Comorbidity: a Modern View on the Problem; Classification (first notice)

Abrahamovych, O.; Fayura, O.; Abrahamovych, U.

doi:10.25040/lkv2015.04.056

Cited by 16 publications

(2 citation statements)

References 33 publications

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“…SLE has numerous clinical manifestations and an unpredictable course, often lasting for several months or years, with alternating remissions and exacerbations [5]. Several organs can be affected simultaneously with different degrees of severity, which leads to the occurrence of comorbid lesions associated with the treatment and actually the disease [1], including cardiovascular diseases [2], metabolic syndrome, osteoporosis, infections and malignant neoplasms, diseases of the musculoskeletal, nervous systems, kidneys, eyes, gastrointestinal tract, and chronic lung diseases [3,4,9,11]. The presence of comorbid lesions in case of SLE can significantly increase the mortality from all causes [7,16].…”

Section: Introduction Systemic Lupus Erythematosus (Sle)mentioning

confidence: 99%

Circulatory System Organs Comorbid Lesions in Patients with Systemic Lupus Erythematosus: Nature and Frequency; Characteristics Depending on Gender, Age and Disease Duration

Kobak¹,

Abrahamovych²,

Abrahamovych³

et al. 2023

Lʹviv. klin. visn.

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Introduction. Systemic lupus erythematosus (SLE) is a disease with numerous clinical manifestations and an unpredictable course. It often lasts for several months or years, with alternating remissions and exacerbations. Multiple organs can be affected simultaneously with varying degrees of severity, resulting in treatment- and disease-related comorbidities, including circulatory system diseases, which are one of the leading causes of death of SLE patients. The aim of the study. To find out the nature and frequency of the circulatory system organs comorbid lesions in patients with systemic lupus erythematosus, to characterize them depending on the gender, age and the disease duration. Materials and methods. Prior to performing the study all patients signed the voluntary consent to participate in accordance with the requirements of Helsinki Declaration of Human Rights, the Council of Europe Convention on Human Rights and Biomedicine. The cohort under investigation included 112 patients with diagnosed SLE of different severity with preliminary stratification as follows: females 89.29 %, patients of working age (57.14 % – young and 39.29 % – middle aged), unemployed (58.04 %), III disability group patients (45.54 %), city residents (62.50 %). According to the results of the disease duration assessment, a significant number of patients with SLE and circulatory system organs comorbid lesions have been ill for 1–5 years (36.61 %) and more than 10 years (38.39 %). All of them were patients of the rheumatology department of the Communal Non-Profit Enterprise of the Lviv Regional Council “Lviv Regional Clinical Hospital” from 2016 to 2021.The research was carried out in several stages, during which the nature and frequency of the circulatory system comorbid lesions with respect to gender, age and disease duration were estimated. Results. While completing the study, almost half of patients with SLE were diagnosed with Raynaud’s syndrome, mitral valve insufficiency and atherosclerosis, about 1/3 – with myocarditis, retinal angiopathy, symptomatic arterial hypertension and livedo reticularis. The varicose veins of the lower extremities, hypertensive disease, diffuse cardiosclerosis, tricuspid valve insufficiency, vein thrombosis, post-thrombophlebitis syndrome, aortic valve insufficiency, capillaritis, pulmonary hypertension, coronary artery disease (CAD) including stable angina pectoris, cardiomyopathy and post-infarction cardiosclerosis were found with the decreasing frequency. Raynaud’s syndrome was significantly more often diagnosed in females and young people; retinal angiopathy, livedo reticularis and symptomatic arterial hypertension – in females and those patients whose SLE lasted for more than 10 years; myocarditis, varicose veins of the lower extremities – in males; capillaritis – in patients with the shortest duration of SLE; atherosclerosis and mitral valve insufficiency – in elderly patients and patients with SLE lasting for 6–10 years; vein thrombosis and stable angina – in elderly patients and those with SLE lasting for more than 10 years; hypertensive disease, diffuse cardiosclerosis, aortic valve insufficiency, post-infarction cardiosclerosis were the most characteristic for the elderly patients with SLE. Conclusions. In patients with systemic lupus erythematosus, a number of circulatory system organs comorbid lesions were found. Having studied their nature and frequency, characterizing them depending on gender, age and the disease duration, we found out the certain features that should be taken into consideration during the screening examination of circulatory system disorders in patients with systemic lupus erythematosus and providing them the integrated care to improve their life quality. With this in mind, systemic lupus erythematosus requires further detailed study.

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Section: Introduction Systemic Lupus Erythematosus (Sle)mentioning

confidence: 99%

Circulatory System Organs Comorbid Lesions in Patients with Systemic Lupus Erythematosus: Nature and Frequency; Characteristics Depending on Gender, Age and Disease Duration

Kobak¹,

Abrahamovych²,

Abrahamovych³

et al. 2023

Lʹviv. klin. visn.

Self Cite

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“…Among the diseases that make up the polymorbid background, the diseases that have a common pathogenetic link with the underlying disorder or other dependence between them (anatomical proximity to the affected organs, causal relationship) deserve the greatest attention. However, the accidental combination of pathologies is not excluded [1,2].…”

Section: Introductionmentioning

confidence: 99%

Features of the State of Internal Organs and the Structure of Comorbidity in Deceased Persons With Alcoholic Liver Cirrhosis, Non-alcoholic Fatty Liver Disease at the Cirrhosis Stage and Alcoholic Liver Cirrhosis Associated With Insulin Resistance and Obesity

Matkovska¹

2020

Lʹviv. klin. visn.

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Redox-Homeostasis Features in Patients With Liver Cirrhosis Depending on Severity of the Internal Organs Syntropic Comorbid Lesions

Abrahamovych

Fayura

et al. 2020

EUMJ

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Relevance and purpose. Oxidative stress, as an imbalance in the anti-/prooxidants system, is a direct cause or one of the most important pathogenetic links of many diseases. Liver cirrhosis is not an exception. With its decompensation the syntropic comorbid lesions that worsen prognosis and often cause the death of patients of working age occur. However, despite the prevalence of studying the pathogenetic mechanisms of liver cirrhosis, the relationship between the content of pro- and antioxidants in the blood and the presence of comorbidities in different C. H. Child – R. N. Pugh classes is still insufficiently studied. Therefore, the aim of the study is to identify the redox homeostasis features in patients with liver cirrhosis depending on the internal organs syntropic comorbid lesions severity. Materials and methods. The study was conducted in two stages. 75 patients (23 females (30.7%), 52 males (68.3%) (mean age – 47.2 ± 10.4 years) were included in the randomized trial with the preliminary stratification by the presence of liver cirrhosis. All of them were hospitalized and treated at the Department of Internal Medicine 1 at Danylo Halytsky Lviv National Medical University and the Gastroenterology Department of Lviv Regional Clinical Hospital – Lviv Regional Hepatology Center. All patients underwent the complex comprehensive clinical laboratory and instrumental examination of all organs and systems in accordance with the requirements of the modern medicine. To study the redox homeostasis state the contents of catalase and thiobarbituric acid products, in particular malondialdehyde, were determined. At the first stage, we determined the levels of malondialdehyde and catalase in the cirrhotic patients and syntropic comorbid lesions of the internal organs. According to the second stage we studied the dependence between the characteristic parameters of redox homeostasis changes and the severity of syntropic comorbidities in the cirrhotic patients using the correlation analysis. The actual material was handled on a personal computer in Excel 2010, Statistica 6.0, RStudio v. 1.1.442 and R Commander v.2.4-4 using descriptive statistics. The results obtained in the case of normal distribution were presented as M ± σ, where n is the number of patients examined in the group, in case of abnormal distribution – Me [25,0%; 75.0%]. The difference was considered statistically significant if p < 0.05. Results. In accordance with the first stage of the study, it was found that the malondialdehyde content was highest in patients with liver cirrhosis and varicose veins of the esophagus (VVE) of 3 degree, cirrhotic gastropathy (CGP) of 3 degree, varicose hemorrhoid veins (VHV) of 2 degree, cirrhotic cardiomyopathy of 3 degree, arterial hypotension of 2 degree, hepatopulmonary syndrome of 3 degree, hepatic encephalopathy (HE) of 3 degree, osteoporosis of 3 degree, anemia of 3 degree. The content of catalase was the lowest in patients with liver cirrhosis and with 3 degree VVE, 3 degree CGP, 3 degree VHV, 3 degree arterial hypotension, 3 degree hepatopulmonary syndrome, 3 degree HE, 2 degree osteoporosis, 2 degree anemia. In accordance with the second stage of the study it was revealed that the severity of VVE, CGP, VHV, cirrhotic cardiomyopathy, hepatopulmonary syndrome of hepatic encephalopathy, osteoporosis significantly increases with malondialdehyde content increasing. In its turn the content of catalase decreases with the VVE, CGP, VHV, cirrhotic cardiomyopathy, arterial hypotension, hepatopulmonary syndrome, osteoporosis severity increase. Conclusions. Patients with liver cirrhosis have some features of redox homeostasis disorders with increasing of malondialdehyde and decreased of catalase content, depending on the severity of the synthropic comorbid lesions of the internal organs, the correlation of which is most pronounced in the presence of hepatopulmonary syndrome, osteoporosis and cirrhotic cardiomyopathy.

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Comorbidity: a Modern View on the Problem; Classification (first notice)

Cited by 16 publications

References 33 publications

Circulatory System Organs Comorbid Lesions in Patients with Systemic Lupus Erythematosus: Nature and Frequency; Characteristics Depending on Gender, Age and Disease Duration

Circulatory System Organs Comorbid Lesions in Patients with Systemic Lupus Erythematosus: Nature and Frequency; Characteristics Depending on Gender, Age and Disease Duration

Features of the State of Internal Organs and the Structure of Comorbidity in Deceased Persons With Alcoholic Liver Cirrhosis, Non-alcoholic Fatty Liver Disease at the Cirrhosis Stage and Alcoholic Liver Cirrhosis Associated With Insulin Resistance and Obesity

Redox-Homeostasis Features in Patients With Liver Cirrhosis Depending on Severity of the Internal Organs Syntropic Comorbid Lesions

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