The aim of this study was to determine trajectories of depression in older adults and to identify predictors of membership in the different trajectory groups. A total of 3983 individuals aged 65 or older were included. Latent class growth models were used to identify trajectory groups. Of 3983 individuals, 2269 (57%) were females, with a mean baseline age of 72.4 years (SD = 6 years). Four depression trajectories were identified across 8 years of follow-up “low-flat” (n = 3636; 86.6%), “low-to-middle” (n = 214; 9.2%), “low-to-high” (n = 31; 1.3%), and “high-stable” (n = 102; 2.9%). Compared to the low-flat depression group, high-stable depression group members were more likely to be female, have three or more chronic diseases, and were more likely not to own a home. Our findings will assist health policy decision-makers in planning intervention programs targeting those most likely to experience persistent depression in order to improve psychological well-being in the elderly.Insulin bolus calculators have proven effective in improving glycemia and patient safety. Insulin calculators are increasingly being implemented for inpatient hospital care. Multidisciplinary teams are often involved in the design and review of the efficacy and utilization for these calculators. At times, unintended consequences and benefits of utilization are found on review. Integration of our insulin calculator into our electronic health record system was a multidisciplinary effort. During implementation, several obstacles to effective care were identified and are discussed in the following manuscript. We describe the barriers to utilization and potential pitfalls in clinical integration. We further describe benefits in patient education, time of insulin administration versus meal delivery, variations in insulin bolus for ketone correction, variation in care, and maximum bolus administration. Sharing lessons learned from experiences using electronic insulin calculator order sets will further our goals of improved patient care in the hospital setting.Red blood cell (RBC) transfusion is a common therapeutic intervention, which is necessary for patients with emergency or hematological disorders to reduce morbidity and mortality. However, to date, blood available for transfusion is a limited resource, and the transfusion coverage system still depends on the volunteer-based collection system. The scarcity of blood supplies commonly develops because of local conditions that transiently affect collection. Moreover, donor-derived infectious disease transmission events also remain a risk. Thus, there is a huge demand for artificial blood. The production of cultured RBCs from stem cells is slowly emerging as a potential alternative to donor-derived red cell transfusion products. In this concise review, we summarize the recent in vitro expansion of RBCs from various stem cell sources, targeted therapy, prospects, and remaining challenges.The coronavirus disease 2019 (COVID-19) pandemic, originating from Wuhan, China, is known to cause severe acute respiratory symptoms. The occurrence of a cytokine storm in the lungs is a critical step in the disease pathogenesis, as it causes pathological lesions, pulmonary edema, and acute respiratory distress syndrome, potentially resulting in death. Currently, there is no effective treatment that targets the cytokine storm and helps regenerate the damaged tissue. Mesenchymal stem cells (MSCs) are known to act as anti-inflammatory/immunomodulatory candidates and activate endogenous regeneration. As a result, MSC therapy is a potential treatment approach for COVID-19. Intravenous injection of clinical-grade MSCs into COVID-19 patients can induce an immunomodulatory response along with improved lung function. Dental pulp stem cells (DPSCs) are considered a potential source of MSCs for immunomodulation, tissue regeneration, and clinical application. Although some current clinical trials have treated COVID-19 patients with DPSCs, this therapy has not been approved. Here, we review the potential use of DPSCs and their significance in the development of a therapy for COVID-19.Contrast-induced nephropathy (CIN) is a serious complication of angiographic procedures. It is the third most common cause of hospital acquired acute renal injury. Ribociclib As there are currently no approved therapies for CIN, prevention could be the best strategy to address this issue. Acetylcysteine may indirectly play an antioxidant role by inducing the synthesis of glutathione. Acetylcysteine can also reduce renal vasoconstriction induced by contrast medium stimulation by stabilizing nitric oxide and acting directly or indirectly on renal cortex and medulla microcirculation. To evaluate the effect of acetylcysteine on the prevention of CIN in patients after angiography, we systematically searched and analyzed the clinical data of patients including the incidence of CIN and change in serum creatinine (SCr) at 48 hours after angiography from selected articles. The result showed that acetylcysteine significantly reduces the incidence of CIN (risk ratios 0.78, 95% CI 0.68-0.90, I2 = 37.3%) and the level of SCr (standardized mean difference -0.53, 95% CI -0.93 to -0.12, I2 = 91.5%) after angiography compared with the control group. Overall, the use of acetylcysteine in patients after angiography was associated with a significant reduction of CIN and the level of SCr.

Infections are common in terminally ill patients (pts), and although antibiotics are frequently prescribed, their benefit for symptom relief is not clear. Antimicrobials at the end of life (EOL) may increase the risk of antimicrobial resistance and

infection. Our aim was to determine the frequency of symptom occurrence at the EOL when comparing pts who did or did not receive antibiotics (AB+ or AB-).

We reviewed electronic medical records of pts admitted to a palliative care unit of a quarternary care hospital between 01/09/2017 and 07/16/2017 and assessed antimicrobial use in the last 14 days of life. Differences in demographics and symptom control between AB+ and AB- pts were analyzed using chi-square analyses; p-values were computed using Mann-Whitney tests.

Of a total of 133 pts included, 90 (68%) received antimicrobials (AB+). The indication for antibiotics was documented in only 12% of pts. The AB+ and AB- groups were similar with respect to demographics, including sex, and Charleston Comorbidity Index except for age (p = 0.