Severe depression and all-cause and cause-specific mortality in Scotland: a 20-year national cohort study

BackgroundUnderstanding cause of death in people with depression could inform approaches to reducing premature mortality.AimTo describe all-cause and cause-specific mortality for people with severe depression in Scotland, by sex, relative to the general population.MethodWe performed a retrospective cohort study, using psychiatric hospital admission data linked to death data, to identify adults (≥18 years old) with severe depression and ascertain cause-specific deaths, during 2000–2019. We estimated relative all-cause and cause-specific mortality for people with severe depression using standardised mortality ratios (SMRs), stratified by sex using the whole Scottish population as the standard.ResultsOf 28 808 people with severe depression, 7903 (27.4%) died during a median follow-up of 8.7 years. All-cause relative mortality was over three times higher than expected (SMR, both sexes combined: 3.26, 95% CI 3.19–3.34). Circulatory disease was the leading cause of death, and, among natural causes of death, excess relative mortality was highest for circulatory diseases (SMR 2.51, 2.40–2.66), respiratory diseases (SMR 3.79, 3.56–4.01) and ‘other’ causes (SMR 4.10, 3.89–4.30). Among circulatory disease subtypes, excess death was highest for cerebrovascular disease. Both males and females with severe depression had higher all-cause and cause-specific mortality than the general population. Suicide had the highest SMR among both males (SMR 12.44, 95% CI 11.33–13.54) and females (22.86, 95% CI 20.35–25.36).ConclusionPeople with severe depression have markedly higher all-cause mortality than the general population in Scotland, with relative mortality varying by cause of death. Effective interventions are needed to reduce premature mortality for people with severe depression.<br/

The effect of COVID-19 on the characteristics of adult emergency department visits:A retrospective cohort tertiary hospital experience in Riyadh

BACKGROUND: On March 2, 2020, Saudi Arabia identified the first positive COVID-19 case. Since then, several aspects of the COVID-19 impact on Emergency Departments (EDs) use have been reported. The objective of this study is to describe the pattern and characteristics of Emergency Department visits during the COVID-19 pandemic period, compared with the same period in the previous year, including the patients’ demographic information, acuity level, length of stay, and admission rate. METHODS: Data were collected from King Abdulaziz Medical City in Riyadh, Saudi Arabia. The health records of all the patients who presented at the Emergency Department from January 2019 to September 2020 were retrospectively reviewed. The variations in the patient and the visit characteristics were described for the periods before and during COVID-19. RESULTS: The records of 209,954 patients who presented at the Emergency Department were retrieved. In contrast to 2019, the number of visits during the pandemic period reduced by 23%. A dramatic decrease was observed after the announcement of the first COVID-19 diagnosed case in Saudi Arabia, and subsequently the numbers gradually increased. The patients who presented at the Emergency Department during the pandemic period were slightly older (mean age, 43.1 versus 44.0 years), more likely to be older, more urgent and had a higher admission rate compared to the pre-pandemic period. There was a slight increase in visits during the daytime curfew hours and a decrease during the nighttime. CONCLUSION: We report a considerable decrease in the number of Emergency Department visits. The reduction was higher in non-urgent and less urgent cases. Patients presenting at the Emergency Department during the curfew times were more likely to stay longer in the Emergency Department and more likely to be admitted, compared with the pre-pandemic period

Incidence, characteristics and outcomes of out-of-hospital cardiac arrests in patients with psychiatric illness:A systematic review

AIM: To conduct a systematic literature review of the existing evidence on incidence, characteristics and outcomes after out-of-hospital cardiac arrest (OHCA) in patients with psychiatric illness. METHODS: We searched Embase, Medline, PsycINFO and Web of Science using a comprehensive electronic search strategy to identify observational studies reporting on OHCA incidence, characteristics or outcomes by psychiatric illness status. One reviewer screened all titles and abstracts, and a second reviewer screened a random 10%. Two reviewers independently performed data extraction and quality assessment. RESULTS: Our search retrieved 11,380 studies, 10 of which met our inclusion criteria (8 retrospective cohort studies and two nested case-control studies). Three studies focused on depression, whilst seven included various psychiatric conditions. Among patients with an OHCA, those with psychiatric illness (compared to those without) were more likely to have: an arrest in a private location; an unwitnessed arrest; more comorbidities; less bystander cardiopulmonary resuscitation; and an initial non-shockable rhythm. Two studies reported on OHCA incidence proportion and two reported on survival, showing higher risk, but lower survival, in patients with psychiatric illness. CONCLUSION: Psychiatric illness in relation to OHCA incidence and outcomes has rarely been studied and only a handful of studies have reported on OHCA characteristics, highlighting the need for further research in this area. The scant existing literature suggests that psychiatric illness may be associated with higher risks of OHCA, unfavourable characteristics and poorer survival. Future studies should further investigate these links and the role of potential contributory factors such as socioeconomic status and comorbidities

Increased emergency calls during the covid-19 pandemic in saudi arabia: A national retrospective study

The coronavirus 2019 (COVID-19) pandemic has a direct and indirect effect on the different healthcare systems around the world. In this study, we aim to describe the impact on the utilization of emergency medical services (EMS) in Saudi Arabia during the COVID-19 pandemic. We studied cumulative data from emergency calls collected from the SRCA. Data were separated into three periods: before COVID-19 (1 January–29 February 2020), during COVID-19 (1 March–23 April 2020), and during the Holy Month of Ramadan (24 April–23 May 2020). A marked increase of cases was handled during the COVID-19 period compared to the number before pandemic. Increases in all types of cases, except for those related to trauma, occurred during COVID-19, with all regions experiencing increased call volumes during COVID-19 compared with before pandemic. Demand for EMS significantly increased throughout Saudi Arabia during the pandemic period. Use of the mobile application ASAFNY to request an ambulance almost doubled during the pandemic but remained a small fraction of total calls. Altered weekly call patterns and increased call volume during the pandemic indicated not only a need for increased staff but an alteration in staffing patterns

Role of Interventional Radiology in Management of Gastrointestinal Bleeding

Gastrointestinal bleeding is a common and potentially life-threatening condition that requires prompt and effective management. Interventional radiology has emerged as a valuable tool in the management of gastrointestinal bleeding, offering minimally invasive techniques that can rapidly control bleeding and improve patient outcomes. This review aims to provide an overview of the role of interventional radiology in the management of gastrointestinal bleeding, including its various techniques and their efficacy. The review discusses the different interventional radiology procedures that can be used to diagnose and treat gastrointestinal bleeding. It also highlights the advantages of techniques used in evaluation and management, including their ability to localize and control bleeding, as well as their low complication rates and shorter recovery times compared to traditional surgical approaches. Furthermore, the review addresses the specific indications for interventional radiology in the management of gastrointestinal bleeding, as well as the role of interventional radiology in the setting of underlying conditions. Overall, this review provides a comprehensive overview of the role of interventional radiology in the management of gastrointestinal bleeding, highlighting its effectiveness and potential benefits for patients. It also emphasizes the need for further research and collaboration between interventional radiologists and gastroenterologists to optimize the use of these techniques in clinical practice

Association between sex and survival after out‐of‐hospital cardiac arrest: A systematic review and meta‐analysis

Abstract The current literature on sex differences in 30‐day survival following out‐of‐hospital cardiac arrest (OHCA) is conflicting, with 3 recent systematic reviews reporting opposing results. To address these contradictions, this systematic literature review and meta‐analysis aimed to synthesize the literature on sex differences in survival after OHCA by including only population‐based studies and through separate meta‐analyses of crude and adjusted effect estimates. MEDLINE and Embase databases were systematically searched from inception to March 23, 2022 to identify observational studies reporting sex‐specific 30‐day survival or survival until hospital discharge after OHCA. Two meta‐analyses were conducted. The first included unadjusted effect estimates of the association between sex and survival (comparing males vs females), whereas the second included effect estimates adjusted for possible mediating and/or confounding variables. The PROSPERO registration number was CRD42021237887, and the search identified 6712 articles. After the screening, 164 potentially relevant articles were identified, of which 26 were included. The pooled estimate for crude effect estimates (odds ratio [OR], 1.42; 95% confidence interval [CI], 1.22–1.66) indicated that males have a higher chance of survival after OHCA than females. However, the pooled estimate for adjusted effect estimates shows no difference in survival after OHCA between males and females (OR, 0.93; 95% CI, 0.84–1.03). Both meta‐analyses involved high statistical heterogeneity between studies: crude pooled estimate I2 = 95.7%, adjusted pooled estimate I2 = 91.3%. There does not appear to be a difference in survival between males and females when effect estimates are adjusted for possible confounding and/or mediating variables in non‐selected populations

Fig 4 -

Representative TF images of the tears collected from four subjects with a high BMI before (a, c, e, and g) and after (b, d, f, and h) wearing a surgical face mask.</p

Side-by-side boxplots for the SPEED scores for the subjects with a high BMI before (SPEED1) and after (SPEED2) wearing a surgical face mask.

Side-by-side boxplots for the SPEED scores for the subjects with a high BMI before (SPEED1) and after (SPEED2) wearing a surgical face mask.</p

The median (IQR) for the SPEED, PRT, and TF scores in the control group (n = 25).

The median (IQR) for the SPEED, PRT, and TF scores in the control group (n = 25).</p