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Mental illness
Published in Govert den Hartogh, What Kind of Death, 2023
On the other hand, even if spontaneous remission, or, more often, partial recovery occurs, sometimes after decennia of illness, the probability of that event is growing smaller over time, and generally speaking the probability of success is also growing smaller for each new unsuccessful attempt to treat the illness.26 This tendency is often reinforced by the experience of inadequate treatment and care or coercion. Often the prospects of positive treatment effects are also worsened by comorbidity. And, as the eventual outcome at the ‘natural’ death of the patient reminds us (Section 13.2), in deciding whether or not to grant his request for euthanasia there is no safe side to err on. It is true that the decision to grant the request is irreversible and the decision not to grant it reversible, but if that is a reason for never granting a request, the difference disappears.
Grafts and Flaps in Head and Neck Reconstruction
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Recipient factors include defect size, location, tissue composition, bed (e.g. radiation), and available vessels. Donor factors include best size and composition match, pedicle length and diameter, donor morbidity, and ability to two-team. Patient factors include age and comorbidity.
Clinical Sequelae and Functional Outcomes
Published in Mark A. Mentzer, Mild Traumatic Brain Injury, 2020
While the relationships of disease states and associated disorders to mTBI are not well understood, post-concussive symptoms (physical, cognitive, emotional/behavioral) are easily overlooked or misdiagnosed as mental health or other physical problems. For instance, PTSD and TBI share symptoms, making a differential diagnosis difficult. With both conditions present, the symptoms can be mutually exacerbating. In recent wars, comorbidity was 48% (American Psychiatric Association, 2013). Another possible comorbidity is depression. Figure 1.1 (Courtesy of CNS Centre for Neuro Skills) illustrates skills and functions associated with the lobes of the brain along with changes observed after brain injury.
Physicians’ experience in blood supply shortages and the top factors that impact the clinical, economic, and humanistic outcomes of patients with myelodysplastic syndromes in 5 European countries
Published in Current Medical Research and Opinion, 2023
Shaloo Gupta, Austin G. Kulasekararaj, Halley Costantino, Jay Grisolano, Jackson Tang, Shalon Jones, Derek Tang
The top 10 factors selected by physicians based on the number of selections and average weighted scores are presented in Table 3 (the remaining factors are presented in Table S1, Supplemental File). Overall, Eastern Cooperative Oncology Group performance status (ECOG PS) was most frequently selected as an important factor (74.6%) and given the greatest mean impact score (8.93). After ECOG PS, the most frequently selected factors overall were hemoglobin level (66.7%), patient age (66.7%), infection (61.1%), and the percentage of blasts in bone marrow at diagnosis (60.1%). For each country, one of these factors was identified as the second most frequently selected factor. Further factors which were similarly highly ranked based on mean impact scores included: bone marrow % blasts at diagnosis (8.25), patient age (7.24), and hemoglobin level (6.75), while infection was ranked at 6.08. Other highly ranked factors were the presence of comorbidities/comorbidity index (6.59) and genetic abnormalities (6.40).
Use of the optimized sodium thiosulfate regimen for the treatment of calciphylaxis in Chinese patients
Published in Renal Failure, 2022
Xin Yang, Yuqiu Liu, Xiaotong Xie, Wen Shi, Jiyi Si, Xiaomin Li, Xiaoliang Zhang, Bicheng Liu
The demographics and clinical characteristics of the patients at baseline were summarized in Table 1. The mean age at diagnosis of calciphylaxis and onset of hemodialysis was 51.10 ± 14.85, 47.45 ± 14.83 respectively. 71% of patients were men and the median time of dialysis initiation to calciphylaxis diagnosis was 74 months (interquartile range 48–120). The primary cause of kidney disease was diabetic nephropathy (25.81%); all other causes were less represented. All patients were undergoing maintenance hemodialysis except for one patient with CKD Stage 3. The percentage of patients diagnosed with calciphylaxis who were overweight (BMI ≥ 25) was 35.5%. The most common comorbidity was hypertension (87.10%), followed by diabetes (45.16%), chronic heart failure (29.03%), autoimmunity disease (12.90%), and tumor (6.45%). Previous medication history included phosphate binders (64.52%), activated vitamin D and analogs (51.60%), cinacalcet (41.94%), and antithrombotic drugs (48.40%, including one patient on warfarin).
The importance of association of comorbidities on COVID-19 outcomes: a machine learning approach
Published in Current Medical Research and Opinion, 2022
José Carlos Arévalo-Lorido, Juana Carretero-Gómez, Jose Manuel Casas-Rojo, Juan Miguel Antón-Santos, José Antonio Melero-Bermejo, Maria Dolores López-Carmona, Lidia Cobos Palacios, Jaime Sanz-Cánovas, Paula Maria Pesqueira-Fontán, Andrés Alberto de la Peña-Fernández, Navas-Maria de la Sierra Alcántara, Gema Maria García-García, José David Torres Peña, Jeffrey Oskar Magallanes-Gamboa, Rosa Fernández-Madera-Martinez, Javier Fernández-Fernández, Manuel Rubio-Rivas, Guillermo Maestro-de la Calle, Eva Cervilla-Muñoz, Antonio Ramos-Martínez, Manuel Méndez-Bailón, José Manuel Ramos-Rincón, Ricardo Gómez-Huelgas
This study has several limitations. First, it is an observational retrospective cohort study conducted during a global pandemic, so there may be additional or unmeasured confounding factors. Additionally, as the registry lacked a control group, we were not able to know the prognosis and complications of the clusters generated in patients without COVID19. Second, misclassification errors in comorbidities could have occurred, as classification depended on the researchers’ judgment, though findings that linked the different diseases to laboratory results were congruent. In this regard, the information about the clinical severity of each comorbidity was lacking which may influence the different prognosis of the patients. Similarly, the classification of the diseases into categories may limit the study's interpretation. Finally, the time from hospital admission to ICU admission was not available, so it was not possible to create a complete Kaplan-Meier curve and regression analysis for the primary endpoint.