Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “MORBIDITY”

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 1,513 records · Page 84Linked to original sources
PubMedDate not supplied

Increased psychiatric morbidity in female outpatients with skin lesions on visible parts of the body.

Psychiatric disorders are frequent among patients with skin diseases. We aimed at identifying factors associated with psychiatric morbidity in dermatological outpatients. All adults attending the outpatient clinics of a dermatological hospital on predetermined days were given the 12-item General Health Questionnaire. The dermatologists indicated the diagnosis and location of skin lesions and rated the disease severity. A total of 1389 patients were asked to take part in the study. Of the 722 who accepted, 389 had a complete set of data and were included in the analysis. To verify the representativeness of our sample, we used the administrative registries to compare participants with the total population of patients who attended the clinics during the same period, and we examined the distribution of missing data. There was a tendency towards a younger age in the sample studied, but no evidence of substantial selection bias. The prevalence of psychiatric morbidity was 20.6%. We found higher probability of psychiatric disorders in women, controlling for age, clinical severity and localization of lesions. In women, but not in men, the prevalence of psychiatric morbidity was higher in patients with lesions on the face or hands. Given that the identification and appropriate management of psychiatric morbidity are important, it seems that the dermatologist should be particularly alert to the possibility of a concurrent psychiatric disorder in women with lesions on the face or hands.

Adult↗
PubMed2004

What's all that noise? The effect of co-morbidity on health outcome questionnaire results after knee arthroplasty.

BACKGROUND: We modified the Charnley Classification for hips to facilitate its use with knee arthroplasty patients and investigated what affect the different classes of co-morbidity had on the results of a spectrum of outcome questionnaires. PATIENTS AND METHODS: 3600 patients from the Swedish Knee Arthroplasty Registry were surveyed by post with a variety of questionnaires ranging from multiple-item general health, to a single-item knee arthroplasty specific questionnaire. All patients also completed a co-morbidity questionnaire, from which a modified Charnley Classification was generated for each patient. We then investigated the correlation and relationship between the results of the questionnaires and the different classes of co-morbidity. RESULTS: The results of the questionnaires tested varied significantly by Charnley Class, regardless of the specificity of the questionnaire used. INTERPRETATION: We suggest that co-morbidity should be taken into account in outcome studies utilizing general health or disease/site specific questionnaires.

Aged↗
PubMed2004

Pregnancy-associated morbidity in Northern Nigeria.

We sought to determine the magnitude and spatio-temporal pattern of maternal morbidity in Kano State, Nigeria. Analysis was on deliveries within the period 1990-1999. We counted 59772 maternal complications among 171621 deliveries, yielding an overall maternal morbidity ratio of 34.8%. We observed yearly variations and increment in the number of complications among mothers (p=0.04). A total of 4154 maternal deaths were registered within the period. The level of maternal deaths correlated significantly with burden of morbidity (r=0.44; p=0.0008). Case fatality rate was 6.9% with temporal fluctuations, and wide variations among the various health institutions. Our study revealed an extremely high morbidity ratio, which indicates that a high proportion of pregnant mothers are in need of essential obstetric care in this population.

Adolescent↗
PubMed1998

Neonatal morbidity associated with disproportionate intrauterine growth retardation at term.

We set out to compare neonatal morbidity between disproportionate intrauterine growth retarded newborn infants and proportionate retarded ones at term, based on ponderal index. This is a prospective study of 185 single pregnancies with evidence of intrauterine growth retardation at term. Sixty three cases (34%) were disproportionate and 122 (66%) proportionate in terms of ponderal index. All were born in the University Hospital 'Principe de Asturias' of Alcala de Henares, Madrid, Spain. Proportionate or disproportionate intrauterine growth retardation diagnosis was established using the ponderal index (weight/length3). The following outcomes of neonatal morbidity were investigated: (1) perinatal asphyxia (meconium-stained amniotic fluid, abnormal fetal heart rates, newborn acidosis or low Apgar score 7 at 5 minutes) and/or (2) early neonatal medical complications. Disproportionate intrauterine growth retardated newborn infants presented higher rates of perinatal asphyxia (54% vs. 32%, P 0.01), with higher abnormal fetal heart rates (37% vs. 15%, P 0.01), higher frequency of arterial pH 7.20 (31% vs. 16%, P 0.05); and also higher rates of early neonatal medical complications (40% vs. 11%, P 0.001), mainly hypoglycaemia (25% vs. 4%, P 0.01). Morbidity among disproportionate intrauterine growth retardated Aconates is significantly higher compared with proportionate ones, demonstrating the heterogeneity of the intrauterine growth retardation population. Proportionate and disproportionate intrauterine growth retardation should be diagnosed as early as possible, since the majority of the morbidity is intimately related to this difference.

Journal Article↗
PubMed1998

Blunt-tipped versus sharp-tipped needles: wound morbidity.

Blunt-tipped needles have previously been shown to reduce needle-stick injury but the issue of morbidity had not been addressed. As awareness of the need for universal precautions heightens, concerns have been raised about any possible morbidity brought about by their use. We present the results of a randomised, controlled study which investigated wound morbidity following caesarean section. Of the 204 women randomised to closure with sharp or blunt-tipped needles, none developed anything other than superficial infection and there were no significant differences between the two groups. We conclude that the use of blunt-tipped needles does not cause an increase in wound morbidity.

Clinical Trial↗
PubMedDate not supplied

Maternal morbidity in rural upper Egypt: levels, determinants, and care seeking.

Although maternal morbidity constitutes a serious public health problem in Egypt, it has remained a neglected area for public health research. In this study we used a synthetic design combining quantitative and qualitative methods to determine the level of maternal morbidity as reported by mothers in rural Upper Egypt and to identify patterns and determinants of care seeking for perceived morbidity in pregnancy, childbirth, and the postpartum period. The reported incidence of danger symptoms indicated that maternal morbidity is a serious problem in Egypt and, therefore, warranted community-based interventions. The study suggested a model explaining the criteria women used to judge whether and from where they would seek care. The model incorporates three cognitive components related to the perceived frequency, and seriousness of the problem and the degree of personal responsibility for the problem. Utilization of care was shown to be low and significantly associated with poverty and husband illiteracy. Likewise, most deliveries were not attended by a trained health care workers, and these unattended deliveries were shown to be associated with nonutilization of antenatal care, illiteracy, nonownership of cattle, and inaccessibility to potable water.

Adult↗
PubMed2006

Comparative analysis of neonatal morbidity for vaginal and caesarean section deliveries using hospital charge.

AIM: To assess the neonatal morbidity of alternative modes of delivery using economic data. METHODS: Two groups of neonatal morbidity data were extracted according to mode of delivery from inpatient claims on National Health Insurance in Taiwan: uncomplicated vaginal and caesarean section deliveries. Outcome variables included number of infants treated as inpatients, duration of hospital stay, and hospital charge during both the first month and the first year of age. RESULTS: Uncomplicated caesarean section delivery of term infants carried a significant increase either in the first month of life or during the first year after birth in both duration of hospital stay and hospital discharge when compared with uncomplicated vaginal delivery. Neonatal jaundice accounted for the greatest morbidity among term newborns, irrespective of delivery mode, followed by infectious, gastrointestinal and respiratory morbidity. Logistic regression analysis demonstrated that uncomplicated vaginal delivery was associated with skin diseases. Uncomplicated caesarean section delivery was associated with infectious disease and disease of the respiratory, digestive and circulatory systems. CONCLUSION: The findings of this study may provide further information for clinicians and would be an important consideration when advising pregnant women on the preferred route of delivery.

Birth Certificates↗
PubMedDate not supplied

Substance misuse and psychiatric comorbidity: an overview of the OPCS National Psychiatric Morbidity Survey.

There have been a number of national surveys of psychiatric morbidity, which have included questions on drugs, alcohol, and tobacco. These surveys have helped delineate the overlap between substance use and dependence and other psychological morbidity. There is a strong association reported between high substance consumption and other measures of psychological problems. This article provides an overview of a national household survey, a survey of institutional residents with psychiatric disorders, and a national survey of a homeless population. All three surveys used comprehensive and complex sampling strategies and lay interviewers to conduct structured diagnostic interviews. The household survey included over 10,000 households, the institutional survey interviewed 755 individuals, and the homeless survey of hostels, night shelters, day centres, and private sector leased accommodation interviewed 1,061 individuals. This overview looks at patterns of nicotine, alcohol, and other drug use in the different samples and examines interactions with other psychiatric morbidity. The survey reports that substance-related disorders are some of the commonest disorders in the community, with 5% of the household sample alcohol dependent, 7% alcohol dependent in the institutional sample and over 21% in the homeless sample recorded as alcohol dependent. Tobacco, alcohol and other drug use and dependence were dramatically higher in the homeless sample than in either of the other two samples. Substance use was significantly associated with higher rates of psychological morbidity as measured by the Clinical Interview Schedule Revised. Future service planning needs to take account of the striking disparity of prevalence of psychiatric disorders in different subsections of the population.

Alcoholism↗
PubMedDate not supplied

Urban-rural mental health differences in Great Britain: findings from the National Morbidity Survey.

Studies of urban-rural differences in prevalence of non-psychotic mental disorder have not given consistent findings. Such differences have received relatively little study in Great Britain. Data from 9777 subjects in the Household Survey of the National Morbidity Survey of Great Britain were analysed for differences between urban, semi-rural, and rural areas. Psychiatric morbidity was assessed by scores on the Revised Clinical Interview Schedule (CIS-R), together with alcohol dependence, drug dependence, and receipt of treatment from general practitioners. Associations with other characteristics were examined by logistic regression. Urban subjects had higher rates than rural of CIS-R morbidity, alcohol dependence, and drug dependence, with semi-rural subjects intermediate. Urban subjects also tended to be members of more deprived social groups, with more adverse living circumstances and greater life stress--factors themselves associated with disorder. Urban-rural differences in alcohol and drug dependence were no longer significant after adjustment for these factors by logistic regression, and differences on CIS-R morbidity were considerably reduced. There were no differences in treatment. There are considerable British urban-rural differences in mental health, which may largely be attributable to more adverse urban social environments.

Adolescent↗
PubMed2000

Simultaneous aortic surgery and malnutrition increase morbidity after revascularisation of the mesenteric arteries.

OBJECTIVE: To evaluate the early and late outcome of mesenteric revascularisation in patients who had had elective mesenteric revascularisation for chronic intestinal ischaemia. DESIGN: Retrospective review. SETTING: Academic clinic, United States. SUBJECT: 19 consecutive patients (7 men, 12 women; mean age 70 years, range 53-83). RESULTS: Angiography showed that 2 mesenteric vessels were affected in 7 patients and 3 in 12. Four patients had coexisting symptomatic aortoiliac occlusive disease and 1 patient had bilateral renal artery stenosis. A total of 36 visceral arteries were revascularised. One patient died postoperatively, and 8 developed serious complications. Morbidity and mortality were significantly higher in patients who had simultaneous infrarenal aortic or renal artery reconstructions (p = 0.01). Patients whose body weight before operation was less than 90% of ideal had more complications (8/11) than patients who were within 10% of their ideal body weight (1/8) (p = 0.02). Cumulative survival was 89% at 1 year, 72% at 3 years, and 57% at 5 years. The cumulative graft patency rate was 92% at 3 years and 66% at 5 years. CONCLUSIONS: Mesenteric bypass procedures for chronic mesenteric ischaemia are durable. Long-term survival and graft patency rates are excellent even in older patients. Simultaneous aortic surgery should be avoided because of the associated morbidity. More than 10% below ideal body weight was associated with higher morbidity. For these patients, early total parenteral nutrition postoperatively, or a period of total parenteral nutrition preoperatively may reduce postoperative morbidity and mortality.

Aged↗
PubMed2001

Morbidity and functional outcome after restorative proctocolectomy for ulcerative colitis.

OBJECTIVE: To find out whether a threefold increase in follow up (median 108 compared with 36 months) influenced major morbidity and functional outcome between the first 32 and the last 32 patients consecutively operated on with J-pouch ileoanal anastomosis for ulcerative colitis from 1984 to 1997. DESIGN: Retrospective and prospective study. SETTING: University hospital, Norway. PATIENTS: 64 patients with ulcerative colitis who had proctocolectomy and ileal pouch-anal anastomoses. INTERVENTIONS: The pouches were mainly hand anastomosed (n = 61) to the dentate line after mucosectomy or anastomosed by double stapling technique without mucosectomy (n = 3). The 58 patients who still had their pouches responded to a questionnaire on functional outcome and satisfaction. MAIN OUTCOME MEASURES: Morbidity, functional outcome, and patients' satisfaction. RESULTS: Major morbidity in these 64 patients comprised pelvic sepsis in 3 (5%), operation for intestinal obstruction in 5 (8%), pouchitis in 12 (19%), fistulas in 7 (11%) and pouch excision in 6 (9%). Thirteen patients (20%) had 35 reoperations and 11 patients (17%) had 22 re-laparotomies. There were more complications among the first 32 patients with the longest follow up than among the last 32 patients, but this difference was significant only concerning the rate of reoperations (31% compared with 9%) because of the higher number of pouch excisions (5 compared with 1) in this group. There were no significant differences in the functional outcome and degree of patient satisfaction between the first 29 and the last 29 patients. Respective values for 24 hour median stool freqency were 7.0 and 6.3, leakage of stool 48% and 38%, ability to defer defaecation 86% and 97%, perineal irritation 59% and 48%, use of antidiarrhoeal medication 55% and 52%, and wearing of pad 28% and 38%. Sexual life (n = 57) was improved in 11 (19%) and reduced in 7 (12%). Potency was reduced in 5 (15%) and ejaculation in 4 (12%), one of whom (3%) had retrograde ejaculation. Three (5%) received disability pensions and five (9%) had reduced workload. After the pouch operation 48 (91%) felt better and 3 (6%) felt worse because of frequent bowel emptying, perineal eczema, or pouch fistula. CONCLUSION: Continence-preserving proctocolectomy carries considerable morbidity, but the long term functional outcome is satisfactory and does not seem to deteriorate substantially.

Adolescent↗
PubMed2003

Identification of psychological morbidity in older people in primary care by practice nurses.

Older people with psychological morbidity generally first present to health services in primary care, where they are increasingly seen by primary care nurses. In order to evaluate primary care nurses' identification of psychological morbidity, 190 older patients attending eight practice nurses completed the General Health Questionnaire (GHQ) and the practice nurses made an assessment as to the presence or absence of psychological problems. The practice nurses identified only 26% of probable cases of psychological morbidity identified by the GHQ. Their threshold for identification was high, rating only 12% of patients as experiencing psychological problems compared to 29% probable cases identified by the GHQ, and their accuracy was low (kappa for agreement between GHQ and nurse ratings = 0.23). Likelihood of identification depended on length and type of visit. The findings suggest that it may be unrealistic to expect practice nurses, without additional training and reorganisation of their work, to identify more than a minority of older patients with psychological morbidity in the course of their routine work.

Aged↗
PubMedDate not supplied

A prospective study and review of pre-morbid characteristics in children with traumatic brain injury.

The pre-morbid characteristics of 32 children requiring inpatient rehabilitation following moderate or severe head injuries were studied prospectively. Teachers completed Rutter and modified Conners questionnaires on the pre-head injury behavioural characteristics of each child and also rated the pre-morbid learning ability of the children on a four-point scale. The children's socioeconomic status was determined using their postcode at the time of the injury. Behavioural questionnaires were returned for 25 of the 32 children. Five of the 25 children obtained total behaviour problem scores on the Rutter teacher scales indicative of pre-morbid psychopathology. The general learning ability of five children was rated as being far below average. The children had a higher mean socioeconomic deprivation score than for the geographic area in which the rehabilitation unit is sited. The incidence of pre-morbid behaviour problems in the study population with moderate or severe traumatic brain injury may be somewhat higher than in the local population, but this did not appear to be a major risk factor in sustaining a head injury. However, adverse environmental conditions, linked to socioeconomic deprivation, did appear to be important risk factors that contributed to a pedestrian road traffic accident.

Accidents, Traffic↗
PubMed2000

Co-morbidity in prostate cancer.

With the widespread use of prostate-specific antigen (PSA) screening, prostate cancer has become the mostly common diagnosed malignancy in the United States. Because prostate cancer preferably affects elderly males and usually progresses slowly, there is an increasing interest in the significance of co-morbid conditions complicating the course of the disease. Several scores have been applied to assess the co-morbidity in newly diagnosed prostate cancer patients and to estimate the impact of concomitant diseases on survival. Patients in their eighth decade of life, diagnosed with well or moderately differentiated localized prostate cancer and suffering from severe co-morbidity, are likely to die of causes other than the malignancy. Clinical trials evaluating different treatment modalities for localized prostate cancer need controlling and stratification for age and co-morbidity. The life expectancy of patients with only one controlled concomitant disorder, however, is not significantly compromised and the management of these patients remains controversial.

Journal Article↗
PubMed2004

Moderate neonatal morbidity after vaginal term breech delivery.

OBJECTIVE: Comparison of the results of term breech births in our clinic with the Term Breech Trial (TBT). MATERIAL AND METHODS: During the investigation period prospective data were collected on all deliveries of a term baby in breech presentation. Some pregnant women were included in the TBT and randomized in a planned cesarean section (CS)-group and a planned vaginal birth (VB)-group. The remaining non-randomized women were divided into a primary CS-group and a started VB-group. Neonatal and maternal mortality and morbidity were analyzed retrospectively, according to the intended mode of delivery. RESULTS: Neonatal or maternal mortality occurred in none of the groups. Neither in the randomized group nor in the non-randomized group were significant differences in serious neonatal and maternal morbidity observed between the intended cesarean section-group and the group that started vaginal delivery. However, in the non-randomized group, moderate neonatal morbidity was significantly lower in the primary CS-group than in the started VB-group. CONCLUSION: The differences in moderate neonatal morbidity support the conclusion of the TBT, that primary cesarean section may be safer for the term breech baby than a trial of vaginal labor.

Adult↗
PubMed2003

The importance of parity to major maternal morbidity in the eclamptic mother with HELLP syndrome.

OBJECTIVE: To determine if the rate of major morbidity from severe preeclampsia with/without hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome differs by parity. METHODS: Retrospective investigation of 970 gravidas with severe preeclampsia with and without HELLP syndrome analyzed according to parity. RESULTS: Altogether 609 (63%) patients were nulliparous and 361 (37%) parous. Between groups there was no significant difference in the incidence of overall major morbidity (21% vs. 19%, p=0.467), or specific morbidities including hematologic/coagulopathic (13.6% vs. 11.9%, p=0.442), cardiopulmonary (8.9% vs. 7.2%, p=0.362), CNS/visual (1.8% vs. 2.8%, p=0.319), or hepatorenal (0.8% vs. 2.2%, p=0.068). Although eclampsia was significantly more common in nulliparous (10.2%) than in parous patients (5.5%, p=0.012), the later significantly more often demonstrated major maternal morbidity associated with eclampsia (50%) than did nulliparous patients (25%, p=0.043). CONCLUSIONS: Unless parous patients with severe preeclampsia with or without HELLP syndrome develop eclampsia, their disease acuity does not differ significantly from their nulliparous counterparts.

Adolescent↗
PubMed1996

Morbidity and mortality of laparoscopic cholecystectomy in an institutional setup.

Laparoscopic cholecystectomy (LC) though a very safe operative procedure does have its own morbidity and mortality. The present study was undertaken to analyze the morbidity and mortality of this procedure in an institutional setting. Between October 1992 and October 1995 a total of 433 patients received LC. Conversion to open cholecystectomy was required in 62 patients (14.3%). The decision to convert was made because the surgeon was forced to convert (3.7%) or the conversion was the operator's choice (10.6%). There was no difference in the conversion rate of consultants versus residents (14.4% vs. 14.2%). Major intraoperative and postoperative morbidity was encountered in 8.3% of patients. One patient required reexploration. The incidence of common bile duct (CBD) injury was 2.5%. There was no operative or 30 days mortality. However, two patients died in the follow-up period due to procedure-related complications. Low threshold for conversion, early recognition of morbidity, and prompt and judicious management of such complications under guided supervision is necessary in order to avoid major postoperative problems. The experience in a teaching hospital training program is different from that of an individual surgical setup.

Adolescent↗
PubMed1987

A review of studies of anaesthetic risk, morbidity and mortality.

In the past two to three decades, advancing knowledge in the areas of physiology, pharmacology and scientific technology have allowed diversification from the purely technical aspects of administration of anaesthesia towards more accurate assessment of outcome for the individual in terms of both anaesthetic-induced morbidity and mortality. In addition, elucidation of the aetiology of the morbidity and mortality produced by anaesthesia, as opposed to that from surgery or concomitant medical or surgical disease processes, is assuming increased importance as a result of the expansion in medical litigation, where anaesthetists find themselves amongst the higher risk specialties in medicine. The morbidity produced by anaesthesia is relatively easy to define for specific populations, but the prediction of risk in an isolated individual remains elusive. For example, there are many studies indicating the incidence of postoperative myocardial infarction following surgical procedures in defined groups; but for the individual patient, more sophisticated risk assessments have so far failed to predict more accurately than the well-established ASA grading system. Nonetheless, it is expected that in future, studies in this area will permit increased precision in the assessment of risk, thereby permitting better consideration by both surgeon and patient of the options available regarding surgical and non-surgical therapy. Increasing emphasis on the safer administration of anaesthesia has been greatly aided by the use of the critical incident technique. By assessing near-misses in addition to existing morbidity and mortality, the technique increases the size and extent of the database, and by removal of the reticence inherent in an anaesthetist's confession of his mistakes, it increases the reporting of potential mishaps. Amongst the useful findings to have emerged from such studies is the previously unforeseen and unsuspected observation that the most dangerous period of anaesthesia is not during induction and recovery, but during the maintenance period. However, perhaps one of the more valuable aspects of this type of methodology is its potential use in quality control and audit within departments. There are undoubted problems and universally acknowledged difficulties in epidemiological research into anaesthetic mortality. Comparison of data between studies is rendered difficult owing to variations in procedure, including its prospective or retrospective nature, the definition of death, the perioperative time period studied, and the patient and hospital populations encompassed.(ABSTRACT TRUNCATED AT 400 WORDS)

Anesthesia↗