The current study aims to assess associations between trimethylamine N-oxide (TMAO) levels and mortality, and to investigate modification effects of genetics. A total of 500 participants from a family-based cohort study were enrolled from 2005 to 2017 and followed up until 2020 in Fangshan District, Beijing, China. Serum TMAO levels were measured using the enzyme-linked immunosorbent assay (ELISA) kit. The primary outcomes were all-cause mortality, and deaths from cardiovascular disease (CVD) and stroke. During a median follow-up time of 7.38 years, 38 deaths were recorded, including 20 deaths due to CVD and 19 deaths due to stroke. Compared with the lowest TMAO quartile group, the hazard ratio (HR) for all-cause mortality was 1.35 (95% CI: 0.44,4.15), 1.65 (95% CI: 0.58,4.64), and 2.45 (95% CI: 0.91,6.57), respectively in higher groups. No association was observed between TMAO and CVD mortality. However, compared with the lowest TMAO concentration group, the HRs for stroke mortality was 1.93 (95% CI: 0.40,9.39), 1.91 (95% CI: 0.41,8.96), and 4.16 (95% CI: 0.94,18.52), respectively in higher groups (P for trend=0.046). Furthermore, polygenic risk score (PRS) for longevity modified the association of TMAO with all-cause mortality (P for interaction=0.008). The risk of mortality (HR=2.20, 95% CI: 1.06,4.57) was higher among participants with lower PRS compared with higher PRS (HR=1.00, 95% CI: 0.71,1.40). The study indicates that elevated serum TMAO levels are potentially associated with long-term mortality risk in rural areas of Northern China, especially for stroke deaths. Additionally, it provides novel evidence that genetic variations might modify the association.

Case Presentation: A 68 year old man. Hospitalized with decreased consciousness. Experienced severe shortness of breath 3 days before entering the hospital. The patient also had wounds on his right and left legs since 1 month ago. But then became more widespread. The patient has kidney failure and routinely undergoes hemodialysis. The patient had diabetes since 6 years ago. Laboratory: Hemoglobin 7.5 Leukocytes 17.8 Netrophils 91.70 Lymphocytes 4.20 Albumin 2.2 Creatinine 2.5 Ureum 61 Artery 2.30, urine bacteria+++. Pus culture results: Enterobacter cloacae with the antibiotic meropenem. Sputum culture results Klebsiella pneumoniae ss. Pneumoniae with amikacin. After 1 week pus culture results: Pseudomonas aeruginosa with amikacin. Blood culture results: Staphylococcus epidermidis suggested vancomycin. The patient underwent debriment in the operating room. However, the condition did not improve. Discussion: This patient experienced sepsis with MDRO. Apart from geriatric age, the patient also has diabetes with complications of kidney failure. This worsens the patient’s immune system. So the patient’s diabetic ulcers and decubitus ulcers worsened with the results of cultures with various antibiotic-resistant multiorganisms. And also the respiratory infections increase the risk of mortality. Conclusion : MDRO is a risk factor for inappropriate antibiotic therapy, which is undoubtedly associated with increased mortality.

Figure :

Diabetic ulcers and decubitus ulcers in patient

Schizophrenia is known to be a disabling psychiatric condition with wide reaching impact on everyday functioning and outcomes. These functional outcomes include increases in all-cause mortality (especially suicide and injury), cognitive and functional capacity deficits, lower reported levels of quality of life (QoL), increased incarceration, higher risk for violence and victimization, and homelessness. Studies have shown that medications and outpatient services can improve each of these functional outcomes in individuals with schizophrenia. However, most studies of pharmacological treatment utilize rating scales that do not reflect these real-world outcomes. This review looks at available studies focused on real-world outcomes and argues for an expansion of this body of research.

Adherence to healthy dietary patterns, including fruits, vegetables and whole grains, is linked to improved health outcomes. However, limited research has explored this association in Latin American populations. This study aimed to investigate the association between adherence to a healthy eating score (unweighted and weighted) and all-cause mortality risk in a Chilean population. This longitudinal study included 5336 Chilean participants from the Chilean National Health Survey 2016 and 2017. Six healthy eating habits were considered to produce the healthy eating score (range: 0–12): consumption of seafood, whole grains, dairy products, fruits, vegetables and legumes. A weighted score was also developed. Participants were categorised into quartiles based on their final scores, with the healthiest quartile used as the reference group. Associations between healthy eating score and all-cause mortality were performed using Cox proportional hazard models adjusted for confounders. After a median follow-up of 5·1 years, 276 (5·2 %) participants died. In the fully adjusted model, compared with participants in the healthiest quartile of the score (Q4), those in the unhealthiest quartile (Q1) had 1·61 (95 % CI: 1·14, 2·27) times higher all-cause mortality risk. A similar association was observed for the weighted healthy eating score (1·52 (95 % CI: 1·03, 2·23)). An inverse trend was observed for both scores (P < 0·05). Sensitivity analyses excluding participants who died within the first 2 years showed consistent results 1·63 (95 % CI: 1·09, 2·42). Individuals with the lowest healthy eating score (unweighted or weighted) had a higher mortality risk compared with their counterparts. A healthy eating score is associated with mortality risk in the Chilean population.

As the population ages, the provision of adult long-term care (LTC) is one of the major challenges facing the UK and other developed nations. LTC funding for the elderly is complex, reflecting the range and level of services provided, with the total cost depending on the duration of LTC required. Institutional care settings (e.g., nursing/residential care homes) represent the most expensive form of LTC. Planning and funding for institutional LTC requires an understanding of the factors affecting the mortality (and hence duration and cost of care) of such LTC recipients. Using data provided by Bupa, one of the largest LTC providers in Britain, this paper investigates factors affecting the mortality of residents of institutional LTC facilities over the period 2016-2019. Consistent with existing research, most residents were female and had a higher average age profile compared with male residents. For those residents who died during the investigation period, the average length of stay was approximately 1.6 times longer for females relative to males. For both males and females, new residents experienced higher mortality in the first-year post admission compared to existing residents. Variations in the mortality of the residents were analysed by condition, funding status and care type on admission.

We examine the impact of decentralisation on COVID-19 mortality and various health outcomes. Specifically, we investigate whether decentralised health systems, which facilitated greater regional participation and information sharing, were more effective in saving lives. Our analysis makes three contributions. First, we draw on evidence from several European countries to assess whether the decentralisation of health systems influenced COVID-19 mortality rates. Second, we explore the regional disparities in one of the most decentralised health systems, Spain, to untangle some of the determinants shaping health outcomes. Third, we estimate the regional loss of Quality Adjusted Life Years (QALYs) due to COVID-19 mortality, broken down by the wave of the pandemic. Our findings suggest that coordinated decentralisation played a critical role in saving lives throughout the COVID-19 pandemic.

We investigate whether the diseases for which there was more biomedical innovation had larger 1999–2019 reductions in premature mortality. Biomedical innovation related to a disease is measured by the change in the mean vintage of descriptors of PubMed articles about the disease. We analyze data on 286 million descriptors of 27 million articles about over 800 diseases. Premature mortality from a disease is significantly inversely related to the lagged vintage of descriptors of articles about the disease. In the absence of biomedical innovation, age-adjusted mortality rates would not have declined. Some factors other than biomedical innovation (e.g., a decline in smoking and an increase in educational attainment) contributed to the decline in mortality. But other factors (e.g., a rise in obesity and the prevalence of chronic conditions) contributed to an increase in mortality. Biomedical innovation reduced the mortality of white people sooner than it reduced the mortality of black people.

Triceps skinfold thickness (TSF) is a surrogate marker of subcutaneous fat. Evidence is limited about the association of sex-specific TSF with the risk of all-cause mortality among maintenance hemodialysis (MHD) patients. We aimed to investigate the longitudinal relationship of TSF with all-cause mortality among MHD patients. A multicenter prospective cohort study was performed in 1034 patients undergoing MHD. The primary outcome was all-cause mortality. Multivariable Cox proportional hazards models were used to evaluate the association of TSF with the risk of mortality. The mean (standard deviation) age of the study population was 54.1 (15.1) years. 599 (57.9%) of the participants were male. The median (interquartile range) of TSF was 9.7 (6.3–13.3 mm) in males and 12.7 (10.0–18.0 mm) in females. Over a median follow up of 4.4 years (interquartile range, 2.4-7.9 years), there were 548 (53.0%) deaths. When TSF was assessed as sex-specific quartiles, compared with those in quartile 1, the adjusted HRs (95%CIs) of all-cause mortality in quartile 2, quartile 3 and quartile 4 were 0.93 (0.73, 1.19), 0.75 (0.58, 0.97) and 0.69 (0.52, 0.92), respectively (P for trend =0.005). Moreover, when analyzed by sex, increased TSF (≥9.7 mm for males and ≥18mm for females) was significantly associated with a reduced risk of all-cause mortality (quartile 3-4 vs. quartile 1-2; HR, 0.70; 95%CI: 0.55, 0.90 in males; quartile 4 vs. Quartile 1-3; HR, 0.69; 95%CI: 0.48, 1.00 in females). In conclusion, high TSF was significantly associated with lower risk of all-cause mortality in MHD patients.