concurrent disease

  • 文章类型: Journal Article
    胰腺炎的组织学证据通常在猫的尸检研究中发现。由于非特异性临床体征,胰腺炎的临床诊断具有挑战性。缺乏诊断脂肪酶切断,和常见的多种疾病。尚不清楚在病猫中发现单独的胰腺炎的频率,以及在病猫中发现胰腺炎的临床病理证据的频率不能导致胰腺炎的临床诊断。我们的目的是评估疑似胰腺炎的猫的合并症程度,评估患有高脂血症的患病猫仅被诊断为非胰腺疾病的频率,并比较他们的临床发现。563只客户拥有的住院猫的医疗记录,可用的脂肪酶活性测量(LIPCRoche)>30U/L(RI,6-26)进行搜索,并按器官系统记录和分组医疗诊断。临床病理结果在单独患有胰腺炎(PA)的猫之间进行了比较,胰腺炎并发疾病(PD),无可疑胰腺炎(NP)。我们发现PA存在于33只(6%)猫中,PD组中有159只猫(28%),371只猫(66%)没有可疑的胰腺炎(NP)。临床,实验室,PA和PD猫的超声检查结果没有差异。三组之间的脂肪酶活性没有差异。PD和NP猫中最常见的疾病类别是胃肠道疾病,肝胆,肾/尿,和内分泌,和肾/尿,胃肠,心脏,和骨骼肌肉,分别。我们得出的结论是,猫很少因为怀疑胰腺炎而住院,PA猫在临床上与PD猫没有差异。未诊断为胰腺炎的病猫高脂血症可能是由于反应性胰腺炎或先前存在的慢性胰腺炎。
    Histological evidence of pancreatitis is commonly found in necropsy studies in cats. A clinical diagnosis of pancreatitis is challenging due to nonspecific clinical signs, a lack of diagnostic lipase cutoffs, and frequent presence of multiple diseases. It is still unknown how often pancreatitis alone is found in sick cats and how often clinicopathological evidence of pancreatitis in sick cats does not lead to a clinical diagnosis of pancreatitis. Our aims were to evaluate the extent of comorbidities in cats with suspected pancreatitis, evaluate how often sick cats with hyperlipasemia are diagnosed only with non-pancreatic diseases, and compare their clinical findings. Medical records of 563 client-owned hospitalized cats with available lipase activity measurement (LIPC Roche) > 30 U/L (RI, 6-26) were searched and medical diagnoses recorded and grouped by organ system. Clinicopathological findings were compared between cats with pancreatitis alone (PA), pancreatitis with concurrent disease (PD), and no suspected pancreatitis (NP). We found that PA was present in 33 (6%) cats, 159 cats (28%) were in the PD group, and 371 cats (66%) had no suspected pancreatitis (NP). Clinical, laboratory, and ultrasonographic findings did not differ between PA and PD cats. Lipase activities did not differ between the three groups. The most common disease categories in PD and NP cats were gastrointestinal, hepatobiliary, renal/urinary, and endocrine, and renal/urinary, gastrointestinal, cardiac, and musculoskeletal, respectively. We conclude that cats are rarely hospitalized because of suspected pancreatitis alone, and PA cats did not differ clinically from PD cats. Hyperlipasemia in sick cats without a diagnosis of pancreatitis may be due to a reactive pancreatopathy or preexisting chronic pancreatitis.
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  • 文章类型: Journal Article
    背景:良性阵发性位置性眩晕(BPPV)的特点是短暂的,由头部位置的突然变化引发的眩晕的剧烈发作。它通常被认为是在成年人中最常见的,虽然它在儿童中被认为是罕见的。为了更好地了解疾病的特征及其自然史,有必要在儿童和成人患者之间进行比较。本研究旨在确定儿童BPPV的临床特征,并将其与成人BPPV患者进行比较。方法:检索我院电子数据库,选择所有诊断为BPPV的≤18岁儿童。通过病历审查确定临床特征。对于成年患者,我们收集了年龄>19岁患者的数据.结果:共纳入30例儿科患者(13.65±4.15岁)和264例成人患者(60.86±13.74岁)。在儿科患者中,侧管占80%,后管占16.67%。在成年患者中,侧管和后管受累相似(p=0.007)。儿科患者的眼震程度为6.82±12.09,而成年人为15.58±20.90(p<0.001)。小儿组并发头晕障碍较高,成年组复发率较高。在回归分析中,发现成年患者的眼球震颤更强,值为6.206deg/sec,小儿组并发头晕障碍的风险高5.413倍(p<0.05)。结论:BPPV发生在患病率较低的儿科患者中,但不容忽视。在儿科组,相对较高比例的患者表现出侧管受累,较弱的眼球震颤,和额外的头晕障碍。
    Background: Benign paroxysmal positional vertigo (BPPV) is characterized by brief, intense episodes of vertigo triggered by abrupt changes in head position. It is generally accepted as being most common in adults, while it is regarded as rare in children. It is necessary to compare the disease between pediatric and adult patients for a better understanding of the disease\'s characteristics and its natural history. This study aimed to identify the clinical characteristics of BPPV in children and compare them with those of adult BPPV patients. Methods: All children ≤ 18 years old who were diagnosed with BPPV were selected by searching the electronic database of our hospital. Clinical features were identified by medical record review. For adult patients, we collected data from patients > 19 years of age. Results: A total of 30 pediatric (13.65 ± 4.15 years old) and 264 adult patients (60.86 ± 13.74 years old) were included in the study. Among pediatric patients, the lateral canals were involved in 80% and the posterior canals in 16.67%. In adult patients, the lateral and posterior canals were involved similarly (p = 0.007). The degree of nystagmus in pediatric patients was 6.82 ± 12.09, while in adults it was 15.58 ± 20.90 (p < 0.001). The concurrent dizziness disorder was higher in the pediatric group and recurrence was higher in the adult group. In the regression analysis, it was found that adult patients had a stronger nystagmus with a value of 6.206 deg/sec, and the risk of concurrent dizziness disorder was found to be 5.413 times higher in the pediatric group (p < 0.05). Conclusions: BPPV occurs in pediatric patients with lower prevalence, but it cannot be overlooked. In the pediatric group, a relatively high proportion of patients demonstrated lateral canal involvement, weaker nystagmus, and additional dizziness disorder.
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  • 文章类型: Editorial
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  • 文章类型: Journal Article
    Multimorbidity is a global health challenge. Here, we define multimorbidity, describe ways multimorbidity is measured, discuss the prevalence of multimorbidity and how it differs across different populations, examine mechanisms of disease and disability, and discuss the effects of multimorbidity on outcomes such as survival and function.
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