Suicide in Nógrád County, Hungary, 1970-1994

Crisis ◽  
1999 ◽  
Vol 20 (2) ◽  
pp. 64-70 ◽  
Author(s):  
Tamás Zonda
Keyword(s):  
High Risk ◽  
Psychiatric Disorders ◽  
Suicide Rate ◽  
Risk Groups ◽  
The Elderly ◽  
Female Ratio ◽  
Suicide Notes ◽  
Suicidal Intention ◽  
Male Female Ratio

The author examined completed suicides occurring over a period of 25 years in a county of Hungary with a traditionally low (relatively speaking) suicide rate of 25.8. The rates are clearly higher in villages than in the towns. The male/female ratio was close to 4:1, among elderly though only 1.5:1. The high risk groups are the elderly, divorced, and widowed. Violent methods are chosen in 66.4% of the cases. The rates are particularly high in the period April-July. Prior communication of suicidal intention was revealed in 16.3% of all cases. Previous attempts had been undertaken by 17%, which in turn means that 83% of suicides were first attempts. In our material 10% the victims left suicide notes. Psychiatric disorders were present in 60.1% of the cases, and severe, multiple somatic illnesses (including malignomas) were present in 8.8%. The majority of the data resemble those found in the literature.

scholarly journals Demographic Factors of Suicide in Chittagong

2018 ◽  
Vol 16 (2) ◽  
pp. 14-16
Author(s):  
Kazal Kanti Barua ◽  
M Jalal Uddin ◽  
Sumon Mutsuddy ◽  
AYM Masud Reza Khan ◽  
Ashim Barua
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Secondary Data ◽  
Descriptive Study ◽  
Professional Group ◽  
Age Group ◽  
Female Ratio ◽  
High Risk Factors ◽  
The World ◽  
Male Female Ratio

Background: Suicide is a devastating problem. It is to some extent preventable if we are aware of its factors. These factors vary according to community, cast and creed. Many studies were conducted at many places of the world but there is none in Chittagong. To know the high risk factors of suicide in Chittagong we have conducted the study.Methods : It was a descriptive study. Secondary data were used. All suicidal reports of Chittagong mortuary in 2012 were studied. Collected data were managed manually. Results were contrasted with recent studies of home & abroad.Results: Total 165 reports were studied. Majority of the victims 128(78%) were of 15-45 years age group. Male female ratio was 49: 51. Married victims were 109(66%). Muslims 125(76%). Majority of the victims 104(63%) were poorly literate (<SSC). Commonest profession of the victims was ‘housewife’57(35%). Next professional group was lower subordinate staffs 49(30%). Commonest method of suicide was Hanging 83(50%). Family feud was the commonest cause of suicide and it was 72(44%).Conclusion: Commonest demographic factor of suicide in Chittagong is ‘Family Feud’ It is mostly manageable and thus we can prevent suicide occurrence significantly. So, everybody should come forward to remove causes of family feud and others for a noble humanitarian cause.Chatt Maa Shi Hosp Med Coll J; Vol.16 (2); July 2017; Page 14-13

scholarly journals Influenza Vaccination of Healthcare Workers and Vaccine Allocation for Healthcare Workers During Vaccine Shortages

2005 ◽  
Vol 26 (11) ◽  
pp. 882-890 ◽  
Author(s):  
Thomas R. Talbot ◽  
Suzanne F. Bradley ◽  
Sara E. Cosgrove ◽  
Christian Ruef ◽  
Jane D. Siegel ◽  
...  
Keyword(s):  
High Risk ◽  
Influenza Vaccination ◽  
Healthcare Workers ◽  
Close Contact ◽  
Risk Groups ◽  
The Elderly ◽  
Term Care ◽  
Vaccination Rates ◽  
Healthcare Associated ◽  
Vaccine Shortages

AbstractInfluenza causes substantial morbidity and mortality annually, particularly in high-risk groups such as the elderly, young children, immunosuppressed individuals, and individuals with chronic illnesses. Healthcare-associated transmission of influenza contributes to this burden but is often under-recognized except in the setting of large outbreaks. The Centers for Disease Control and Prevention has recommended annual influenza vaccination for healthcare workers (HCWs) with direct patient contact since 1984 and for all HCWs since 1993. The rationale for these recommendations is to reduce the chance that HCWs serve as vectors for healthcare-associated influenza due to their close contact with high-risk patients and to enhance both HCW and patient safety. Despite these recommendations as well as the effectiveness of interventions designed to increase HCW vaccination rates, the percentage of HCWs vaccinated annually remains unacceptably low. Ironically, at the same time that campaigns have sought to increase HCW vaccination rates, vaccine shortages, such as the shortage during the 2004-2005 influenza season, present challenges regarding allocation of available vaccine supplies to both patients and HCWs. This two-part document outlines the position of the Society for Healthcare Epidemiology of America on influenza vaccination for HCWs and provides guidance for the allocation of influenza vaccine to HCWs during a vaccine shortage based on influenza transmission routes and the essential need for a practical and adaptive strategy for allocation. These recommendations apply to all types of healthcare facilities, including acute care hospitals, long-term-care facilities, and ambulatory care settings.

scholarly journals Burden of influenza hospitalization among high-risk groups in the United States

2021 ◽  
Author(s):  
Aimee Near ◽  
Jenny Tse ◽  
Yinong Young-Xu ◽  
David K. Hong ◽  
Carolina M. Reyes
Keyword(s):  
United States ◽  
High Risk ◽  
Risk Groups ◽  
The Elderly ◽  
The United States ◽  
Emergency Department Visits ◽  
Chronic Obstructive ◽  
Elderly Age ◽  
Multivariable Logistic Regression Model ◽  
Stage 1

AbstractBackgroundSeasonal influenza poses a substantial clinical and economic burden in the United States and vulnerable populations, including the elderly and those with comorbidities, are at elevated risk for influenza-related medical complications.MethodsWe conducted a retrospective cohort study using the IQVIA PharMetrics® Plus claims database in two stages. In Stage 1, we identified patients with evidence of medically-attended influenza during influenza seasons from October 1, 2014 to May 31, 2018 (latest available data for Stage 1) and used a multivariable logistic regression model to identify patient characteristics that predicted 30-day influenza-related hospitalization. Findings from Stage 1 informed high-risk subgroups of interest for Stage 2, where we selected cohorts of influenza patients during influenza seasons from October 1, 2014 to March 1, 2019 and used 1:1 propensity score matching to patient without influenza with similar high-risk characteristics to compare influenza-attributable rates of all-cause hospital and emergency department visits during follow-up (30-day and in index influenza season).ResultsIn Stage 1, more than 1.6 million influenza cases were identified, of which 18,509 (1.2%) had a hospitalization. Elderly age was associated with 9 times the odds of hospitalization (≥65 years vs. 5-17 years; OR=9.4, 95% CI 8.8-10.1) and select comorbidities were associated with 2-3 times the odds of hospitalization. In Stage 2, elderly influenza patients with comorbidities had 3 to 7 times higher 30-day hospitalization rates compared to matched patients without influenza, including patients with congestive heart failure (41.0% vs.7.9%), chronic obstructive pulmonary disease (34.6% vs. 6.1%), coronary artery disease (22.8% vs. 3.8%), and late-stage chronic kidney disease (44.1% vs. 13.1%; all p<0.05).ConclusionsThe risk of influenza-related complications is elevated in the elderly, especially those with certain underlying comorbidities, leading to excess healthcare resource utilization. Continued efforts, beyond currently available vaccines, are needed to reduce influenza burden in high-risk populations.

scholarly journals Eldre personer er sårbare i ekstreme værsituasjoner

2009 ◽  
Vol 14 (2) ◽  
Author(s):  
Anette Hylen Ranhoff
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Elderly People ◽  
Heat Waves ◽  
Weather Conditions ◽  
Risk Groups ◽  
The Elderly ◽  
Extreme Weather ◽  
Vulnerable Groups ◽  
Font Size

<span style="font-size: x-small; font-family: TimesNewRomanPSMT;"><span style="font-size: x-small; font-family: TimesNewRomanPSMT;"><p align="left">I fjor sommer ble Europa rammet av en hetebølge og tusenvis av eldre mennesker døde. Sammenhengen mellom helsetilstand og påvirkning av klima er kompleks og medisinske, sosiale og miljømessige faktorer er involvert. Imidlertid er hete- og kulderelaterte sykdommer, skade og død i høy grad mulig å forebygge, og det er behov for å analysere denne situasjonen og andre ekstreme værsituasjoner for å kunne sikre helsen til eldre personer ved liknede hendelser i fremtiden.   Artikkelen gir en oversikt over litteratur som omhandler sykelighet og dødelighet som følge av ekstreme værforhold: hete, kulde og situasjoner der transport, elektrisitet og andre leveranser er begrenset, som etter en orkan, enorme snøfall eller liknende. Sammenhenger mellom sykelighet, dødelighet og temperatur i alminnelighet bli også omtalt, med spesielt fokus på de eldre.            </p><p align="left">Eldre som lever alene og er sosialt isolerte, og spesielt de som har funksjonshemning eller kognitiv svikt har høyest risiko for sykdom, skade og død i ekstreme værsituasjoner. Dette kan trolig i stor grad forebygges. Det anbefales at alle kommuner har kriseplaner for naturkatastrofer og ekstreme værsituasjoner som spesielt inneholder tiltak rettet mot sårbare eldre. Planene bør inneholde generell alarmering og informasjon samt systemer for oppsøkende virksomhet overfor risikogrupper.</p><p align="left"> </p><span style="font-size: x-small; font-family: TimesNewRomanPSMT;"><span style="font-size: x-small; font-family: TimesNewRomanPSMT;"><p>The 2003 heat wave in Europe was responsible for the deaths of thousands of elderly people. Heat- and cold-related illnesses, injuries and deaths are supposed to be largely preventable, and it is a need for analysing this situation and other situations with extreme weather conditions where elderly people are believed to be particularly vulnerable</p><p>This article is a review of the literature concerning morbidity and mortality in extreme weather conditions like heat, cold and situations where transportation, electricity, and other supplies are limited as a consequence of extreme weather such as after a hurricane or an enormous snowfall. Associations between mortality, morbidity and temperature in general are also discussed with focus on the elderly population<strong>. </strong>after a hurricane or an enormous snowfall. The frailest elderly are at the highest risk. In situati The elderly are at high risk for illnesses, injuries and death in extreme weather conditions. There are numerous reports from heat waves, but also cold-related problems are well documented. Other risk factors are disability, cognitive impairment, chronic disease, the use of special drugs and social isolation. Many risk factors are common for heat-, and cold-related problems, and also for other situations like<strong> </strong>ons with extreme weather conditions, we recommend local and central authorities to have emergency plans with special adaptations to the needs of elderly people and other vulnerable groups. These plans should include general warning and information and systems for preventive visits to high-risk groups.</p>. </span></span></span></span>

scholarly journals Alterations in Bone Turnover during Chemotherapy in Children with Acute Lymphoblastic Leukemia

2021 ◽  
Vol 10 (03) ◽  
pp. 183-186
Author(s):  
Vineeta Gupta ◽  
Shalini Dash ◽  
Priyanka Aggarwal ◽  
Surya Kumar Singh
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
High Risk ◽  
Mineral Metabolism ◽  
Lymphoblastic Leukemia ◽  
Risk Groups ◽  
Cell Group ◽  
Enzyme Linked Immunosorbent Assay ◽  
Female Ratio ◽  
Increased Risk ◽  
The Mean

Abstract Background Disturbances of bone metabolism frequently occur in children with acute lymphoblastic leukemia (ALL), leading to increased risk of osteopenia and osteoporosis at diagnosis, during and after completion of chemotherapy. The present study was performed to evaluate alteration in bone mineral metabolism in children with ALL during chemotherapy. Method Fifty newly diagnosed patients with ALL in the age group of 2 to 14 years were included. Relapsed and refractory cases were excluded. Enrolled children were stratified into standard and high risk according to National Cancer Institute criteria. Quantitative analysis of bone resorptive marker carboxyl-terminal telopeptide of human type 1 collagen (ICTP) was assessed at baseline and 3 months after chemotherapy by the sandwich enzyme-linked immunosorbent assay technique. Results Of 50 patients enrolled, 21 were standard and 29 were high risk. The mean age was 7.75 ± 4.0 years and the male-to-female ratio was 3.5:1. ICTP levels were analyzed in 44 patients, of which 37 (84%) showed significantly increased levels. The mean ICTP level in patients at diagnosis and controls was 1.78 ± 1.39 and 0.96 ± 0.32 µg/L, respectively (p = 0.001). The mean ICTP level at 3 months after chemotherapy increased to 3.55 ± 1.40 µg/L (p = 0.000). It was significantly increased in males (p = 0.000) and in B cell ALL group (p = 0.000) in comparison to females and T cell group. Both standard and high risk groups were equally affected (p = 0.000). On multivariate analysis, no single risk factor could be identified. Conclusion The marker of bone resorption (ICTP) in children with ALL was increased at diagnosis, which further increased during chemotherapy. The disease itself and the intensive chemotherapy both contributed to the increased levels.

scholarly journals Pneumococcal Vaccination in High-Risk Individuals: Are We Doing It Right?

2016 ◽  
Vol 23 (5) ◽  
pp. 388-395 ◽  
Author(s):  
Ioanna Papadatou ◽  
Vana Spoulou
Keyword(s):  
High Risk ◽  
Cellular Response ◽  
Pneumococcal Disease ◽  
Pneumococcal Vaccination ◽  
Primary Vaccination ◽  
Risk Groups ◽  
The Elderly ◽  
Polysaccharide Vaccine ◽  
Disease Epidemiology ◽  
Meta Analyses

ABSTRACTControversy exists regarding the optimal use of the 23-valent pneumococcal conjugate vaccine for the protection of high-risk individuals, such as children and adults with immunocompromising conditions and the elderly. The effectiveness and immunogenicity of 23-valent pneumococcal polysaccharide vaccine (PPV23) are limited in such high-risk populations compared to the healthy, with meta-analyses failing to provide robust evidence on vaccine efficacy against invasive pneumococcal disease (IPD) or pneumonia. Moreover, several studies have demonstrated a PPV23-induced state of immune tolerance or hyporesponsiveness to subsequent vaccination, where the response to revaccination does not reach the levels achieved with primary vaccination. The clinical significance of hyporesponsiveness is not yet clarified, but attenuated humoral and cellular response could lead to reduced levels of protection and increased susceptibility to pneumococcal disease. As disease epidemiology among high-risk groups shows that we are still in need of maximum serotype coverage, the optimal use of PPV23 in the context of combined conjugate/polysaccharide vaccine schedules is an important priority. In this minireview, we discuss PPV23-induced hyporesponsiveness and its implications in designing highly effective vaccination schedules for the optimal protection for high-risk individuals.

Neoadjuvant capecitabine and oxaliplatin (CAPOX) followed by chemoradiation (CRT) in high-risk rectal cancer: A single-institution experience.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14100-e14100
Author(s):  
Saif Ahmad ◽  
Deepak Parashar ◽  
Catherine Rachel Jephcott ◽  
Hugo Ford ◽  
Charles Wilson
Keyword(s):  
Rectal Cancer ◽  
High Risk ◽  
Standard Of Care ◽  
Complete Response ◽  
Outcome Data ◽  
R0 Resection ◽  
Chemotherapy Response ◽  
Female Ratio ◽  
High Risk Disease ◽  
Male Female Ratio

e14100 Background: Total Mesorectal Excision (TME) is standard of care in early rectal cancer. Pre-operative CRT facilitates microscopic complete resection (R0), improving outcome in high risk disease. Recent Phase 2 studies investigated the role of neoadjuvant CAPOX chemotherapy pre-CRT with promising results. We have adopted this strategy in high risk cancers with threatened circumferential resection margin (CRM) on MRI, and report our institution’s early outcome data. Methods: Retrospective data was collected on 37 patients with high risk disease treated March 2007 to December 2011. Patients received 12 weeks oxaliplatin (130mg/m2) and capecitabine (1000mg/m2 BD for 14 days) every 3 weeks, followed by CRT (45 Gy/ 25 #) with concurrent capecitabine (800mg/m2 BD). 11/37 patients had a 5.4 Gy/ 3 # boost with CRT. 4 patients were in a clinical trial, 2 of whom had cetuximab in addition to CAPOX. Patients deemed operable on repeat MRI had TME and 4 cycles of adjuvant CAPOX. Results: Median age was 64 (33-78) and male: female ratio 2.1:1. Median follow-up was 22 months (1.9-53.7). 2 patients did not complete 4 cycles neoadjuvant CAPOX due to toxicity. Median time to surgery post CRT was 6.6 weeks (4.7-10 weeks). 1 patient had an embolic event and femoral embolectomy. 7/31 (23%) patients had no post-operative chemotherapy (4 wound; 2 previous toxicity; 1 comorbidity). Radiological response rates post CRT were 26/34 (76%). 2 patients progressed and were unable to have radical surgery. 1 further patient was found to have unsuspected metastatic disease (liver) at time of surgery. 28/35 (80%) patients had R0 resection and pathological complete response (pCR) was 6/37 (16%). 2 year DFS and OS was 89% and 91.3%. Conclusions: Our outcomes, within an unselected cohort, reflect outcomes consistent with published trial data and support routine use of pre-operative CAPOX and CRT in high risk rectal cancers. This strategy is feasible in a non-trial population, and offers the benefit of early sterilisation of micrometastases, better prediction of chemotherapy response and facilitates the incorporation of novel agents within neoadjuvant window studies.

scholarly journals Clinical significance of increased arterial stiffness associated with atrial fibrillation, according to Framingham risk score

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Goh Eun Chung ◽  
Hyo Eun Park ◽  
Heesun Lee ◽  
Su-Yeon Choi
Keyword(s):  
Atrial Fibrillation ◽  
Cardiovascular Risk ◽  
High Risk ◽  
Arterial Stiffness ◽  
Risk Score ◽  
Framingham Risk Score ◽  
Risk Groups ◽  
The Elderly ◽  
High Cardiovascular Risk ◽  
Framingham Risk

AbstractAtrial fibrillation (AF) is the most common arrhythmia in the elderly. Arterial stiffness may predict the risk of AF, but this relationship has not been fully evaluated. We assessed the association between arterial stiffness and prevalent AF. All subjects who had electrocardiography performed and a cardio-ankle vascular index (CAVI) calculated during a screening examination between 2010 and 2019 were enrolled. To evaluate the association between increased arterial stiffness and AF, we divided the population according to their Framingham risk score (FRS) into low-, intermediate-, and high-risk groups. A total of 8048 subjects were evaluated. The multivariate analysis revealed that increased arterial stiffness was significantly associated with AF prevalence, even after adjusting cardiovascular risk factors [odds ratio (OR) 1.685, 95% confidence interval (CI) 1.908–2.588, p = 0.017]. When we subcategorized the subjects according to their FRS, increased arterial stiffness was significantly associated with AF in the intermediate- and high-risk groups (OR 3.062, 95% CI 1.39-6.740 and OR3.877, 95% CI 1.142-13.167, respectively, BMI adjusted. High arterial stiffness shows a significant association with AF in those with intermediate or high cardiovascular risk, and can be used for further risk stratification of patients.

scholarly journals Patients at high risk for a severe clinical course of COVID-19 — small-area data in support of vaccination and other population-based interventions in Germany

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jakob Holstiege ◽  
Manas K. Akmatov ◽  
Claudia Kohring ◽  
Lotte Dammertz ◽  
Frank Ng ◽  
...  
Keyword(s):  
High Risk ◽  
Chronic Conditions ◽  
Small Area ◽  
Risk Group ◽  
Regional Analysis ◽  
Age Groups ◽  
Risk Groups ◽  
The Elderly ◽  
German Population ◽  
Social Law

Abstract Background Research has shown that the risk for a severe course of COVID-19 is increased in the elderly population and among patients with chronic conditions. The aim of this study was to provide estimates of the size of vulnerable populations at high risk for a severe COVID-19 course in Germany based on the currently available risk factor data. Methods We used nationwide outpatient claims data from the years 2010 to 2019 collected according to § 295 of the Code of Social Law V, covering data for all statutory health insurees (SHI) which is nearly 87% of the entire German population. We considered 15 chronic disorders based on the current state of knowledge about clinically relevant risk factors. Three risk groups for a severe COVID-19 course were defined: 1. individuals in the age group 15 to 59 years with at least two comorbid disorders; 2. individuals aged 60 to 79 years with at least one disorder and 3. all individuals 80 years and older irrespective of the presence of chronic conditions. Regional analysis was conducted at the level of administrative districts (n = 401). Results Overall, 26% of individuals over 15 years were at high risk for a severe COVID-19 course in 2019 amounting to a total number of nearly 18.5 million individuals in Germany. This included 3.8 million individuals in risk group 1, 9.2 million in risk group 2, and 5.4 million in risk group 3, corresponding to 8, 50 and 100% of German inhabitants in the respective age groups. On the level of the 17 administrative regions formed by the Association of SHI Physicians (ASHIP regions), the proportion of individuals at high risk ranged between 21% in Hamburg and 35% in Saxony-Anhalt. Small-area estimates varied between 18% in Freiburg (Baden-Württemberg) and 39% in the district Elbe-Elster (Brandenburg). Conclusions The present study provides small-area estimates of populations at high risk for a severe COVID-19 course. These data are of particular importance for planning of preventive measures such as vaccination. Trial registration not applicable.

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