Fractures and the increased risk of suicide

2018 ◽  
Vol 100-B (6) ◽  
pp. 780-786 ◽  
Author(s):  
C-F. Chang ◽  
E. C-C. Lai ◽  
M-K. Yeh
Keyword(s):  
Mental Health Problems ◽  
Conditional Logistic Regression ◽  
Spinal Fractures ◽  
High Rate ◽  
Physical And Mental Health ◽  
Additional Risk ◽  
Never Married ◽  
Increased Risk ◽  
Contextual Setting ◽  
Control Study

Aims A high rate of suicide has been reported in patients who sustain fractures, but the association remains uncertain in the context of other factors. The aim of this study was to examine the association between fractures and the risk of suicide in this contextual setting. Patients and Methods We performed a case-control study of patients aged 40 years or older who died by suicide between 2000 and 2011. We included patients’ demographics, physical and mental health problems, and socioeconomic factors. We performed conditional logistic regression to evaluate the associations between fractures and the risk of suicide. Results We included a total of 34 794 patients who died by suicide and 139 176 control patients. We found that fractures as a homogenous group (adjusted odds ratios (aOR), 1.48; 95% confidence interval (CI) 1.43 to 1.53), and specifically pelvic (aOR 2.04; 95% CI 1.68 to 2.47) and spinal fractures (aOR 1.53; 95% CI 1.43 to 1.64), were associated with a higher risk of suicide. In addition, we found that patients who had a lower income, had never married, had lower levels of educational attainment, or had coexistent physical and mental conditions such as anxiety, mood disorders, and psychosis-related disorders had a higher risk of suicide. Conclusion Fractures, specifically those of the hip and spine, were associated with an increased risk of suicide. The findings suggest that greater clinical attention should be given to this risk in patients with fractures, especially for those with additional risk factors. Cite this article: Bone Joint J 2018;100-B:780–6.

Socio Demographic and Clinical Profile of Indoor Female Patients of RINPAS

2017 ◽  
Vol 8 (1) ◽  
pp. 33
Author(s):  
Rajni Suri ◽  
Anshu Suri ◽  
Neelam Kumari ◽  
Amool R. Singh ◽  
Manisha Kiran
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mentally Ill ◽  
Mental Health Problems ◽  
Demographic Data ◽  
Relevant Information ◽  
Health Problems ◽  
High Rate ◽  
Physical And Mental Health ◽  
Cross Sectional

The role of women is very crucial in our society. She cares for her parents, partner, children and other relatives. She performs all types of duties in family and also in the society without any expectations. Because of playing many roles, women often face many challenges in their life including both physical and mental. Mental health problems affect women and men equally, but some problems are more common among women including both physical and mental health problems. Aim of the study - The present study is aimed to describe and compare the clinical and socio-demographic correlates of female mentally ill patients. Methods and Materials: The study includes 180 female mentally ill patients based on cross sectional design and the sample for the study was drawn purposively. A semi structured socio-demographic data sheet was prepared to collect relevant information as per the need of the study. Result: The present study reveals that the socio-demographic factors contribute a vital role in mental illness. Findings also showed that majority of patients had mental problems in the age range of 20-30 have high rate. Illiterate and primary level of education and daily wage working women as well as low and middle socio-economic status women are more prone to have mental illness. Other factors like marital status, type of family and religion etc also important factors for mental illness. Keywords: Socio demographic profile, female, psychiatric patient

scholarly journals High Rate of Fatal Overdose After Release from Prison In BC, Canada: A Data Linkage Study

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Stuart A Kinner ◽  
Wenqi Gan ◽  
Amanda Slaunwhite
Keyword(s):  
Risk Factors ◽  
Target Population ◽  
Linkage Study ◽  
High Rate ◽  
Physical And Mental Health ◽  
Overdose Death ◽  
Fatal Overdose ◽  
Increased Risk ◽  
The Impact ◽  
Release From Prison

IntroductionThe province of BC, Canada is in the grips of a sustained overdose epidemic. People released from prison are at increased risk of fatal drug overdose, but the impact of the overdose epidemic on mortality after release from prison in BC is poorly understood. Few studies have been able to examine risk factors for overdose death in this population. Objectives and ApproachWe aimed to (a) measure risk of overdose-related and all-cause death in different time periods after release from prison; and (b) identify risk factors for overdose-related and all-cause death. In a random 20% sample of the population of BC, Canada, we identified those released from prison 2015-2017 and examined linked health and correctional records for this cohort. ResultsOf 6106 persons released from prison 2015-2017, 77 (1.3%) died from any cause and 48 (0.8%) died from overdose 2015-2017. The incidence of all-cause death was 16.1 (95%CI 13.7-18.8) per 1000 person years, and the incidence of overdose death was 11.2 (95%CI 9.2-13.5) per 1000 person years. Risk factors for overdose death included a history of 3 or more incarcerations (HR=3.00, 95%CI 1.67-5.39), co-occurring substance use disorder and mental illness (HR=4.73, 95%CI 2.94-7.62), chronic physical morbidity (HR=3.10, 95%CI 1.97-4.88), and being dispensed benzodiazepines (HR=3.31, 95%CI 2.27-4.84) or opioids for pain (HR=6.77, 95%CI 3.86-11.89). The incidence of fatal overdose was significantly higher in the first two weeks post-release than at any other time during follow-up. ConclusionPeople released from prison in BC are at markedly increased risk of preventable death, mainly due to overdose. As such, people transitioning from prison to the community should be a key target population for overdose prevention efforts. To be maximally effective, these efforts must go beyond provision of methadone and naloxone on release, to consider physical and mental health comorbidities, and psychosocial disadvantage.

scholarly journals Using Linked Data to Examine the Epidemiology of All-Cause and Cause-Specific Mortality Following Release from Incarceration in Eleven Countries

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Rohan Borschmann ◽  
Claire Keen ◽  
Jesse T Young ◽  
Alexander D Love ◽  
Matthew Spittal ◽  
...  
Keyword(s):  
Linked Data ◽  
Mental Health Problems ◽  
Meta Analysis ◽  
Physical And Mental Health ◽  
Relevant Evidence ◽  
Analysis Methodology ◽  
Increased Risk ◽  
Global Epidemiology ◽  
Individual Participant ◽  
Causes And Risk Factors

IntroductionMore than 30 million adults are released from incarceration globally each year. Many experience complex physical and mental health problems, and are at markedly increased risk of preventable mortality. Despite this, evidence regarding the global epidemiology of mortality following release from incarceration is insufficient to inform the development of targeted, evidence-based responses. Many previous studies have suffered from inadequate power and poor precision, and even large studies have limited capacity to disaggregate data by specific causes of death, sub-populations or time since release to answer questions of clinical and public health relevance. Objectives and ApproachWe aimed to comprehensively document the incidence, timing, causes and risk factors for mortality in adults released from incarceration. We created the Mortality After Release from Incarceration Consortium (MARIC), a multi-disciplinary collaboration representing 29 cohorts of adults who have experienced incarceration from 11 countries. Findings across cohorts will be analysed using a two-step, individual participant data meta-analysis methodology. ResultsUsing linked data from the 29 individual cohorts, the combined sample includes 1,337,993 individuals (89% male), with 75,795 deaths recorded over 9,191,393 person-years of follow-up. Preliminary analyses indicate a marked elevation in mortality risk following release from incarceration, with this risk beginning on the day of release. At the time of writing, more detailed analyses are underway regarding all-cause and cause-specific deaths – along with risk and protective factors – and findings will be presented at the IPDLN conference in October. Conclusion / ImplicationsThe MARIC consortium represents an important advancement in the field, bringing international attention to this problem. It will provide internationally relevant evidence to guide policymakers and clinicians in reducing preventable deaths in this marginalised population.

Cigarette smoking and risk of intracranial aneurysms in middle-aged women

2020 ◽  
Vol 91 (9) ◽  
pp. 985-990 ◽  
Author(s):  
Christopher S Ogilvy ◽  
Santiago Gomez-Paz ◽  
Kimberly P Kicielinski ◽  
Mohamed M Salem ◽  
Yosuke Akamatsu ◽  
...  
Keyword(s):  
Smoking Status ◽  
Conditional Logistic Regression ◽  
Multivariable Analysis ◽  
Smoking History ◽  
Chronic Hypertension ◽  
Unruptured Intracranial Aneurysm ◽  
Increased Risk ◽  
Single Centre Study ◽  
Chronic Headaches ◽  
Control Study

Background and purposeWe previously reported a single-centre study demonstrating that smoking confers a six-fold increased risk for having an unruptured intracranial aneurysm (UIA) in women aged between 30 and 60 years and this risk was higher if the patient had chronic hypertension. There are no data with greater generalisability evaluating this association. We aimed to validate our previous findings in women from a multicentre study.MethodsA multicentre case-control study on women aged between 30 and 60 years, that had magnetic resonance angiography (MRA) during the period 2016–2018. Cases were those with an incidental UIA, and these were matched to controls based on age and ethnicity. A multivariable conditional logistic regression was conducted to evaluate smoking status and hypertension differences between cases and controls.ResultsFrom 545 eligible patients, 113 aneurysm patients were matched to 113 controls. The most common reason for imaging was due to chronic headaches in 62.5% of cases and 44.3% of controls. A positive smoking history was encountered in 57.5% of cases and in 37.2% of controls. A multivariable analysis demonstrated a significant association between positive smoking history (OR 3.7, 95%CI 1.61 to 8.50), hypertension (OR 3.16, 95% CI 1.17 to 8.52) and both factors combined with a diagnosis of an incidental UIA (OR 6.9, 95% CI 2.49 to 19.24).ConclusionsWomen aged between 30 and 60 years with a positive smoking history have a four-fold increased risk for having an UIA, and a seven-fold increased risk if they have underlying chronic hypertension. These findings indicate that women aged between 30 and 60 years with a positive smoking history might benefit from a screening recommendation.

Association Between Drug Exposure and Occurrence of Parkinsonism in Korea: A Population-Based Case-Control Study

2019 ◽  
Vol 53 (11) ◽  
pp. 1102-1110 ◽  
Author(s):  
Siin Kim ◽  
Sang-Myung Cheon ◽  
Hae Sun Suh
Keyword(s):  
Cumulative Dose ◽  
Drug Exposure ◽  
Case Control Study ◽  
Conditional Logistic Regression ◽  
Population Level ◽  
Population Based ◽  
Case Control ◽  
Drug Induced ◽  
Increased Risk ◽  
Control Study

Background: Although drug-induced parkinsonism is reversible in most cases, some patients can suffer from persistent/recurrent symptoms. Therefore, prevention is the most efficient way to manage drug-induced parkinsonism. However, there is a paucity of studies exploring the relationship between parkinsonism and drug exposure. Objective: To examine the association between drug exposure and the risk of parkinsonism using Korean population-based data. Methods: We conducted a matched case-control study using the National Health Insurance Service—National Sample Cohort database. Cases and controls were defined as individuals with and without parkinsonism, respectively, between 2007 and 2013. Cases and controls were matched for sex, age group, income, type of insurance, and Charlson comorbidity index. Drug exposures, including propulsives, antipsychotics, and flunarizine, were identified at 1 year before the first date of parkinsonism and stratified by recency and cumulative dose. Conditional logistic regression was used to estimate odds ratios (ORs) and 95% CIs. Results: We identified 5496 cases and 5496 controls. ORs for current use group of propulsives, antipsychotics, and flunarizine compared with those of the never use group were 2.812 (95% CI = 2.466-3.206), 3.009 (95% CI = 1.667-5.431), and 4.950 (95% CI = 2.711-9.037), respectively. ORs were greater in those more recently exposed and those exposed to higher cumulative doses. Conclusion and Relevance: At the population level, use of propulsives, antipsychotics, and flunarizine had a significant association with the increased risk of parkinsonism, depending on recency and cumulative dose. Drugs associated with parkinsonism should be used with careful monitoring to prevent drug-induced parkinsonism.

Calcium Use Increases Risk of Calciphylaxis: A Case-Control Study

1999 ◽  
Vol 19 (3) ◽  
pp. 248-252 ◽  
Author(s):  
James M. Zacharias ◽  
Bunny Fontaine ◽  
Adrian Fine
Keyword(s):  
Risk Factor ◽  
Peritoneal Dialysis ◽  
Calcium Carbonate ◽  
Case Control Study ◽  
Conditional Logistic Regression ◽  
Laboratory Data ◽  
Case Control ◽  
Calcium Deposition ◽  
Increased Risk ◽  
Control Study

Objective To investigate the risk factors for the development of calciphylaxis in renal failure, a poorly understood and often fatal condition characterized by calcium deposition in tissues. Design Retrospective case-control study. Setting University hospital peritoneal dialysis center. Patients Eight continuous ambulatory peritoneal dialysis (CAPD) patients with calciphylaxis were identified in a 3-year period. We matched up to five controls for dialysis modality and length of time on dialysis with each case. Statistics Multivariate conditional logistic regression analysis for matched case-controls. Main Outcome Measures Laboratory data and demographics were collected as well as cumulative calcium and vitamin D ingestion over the year prior to disease onset. Results All the patients were female, versus only 38% (14/37) of controls ( p < 0.0001). While not statistically significant, a majority of the patients were diabetic [62.5% (5/8) vs 32% (12/37)]. Peak and average levels of serum calcium, phosphate, calcium x phosphate product, parathyroid hormone (PTH), albumin, iron, total iron-binding capacity (TIBC), and ferritin were not significantly different in cases compared with controls. The use of calcitriol alone or with calcium carbonate was not found to be a significant risk factor for the development of calciphylaxis. In a multivariate analysis, iron intake seemed to be protective, contrary to previous reports, while the use of calcium carbonate was associated with a strong trend to increased risk of calciphylaxis development (odds ratio = 1.029/g and 1.011/g calcium ingested per month, at 1 and 2 – 3 months prior to calciphylaxis development; p = 0.0556 and 0.0565, respectively). Conclusion These data, although limited by the small numbers of index cases, suggest that calcium ingestion is a risk factor for calciphylaxis. The increased use of calcium salts as a phosphate binder in recent years might explain the apparent increased incidence of calciphylaxis in our and other centers. The preponderance of female diabetics among cases reported elsewhere was confirmed in our study.

scholarly journals Metformin and Risk of Alzheimer’s Disease Among Community-Dwelling People With Diabetes: A National Case-Control Study

2019 ◽  
Vol 105 (4) ◽  
pp. e963-e972 ◽  
Author(s):  
Janet K Sluggett ◽  
Marjaana Koponen ◽  
J Simon Bell ◽  
Heidi Taipale ◽  
Antti Tanskanen ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Case Control Study ◽  
Conditional Logistic Regression ◽  
Case Control ◽  
Community Dwelling ◽  
High Dose ◽  
Defined Daily Doses ◽  
Increased Risk ◽  
Control Study

Abstract Context Type 2 diabetes has been linked with an increased risk of Alzheimer’s disease (AD). Studies on the association between metformin use and AD have reported conflicting results. Objective To investigate whether metformin use modifies the association between diabetes and incident, clinically verified AD. Design Nested case-control study. Setting All community-dwelling people in Finland. Participants Cases were all community-dwelling Finns with AD diagnosed from 2005 to 2011 and with diabetes diagnosed ≥ 3 years before AD (n = 9862). Cases were matched with up to 2 control persons by age, sex, and diabetes duration (n = 19 550). Main outcome measure Cumulative metformin exposure was determined from reimbursed dispensings over a 10- to 16-year period. Adjusted odds ratios (aORs) were calculated using conditional logistic regression to estimate associations, with adjustment for potential confounders. Results A total of 7225 (73.3%) cases and 14528 (74.3%) controls received metformin at least once. Metformin use (ever use) was not associated with incident AD (aOR 0.99; 95% confidence interval [CI], 0.94–1.05). The adjusted odds of AD were lower among people dispensed metformin for ≥ 10 years (aOR 0.85; 95% CI, 0.76–0.95), those dispensed cumulative defined daily doses (DDDs) of &lt; 1825–3650 (aOR 0.91; 95% CI, 0.84–0.98) and &gt; 3650 DDDs (aOR 0.77; 95% CI, 0.67–0.88), and among persons dispensed an average of 2 g metformin daily (aOR 0.89; 95% CI, 0.82–0.96). Conclusion In this large national sample we found no evidence that metformin use increases the risk of AD. Conversely, long-term and high-dose metformin use was associated with a lower risk of incident AD in older people with diabetes.

Assessment of Chronic Pain in Military Patients with PTSD

2017 ◽  
Vol 41 (S1) ◽  
pp. S721-S721
Author(s):  
E. Ben Zina ◽  
M.W. Krir ◽  
H. Bel Hadj ◽  
A. Tajmout ◽  
C. Ben Cheikh ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Mental Health Problems ◽  
Short Form ◽  
Depression Scale ◽  
High Rate ◽  
Traumatic Experience ◽  
Military Hospital ◽  
Future Research ◽  
Physical And Mental Health ◽  
Pain Symptoms

IntroductionPatients with post-traumatic stress disorder (PTSD) presents often with several concomitant physical and mental health problems. Recent evidence suggests that pain is one of the most commonly reported symptoms in patients with PTSD, regardless of the nature of their traumatic experience.Aim of the studyTo evaluate chronic pain in patients with PTSD in a Tunisian military sample.MethodsTransversal descriptive study of a sample of 22 patients treated for PTSD in the Principal Military Hospital of Instruction of Tunis during the period between August and October 2016.The PTSD Checklist for DSM-5 (PCL-5), Hospital Anxiety and Depression scale (HAD), and the Brief Pain Inventory Short Form (BPI-SF) were administered for patients.ResultsAll the patients of the study were male. The mean age of the sample was 29.6 years. Fifty percent presented with a co-morbid major depression and 59.1% with chronic pain symptoms. Locations of chronic pain were as follow: limb pain (69.23%), back pain (38.46%), headache (30.76%) and torso pain (7.69%). Sequelae from combat-related trauma were present in 31.8% of cases.ConclusionThe results of this study illustrate a high rate of chronic pain symptoms among PTSD patients. This suggests that closer attention should be given to the interaction of medical problems, especially pain, with PTSD symptomatology in clinical management and in future research.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Risk and protective factors for suicidal ideation and behaviour in Rwandan children

2015 ◽  
Vol 207 (3) ◽  
pp. 262-268 ◽  
Author(s):  
Lauren C. Ng ◽  
Catherine M. Kirk ◽  
Frederick Kanyanganzi ◽  
Mary C. Smith Fawzi ◽  
Vincent Sezibera ◽  
...  
Keyword(s):  
Mental Health ◽  
Suicidal Ideation ◽  
Mental Health Problems ◽  
Sub Saharan Africa ◽  
Hiv Positive ◽  
Hiv Status ◽  
Increased Risk ◽  
Matched Case ◽  
Sub Saharan ◽  
Control Study

BackgroundSuicide is a leading cause of death for young people. Children living in sub-Saharan Africa, where HIV rates are disproportionately high, may be at increased risk.AimsTo identify predictors, including HIV status, of suicidal ideation and behaviour in Rwandan children aged 10–17.MethodMatched case–control study of 683 HIV-positive, HIV-affected (seronegative children with an HIV-positive caregiver), and unaffected children and their caregivers.ResultsOver 20% of HIV-positive and affected children engaged in suicidal behaviour in the previous 6 months, compared with 13% of unaffected children. Children were at increased risk if they met criteria for depression, were at high-risk for conduct disorder, reported poor parenting or had caregivers with mental health problems.ConclusionsPolicies and programmes that address mental health concerns and support positive parenting may prevent suicidal ideation and behaviour in children at increased risk related to HIV.

scholarly journals Serum IGFBP-2 and Risk of Atypical Hyperplasia of the Breast

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Chelsea Catsburg ◽  
Marc J. Gunter ◽  
Lesley Tinker ◽  
Rowan T. Chlebowski ◽  
Michael Pollak ◽  
...  
Keyword(s):  
Conditional Logistic Regression ◽  
Atypical Hyperplasia ◽  
Mammary Tissue ◽  
Inverse Association ◽  
Logistic Regression Models ◽  
Increased Risk ◽  
Nested Case Control ◽  
Nonsignificant Decrease ◽  
Control Study

Atypical hyperplasia of the breast (AH) is associated with increased risk of subsequent invasive breast cancer, yet little is known about the etiology of AH. Insulin-like growth factor binding protein 2 (IGFBP-2) may contribute to the development of AH due to its proliferative effects on mammary tissue. We conducted a nested case-control study of postmenopausal women enrolled in Women’s Health Initiative-Clinical Trial. Cases were 275 women who developed incident AH during follow-up, individually (1 : 1) matched to controls. Levels of IGFBP-2 were determined from fasting serum collected at baseline. Multivariable conditional logistic regression models were used to estimate odds ratios for the association of IGFBP-2 with risk of AH. Serum IGFBP-2 was associated with a nonsignificant decrease in risk for AH, when comparing the highest quartile to lowest quartile (OR = 0.65; 95% CI = 0.32–1.31). This decrease in risk was most evident when analyses were restricted to nondiabetic, nonusers of hormone therapy (OR = 0.33, 95% CI = 0.13–0.86,ptrend= 0.06) and nondiabetic women who were overweight or obese (OR = 0.43, 95% CI = 0.18–1.03,ptrend= 0.05). Results from this study provide some support for an inverse association between serum IGFBP2 levels and risk of AH, particularly in nondiabetic women who are overweight or obese. Further studies are required to confirm these results.

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