Methods In a cross-sectional study we extracted data on 40 morbidities from a database of 1 751

841 people registered with 314 medical practices in Scotland as of March, 2007. We analysed the data according to the number of morbidities, disorder type (physical Sotrastaurin purchase or mental), sex, age, and socioeconomic status. We defined multimorbidity as the presence of two or more disorders.

Findings 42.2% (95% CI 42.1-42.3) of all patients had one or more morbidities, and 23.2% (23.08-23.21) were multimorbid. Although the prevalence of multimorbidity increased substantially with age and was present in most people aged 65 years and older, the absolute number of people with multimorbidity was higher in those younger than 65 years (210 500 vs 194 996). Onset of this website multimorbidity occurred 10-15 years earlier in people living in the most deprived areas compared with the most affluent, with socioeconomic deprivation particularly associated with multimorbidity that included mental health disorders

(prevalence of both physical and mental health disorder 11.0%, 95% CI 10.9-11.2% in most deprived area vs 5.9%, 5.8%-6.0% in least deprived). The presence of a mental health disorder increased as the number of physical morbidities increased (adjusted odds ratio 6.74, 95% CI 6.59-6.90 for five or more disorders vs 1.95, 1.93-1.98 for one disorder), and was much greater in more deprived than in less deprived people (2.28, 2.21-2.32 vs 1.08, 1.05-1.11).

Interpretation Our findings challenge the single-disease framework

by which most health care, medical research, and medical education is configured. A complementary strategy is needed, supporting generalist clinicians to provide personalised, comprehensive continuity of care, especially in socioeconomically deprived areas.”
“In our CYTH4 previous study we showed that central pain syndrome (CPS) induced by electrolytic injury caused in the unilateral spinothalamic tract (SIT) is a concomitant of glial alteration at the site of injury. Here, we investigated the activity of glial cells in thalamic ventral posterolateral nuclei (VPL) and their contribution to CPS. We also examined whether post-injury administration of a pharmacological dose of estradiol can attenuate CPS and associated molecular changes. Based on the results,in the ipsilateral VPL the microglial phenotype switched o hyperactive mode and Iba1 expression was increased significantly on days 21 and 28 post-injury. The same feature was observed in contralateral VPL on day 28 (P<.05). These changes were strongly correlated with the onset of CPS (r(2) = 0.670). SIT injury did not induce significant astroglial response in both ipsilateral and contralateral VPL. Estradiol attenuated bilateral mechanical hypersensitivity 14 days after SIT lesion (P<.05).