Suicide and other causes of mortality after post-partum psychiatric admission

1998 ◽  
Vol 173 (3) ◽  
pp. 209-211 ◽  
Author(s):  
Louis Appleby ◽  
Preben B. Mortensen ◽  
E. Brian Faragher
Keyword(s):  
Psychiatric Disorder ◽  
Psychiatric Hospital ◽  
Post Partum ◽  
High Rate ◽  
First Year ◽  
Psychiatric Admission ◽  
Case Register ◽  
Postnatal Women ◽  
Causes Of Mortality ◽  
One Year

BackgroundThe risk of suicide in postnatal women is low and those suicides that occur appear to be associated with severe psychiatric illness. No previous study has specifically studied the risk of suicide following post-partum psychiatric disorder.MethodWe calculated standardised mortality ratios (SMRs) for suicide, unnatural deaths and deaths from natural causes for women admitted to psychiatric hospital in the first year after childbirth, using computerised cross-linkages between the Danish Psychiatric Case Register and the Danish registers of birth and causes of death for 1973–1993.ResultsDuring the study period 1567 women were admitted to psychiatric hospital of whom 107 (6.8%) died. The SMRs (compared with 100) were 1719 (95% CI 1284–2254) for suicide, 1329 (95% CI 1038–1676) for all unnatural causes and 238 (95% CI 167–329) for natural causes. Suicides and deaths from all unnatural causes were most likely to occur in the first year after childbirth, the SMR for suicide within one year being 7216 (95% CI 3945–12 108).ConclusionsAlthough postnatal women as a whole appear to have a low rate of suicide, severe post-partum psychiatric disorder is associated with a high rate of deaths from natural and unnatural causes, particularly suicide. The risk is especially high in the first postnatal year, when the suicide risk is increased 70-fold. Close clinical superivision at this time is indicated.

scholarly journals The First Fifty ABO Blood Group Incompatible Kidney Transplantations: The Rotterdam Experience

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Madelon van Agteren ◽  
Willem Weimar ◽  
Annelies E. de Weerd ◽  
Peter A. W. te Boekhorst ◽  
Jan N. M. Ijzermans ◽  
...  
Keyword(s):  
Graft Survival ◽  
Intravenous Immunoglobulins ◽  
High Rate ◽  
Long Term Results ◽  
Control Group ◽  
First Year ◽  
Single Center Experience ◽  
Kidney Transplantations ◽  
One Year

This study describes the single center experience and long-term results of ABOi kidney transplantation using a pretransplantation protocol involving immunoadsorption combined with rituximab, intravenous immunoglobulins, and triple immune suppression. Fifty patients received an ABOi kidney transplant in the period from 2006 to 2012 with a follow-up of at least one year. Eleven antibody mediated rejections were noted of which 5 were mixed antibody and cellular mediated rejections. Nine cellular mediated rejections were recorded. Two grafts were lost due to rejection in the first year. One-year graft survival of the ABOi grafts was comparable to 100 matched ABO compatible renal grafts, 96% versus 99%. At 5-year follow-up, the graft survival was 90% in the ABOi versus 97% in the control group. Posttransplantation immunoadsorption was not an essential part of the protocol and no association was found between antibody titers and subsequent graft rejection. Steroids could be withdrawn safely 3 months after transplantation. Adverse events specifically related to the ABOi protocol were not observed. The currently used ABOi protocol shows good short and midterm results despite a high rate of antibody mediated rejections in the first years after the start of the program.

Parasuicide in the first postnatal year

1995 ◽  
Vol 25 (5) ◽  
pp. 1087-1090 ◽  
Author(s):  
Louis Appleby ◽  
Gill Turnbull
Keyword(s):  
Confidence Interval ◽  
Psychiatric Disorder ◽  
Odds Ratio ◽  
Catchment Area ◽  
Psychiatric Morbidity ◽  
High Rate ◽  
Prevention Services ◽  
Postnatal Women ◽  
Self Harm ◽  
Area Data

SYNOPSISData were collected on a consecutive 6 month sample of women aged 15–44 years attending their catchment area Casualty Department because of parasuicide. Information included age and childbirth within the previous year. Using this information and catchment area data on population size and births, an odds ratio for parasuicide in postnatal as compared to nonpostnatal women was calculated. Five of 131 study subjects had delivered a baby in the previous 12 months. The odds ratio was calculated to be 0·43 (95% confidence interval 0·17–0·95). These findings suggest that the rate of parasuicide in the first postnatal year is low despite the high rate of psychiatric morbidity at this time. The result supports previous findings on suicide and suggests that postnatal women, despite their high rates of psychiatric disorder, are protected against fatal and non-fatal self harm. The implications for postnatal and suicide prevention services are discussed.

scholarly journals A retrospective analysis on acceptability and complications of PPIUCD insertion

2018 ◽  
Vol 7 (11) ◽  
pp. 4536
Author(s):  
Prabha Lal ◽  
Nihita Pandey ◽  
Abha Singh
Keyword(s):  
Family Planning ◽  
Post Partum ◽  
Tertiary Care ◽  
Unmet Need ◽  
First Year ◽  
Care Hospital ◽  
Population Crisis ◽  
One Year ◽  
Long Acting

Background: In India, 65% of women in the first year postpartum have an unmet need for family planning but only 26% of women are using any method of family planning during the first year postpartum. This leaves a huge gap which needs to be addressed if maternal health is to be optimized. This calls for a method which is both effective and acceptable immediately post-partum. This is where the role of PPIUCD needs to be studied.Methods: This study was a retrospective observational study conducted in a tertiary care hospital. All deliveries during the time period from September 2016 to August 2017 were included in the study and the women accepting PPIUCD were studied for analysed for their age, parity, booking status and complaints during the follow up visit.Results: A total of 13,039 deliveries took place in one year between Sept 2016 to Aug 2017 out of which, 1118 (8.6%) accepted PPIUCD as a method of contraception. 44.3% PPIUCD users were in the age group of 21-25 years. 57% of PPIUCD users were primigravidas. 84% of PPIUCD users were booked cases. Missing threads was the most common complication, with 8.4% patients reporting it at follow up. There were no major complications noted in the study.Conclusions: PPIUCD is a safe and effective long acting reversible contraception method. Is particularly beneficial in a setting where women do not return for contraceptive advice. With low expulsion rates and high continuation rate, authors can conclude that PPIUCD can be the solution to a country like India currently facing population crisis and high unmet need.

Tennis- und Golfer-Ellenbogen

2015 ◽  
Vol 63 (4) ◽  
Keyword(s):  
Spontaneous Recovery ◽  
Clinical Symptoms ◽  
Lateral Epicondylitis ◽  
High Rate ◽  
Evidence Based ◽  
Physical Methods ◽  
Local Injections ◽  
One Year ◽  
Golfer’S Elbow ◽  
Non Surgical Treatment

“Tennis and golfer’s elbow” are common pathologies due to overload of forearm extensors and flexors, and actually occur mostly outside tennis and golf sports. Several differential diagnoses of medial and lateral epicondylitis have to be excluded as there are a number of other conditions with similar clinical symptoms. The high rate of spontaneous recovery has to be considered in treatment. Evidence based conservative treatment comprises excentric physiotherapy, local injections, and physical methods. Surgery is reserved for patients with persistence of symptoms for more than one year despite non-surgical treatment.

Obtaining Secondary Treatment with RBC/Underflow Clarifiers

1982 ◽  
Vol 14 (6-7) ◽  
pp. 429-442
Author(s):  
I L Bogert
Keyword(s):  
Treatment Process ◽  
High Rate ◽  
Experimental Program ◽  
Secondary Treatment ◽  
Lower Zone ◽  
Treatment Efficiency ◽  
Winter Conditions ◽  
Rotating Biological Contactors ◽  
One Year ◽  
The U.S

A one-year experimental program conducted at Edgewater, New Jersey, U.S.A. evaluated the concept of providing secondary treatment by the installation of rotating biological contactors (RBC's) in modified primary sedimentation tanks. A primary tank was divided horizontally into two zones separated by an intermediate floor. Four RBC's were placed in the upper zone. The lower zone provided secondary sedimentation. High rate primary sedimentation was provided to remove grit and trash without removing substantial portions of BOD and SS. The experimental program funded by the U.S. EPA and the Borough of Edgewater was conducted over a full year at different loads. The system proved to be an effective secondary treatment process with little difference in treatment efficiency between summer and winter conditions.

scholarly journals Cardiovascular risk factors associated with acute myocardial infarction and stroke in the MADIABETES cohort

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
M. A. Salinero-Fort ◽  
F. J. San Andrés-Rebollo ◽  
J. Cárdenas-Valladolid ◽  
M. Méndez-Bailón ◽  
R. M. Chico-Moraleja ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Antihypertensive Drugs ◽  
Hdl Cholesterol ◽  
First Year ◽  
Backward Elimination ◽  
One Year ◽  
Time Varying Covariates

AbstractWe aimed to develop two models to estimate first AMI and stroke/TIA, respectively, in type 2 diabetes mellitus patients, by applying backward elimination to the following variables: age, sex, duration of diabetes, smoking, BMI, and use of antihyperglycemic drugs, statins, and aspirin. As time-varying covariates, we analyzed blood pressure, albuminuria, lipid profile, HbA1c, retinopathy, neuropathy, and atrial fibrillation (only in stroke/TIA model). Both models were stratified by antihypertensive drugs. We evaluated 2980 patients (52.8% women; 67.3 ± 11.2 years) with 24,159 person-years of follow-up. We recorded 114 cases of AMI and 185 cases of stroke/TIA. The factors that were independently associated with first AMI were age (≥ 75 years vs. < 75 years) (p = 0.019), higher HbA1c (> 64 mmol/mol vs. < 53 mmol/mol) (p = 0.003), HDL-cholesterol (0.90–1.81 mmol/L vs. < 0.90 mmol/L) (p = 0.002), and diastolic blood pressure (65–85 mmHg vs. < 65 mmHg) (p < 0.001). The factors that were independently associated with first stroke/TIA were age (≥ 75 years vs. < 60 years) (p < 0.001), atrial fibrillation (first year after the diagnosis vs. more than one year) (p = 0.001), glomerular filtration rate (per each 15 mL/min/1.73 m2 decrease) (p < 0.001), total cholesterol (3.88–6.46 mmol/L vs. < 3.88 mmol/L) (p < 0.001), triglycerides (per each increment of 1.13 mmol/L) (p = 0.031), albuminuria (p < 0.001), neuropathy (p = 0.01), and retinopathy (p = 0.023).

scholarly journals Mortality in older adults following a fragility fracture: real-world retrospective matched-cohort study in Ontario

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jacques P. Brown ◽  
Jonathan D. Adachi ◽  
Emil Schemitsch ◽  
Jean-Eric Tarride ◽  
Vivien Brown ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hip Fracture ◽  
Fragility Fracture ◽  
Mortality Risk ◽  
Real World ◽  
First Year ◽  
Matched Cohort ◽  
Matched Cohort Study ◽  
Fracture Cohort ◽  
One Year

Abstract Background Recent studies are lacking reports on mortality after non-hip fractures in adults aged > 65. Methods This retrospective, matched-cohort study used de-identified health services data from the publicly funded healthcare system in Ontario, Canada, contained in the ICES Data Repository. Patients aged 66 years and older with an index fragility fracture occurring at any osteoporotic site between 2011 and 2015 were identified from acute hospital admissions, emergency and ambulatory care using International Classification of Diseases (ICD)-10 codes and data were analyzed until 2017. Thus, follow-up ranged from 2 years to 6 years. Patients were excluded if they presented with an index fracture occurring at a non-osteoporotic fracture site, their index fracture was associated with a trauma code, or they experienced a previous fracture within 5 years prior to their index fracture. This fracture cohort was matched 1:1 to controls within a non-fracture cohort by date, sex, age, geography and comorbidities. All-cause mortality risk was assessed. Results The survival probability for up to 6 years post-fracture was significantly reduced for the fracture cohort vs matched non-fracture controls (p < 0.0001; n = 101,773 per cohort), with the sharpest decline occurring within the first-year post-fracture. Crude relative risk of mortality (95% confidence interval) within 1-year post-fracture was 2.47 (2.38–2.56) in women and 3.22 (3.06–3.40) in men. In the fracture vs non-fracture cohort, the absolute mortality risk within one year after a fragility fracture occurring at any site was 12.5% vs 5.1% in women and 19.5% vs 6.0% in men. The absolute mortality risk within one year after a fragility fracture occurring at a non-hip vs hip site was 9.4% vs 21.5% in women and 14.4% vs 32.3% in men. Conclusions In this real-world cohort aged > 65 years, a fragility fracture occurring at any site was associated with reduced survival for up to 6 years post-fracture. The greatest reduction in survival occurred within the first-year post-fracture, where mortality risk more than doubled and deaths were observed in 1 in 11 women and 1 in 7 men following a non-hip fracture and in 1 in 5 women and 1 in 3 men following a hip fracture.

scholarly journals Across the COVID-19 Waves; Assessing Temporal Fluctuations in Perceived Stress, Post-Traumatic Symptoms, Worry, Anxiety and Civic Moral Disengagement over One Year of Pandemic

2021 ◽  
Vol 18 (11) ◽  
pp. 5651
Author(s):  
Alessio Gori ◽  
Eleonora Topino
Keyword(s):  
Perceived Stress ◽  
State Anxiety ◽  
Moral Disengagement ◽  
Online Survey ◽  
Well Being ◽  
First Year ◽  
Effective Interventions ◽  
Post Traumatic ◽  
One Year ◽  
Traumatic Symptoms

This study aimed at investigating the psychological effect of the COVID-19 pandemic in Italy by analysing the trends of perceived stress, post-traumatic symptoms, state anxiety, worry, and civic moral disengagement in four different moments from March 2020 to March 2021. The study involved a total of 1827 Italian participants (30% men and 70% women; Mage = 34.72; SD = 12.40) divided into four groups to which an online survey was administered. The first group completed the survey in March 2020, the second one in August 2020, the third one in November 2020, and the fourth one in March 2021. Results highlighted significant decreases in post-traumatic symptoms and a significant increase in civic moral disengagement over the first year of the COVID-19 pandemic. The levels of perceived stress, worry, and state anxiety remained constant. The correlations between the variables at different times were also explored, as well as gender differences over the year. The COVID-19 emergency has had significant effects on the mental state of the population, with important repercussions for individual and collective well-being during but probably also after the pandemic. This study offers a clear snapshot of the psychological outcomes over one COVID-19 pandemic year, providing important information that may contribute to tailor more effective interventions for mental health.

Breast-feeding in Manila, Philippines preliminary results from a longitudinal study

1985 ◽  
Vol 17 (S9) ◽  
pp. 137-146 ◽  
Author(s):  
Mayling Simpson-Hebert ◽  
Lorna P. Makil
Keyword(s):  
Longitudinal Study ◽  
Breast Feeding ◽  
Low Income ◽  
Post Partum ◽  
Maternity Hospital ◽  
Cultural Factors ◽  
Bottle Feeding ◽  
Early Termination ◽  
First Year ◽  
Low Income Families

SummaryLongitudinal data collected over a 2-year period (1982–84) on 152 first and second parity mothers who were delivered in a charity maternity hospital in Manila, Philippines, indicate the reasons for never brest-feeding and for early termination of brest-feeding. Socio-Cultural factors and beliefs are more important than physiological problems in minating breast-feeding.Proper bottle-feeding is too costly for most low-income families. Bottle-fed babies have a higher incidence of diarrhoea. Mothers who change from breast- to bottle-feeding in the first 6 months are 1·7 times as likely to become pregnant in the first year post-partum as mothers Who brest-feed for 7 or more months.

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