Prevalence Of Medical Problems Research Articles

From Toddlerhood to Adolescence, Trajectories and Predictors of Outcome: Long-Term Follow-Up Study in Autism Spectrum Disorder.

This study is one of a very few prospective long-term studies in autism spectrum disorder (ASD). The study compared outcome trajectories in three adolescent groups (T2): "best outcome" (BO, n = 11) did not meet cut-off points for ASD and IQ scores ≥85; high functioning (HF-ASD, n = 14); and lower functioning (LF-ASD, n = 43). Additionally, the study searched for characteristics at toddlerhood (T1) that may predict belonging to the above groups. The study included 68 adolescents (63 males) diagnosed with ASD at toddlerhood (mean age: 13:10 years), mean follow-up time was 11:7 years. Participants underwent comprehensive assessments at T1 and T2. Different trajectories were found for the three defined groups. The BO group improved significantly in cognitive ability, autism severity, and adaptive skills in comparison to no improvement for the LF-ASD group or partial progress for the HF-ASD group. At toddlerhood, better cognition and less severe autism social affect symptoms were generally associated with a better outcome. Early social behaviors including better "pointing," "facial expression directed to others," "showing," and "response to joint attention" were associated with membership in the BO group. In addition, the BO group had the lowest prevalence of significant T2 inattention and anxiety symptoms. No significant differences between the three outcome groups were noted in the birth and prevalence of medical problems. Higher cognitive ability and better T1 showing and pointing behaviors predicted better outcome. The study points to the change in autism severity over time and to the prognostic value of early developmental abilities, social engagement behaviors, and the existence of comorbidities. Autism Res 2020, 13: 1130-1143. © 2020 International Society for Autism Research and Wiley Periodicals LLC. LAY SUMMARY: This long-term study compared characteristics of toddlers diagnosed with autism spectrum disorder (ASD) in three outcome groups in adolescence: best outcome (BO-average IQ/not meeting criteria for ASD), high-functioning ASD, and low-functioning ASD (LF-ASD). At toddlerhood, the BO group displayed less severe autism symptoms, mostly in sharing interests, compared to the LF-ASD group. The BO group had fewer inattention and anxiety symptoms than the two ASD groups. Additionally, early cognitive level and social engagement behaviors predicted outcome in ASD.

Polypharmacy: A Prevailing but Neglected Drug Use Issue

With the advancement in medical science, pharmaceutical industry has come up with solutions to countless health related issues. One can easily find treatment for all the ailments, be it prophylactic or curative. Also, with advancement, growth has been seen in the diversity and prevalence of medical problems. People from all age groups are suffering from varying conditions and are taking multiple medications for the same. This phenomenon called polypharmacy has been associated with multimorbidity and is counted as an important risk factor for poor outcomes.

Medical problems in pregnancy

The prevalence of medical problems in pregnancy is increasing because of a complex interplay between demographic and lifestyle factors, and developments in modern medicine. Maternal mortality and morbidity resulting from treatable medical conditions, such as venous thromboembolism, epilepsy and autoimmune disease, have not decreased in recent years. This is despite a marked decrease in overall maternal mortality. It is vital that all physicians acquire a basic knowledge and understanding of medical problems in pregnancy. This includes prepregnancy measures such as counselling and optimisation of medical therapy, as well as multidisciplinary management throughout pregnancy and the postpartum period. Prompt recognition and treatment of acute and chronic illness is of clear benefit, and most drugs and many radiological investigations may be used in pregnancy.

Health characteristics of heart transplant recipients surviving into their 80s

BackgroundHeart transplantation (HTx) is the preferred treatment for patients with end-stage heart failure and has been successful for >30 y. The clinical course of recipients at the extreme of age is unknown. We reviewed our experience to determine the overall health and prevalence of Tx-related medical problems for recipients in their ninth decade. MethodsWe reviewed the UCTP experience from 1985 to present to identify patients who survived into their 80s and matched (1:1) with other recipients for gender and age at HTx, but did not survive to ≥80 y. The end point was the prevalence of medical problems. ResultsSince 1985, 1129 adult HTx have been performed and 14 patients (1.2%) survived to ≥80 y old. The mean age at HTx was 63 ± 4 y. Of octogenarians, the majority were males with ischemic cardiomyopathy. The average survival after transplant was 19 ± 5 y in the octogenarians and 5 ± 5 y in the controls (P < 0.01). Over time, the prevalence of comorbidities increased. Compared with nonoctogenarians, we observed higher prevalence of dyslipidemia (P = 0.02), and chronic renal insufficiency (P = 0.02) during follow-up. Cardiac function was normal (ejection fraction > 55%) for all octogenarians at age 80 y. ConclusionsDespite improvements in posttransplant care, survival of HTx patients into the ninth decade is rare (1%). For those surviving into their 80s, cardiac function is preserved but dyslipidemia, renal insufficiency, and skin cancers are common. As the age of Htx patients continues to increase, posttransplant care should be tailored to minimize post-HTx complications and further extend survival.

Medical problems in pregnancy

The prevalence of medical problems in pregnancy is increasing because of a complex interplay between demographic and lifestyle factors, and developments in modern medicine. Maternal mortality and morbidity resulting from treatable medical conditions, such as venous thromboembolism, epilepsy and autoimmune disease, have not decreased in recent years. This is despite a marked decrease in overall maternal mortality. It is vital that all physicians acquire a basic knowledge and understanding of medical problems in pregnancy. This includes prepregnancy measures such as counselling and optimisation of medical therapy, as well as multidisciplinary management throughout pregnancy and the postpartum period. Prompt recognition and treatment of acute and chronic illness is of clear benefit, and most drugs and many radiological investigations may be used in pregnancy.

A Community Cross-Sectional Survey of Medical Problems in 440 Children with Down Syndrome in New York State

To determine the frequency of medical problems in a large population of children with Down syndrome. Study population included 440 children with Down syndrome (ages 3-14years) identified primarily through the New York Congenital Malformations Registry. Parents completed questionnaires on medical problems. Our study population was predominately White (92.3%), non-Hispanic (72.3%) with at least 1 college educated parent (72.3%). The prevalence of medical problems was as follows: heart disease (55%), hearing problem (39%), vision problem (39%), thyroid disease (27%), celiac disease (5%), alopecia (5%), seizures (7%), asthma/reactive airway disease (32%), diabetes (1%), and juvenile rheumatoid arthritis (0.2%). Of the children with heart disease, 58% needed surgery at a mean age of 9months. Of the children with hearing loss, 29% were identified on newborn screening and 13% used an amplification device. Of the children with thyroid disease, 31% were diagnosed in the newborn period. Only 7% of these children with Down syndrome had no medical problem listed. Prevalence data of medical illnesses in a large population of children with Down syndrome provide us with data to support implementation of the American Academy of Pediatrics guidelines for health supervision for children with Down syndrome. The long-term health implications of the conditions we surveyed will be important for decreasing morbidity and increasing overall health and wellness into adulthood.

Prevalence of Medical Problems among Double Reed Performers

One aspect of double reed performance warranting consideration involves the biomechanical stress placed on the human body through the performance of these instruments. At present, inadequate information exists that can effectively answer questions regarding the types of physical problems experienced by oboe and bassoon players and the percentages of players who suffer from such problems. The purpose of this study is to describe medical problems of double reed players utilizing data collected through the University of North Texas Musician Health Survey (UNT-MHS). Sixty survey respondents identified oboe as their primary instrument. The majority of musculoskeletal problems reported by oboists related to the right wrist, right hand, right fingers, right forearm, right neck, and right lower back. In all areas, females reported higher percentages of problems than did males. Among nonmusculoskeletal problems, oboists reported a high incidence of headaches, blackouts/dizziness, and stage fright. Seventy-five subjects identified bassoon as their primary instrument. The majority of musculoskeletal problems reported by bassoonists related to the left wrist, left hand, right wrist, and left fingers. Among nonmusculoskeletal problems, bassoonists reported a high incidence of headaches, eyestrain, and fatigue. Since the lack of a truly randomized sample prevents generalization of these results to the total double-reed-playing population, these results should be interpreted with caution. However, the high rates of right upper extremity dysfunction among oboists and left upper extremity dysfunction among bassoonists illustrated in this study warrant additional research.

What is a healthy weight for middle aged women?

To explore associations between body mass index (BMI) and selected indicators of health and well-being and to suggest a healthy weight range (based on BMI) for middle aged Australian women. Population based longitudinal study (cross-sectional baseline data). 13431 women aged 45-49 y who participated in the baseline survey for the Australian Longitudinal Study on Women's Health. Forty-eight percent of women had a BMI>25 kg/m2. Prevalence of medical problems (for example, hypertension, diabetes), surgical procedures (cholescystectomy, hysterectomy) and symptoms (for example, back pain) increased monotonically with BMI, while indicators of health care use (for example, visits to doctors) showed a 'J' shaped relationship with BMI. Scores for several sub-scales of the MOS short form health survey (SF36) (for example, general health, role limitations due to emotional difficulties, social function, mental health and vitality) were optimal when BMI was around 19-24 kg/m2. After adjustment for area of residence, education, smoking, exercise and menopausal status, low BMI was associated with fewer physical health problems than mid-level or higher BMI, and the nationally recommended BMI range of 20-25 was associated with optimum mental health, lower prevalence of tiredness and lowest use of health services. Acknowledging the limitations of the cross-sectional nature of these data, the results firmly support the benefits of leanness in terms of reducing the risk of cardiovascular disease, diabetes and gall bladder disease. The findings are moderated, however, by the observation that both low and high BMI are associated with decreased vitality and poorer mental health. The optimal range for BMI appears to be about 19-24 kg/m2. From a public health perspective this study provides strong support for the recommended BMI range of 20-25 as an appropriate target for the promotion of healthy weight in middle aged Australian women.

Asian Pacific Elders: Implications for Health Care Providers

Asian Pacific Islanders are a diverse group that include recent immigrants as well as long-term residents. They may be isolated or unsettled in their relationships with their own families and unfamiliar with Western medical care and thought. Medical care should take into consideration unique features of their traditional health benefits, traditional medications, prevalence of medical problems, pharmacokinetics and pharmacodynamics, diet, health risks, and health promotion. Although they cannot be homogenized into one tidy bundle, certain commonalities apply, and are addressed.

The Increased Needs of Patients in Nursing Homes and Patients Receiving Home Health Care

To evaluate the effects of Medicare's prospective payment system and Medicaid's preadmission regulations on long-term care, we constructed clinical profiles in 1982 and 1986 of about 500 randomly selected patients from each of three types of facilities: nursing homes with relatively high proportions of Medicare patients (high-Medicare nursing homes; n = 23), traditional nursing homes (n = 19), and home health agencies (n = 18). Data were obtained directly from the care givers on the medical problems, problems requiring skilled nursing, and functional problems of these representative patients from 12 states. For Medicare patients in high-Medicare nursing homes, the prevalence of medical problems and problems requiring skilled nursing increased substantially, whereas the prevalence of functional problems remained relatively unchanged. For example, from 1982 to 1986 there was a marked increase in the frequency of tube feedings (21 to 29 percent), oxygen use (6 to 14 percent), urinary tract infection (7 to 13 percent), and diastolic hypertension (1 to 10 percent), but not difficulty in eating (48 to 51 percent) or speaking (28 to 29 percent). In contrast, in traditional nursing homes there was an increase in the prevalence of functional disability, but virtually no change in that of problems requiring medical and skilled nursing care. In home health care the functional care needs of Medicare patients increased significantly, and there was a slight increase in the prevalence of problems requiring medical and skilled nursing care. We conclude that from 1982 to 1986 the needs of patients in long-term care increased substantially. This trend appears to result from Medicare's prospective payment system, which encourages earlier hospital discharge to long-term care settings, and from Medicaid's policy of de-institutionalization. Meeting this greater need for care will be costly. We require a better system of reimbursing for long-term care and ensuring its quality.

Prevalence of medical problems in periodontal patients obtained from three different populations.

Data from three different sources of periodontal patients were collected and examined to find if there was a significant difference between these groups relative to the prevalence of medical problems. Data were evaluated to show if age and sex were significantly related to the existence of medical problems and to determine which problems were the most prevalent. A total of 581 periodontal patients' records were obtained. Results of the evaluation showed that the private office group had 27.6% medical problems, the academic dental center had 46.3%, and the hospital dental clinic had 74.1%. Cardiovascular disease was the most prevalent medical problem in all groups and orthopedic disease or injury was second. Within each group, sex was not significantly related to the presence of a medical problem. Age was a highly significant factor, with the prevalence of medical problems increasing with advancing age.

Psychiatric and medical problems in rural communities

Abstract To delineate the health needs of rural communities, this household survey of 713 adults in nine rural counties of the southern United States examined: (1) the prevalence of psychiatric impairment and of various medical problems in the rural population, (2) demographic correlates of psychiatric and medical problems, and (3) the interplay between psychiatric and medical problems. A 70-minute interview provided data on psychiatric symptoms (HOS, CES-D, and GWB scales), chronic medical problems, self-ratings of health, days of work missed, and demographic characteristics. Approximately 12% of the rural adults were psychiatrically impaired, with impairment higher among females, non-married, and low SES individuals. Medical problems were reported most frequently by females, older, and less educated respondents. Older and low SES respondents also perceived themselves to be in poorer health. Chronic medical problems were strongly associated with psychiatric impairment. When the effects of medical problems were controlled, education was much less strongly related to psychiatric impairment and higher levels of impairment were observed among younger respondents. The data suggest that the differential prevalence of psychiatric symptoms among lower class and older individuals may reflect the differential prevalence of medical problems in those groups. Implications for both health screening and planning of rural health care delivery systems are discussed.

Project VISA: Visually Impaired Senior Adults

Describes a model demonstration project to provide community-based services to blind and visually impaired senior citizens. Services provided include: transportation; integration into on-going activities; information and referral, shopping, glaucoma screening, and group activities, such as newspaper reading, weaving, and discussions. Orientation and mobility training is offered, but has not been widely used owing to the prevalence of medical problems.