ABSTRACT
OBJECTIVES: To assess if baseline iron deficiency, with or without anemia, is associated with incident infections over 3 years among community-dwelling older adults. DESIGN: Prospective secondary analysis of DO-HEALTH, a 3-year randomized, double-blind controlled trial. SETTING AND PARTICIPANTS: 2157 community-dwelling adults age 70+ from 5 European countries with good cognitive function and mobility and no major health events in the 5 years prior to enrollment Measurements: Incident infections, their severity and type were recorded every 3 months throughout the 3-year follow-up. Iron deficiency was defined as soluble transferrin receptor (sTfR) levels > 28.1 nmol/l and anemia as hemoglobin levels < 120 g/l for women and 130 g/l for men. We applied negative binomial mixed effects regression models with random effects for countries, and controlling for treatment allocation, age, sex, body mass index, polypharmacy, number of comorbidities, smoking status, living situation, alcohol intake, frailty status, and physical activity levels. A pre-defined stratified analysis was performed to explore if the associations between iron deficiency and infections were consistent by baseline anemia status. RESULTS: In total, 2141 participants were included in the analyses (mean age 74.9 years, 61.5% of women, 26.8% with iron deficiency). Across all participants, baseline iron deficiency was not associated with incident overall infections, but was associated with a 63% greater rate of incident severe infections requiring hospitalization (incidence rate ratio [IRR] 1.63, 95% Confidence Interval [CI] 1.11-2.41, p=0.01). This association was more pronounced among the 2000 participants who did not have anemia at baseline (IRR=1.80, 95% CI 1.20-2.69, p=0.005). CONCLUSION: Based on this prospective study among generally healthy European community-dwelling older adults, iron deficiency was not associated with the incidence rate of overall infections but may increase the incidence of severe infections. Intervention studies are needed to prove the causality of this observation.
Subject(s)
Anemia, Iron-Deficiency , Anemia , Iron Deficiencies , Aged , Anemia, Iron-Deficiency/epidemiology , Female , Hemoglobins , Humans , Independent Living , Iron , Male , Prospective Studies , Receptors, TransferrinABSTRACT
Several studies have demonstrated either a direct or an indirect relationship between alcoholism and death causes. The present paper is a descriptive study about death causes in 428 alcoholic patients from San José, Costa Rica, metropolitan area, whose death occurred between 1978 and 1988. Sample subjects were males, under 90-year-old at death time. It was found out that basic death causes were: Traumatism and poisoning, 25%; circulatory system illnesses, 20%; digestive system illnesses, 18.5%, and tumors, 15%.
Subject(s)
Alcoholism/mortality , Adult , Aged , Alcoholism/epidemiology , Cause of Death , Cerebrovascular Disorders/epidemiology , Cerebrovascular Disorders/mortality , Costa Rica/epidemiology , Digestive System Diseases/epidemiology , Digestive System Diseases/mortality , Humans , Male , Mental Disorders/epidemiology , Mental Disorders/mortality , Middle Aged , Neoplasms/epidemiology , Neoplasms/mortality , Risk Factors , Wounds and Injuries/epidemiology , Wounds and Injuries/mortalityABSTRACT
Several studies have demonstrated either a direct or an indirect relationship between alcoholism and death causes. The present paper is a descriptive study about death causes in 428 alcoholic patients from San José, Costa Rica, metropolitan area, whose death occurred between 1978 and 1988. Sample subjects were males, under 90-year-old at death time. It was found out that basic death causes were: Traumatism and poisoning, 25
; circulatory system illnesses, 20
; digestive system illnesses, 18.5
, and tumors, 15
.
ABSTRACT
Several studies have demonstrated either a direct or an indirect relationship between alcoholism and death causes. The present paper is a descriptive study about death causes in 428 alcoholic patients from San José, Costa Rica, metropolitan area, whose death occurred between 1978 and 1988. Sample subjects were males, under 90-year-old at death time. It was found out that basic death causes were: Traumatism and poisoning, 25
; circulatory system illnesses, 20
; digestive system illnesses, 18.5
, and tumors, 15
.
Subject(s)
Adolescent , Adult , Middle Aged , Humans , Female , Delivery of Health Care , Hospitals, General , Cost-Benefit Analysis , Professional PracticeABSTRACT
El Cuestionario General de Salud fue aplicado a una muestra de la poblacion que asistio a consulta medica general en un sanatorio privado de la ciudad de Mexico, en el transcurso de un mes. De esta poblacion se seleccionaron al azar 75 personas con edades superiores a los 65 anos con el fin de medir la sensibilidad y la especificidad del instrumento en personas de edad avanzada. Los resultados obtenidos por el Cuestionario General de Salud fueron confirmados por medio de la entrevista psiquiatrica estandarizada, que fue aplicada en forma independiente a quienes formaron la muestra en estudio. Los resultados informaron que a pesar de que el Cuestionario General de Salud no es recomendado para personas de edad avanzada, debido a la cronicidad de su sintomatologia general el instrumento si resalta variaciones considerables entre los resultados de las personas "casos" y los "no casos", detectando en forma eficaz a los primeros y encontrando un nivel de error comparable al obtenido por el estudio realizado en forma paralela al presente, en personas con edades entre 18 y 64 anos
Subject(s)
Humans , Aged , Mental Disorders , Mexico , Surveys and QuestionnairesABSTRACT
The Standardized Psychiatric Interview (SPI) was developed by Goldberg et al., for use in community surveys. The authors made the translation and adaptation of this instrument to Spanish and in this paper they present the inter-rater reliability study of different clinicians using the SPI in a sample of 30 women psychiatric out-patients. The raters were 4 psychiatrists and 2 clinical psychologists. A one week training course was developed before the study in order to get acquainted with the instrument, discuss it and use the standard technique to elicit and record psychiatric symptoms on 5 audiotapes and 10 subjects with different degrees of pathology. The inter-rater reliability was tested using the product-moment correlation, the statistic Kappa and a descriptive index of association in order to show the agreement between raters when the symptom was present or absent. A two-way analysis of variance was also carried out in order to test if there were any differences among the raters. The results show a mean product-moment correlation of 0.90 and a mean Kappa of 0.82. In 20 of the interviews a psychiatrist and a psychologist acted as raters and the results were almost the same. The authors conclude that the SPI is an useful technique for further studies in general practice and community surveys in the hands of mental health personnel trained in the use of Standardized Psychiatric Interview.
Subject(s)
Interview, Psychological/methods , Mental Disorders/diagnosis , Psychiatric Status Rating Scales , Adult , Female , Health Surveys , Humans , Mass Screening , Psychiatry/standards , Psychology, Clinical/standardsABSTRACT
The Standardized Psychiatric Interview (SPI) was developed by Goldberg et al., for use in community surveys. The authors made the translation and adaptation of this instrument to Spanish and in this paper they present the inter-rater reliability study of different clinicians using the SPI in a sample of 30 women psychiatric out-patients. The raters were 4 psychiatrists and 2 clinical psychologists. A one week training course was developed before the study in order to get acquainted with the instrument, discuss it and use the standard technique to elicit and record psychiatric symptoms on 5 audiotapes and 10 subjects with different degrees of pathology. The inter-rater reliability was tested using the product-moment correlation, the statistic Kappa and a descriptive index of association in order to show the agreement between raters when the symptom was present or absent. A two-way analysis of variance was also carried out in order to test if there were any differences among the raters. The results show a mean product-moment correlation of 0.90 and a mean Kappa of 0.82. In 20 of the interviews a psychiatrist and a psychologist acted as raters and the results were almost the same. The authors conclude that the SPI is an useful technique for further studies in general practice and community surveys in the hands of mental health personnel trained in the use of Standardized Psychiatric Interview.
ABSTRACT
Los autores realizaron la traduccion y adaptacion a la poblacion de Mexico de la Entrevista Psiquiatrica Estructurada desarrollada por Goldberg y cols., para hacer diagnosticos psiquiatricos en estudios de comunidad. Este trabajo presenta el estudio de confiabilidad entrevistador-observador utilizando este metodo en donde participaron 4 psiquiatras y 2 psicologas clinicas aplicando el instrumento a 30 pacientes femeninos de consulta externa de psiquiatria. La media de correlacion producto-momento fue de 0.90 y la media del Kappa fue de 0.82. Los autores concluyen que el instrumento es util para futuros estudios en consulta general y comunidad pudiendo ser empleado por personal de la salud capacitado a traves de un curso previo en el empleo de la entrevista
Subject(s)
Interview, Psychological , Community PsychiatryABSTRACT
Los autores realizaron la traduccion y adaptacion a la poblacion de Mexico de la Entrevista Psiquiatrica Estructurada desarrollada por Goldberg y cols., para hacer diagnosticos psiquiatricos en estudios de comunidad. Este trabajo presenta el estudio de confiabilidad entrevistador-observador utilizando este metodo en donde participaron 4 psiquiatras y 2 psicologas clinicas aplicando el instrumento a 30 pacientes femeninos de consulta externa de psiquiatria. La media de correlacion producto-momento fue de 0.90 y la media del Kappa fue de 0.82. Los autores concluyen que el instrumento es util para futuros estudios en consulta general y comunidad pudiendo ser empleado por personal de la salud capacitado a traves de un curso previo en el empleo de la entrevista
Subject(s)
Community Psychiatry , Interview, PsychologicalABSTRACT
Ro 13-9904/001 is a novel parenteral cephalosporin antibiotic with potent in vitro activity against a wide range of beta-lactamase-producing and non-producing pathogens. In addition, Ro 13-9904/001 proved to possess a very long plasma half-life and, as a consequence, high prophylactic in vivo effectiveness.
