Rising to the challenge of multimorbidity
Christopher J. M. Whitty,Carrie MacEwen,Andrew Goddard,Derek Alderson,Martin Marshall,Catherine Calderwood,Frank Atherton,Michael McBride,John Atherton,Helen Stokes-Lampard,Wendy Reid,Stephen Powis,Clare Marx +12 more
TLDR
The next generation of scientists will need to combine generalist and specialist skills in order to compete in the rapidly changing world of information and communications.Abstract:
Tuberculosis is a leading cause of infectious disease–related death worldwide; however, only 10% of people infected with Mycobacterium tuberculosis develop disease. Factors that contribute to protection could prove to be promising targets for M. tuberculosis therapies. Analysis of peripheral blood gene expression profiles of active tuberculosis patients has identified correlates of risk for disease or pathogenesis. We sought to identify potential human candidate markers of host defense by studying gene expression profiles of macrophages, cells that, upon infection by M. tuberculosis, can mount an antimicrobial response. Weighted gene coexpression network analysis revealed an association between the cytokine interleukin-32 (IL-32) and the vitamin D antimicrobial pathway in a network of interferon-γ– and IL-15–induced “defense response” genes. IL-32 induced the vitamin D–dependent antimicrobial peptides cathelicidin and DEFB4 and to generate antimicrobial activity in vitro, dependent on the presence of adequate 25-hydroxyvitamin D. In addition, the IL-15–induced defense response macrophage gene network was integrated with ranked pairwise comparisons of gene expression from five different clinical data sets of latent compared with active tuberculosis or healthy controls and a coexpression network derived from gene expression in patients with tuberculosis undergoing chemotherapy. Together, these analyses identified eight common genes, including IL-32, as molecular markers of latent tuberculosis and the IL-15–induced gene network. As maintaining M. tuberculosis in a latent state and preventing transition to active disease may represent a form of host resistance, these results identify IL-32 as one functional marker and potential correlate of protection against active tuberculosis.read more
Citations
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Examining variation in the measurement of multimorbidity in research: a systematic review of 566 studies.
Iris Iris Szu-Szu Ho,Amaya Azcoaga-Lorenzo,Ashley Akbari,Corri Black,Jim Davies,Peter Hodgins,Kamlesh Khunti,Umesh T. Kadam,Ronan A Lyons,Colin McCowan,Stewart W Mercer,Krishnarajah Nirantharakumar,Bruce Guthrie +12 more
TL;DR: In this article, the authors used Health Data Research UK (HDR-UK) grant number CFC0110 to support the development of the Wellcome Trust-funded British Heart Foundation (BHF).
Journal ArticleDOI
Beliefs about the body and pain: the critical role in musculoskeletal pain management.
TL;DR: Clinicians are encouraged to exercise self-reflection to explore their own beliefs and better understand their biases, which may influence their management of patients with musculoskeletal pain.
Journal ArticleDOI
Impact of multimorbidity on healthcare costs and utilisation: a systematic review of the UK literature
Marina Soley-Bori,Mark Ashworth,Alessandra Bisquera,Hiten Dodhia,Rebecca Lynch,Yanzhong Wang,Julia Fox-Rushby +6 more
TL;DR: In the UK, multimorbidity increases healthcare utilisation and costs of primary, secondary, and dental care and future research is needed to examine whether integrated care schemes offer efficiencies in healthcare provision for multimorbridity.
Journal ArticleDOI
Prevalence and patterns of multimorbidity among the elderly in China: a cross-sectional study using national survey data.
TL;DR: Asthma, stroke, heart attack and six other chronic conditions were the main components of multimorbidity due to their high relative risk ratios and highlighted the high prevalence of multimOrbidity in the elderly population in China.
Journal ArticleDOI
Plasma metabolites to profile pathways in noncommunicable disease multimorbidity.
Maik Pietzner,Isobel D. Stewart,Johannes Raffler,Kay-Tee Khaw,Gregory A. Michelotti,Gabi Kastenmüller,Nicholas J. Wareham,Claudia Langenberg,Claudia Langenberg +8 more
TL;DR: In this paper, the authors used baseline untargeted plasma metabolomics profiling covering >1,000 metabolites to characterize pathways associated with and across 27 incident non-communicable diseases (NCDs) assessed using electronic health record hospitalization and cancer registry data from over 11,000 participants (219,415 person years).
References
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Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study
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Adapting clinical guidelines to take account of multimorbidity
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Journal ArticleDOI
Prevalence and patterns of multimorbidity among the elderly in China: a cross-sectional study using national survey data.
TL;DR: Asthma, stroke, heart attack and six other chronic conditions were the main components of multimorbidity due to their high relative risk ratios and highlighted the high prevalence of multimOrbidity in the elderly population in China.
Journal ArticleDOI
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