Using Pharmacologic Smoking Cessation Treatments in Pregnancy

Smoking in pregnancy constitutes a major global public health problem and is the leading cause of avoidable harm to women and infants, including fetal and neonatal deaths and long-term health issues. Outside of pregnancy, a range of smoking cessation medications are available to help individuals quit smoking. However, pharmacologic treatment options during pregnancy are limited by a thin evidence base, with most available evidence focused on the safety and efficacy of nicotine replacement therapy (NRT) to help pregnant individuals stop smoking.

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High prevalence of diabetes mellitus among patients with Fabry disease in Taiwan: a cross-sectional study

Objectives
This study aimed to investigate the prevalence of diabetes mellitus in patients with Fabry disease using a nationwide population-based dataset. We hypothesised that patients with Fabry disease would have a higher prevalence of diabetes mellitus compared with the general population.

Design
A cross-sectional study.

Setting
Taiwan.

Participants
We identified a study sample from Taiwan’s LHID2010 Database. There were 9408 sampled patients in this study, 2352 study patients with Fabry disease and 7056 propensity-score-matched comparison patients.

Primary outcome measures
Multiple logistic regression analyses were conducted to explore the association between diabetes mellitus and Fabry disease after taking the variables of age, sex, geographic location, monthly income category, urbanisation level of the patient’s residence, hyperlipidaemia and hypertension into consideration.

Results
The results revealed significantly higher prevalence of diabetes mellitus among patients with Fabry disease than among comparison patients (35.8% vs 29.6%, p

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Epidemiology and risk of psychiatric disorders in patients with polymyositis and dermatomyositis: a nationwide population-based cohort study in Taiwan

Objectives
To evaluate the incidence and risk factors for psychiatric disorders, including depression and anxiety, and assess the risk of suicide in patients with polymyositis (PM) and dermatomyositis (DM).

Design
Retrospective cohort study.

Setting
Data were obtained from Taiwan’s National Health Insurance Research Database (NHIRD) between 2000 and 2018.

Participants
A total of 3477 patients with PM/DM and 13 908 age- and sex-matched non-PM/DM controls were included in the study.

Primary and secondary outcome measures
The primary outcome was the incidence and risk of psychiatric disorders in patients with PM/DM compared with controls. Secondary outcomes included the identification of risk factors for psychiatric disorders, mortality and suicide risk in the PM/DM cohort.

Results
The incidence rate ratio (IRR) of psychiatric disorders was significantly higher in the PM/DM cohort than in controls (IRR 1.62, 95% CI 1.39 to 1.89), with depression being the most prevalent disorder (IRR 2.25, 95% CI 1.83 to 2.75). Key risk factors included female sex, intravenous steroid therapy, and high-dose oral steroid use. Additionally, the PM/DM cohort exhibited a higher mortality rate (IRR 3.4, 95% CI 3.15 to 3.67) and elevated suicide risk (IRR 1.99, 95% CI 0.96 to 3.86) compared with controls.

Conclusion
Patients with PM/DM face a significantly higher risk of psychiatric disorders, mortality and suicide. Integrating mental healthcare into the routine management of PM/DM is crucial to improving patient outcomes and reducing mortality. Future research should focus on the impact of early psychiatric interventions on survival outcomes in this population.

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Life Support and Outcomes Among ICU Patients

This cohort study uses data from US health systems continuously contributing to the Epic Cosmos database from 2014-2023 to characterize changes in intensive care unit (ICU) outcomes (ICU length of stay; use of mechanical ventilation or vasopressors; in-hospital mortality) and use of life support before, during, and after the COVID-19 pandemic.

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