre de 2020 en Reynosa se dividieron en supervivientes y no supervivientes. Los datos se analizaron mediante pruebas de χ2 y Mann-Whitney, análisis de componentes principales y regresión de Cox. Resultados: El mayor número de casos COVID-19 y de decesos se observó en julio, en hombres de 36-40 años. Los síntomas más fre-cuentes (37-51%) fueron cefalea, fiebre, tos, mialgia y artralgia. Las características clínicas entre sobrevivientes y no sobrevivientes fue-ron significativas (P

Several investigations demonstrated a remarkable prevalence of comorbid anxiety symptoms in people affected by an autism spectrum disorder (ASD). This prevalence is much higher than the one observed in the normotypical population. This research aims to clarify whether context moderates this association between anxiety and autism. One hundred twenty-one adults (M = 35.46 years, SD = 9.46) with ASD and intellectual disability (ID) participated in this study. A moderation analysis was performed to determine the role of context - rural or urban - in the development of anxiety symptoms in people with ASD. The results reached allow us to conclude that the urban context significantly moderated the relationship between ASD and anxiety symptoms. These results suggest implications for preventing or reducing anxiety symptoms in people with ASD and ID related to the characteristics of the context in which they develop. [ABSTRACT FROM AUTHOR]

Copyright of Revista Habanera de Ciencias Médicas is the property of Universidad de Ciencias Medicas de La Habana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Gerokomos is the property of Indemm Farma SL and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

El concepto de trastorno mental permite justificar intervenciones médicas, psicológicas y judiciales. Además, facilita a la/el consultante acceder a tratamientos mediante reembolsos o programas de salud pública, y por otro lado, podría conllevar estereotipos sociales. No obstante, el significado de dicho concepto no ha dejado de suscitar debate. En el presente artículo argumentaré que los trastornos de personalidad, tal como son definidos en el DSM-5, no cumplen con los criterios de patología de las propuestas principales (i.e. teoría bio-estadística de la salud, disfunción dañina, o entidad patológica) debido a tres razones independientes: (i) no se han propuesto dis/funciones a la base de cada trastorno y, dado el estado del arte de la psicología evolucionista, es poco probable que se pueda llevar a cabo ese programa en el futuro; (ii) el concepto de daño (distrés, perjuicio) aplicable a los trastornos de personalidad es constitutivamente social (aunque no exclusivamente social), por lo que resulta más adecuado hablar de grados de discapacidad que de trastornos del individuo; y (iii) que la ausencia de condiciones patognomónicas para cada trastorno, junto a la elevada comorbilidad y multimorbilidad entre trastornos de personalidad, horada la validez de la nosología actual y de los diagnósticos diferenciales. Propondré como solución la eliminación de los trastornos de personalidad de la nosología psiquiátrica. Eliminar los trastornos de personalidad no equivale a desconocer el sufrimiento de las personas diagnosticadas, ni a ignorar que dicho sufrimiento precede a, –y no acaba con la disolución de– la etiqueta diagnóstica. Por ello, se propondrá una reconceptualización de dicho sufrimiento en términos de discapacidad, entendida desde el modelo social, y que no presupone patología.

Antecedentes: Según estudios a nivel internacional, los casos fatales de la COVID-19 están relacionados con edad avanzada, sexo masculino y presencia de enfermedades crónicas. Objetivo: Determinar factores de riesgo asociados a mortalidad por COVID-19 en pacientes adultos ingresados en un hospital público de Honduras. Métodos: Estudio tipo casos y controles en pacientes ingresados con diagnóstico de COVID-19; Casos: pacientes con diagnóstico de COVID-19 con condición de egreso fallecido, Controles: pacientes con diagnóstico de COVID-19 con condición de egreso alta médica. Se analizó una muestra de 100 casos y 200 controles. Se realizó análisis de características demográficas, clínicas y laboratoriales, posteriormente se estimaron OR y se construyó un modelo de regresión logística múltiple. Resultados: Se encontró que 57.5% (171/300) tenía 60 años o más y 60.3% (181/300) era del sexo masculino. Los síntomas más frecuentes fueron dificultad respiratoria 94%, fiebre 90.3% y tos 86%. Los factores de riesgo asociados a mortalidad por COVID-19 fueron edad (OR 10.40 IC95% 3.96-27.30), sexo masculino (OR 3.25 IC95% 1.75-6.06), comorbilidades (OR 2.14 IC95% 1.03-4.45), niveles elevados de dímero D (OR 2.28 IC95% 1.20-4.32) y LDH (OR 5.65 IC95% 2.62-12.18). Discusión: Los factores de riesgo asociados a mortalidad por COVID-19 encontrados en este estudio coinciden con los presentados en estudios internacionales. Es necesario identificar los pacientes con estos factores para ofrecer manejos oportunos según su condición clínica.

Se han propuesto varios parámetros hematológicos como marcadores de gravedad de la COVID-19. Aún no se han realizado estudios en Makassar (Indonesia), para evaluar potenciales diferencias en el perfil hematológico de los pacientes según la gravedad de la enfermedad y las comorbilidades que presentan. Así mismo, tampoco se ha estudiado la correlación entre perfil hematológico y umbral de número de ciclos (Ct). El objetivo de este estudio es investigar posibles diferencias en el perfil hematológico de los pacientes con COVID-19 según la gravedad de la enfermedad y sus comorbilidades, así como determinar la posible correlación entre el perfil hematológico y el Ct en estos pacientes.

RESUMEN: Objetivo: Conocer las comorbilidades de los pacientes hospitalizados con COVID-19 e identificar cuales se asocian a mayor severidad y/o mortalidad intrahospitalaria. Métodos: Estudio de cohortes retrospectivo en el que se incluyeron todos los pacientes ingresados con COVID-19 desde 1 de marzo del 2020 hasta el 31 mayo de 2020. Se realizó un análisis descriptivo de las comorbilidades y se vio cuales se asocian a una mayor mortalidad intrahospitalaria y/o severidad de la enfermedad mediante un modelo de regresión logística binaria. Resultados: Un total de 336 pacientes fueron incluidos en el estudio de los cuales 52 (15,5%) fallecieron durante el ingreso. Un 58% eran varones, la edad media fue 66 años y el índice Charlson fue de 1. En el análisis multivariante se identificaron como comorbilidades asociadas a mortalidad la edad > 65 años (OR 2,65; p 0,021), el sexo masculino (OR 3,26; p 0,004), la enfermedad cardiovascular ateroesclerótica (OR 2,11; p 65 años (OR 1,87; p 0,033), el sexo masculino (OR 2,86; p 65 años y el sexo masculino se asocian a una mayor severidad y mortalidad intrahospitalaria. ABSTRACT: Objective: To evaluate the comorbidities in hospitalized patients with COVID-19 and identify which ones are associated with severe COVID-19 disease and/or in-hospital mortality. Methods: A retrospective cohort study was performed. All patients admitted with confirmed COVID-19 from March 1, 2020 to May 31, 2020 were included. A descriptive analysis of comorbidities was made. We evaluated what comorbidities are associated with in-hospital mortality and/or severe COVID-19 disease using a binary logistic regression model. Results: A total of 336 patients were included in the study: 52 (15,5%) died during hospitalization. Mean age was 66 + 14 years, 58% were men and the Charlson Comorbidity Index was 1. In multivariate analysis, age >65 years (HR 2,65; p 0,021), male sex (HR 3,26; p 0,004), atherosclerotic cardiovascular disease (HR 2,11; p 0,040), non-atherosclerotic cardiovascular disease (HR 6,40; p65 years (HR 1,87; p 0,033), male sex (HR 2,86; p65 years and male sex are associated with both.

Copyright of Salud Uninorte is the property of Fundacion Universidad del Norte and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Nefrologia is the property of Revista Nefrologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Many research studies have shown a prevalence of comorbid depressive symptomatology in people with an autism spectrum disorder. This prevalence is much higher than the rates in the normotypic population. The purpose of this study is to clarify the factors that moderate the association between depression and autism. One hundred and twenty-one adults (M = 35.46 years¸ SD = 9.46) with ASD and an intellectual disability participated in this study. The results showed that sex and age significantly moderate the relationship between ASD and depressive symptoms. Specifically, males aged between 30 and 49 were the most vulnerable group for the development of depressive symptoms. These results suggest that interventions designed to prevent or reduce depressive symptoms in people with ASD should consider that males aged 30–49 are more vulnerable than the rest of the population to suffering from a depressive disorder. [ABSTRACT FROM AUTHOR]

Introducción: La demencia es la primera causa de discapacidad en adultos mayores y la mayor contribuyente de dependencia, sobrecarga económica y estrés psicológico en el cuidador, sin embargo, aún no recibe la misma prioridad que otras enfermedades crónicas no trasmisibles. Objetivo: Estimar la prevalencia, asociaciones de riesgo e impacto de la demencia en adultos de 65 años y más en una comunidad de bajos ingresos en Santo Domingo, República Dominicana. Sujetos y métodos: Se realizó un estudio prospectivo longitudinal de una cohorte de 2011 adultos de 65 años y más, en los sectores de Villa Francisca, San Carlos, Zona Colonial, Mejoramiento Social y zonas aledañas, en dos fases: la primera, un estudio de corte transversal, puerta a puerta, durante el periodo 2003–2006 y la segunda, el seguimiento y evaluación de la cohorte, realizado entre el 2007 y el 2010, con una media de seguimiento de 5.1 años. El diagnóstico de demencia se realizó de acuerdo con los criterios del DSM IV y los criterios propuestos por el Grupo de Investigación 10/66. Se evaluaron los factores de riesgos vasculares y otras enfermedades crónicas según los criterios internacionalmente establecidos. Se utilizaron para evaluar el impacto de la demencia dos indicadores: necesidades de cuidados y morbilidad psicológica del cuidador. Resultados: La prevalencia de síndrome demencial según los criterios del DSM IV es de 5.4 % y de 11.7 % según los criterios del 10/66 en la población de 65 años y más, asociándose en el estudio transversal a diversos factores de riesgo, en particular edad avanzada, antecedentes de trauma craneal, historia familiar de demencia y antecedentes de ictus. La demencia, en una proporción mayor que el ictus, la depresión y tener enfermedades físicas limitantes, constituyó el mayor contribuyente de necesitar cuidado en la población estudiada. Conclusión: La prevalencia de la demencia en la República Dominicana es elevada. Se requiere brindar una mayor prioridad a enfermedades crónicas, como la demencia en especial, ya que está asociada a mayores necesidades de cuidados y por tanto a mayor discapacidad, generando esto una alta carga social económica y de salud.

Introduction: A nosocomial outbreak of coronavirus disease (COVID-19) occurred in the Toda Chuo General Hospital in Toda City, Saitama Prefecture, Japan in December 2020. The purpose of this study was to compare the accuracy of three prognostic indices for predicting the outcome of COVID-19 in patents with COVID-19 pneumonia. Patients and methods: Patients in the Department of Urology and Transplant Surgery at Toda Chuo General Hospital with nosocomially acquired COVID-19 confirmed by a positive polymerase chain reaction test were included in the study. We used the COVID-GRAM, International Severe Acute Respiratory and Emerging Infections Consortium’s World Health Organization 4C Mortality Score, and COVID-19 Registry Japan to independently predict the prognoses of 10 patients and identify common prognostic factors. All three indices include age, dyspnea, and comorbidities as prognostic factors. Results: Ten patients were included in the study, of which two patients died. According to the COVID-GRAM both patients were “high risk,” whereas the 4C Mortality Score predicted “high risk” and “very high risk.” Conclusion: The prognostic scores of all three indices were useful for predicting illness severity. Resumen: Objetivos: En diciembre de 2020 se produjo un brote nosocomial de enfermedad por coronavirus (COVID-19) en el Hospital General Toda Chuo de la ciudad de Toda, prefectura de Saitama, Japón. El propósito de este estudio fue comparar la exactitud de tres índices pronósticos para predecir el resultado de COVID-19 en pacientes con neumonía por COVID-19. Métodos: Se incluyeron en el estudio pacientes del Departamento de Urología y Cirugía de Trasplantes del Hospital General Toda Chuo con COVID-19 adquirida por vía nosocomial confirmada por una prueba de reacción en cadena de la polimerasa positiva. Se utilizaron los índices COVID-GRAM, International Severe Acute Respiratory and Emerging Infections Consortium's World Health Organization 4C Mortality Score y COVID-19 Registry Japan para predecir de forma independiente el pronóstico de 10 pacientes e identificar factores pronósticos comunes. Los tres índices incluyen la edad, la disnea y las comorbilidades como factores pronósticos. Resultados: Se incluyeron en el estudio 10 pacientes. Dos pacientes fallecieron. Según el COVID-GRAM ambos pacientes eran de ''alto riesgo'', mientras que el 4C Mortality Score predijo ''alto riesgo'' y ''muy alto riesgo''. Conclusión: Las puntuaciones pronósticas de los tres índices fueron útiles para predecir la gravedad de la enfermedad.

Introducción: las enfermedades de trasmisión sexual constituyen un problema a nivel mundial, siendo la sífilis una enfermedad bacteriana sexualmente transmisible, es curable si se diagnostica y trata en sus fases tempranas. En Cuba se notifican anualmente alrededor de 50 000 casos de infecciones de transmisión sexual, con una tendencia ascendente en los últimos años. Objetivo: caracterizar a pacientes con sífilis en el municipio de Matanzas durante el año 2021. Métodos: se realizó un estudio observacional, descriptivo y de corte transversal en el municipio Matanzas durante el año 2021. El universo lo integró 236 pacientes con la enfermedad y la muestra seleccionada fue de 31. Las variables analizadas fueron: edad, sexo, conducta sexual, preferencia sexual y comorbilidades asociadas. Los datos recogidos fueron procesados en Excel. Se utilizaron los estadígrafos descriptivos (frecuencias absolutas y relativas). Resultados: se evidenció mayor predominio del sexo masculino con 21 pacientes para un 67,74 % de pacientes con edades comprendidas entre los 31-40 años, de pacientes solteros para un 48,38 %, fue superior con un 51,61 % el número de pacientes identificados como homosexuales, el mayor número de pacientes fueron fumadores lo que representa un 29,03 %. Conclusiones: se pudo observar en este estudio que la sífilis contagió principalmente a hombres. El grupo de edad más afectado lo constituyeron los adultos que superan los 30 años. La homosexualidad se encontró también como uno de los factores predisponentes. Se evidenció como factor de riesgo predominante que los pacientes en su mayoría eran fumadores.

Introducción. La cirugía bariátrica es una estrategia válida de tratamiento en obesidad severa. El objetivo de este estudio fue evaluar la reducción de peso y la resolución de comorbilidades comparando dos técnicas quirúrgicas, baipás gástrico en Y de Roux y manga gástrica. Métodos. Estudio descriptivo de tipo analítico que incluyó pacientes con obesidad grados II y III. Se analizaron variables demográficas y perioperatorias, y las comorbilidades asociadas a la obesidad. La reducción del peso se evaluó con el porcentaje de pérdida del exceso de peso. Se realizó un análisis descriptivo univariado, usando medianas, rangos intercuartílicos, frecuencias y proporciones. Se usaron las pruebas de U de Mann-Whitney y Chi cuadrado para el análisis de grupos. Un valor de p