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Abstract Emergency general surgeons often provide care to severely ill patients requiring surgical interventions and intensive support. One of the primary drivers of morbidity and mortality is perioperative bleeding. In general, when addressing life threatening haemorrhage, blood transfusion can become an essential part of overall resuscitation. However, under all circumstances, indications for blood transfusion must be accurately evaluated. When patients decline blood transfusions, regardless of the reason, surgeons should aim to provide optimal care and respect and accommodate each patient’s values and target the best outcome possible given the patient’s desires and his/her clinical condition. The aim of this position paper was to perform a review of the existing literature and to provide comprehensive recommendations on organizational, surgical, anaesthetic, and haemostatic strategies that can be used to provide optimal peri-operative blood management, reduce, or avoid blood transfusions and ultimately improve patient outcomes.

Emergency general surgeons often provide care to severely ill patients requiring surgical interventions and intensive support. One of the primary drivers of morbidity and mortality is perioperative bleeding. In general, when addressing life threatening haemorrhage, blood transfusion can become an essential part of overall resuscitation. However, under all circumstances, indications for blood transfusion must be accurately evaluated. When patients decline blood transfusions, regardless of the reason, surgeons should aim to provide optimal care and respect and accommodate each patient's values and target the best outcome possible given the patient's desires and his/her clinical condition. The aim of this position paper was to perform a review of the existing literature and to provide comprehensive recommendations on organizational, surgical, anaesthetic, and haemostatic strategies that can be used to provide optimal peri-operative blood management, reduce, or avoid blood transfusions and ultimately improve patient outcomes. [ABSTRACT FROM AUTHOR]

Abstract Heart failure (HF) is a long‐term clinical syndrome, with increasing prevalence and considerable healthcare costs that are further expected to increase dramatically. Despite significant advances in therapy and prevention, mortality and morbidity remain high and quality of life poor. Epidemiological data, that is, prevalence, incidence, mortality, and morbidity, show geographical variations across the European countries, depending on differences in aetiology, clinical characteristics, and treatment. However, data on the prevalence of the disease are scarce, as are those on quality of life. For these reasons, the ESC‐HFA has developed a position paper to comprehensively assess our understanding of the burden of HF in Europe, in order to guide future policies for this syndrome. This manuscript will discuss the available epidemiological data on HF prevalence, outcomes, and human costs—in terms of quality of life—in European countries.

Sudden unexpected death of an individual with epilepsy can pose a challenge to death investigators, as most deaths are unwitnessed, and the individual is commonly found dead in bed. Anatomic findings (eg, tongue/lip bite) are commonly absent and of varying specificity, thereby limiting the evidence to implicate epilepsy as a cause of or contributor to death. Thus it is likely that death certificates significantly underrepresent the true number of deaths in which epilepsy was a factor. To address this, members of the National Association of Medical Examiners, North American SUDEP Registry, Epilepsy Foundation SUDEP Institute, American Epilepsy Society, and the Centers for Disease Control and Prevention constituted an expert panel to generate evidence-based recommendations for the practice of death investigation and autopsy, toxicological analysis, interpretation of autopsy and toxicology findings, and death certification to improve the precision of death certificate data available for public health surveillance of epilepsy-related deaths. The recommendations provided in this paper are intended to assist medical examiners, coroners, and death investigators when a sudden unexpected death in a person with epilepsy is encountered.

Three hundred and ninety one male employees aged 35-65 in a Swedish pulp and paper company were followed up for 22 years; 151 deaths were recorded by 31 December 1983. On the basis of data from 1961, indices for job decision latitude, job support, and other work related psychosocial factors were constructed as were five indices for non-work related social network factors. All indices were checked by life table analysis in respect of mortality. Job decision latitude and a combined index for job decision latitude and job support showed significant associations with mortality. These two indices were investigated by multivariate analysis with scale for evaluation of neuroticism and known somatic risk factors such as smoking, cholesterol, and systolic and diastolic blood pressure. Age, educational level, occupational status, physically heavy work, and general health state were also included in the multivariate analysis. Age, systolic blood pressure, the combined index for job decision latitude and job support, smoking, and neuroticism were shown to be independent predictors of mortality.

The different studies published and indexed in Medline and in the Spanish Medical Index (IME) from 1984 up to 1998 (IME: 1971-1996) are reviewed. To start with, an assessment was made of the number of publications put out which have to do with the impact of pollution on human health as well as the percentage thereof which analyze the mortality as a health indicator. Afterward, the original works published within the January 1994-June 1998 period were reviewed in detail. Most of the original articles are combined time series studies which analyze, on a single-day basis, the relationship between the levels of pollution and the mortality for non-accidental causes. Other original articles were also summarized based on an approach other than the time series one, highlighting different cohort studies which relate the levels of pollution to the mortality on an individual level and which confirm the findings of prior ecological studies. The pollutants analyzed most often are the different types of particles, although studies are also common regarding the impact of sulfur dioxide, nitrogen dioxide, ozone and carbon monoxide. The method of analysis most used is the Poisson regression, into which different confusion variables bearing an impact thereon such as seasonality and tendency, temperature and relative humidity and day of the year are basically added. In the studies reviewed, the positive significant findings prevail, being consistent especially for particles, which is the pollutant most analyzed. The articles studying other pollutants, although fewer in number, also indicate a significant relationship between pollution levels and the mortality.

Abstract In light of the accumulating evidence on the negative predictive value of soluble urokinase plasminogen activator receptor (suPAR), a group of experts from the fields of intensive care medicine, emergency medicine, internal medicine and infectious diseases frame a position statement on the role of suPAR in the screening of patients admitted to the emergency department. The statement is framed taking into consideration existing publications and our own research experience. The main content of this statement is that sUPAR is a non-specific marker associated with a high negative predictive value for unfavourable outcomes; levels < 4 ng/ml indicate that it is safe to discharge the patient, whereas levels > 6 ng/ml are an alarming sign of risk for unfavourable outcomes. However, the suPAR levels should always be interpreted in light of the patient's history.

Poverty is an important social determinant of health that is associated with increased risk of death 1-5 . Cash transfer programmes provide non-contributory monetary transfers to individuals or households, with or without behavioural conditions such as children's school attendance 6,7 . Over recent decades, cash transfer programmes have emerged as central components of poverty reduction strategies of many governments in low- and middle-income countries 6,7 . The effects of these programmes on adult and child mortality rates remains an important gap in the literature, however, with existing evidence limited to a few specific conditional cash transfer programmes, primarily in Latin America 8-14 . Here we evaluated the effects of large-scale, government-led cash transfer programmes on all-cause adult and child mortality using individual-level longitudinal mortality datasets from many low- and middle-income countries. We found that cash transfer programmes were associated with significant reductions in mortality among children under five years of age and women. Secondary heterogeneity analyses suggested similar effects for conditional and unconditional programmes, and larger effects for programmes that covered a larger share of the population and provided larger transfer amounts, and in countries with lower health expenditures, lower baseline life expectancy, and higher perceived regulatory quality. Our findings support the use of anti-poverty programmes such as cash transfers, which many countries have introduced or expanded during the COVID-19 pandemic, to improve population health., (© 2023. The Author(s), under exclusive licence to Springer Nature Limited.)