Comorbid Diseases Research Articles

Home Remedy Practices Among Stay-at-Home COVID-19 Patients in Bangladesh

During the early phases of the COVID-19 pandemic, Bangladesh lacked treatments and immunizations, so patients used several home remedies to heal themselves. This study was conducted among stay-at-home COVID-19 patients in Bangladesh to determine their awareness of the disease and establish correlations between COVID-19 symptoms and the use of home remedies. This is a cross-sectional study that employed a convenient sampling technique. Primary data were collected using a convenient sampling technique from various demographic bases. Data were gathered through 70 face-to-face interviews and an online survey with 276 participants using a semi-structured questionnaire. Participants were from different regions and districts of Bangladesh. In total, 346 respondents participated in the study from May to August 2021. Nearly equal numbers of males and females of various ages participated. More than half of the participants were aged 21–30. Dhaka had the highest participation rate (82%). The study found that 95% of people were aware of the need to consult a doctor, and 99% of participants took the COVID-19 test. 46% of the participants were isolated for 1–2 weeks. Fever, dry cough, loss of smell, tiredness and fatigue, and aches and pains were the most commonly reported symptoms. 77% of the study's participants checked their O2 saturation level daily. Participants with and without various comorbid diseases used home remedies, like drinking honey-ginger tea, taking vapors or steam, eating more citrus fruits, frequent hand washing, etc. In Bangladesh, home remedies such as citrus fruits, honey-ginger tea, steam inhalation, hand washing, and mask usage were common among stay-at-home COVID-19 patients due to limited medical access. Despite seeking medical advice and testing, patients still prefer home care. This study emphasizes the need to understand these patterns and conduct further research to evaluate efficacy and inform policy development.

Clinical characteristics of patients diagnosed with bilateral sudden sensorineural hearing loss.

This study investigated the etiology, clinical features, and prognosis of patients diagnosed with bilateral sudden sensorineural hearing loss (BSSNHL). The clinical data of 100 patients with bilateral sudden hearing loss as a chief complaint treated at Xiangya Second Hospital of Central South University between January 2010 and August 2022, including clinical characteristics, audiometric data, and prognosis, were retrospectively analyzed. These 100 cases accounted for 8.09% (100/1235) of all patients admitted for sudden sensorineural hearing loss (SSNHL) during the same period. Of these, 71 were simultaneous cases and 29 were sequential cases of BSSNHL. Among the 200 ears analyzed in this study, 13, 36, 57, and 94 had mild, moderate, severe, and profound sensorineural hearing loss, respectively. The overall effective rate after comprehensive treatment was 32%, with significant differences in efficacy and prognosis among different degrees of hearing loss (p < 0.05). Comorbidities of hypertension (24 cases), diabetes (14 cases), and coronary heart disease (9 cases) significantly impacted therapeutic efficacy and prognosis in patients with BSSNHL (p < 0.05). Compared to unilateral SSNHL, BSSNHL exhibits distinctive characteristics.

Obesity-associated inflammation countered by a Mediterranean diet: the role of gut-derived metabolites.

The prevalence of obesity has increased dramatically worldwide and has become a critical public health priority. Obesity is associated with many co-morbid conditions, including hypertension, diabetes, and cardiovascular disease. Although the physiology of obesity is complex, a healthy diet and sufficient exercise are two elements known to be critical to combating this condition. Years of research on the Mediterranean diet, which is high in fresh fruits and vegetables, nuts, fish, and olive oil, have demonstrated a reduction in numerous non-communicable chronic diseases associated with this diet. There is strong evidence to support an anti-inflammatory effect of the diet, and inflammation is a key driver of obesity. Changes in diet alter the gut microbiota which are intricately intertwined with human physiology, as gut microbiota-derived metabolites play a key role in biological pathways throughout the body. This review will summarize recent published studies that examine the potential role of gut metabolites, including short-chain fatty acids, bile acids, trimethylamine-N-oxide, and lipopolysaccharide, in modulating inflammation after consumption of a Mediterranean-like diet. These metabolites modulate pathways of inflammation through the NOD-like receptor family pyrin domain-containing 3 (NLRP3) inflammasome, toll-like receptor 4 signaling, and macrophage driven effects in adipocytes, among other mechanisms.

Similar Efficacy of Mesalazine in Adult and Older Adult Ulcerative Colitis Patients: Post Hoc Analysis of a Randomized Noninferiority Trial of 1600mg vs 400mg Tablets.

The efficacy data on treatment in older adults are scarce, while the greatest increase in ulcerative colitis (UC) prevalence is observed in age groups of individuals 40 to 65 years of age and ≥65 years of age. We assessed the difference in rates of clinical and endoscopic response and remission in UC adults (≤60 years) and older adults (>60 years) treated with mesalazine. We performed a post hoc analysis of data from a phase 3 noninferiority trial of 817 UC patients treated with mesalazine for 8 and additional 26 weeks in a double-blind and open-label study, respectively. We used Wilcoxon rank sum or chi-square test to analyze differences between groups and multivariable logistic regression to determine the associations between endoscopic remission as outcome (Mayo endoscopic subscore [MES] = 0 or ≤1) and independent variables including disease duration, baseline MES, age, sex, comedications, and comorbidities. Older adults had a longer disease duration, a higher number of comorbidities, concomitant medications, and higher baseline MES (2.38 ± 0.486 in older adults vs 2.26 ± 0.439 in adults; P = .008) compared with adults. We observed no difference in rates of combined clinical and endoscopic remission, clinical remission and response, and endoscopic remission and response at week 8 and 38 post-treatment. In addition to other well-known predictors of worse outcome, patients with ≥3 comedications were less likely to achieve an MES = 0 at week 8 and 38 and an MES ≤1 at week 38. We observed similar efficacy of mesalazine in adult and older adult UC patients. The increased comedication number rather than age may decrease effectiveness of UC medications, highlighting the importance of healthy aging.

Factors associated with deterioration of myocardial inotropic function in patients with coronary artery disease

Material and methods. One hundred patients with functional class III-IV CAD, stage I-IIa heart failure with LV ejection fraction (EF) &gt;40%, successful coronary artery bypass grafting, SYNTAX Score of 33. During hospitalization, echocardiography, matrix metalloproteinase 9 (MMP-9), tissue inhibitor of metalloproteinase 1 (TIMP-1), monocyte chemoattractant protein 1 (MCP-1) were studied, while systemic immune-inflammation index (SII) was estimated. After 6 months, echocardiography revealed a group of patients with a decrease in LVEF.Results. The following factors of decreased LVEF were identified: type 2 diabetes, chronic kidney disease (p&lt;0,001), &gt;4 comorbid diseases (r=-0,597, p&lt;0,001), increase in SII by 44,6% (p&lt;0,001), MMP-9 by 62% (p&lt;0,001), MCP-1 by 55,1% (p&lt;0,001), TIMP-1 by 45,8% (p&lt;0,001). An inverse relationship was found between LVEF and the level of SII (r=-0,626, p&lt;0,001), MCP-1 (r=-0,747, p&lt;0,001), MMP-9 (r=-0,718, p&lt;0,001). There were following threshold values for predicting a decrease in LVEF: SII — 356,43, MMP-9 — 318,7 ng/ml, MCP-1 — 459,6 pg/ml.Conclusion. There are following markers of decreased LVEF in patients with CAD 6 months after successful coronary artery bypass surgery: type 2 diabetes, chronic kidney disease, &gt;4 comorbid diseases, SII, MMP-9 and MCP-1 with a threshold value of 356,43, 318,7 ng/ml and 459,6 pg/ml, respectively.

Relationship of normal weight central obesity on comorbid diseases: Systematic Review

Relationship of normal weight central obesity on comorbid diseases: Systematic Review

Comparative Analysis of Antihypertensive and Anticonvulsant Regimens in Managing Pre-eclampsia and Eclampsia: Insights from a Sudanese Retrospective Study.

BACKGROUND Preeclampsia presents with gestational proteinuria, usually after 20 weeks of gestation, and can be complicated by generalized tonic-clonic seizures of eclampsia. Particularly in countries with limited healthcare resources, preeclampsia and eclampsia are major causes of maternal morbidity and mortality. This retrospective study aimed to evaluate the presentation, management, and outcomes of 185 women with preeclampsia and eclampsia in 2 maternity hospitals in Omdurman, Sudan, between January and December 2020. MATERIAL AND METHODS An analytical retrospective study was conducted in 2 main maternity hospitals in Omdurman, Sudan, between January and December 2020. The study included 185 pregnant women with preeclampsia or eclampsia. Data on clinical and obstetric characteristics (history of the illness, comorbid diseases, parity, gravida, multifetal pregnancy, and laboratory investigations), medications used, and maternal and neonatal outcomes were obtained for the diagnosis. The data were analyzed using the SPSS version 27. RESULTS Results: The mean age was 27.2±6.3 years, with 42.7% primigravida, 30% had a triple-drug regimen, nifedipine was the most common antihypertensive (60.5%), and 17.3% of patients underwent observation only. The seizure rate was 20%, with 92.73% controlled with magnesium sulfate. The antihypertensive regimen before delivery was significantly associated with the mode of delivery (P=0.001) and maternal outcomes (P=0.047); the regimen used after delivery significantly achieved blood pressure control (P=0.043) and improved maternal outcomes (P=0.007), but not fetal outcomes. CONCLUSIONS Maternal outcomes were markedly affected by the antihypertensive drug regimens used and the patient's seizure control status, and use of anti-convulsants successfully controlled all seizures.

Mapping the evidence on integrated service delivery for non-communicable and infectious disease comorbidity in sub-Saharan Africa: protocol for a scoping review

IntroductionThe concurrent occurrence of infectious diseases (IDs) and non-communicable diseases (NCDs) presents complex healthcare challenges in sub-Saharan Africa (SSA), where healthcare systems often grapple with limited resources. While an integrated...

Are there any potential drug-drug interactions with oral inhaler medications?: A retrospective study

BackgroundOral inhaler medications (OIMs) are widely used for many respiratory diseases. Although OIMs have minimal systemic effects, they may cause potential drug-drug interactions (pDDIs).Objectives: This study aims to evaluate drug interactions in patients using OIMs. MethodsThis retrospective, and descriptive study was conducted in a community pharmacy in Istanbul (Turkey) between January 1, andMay 312,021. Prescriptions of all asthma and COPD patients aged 18 and over on the specified date were included in the study. Data were collected from the pharmacy information system. Sociodemograhic characteristics were recorded. pDDIs were analyzed via Medscape and Lexicomp drug interaction checker databases. Significant (monitor closely), Serious (use alternative), Contraindicated categories in the Medscape database and D (consider treatment modification) and X (avoid combination) categories in the Lexi-Interact™ database were evaluated as pDDIs. SPSS analysis was performed. ResultsA total of 54 asthma and 42 chronic obstructive pulmonary disease (COPD) patients were included in the study. Most asthma (76%) and COPD (83%) patients were found to have at least one comorbid disease. A total of81 pDDIs were identified in the Medscape database in asthma patients, and 86.5% of them were classified as “monitor closely”. A total of 12 drug interactions were detected in the Lexicomp database, with 75% of them were “D” category for asthma patients. In the prescriptions of COPD patients, a total of 162 drug interactions were determined via the Medscape database, with 94.4% classified as “monitor closely”. A total of 13 drug interactions were detected in the Lexicomp database, with 61.5% of them falling into the “X” category for COPD patients. ConclusionsAccording to the results of this study COPD patients who may be at a high risk of experiencing pDDIs. Healthcare providers should consider the individual patient's clinical profile, including comorbidities and medication regimen, to minimize the risk of pDDIs and optimize treatment outcomes. Further research is needed to elucidate the mechanisms underlying these findings and develop tailored strategies to diminish the risks associated with pDDIs in respiratory disease management.

A Multi-Omics Approach to Defining Target Organ Injury in Youth with Primary Hypertension.

Primary hypertension in childhood tracks into adulthood and may be associated with increased cardiovascular risk. Studies conducted in children and adolescents provide an opportunity to explore the early cardiovascular target organ injury (CV-TOI) in a population free from many of the comorbid cardiovascular disease risk factors that confound studies in adults. Youths (n=132, mean age 15.8 years) were stratified by blood pressure (BP) as low, elevated, and high-BP and by left ventricular mass index (LVMI) as low- and high-LVMI. Systemic circulating RNA, miRNA, and methylation profiles in peripheral blood mononuclear cells and deep proteome profiles in serum were determined using high-throughput sequencing techniques. VASH1 gene expression was elevated in youths with high-BP with and without high-LVMI. VASH1 expression levels positively correlated with systolic BP (r=0.3143, p=0.0034). The expression of hsa-miR-335-5p, one of the VASH1-predicted miRNAs, was downregulated in high-BP with high-LVMI youths and was inversely correlated with systolic BP (r=-0.1891, p=0.0489). GSE1 hypermethylation, circulating PROZ upregulation (log2FC=0.61, p=0.0049 and log2FC=0.62, p=0.0064), and SOD3 downregulation (log2FC=-0.70, p=0.0042 and log2FC=-0.64, p=0.010) were observed in youths with elevated BP and high-BP with high-LVMI. Comparing the transcriptomic and proteomic profiles revealed elevated HYAL1 levels in youths displaying high-BP and high-LVMI. The findings are compatible with a novel blood pressure-associated mechanism that may occur through impaired angiogenesis and extracellular matrix degradation through dysregulation of Vasohibin-1 and Hyaluronidase1 was identified as a possible mediator of CV-TOI in youth with high-BP and suggests strategies for ameliorating TOI in adult-onset primary hypertension.

Magnitude and Temporal Variations of Socioeconomic Inequalities in the Quality of Life After Early Breast Cancer: Results From the Multicentric French CANTO Cohort.

Socioeconomic status (SES) influences the survival outcomes of patients with early breast cancer (EBC). However, limited research investigates social inequalities in their quality of life (QoL). This study examines the socioeconomic inequalities in QoL after an EBC diagnosis and their time trends. We used data from the French prospective multicentric CANTO cohort (ClinicalTrials.gov identifier: NCT01993498), including women with EBC enrolled between 2012 and 2018. QoL was assessed using the European Organisation for Research and Treatment of Cancer QoL Core 30 questionnaire (QLQ-C30). summary score at diagnosis and 1 and 2 years postdiagnosis. We considered three indicators of SES separately: self-reported financial difficulties, household income, and educational level. We first analyzed the trajectories of the QLQ-C30 summary score by SES group. Then, social inequalities in QLQ-C30 summary score and their time trends were quantified using the regression-based slope index of inequality (SII), representing the absolute change in the outcome along socioeconomic gradient extremes. The analyses were adjusted for age at diagnosis, Charlson Comorbidity Index, disease stage, and type of local and systemic treatment. Among the 5,915 included patients with data on QoL at diagnosis and at the 2-year follow-up, social inequalities in QLQ-C30 summary score at baseline were statistically significant for all SES indicators (SIIfinancial difficulties = -7.6 [-8.9; -6.2], SIIincome = -4.0 [-5.2; -2.8]), SIIeducation = -1.9 [-3.1; -0.7]). These inequalities significantly increased (interaction P < .05) in year 1 and year 2 postdiagnosis, irrespective of prediagnosis health, tumor characteristics, and treatment. Similar results were observed in subgroups defined by menopausal status and type of adjuvant systemic treatment. The magnitude of preexisting inequalities in QoL increased over time after EBC diagnosis, emphasizing the importance of considering social determinants of health during comprehensive cancer care planning.

Effect of Chronic Kidney Disease on All-Cause Mortality After Hip Fracture Surgery: A Retrospective Cohort Study.

In this retrospective cohort study, we investigated: (1) The impact of comorbid chronic kidney disease (CKD) on postoperative mortality in patients with a hip fracture; (2) mortality variations by dialysis type, potentially indicating CKD stage; (3) the efficacy of different hip fracture surgical methods in reducing mortality for patients with CKD. This study included 25,760 patients from the Korean National Health Insurance Service-Senior cohort (2002-2019) who underwent hip fracture surgery. Participants were categorized as CKD and Non-CKD. Mortality rate was determined using a generalized linear model with a Poisson distribution. The effect size was presented as a hazard ratio (HR) through a Cox proportional-hazard model. During follow-up, we ascertained that 978 patients (3.8%) had CKD preoperatively. Compared to the Non-CKD group, the mortality risk (HR) in the CKD group was 2.17 times higher (95% confidence interval [CI], 1.99-2.37). In sensitivity analysis, the mortality risk of in patients who received peritoneal dialysis and hemodialysis was 6.21 (95% CI, 3.90-9.87) and 3.62 times (95% CI, 3.11-4.20) higher than that of patients who received conservative care. Mortality risk varied by surgical method: hip hemiarthroplasty (HR, 2.11; 95% CI, 1.86-2.40), open reduction and internal fixation (HR, 2.21; 95% CI, 1.94-2.51), total hip replacement (HR, 2.27; 95% CI, 1.60-3.24), and closed reduction and percutaneous fixation (HR, 3.08; 95% CI, 1.88-5.06). Older patients with CKD undergoing hip fracture surgery had elevated mortality risk, necessitating comprehensive pre- and postoperative assessments and management.

Sympathetic and blood pressure reactivity in young adults with major depressive disorder

BackgroundSympathetic and blood pressure (BP) hyper-reactivity to stress may contribute to increased cardiovascular disease (CVD) risk in adults with major depressive disorder (MDD); however, whether this is evident in young adults with MDD without comorbid disease remains unclear. We hypothesized that acute stress-induced increases in muscle sympathetic nerve activity (MSNA) and BP would be exaggerated in young adults with MDD compared to healthy non-depressed young adults (HA) and that, in adults with MDD, greater symptom severity would be positively related to MSNA and BP reactivity. MethodsIn 28 HA (17 female) and 39 young adults with MDD of mild-to-moderate severity (unmedicated; 31 female), MSNA (microneurography) and beat-to-beat BP (finger photoplethysmography) were measured at rest and during the cold pressor test (CPT) and Stroop color word test (SCWT). ResultsThere were no group differences in resting MSNA (p = 0.24). Neither MSNA nor BP reactivity to either the CPT [MSNA: ∆24 ± 10 HA vs. ∆21 ± 11 bursts/min MDD, p = 0.67; mean arterial pressure (MAP): ∆22 ± 7 HA vs. ∆21 ± 10 mmHg MDD, p = 0.46)] or the SCWT (MSNA: ∆-4 ± 6 HA vs. ∆-5 ± 8 bursts/min MDD, p = 0.99; MAP: ∆7 ± 8 HA vs ∆9 ± 5 mmHg MDD; p = 0.82) were different between groups. In adults with MDD, symptom severity predicted MAP reactivity to the CPT (β = 0.78, SE = 0.26, p = 0.006), but not MSNA (p = 0.42). LimitationsThe mild-to-moderate symptom severity reflects only part of the MDD spectrum. ConclusionsNeither sympathetic nor BP stress reactivity are exaggerated in young adults with MDD; however, greater symptom severity may amplify BP reactivity to stress, thereby increasing CVD risk.

CLINICAL AND LABORATORY CHARACTERISTICS OF PATIENTS WITH CORONAVIRUS INFECTION COVID-19 AND ITS COMORBIDITY

Introduction. The coronavirus disease has reached an alarming epidemic scale with extraordinary morbidity and mortality rates for the entire world population. The majority of patients with COVID–19 note damage to the respiratory tract and state a more severe course of the disease with the development of systemic damage. A more severe course of COVID-19 is associated with the presence of comorbid diseases. Aim. To investigate and analyze clinical and laboratory manifestations and to determine the main comorbidities of patients with COVID-19 infection. Materials and methods. The research was carried out in accordance with bioethical norms and rules. 179 patients with COVID-19 (the main group) and 42 people of the control group were examined. Diagnosis and treatment of the COVID-19 coronavirus infection was carried out taking into account the relevant national recommendations. The average value and standard deviation were statistically determined. The probability of differences was performed using the Mann-Whitney U-test and the Wilcoxon W-test of signed ranks. The threshold value of the level of statistical significance of all calculated features was taken as 0.05 (p=0.05). Results. A high comorbidity with cardiovascular system pathology was found – 40.2%, type 2 diabetes – 22.3%, respiratory system diseases – 20.7%. Disorders of the functional state of the cardiovascular system were determined: pulse values – 91.01±13.44, systolic (127.9±15.19) and diastolic (79.3±11.6) blood pressure. Changes in clinical blood analysis were noted: erythrocytes – 4.38±0.65 x1012/l, hemoglobin – 127.6±21.2 g/l, hematocrit – 0.37±0.07, leukocytes – 10.7±7, 32 x109/l, segmented (65.4±14.8%) and rod-nuclear (9.03±9.99%) neutrophils, platelets – 226.1±90.6 x109/l, lymphocytes – 20.24±12.43%, monocytes – 6.60±4.37% and erythrocyte sedimentation rate (ESR) – 25.4±14.9 mm/h. Significant (almost fourfold) increases in IL-6 levels (24.56±22.9 pg/ml) and blood glucose concentrations (7.40±3.42 mmol/l) were determined. Conclusions. A significant comorbidity of COVID-19 was determined and a significant prevalence of indicators of the functional state of the cardiovascular system and a decrease in the average levels of the quantitative composition of erythrocytes and indicators of hemoglobin and hematocrit were established. Significant leukocytosis, neutrophilia, lymphocytosis and monocytosis, significant excesses of ESR and IL-6 and blood serum glucose were determined, which confirmed the presence of a significant inflammatory reaction in response to infection with COVID-19.

Adolescent with severe atopic dermatitis and comorbid joit disease: remission achievement by selective JAK1-inhibitor treatment

Atopic dermatitis is a heterogenous in terms of inflammatory pathways and severity prognosis skin disease. The typical clinical manifestations of the disease are intense itching and eczematisation of the skin. The prevalence of atopic dermatitis is markedly higher in children than in adult patients. Persistence of clinical manifestations and recurrent exacerbations of the disease in adolescents can determine the prognosis for decades of working age, leading to a decrease in the quality of life, socialisation and educational success. Some patients demonstrate severe recurrent course of the disease which do not respond on standard topical anti-inflammatory preparations. Comorbid diseases (not only atopic ones) could serve additional factors complicating atopic dermatitis control achievement. The adolescent patient (well-known for low adherence to topical treatment) could become a special difficulty in clinical management. A clinical case of successful systemic therapy (upadacitinib 15 mg once daily) of severe atopic dermatitis patient comorbid with immunologically-driven joint disease presented. Previous topical treatment of atopic dermatitis was inefficient. Effectiveness (indexes SCORAD and DLQI, digital itch scale) and safety (laboratory data and complains) were evaluated for more than 1 year (15 months) of therapy. Rapid and sustain positive changes in course control of atopic dermatitis with possible T2-associated and other inflammatory mediators were demonstrated.

Ischemic cardio-cerebrovascular disease and all-cause mortality in Chinese elderly patients: a propensity-score matching study

BackgroundIschemic cardio-cerebrovascular disease is the leading cause of mortality worldwide. However, studies focusing on elderly and very elderly patients are scarce. Hence, our study aimed to characterize and investigate the long-term prognostic implications of ischemic cardio-cerebrovascular diseases in elderly Chinese patients.MethodsThis retrospective cohort study included 1026 patients aged ≥ 65 years who were categorized into the mono ischemic cardio-cerebrovascular disease (MICCD) (either coronary artery disease or ischemic stroke/transient ischemic attack) (n = 912) and the comorbidity of ischemic cardio-cerebrovascular disease (CICCD) (diagnosed with both coronary artery disease and ischemic stroke/transient ischemic attack at admission) (n = 114). The primary outcome was all-cause death. The mortality risk was evaluated using the Cox proportional hazards risk model with multiple adjustments by conventional and propensity-score-based approaches.ResultsOf the 2494 consecutive elderly patients admitted to the hospital, 1026 (median age 83 years [interquartile range]: 76.5–86.4; 94.4% men) met the inclusion criteria. Patients with CICCD consisted mostly of very elderly (79.2% vs. 66.1%, P < 0.001) individuals with a higher burden of comorbidities. Over a median follow-up of 10.4 years, 398 (38.8%) all-cause deaths were identified. Compared with the MICCD group, the CICCD group exhibited a higher adjusted hazard ratio (HR) (95% confidential interval, CI) of 1.71 (1.32–2.39) for long-term mortality after adjusting for potential confounders. The sensitivity analysis results remained robust. After inverse probability of treatment weighting (IPTW) modeling, the CICCD group displayed an even worse mortality risk (IPTW-adjusted HR: 2.07; 95% CI 1.47–2.90). In addition, anemia (adjusted HR: 1.48; 95% CI 1.16–1.89) and malnutrition (adjusted HR: 1.43; 95% CI 1.15–1.78) are also independent risk factors for all-cause mortality among elderly and very elderly patients.ConclusionsOur results thus suggest that elderly patients with ischemic cardio-cerebrovascular disease and anemia or malnutrition may have higher mortality, which may be predicted upon admission. These findings, however, warrant further investigation.Graphical

Effect of care bundles based on importance degree analysis on postoperative comorbid state, coping style and disease management ability of patients with coronary heart disease.

Coronary heart disease (CHD) is a significant global health concern, particularly among the elderly. While care bundles present a comprehensive strategy for clinical disorders, their application in CHD rehabilitation remains understudied. This research addresses this gap by investigating the effectiveness of care bundles in CHD patients. By analyzing important performance degrees, we aim to contribute valuable insights to bridge existing knowledge deficiencies. Our study strives to establish a theoretical foundation for the broader implementation of care bundles, potentially improving the quality of care and patient outcomes in CHD rehabilitation. This is a retrospective study. 360 patients with CHD who were admitted to our hospital from January 2019 to October 2022 were enrolled in this retrospective study and divided into the observation group (n = 180) and control group (n = 180) according to the different care that they received. All cases were given routine nursing after CHD operation, and the observation group was given care bundles on the basis of the analysis of important performance degrees. The perioperative indexes, self-management ability score, depression, anxiety, stress scale (DASS), coping styles, medical compliance and the incidence of complications were compared between the 2 groups. Aftercare, the time of hospitalization and getting out-of-bed in the observation group was notably shorter (P < .05). Aftercare, the scores of self-management ability and related dimensions in the observation group were notably higher (P < .05). After care, the score of depression (P < .001), anxiety (P = .003) and stress (P = .017) of the observation group were notably lower. Aftercare, the observation group face score was significantly higher than the control group (P = .005), while the observation group avoidance score (P = .028) and yield score (P < .001) were significantly lower than the control group scores. Aftercare, the compliance behavior of patients in the observation group was notably better (P = .013). Aftercare, the incidence of complications in the observation group was notably lower (P = .039). Care bundles based on the degree of importance analysis can play a positive role in postoperative comorbid state, coping styles and self-management ability of patients with CHD, which can improve the rehabilitation effects on patients.

Modulation of the intestinal microbiota as a new strategy for the prevention and treatment of comorbid chronic cardiovascular diseases and colorectal cancer in one patient. Review

To date, the etiological causes of adverse outcomes associated with cardiovascular diseases and concomitant colorectal cancer in one patient, especially over 60 years of age, are multifactorial: from undiagnosed timely above-mentioned pathological conditions to poor adherence to treatment. It is a multi-level approach that is the future guarantee of reducing the burden on public health as a result of these most common nosologies.The aim of the work is to evaluate discussions between different experts with an analysis of fundamental and clinical studies based on world literature in the search for new prospects for the treatment of patients with cardiovascular pathology and comorbid colorectal cancer based on the composition and function of the intestinal microbiota.A literature search was conducted in the PubMed electronic database using the keywords: intestinal microbiota, cardio-oncology, oncosurgery, colorectal cancer, cardiovascular diseases. Additional sources were identified through literature cross-referencing. Search period: 2023.The gut microbiome is a potential marker for better risk stratification of cardiovascular diseases, colorectal cancer, and prediction of shortand long-term major adverse cardiovascular and cancer events. To develop clear recommendations and conclusions, additional research is required.

Autoimmune thyroiditis — what is new?

Recently, the prevalence of autoimmune diseases has been steadily increasing among the population, posing a significant problem for healthcare. One of the most common autoimmune pathologies is autoimmune thyroiditis (AIT). Due to the absence of prognostic markers to predict outcomes of AIT, such as the development of hypothyroidism, there is an increasing necessity for molecular-genetic research into the autoimmune changes occurring within this disease. This research is likely to contribute to the development of new diagnostic methods and the identification of key aspects of pathogenesis, thereby preventing the development of the autoimmune process. One area of research includes analyzing the impact of environmental factors on the autoimmune process. Investigating the relationships between factors and stages of AIT pathogenesis can form the basis for methods aimed at modifying these factors to prevent disease progression. Studying the comorbidity of autoimmune diseases and the relationships between various thyroid pathologies of different etiologies, helps identify high-risk groups for subsequent screening and early detection. Thus, exploring the molecular-biological basis of AIT development lays the foundation for developing effective strategies in prevention, diagnosis, and therapy, aimed at improving the quality of life of patients.

Comorbidity of Autoimmune Thyroid Disease and Psychiatric Disorders: A Cross-Sectional Study from Southern India.

Background and Aims: Autoimmune thyroid disease (AITD) is associated with a multitude ofneuropsychiatric symptoms and cognitive impairment. Though it is one of the most common cause ofacquired primary hypothyroidism, there is a dearth of literature regarding the psychiatricpresentations of thyroid autoimmunity in southern India. Objectives: To study the psychiatriccomorbidities in patients with AITD and determine the relationship between thyroid peroxidaseantibody level with severity of psychiatric illness and cognitive impairment. Materialsand Methods: This cross-sectional study of one year duration was conducted in department of Psychiatry ofatertiary-care hospital in Kerala. Subjects with AITD andnew onset behavioural symptoms wereselected, diagnosis was made based on DSM 5 diagnostic criteria, illness severity was assessed usingHAM-A, HAM-D, BPRS rating scales and severity of cognitive impairment was assessed usingMoCA scale. Statistical analysis was done using percentage, mean , SD andSpearmann’s correlationcoefficient. Results: Out of 60 subjects, 82%were women and 52%had a family history of thyroiddysfunction. The most common psychiatric diagnosis were Major Depressive Disorder, Panic disorderand Schizophreniform disorderwith moderate to severe illness and mild cognitive impairment. Significant positive correlation between thyroid peroxidase antibody level and severity of depressiveand anxiety disorder was found. Conclusion: The common psychiatric comorbities, its severity andcognitive impairment in AITD and its relation with thyroid peroxidase antibody level could bedescribed. A holistic teamwork comprising of endocrinologists and psychiatrists can help in earlydetection and management of these issues. Keywords: anxiety, autoimmunity, cognition, depression, psychosis, thyroid