Morbid Events (morbid + event)

Distribution by Scientific Domains


Selected Abstracts


Trends and determinants of severe morbidity in HIV-infected patients: the ANRS CO3 Aquitaine Cohort, 2000,2004,

HIV MEDICINE, Issue 8 2007
F Bonnet
Objective The aim of the study was to characterize the causes, trends and determinants of severe morbidity in a large cohort of HIV-infected patients between 2000 and 2004. Method Severe morbid events were defined as medical events associated with hospitalization or death. Epidemiological and biological data were recorded at the time of the morbid event. Trends were estimated using Poisson regression. Results Among 3863 individuals followed between 2000 and 2004, 1186 experienced one or more severe events, resulting in 1854 hospitalizations or deaths. The severe events recorded included bacterial infections (21%), AIDS events (20%), psychiatric events (10%), cardiovascular events (9%), digestive events including cirrhosis (7%), viral infections (6%) and non-AIDS cancers (5%). Between 2000 and 2004, the incidence rate of AIDS events decreased from 60 to 20 per 1000 person-years, that of bacterial infections decreased from 45 to 24 per 1000 person-years, and that of psychiatric events decreased from 26 to 14 per 1000 person-years (all P<0.01), whereas the incidences of cardiovascular events and of non-AIDS cancers remained stable at 14 and 10 per 1000 person-years, on average, respectively. Conclusion Severe morbidity has shifted from AIDS-related to non-AIDS-related events during the course of HIV infection in developed countries. Limiting endpoints to AIDS events and death is insufficient to describe HIV disease progression in the era of combination antiretroviral therapy. [source]


Maximum Daily 6 Minutes of Activity: An Index of Functional Capacity Derived from Actigraphy and Its Application to Older Adults with Heart Failure

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 5 2010
Jason Howell BA
OBJECTIVES: To compare the correlation between the maximum 6 minutes of daily activity (M6min) and standard measures of functional capacity in older adults with heart failure (HF) with that in younger subjects and its prognostic utility. DESIGN: Prospective, cohort study. SETTING: Tertiary care, academic HF center. PARTICIPANTS: Sixty, ambulatory, adults, New York Heart Association (NYHA) Class I to III, stratified into young (50.9 ± 9.4) and older cohorts (76.8 ± 8.0). MEASUREMENTS: Correlation between M6min and measures of functional capacity (6-minute walk test; 6MWT) and peak oxygen consumption (VO2) according to cardiopulmonary exercise testing in a subset of subjects. Survival analysis was employed to evaluate the association between M6min and adverse events. RESULTS: Adherence to actigraphy was high (90%) and did not differ according to age. The correlation between M6min and 6MWT was higher in subjects aged 65 and older than in those younger than 65 (correlation coefficient (r=0.702, P<.001 vs r=0.490, P=.002). M6min was also significantly associated with peak VO2 (r=0.612, P=.006). During the study, 26 events occurred (2 deaths, 10 hospitalizations, 8 emergency department visits, and 6 intercurrent illnesses). The M6min was significantly associated with subsequent events (hazard ratio=2.728, 95% confidence interval=1.10,6.77, P=.03), independent of age, sex, ejection fraction, NYHA class, brain natriuretic peptide, and 6MWT. CONCLUSION: The high adherence to actigraphy and association with standard measures of functional capacity and independent association with subsequent morbid events suggest that it may be useful for monitoring older adults with HF. [source]


Identifying Early Cardiovascular Disease to Target Candidates for Treatment

JOURNAL OF CLINICAL HYPERTENSION, Issue 3 2008
Daniel A. Duprez MD
Most attempts to identify individuals at risk for cardiovascular morbid events have involved screening for risk factors. These traditional risk factors do not identify the underlying atherosclerotic disease nor assess the severity of disease in individual patients. The goal for identifying a marker or markers for early cardiovascular disease that could serve as a surrogate for disease progression and ultimate morbid events is to improve the precision for early detection and treatment. The authors utilize a variety of techniques, which consist of 7 vascular tests (large and small artery elasticity, resting blood pressure and exercise blood pressure response, optic fundus photography, carotid intimal-media thickness, and microalbuminuria) and 3 cardiac tests (electrocardiography, [N-terminal pro-] B-type natriuretic peptide, and left ventricular ultrasonography). Each test is individually scored, and the total disease score is the sum of all the test scores. A study is ongoing to compare the new disease score vs the classical Framingham risk estimate in the prediction of cardiovascular events. [source]