【思覺失調症會增加感染COVID-19的死亡風險(JAMA Psychiatry. 2021;78(4):380-386.)】:我們都知道感染COVID-19死亡的患者,通常年齡較大、也都常有高血壓、糖尿病等慢性疾病。精神疾病大多也是慢性病,是不是像高血壓、糖尿病一樣會增加COVID-19的死亡率呢?
發表在《美國醫學會精神醫學期刊》(JAMA Psychiatry)的論文分析:感染COVID-19後45天的死亡危險因子中,僅次於年齡的,就是「思覺失調類群疾病」的病史(odds ratio [OR], 2.67; 95% CI, 1.48-4.80)這是比高血壓、糖尿病還要高的風險比。
這集的podcast綜合三篇頂尖期刊的大型研究,討論精神疾病患者在COVID-19疫情期間的三個臨床重點:
1.憂鬱、焦慮、強迫症患者,在疫情期間,精神症狀在疫情較嚴重、封城的短期內,心理健康狀態比一般人還要不好,但沒有比疫情之前還要嚴重
2.所有的精神科病史,都會增加感染COVID-19的風險
3.思覺失調症的患者會增加感染COVID-19的死亡風險
📖 參考論文
1.The mental health impact of the COVID-19 pandemic on people with and without depressive, anxiety, or obsessive-compulsive disorders: a longitudinal study of three Dutch case-control cohorts. Lancet Psychiatry. 2021 Feb;8(2):121-129.
https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(20)30491-0/fulltext
2.Bidirectional associations between COVID-19 and psychiatric disorder: retrospective cohort studies of 62 354 COVID-19 cases in the USA. Lancet Psychiatry. 2021 Feb;8(2):130-140.
https://linkinghub.elsevier.com/retrieve/pii/S2215-0366(20)30462-4
3.Association of Psychiatric Disorders With Mortality Among Patients With COVID-19. JAMA Psychiatry. 2021;78(4):380-386.
https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2775179
📖 對「思覺失調症」的診斷性會談技巧,也可以參考以下資訊圖表
http://yuhsuanlinmd.blogspot.com/2021/04/blog-post.html
#思覺失調症, #死亡率, #憂鬱症, #焦慮症, #強迫症, #COVID-19, #schizophrenia
📻收聽平台
➡️ Apple Podcasts:
https://podcasts.apple.com/us/podcast/思覺失調症會增加感染covid-19的死亡風險-jama-psychiatry-2021-78-4-380-386/id1556170884?i=1000524881032
➡️ Google Podcast
https://reurl.cc/kVOgmG
➡️ Spotify
https://reurl.cc/L0Wq9a
➡️ Pocket Casts
https://reurl.cc/YWEpZO
➡️ KKBOX
https://reurl.cc/Q7Rx80
➡️ Firstory
https://reurl.cc/nnNAQn
➡️ YouTube
https://www.youtube.com/watch?v=gCdKKclTJQo
( 財團法人國家衛生研究院 林煜軒醫師摘要整理)
📖 更多 Covid-19 照護指引 相關文章,詳:
(國家衛生研究院-論壇)
https://forum.nhri.edu.tw/covid19/category/guideline/
衛生福利部
國民健康署
疾病管制署 - 1922防疫達人
國家衛生研究院-論壇
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【PM 2.5 和子宮肌瘤的生成可能有關 】
中山附醫海扶刀中心主任 沈煌彬博士
以前外地人談到台中,就會想到某個知名的八大行業,現在多了一項新話題,也就是「霧霾」。
根據中國醫藥大學在2019年02月所發表的研究,從健保資料庫分析。收集了2001到2010年的資料,含括了11028個子宮肌瘤病人。發現PM 2.5每增加10 μg/m ³ ,肌瘤的風險增加1.105倍。
沈醫師還是要提醒,健保資料庫的研究只是一種研究方法,並不代表有必然關係,將來相關研究還是要繼續進行。霧霾天氣出門,戴口罩不一定可以減少肌瘤發生,至少可以減少肺部疾病。
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原文標題: The effects of exposure to air pollution on the development of uterine fibroids
原文出處: International Journal of Hygiene and Environmental Health 222(3) · February 2019
原文摘要: Air pollution may cause specific genetic or epigenetic abnormalities and lead to the development of uterine fibroids (UFs). However, there have been limited studies evaluating the relationship between air pollutant exposure and the development of UFs. We conducted a 10-year cohort-based case-control study in Taiwan from 2001 to 2010 using National Health Institute Research Database (NHIRD) to assess the association between air pollution and the UFs development among Taiwanese women. The case group consisted of 11,028 women newly diagnosed with UFs during the study period and the control group was 44,112 women aged 25–45 years using density sampling with a 1:4 matching on the date of birth from 224,675 women in 2001–2010. The average age of onset was 36 ± 4.37 years old. Daily concentrations of PM 2.5 were estimated by linear mixed-effects model integrating aerosol optical depth (AOD) and meteorological variables; daily concentrations of O 3 , CO, NO 2 and SO 2 were calculated by the Inverse Distance Weighting (IDW). The annual cumulative exposure to air pollutants during the study period was calculated corresponding to residential zip codes. Results: In the conditional logistic regression adjusting for confounders, the adjusted odds ratio (aOR) for UFs per 10 μg/m ³ increase in PM 2.5 was 1.105 (95% confidence interval: 1.069, 1.141), per 10 ppb increase in O 3 was 1.075 (95% confidence interval: 1.039, 1.113), respectively. Conclusions: Our study suggests that exposure to PM 2.5 and O 3 may increase the risk of developing UFs. Further studies are needed to confirm this novel finding.
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Nov 16, 2018 - Enjoy the videos and music you love, upload original content, and share it all with friends, family, and the world on YouTube. ... <看更多>
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Nov 16, 2018 - Enjoy the videos and music you love, upload original content, and share it all with friends, family, and the world on YouTube. ... <看更多>
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That means, where the rare outcome assumption is met, and the study is well designed, reasonable estimates to the RR can be obtained by ... ... <看更多>
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