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e thought provoking for patients, healthcare providers and policy-makers in both jurisdictions.
The overall aim of this study is to gain greater knowledge about the risk of suicide among suicide attempters in a very long-term perspective. Specifically, to investigate possible differences in clinical risk factors at short (≤5 years) versus long term (>5 years), with the hypothesis that risk factors differ in the shorter and longer perspective.
Prospective study with register-based follow-up for 21-32 years.
Medical emergency inpatient unit in the south of Sweden.
1044 individuals assessed by psychiatric consultation when admitted to medical inpatient care for attempted suicide during 1987-1998.
Suicide and all-cause mortality.
At follow-up, 37.6% of the participants had died, 7.2% by suicide and 53% of these within 5 years of the suicide attempt. A diagnosis of psychosis at baseline represented the risk factor with the highest HR at long-term follow-up, that is, >5 years, followed by major depression and a history of attempted suicide before the index attempt. The severity of a suicide than at long term. This should be considered in the assessment of suicide risk and the implementation of care for these individuals.
Integration of evidence-based interventions for alcohol use disorders (AUDs) into primary healthcare has potential to increase coverage and reduce population burden. However, these interventions are rarely implemented in low- and middle-income countries and there is little existing guidance on how this could be achieved. Niacinamide The aim of the proposed study is to adapt and pilot an integrated model for AUDs in Tanzanian primary healthcare.
The study design will include a situational analysis, a qualitative study, a series of participatory Theory of Change (ToC) workshops and pilot intervention study. The evidence-based packages of care for AUD from the WHO mental health Gap Intervention Guide will form the basis of intervention. The situation analysis will use publicly available data to identify existing resources and system functioning. In-depth interviews will be conducted with key stakeholders (people with lived experience of substance use problems, health workers, health planners and community-based organisam Addis Ababa University College of Health Science Institutional Review Board and Muhimbili University of Health and Allied Sciences Institutional Review Board. Findings will be disseminated to inform strategies for scale up of integrated interventions for people with AUDs in Tanzania and similar contexts.
This study evaluates the impact of frailty, which is a state of increased vulnerability to stressors, on 30-day and 1-year mortality among elderly patients with community-acquired pneumonia (CAP). The main hypothesis is that frailty is an independent predictor of prognosis in elderly CAP patients.
Prospective, observational, follow-up cohort study.
A 2000-bed tertiary care hospital in Beijing, China.
Consecutive CAP patients aged ≥65 years admitted to the geriatric department of our hospital between September 2017 and February 2019.
The primary outcomes were all-cause mortality at 30 days and 1 year after hospital admission. The impact of frailty (defined by frailty phenotype) on 30-day and 1-year mortality of elderly patients with CAP was assessed by Cox regression analysis.
The cohort included 256 patients. The median (IQR) age was 86 (81-90) years, and 180 (70.3%) participants were men. A total of 171/256 (66.8%) patients were frail. The prevalence of frailty was significantly associated with ots with CAP, and frailty should be detected early to improve the management of these patients.
Postoperative atrial fibrillation (POAF) is a potentially lethal and morbid complication after open heart surgery. This systematic review and meta-analysis aimed to investigate metoprolol compared with other treatments for prophylaxis against POAF.
We searched CENTRAL, MEDLINE, EMBASE and trial registries for randomised controlled trials that evaluated metoprolol for preventing the occurrence of POAF after surgery against other treatments or placebo. Random-effects model was used for estimating the risk ratios (RRs) and mean differences with 95% CIs.
Nine trials involving 1570 patients showed metoprolol reduced POAF compared with placebo (416 patients; RR 0.46, 95% CI 0.33 to 0.66; I²=21%; risk difference (RD) -0.19, 95% CI -0.28 to -0.10). However, metoprolol increased the risk of POAF compared with carvedilol (159 patients; RR 1.59, 95% CI 1.20 to 2.12; I²=4%; RD 0.13, 95% CI 0.06 to 0.20). There was no difference when compared with sotalol or amiodarone. The occurrence of cardiovascular conditions after drugs administration or death between the groups was not different. The overall quality of evidence was moderate to high. Subgroup analysis and funnel plot were not performed.
Metoprolol is effective in preventing POAF compared with placebo and showed no difference with class III antiarrhythmic drugs. Death and thromboembolism are associated with open heart surgery, but not significant in relation to the use of metoprolol.
CRD42019131585.
CRD42019131585.
To identify the prevalence of anaemia among older adults in China by sociodemographic and geographical regions, and cross-sectionally examine the associations between anaemia and several geriatric outcomes.
Cross-sectional study.
Participants were 6656 older adults aged at least 60 years with haemoglobin data from the 2015 to 2016 wave of the China Health and Retirement Longitudinal Study.
We examined the prevalence of anaemia by sociodemographics (age, sex, residence, education, marital status) and geographical regions, adjusting for age. We investigated the associations between anaemia and geriatric conditions.
The prevalence of anaemia was 20.6% among adults ≥60 years and was higher at advanced ages, among those who were females, living in rural areas, and those who were unmarried. The southern region of China had a higher burden of anaemia than the north. Anaemic adults had a higher age-adjusted prevalence of falls, activities of daily living (ADL) disability, instrumental ADL disability, lower extremely functional limitation, upper extremely functional limitation, low gait speed, low grip strength and low self-reported memory.
Homepage: https://www.selleckchem.com/products/Nicotinamide(Niacinamide).html
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