The Impact of Comorbid Conditions on Treatment of Temporomandibular Disorders

Abstract Objective: Elevated body mass index (BMI) is associated with multiple chronic conditions including diabetes and cardiovascular disease. Patients with overweight or obesity may also suffer from comorbidities not directly related to the pathophysiology of elevated BMI. The current study sought to determine the impact of BMI and different types of chronic conditions on health-related quality of life (HRQoL) outcomes. Design: Six weight categories by BMI were identified: Underweight, Normal weight, Overweight, Class-I obesity, Class-II obesity, and Class-III obesity. Twenty chronic conditions were considered and categorized as elevated BMI-related (concordant) or -unrelated (discordant) conditions. HRQoL outcomes were measured using Short Form-6 Dimensions (SF-6D). Multivariable regression models were performed to examine the impact of type, number of comorbid conditions, and BMI categories on SF-6D scores. Setting: Medical Expenditure Panel Survey (2013-2015). Participants: Nationally representative sample of US population; 18 years or older (n=58,960). Results: Of the sample, 1.7%, 32.9%, 34.0%, and 31.4% were classified as underweight, normal weight, overweight, and obese, respectively. The SF-6D scores were significantly decreased across all obesity classes, with the largest reduction in Class-III obesity (0.033; p < 0.001). Additionally, individuals with obesity having one or more concordant or discordant comorbidities further reduced SF-6D scores between 0.031 and 0.148 (p-values < 0.001) or between 0.080 and 0.212 (p-values < 0.001), respectively. Conclusions: Individuals with obesity had a significant reduction in HRQoL outcomes compared to those with normal BMI. Importantly, discordant comorbidity resulted in greater reduction in HRQoL outcomes compared to concordant comorbidity in subjects with elevated BMI.

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Comorbidity is associated with disease activity in MS

Neurology ◽

10.1212/wnl.0000000000010024 ◽

2020 ◽

Vol 95 (5) ◽

pp. e446-e456 ◽

Cited By ~ 2

Author(s):

Amber Salter ◽

Kaarina Kowalec ◽

Kathryn C. Fitzgerald ◽

Gary Cutter ◽

Ruth Ann Marrie

Keyword(s):

Clinical Trial ◽

Disease Activity ◽

Cox Regression ◽

Secondary Analysis ◽

Large Trial ◽

Comorbid Conditions ◽

Comorbidity Burden ◽

Concomitant Medications ◽

Comorbidity Status ◽

The Impact

ObjectiveTo determine whether comorbidity is associated with clinical (relapses, disability worsening) and MRI outcomes in multiple sclerosis (MS) by conducting a secondary analysis of the CombiRx clinical trial.MethodsCombiRx compared interferon beta-1a, glatiramer acetate, and the combination of these agents. For participants eligible for evaluation of 6-month confirmed disability worsening, we used medical history, concomitant medications, and adverse events to ascertain comorbidity status. Comorbid conditions evaluated included hypertension, dyslipidemia, diabetes mellitus, depression, anxiety disorders, and migraine. Clinical outcomes included disease activity consisting of protocol-defined relapses, disability worsening, and MRI activity. We summarized the prevalence of these comorbid conditions and their association with disease activity and its components using multivariable Cox regression.ResultsOf the 1,008 participants randomized, 959 (95.1%) were eligible for assessment of 6-month disability worsening; for this subgroup, the median length of follow-up was 3.4 years (range 0.5–6.9 years). Overall, 55.1% of participants had ≥1 comorbidity at enrollment. After adjustment, anxiety (hazard ratio [HR] 1.25, 95% confidence interval [CI] 1.01–1.55) and dyslipidemia (HR 1.32, 95% CI 1.01–1.72) were associated with an increased hazard of any disease activity, while migraine (HR 0.80, 95% CI 0.67–0.97) was associated with a decreased hazard.ConclusionsIn this large trial population with rigorously obtained outcomes, comorbid conditions were common among participants and influenced disease outcomes, including relapses. The comorbidity burden of clinical trial participants with MS may be an important factor in the outcome of clinical trials. Additional investigations of the impact of comorbidity on clinical trial outcomes and response to disease-modifying therapies are warranted.

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Comorbid conditions associated with painful temporomandibular disorders in adolescents from Brazil, Canada and France: A cross‐sectional study

Journal of Oral Rehabilitation ◽

10.1111/joor.12923 ◽

2020 ◽

Vol 47 (4) ◽

pp. 417-424

Author(s):

Khurram Khan ◽

Michèle Muller‐Bolla ◽

Oscar Anacleto Teixeira Junior ◽

Mervyn Gornitsky ◽

Antonio Sergio Guimarães ◽

...

Keyword(s):

Temporomandibular Disorders ◽

Cross Sectional Study ◽

Sectional Study ◽

Comorbid Conditions ◽

Cross Sectional

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Comorbidity Profile among Patients with Rheumatoid Arthritis and the Impact on Prescriptions Trend

Clinical Medicine Insights Arthritis and Musculoskeletal Disorders ◽

10.4137/cmamd.s11481 ◽

2013 ◽

Vol 6 ◽

pp. CMAMD.S11481 ◽

Cited By ~ 12

Author(s):

J Al-Bishri ◽

SM Attar ◽

Nawal Bassuni ◽

Yasser Al-Nofaiey ◽

Hamed Qutbuddeen ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Biological Therapy ◽

Cross Sectional Study ◽

Diabetic Patients ◽

Sectional Study ◽

Comorbid Conditions ◽

Cross Sectional ◽

Common Drug ◽

The Impact ◽

The Relationship

Comorbid conditions play a pivotal role in rheumatoid arthritis management and outcomes. We estimated the percentage of comorbid illness among rheumatoid arthritis patients and explored the relationship between this comorbidity and different prescriptions. A cross-sectional study of patients with rheumatoid arthritis in three centers in Saudi Arabia was carried out. Comorbidity and antirheumatoid medication regimens prescribed were recorded on a specially designed Performa. The association between comorbidity and different drugs was analyzed. A total of 340 patients were included. The most comorbidities were hypertension 122 (35.9%), diabetes 105 (30.9%), osteoporosis 88 (25.8%), and dyslipidemia in 66 (19.4). The most common drug prescribed was prednisolone in 275 (80.8%) patients followed by methotrexate in 253 (74.4%) and biological therapy in 142 (41.5%) patients. Glucocorticoids were prescribed considerably more frequently in hypertensive and diabetic patients as well as in patients with osteoporosis and dyslipidemia. Most patients with rheumatoid arthritis suffered from comorbid diseases.

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Social Factors and Comorbidity of Depressive and Anxiety Disorders

The British Journal of Psychiatry ◽

10.1192/s0007125000298413 ◽

1996 ◽

Vol 168 (S30) ◽

pp. 50-57 ◽

Cited By ~ 46

Author(s):

G.W. Brown ◽

T. O. Harris ◽

M. J. Eales

Keyword(s):

Inner City ◽

Psychosocial Factors ◽

Social Factors ◽

Adult Life ◽

Anxiety And Depression ◽

Clinical Implications ◽

Comorbid Conditions ◽

Childhood Experiences ◽

Considerable Impact ◽

The Impact

Differences in rates of depression across and between populations can be considerable and are largely determined by psychosocial factors. Such findings have important implications for comorbidity. On the basis of multiplying independent probabilities, the proportion of comorbid conditions increases as base rates of the disorders increase in a population. If such a chance combination has clinical implications, it would appear to be a “fact” of significance irrespective of biological underpinnings. In a recent survey of 404 women living with at least one child in an inner-city area, the rate of both anxiety and depression was highly related to the childhood experiences of neglect and abuse. However, adversity in adult life (e.g. widowhood or divorce), which might be expected to relate to current stressors, was only related to the rate of depression. The two risk factors had a considerable impact on comorbidity by increasing the rate of each disorder and thus the probability of their occurring together. They had a lesser impact as “common antecedents”. If both influences are considered, such adversity explains around half of the comorbidity. This is a conservative estimate of the impact of psychosocial factors.

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The Impact of Morbid Obesity and Bariatric Surgery on Comorbid Conditions: A Comprehensive Examination of Comorbidities in an Employed Population

Journal of Occupational and Environmental Medicine ◽

10.1097/jom.0b013e31818def04 ◽

2009 ◽

Vol 51 (2) ◽

pp. 170-179 ◽

Cited By ~ 11

Author(s):

Nathan L. Kleinman ◽

Arthur Melkonian ◽

Spencer Borden ◽

Nicholas Rohrbacker ◽

Wendy D. Lynch ◽

...

Keyword(s):

Bariatric Surgery ◽

Morbid Obesity ◽

Comorbid Conditions ◽

Comprehensive Examination ◽

The Impact

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Assessment of the impact of clinical procedures and laboratory fabrication of full dentures on the musculo-articular functions in edentulous patients with temporomandibular disorders

Prosthodontics ◽

10.5114/ps/122307 ◽

2020 ◽

Vol 70 (2) ◽

pp. 156-170

Author(s):

Magdalena Orczykowska ◽

Małgorzata Pihut ◽

Grażyna Wiśniewska ◽

Andrzej Gala ◽

Rafał Rój

Keyword(s):

Temporomandibular Disorders ◽

Clinical Procedures ◽

Edentulous Patients ◽

The Impact

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Impact of diabetes on COVID-19-related in-hospital mortality: a retrospective study from Northern Italy

10.21203/rs.3.rs-36391/v1 ◽

2020 ◽

Author(s):

Stefano Ciardullo ◽

Francesca Zerbini ◽

Silvia Perra ◽

Emanuele Muraca ◽

Rosa Cannistraci ◽

...

Keyword(s):

Retrospective Study ◽

Hospital Mortality ◽

Northern Italy ◽

Hospital Death ◽

Chronic Obstructive ◽

Malignant Neoplasms ◽

Single Center ◽

Comorbid Conditions ◽

Diabetes Status ◽

The Impact

Abstract Purpose. The purpose of this study was to evaluate the impact of pre-existing diabetes on in-hospital mortality in patients admitted for Coronavirus Disease 2019 (COVID-19).Methods. This is a single center, retrospective study conducted at Policlinico di Monza hospital, located in the Lombardy region, Northern Italy. We reviewed medical records of 373 consecutive adult patients who were hospitalized with COVID-19 between February 22 and May 15, 2020. Data were collected on diabetes status, comorbid conditions and laboratory findings. Multivariable logistic regression was performed to evaluate the effect of diabetes on in-hospital mortality after adjustment for potential confounding variables.Results. Mean age of the patients was 72 ± 14 years (range 17-98), 244 (65.4%) were male and 69 (18.5%) had diabetes. The most common comorbid conditions were hypertension (237 [64.8%]), cardiovascular disease (140 [37.7%]) and malignant neoplasms (50 [13.6%]). In-hospital death occurred in 142 (38.0%) patients. In the multivariable model older age (Odds Ratio [OR] 1.07 [1.04-1.10] per year), diabetes (OR 2.2 [1.10-4.73]), chronic obstructive pulmonary disease (OR 3.30 [1.22-8.90]), higher values of lactic dehydrogenase and C-reactive protein were independently associated with in-hospital mortality.Conclusion. In this retrospective single-center study, diabetes was independently associated with a higher in-hospital mortality. More intensive surveillance of patients with this condition is to be warranted.

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