Articles: mortality.
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Approximately 55 million people in the US and approximately 1.1 billion people worldwide are postmenopausal women. To inform clinical practice about the health effects of menopausal hormone therapy, calcium plus vitamin D supplementation, and a low-fat dietary pattern, the Women's Health Initiative (WHI) enrolled 161 808 postmenopausal US women (N = 68 132 in the clinical trials) aged 50 to 79 years at baseline from 1993 to 1998, and followed them up for up to 20 years. ⋯ For postmenopausal women, the WHI randomized clinical trials do not support menopausal hormone therapy to prevent cardiovascular disease or other chronic diseases. Menopausal hormone therapy is appropriate to treat bothersome vasomotor symptoms among women in early menopause, without contraindications, who are interested in taking hormone therapy. The WHI evidence does not support routine supplementation with calcium plus vitamin D for menopausal women to prevent fractures or a low-fat diet with increased fruits, vegetables, and grains to prevent breast or colorectal cancer. A potential role of a low-fat dietary pattern in reducing breast cancer mortality, a secondary outcome, warrants further study.
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COPD is a common and lethal chronic condition, recognized as a leading cause of death worldwide. COPD is associated with significant morbidity and disability, particularly among older adults. The disease course is marked by periods of stability and disease exacerbations defined by worsening respiratory status resulting in a high burden of health care utilization and an increased risk of mortality. ⋯ In addition to the clinical benefits, PR is estimated to be a cost-effective medical intervention. Despite these benefits, participation in PR remains low. We will review the evidence for PR in each of these benefit domains among patients with stable COPD and in those recovering from a COPD exacerbation.
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Pol. Arch. Med. Wewn. · May 2024
Comparative StudyA comparison of interpretable XGBoost and artificial neural network model for the prediction of severe acute pancreatitis.
Acute pancreatitis (AP) that progresses to persistent organ failure is referred to as severe acute pancreatitis (SAP). It is a condition associated with a relatively high mortality. A prediction model that would facilitate early recognition of patients at risk for SAP is crucial for improvement of patient prognosis. ⋯ An interpretable XGBoost model showed better discriminatory efficiency for predicting SAP than the ANN model, and could be used in clinical practice to identify patients at risk for SAP.
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Pol. Arch. Med. Wewn. · May 2024
ReviewDietary salt intake in chronic kidney disease. Recent studies and their practical implications.
Epidemiologic studies in the general population show that the level of dietary salt intake is associated with increases in blood pressure (BP), cardiovascular events, and mortality. According to trial data, reducing salt intake lowers the incidence of these 3 outcomes. ⋯ However, these trials have typically used resource‑intensive approaches to dietary salt reduction that are not suitable for routine clinical care, and salt intake typically remains high in people with CKD. The OxSalt care bundle is a low‑cost intervention that was demonstrated in the OxCKD1 trial to help people with CKD lower their salt intake, and could be applied in routine clinical practice.
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Comparative Study
Racial and Ethnic Disparities in All-Cause and Cause-Specific Mortality Among US Youth.
Mortality rates in US youth have increased in recent years. An understanding of the role of racial and ethnic disparities in these increases is lacking. ⋯ In this study, racial and ethnic disparities were observed for almost all leading causes of injury and disease that were associated with recent increases in youth mortality rates. Addressing the increasing disparities affecting American Indian or Alaska Native and Black youth will require efforts to prevent homicide and suicide, especially those events involving firearms.