Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Severity”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 109 records · Page 6Linked to original sources
PubMed2006

The long-term relationships between the motivation for change and alcohol use severity among patients with severe and persistent mental illness.

This study examined the long-term relationship of changes in the motivation to remedy alcohol abuse to alcohol use severity among patients with a dual diagnosis of substance abuse disorder and severe and persistent mental illness. Linear regression analyses showed that patients who increasingly recognized alcohol use problems over a 9-month period exhibited significantly greater alcohol use severity at 9 months and a significant increase in alcohol use severity over time. Moreover, patients who became increasingly determined to take actions against alcohol use over a 9-month period exhibited significantly lower alcohol use severity at 9 months and a significant decrease in alcohol use severity over time. The findings support Prochaska et al.'s transtheoretical model of the motivation for change. They suggest that the recognition of alcohol use problems comes along with learning adverse consequences of alcohol use and that increased determination to take actions is critical to the long-term behavioral changes in alcohol use.

Adult↗
PubMed2004

Impacts of motivation for change on the severity of alcohol use by patients with severe and persistent mental illness.

OBJECTIVE: This study examined the effect of motivation for change, measured by the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES), on alcohol use severity among alcoholic patients with severe and persistent mental illness. METHOD: At a Veterans Affairs hospital, 390 dually diagnosed patients were recruited and assessed for motivation for change, alcohol use severity, psychotic symptoms and global functioning at baseline and 9-month follow-up. RESULTS: Regression analyses showed that patients who were highly ambivalent about their alcohol use at baseline consumed significantly more alcohol 9 months later, on the basis of Addiction Severity Index ratings (p < or = .01), than patients who felt less ambivalent. CONCLUSIONS: The findings suggest that increased awareness of alcohol-related problems is essential to reducing alcohol use severity for alcoholic patients with severe and persistent mental illness. The implications and limitations of the findings are discussed.

Adult↗
PubMed2003

Correlation between severity of coronary artery athesclerosis and duration and severity of diabetes mellitus in type 2 diabetic patients.

Hundred patients of Type 2 diabetes mellitus with coronary artery disease undergoing diagnostic coronary angiography were studied to determine the relation between the severity and duration of diabetes mellitus and the severity of coronary artery disease. A coronary scoring system using segmental distribution method was used to determine the severity of coronary artery disease and severity of diabetes was assessed by the level of fasting blood glucose within 48 hours of the procedure and also considering the types of treatment received for diabetes mellitus. No significant correlation was demonstrated between the severity of coronary artery disease and the severity (r =.089602; P>0.1) nor the duration (r =0.07865; P> 0.1) of diabetes mellitus on univariate analysis. So the Type 2 diabetic patients had an increased incidence of atherosclerosis in their coronary angiograms did not reflect an angiographically evident progressive coronary artery disease and results of this study suggest that the progress of large vessel coronary athesclerotic disease in diabetes mellitus of adult onset takes place independently of the progress of diabetes mellitus itself.

Adult↗
PubMed2003

Comparison between two perception tests in patients with severe and profoundly severe prelingual sensori-neural deafness.

Patients with severe and profoundly severe bilateral sensorineural prelingual deafness constitute a group of particular interest in the organization of the National Health Service; every patient must, in fact, follow a prosthetic-rehabilitative-educational programme lasting many years and organized under different areas to compensate for his/her communicative difficulties, especially with regard to the speech canal. No reliable data providing details of the efficacy and efficiency of any of these points is available. A critical point in the rehabilitation process is that of auditory perception training. Of the few auditory perception tests presently available in Italian, the following were examined: namely, EARS (Evaluation of Auditory Responses to Speech) battery, on the one hand, and the Italian version of the ESP (Early Speech Perception), GASP (Glendonald Auditory Screening Procedure). NU-CHIPS (Northwestern University Children's Perception of Speech) and WIPI (Word Intelligibility by Picture Identification) tests on the other. A group of 10 patients presenting severe and profoundly severe bilateral sensori-neural prelingual deafness received the two tests at the beginning and after six months of auditory perception rehabilitation. The findings emerging from the two different test sessions were analysed and compared. The EARS battery was seen to have enabled even very early and highly developed stages of auditory perception to be detected in comparison with the other battery, which, however, was more accurate in evaluating the ability to discriminate and identify words on the basis of their spectral characteristics. The Authors propose the combined use of the two test batteries to evaluate the efficacy and efficiency of auditory perception training in patients with severe and profoundly severe bilateral sensori-neural prelingual deafness.

Auditory Threshold↗
PubMed2006

Symptom prevalence and severity in people severely affected by multiple sclerosis.

AIM: This study sought to assess symptom severity and prevalence in people severely affected by multiple sclerosis (MS). METHODS: We collected data on symptoms and problems of patients as self-reported to trained interviewers on standardized questionnaires (including the Palliative Outcome Scale MS symptom checklist, POS-MSS). RESULTS: 52 patients were included, mean age 53 years; 26 had secondary progressive MS, 23 had primary progressive MS, three had other forms; 32/52 were unable to walk independently. Patients reported a mean of nine (median = 8.5, mode = 12) symptoms. Six symptoms affected more than 50% of patients: problems using legs, problems using arms, fatigue/lack of energy, spasms, pain, and feeling sleepy. Higher levels of disability were correlated with greater symptom severity for nine symptoms (Spearman rho ranged 0.28-0.56, p < 0.05). CONCLUSION: Many symptoms in people severely affected by MS are as highly prevalent and severe as those experienced by patients with advanced cancer. Increased disability is associated with increased severity for some symptoms.

Activities of Daily Living↗
PubMed2000

Individual psychodynamic psychotherapy and psychoanalysis for schizophrenia and severe mental illness.

BACKGROUND: People with schizophrenia and severe mental illness may need much support from health care professionals, in most cases over a long period of time. Research on the effects of psychotherapy for schizophrenia shows mixed results. Although pharmacological interventions remain the treatment of choice for schizophrenia patients, it is also of interest to look at the effects of treatment methods focusing on psychosocial factors affecting schizophrenia. OBJECTIVES: To review the effects of individual psychodynamic psychotherapy and/or psychoanalysis for people with schizophrenia or severe mental illness. SEARCH STRATEGY: Electronic searches of Biological Abstracts (1985-1999), CINAHL (1982-1999), The Cochrane Library CENTRAL (Issue 1, 1999), The Cochrane Schizophrenia Group's Register (1999), Dissertation Abstracts On disc (1866-1999), EMBASE (1980-1999), MEDLINE (1966-1999), PsycLIT (1974-1999), and Sociofile (1974-1998) were made. Authors of included trials were contacted for information on further trials. SELECTION CRITERIA: All randomised trials of individual psychodynamic psychotherapy or psychoanalysis for people with schizophrenia or severe mental illness (however defined) were selected. DATA COLLECTION AND ANALYSIS: Data were independently extracted by at least two reviewers. For dichotomous data relative risks (RR) were calculated and for continuous data weighted mean differences (WMD) between groups were calculated. MAIN RESULTS: No trials of a psychoanalytic approach were identified. Data are sparse for all comparisons involving a psychodynamic approach. There is no evidence of any positive effect of psychodynamic therapy and the possibility of adverse effects seems never to have been considered. The psychodynamic approach may be more acceptable to people than a more cognitive reality-adaptive therapy. REVIEWER'S CONCLUSIONS: Current data do not support the use of psychodynamic psychotherapy techniques for hospitalised people with schizophrenia. If psychoanalytic therapy is being used for people with schizophrenia there is an urgent need for trials.

Humans↗
PubMed1992

Disease severity in rheumatoid arthritis: relationships of plasma tumor necrosis factor-alpha, soluble interleukin 2-receptor, soluble CD4/CD8 ratio, neopterin, and fibrin D-dimer to traditional severity and functional measures.

Rheumatoid arthritis is a complex inflammatory disease of unknown cause. Although various laboratory and clinical measurements are useful in managing these patients, there is a need for better tests to quantitatively assess disease activity. The purpose of this study was to investigate the association of certain immune and inflammation (I-I) parameters with four traditional disease severity measures and a functional measure in rheumatoid arthritis patients. A single set of patient blood samples was analyzed, and four traditional disease severity measures and patient functional statuses were determined from 64 consecutive outpatients with rheumatoid arthritis. Plasma tumor necrosis factor-alpha (TNF), soluble interleukin-2 receptor (sIL-2R), sCD4 and sCD8 (and the sCD4/sCD8 ratio), neopterin, and fibrin D-dimer were analyzed in relationship to Westergren erythrocyte sedimentation rate (ESR), physician assessment of disease activity, joint pain count, grip strength, and Arthritis Impact Measurement Scale (AIMS) scores. Rheumatoid arthritis patients had higher mean levels of all I-I measures (except sCD4) compared to healthy subjects. Initial significant correlations between TNF, sIL-2R, and D-dimer and several disease severity and functional measures were detected. When we controlled for the covariates age, gender, race, and medications, regression analyses indicated that, as a group, the I-I measures were significantly related to grip strength, physician disease severity rating, ESR, and total joint pain. When the predictive values of the I-I measures were tested controlling for the covariates and ESR, D-dimer was independently and significantly associated with variability in grip strength, physician disease severity, and AIMS physical disability, while TNF was associated with a significant amount of variability in total joint pain.(ABSTRACT TRUNCATED AT 250 WORDS)

Antifibrinolytic Agents↗
PubMed2005

Preoperative moderate to severe diastolic dysfunction: a novel Doppler echocardiographic long-term prognostic factor in patients with severe aortic stenosis.

OBJECTIVE: We studied long-term outcomes in severe aortic stenosis and the importance of prosthesis type (mechanical vs biologic) and size, preoperative left ventricular ejection fraction, diastolic function, and left ventricular mass. METHODS: Patients undergoing valve replacement from 1991 to 1993 (n = 399, 45% women) were included. The diastolic function was evaluated by integrating mitral and pulmonary venous flow data with Doppler echocardiography. The patients were classified as having either normal diastolic function to mild diastolic dysfunction or moderate to severe diastolic dysfunction. Left ventricular ejection fraction and the diastolic function category were incorporated together with age, sex, and time since operation into a Poisson regression model with death as the end point. Prosthesis type and size and left ventricular mass were also investigated. RESULTS: The age (mean +/- SD) was 71 +/- 9 years, and the overall survival after 12 years was 50%. Although markedly reduced during the initial 6-month period, mortality risk subsequently increased more than could be explained by age (hazard ratio of 1-year difference = 1.12, P = .0005). The moderate to severe diastolic dysfunction pattern independently predicted late mortality (hazard ratio = 1.72, P = .0038), whereas left ventricular ejection fraction did not (hazard ratio = 0.99, P = .18). The prognostic importance of moderate to severe diastolic dysfunction did not diminish with time; on the contrary, it tended to increase. Mortality after 12 years was not predicted by left ventricular mass (P = .66), prosthesis type (P = .57), or prosthesis size (P = .58). CONCLUSION: This study reveals that moderate to severe diastolic dysfunction in patients with aortic stenosis is an independent predictor of late mortality after valve replacement and that its importance does not decrease with time. Our findings may suggest that moderate to severe diastolic dysfunction implies nonreversible myocardial changes that negatively affect survival.

Age Factors↗
PubMed1991

Reversible T-wave abnormality in severe acute asthma: an electrocardiographic sign of severity.

Reversible electrocardiographic (ECG) abnormalities are well recognized in severe acute asthma. Inferior lead T-wave abnormalities have only rarely been reported, and their frequency and significance have not been well documented. We studied 70 consecutive patients with severe acute asthma on admission to hospital and during recovery, in order to examine the frequency and natural history of such changes and to document their relationship to the severity of the attack. Twenty-two patients (34%) had inferior lead T-wave inversion on ECGs performed within 1 h of admission (group 1), whereas the rest did not (group 2). Apart from sinus tachycardia this was the most common ECG abnormality. Patients with inferior T-wave inversion were found to have more severe asthma in terms of degree of pulsus paradoxus, peak expiratory flow rate, forced expiratory volume in 1 s and arterial blood oxygen tension. Ten group 1 and ten group 2 patients underwent two-dimensional echocardiography during the acute phase of their illness and during recovery. Six (60%) group 1 patients showed echocardiographic evidence of right ventricular pressure overload compared with only one (10%) patient in group 2 (P less than 0.02). Following recovery, voluntary hyperventilation and exercise testing in ten group 1 patients failed to reproduce the ECG changes seen on admission. Reversible inferior lead T-wave abnormalities may occur in the severe acute asthma and appear to be related to the severity of the attack.

Acute Disease↗
PubMed2006

Characteristics and health status change over 6 months in people with moderately severe to severe Alzheimer's disease in the U.K.

BACKGROUND AND OBJECTIVES: Until recently, attention and treatment strategies have focused mainly on patients in the early phases of Alzheimer's disease (AD). The objectives of this study were to collect information on moderately severe and severe AD patients (Mini-mental State Examination score < 15) in terms of epidemiological, clinical and economic characteristics and disease change in the later stages of AD, and to compare this specific AD population over 6 months with those in the earlier stages. METHODS: This descriptive analysis recruited institutionalized patients and patients living within the community from the city of London and the South-East region of the U.K. Subgroup analyses at baseline and 6 months were performed using the study population from the London and South-East Region Alzheimer's Disease (LASER-AD) Study. Data from a range of clinical scales, a quality of life (QOL) scale and a resource-utilization questionnaire were analyzed. RESULTS: People with moderately severe or severe AD are a heterogeneous group with varying QOL, cognitive and functional disabilities, neuropsychological symptoms and relatively low health care resource consumption. This patient group continued to decline but progression of the disease was observed only in some domains. CONCLUSION: Even at the later stages of AD, patients show varying rates of decline. Improved knowledge about the characteristics and progression of the disease reveals that moderately severe and severe patients cannot be regarded as beyond help and have the potential to experience varying and even high levels of QoL.

Activities of Daily Living↗
PubMed2006

Matrix-metalloproteinases and their inhibitors are elevated in severe sepsis: prognostic value of TIMP-1 in severe sepsis.

The enzyme group of matrix metalloproteinases (MMPs) and their inhibitors, so-called tissue inhibitors of matrix-metalloproteinases (TIMPs), are crucial mediators responsible for wound repair after parenchymal damage. Little is known about the role of MMPs and TIMPs in severe sepsis. The aim of the present study was therefore to investigate their levels in patients with severe sepsis and to examine their association with prognosis. MMP-2, MMP-9, TIMP-1, TIMP-2 and interleukin-6 (IL-6) plasma levels were measured by ELISA methods in 37 patients on day 1 of severe sepsis. 37 healthy volunteers served as controls. Levels of MMP-9, TIMP-1, TIMP-2 and IL-6 in septic patients were significantly higher compared to healthy controls (p<0.001), whereas MMP-2 levels were not different in patients and controls. TIMP-1 levels were significantly higher in non-survivors (4675+/-435 ng/ml, mean+/-SEM) compared to survivors of severe sepsis (3201+/-249 ng/ml; p<0.01). Septic patients with TIMP-1 values >3200 ng/ml were 4.5 times more likely to die than patients with lower values (RR = 4.5; 95% CI 1.14-17.6, p = 0.014). Our results indicate that MMP-9, TIMP-2 and TIMP-1 are elevated in severe sepsis. Furthermore, TIMP-1 may serve as a useful laboratory marker to predict the clinical outcome of patients presenting with severe sepsis.

Aged↗
PubMed1986

Severe measles in Sunderland, 1885: a European-African comparison of causes of severe infection.

On the basis of research in Guinea-Bissau, this paper re-analyses a severe measles epidemic which occurred in 1885 in Sunderland (England). In both England and Guinea-Bissau, acute measles mortality was higher in households with multiple cases than in families with only a single case of measles. Secondary cases (infected in the house) had higher mortality and higher frequency of severe complications than index and single cases. In Sunderland, severe complications were associated with a history of previous respiratory infection and with greater number of siblings. Since cases with severe complications had significantly prolonged prodromal symptoms and shorter periods of incubation, it is suggested that high dose of infection may be an essential mechanism in the pathogenesis of severe disease. Overcrowding may be a major determinant of severe measles because it increases the risks of intensive exposure, intercurrent infections, and previous respiratory infection.

Adolescent↗
PubMed1997

Illness severity and treatment services for dually diagnosed severely mentally ill outpatients.

This study of a frequently endorsed, but untested, model of outpatient treatment for persons with coexisting severe mental illness and substance use disorders assessed how the amount of treatment services delivered was related to an individual's global severity of illness, whether different modes of treatment were related to different aspects of illness, how noncompliance with treatment was related to the severity of illness and amount of services delivered, and how the diagnosis of schizophrenia/schizoaffective influenced these issues. Participants with high total severity of illness (TSI) received about twice the number of appointments (20.7 vs. 12.3) per month as those with low TSI scores. Higher TSI was also related to a DSM-IV diagnosis of schizophrenia/schizoaffective, being in a lower "phase" of treatment, representative payee benefit management, homelessness, and more hospitalizations. Participants with higher psychiatric symptom severity received significantly more case management and medication services, but not group therapy or day treatment. Severity of substance use condition was significantly related only to case management. This model of treatment was found to be successful in delivering higher levels of treatment services to those needing them.

Adult↗