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Healthcare Payment Systems
Published in Jennifer Doley, Mary J. Marian, Adult Malnutrition, 2023
The underlying disease state or condition of a patient determines the SOI and ROM scores.5 Higher SOI and ROM scores are assigned to patients with multiple serious diseases and the interactions between those diseases. Severity of Illness refers to the extent of physiological decompensation or organ damage and loss of function. Risk of Mortality refers to a patient’s risk of dying. There are four classifications: – Minor– Moderate– Major– Extreme
Naturopathic Medicine and the Prevention and Treatment of Cardiovascular Disease
Published in Stephen T. Sinatra, Mark C. Houston, Nutritional and Integrative Strategies in Cardiovascular Medicine, 2022
Compared to those who did not eat nuts, those subjects who reported consuming greater than 3 servings of nuts per week before the study started had a significant 39% lower risk of all-cause mortality when the study was completed nearly 5 years later. When subjects were then randomized into one of the three treatment groups, the results were even more conclusive. The participants following a Mediterranean diet who consumed nuts greater than 3 servings per week at the beginning of the study had a whopping 63% reduced risk of mortality compared to those consuming the low-fat diet and less than 3 servings of nuts per week. A reduced risk of mortality means a reduced risk of dying from any cause.16
The impact of COVID-19 on the lives of sexual and gender minority people
Published in J. Michael Ryan, COVID-19, 2020
Matthew D. Skinta, Angela H. Sun, Daniel M. Ryu
Further, many SGM individuals are reluctant to seek medical care due to negative experiences when seeking care (Kcomt et al. 2020). There is a lack of providers who are not only culturally competent, but also willing to work with SGM populations at all. Many SGM individuals receive substandard care or outright denial of care based on sexual orientation, gender identity, and gender expression. For transgender individuals, even seeking routine care has the potential for humiliation, discrimination, violations of privacy, and even violence. Nearly one-quarter (23%) of transgender individuals surveyed in the 2015 U.S. Transgender Survey avoided seeking needed health care due to fear of discrimination (James et al. 2016). Each of these factors – access to health care, insurance in the United States, the possibility of mistreatment by medical providers, or humiliation in medical settings – may lead to deferred treatment and worsened outcome when an SGM individual notices symptoms that may indicate infection with COVID-19. Similarly, elevated rates of smoking, alcohol use, and underlying medical disorders may lead to a heightened risk of mortality that will not be clear until after the pandemic subsides and a greater examination of outcome data is possible.
Cubosome-based thermosensitive in situ gelling system for intranasal administration of lamotrigine with enhanced antiepileptic efficacy
Published in Pharmaceutical Development and Technology, 2023
Amira Mohamed Mohsen, Abeer A. A. Salama, Marwa Hasanein Asfour
Epilepsy is the most prevalent central nervous system (CNS) disorder, characterized by various symptoms, including high-spike seizures, convulsions, and loss of consciousness (do Canto et al. 2020). Children have a high prevalence of epilepsy, which nearly doubles that among adult and middle-aged patients (Benamer and Grosset 2009; Aeby et al. 2022). Although more than 20 antiepileptic drugs have been introduced, the pharmacological treatment management of epilepsy has failed to achieve perfection, with up to one-third of patients still experiencing seizures or undesirable drug adverse effects (do Canto et al. 2020). Absolutely, pharmacoresistance has been thought to be the main reason for the failure of antiepileptic treatments. Moreover, it is usually accompanied by a higher risk of mortality and morbidity (Fattorusso et al. 2021).
Socio-economic context of alcohol consumption and the associated risky behavior among male teenagers and young adults in India
Published in Journal of Substance Use, 2023
Adolescence is a period of major physical, physiological, and behavioral changes (Sunitha & Gururaj, 2014) and adolescence is also a time of experimentation including smoking and alcohol use as these are seen as adult behaviors. The initiation of drinking at an early age is associated with peer group pressure, perception of pleasure and socialization (Ham & Hope, 2003). Drinking behavior among adults is influenced by promotion, accessibility and space (Fielding-Singh & Wang, 2017; MacArthur et al., 2016). Heavy alcohol consumption is associated with a high risk of mortality and morbidity (Hingson et al., 2006; Windle & Windle, 2012). Regular and early use of alcohol is associated with cancers of the liver, colon and rectum, breast and esophageal cancer, neurological disorders and early onset of mental impairment (Singleton & Wolfson, 2009). It is also found that adolescents who consume alcohol are found to have poor academic performance, are more violent and are also involved in different types of substance use, unsafe sex, etc (Hildebrand et al., 2013; Lu et al., 2015; MacArthur et al., 2020; Obot & Room, 2005).
Sex differences in patients undergoing heart transplantation and LVAD therapy
Published in Expert Review of Cardiovascular Therapy, 2022
Gal Rubinstein, Dor Lotan, Cathrine M Moeller, Ersilia M DeFilippis, Sharon Slomovich, Daniel Oren, Melana Yuzefpolskaya, Gabriel Sayer, Nir Uriel
Mixed data exist regarding outcomes for women on LVAD support. According to the International Society for Heart and Lung Transplantation (ISHLT) Mechanically Assisted Circulatory Support (IMACS) Registry, female sex is a risk factor for mortality (early hazard ratio (HR) of 1.28, p < 0.003 and constant HR of 1.18, p < 0.008) [27]. A recent INTERMACS data analysis of 18,868 patients with LVAD showed no difference in median survival between sexes in an unadjusted analysis (47.3 months for men vs 48.6 months for women, respectively, p = 0.52) [12]. After adjustment for various clinical factors and acuity, a higher mortality risk among women was found (HR: 1.15; 95% CI: 1.07 to 1.23; p < 0.001), especially women age <50 years (HR: 1.34; 95% CI: 1.12 to 1.60), and women age 50–64 (HR: 1.21; 95% CI: 1.07 to 1.38). For recipients above 65 years of age, the risk of mortality was similar for men and women (HR: 1.09; 95% CI: 0.95 to 1.24). This is consistent with data from EUROMACS which found that 1-year survival after isolated LVAD implantation was significantly worse in women compared to men (75.5% vs 83.2%) [28]. A recent analysis has specified this finding and concluded that females have a 74% increased mortality risk only during the first 4 months following LVAD implantation (HR 1.74; 95% CI 1.47–2.06; p < 0.0001) [29]. Previous studies have reported similar findings [30]. The differences in outcomes may be attributed to higher complications rate in females, as discussed in the next subsection.