Open Access Pub publishes peer-reviewed, free-to-read open-access articles. Showing
articles matching Comorbidities — open any to read the full text,
or download the PDF or XML.
Apr 2024 DOI 10.14302/issn.2994-6743.ijstd-24-5006
Khatoon Hossein Mehdi Poor NargisCorresponding author
Objectives This study explores the clinical characteristics, associated infections, and management outcomes of syphilis within a specific population over the years 2018 to 2022. With a focus on the frequency, clinical manifestations, and co-infections of syphilis, the research addresses a critical gap in understanding the nuanced dynamics of this sexually transmitted infection and its impact on public health. Methods The study employs a retrospective analysis of data collected from 2018 to 2022, utilizing three key serological tests (Syphilis AB, RPR/VDRL, and TPHA) to characterize syphilis infections within the population. Clinical manifestations and associated infections, including HIV, HBV, HCV, Chlamydia, Gonorrhea, and HPV, are systematically assessed. Treatment rates and re-infection patterns are also analyzed, providing a comprehensive overview of syphilis epidemiology within the studied timeframe. Results The frequency of syphilis, particularly indicated by the Syphilis AB test, exhibited a marked increase in 2020, reaching 96%, suggesting a heightened frequency within the population. RPR/VDRL test results demonstrated consistent frequency, emphasizing the persistent presence of active syphilis infections. Clinical manifestations, such as chancre, skin rashes, alopecia syphilitica, and lymphadenopathy, displayed dynamic patterns over the study years. Co-infection rates varied, with fluctuations observed in HIV, Chlamydia, Gonorrhea, and HPV, while HBV and HCV showed infrequent but stable frequency. The management of syphilis cases demonstrated commendable treatment rates, but an increase in re-infection rates in 2021 highlights the need for continued vigilance. Conclusion This study provides a comprehensive evaluation of syphilis epidemiology, clinical characteristics, and associated infections within the studied population. The results offer valuable insights into the dynamic nature of syphilis and its co-infections, informing public health initiatives and interventions. The findings contribute to our understanding of the epidemiological landscape and underscore the importance of sustained efforts in both prevention and treatment to curb the transmission of syphilis and its associated infections. The study, however, calls for continued vigilance and research to address the evolving trends and challenges in syphilis management within the specified population.
Mar 2026 DOI 10.14302/issn.2994-6743.ijstd-26-6060
Francesco Amadeo PierCorresponding author
Objective To describe the clinical features and real-world treatment of people living with human immunodeficiency virus (PLHIV) using fixed-dose or free combinations of 2-drug regimens (2DR) of antiretroviral therapy (ART). Design Italian retrospective cohort study. Methods Data were extracted from PLHIV who initiated or switched to 2DR: Group 1 (fixed dose), Group 2 (free combination). Results Group 1 was younger and more predominantly male, and had shorter time from AIDS-defining diagnosis to 2DR-ART and from diagnosis to baseline, a lower prevalence of resistance, and fewer comorbidities than Group 2. Median baseline viral load was <50 copies/mL in both groups, but Group 1 had a higher mean due to outliers. The most common ART classes before switching to 2DR were Integrase Strand Transfer Inhibitor (INSTI)-based (48.97%), Non-Nucleoside Reverse Transcriptase Inhibitor (NNRTI)-based (22.73%), and Protease Inhibitor (PI)-based (16.53%). Distribution varied: Group 1: INSTI-based (53.13%), NNRTI-based (24.31%), and PI-based (15.04%); Group 2: INSTI-based (29.41%), PI-based (23.53%), and NNRTI-based (15.29%). After switching, Group 1 was on dolutegravir/lamivudine (79,33%) and dolutegravir/rilpivirine (20,67%); Group 2 mostly on INSTI-PI (52.81%), followed by NNRTI combinations, mainly with doravirine (19.10%). Duration of ART after switching was shorter in Group 1. Conclusion Italian PLHIV on 2DR fixed-dose combinations were younger, virologically suppressed individuals at baseline, with a shorter lead time from diagnosis, lower prevalence of resistance and lower comorbidity rate compared to those on free combinations. These findings underscore an unmet need for 2DR fixed-dose combinations, as the free combinations were predominantly utilized for more challenging populations.
May 2025 DOI 10.14302/issn.2694-2283.jsem-25-5529
Al-saeed NawafCorresponding author
Background Septic arthritis is a potentially limb or life-threatening joint infection that requires prompt recognition and intervention to reduce morbidity and mortality. While intra-articular joint injections are commonly performed for osteoarthritis and other arthropathies, they carry a rare but significant risk of iatrogenic infection, particularly when performed in the presence of unrecognized joint or periarticular infection. Case Presentation We report a case of a 52-year-old female with a history of traumatic brain injury and chronic right knee pain who developed severe knee swelling, pain, and systemic symptoms following an intra-articular corticosteroid injection performed without ultrasound evaluation/guidance. Post-procedure, she presented with fever, elevated inflammatory markers, and purulent knee effusion. Operative washout revealed a purulent tract extending from the knee joint capsule to the lateral thigh. Cultures from joint aspiration and intraoperative samples grew Streptococcus dysgalactiae. Blood cultures were negative. The patient reported frequent cat scratches to the affected knee and described an unusual sensation of the injection needle tracking laterally during the joint injection. She was treated with surgical drainage and a four-week course of amoxicillin, with full clinical recovery. Discussion This case highlights an unusual presentation of septic arthritis with extra-capsular extension likely due to iatrogenic needle tracking during joint injection. The causative organism, S. dysgalactiae, is an uncommon pathogen in septic arthritis, and the presumed source was contiguous spread from untreated cellulitis, possibly related to cat scratches/bites. The absence of predisposing comorbidities and negative blood cultures further support a local rather than hematogenous source. The case emphasizes the importance of thorough clinical evaluation and consideration of infection prior to joint injections, as well as the potential benefits of ultrasound guidance to minimize procedural complications. Conclusion Careful history, physical examination, and appropriate imaging are essential prior to joint interventions to avoid iatrogenic complications. This case illustrates the rare but serious risk of extra-capsular extension of septic arthritis following intra-articular injection and emphasizes the need for vigilance in identifying underlying infection before proceeding with invasive procedures.
Nov 2024 DOI 10.14302/issn.2574-4518.jsdr-24-5271
Kovila RajivCorresponding author
Background/Aim Obstructive Sleep Apnea (OSA) is a prevalent disorder characterized by recurrent respiratory disturbances during sleep. Patients with Type 2 Diabetes Mellitus (T2DM) and obesity exhibit a substantial susceptibility to OSA (23%–86%). People with OSA have a high risk of several comorbidities like insulin resistance, cardiovascular disease, depressed mood and hypertension. Thus, the objective was to comprehensively evaluate the risk of OSA among T2DM patients in India. Materials and Methods A cross-sectional survey was conducted across four cities in India involving 2,000 T2DM patients. The survey gathered data on patient demographics, clinical endpoints, and estimated the risk of OSA using an app which included the STOP BANG questionnaire. Multivariate logistic regression analysis was used to evaluate the association between OSA risk and key variables such as age, gender, BMI, and HbA1c. Result Overall, 63.9% of T2DM patients were identified as high risk and 27.3% were at intermediate risk for OSA development. Results of the multivariate logistic regression demonstrated that patients with high BMI ≥35 had significantly greater odds (OR: 5.70; p<0.00) of developing OSA; males had 2.75 times higher odds (p<0.00) and patients with HbA1c value >8% had higher odds (OR: 1.22; p<0.00) of developing OSA. Conclusion OSA risk and prevalence are significantly higher in T2DM patients than in the general population with a notable escalation in patients who are overweight/obese, older, and have prolonged diabetes duration. Early screening using digitalization with a highly sensitive, cost-efficient, and valid tool like STOP-BANG followed by appropriate intervention for OSA can not only reduce the eventual economic burden but can improve patient outcomes.
Aug 2023 DOI 10.14302/issn.2688-5328.ijp-23-4624
James AndersonCorresponding author
Periauricular Vagus Nerve Stimulation (pVNS) has been proven safe and effective in reducing chronic pain and related comorbidities in numerous clinical studies. This multicenter, interventional study used a non-randomized, interrupted time-series analysis to test the efficacy of an 8-week treatment protocol using the Stivax neurostimulator device. Subjects (n=33, 15 F, 18 M, age 40-77) were recruited at 3 clinic sites in California and Colorado. All subjects had long-term chronic pain and had failed other treatments. Subjects were treated with the Stivax device 3 times (2 weeks on, 1 week off). Subjective assessments of pain (Visual Analog Scale), disability (Oswestry Disability Index), depression (PHQ-9), and activity (IPAQ-E) were collected at baseline and weekly. Objective blood levels of pain-related cytokines collected at the end of weeks 2 and 8. Most subjects reported reduced pain, disability, and depression, with increased activity levels. At the end of week 8, subjects reported an average reduction in pain by 38.5% (3 subjects reported no pain), depression by 43.6% (2 subjects reported no depression), disability by 38.6% (2 subjects reported no disability), and an average 26.1% increase in activity level (5 subjects doubled their activity level). Levels of the pain-related cytokines IL-1ꞵ, IL-2, IL-3, IL-7, IL-10, IL-15, IL-17α, IL-21, TNF-α, IFN-γ, and FLT3-ligand showed improvement at week 8. pVNS is believed to “reset” central sensitization underlying chronic pain and other central sensitization syndromes, engaging the body’s pain modulation systems. Our results indicate that pVNS can clinically significantly improve chronic pain and associated morbidities without adverse effects.
Nov 2022 DOI 10.14302/issn.2372-6601.jhor-22-4344
Rocio QuilodranCorresponding author
Geriatricians, Arturo Lopez Perez Foundation, Chile
This study characterizes an oncogeriatric cohort at a cancer institute, reporting tumor types, comorbidities, geriatric assessments, and treatment patterns. Findings inform service planning and individualized care for older adults with cancer.
Dec 2021 DOI 10.14302/issn.2692-1537.ijcv-21-4045
D. Natividad III GracianoCorresponding author
Philippines.
Introduction In December 2019, cases of serious illness causing pneumonia and death were first reported in Wuhan, China.2 The clinical features of Corona Virus Disease-19 (COVID-19) are ranging from asymptomatic to multi organ dysfunction. The disease can progress to pneumonia, respiratory failure and death.4 Thus, a tool is needed that can predict the severity and in-hospital mortality risk of a patient with COVID-19 Pneumonia. The PIRO (predisposition, insult, response, and organ dysfunction) scoring was developed for use in the emergency department to risk stratify sepsis cases.15 Eventually it was adapted in pneumonia cases to predict its severity. Objective To validate PIRO score as an assessment tool for COVID-19 mortality risk among patients with confirmed COVID-19 RT-PCR test among patients aged 19 and above admitted in World Citi Medical Center from March 2020 to August 2020 Methods This study included 93 patients aged 19 and above admitted in World Citi Medical Center with a primary diagnosis of COVID-19 Confirmed with pneumonia between March 2020 to August 2020. The patients’ charts were retrieved from the hospital medical records and case notes were reviewed. A severity assessment score was developed based on PIRO score (Predisposition comorbidities and age; Insult multilobar opacities and viremia; Response shock and hypoxemia; Organ Dysfunciton) were extracted. The patients were stratified in four levels of risk: a)Low,0-2 points; b)Mild,3 points; c)High,4 points; d)Very High,5-8 points. The PIRO score and the clinical outcome were compared. The discriminative ability of PIRO score to predict mortality risk was evaluated under receiver operating characteristic curve (AUC). Results The PIRO score had an excellent predictive ability for in-hospital mortality (AUC0.9197). Analysis of variance showed that higher levels of PIRO scores were significantly associated with higher mortality (p<0.001). Patients with Mild PIRO risk category were 98.65% less likely to expire (p<0.001, 95%CI 0.0015) and High PIRO risk category were 94.47% less likely to expire (p<0.001, 95%CI 0.0124), both compared to patients with Very high PIRO risk category. Finally, Very High PIRO risk category were more than 44 times likely to expire compared to patients with Low, Mild and High PIRO risk category (p<0.001, 95%CI 11.738). Conclusions The PIRO score is a valid risk model that can be used to predict in-hospital mortality, that can help clinicians provide timely and accurate assessment, and hence appropriate management to patients with COVID-19 Pneumonia.
Dec 2021 DOI 10.14302/issn.2692-1537.ijcv-21-4025
M. Quirit AllenCorresponding author
MD.
Introduction The COVID-19 pandemic continues to affect a large swath of the global population. The Philippine records four hundred seventy-four thousand sixty-four (474, 064) confirmed COVID 19 cases since December 31 2020. The COVID 19 pandemic recently highlighted the role of systemic hyperferritenemia as a major cause of death. In this study, we were able to correlate the serum ferritin level and predict 30 day in hospital mortality in COVID 19 pneumonia. Objective The aim of the study is to investigate the correlation between serum ferritin level and disease mortality in COVID19 pneumonia with subset analysis on demographics and co-morbidities of patients with COVID 19 pneumonia. Methodology We reviewed the records of all laboratory confirmed COVID 19 patients from World Citi Medical Center from April 2020 up to April 2021.A statistically significant sample size of seventy nine (79) admitted patients were used in this study. A serum ferritin level was assayed using electrochemilumenescence immunoassay with a Roche COBAS analyzer. Results Result showed that high ferritin level is associated with in hospital mortality. With ferritin level of 1437.07ng/ml, poor clinical outcome and in hospital mortality was considered. We also observed that demographics and co morbidities of patients in this study were significant to predict in hospital mortality. Further sub-analysis of co morbidities such as Hypertensive cardiovascular disease, Type 2 Diabetes Mellitus, Chronic kidney disease, Liver disease, Chronic obstructive pulmonary disease and Cerebrovascular disease showed poor outcome which were directly related to ferritin levels with p value of <0.0001. Conclusion This study has demonstrated that elevated ferritin levels were shown to correlate with 30 day in hospital mortality as well as medical comorbidities such as Hypertensive Cardiovascular disease, Type 2 Diabetes Mellitus, and chronic kidney disease have shown significant evidence for in hospital mortality.
Oct 2020 DOI 10.14302/issn.2379-7835.ijn-20-3377
Amanya Mutuli LucyCorresponding author
PhD of Masinde Muliro University of Science and Technology 190-50100
Introduction Sub-optimal dietary intake patterns have a major detrimental impact on the nutritional status of an alcoholic. These patterns exacerbate the status of alcoholism and the functioning of the alcoholic’s body. Objective This study aimed to examine alcoholic’s dietary intake patterns. Methods A cross-sectional study was conducted on 204 alcoholics undergoing alcohol rehabilitation in selected rehabilitation centers. A 24 hour food recall and food frequency questionnaire was used to assess dietary intake of the respondents. Factor analysis of food items and groups, cluster analysis of dietary intake patterns, and multivariate regressions were carried out. Results Three dietary intake patterns were identified among alcoholics namely a low calorie intake (described mainly by consumption of plant-based foods); a composite intake (distinguished by adequate consumption of both plant-based and animal-based foods) and a high calorie intake (characterized by high consumption of animal-based foods). Conclusion Optimal dietary intake promotion programs are needed to address the dietary intakes of recuperating alcoholics under rehabilitation to help prevent malnutrition and other associated comorbidities.
Jun 2020 DOI 10.14302/issn.2691-8862.jvat-20-3320
Ataie AminCorresponding author
Babol university of medical science, Department of Toxicology and Pharmacology, Iran
By increase the incidence of infection of coronavirus disease 2019 (COVID-19), diagnostic factors for early identification of high-risk individuals are important. On the other hand, more infections are in older patient, comorbidities, and male patients. Identification of components that related to severity of COVID-19 contributed to ACE2 and TMPRSS2 genes, which are critical for viral infection. It was found that adding enzyme copy, hrsACE2, lures the virus to attach itself to it instead of the actual cells… It inhibits the virus from infecting the cells in the lungs and other organs.
Feb 2019 DOI 10.14302/issn.2572-3030.jcgb-19-2581
Khan AshrafCorresponding author
Departments of Pathology, UMass Memorial Medical Center, University of Massachusetts Medical School, Worcester, MA 01605, USA
We report the case of a 75 year-old female with past history of ampullary adenocarcinoma presenting with a rapidly enlarging breast mass, initially misclassified on fine needle aspiration as a probable sarcoma, which was ultimately diagnosed as melanoma on resection in the absence of a known cutaneous primary lesion. Next-generation sequencing (NGS) of the tumor revealed a mutation in the Smoothened oncogene (SMO) of unknown significance and wild-type BRAF. To our knowledge, SMO mutation in melanoma of any site has not been previously reported, though the effectiveness of SMO inhibitors has been studied in both in vivo and in vitro models of melanoma. Currently, these inhibitors have not been studied in SMO mutant melanoma. The patient declined further therapy after resection due to multiple comorbidities. She expired two years after presenting with the breast mass from complications of high grade urothelial carcinoma.
May 2018 DOI 10.14302/issn.2474-3585.jpmc-18-2059
Jnr. John Elvis HaganCorresponding author
Neurocognition and Action - Biomechanics"- Research Group, Faculty of Psychology and Sport Sciences, Bielefeld University, 33501 Bielefeld, Germany
Extant epidemiological and social diagnosis information shows an alarming upsurge in the prevalence of overweight and obesity over the last decade in developing countries including Ghana. Despite literature on the dangers and associated risk factors of these two health related constructs is well-written and documented, there seems to be a distinct knowledge gap on cultural influences that may trigger the onset of overweight and obesity, and related comorbidities. This review paper provides a general overview on overweight and obesity, and presents a supportive evidence of their rising prevalence as well as associated overall implications on public health in Ghana. Additionally, the paper explores how indigenous cultural perceptions, beliefs and norms impact on dietary and physical activity behaviours of the people. Based on available evidence, the complementary role of behaviour modification towards the management of overweight and obesity is suggested. The PEN-3 model as an appropriate cultural framework is proposed for future empirical investigations. This would afford programme planners to assess how to design culturally underpinned appropriate intervention programmes that would positively influence long term behavioural practices of the local people.
Jul 2017 DOI 10.14302/issn.2379-7835.ijn-17-1636
R. Holt PeterCorresponding author
The Rockefeller University
Adipose tissue inflammation is associated with obesity comorbidities. Reducing such inflammation may ameliorate these comorbidities. n-3 fatty acids have been reported to have anti-inflammatory properties in obesity, which may modulate this inflammatory state. In the current study a 1 gram per day oral supplement of the n-3 fatty acid docosahexaenoic acid (DHA) was administered for 12 weeks to 10 grade 12 obese postmenopausal women and markers of adipose tissue and systemic inflammation measured and compared before and after supplementation. DHA administration resulted in approximately a doubling of plasma and red cell phospholipid and adipose tissue DHA content but no change in systemic markers of inflammation, such as circulating C-reactive protein (CRP) or interleukins (IL) 6, 8 and 10 (IL-6, IL-8, IL-10). DHA supplementation did not alter the adipose tissue marker of inflammation crown-like structure density nor did it affect any gene expression pathways, including anti-inflammatory, hypoxic and lipid metabolism pathways. The obese postmenopausal women studied were otherwise healthy, which leads us to suggest that in such women DHA supplementation is not an effective means for reducing adipose tissue or systemic inflammation. Further testing is warranted to determine if n-3 fatty acids may ameliorate inflammation in other, perhaps less healthy, populations of obese individuals.
Apr 2017 DOI 10.14302/issn.2474-7785.jarh-17-1483
Dorfman JonCorresponding author
Department of Surgery, University of Massachusetts Memorial Medical Center Worcester, MA
Background: Discharge disposition planning begins at admission and is frequently one of the first questions posed to healthcare providers by patients and families. We hypothesized that pre-injury functional status would predict discharge disposition. Methods: We linked prospective data from the Worcester, MA cohort of the Global Longitudinal Study of Osteoporosis (GLOW) study and the UMassMemorial Level 1 Trauma Center Registry to determine predictors of discharge disposition for female geriatric (over the age of 55) trauma patients using bivariate comparisons and multivariable modeling. Results: 154 women of 5,091 in the Worcester GLOW cohort were evaluated for traumatic injury at UMassMemorial and were discharged alive either to their home (n=30) or to rehabilitation, skilled nursing, or nursing home facilities (n=124). The mean age was 79 years and the majority (99%) was white. There were no statistically significant differences in comorbidities or injury severity score between the groups. All women with femur fractures were discharged to a facility. The most common injury among women discharged home was traumatic brain injury. While univariate analysis revealed differences in pre-injury activity status, only age remained statistically different in a logistic regression model predicting discharge to facility (OR 2.61 per additional 10 years of age, 95% CI 1.62 to 4.19, p<0.0001). Conclusions: The majority of elderly women are not discharged home after injury. Pre-injury activity status was not associated with discharge disposition when accounting for other factors. It appears that physical function, which deteriorates with age, is a proxy for aging in older women at risk for osteoporosis.
Feb 2017 DOI 10.14302/issn.2474-7785.jarh-16-1398
Fan LinlinCorresponding author
Department of Agricultural and Consumer Economics, University of Illinois Urbana-Champaign, Champaign, IL, USA
Oral nutritional supplements (ONS) have been shown to improve patient outcomes in the hospital setting, but limited results from long-term care or community settings exist. Using electronic health records (EHRs) from 2009 to 2014 for both adult inpatients and outpatients, we compare the demographic and clinical characteristics of patients who received ONS (n = 1,251) with a non-ONS control group (n =25,513). Multivariable logistic regression modeling was used to describe and compare differences in baseline characteristics between the groups including age, sex, race, tobacco use, and comorbidities. We found that patients receiving ONS were older and sicker than control patients. Hospitalized ONS patients were more likely to be admitted from the emergency department and have a hospitalization within the last month prior to the index date. Our results suggest that there is a need for nutrition screening and incorporating nutrition status into the EHR as an important way to coordinate hospital and community medical care. ONS can be an important therapy for vulnerable populations in both the hospital and the community settings.
Feb 2014 DOI 10.14302/issn.2324-7339.jcrhap-13-191
L. Fazeli PariyaCorresponding author
Edward R. Roybal Center for Translational Research in Aging and Mobility; University of Alabama at Birmingham; Birmingham, AL, USA
Objective: This cross-sectional study examined cognitive subtypes and influential factors in HIV-positive (HIV+) adults. Method: Two-step cluster analysis was conducted on a neurocognitive test battery in a sample (N = 78) of adults and older adults with HIV (Mage = 46.1). Next, cognitive, functional, and mental and physical health differences were compared between the HIV+ clusters and an HIV- reference group (N = 84; Mage = 47.9). Results: A two-cluster solution emerged, with a lower performing cluster exhibiting poorer performance across all domains except psychomotor speed, and a “normal” cluster displaying similar performance as the HIV- group. The most influential factors to classification in the lower performing cluster were older age and presence of stroke and hypertension. There were trends for longer duration of HIV-infection, higher unemployment rates, and greater prevalence of Hepatitis C co-infection in the lower performing cluster. Conclusions: These findings suggest that there are not unique cognitive subtypes in HIV, but rather a subset of individuals who exhibit globally normal performance and those with below average performance. Older age and the related cardiovascular comorbidities of both aging and HIV medications may be key influential factors to variability in neurocognitive functioning in this population and thus should be considered in future studies. Implications for research and practice are provided.