Journal of internal medicine
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The risk of major bleeding from anticoagulant treatment is influenced by both the treatment and the patient's baseline risk, which is often disregarded. ⋯ The excess bleeding risk from anticoagulant treatment was high during initial treatment, particularly among females and the elderly, but lower and not influenced by sex or age during extended treatment.
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Motoric cognitive risk syndrome (MCR) has been associated with dementia, functional dependence, and mortality. We sought to describe the prevalence and distribution of MCR and to explore the clinical, biological, and neuroimaging profiles for MCR in rural-dwelling Chinese older adults. ⋯ MCR affects approximately one-seventh of rural-dwelling Chinese older adults. The clinical and neuroimaging profiles for MCR are characterized by cardiometabolic disorders, osteoarthritis, hip fracture, and depressive symptoms as well as global and regional brain atrophy and cerebral microvascular lesions.
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People with diabetes have increased suicide risk. However, it is unclear whether those with type 1 diabetes (T1D) have a higher risk than those with cancer, a disease associated with significant psychological stress and suicide risk. ⋯ This nationwide study demonstrated a significant association between T1D and increased suicide risk compared to the general population and patients with cancer. This underscores the importance of mental health screening and targeted interventions for this population.
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Multicenter Study
Fluid overload trajectories and mortality in hemodialysis patients.
Fluid overload remains critical in managing patients with end-stage kidney disease. However, there is limited empirical understanding of fluid overload's impact on mortality. This study analyzes fluid overload trajectories and their association with mortality in hemodialysis patients. ⋯ This longitudinal study highlights the significant risk of chronic fluid overload in hemodialysis patients. Latent trajectory analysis provides novel information into the dynamic nature of fluid overload and its impact on mortality in the hemodialysis population.
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In recent years, there has been resurgence in donation after circulatory death (DCD). Despite that, the number of organs transplanted from these donors remains low due to concerns about their function and a lack of an objective assessment at the time of donation. This overview examines the current DCD practices and the classification modifications to accommodate regional perspectives. ⋯ With many strategies at our disposal, there is an urgent need for comparative trials to determine the optimal use of perfusion technologies for each donated organ type. Additional progress in defining therapeutic strategies to repair the damage sustained during the dying process should further improve DCD organ utilization and outcomes. However, there remains wide variability in access to DCD donation and transplantation, and organizational efforts should be doubled up with consensus on key ethical issues that still surround DCD donation in the era of machine perfusion.