The coexistence of terms to describe the presence of multiple concurrent diseases

Background: Consensus on terminology for multiple diseases is lacking. Because of the clinical relevance and social impact of multiple concurrent diseases, it is important that concepts are clear. Objective: To highlight the diversity of terms in the literature referring to the presence of multiple concurrent diseases/conditions and make recommendations. Design: A bibliometric analysis of English-language publications indexed in the MEDLINE database from 1970 to 2012 for the terms comorbidity, multimorbidity, polymorbidity, polypathology, pluripathology, multipathology, and multicondition, and a review of definitions of multimorbidity found in English-language publications indexed from 1970 to 2012 in the MEDLINE and SCOPUS databases. Results: Comorbidity was used in 67,557 publications, multimorbidity in 434, and the other terms in three to 31 publications. At least 144 publications used the term comorbidity without referring to an index disease. Thirteen general definitions of multimorbidity were identified, but only two were frequently used (91% of publications). The most frequently used definition (48% of publications) was “more than one or multiple chronic or long-term diseases/conditions”. Multimorbidity was not defined in 51% of the publications using the term. Conclusions: Comorbidity was overwhelmingly used to describe any clinical entity coexisting with an index disease under study. Multimorbidity was the term most frequently used when no index disease was designated. Several definitions of multimorbidity were found. However, most authors using the term did not define it. The use of clearly defined terms in the literature is recommended until a general consensus on the terminology of multiple coexistent diseases is reached.Journal of Comorbidity 2013;3(1):4–9 

Multimorbidity and quality of life: a closer look

© 2007 Fortin et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

Comorbidity and glycemia control among patients with type 2 diabetes in primary care

Reports on the relationship between comorbidity and glycemia control in diabetic patients are conflicting and the method of measuring comorbidity varies widely among studies. The aim of the present study was to evaluate the relationship between diabetes control and comorbidity, taking into account all comorbidities and their severity, in a primary care setting. We performed a retrospective descriptive study based on chart review of 96 randomly selected type 2 diabetic patients. Comorbidity was measured with the cumulative illness rating scale (CIRS), an exhaustive comorbidity index. Diabetes was considered as controlled if the mean value of two measurements of glycosylated hemoglobin A (HbA1c) was less than 7%. Taking diabetes control as the dependent variable, its relationship with the CIRS score, age, sex, diabetes duration, and diabetes-related complications was explored. Diabetes control was not significantly related with the CIRS score, age, sex or diabetes severity. Diabetes duration was the only variable significantly related to diabetes control. Our study suggests that comorbidity measured with the CIRS in patients with type 2 diabetes is not a factor that prevents the achievement of a good glycemia control

Creación de instrucciones de trabajo para mantenimiento de líneas propulsoras en dique seco en un astillero de súper yates.

El objetivo de este proyecto final de carrera es poder hacer unas instrucciones de trabajo para realización de trabajos de dique seco en un astillero de yates de grande eslora. Dentro de toda la diversidad de trabajos que se pueden realizar en dique seco, nos centraremos en la línea propulsora, desde el acople con el volante de la reductora hasta la hélice de propulsión. Mediante el uso de estas instrucciones los operarios y los jefes de buque o directores de proyecto, encargados del seguimiento de la reparación de un yate cuando está en astillero, saben como proceder y como realizar los trabajos paso a paso. Además estas instrucciones pueden retroalimentarse en el caso que nuevas tecnologías o nuevos procesos se lleven a cabo. Si se diera la situación, se puede indicar y modificar los procesos para que quede constancia. Esto ocurrirá también a medida que se vaya adquiriendo más experiencia en los trabajos. Otra ventaja de crear estas instrucciones es que se puede utilizar operarios de diferentes sectores y talleres y asegurarse que realizan trabajos correctamente

Habitatge buit i altres situacions anòmales del Parc d'habitatge: diagnosi i estratègies d'actuació: el cas de Molins de Rei: pla de treball

Preprin

Habitatge buit i altres situacions anòmales del Parc d'habitatge: diagnosi i estratègies d'actuació: el cas de Molins de Rei. Part II: Parc vacant

Preprin

Habitatge buit i altres situacions anòmales del Parc d'habitatge: diagnosi i estratègies d'actuació: el cas de Molins de Rei. Part I: Infrahabitatge

Preprin

Habitatge buit i altres situacions anòmales del Parc d'habitatge: diagnosi i estratègies d'actuació: el cas de Molins de Rei. Part III: Parc sobreocupació

Preprin

Prevalence estimates of multimorbidity: a comparative study of two sources

<p>Abstract</p> <p>Background</p> <p>Published prevalence studies on multimorbidity present diverse data collection methods, sources of data, targeted age groups, diagnoses considered and study populations, making the comparability of prevalence estimates questionable. The objective of this study was to compare prevalence estimates of multimorbidity derived from two sources and to examine the impact of the number of diagnoses considered in the measurement of multimorbidity.</p> <p>Methods</p> <p>Prevalence of multimorbidity was estimated in adults over 25 years of age from two separate Canadian studies: a 2005 survey of 26,000 respondents randomly selected from the general population and a 2003 study of 980 patients from 21 family practices. We estimated the prevalence of multimorbidity based on the co-occurrence of ≥ 2 and ≥ 3 diseases of the seven diseases listed in the general population survey. For primary care patients, we also estimated multimorbidity prevalence using an open list of chronic diseases.</p> <p>Results</p> <p>Prevalence estimates were considerably higher for each age group in the primary care sample than in the general population. For primary care patients, the number of chronic diseases considered for estimates resulted in large differences, especially in younger age groups. The prevalence of multimorbidity increased with age in both study populations.</p> <p>Conclusions</p> <p>The prevalence of multimorbidity was substantially lower when estimated in a general population than in a family practice-based sample and was higher when the number of conditions considered increased.</p

Gaussianization of LA-ICP-MS features to improve calibration in forensic glass comparison

The forensic comparison of glass aims to compare a glass sample of an unknown source with a control glass sample of a known source. In this work, we use multi-elemental features from Laser Ablation Inductively Coupled Plasma with Mass Spectrometry (LA-ICP-MS) to compute a likelihood ratio. This calculation is a complex procedure that generally requires a probabilistic model including the within-source and betweensource variabilities of the features. Assuming the within-source variability to be normally distributed is a practical premise with the available data. However, the between-source variability is generally assumed to follow a much more complex distribution, typically described with a kernel density function. In this work, instead of modeling distributions with complex densities, we propose the use of simpler models and the introduction of a data pre-processing step consisting on the Gaussianization of the glass features. In this context, to obtain a better fit of the features with the Gaussian model assumptions, we explore the use of different normalization techniques of the LA-ICP-MS glass features, namely marginal Gaussianization based on histogram matching, marginal Gaussianization based on Yeo-Johnson transformation and a more complex joint Gaussianization using normalizing flows. We report an improvement in the performance of the Likelihood Ratios computed with the previously Gaussianized feature vectors, particularly relevant in their calibration, which implies a more reliable forensic glass comparisonThis work has been supported by the Spanish Ministerio de Ciencia e Innovación through grant PID2021-125943OB-I0