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Sample records for premature mortality due

  1. Premature mortality in Japan due to ozone

    NASA Astrophysics Data System (ADS)

    Nawahda, Amin; Yamashita, Ken; Ohara, Toshimasa; Kurokawa, Junichi; Ohizumi, Tsuyoshi; Chen, Fang; Akimoto, Hajime

    2013-12-01

    In Japan, all 47 prefectures conduct routine air quality monitoring at 1145 stations throughout the country to assess environmental effects. This study aims to provide a better understanding of possible estimations of premature mortality in Japan caused by exposure to monitored and modeled concentrations of tropospheric ozone during the period from January to December, 2005. The spatial distribution and temporal variation of ozone concentrations were modeled using the Models-3 Community Multiscale Air Quality modeling system coupled with the Regional Emission Inventory in Asia (CMAQ/REAS). Premature mortality caused by exposure to ozone was calculated assuming a relative risk (RR) value of 1.003 [95% Confidence Interval (CI): 1.001-1.004] for concentrations above 35 ppb according to the SOMO35 index (annual Sum of daily maximum 8-h Ozone Means Over 35 ppb) recommended by WHO (2008). Based on CMAQ/REAS simulations, the estimated all-cause premature mortality in 2005 is about 13,000 (95% CI: 4320-17,300) cases. This value is 2.5 times greater than the estimated premature mortality based on monitored ozone concentrations, which is 5220 (95% CI: 1740-6960) cases.

  2. Premature mortality due to cancer in Japan, 1995 and 2005.

    PubMed

    Pham, Truong-Minh; Fujino, Yoshihisa; Matsuda, Shinya; Yoshimura, Takesumi

    2010-07-01

    To better understand premature mortality due to cancer, we estimated years of life lost (YLL) and average years of life lost (AYLL) due to cancer for the years 1995 and 2005, based on data from the Vital Statistic of Japan. In men, we identified a total of 159,623 cancer deaths in 1995 and 196,603 in 2005. Total YLL were 2,342,560.4 and 2,724,066.0 years, respectively. Averaged for all cancers, people died 14.7 years earlier than life expectancy in 1995 and 13.9 years in 2005. AYLL was longest for brain cancer deaths, at 26.3 years earlier than expected in 1995 and 22.8 years in 2005, followed by leukemia. In women, a total of 103,399 cancer deaths occurred in 1995 and 129,338 in 2005. Total YLL were 1,818,960.4 years in 1995 and 2,160,706.5 years in 2005, corresponding to AYLL for all cancer combined of 17.6 and 16.7 years. The AYLL of brain cancer deaths was also the longest, at 29.4 years in 1995 and 27.8 in 2005, followed by leukemia and female sex-related cancers. Results showed that cancer of the stomach, colorectum, liver and lung were the most frequent cancers in both sexes in both 1995 and 2005 and responsible for a remarkable number of YLL. Further, AYLL was greatest for brain cancer and leukemia in both sexes and for sex-related cancers in women, namely breast, cervix and ovarian cancer.

  3. The Productivity Costs of Premature Mortality Due to Cancer in Australia: Evidence from a Microsimulation Model

    PubMed Central

    Schofield, Deborah J.; Shrestha, Rupendra

    2016-01-01

    Aim To estimate the productivity costs of premature mortality due to cancer in Australia, in aggregate and for the 26 most prevalent cancer sites. Methods A human capital approach was adopted to estimate the long term impacts of Australian cancer deaths in 2003. Using population mortality data, the labour force participation and the present value of lifetime income (PVLI) forgone due to premature mortality was estimated based on individual characteristics at the time of death including age, sex and socioeconomic status. Outcomes were modelled to the year 2030 using economic data from a national microsimulation model. A discount rate of 3% was applied and costs were reported in 2016 Australian dollars. Results Premature deaths from cancer in 2003 resulted in 88,000 working years lost and a cost of $4.2 billion in the PVLI forgone. Costs were close to three times higher in males than females due to the higher number of premature deaths in men, combined with higher levels of workforce participation and income. Lung, colorectal and brain cancers accounted for the highest proportion of costs, while testicular cancer was the most costly cancer site per death. Conclusions The productivity costs of premature mortality due to cancer are significant. These results provide an economic measure of the cancer burden which may assist decision makers in allocating scare resources amongst competing priorities. PMID:27942032

  4. Premature mortality in India due to PM2.5 and ozone exposure

    NASA Astrophysics Data System (ADS)

    Ghude, Sachin D.; Chate, D. M.; Jena, C.; Beig, G.; Kumar, R.; Barth, M. C.; Pfister, G. G.; Fadnavis, S.; Pithani, Prakash

    2016-05-01

    This bottom-up modeling study, supported by new population census 2011 data, simulates ozone (O3) and fine particulate matter (PM2.5) exposure on local to regional scales. It quantifies, present-day premature mortalities associated with the exposure to near-surface PM2.5 and O3 concentrations in India using a regional chemistry model. We estimate that PM2.5 exposure leads to about 570,000 (CI95: 320,000-730,000) premature mortalities in 2011. On a national scale, our estimate of mortality by chronic obstructive pulmonary disease (COPD) due to O3 exposure is about 12,000 people. The Indo-Gangetic region accounts for a large part (~42%) of the estimated mortalities. The associated lost life expectancy is calculated as 3.4 ± 1.1 years for all of India with highest values found for Delhi (6.3 ± 2.2 years). The economic cost of estimated premature mortalities associated with PM2.5 and O3 exposure is about 640 (350-800) billion USD in 2011, which is a factor of 10 higher than total expenditure on health by public and private expenditure.

  5. Lost productivity due to premature mortality in developed and emerging countries: an application to smoking cessation

    PubMed Central

    2012-01-01

    Background Researchers and policy makers have determined that accounting for productivity costs, or “indirect costs,” may be as important as including direct medical expenditures when evaluating the societal value of health interventions. These costs are also important when estimating the global burden of disease. The estimation of indirect costs is commonly done on a country-specific basis. However, there are few studies that evaluate indirect costs across countries using a consistent methodology. Methods Using the human capital approach, we developed a model that estimates productivity costs as the present value of lifetime earnings (PVLE) lost due to premature mortality. Applying this methodology, the model estimates productivity costs for 29 selected countries, both developed and emerging. We also provide an illustration of how the inclusion of productivity costs contributes to an analysis of the societal burden of smoking. A sensitivity analysis is undertaken to assess productivity costs on the basis of the friction cost approach. Results PVLE estimates were higher for certain subpopulations, such as men, younger people, and people in developed countries. In the case study, productivity cost estimates from our model showed that productivity loss was a substantial share of the total cost burden of premature mortality due to smoking, accounting for over 75 % of total lifetime costs in the United States and 67 % of total lifetime costs in Brazil. Productivity costs were much lower using the friction cost approach among those of working age. Conclusions Our PVLE model is a novel tool allowing researchers to incorporate the value of lost productivity due to premature mortality into economic analyses of treatments for diseases or health interventions. We provide PVLE estimates for a number of emerging and developed countries. Including productivity costs in a health economics study allows for a more comprehensive analysis, and, as demonstrated by our

  6. Source Contributions to Premature Mortality Due to Ambient Particulate Matter in China

    NASA Astrophysics Data System (ADS)

    Hu, J.; Huang, L.; Ying, Q.; Zhang, H.; Shi, Z.

    2016-12-01

    Outdoor air pollution is linked to various health effects. Globally it is estimated that ambient air pollution caused 3.3 million premature deaths in 2010. The health risk occurs predominantly in developing countries, particularly in Asia. China has been suffering serious air pollution in recent decades. The annual concentrations of ambient PM2.5 are more than five times higher than the WHO guideline value in many populous Chinese cities. Sustained exposure to high PM2.5 concentrations greatly threatens public health in this country. Recognizing the severity of the air pollution situation, the Chinese government has set a target in 2013 to reduce PM2.5 level by up to 25% in major metropolitan areas by 2017. It is urgently needed for China to assess premature mortality caused by outdoor air pollution, identify source contributions of the premature mortality, and evaluate responses of the premature mortality to air quality improvement, in order to design effective control plans and set priority for air pollution controls to better protect public health. In this study, we determined the spatial distribution of excess mortality (ΔMort) due to adult (> 30 years old) ischemic heart disease (IHD), cerebrovascular disease (CEV), chronic obstructive pulmonary disease (COPD) and lung cancer (LC) at 36-km horizontal resolution for 2013 from the predicted annual-average surface PM2.5 concentrations using an updated source-oriented Community Multiscale Air Quality (CMAQ) model along with an ensemble of four regional and global emission inventories. Observation data fusing was applied to provide additional correction of the biases in the PM2.5 concentration field from the ensemble. Source contributions to ΔMort were determined based on total ΔMort and fractional source contributions to PM2.5 mass concentrations. We estimated that ΔMort due to COPD, LC, IHD and CEV are 0.329, 0.148, 0.239 and 0.953 million in China, respectively, leading to a total ΔMort of 1.669 million

  7. Global premature mortality due to anthropogenic outdoor air pollution and the contribution of past climate change

    NASA Astrophysics Data System (ADS)

    Silva, Raquel A.; West, J. Jason; Zhang, Yuqiang; Anenberg, Susan C.; Lamarque, Jean-François; Shindell, Drew T.; Collins, William J.; Dalsoren, Stig; Faluvegi, Greg; Folberth, Gerd; Horowitz, Larry W.; Nagashima, Tatsuya; Naik, Vaishali; Rumbold, Steven; Skeie, Ragnhild; Sudo, Kengo; Takemura, Toshihiko; Bergmann, Daniel; Cameron-Smith, Philip; Cionni, Irene; Doherty, Ruth M.; Eyring, Veronika; Josse, Beatrice; MacKenzie, I. A.; Plummer, David; Righi, Mattia; Stevenson, David S.; Strode, Sarah; Szopa, Sophie; Zeng, Guang

    2013-09-01

    Increased concentrations of ozone and fine particulate matter (PM2.5) since preindustrial times reflect increased emissions, but also contributions of past climate change. Here we use modeled concentrations from an ensemble of chemistry-climate models to estimate the global burden of anthropogenic outdoor air pollution on present-day premature human mortality, and the component of that burden attributable to past climate change. Using simulated concentrations for 2000 and 1850 and concentration-response functions (CRFs), we estimate that, at present, 470 000 (95% confidence interval, 140 000 to 900 000) premature respiratory deaths are associated globally and annually with anthropogenic ozone, and 2.1 (1.3 to 3.0) million deaths with anthropogenic PM2.5-related cardiopulmonary diseases (93%) and lung cancer (7%). These estimates are smaller than ones from previous studies because we use modeled 1850 air pollution rather than a counterfactual low concentration, and because of different emissions. Uncertainty in CRFs contributes more to overall uncertainty than the spread of model results. Mortality attributed to the effects of past climate change on air quality is considerably smaller than the global burden: 1500 (-20 000 to 27 000) deaths yr-1 due to ozone and 2200 (-350 000 to 140 000) due to PM2.5. The small multi-model means are coincidental, as there are larger ranges of results for individual models, reflected in the large uncertainties, with some models suggesting that past climate change has reduced air pollution mortality.

  8. Sex and Racial/Ethnic Differences in Premature Mortality Due to HIV: Florida, 2000–2009

    PubMed Central

    Niyonsenga, Theophile; Fennie, Kristopher P.; McKelvey, Karma; Lieb, Spencer; Maddox, Lorene M.

    2015-01-01

    Objective This study aimed to characterize premature mortality among people diagnosed with HIV infection from 2000 to 2009 in Florida, by sex and race/ethnicity, to estimate differences in premature mortality that could be prevented by linkage to HIV care and treatment. Methods Florida surveillance data for HIV diagnoses (excluding concurrent AIDS diagnoses) were linked with vital records data to ascertain deaths through 2011. Years of potential life lost (YPLL) were obtained from the expected number of remaining years of life at a given age from the U.S. sex-specific period life tables. Results Among 41,565 people diagnosed with HIV infection during the study period, 5,249 died, and 2,563 (48.8%) deaths were due to HIV/AIDS. Age-standardized YPLL (aYPLL) due to HIV/AIDS per 1,000 person-years was significantly higher for females than males (372.6, 95% confidence interval [CI] 349.8, 396.2 vs. 295.2, 95% CI 278.4, 312.5); for non-Hispanic black (NHB) females than non-Hispanic white (NHW) and Hispanic females (388.2, 95% CI 360.7, 416.9; 294.3, 95% CI 239.8, 354.9; and 295.0, 95% CI 242.9, 352.5, respectively); and for NHB males compared with NHW and Hispanic males (378.7, 95% CI 353.7, 404.7; 210.6, 95% CI 174.3, 250.8; and 240.9, 95% CI 204.8, 280.2, respectively). In multilevel modeling controlling for individual factors, NHB race was associated with YPLL due to HIV/AIDS for women (p=0.04) and men (p<0.001). Conclusion Among people diagnosed with HIV infection, females and NHB people had a disproportionately high premature mortality from HIV/AIDS, suggesting the need for enhanced efforts to improve linkage to and retention in care and medication adherence for these groups. PMID:26327728

  9. Model calculated global, regional and megacity premature mortality due to air pollution

    NASA Astrophysics Data System (ADS)

    Lelieveld, J.; Barlas, C.; Giannadaki, D.; Pozzer, A.

    2013-03-01

    Air pollution by fine particulate matter (PM2.5) and ozone (O3) has increased strongly with industrialization and urbanization. We estimated the premature mortality rates and the years of human life lost (YLL) caused by anthropogenic PM2.5 and O3 in 2005 for epidemiological regions defined by the World Health Organization. We carried out high-resolution global model calculations to resolve urban and industrial regions in greater detail compared to previous work. We applied a health impact function to estimate premature mortality for people of 30 yr and older, using parameters derived from epidemiological cohort studies. Our results suggest that especially in large countries with extensive suburban and rural populations, air pollution-induced mortality rates have previously been underestimated. We calculate a global respiratory mortality of about 773 thousand yr-1 (YLL ≈ 5.2 million yr-1), 186 thousand yr-1 by lung cancer (YLL ≈ 1.7 million yr-1) and 2.0 million yr-1 by cardiovascular disease (YLL ≈ 14.3 million yr-1). The global mean per capita mortality caused by air pollution is about 0.1 % yr-1. The highest premature mortality rates are found in the Southeast Asia and Western Pacific regions (about 25% and 46% of the global rate, respectively) where more than a dozen of the most highly polluted megacities are located.

  10. Multimodel estimates of premature human mortality due to intercontinental transport of air pollution

    NASA Astrophysics Data System (ADS)

    Liang, C.; Silva, R.; West, J. J.; Sudo, K.; Lund, M. T.; Emmons, L. K.; Takemura, T.; Bian, H.

    2015-12-01

    Numerous modeling studies indicate that emissions from one continent influence air quality over others. Reducing air pollutant emissions from one continent can therefore benefit air quality and health on multiple continents. Here, we estimate the impacts of the intercontinental transport of ozone (O3) and fine particulate matter (PM2.5) on premature human mortality by using an ensemble of global chemical transport models coordinated by the Task Force on Hemispheric Transport of Air Pollution (TF HTAP). We use simulations of 20% reductions of all anthropogenic emissions from 13 regions (North America, Central America, South America, Europe, Northern Africa, Sub-Saharan Africa, Former Soviet Union, Middle East, East Asia, South Asia, South East Asia, Central Asia, and Australia) to calculate their impact on premature mortality within each region and elsewhere in the world. To better understand the impact of potential control strategies, we also analyze premature mortality for global 20% perturbations from five sectors individually: power and industry, ground transport, forest and savannah fires, residential, and others (shipping, aviation, and agriculture). Following previous studies, premature human mortality resulting from each perturbation scenario is calculated using a health impact function based on a log-linear model for O3 and an integrated exposure response model for PM2.5 to estimate relative risk. The spatial distribution of the exposed population (adults aged 25 and over) is obtained from the LandScan 2011 Global Population Dataset. Baseline mortality rates for chronic respiratory disease, ischemic heart disease, cerebrovascular disease, chronic obstructive pulmonary disease, and lung cancer are estimated from the GBD 2010 country-level mortality dataset for the exposed population. Model results are regridded from each model's original grid to a common 0.5°x0.5° grid used to estimate mortality. We perform uncertainty analysis and evaluate the sensitivity

  11. Costs resulting from premature mortality due to cardiovascular causes: A 20-year follow-up of the DRECE study.

    PubMed

    Gómez-de la Cámara, A; Pinilla-Domínguez, P; Vázquez-Fernández Del Pozo, S; García-Pérez, L; Rubio-Herrera, M A; Gómez-Gerique, J A; Gutiérrez-Fuentes, J A; Rivero-Cuadrado, A; Serrano-Aguilar, P

    2014-10-01

    Cardiovascular diseases are still the leading cause of death in Spain. The DRECE study (Diet and Cardiovascular Disease Risk in Spain), based on a representative cohort of the Spanish general population, analyzed nutritional habits and lifestyle and their association with morbidity and mortality patterns. We estimated the impact, in terms of loss of productivity, of premature mortality attributed to cardiovascular diseases. The loss of productivity attributed to premature mortality was calculated from 1991, based on the potential years of life lost and the potential years of working life lost. During the 20-year follow-up of a cohort of 4779 patients, 225 of these patients died (men, 152). Sixteen percent of the deaths were attributed to cardiovascular disease. The costs due to lost productivity by premature mortality exceeded 29 million euros. Of these, 4 million euros (14% of the total cost) were due to cardiovascular causes. Premature cardiovascular mortality in the DRECE cohort represented a significant social cost due to lost productivity. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  12. Model calculated global, regional and megacity premature mortality due to air pollution

    NASA Astrophysics Data System (ADS)

    Lelieveld, J.; Barlas, C.; Giannadaki, D.; Pozzer, A.

    2013-07-01

    Air pollution by fine particulate matter (PM2.5) and ozone (O3) has increased strongly with industrialization and urbanization. We estimate the premature mortality rates and the years of human life lost (YLL) caused by anthropogenic PM2.5 and O3 in 2005 for epidemiological regions defined by the World Health Organization (WHO). This is based upon high-resolution global model calculations that resolve urban and industrial regions in greater detail compared to previous work. Results indicate that 69% of the global population is exposed to an annual mean anthropogenic PM2.5 concentration of >10 μg m-3 (WHO guideline) and 33% to > 25 μg m-3 (EU directive). We applied an epidemiological health impact function and find that especially in large countries with extensive suburban and rural populations, air pollution-induced mortality rates have been underestimated given that previous studies largely focused on the urban environment. We calculate a global respiratory mortality of about 773 thousand/year (YLL ≈ 5.2 million/year), 186 thousand/year by lung cancer (YLL ≈ 1.7 million/year) and 2.0 million/year by cardiovascular disease (YLL ≈ 14.3 million/year). The global mean per capita mortality caused by air pollution is about 0.1% yr-1. The highest premature mortality rates are found in the Southeast Asia and Western Pacific regions (about 25% and 46% of the global rate, respectively) where more than a dozen of the most highly polluted megacities are located.

  13. Years of potential life lost and productivity costs due to premature cancer-related mortality in Iran.

    PubMed

    Khorasani, Soheila; Rezaei, Satar; Rashidian, Hamideh; Daroudi, Rajabali

    2015-01-01

    Cancer is recently one of the major concerns of the public health both in the world and Iran. To inform priorities for cancer control, this study estimated years of potential life lost (YPLL) and productivity losses due to cancer-related premature mortality in Iran in 2012. The number of cancer deaths by sex for all cancers and the ten leading causes of cancer deaths in Iran in 2012 were obtained from the GLOBOCAN database. The life expectancy method and the human capital approach were used to estimate the YPLL and the value of productivity lost due to cancer-related premature mortality. There were 53,350 cancer-related deaths in Iran. We estimated that these cancer deaths resulted in 1,112,680 YPLL in total, 563,332 (50.6%) in males and 549,348 (49.4%) in females. The top 10 ranked cancers accounted for 75% of total death and 70% of total YPLL in the males and 69% for both death and YPLL in the females. The largest contributors for YPLL in the two genders were stomach and breast cancers, respectively. The total cost of lost productivity due to cancer-related premature mortality discounted at 3% rate in Iran, was US$ 1.93 billion. The most costly cancer for the males was stomach, while for the females it was breast cancer. The percentage of the total costs that were attributable to the top 10 cancers was 67% in the males and 71% in the females. The YPLL and productivity losses due to cancer-related premature mortality are substantial in Iran. Setting resource allocation priorities to cancers that occur in younger working-age individuals (such as brain and central nervous system) and/or cancers with high incidence and mortality rates (such as stomach and breast) could potentially decrease the productivity losses and the YPLL to a great extent in Iran.

  14. Productivity loss due to premature mortality caused by blood cancer: a study based on patients undergoing stem cell transplantation.

    PubMed

    Ortega-Ortega, Marta; Oliva-Moreno, Juan; Jiménez-Aguilera, Juan de Dios; Romero-Aguilar, Antonio; Espigado-Tocino, Ildefonso

    2015-01-01

    Stem cell transplantation has been used for many years to treat haematological malignancies that could not be cured by other treatments. Despite this medical breakthrough, mortality rates remain high. Our purpose was to evaluate labour productivity losses associated with premature mortality due to blood cancer in recipients of stem cell transplantations. We collected primary data from the clinical histories of blood cancer patients who had undergone stem cell transplantation between 2006 and 2011 in two Spanish hospitals. We carried out a descriptive analysis and calculated the years of potential life lost and years of potential productive life lost. Labour productivity losses due to premature mortality were estimated using the Human Capital method. An alternative approach, the Friction Cost method, was used as part of the sensitivity analysis. Our findings suggest that, in a population of 179 transplanted and deceased patients, males and people who die between the ages of 30 and 49 years generate higher labour productivity losses. The estimated loss amounts to over €31.4 million using the Human Capital method (€480,152 using the Friction Cost method), which means an average of €185,855 per death. The highest labour productivity losses are produced by leukaemia. However, lymphoma generates the highest loss per death. Further efforts are needed to reduce premature mortality in blood cancer patients undergoing transplantations and reduce economic losses. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

  15. Measuring the societal burden of cancer: the cost of lost productivity due to premature cancer-related mortality in Europe.

    PubMed

    Hanly, Paul; Soerjomataram, Isabelle; Sharp, Linda

    2015-02-15

    Every cancer-related death in someone of working age represents an economic loss to society. To inform priorities for cancer control, we estimated costs of lost productivity due to premature cancer-related mortality across Europe, for all cancers and by site, gender, region and country. Cancer deaths in 2008 were obtained from GLOBOCAN for 30 European countries across four regions. Costs were valued using the human capital approach. Years of productive life lost (YPLL) were computed by multiplying deaths between 15 and 64 years by working-life expectancy, then by country-, age- and gender-specific annual wages, corrected for workforce participation and unemployment. Lost productivity costs due to premature cancer-related mortality in Europe in 2008 were €75 billion. Male costs (€49 billion) were almost twice female costs (€26 billion). The most costly sites were lung (€17 billion; 23% of total costs), breast (€7 billion; 9%) and colorectum (€6 billion; 8%). Stomach cancer (in Southern and Central-Eastern Europe) and pancreatic cancer (in Northern and Western Europe) were also among the most costly sites. The average lost productivity cost per cancer death was €219,241. Melanoma had the highest cost per death (€312,798), followed by Hodgkin disease (€306,628) and brain and CNS cancer (€288,850). Premature mortality costs were 0.58% of 2008 European gross domestic product, highest in Central-Eastern Europe (0.81%) and lowest in Northern Europe (0.51%). Premature cancer-related mortality costs in Europe are significant. These results provide a novel perspective on the societal cancer burden and may be used to inform priority setting for cancer control.

  16. [Trendency analysis of infant mortality rate due to premature birth or low birth weight in China from 1996 to 2013].

    PubMed

    Cui, Hao; He, Chunhua; Miao, Lei; Zhu, Jun; Wang, Yanping; Li, Qi; Li, Xiaohong; Shen, Liqin

    2015-02-01

    To study the secular trend and characteristics of infant mortality rate due to premature birth or low birth weight (IMRPL) in China from 1996 to 2013. Data used in this study was collected from the population-based Child's Health Surveillance Network of China. The Cochran-Armitage Trend test and Poisson regression were used to test the trend of IMRPL and explore the differences of the trend among different regions or areas. The nationwide IMRPL was 629.9 per 100 000 live births in 1996 and it decreased to 214.6 per 100 000 live births in 2013. The average annual decline rate was 6.14%, while the proportion of infant mortality due to premature birth or low birth weight in all infant deaths was on the rise with the average annual growth rate of 1.52%. And the proportion increased to 22.6% in 2013. IMRPLin rural and urban areas fell 28.1% and 66.6% respectively during 1996 and 2013. But the differences between urban and rural areas was obvious. During the same period, the average IMRPLin the central region was 1.40 times (95%CI:1.31-1.49) of that in the eastern region. And the average IMRPL in the western region was 2.25 times (95%CI:2.12-2.40) of that in the eastern region. The differences among different regions was obvious. Male infant mortality rate due to premature birth or low birth weight was 1.09 times (95%CI:1.05-1.14) of that in female infant from 1996 to 2013. The risk of IMRPL decreased substantially in China from 1996 to 2013. And the risk of IMRPL decreased more in rural areas than that in urban areas. The differences among different regions and areas were obvious. Premature birth or low birth weight as one of main factors has become a serious threat for health of Chinese children.

  17. Exploring the uncertainty associated with satellite-based estimates of premature mortality due to exposure to fine particulate matter

    NASA Astrophysics Data System (ADS)

    Ford, Bonne; Heald, Colette L.

    2016-03-01

    The negative impacts of fine particulate matter (PM2.5) exposure on human health are a primary motivator for air quality research. However, estimates of the air pollution health burden vary considerably and strongly depend on the data sets and methodology. Satellite observations of aerosol optical depth (AOD) have been widely used to overcome limited coverage from surface monitoring and to assess the global population exposure to PM2.5 and the associated premature mortality. Here we quantify the uncertainty in determining the burden of disease using this approach, discuss different methods and data sets, and explain sources of discrepancies among values in the literature. For this purpose we primarily use the MODIS satellite observations in concert with the GEOS-Chem chemical transport model. We contrast results in the United States and China for the years 2004-2011. Using the Burnett et al. (2014) integrated exposure response function, we estimate that in the United States, exposure to PM2.5 accounts for approximately 2 % of total deaths compared to 14 % in China (using satellite-based exposure), which falls within the range of previous estimates. The difference in estimated mortality burden based solely on a global model vs. that derived from satellite is approximately 14 % for the US and 2 % for China on a nationwide basis, although regionally the differences can be much greater. This difference is overshadowed by the uncertainty in the methodology for deriving PM2.5 burden from satellite observations, which we quantify to be on the order of 20 % due to uncertainties in the AOD-to-surface-PM2.5 relationship, 10 % due to the satellite observational uncertainty, and 30 % or greater uncertainty associated with the application of concentration response functions to estimated exposure.

  18. Exploring the uncertainty associated with satellite-based estimates of premature mortality due to exposure to fine particulate matter

    NASA Astrophysics Data System (ADS)

    Ford, B.; Heald, C. L.

    2015-09-01

    The negative impacts of fine particulate matter (PM2.5) exposure on human health are a primary motivator for air quality research. However, estimates of the air pollution health burden vary considerably and strongly depend on the datasets and methodology. Satellite observations of aerosol optical depth (AOD) have been widely used to overcome limited coverage from surface monitoring and to assess the global population exposure to PM2.5 and the associated premature mortality. Here we quantify the uncertainty in determining the burden of disease using this approach, discuss different methods and datasets, and explain sources of discrepancies among values in the literature. For this purpose we primarily use the MODIS satellite observations in concert with the GEOS-Chem chemical transport model. We contrast results in the United States and China for the years 2004-2011. We estimate that in the United States, exposure to PM2.5 accounts for approximately 4 % of total deaths compared to 22 % in China (using satellite-based exposure), which falls within the range of previous estimates. The difference in estimated mortality burden based solely on a global model vs. that derived from satellite is approximately 9 % for the US and 4 % for China on a nationwide basis, although regionally the differences can be much greater. This difference is overshadowed by the uncertainty in the methodology for deriving PM2.5 burden from satellite observations, which we quantify to be on order of 20 % due to uncertainties in the AOD-to-surface-PM2.5 relationship, 10 % due to the satellite observational uncertainty, and 30 % or greater uncertainty associated with the application of concentration response functions to estimated exposure.

  19. Exploring the Uncertainty Associated with Satellite-Based Estimates of Premature Mortality due to Exposure to Fine Particulate Matter

    PubMed Central

    Ford, Bonne; Heald, Colette L.

    2017-01-01

    The negative impacts of fine particulate matter (PM2.5) exposure on human health are a primary motivator for air quality research. However, estimates of the air pollution health burden vary considerably and strongly depend on the datasets and methodology. Satellite observations of aerosol optical depth (AOD) have been widely used to overcome limited coverage from surface monitoring and to assess the global population exposure to PM2.5 and the associated premature mortality. Here we quantify the uncertainty in determining the burden of disease using this approach, discuss different methods and datasets, and explain sources of discrepancies among values in the literature. For this purpose we primarily use the MODIS satellite observations in concert with the GEOS-Chem chemical transport model. We contrast results in the United States and China for the years 2004–2011. Using the Burnett et al. (2014) integrated exposure response function, we estimate that in the United States, exposure to PM2.5 accounts for approximately 2% of total deaths compared to 14% in China (using satellite-based exposure), which falls within the range of previous estimates. The difference in estimated mortality burden based solely on a global model vs. that derived from satellite is approximately 14% for the U.S. and 2% for China on a nationwide basis, although regionally the differences can be much greater. This difference is overshadowed by the uncertainty in the methodology for deriving PM2.5 burden from satellite observations, which we quantify to be on the order of 20% due to uncertainties in the AOD-to-surface-PM2.5 relationship, 10% due to the satellite observational uncertainty, and 30% or greater uncertainty associated with the application of concentration response functions to estimated exposure. PMID:28649266

  20. Development of a Deprivation Index and its relation to premature mortality due to diseases of the circulatory system in Hungary, 1998-2004.

    PubMed

    Juhász, Attila; Nagy, Csilla; Páldy, Anna; Beale, Linda

    2010-05-01

    An association between health and socio-economic status is well known. Based on international and national studies, the aims of this study were to develop a multi-dimensional index at the municipality level, to provide information about socio-economic deprivation in Hungary and to investigate the association between socio-economic status and the spatial distribution of premature mortality due to diseases of the circulatory system. Seven municipality level socio-economic indicators were used from the National Information System of Spatial Development (income, low qualification, unemployment, one-parent families, large families, density of housing and car ownership). After normalisation and standardisation, indicator weights were evaluated using factor analysis. A risk analysis study was conducted using the Rapid Inquiry Facility software to evaluate the association between deprivation and the spatial distribution of premature mortality due to diseases of the circulatory system for the years 1998-2004. Areas of significantly high deprivation were identified in the northeastern, eastern and southwestern parts of Hungary. A statistically significant association was found between premature cardiovascular mortality and deprivation status in both genders. The Deprivation Index is the first composite index at the municipality level in Hungary and includes key factors that affect socio-economic status. The identified association highlighted the fact that inequalities in socio-economic status may reflect the spatial distribution of health status in a population. The results can be used to inform prevention strategies and help plan local health promotion programs aimed at reducing health inequalities.

  1. Future Premature Mortality Due to O3, Secondary Inorganic Aerosols and Primary PM in Europe — Sensitivity to Changes in Climate, Anthropogenic Emissions, Population and Building Stock

    PubMed Central

    Geels, Camilla; Andersson, Camilla; Hänninen, Otto; Lansø, Anne Sofie; Schwarze, Per E.; Ambelas Skjøth, Carsten; Brandt, Jørgen

    2015-01-01

    Air pollution is an important environmental factor associated with health impacts in Europe and considerable resources are used to reduce exposure to air pollution through emission reductions. These reductions will have non-linear effects on exposure due, e.g., to interactions between climate and atmospheric chemistry. By using an integrated assessment model, we quantify the effect of changes in climate, emissions and population demography on exposure and health impacts in Europe. The sensitivity to the changes is assessed by investigating the differences between the decades 2000–2009, 2050–2059 and 2080–2089. We focus on the number of premature deaths related to atmospheric ozone, Secondary Inorganic Aerosols and primary PM. For the Nordic region we furthermore include a projection on how population exposure might develop due to changes in building stock with increased energy efficiency. Reductions in emissions cause a large significant decrease in mortality, while climate effects on chemistry and emissions only affects premature mortality by a few percent. Changes in population demography lead to a larger relative increase in chronic mortality than the relative increase in population. Finally, the projected changes in building stock and infiltration rates in the Nordic indicate that this factor may be very important for assessments of population exposure in the future. PMID:25749320

  2. Future premature mortality due to O3, secondary inorganic aerosols and primary PM in Europe--sensitivity to changes in climate, anthropogenic emissions, population and building stock.

    PubMed

    Geels, Camilla; Andersson, Camilla; Hänninen, Otto; Lansø, Anne Sofie; Schwarze, Per E; Skjøth, Carsten Ambelas; Brandt, Jørgen

    2015-03-04

    Air pollution is an important environmental factor associated with health impacts in Europe and considerable resources are used to reduce exposure to air pollution through emission reductions. These reductions will have non-linear effects on exposure due, e.g., to interactions between climate and atmospheric chemistry. By using an integrated assessment model, we quantify the effect of changes in climate, emissions and population demography on exposure and health impacts in Europe. The sensitivity to the changes is assessed by investigating the differences between the decades 2000-2009, 2050-2059 and 2080-2089. We focus on the number of premature deaths related to atmospheric ozone, Secondary Inorganic Aerosols and primary PM. For the Nordic region we furthermore include a projection on how population exposure might develop due to changes in building stock with increased energy efficiency. Reductions in emissions cause a large significant decrease in mortality, while climate effects on chemistry and emissions only affects premature mortality by a few percent. Changes in population demography lead to a larger relative increase in chronic mortality than the relative increase in population. Finally, the projected changes in building stock and infiltration rates in the Nordic indicate that this factor may be very important for assessments of population exposure in the future.

  3. Years of life lost of inhabitants of rural areas in Poland due to premature mortality caused by external reasons of death 1999-2012.

    PubMed

    Bryła, Marek; Maniecka-Bryła, Irena; Burzyńska, Monika; Pikala, Małgorzata

    2016-12-23

    External causes of death are the third most common causes of death, after cardiovascular diseases and malignant neoplasms, in inhabitants of Poland. External causes of death pose the greatest threat to people aged 5-44, which results in a great number of years of life lost. The aim of the study is the analysis of years of life lost due to external causes of death among rural inhabitants in Poland, particularly due to traffic accidents and suicides. The study material included a database created on the basis of 2,100,785 certificates of rural inhabitants in Poland in the period 1999-2012. The SEYLLp (Standard Expected Years of Life Lost per living person) and the SEYLLd (per death) indices were used to determine years of life lost due to external causes of death. Joinpoint models were used to analyze time trends. In the period 1999-2012, 151,037 rural inhabitants died due to external causes, including 27.2% due to traffic accidents and 25.2% due to suicides. In 2012, the SEYLLp was 1,817 per 100,000 males and 298 per 100,000 females. Among males, suicides (SEYLLp = 633 years per 100,000) and traffic accidents (SEYLLp = 473 years per 100,000) contributed to the largest number of years of life lost. Among females, SEYLLp values were: 109 years due to traffic accidents and 69 years due to suicides (per 100,000). Among males, SEYLLp values started to decrease in 2008 at the average annual rate of 3.2%. In the group of females in the period 1999-2012, SEYLLp values were decreasing by 2.4% per year. The decreasing trend of the number of lost years of life due to external causes among rural inhabitants does not apply to suicides among men. The SEYLLp due to this group of causes has been steadily increasing since 1999. Analysis of the years of life lost focuses on the social and economic aspects of premature mortality due to external causes.

  4. The valuation of productivity costs due to premature mortality: a comparison of the human-capital and friction-cost methods for schizophrenia.

    PubMed

    Goeree, R; O'Brien, B J; Blackhouse, G; Agro, K; Goering, P

    1999-06-01

    To compare productivity-cost estimates for schizophrenia-related premature mortality in Canada in 1996 using the human-capital (HC) approach and friction-cost (FC) method. The number of deaths directly attributed to schizophrenia was combined with the estimated number of deaths attributable to schizophrenia from suicide. These premature deaths were valued using 2 methods: 1) the traditional HC approach, based on "potential" lost output to normal age of retirement, and 2) the FC method, based on finding a replacement worker. In 1996, there were 342 male and female preretirement deaths attributed to schizophrenia, directly or indirectly by suicide, in Canada. Most deaths were in males (78%) and by suicide (97%). The productivity cost of these deaths was estimated to be $105 million using the HC approach but only $1.53 million using the FC method. Productivity-cost estimates from the HC approach are substantially higher than those obtained from the FC method (69 times higher). In circumstances of unemployment, the HC approach is an overestimate of future productivity losses for premature mortality.

  5. Premature mortality in active convulsive epilepsy in rural Kenya

    PubMed Central

    Bottomley, Christian; Fegan, Gregory; Chengo, Eddie; Odhiambo, Rachael; Bauni, Evasius; Neville, Brian; Kleinschmidt, Immo; Sander, Josemir W.; Newton, Charles R.

    2014-01-01

    Objective: We estimated premature mortality and identified causes of death and associated factors in people with active convulsive epilepsy (ACE) in rural Kenya. Methods: In this prospective population-based study, people with ACE were identified in a cross-sectional survey and followed up regularly for 3 years, during which information on deaths and associated factors was collected. We used a validated verbal autopsy tool to establish putative causes of death. Age-specific rate ratios and standardized mortality ratios were estimated. Poisson regression was used to identify mortality risk factors. Results: There were 61 deaths among 754 people with ACE, yielding a rate of 33.3/1,000 persons/year. Overall standardized mortality ratio was 6.5. Mortality was higher across all ACE age groups. Nonadherence to antiepileptic drugs (adjusted rate ratio [aRR] 3.37), cognitive impairment (aRR 4.55), and age (50+ years) (rate ratio 4.56) were risk factors for premature mortality. Most deaths (56%) were directly related to epilepsy, with prolonged seizures/possible status epilepticus (38%) most frequently associated with death; some of these may have been due to sudden unexpected death in epilepsy (SUDEP). Possible SUDEP was the likely cause in another 7%. Conclusion: Mortality in people with ACE was more than 6-fold greater than expected. This may be reduced by improving treatment adherence and prompt management of prolonged seizures and supporting those with cognitive impairment. PMID:24443454

  6. Geographic disparity in premature mortality in Ontario, 1992–1996

    PubMed Central

    Altmayer, Chris A; Hutchison, Brian G; Torrance-Rynard, Vicki L; Hurley, Jeremiah; Birch, Stephen; Eyles, John D

    2003-01-01

    Background Standardized mortality ratios are used to identify geographic areas with higher or lower mortality than expected. This article examines geographic disparity in premature mortality in Ontario, Canada, at three geographic levels of population and considers factors that may underlie variations in premature mortality across geographic areas. All-cause, sex and disease chapter specific premature mortality were analyzed at the regional, district and public health unit level to determine the extent of geographic variation. Standardized mortality ratios for persons aged 0–74 years were calculated to identify geographic areas with significantly higher or lower premature mortality than expected, using Ontario death rates as the basis for the calculation of expected deaths in the local population. Data are also presented from the household component of the 1996/97 National Population Health Survey and from the 1996 Statistics Canada Census. Results Results showed approximately 20% higher than expected all-cause premature mortality for males and females in the North region. However, disparity in all-cause premature mortality in Ontario was most pronounced at the public health unit level, ranging from 20% lower than expected to 30% higher than expected. Premature mortality disparities were largely influenced by neoplasms, circulatory diseases, injuries and poisoning, respiratory diseases and digestive diseases, which accounted for more than 80% of all premature deaths. Premature mortality disparities were also more pronounced for disease chapter specific mortality. Conclusion Geographic disparities in premature mortality are clearly greater at the small area level. Geographic disparities in premature mortality undoubtedly reflect the underlying distribution of population health determinants such as health related behaviours, social, economic and environmental influences. PMID:14561226

  7. Serbia within the European context: An analysis of premature mortality.

    PubMed

    Santric Milicevic, Milena; Bjegovic, Vesna; Terzic, Zorica; Vukovic, Dejana; Kocev, Nikola; Marinkovic, Jelena; Vasic, Vladimir

    2009-08-05

    Based on the global predictions majority of deaths will be collectively caused by cancer, cardiovascular diseases, and traffic accidents over the coming 25 years. In planning future national health policy actions, inter - regional assessments play an important role. The purpose of the study was to analyze similarities and differences in premature mortality between Serbia, EURO A, EURO B, and EURO C regions in 2000. Mortality and premature mortality patterns were analysed according to cause of death, by gender and seven age intervals. The study results are presented in relative (%) and absolute terms (age-specific and age-standardized death rates per 100,000 population, and age-standardized rates of years of life lost - YLL per 1,000). Direct standardization of rates was undertaken using the standard population of Europe. The inter-regional comparison was based on a calculation of differences in YLL structures and with a ratio of age-standardized YLL rates per 1,000. A multivariate generalized linear model was used to explore mortality of Serbia and Europe sub-regions with ln age-specific death rates. The dissimilarity was achieved with a p mortality pattern, Serbia was similar to EURO B, but with a lower average YLL per death case. YLL patterns indicated similarities between Serbia and EURO A, while SRR YLL had similarities between Serbia and EURO B. Compared to all Europe sub-regions, Serbia had a major excess of premature mortality in neoplasms and diabetes mellitus. Serbia had lost more years of life than EURO A due to cardiovascular, genitourinary diseases, and intentional injuries. Yet, Serbia was not as burdened with communicable diseases and injuries as were EURO B and EURO C. With a premature mortality pattern, Serbia is placed in the middle position of the Europe triangle. The main excess of YLL in Serbia was due to cardiovascular, malignant diseases, and diabetes mellitus. The results may be used for assessment of unacceptable

  8. Power relations and premature mortality in Spain's autonomous communities.

    PubMed

    Rodríguez-Sanz, Maica; Borrell, Carme; Urbanos, Rosa; Pasarín, M Isabel; Rico, Ana; Fraile, Marta; Ramos, Xavier; Navarro, Vicente

    2003-01-01

    This trends ecological study analyzes, across 17 autonomous communities of Spain from 1989 to 1998, the relationship between mortality (total and by main causes of death) and power relations (type of government: social democratic (SDP), conservative (CDP), and others), labor market variables, welfare state variables, income inequality, absolute income, poverty, and number of civil associations. The authors conducted a descriptive analysis; a bivariate analysis (Pearson correlation coefficients) between mortality and each of the independent variables; and a multivariate analysis, adjusting multilevel linear regression models. All dimensions of the conceptual power relations model were related to premature mortality in the direction hypothesized. The cross-pooled multilevel regression models show that total premature mortality in males, male and female cerebrovascular mortality, male and female cirrhosis mortality, and male lung cancer mortality decreased somewhat more in communities where primary health care reform was implemented more quickly. Premature mortality decreased somewhat more in SDP than in CDP communities for male and female total premature mortality, cerebrovascular mortality, and cirrhosis mortality, and male lung cancer mortality. These results are in accord with earlier studies that found a relationship among health indicators and variables related to labor market, welfare state, income inequalities, civil associations, and power relations.

  9. Historical Trends in Pm2.5-Related Premature Mortality ...

    EPA Pesticide Factsheets

    Background: Air quality across the northern hemisphere over the past two decades has witnessed dramatic changes, with continuous improvement in developed countries in North America and Europe, but a contrasting sharp deterioration in developing regions of Asia. Objective: This study investigates the historical trend in the long-term exposure to PM2.5 and PM2.5-related premature mortality (PM2.5-mortality) and its response to changes in emission that occurred during 1990-2010 across the northern hemisphere. Implications for future trends in human exposure to air pollution in both developed and developing regions of the world are discussed. Methods: We employed the integrated exposure-response model developed by Health Effects Institute to estimate the PM2.5-mortality. The 1990-2010 annual-average PM2.5 concentrations were obtained from the simulations using WRF-CMAQ model. Emission mitigation efficiencies of SO2, NOx, NH3 and primary PM are estimated from the PM2.5-mortality responses to the emission variations. Results: Estimated PM2.5-mortalities in East Asia and South Asia increased by 21% and 85% respectively, from 866,000 and 578,000 in 1990, to 1,048,000 and 1,068,000 in 2010. PM2.5-mortalities in developed regions, i.e., Europe and high-income North America decreased substantially by 67% and 58% respectively. Conclusions: Over the past two decades, correlations between population and PM2.5 have become weaker in Europe and North America due to air pollu

  10. Psychosocial determinants of premature cardiovascular mortality differences within Hungary

    PubMed Central

    Kopp, Maria; Skrabski, Árpád; Szántó, Zsuzsa; Siegrist, Johannes

    2006-01-01

    Objectives The life expectancy gap between Central‐Eastern European (CEE) countries, including Hungary, and Western Europe (WE) is mainly attributable to excess cardiovascular (CV) mortality in midlife. This study explores the contribution of socioeconomic, work related, psychosocial, and behavioural variables to explaining variations of middle aged male and female CV mortality across 150 sub‐regions in Hungary. Design Cross sectional, ecological analyses. Setting 150 sub‐regions of Hungary. Participants and methods 12 643 people were interviewed in Hungarostudy 2002 survey, representing the Hungarian population according to sex, age, and sub‐regions. Independent variables were income, education, control in work, job insecurity, weekend working hours, social support, depression, hostility, anomie, smoking, body mass index, and alcohol misuse. Main outcome measures Gender specific standardised premature (45–64 years) total CV, ischaemic heart disease, and cerebrovascular mortality rates in 150 sub‐regions of Hungary. Results Low education and income were the most important determinants of mid‐aged CV mortality differences across sub‐regions. High weekend workload, low social support at work, and low control at work account for a large part of variation in male premature CV mortality rates, whereas job insecurity, high weekend workload, and low control at work contribute most noticeably to variations in premature CV mortality rates among women. Low social support from friends, depression, anomie, hostility, alcohol misuse and cigarette smoking can also explain a considerable part of variations of premature CV mortality differences. Conclusion Variations in middle aged CV mortality rates in a rapidly changing society in CEE are largely accounted for by distinct unfavourable working and other psychosocial stress conditions. PMID:16905723

  11. [Loss of labour productivity caused by premature mortality in Spain in 2005].

    PubMed

    Oliva, Juan

    2009-01-01

    Jointly with deaths, loss of quality of life and pain of patients and families, there are complementary indicators that help to reveal the social impact caused by illnesses and accidents. In the analysis, loss of labour productivity due to premature mortality in 2005 is estimated. The aim of this work is to estimate a part of the non health care costs caused by illnesses and accidents in the economy. A simulation model based in the human capital approach is developed using several available Spanish data bases (Death Registry According to Cause of Death, Structural Wage Survey, Labour Force Survey). A loss of production up to 9,100 millions of Euros due to premature mortality is estimated in Spain for the base year. This figure is equivalent to a 1.01% of the Spanish Gross Domestic Product, or to an 18.25% of the Public Health Care Expenditure of 2005. Premature mortality caused a very high labour cost.

  12. Time trends and risk factor associated with premature birth and infants deaths due to prematurity in Hubei Province, China from 2001 to 2012.

    PubMed

    Xu, Haiqing; Dai, Qiong; Xu, Yusong; Gong, Zhengtao; Dai, Guohong; Ding, Ming; Duggan, Christopher; Hu, Zubin; Hu, Frank B

    2015-12-10

    The nutrition and epidemiologic transition has been associated with an increasing incidence of preterm birth in developing countries, but data from large observational studies in China have been limited. Our study was to describe the trends and factors associated with the incidence of preterm birth and infant mortality due to prematurity in Hubei Province, China. We conducted a population-based survey through the Maternal and Child Health Care Network in Hubei Province from January 2001 to December 2012. We used data from 16 monitoring sites to examine the trend and risk factors for premature birth as well as infant mortality associated with prematurity. A total of 818,481 live births were documented, including 76,923 preterm infants (94 preterm infants per 1,000 live births) and 2,248 deaths due to prematurity (2.75 preterm deaths per 1,000 live births). From 2001 to 2012, the incidence of preterm birth increased from 56.7 to 105.2 per 1,000 live births (P for trend < 0.05), while the infant mortality rate due to prematurity declined from 95.0 to 13.4 per 1,000 live births (P for trend < 0.05). Older maternal age, lower maternal education, use of assisted reproductive technology (ART), higher income, residence in urban areas, and infant male sex were independently associated with a higher incidence of preterm birth (all p values < 0.05). Shorter gestation, lower birth weight, and lower income were associated with a higher mortality rate, while use of newborn emergency transport services (NETS) was associated with a lower preterm mortality rate (all p values < 0.05). An increasing incidence of preterm birth and a parallel reduction in infant mortality due to prematurity were observed in Hubei Province from 2001 to 2012. Our results provide important information for areas of improvements in reducing incidence and mortality of premature birth.

  13. Adverse childhood experiences and premature all-cause mortality.

    PubMed

    Kelly-Irving, Michelle; Lepage, Benoit; Dedieu, Dominique; Bartley, Mel; Blane, David; Grosclaude, Pascale; Lang, Thierry; Delpierre, Cyrille

    2013-09-01

    Events causing stress responses during sensitive periods of rapid neurological development in childhood may be early determinants of all-cause premature mortality. Using a British birth cohort study of individuals born in 1958, the relationship between adverse childhood experiences (ACE) and mortality≤50 year was examined for men (n=7,816) and women (n=7,405) separately. ACE were measured using prospectively collected reports from parents and the school: no adversities (70%); one adversity (22%), two or more adversities (8%). A Cox regression model was carried out controlling for early life variables and for characteristics at 23 years. In men the risk of death was 57% higher among those who had experienced 2+ ACE compared to those with none (HR 1.57, 95% CI 1.13, 2.18, p=0.007). In women, a graded relationship was observed between ACE and mortality, the risk increasing as ACE accumulated. Women with one ACE had a 66% increased risk of death (HR 1.66, 95% CI 1.19, 2.33, p=0.003) and those with ≥2 ACE had an 80% increased risk (HR 1.80, 95% CI 1.10, 2.95, p=0.020) versus those with no ACE. Given the small impact of adult life style factors on the association between ACE and premature mortality, biological embedding during sensitive periods in early development is a plausible explanatory mechanism.

  14. [Unnecessary premature and avoidable mortality in Costa Rica].

    PubMed

    Llorca Castro, Fernando; Ortún Rubio, Vicente

    2010-01-01

    With the intention of establishing economic inequities, the article analyzes the variations of the Unnecessarily Premature and Sanitarily Avoidable Mortality (MIPSE) of each of the 81 cantons of Costa Rica during 2000-2005. It is important to identify those inequities, to establish policies and strategies trying to mitigate them. It applies the MIPSE classification proposed by members of the Information and Studies Service, of the Catalunya's Sanitary Resources Headquarter, Spain. By an Indicator of Socioeconomic Development (IDSE) of a University of Costa Rica economist's team, it organised each canton in groups of quintiles (I for the richest, V for the poorest), previous people standardization. We found as a major causes of mortality MIPSE in the country: Heart Isquemic Disease (19,55% MIPSE causes), Traffic Accidents with Motor Vehicles (11,60%), Brain Vascular Disease (6,95%), Perinatal (6,92%) and Suicide (5,14%). The VIH infection - AIDS mortality, the Best Cancer in Women, Uterus Cancer, Skin Cancer and Hepatic Disease Secondary to Alcohol Consumption, affects more the cantons with better financial conditions and the Prostate Benign Hyperplasia mortality, Mothers mortality related with Pregnancy, Childbirth or Puerperal Stage and the Abdominal Hernia mortality, affects more to those with worst economic level. Two MIPSE groups were identified with similar inequality: Leukaemia and Congenital Cardiovascular Disease.

  15. Premature Mortality from Cardiovascular Disease in the Americas - Will the Goal of a Decline of "25% by 2025" be Met?

    PubMed

    Ordunez, Pedro; Prieto-Lara, Elisa; Pinheiro Gawryszewski, Vilma; Hennis, Anselm J M; Cooper, Richard S

    2015-01-01

    Cardiovascular diseases (CVD) are the underlying cause 1.6 million deaths per year in the Americas, accounting for 30% of total mortality and 38% of by non-communicable deaths diseases (NCDs). A 25% reduction in premature mortality due four main NCDs was targeted by the 2011 High-level Meeting of the General Assembly on the Prevention and Control of NCDs. While overall CVD mortality fell in the Americas during the past decade, trends in premature CVD mortality during the same period have not been described, particularly in the countries of Latin America and the Caribbean. This is a population-based trend-series study based on a total of 6,133,666 deaths to describe the trends and characteristics of premature mortality due to CVD and to estimates of the average annual percentage of change during the period 2000-2010 in the Americas. Premature mortality due to CVD in the Americas fell by 21% in the period 2000-2010 with a -2.5% average annual rate of change in the last 5 year-a statistically significant reduction of mortality-. Mortality from ischemic diseases, declined by 25% - 24% among men and 26% among women. Cerebrovascular diseases declined by 27% -26% among men and 28% among women. Guyana, Trinidad and Tobago, the Dominican Republic, Bahamas, and Brazil had CVD premature mortality rates over 200 per 100,000 population, while the average for the Region was 132.7. US and Canada will meet the 25% reduction target before 2025. Mexico, Costa Rica, Venezuela, Dominican Republic, Panama, Guyana, and El Salvador did not significantly reduce premature mortality among men and Guyana, the Dominican Republic, and Panama did not achieve the required annual reduction in women. Trends in premature mortality due to CVD observed in last decade in the Americas would indicate that if these trends continue, the Region as a whole and a majority of its countries will be able to reach the goal of a 25% relative reduction in premature mortality even before 2025.

  16. Finely Resolved On-Road PM2.5 and Estimated Premature Mortality in Central North Carolina.

    PubMed

    Chang, Shih Ying; Vizuete, William; Serre, Marc; Vennam, Lakshmi Pradeepa; Omary, Mohammad; Isakov, Vlad; Breen, Michael; Arunachalam, Saravanan

    2017-02-28

    To quantify the on-road PM2.5 -related premature mortality at a national scale, previous approaches to estimate concentrations at a 12-km × 12-km or larger grid cell resolution may not fully characterize concentration hotspots that occur near roadways and thus the areas of highest risk. Spatially resolved concentration estimates from on-road emissions to capture these hotspots may improve characterization of the associated risk, but are rarely used for estimating premature mortality. In this study, we compared the on-road PM2.5 -related premature mortality in central North Carolina with two different concentration estimation approaches-(i) using the Community Multiscale Air Quality (CMAQ) model to model concentration at a coarser resolution of a 36-km × 36-km grid resolution, and (ii) using a hybrid of a Gaussian dispersion model, CMAQ, and a space-time interpolation technique to provide annual average PM2.5 concentrations at a Census-block level (∼105,000 Census blocks). The hybrid modeling approach estimated 24% more on-road PM2.5 -related premature mortality than CMAQ. The major difference is from the primary on-road PM2.5 where the hybrid approach estimated 2.5 times more primary on-road PM2.5 -related premature mortality than CMAQ due to predicted exposure hotspots near roadways that coincide with high population areas. The results show that 72% of primary on-road PM2.5 premature mortality occurs within 1,000 m from roadways where 50% of the total population resides, highlighting the importance to characterize near-road primary PM2.5 and suggesting that previous studies may have underestimated premature mortality due to PM2.5 from traffic-related emissions.

  17. The role of socio-demographic factors in premature cervical cancer mortality in Colombia.

    PubMed

    Bermedo-Carrasco, Silvia; Waldner, Cheryl L

    2016-09-15

    protection against CC mortality when compared to not having insurance, suggesting the need to examine diagnostic and treatment services available under the subsidised insurance plan. Our results could be used to target interventions to optimise the impact of resources to prevent premature mortality due to CC in Colombia.

  18. Trends of premature mortality in Swietokrzyskie Province (Poland), years 2002-2010.

    PubMed

    Gózdz, Stanislaw; Krzyzak, Michalina; Maślach, Dominik; Wróbel, Monika; Bielska-Lasota, Magdalena

    2013-01-01

    Premature mortality in younger age groups influences the society as far as social and economic aspects are concerned. Therefore, it is important to come up with a tool which will allow to assess them, and will enable to implement only these health care measures that bring tangible benefits. That is the reason for introducing PYLL rate (PYLL - potential years of life lost), which is an addition to the analysis of premature mortality as it includes the number of deaths due to a particular cause and the age at death. The purpose of this study was to analyse the level and trends of PYLL rate according to death causes in years 2002 -2010 in Swietokrzyskie Province. The material for the analysis was the information from the Central Statistical Office on the number of deaths due to all causes registered among the inhabitants of Swiytokrzyskie Province in years 2002-2010. Causes of death were coded according to the 10th revision of the International Classification of Diseases. The analysis of premature mortality was carried out with the use of PYLL rate. PYLL rate was calculated according to the method proposed by Romeder, according to which the premature mortality was defined as death before the age of 70. The analysis of time trends of PYLL rate and the APC (annual percent change) of the PYLL rate were calculated using jointpoint model as well as the Jointpoint Regression Program (Version 4.0.1 - January 2013). In men, in years 2002 - 2007 PYLL rate increased by 1.5% per year (p<0.05). From year 2007 the trend went downward and PYLL rate decreased on average by 3.1% per year till year 2010. External causes of death, cardiovascular diseases and cancers in years 2002 - 2010 were the reason for almost 74.0% PYLL in men. In year 2010 PYLL rate due to all death causes amounted to 8913.8/105 and was three times higher than in women (2975.5/10(5)). In women, however, during the analysed period PYLL rate did not change significantly, and was dominated by cancers, cardiovascular

  19. The impact of pharmaceutical innovation on premature mortality, cancer mortality, and hospitalization in Slovenia, 1997-2010.

    PubMed

    Lichtenberg, Frank R

    2015-04-01

    In Slovenia during the period 2000-2010, the number of years of potential life lost before the age of 70 years per 100,000 population under 70 years of age declined 25 %. The aim of this study was to test the hypothesis that pharmaceutical innovation played a key role in reducing premature mortality from all diseases in Slovenia, and to examine the effects of pharmaceutical innovation on the age-standardized number of cancer deaths and on hospitalization from all diseases. Estimates and other data were used to calculate the incremental cost effectiveness of pharmaceutical innovation in Slovenia. Longitudinal disease-level data was analyzed to determine whether diseases for which there was greater pharmaceutical innovation-a larger increase in the number of new chemical entities (NCEs) previously launched-had larger declines in premature mortality, the age-standardized number of cancer deaths, and the number of hospital discharges. My methodology controls for the effects of macroeconomic trends and overall changes in the healthcare system. Premature mortality from a disease is inversely related to the number of NCEs launched more than 5 years earlier. On average, the introduction of an additional NCE for a disease reduced premature mortality from the disease by 2.4 % 7 years later. The age-standardized number of cancer deaths is inversely related to the number of NCEs launched 1-6 years earlier, conditional on the age-standardized number of new cancer cases diagnosed 0-2 years earlier. On average, the launch of an NCE reduced the number of hospital discharges 1 year later by approximately 1.5 %. The estimates imply that approximately two-thirds of the 2000-2010 decline in premature mortality was due to pharmaceutical innovation. If no NCEs had been launched in Slovenia during 1992-2003, the age-standardized number of cancer deaths in 2008 would have been 12.2 % higher. The NCEs launched in Slovenia during 2003-2009 are estimated to have reduced the number of

  20. Maternal mortality due to violence.

    PubMed

    Rizzi, R G; Córdoba, R R; Maguna, J J

    1998-12-01

    The objectives were to investigate the death of women by violent injuries, including induced abortion, in the Province of Córdoba, Argentina, 1992-1996 and to perform a bibliographic review on maternal death due to violence. Reports of autopsies of all violent deaths in women aged 12-44 years were reviewed to determine the cause of death for cases of suicide, homicide, accident or induced abortion and a bibliographic review was performed through MEDLINE. Two hundred and seventy two women died due to violence, including 22 which were due to complications of induced abortion. The remaining 250 deaths were: 44 (17.6%) by suicide, 51 (20.4%) by homicide and 155 (62%) by traffic accidents, including 6 pregnant women (2 died by suicide, 1 by homicide and 3 by accidents). Violence against women and pregnant women is a growing problem in developing countries. The implication of a simplified screening has been proposed to identify abuses against women, searching for frequency of abuse, its severity and to determine who provokes it.

  1. Premature mortality in North Carolina: progress, regress, and disparities by county and race, 2000-2010.

    PubMed

    Jones, Katherine; Mansfield, Christopher J

    2014-01-01

    This study examined trends in premature mortality--defined as years of potential life lost before age 75 years--in North Carolina during the period 2000-2010. Premature mortality at the county level was calculated and compared for two 5-year periods (1996-2000 and 2006-2010) for the entire population, among whites, and among nonwhites. This study also examined and compared leading causes of death that contributed to premature mortality among whites and nonwhites in each county and in the state as a whole. Premature mortality in North Carolina was reduced 13.3% for the population as a whole, 26.6% for nonwhites, and 7.2% for whites. However, premature mortality actually increased for the population as a whole in 20 counties, among whites in 35 counties, and among nonwhites in 8 counties. Among whites, chronic obstructive pulmonary disease, suicide, injuries, and motor vehicle crashes each contributed an above-average share of premature mortality. Among nonwhites, stroke, diabetes, homicide, and heart disease each contributed an above-average share of premature mortality. We were unable to calculate reliable rates of premature mortality for Hispanics, Asians, American Indians, and other nonwhite ethnic groups because the numbers at the county level were too small. Public health professionals should focus attention on counties in which premature mortality is increasing or remaining constant and should address the specific underlying causes of such deaths. In counties in which premature mortality among whites is increasing, community health efforts should focus on prevention of smoking, suicide, and injury. In counties with large nonwhite populations, programs should focus on prevention of stroke, heart disease, diabetes, homicide, and kidney disease.

  2. The burden of premature mortality in Spain using standard expected years of life lost: a population-based study

    PubMed Central

    2011-01-01

    Background Measures of premature mortality have been used to guide debates on future health priorities and to monitor the population health status. Standard expected years of life lost (SEYLL) is one of the methods used to assess the time lost due to premature death. This article affords an overview of premature mortality in Spain for the year 2008. Methods A population-based study was conducted estimating SEYLL by sex and age groups. SEYLL, a key component of the disability-adjusted life years measure of disease burden, was calculated using Princeton West standard life tables with life expectancy at birth fixed at 80 years for males and 82.5 years for females. Population data and specific death records were obtained from the official registers of the National Institute of Statistics. All data were analysed and prepared in GesMor and Epidat software packages. Results The burden of premature mortality was estimated at 2.1 million SEYLL when age at death is taken into account. Males lost 60.9% and females lost 39.1% of total SEYLL. Malignant tumors (34.5%) and cardiovascular diseases (24.0%) were the leading categories in terms of SEYLL. Ischaemic heart disease (8.5%) and lung cancers (8.0%) were the most common specific causes of SEYLL followed by cerebrovascular diseases (5.9%), colorectal cancer (4.1%), road traffic accidents (3.5%), Alzheimer and other dementias (2.9%), chronic obstructive pulmonary disease (2.8%), breast cancer (2.8%) and suicides (2.6%). Conclusions In Spain, premature mortality was essentially due to chronic non-communicable diseases. Data provided in this study are relevant for a more balanced health agenda aimed at reducing the burden of premature mortality. This study also represents a first step in estimating the overall burden of disease in terms of premature death and disability. PMID:21989453

  3. Modeled global effects of airborne desert dust on air quality and premature mortality

    NASA Astrophysics Data System (ADS)

    Giannadaki, D.; Pozzer, A.; Lelieveld, J.

    2013-09-01

    Fine particulate matter is one of the most important factors contributing to air pollution. Epidemiological studies have related increased levels of atmospheric particulate matter to premature human mortality caused by cardiopulmonary disease and lung cancer. However, a limited number of investigations have focused on the contribution of airborne desert dust particles. Here we assess the effects of dust particles with an aerodynamic diameter smaller than 2.5 μm (DU2.5) on human mortality for the year 2005. We used the EMAC atmospheric chemistry general circulation model at high resolution to simulate global atmospheric dust concentrations. We applied a health impact function to estimate premature mortality for the global population of 30 yr and older, using parameters from epidemiological studies. We estimate a global cardiopulmonary mortality of about 402 thousand and about 10 thousand by lung cancer in 2005. The associated years of life lost are about 3.47 million and 96 thousand per year due to cardiopulmonary disease and lung cancer, respectively. We estimate the global fraction of the cardiopulmonary and lung cancer deaths caused by atmospheric desert dust to be about 1.7%, though in the 20 countries most affected by dust this is much higher, about 15-50%. These countries are primarily found in the so-called "dust belt" from North Africa across the Middle East and South Asia to East Asia.

  4. The Effect of Clozapine on Premature Mortality: An Assessment of Clinical Monitoring and Other Potential Confounders

    PubMed Central

    Hayes, Richard D.; Downs, Johnny; Chang, Chin-Kuo; Jackson, Richard G.; Shetty, Hitesh; Broadbent, Matthew; Hotopf, Matthew; Stewart, Robert

    2015-01-01

    Clozapine can cause severe adverse effects yet it is associated with reduced mortality risk. We test the hypothesis this association is due to increased clinical monitoring and investigate risk of premature mortality from natural causes. We identified 14 754 individuals (879 deaths) with serious mental illness (SMI) including schizophrenia, schizoaffective and bipolar disorders aged ≥ 15 years in a large specialist mental healthcare case register linked to national mortality tracing. In this cohort study we modeled the effect of clozapine on mortality over a 5-year period (2007–2011) using Cox regression. Individuals prescribed clozapine had more severe psychopathology and poorer functional status. Many of the exposures associated with clozapine use were themselves risk factors for increased mortality. However, we identified a strong association between being prescribed clozapine and lower mortality which persisted after controlling for a broad range of potential confounders including clinical monitoring and markers of disease severity (adjusted hazard ratio 0.4; 95% CI 0.2–0.7; p = .001). This association remained after restricting the sample to those with a diagnosis of schizophrenia or those taking antipsychotics and after using propensity scores to reduce the impact of confounding by indication. Among individuals with SMI, those prescribed clozapine had a reduced risk of mortality due to both natural and unnatural causes. We found no evidence to indicate that lower mortality associated with clozapine in SMI was due to increased clinical monitoring or confounding factors. This is the first study to report an association between clozapine and reduced risk of mortality from natural causes. PMID:25154620

  5. The effect of future ambient air pollution on human premature mortality to 2100 using output from the ACCMIP model ensemble

    NASA Astrophysics Data System (ADS)

    Silva, Raquel A.; West, J. Jason; Lamarque, Jean-François; Shindell, Drew T.; Collins, William J.; Dalsoren, Stig; Faluvegi, Greg; Folberth, Gerd; Horowitz, Larry W.; Nagashima, Tatsuya; Naik, Vaishali; Rumbold, Steven T.; Sudo, Kengo; Takemura, Toshihiko; Bergmann, Daniel; Cameron-Smith, Philip; Cionni, Irene; Doherty, Ruth M.; Eyring, Veronika; Josse, Beatrice; MacKenzie, Ian A.; Plummer, David; Righi, Mattia; Stevenson, David S.; Strode, Sarah; Szopa, Sophie; Zengast, Guang

    2016-08-01

    Ambient air pollution from ground-level ozone and fine particulate matter (PM2.5) is associated with premature mortality. Future concentrations of these air pollutants will be driven by natural and anthropogenic emissions and by climate change. Using anthropogenic and biomass burning emissions projected in the four Representative Concentration Pathway scenarios (RCPs), the ACCMIP ensemble of chemistry-climate models simulated future concentrations of ozone and PM2.5 at selected decades between 2000 and 2100. We use output from the ACCMIP ensemble, together with projections of future population and baseline mortality rates, to quantify the human premature mortality impacts of future ambient air pollution. Future air-pollution-related premature mortality in 2030, 2050 and 2100 is estimated for each scenario and for each model using a health impact function based on changes in concentrations of ozone and PM2.5 relative to 2000 and projected future population and baseline mortality rates. Additionally, the global mortality burden of ozone and PM2.5 in 2000 and each future period is estimated relative to 1850 concentrations, using present-day and future population and baseline mortality rates. The change in future ozone concentrations relative to 2000 is associated with excess global premature mortality in some scenarios/periods, particularly in RCP8.5 in 2100 (316 thousand deaths year-1), likely driven by the large increase in methane emissions and by the net effect of climate change projected in this scenario, but it leads to considerable avoided premature mortality for the three other RCPs. However, the global mortality burden of ozone markedly increases from 382 000 (121 000 to 728 000) deaths year-1 in 2000 to between 1.09 and 2.36 million deaths year-1 in 2100, across RCPs, mostly due to the effect of increases in population and baseline mortality rates. PM2.5 concentrations decrease relative to 2000 in all scenarios, due to projected reductions in emissions, and

  6. The Effect of Future Ambient Air Pollution on Human Premature Mortality to 2100 Using Output from the ACCMIP Model Ensemble

    NASA Technical Reports Server (NTRS)

    Silva, Raquel A.; West, J. Jason; Lamarque, Jean-Francois; Shindell, Drew T.; Collins, William J.; Dalsoren, Stig; Faluvegi, Greg; Folberth, Gerd; Horowitz, Larry W.; Nagashima, Tatsuya; Strode, Sarah

    2016-01-01

    Ambient air pollution from ground-level ozone and fine particulate matter (PM(sub 2.5)) is associated with premature mortality. Future concentrations of these air pollutants will be driven by natural and anthropogenic emissions and by climate change. Using anthropogenic and biomass burning emissions projected in the four Representative Concentration Pathway scenarios (RCPs), the ACCMIP ensemble of chemistry climate models simulated future concentrations of ozone and PM(sub 2.5) at selected decades between 2000 and 2100. We use output from the ACCMIP ensemble, together with projections of future population and baseline mortality rates, to quantify the human premature mortality impacts of future ambient air pollution. Future air-pollution-related premature mortality in 2030, 2050 and 2100 is estimated for each scenario and for each model using a health impact function based on changes in concentrations of ozone and PM(sub 2.5) relative to 2000 and projected future population and baseline mortality rates. Additionally, the global mortality burden of ozone and PM(sub 2.5) in 2000 and each future period is estimated relative to 1850 concentrations, using present-day and future population and baseline mortality rates. The change in future ozone concentrations relative to 2000 is associated with excess global premature mortality in some scenarios/periods, particularly in RCP8.5 in 2100 (316 thousand deaths per year), likely driven by the large increase in methane emissions and by the net effect of climate change projected in this scenario, but it leads to considerable avoided premature mortality for the three other RCPs. However, the global mortality burden of ozone markedly increases from 382000 (121000 to 728000) deaths per year in 2000 to between 1.09 and 2.36 million deaths per year in 2100, across RCPs, mostly due to the effect of increases in population and baseline mortality rates. PM(sub 2.5) concentrations decrease relative to 2000 in all scenarios, due to

  7. The Effect of Future Ambient Air Pollution on Human Premature Mortality to 2100 Using Output from the ACCMIP Model Ensemble

    NASA Technical Reports Server (NTRS)

    Silva, Raquel A.; West, J. Jason; Lamarque, Jean-Francois; Shindell, Drew T.; Collins, William J.; Dalsoren, Stig; Faluvegi, Greg; Folberth, Gerd; Horowitz, Larry W.; Nagashima, Tatsuya; hide

    2016-01-01

    Ambient air pollution from ground-level ozone and fine particulate matter (PM(sub 2.5)) is associated with premature mortality. Future concentrations of these air pollutants will be driven by natural and anthropogenic emissions and by climate change. Using anthropogenic and biomass burning emissions projected in the four Representative Concentration Pathway scenarios (RCPs), the ACCMIP ensemble of chemistry climate models simulated future concentrations of ozone and PM(sub 2.5) at selected decades between 2000 and 2100. We use output from the ACCMIP ensemble, together with projections of future population and baseline mortality rates, to quantify the human premature mortality impacts of future ambient air pollution. Future air-pollution-related premature mortality in 2030, 2050 and 2100 is estimated for each scenario and for each model using a health impact function based on changes in concentrations of ozone and PM(sub 2.5) relative to 2000 and projected future population and baseline mortality rates. Additionally, the global mortality burden of ozone and PM(sub 2.5) in 2000 and each future period is estimated relative to 1850 concentrations, using present-day and future population and baseline mortality rates. The change in future ozone concentrations relative to 2000 is associated with excess global premature mortality in some scenarios/periods, particularly in RCP8.5 in 2100 (316 thousand deaths per year), likely driven by the large increase in methane emissions and by the net effect of climate change projected in this scenario, but it leads to considerable avoided premature mortality for the three other RCPs. However, the global mortality burden of ozone markedly increases from 382000 (121000 to 728000) deaths per year in 2000 to between 1.09 and 2.36 million deaths per year in 2100, across RCPs, mostly due to the effect of increases in population and baseline mortality rates. PM(sub 2.5) concentrations decrease relative to 2000 in all scenarios, due to

  8. Productivity losses due to illness, disability and premature death in different occupational groups in Finland.

    PubMed

    Vinni, K

    1983-01-01

    In this study losses due to illness, disability and premature death for the economically active population in Finland in 1975 were examined. Total losses of the employed population due to premature death, disability and illness were 503,000 workyears. In monetary terms the losses were 7.91 billion Finnish marks. Age standardized losses per 1000 economically active males were 266 years and per 1000 economically active females 233 years. Losses for males in agriculture and in industry were almost three times higher than in administration. Among females the losses in agriculture were 3.3 times greater and in industry and in services 2.5 times greater than in administration. The main reason for the differences between the total losses was the uneven distribution of invalidity pensions. Losses associated with occupation were calculated assuming that the morbidity, disability and mortality rates in all occupational groups were the same as in healthiest group (administration). If the extra mortality, disability and illnesses of occupational groups were eliminated, the savings would be 255,000 workyears or about 3.9 billion Finnish marks per year e.g. the total losses would decrease to below half of the present level.

  9. Mortality due to lung cancer in Mexico.

    PubMed

    Ruíz-Godoy, L; Rizo Rios, P; Sánchez Cervantes, F; Osornio-Vargas, A; García-Cuellar, C; Meneses García, A

    2007-11-01

    The highest mortality due to cancer worldwide for both genders corresponds to lung cancer (1,179,000 deaths). In Mexico, the crude mortality rate due to lung cancer was of 5.01 per 10(5) inhabitants in 1979. The most important risk factor is smoking. The present study was aimed at analyzing the mortality due to lung cancer in Mexico, assessing data from each of the states constituting the Mexican Republic during the 1998-2004 period. Data were obtained from the National Institute of Statistics, Geography and Informatics (INEGI, for its initials in Spanish) corresponding to deaths due to lung cancer (1998-2004). We estimated the mean annual mortality rate (MAMR) for each of the 32 states of Mexico. We used the "World Population Standard". The MAMR was standardized according to age (ARS) direct method, and the standard error was determined by Poisson's approximation at a 95% confidence interval. To know the excess risk due to mortality, we calculated the standardized mortality ratios (SMRs) of ARS for each federal state, using the national rate as reference. In this period, 397,400 deaths due to malignant neoplasms were recorded, corresponding 45,578 (11.5%) to lung cancer; for men, 31,025 (68.1%) with MAMR of 8.9 and the respective ARS of 13.2 both x10(5) inhabitants. For women, results were 4553 (31.9%) deaths with MAMR of 4.1 and ARS of 5.4 both x10(5) inhabitants. The highest mortality rates due to lung cancer in both genders were observed in the north of Mexico, whereas for women this was observed in the central states. Although smoking is the main risk for lung cancer, there are other factors such as environmental pollution or exposure to toxicants that could be associated to this cancer. The years potentially lost due to lung cancer were 258,550 for men and 133,315 for women, with a total of 391,865 according to histopathology registry neoplasm malignant RHNM (1985-1995). Studies focused on the characterization and measurement of polluting agents would be a

  10. Familial risk of premature cardiovascular mortality and the impact of intergenerational occupational class mobility.

    PubMed

    Tiikkaja, Sanna; Olsson, Marita; Malki, Ninoa; Modin, Bitte; Sparén, Pär

    2012-11-01

    The negative impact of low social class on cardiovascular disease (CVD) and mortality has been consistently documented. However, less scientific consistency exists in terms of whether a unique health effect of social mobility from childhood to adulthood prevails. This study explored how childhood and adult social class and the transition between them (social mobility), are related to premature CVD mortality when familial aggregation of CVD among siblings is also considered. The study includes nearly 1.9 million Swedish residents born 1939-1959 distributed over 1,044,725 families, of whom 14,667 died prematurely from CVD in 1990-2003. Information on parental class (1960) and own mid-life occupational class (1990) was retrieved from the respective censuses. Odds ratios for premature CVD mortality according to trajectory-specific social mobility, along with pairwise mean odds ratios for sibling resemblance of premature CVD mortality, were calculated by means of alternating logistic regression. This model calculates the remaining dependency of CVD mortality within sibships after accounting for available risk factors (like parental and adult social class) in the population mean model. Results showed that premature CVD mortality was associated with both parental and own adult social class. A clear tendency for the downwardly mobile to have increased, and for the upwardly mobile to experience a decreased risk of premature CVD mortality was found, as well as a corresponding unique effect of social mobility per se among the manual and non-manual classes. This effect was verified for men, but not for women, when they were analysed separately. The pairwise mean odds ratios for premature CVD mortality among full siblings were 1.78 (95% CI: 1.52-2.08), and were independent of parental CVD mortality and parental or adult occupational class.

  11. Fetal MRI for prediction of neonatal mortality following preterm premature rupture of the fetal membranes.

    PubMed

    Messerschmidt, Agnes; Pataraia, Anna; Helmer, Hanns; Kasprian, Gregor; Sauer, Alexandra; Brugger, Peter C; Pollak, Arnold; Weber, Michael; Prayer, Daniela

    2011-11-01

    Lung MRI volumetrics may be valuable for fetal assessment following early preterm premature rupture of the foetal membranes (pPROM). To evaluate the predictive value of MRI lung volumetrics after pPROM. Retrospective cohort study of 40 fetuses after pPROM in a large, tertiary, perinatal referral center. Fetuses underwent MRI lung volumetrics. Estimated lung volume was expressed as percentage of expected lung volume (our own normal references). Primary outcome was neonatal mortality due to respiratory distress before discharge from hospital. Gestational age range was 16-27 weeks. Estimated-to-expected lung volume was 73% in non-survivors and 102% in survivors (P < 0.05). There were no survivors with a lung volume less than 60% of expected. By logistic regression, mortality could be predicted with a sensitivity of 80%, specificity of 86% and accuracy of 85%. Fetal MR lung volumetrics may be useful for predicting mortality due to respiratory distress in children with early gestational pPROM.

  12. [Precocious neonatal mortality in premature newborns with low weight at birth and death].

    PubMed

    Garrido-calderon, J; Perez-lachapelle, A; Brito, A; Alvarez, P

    1996-01-01

    A retrospective study was conducted of all live births occurring in 1992 at a Dominican Institute of Social Security hospital in Santo Domingo to analyze the association between prematurity, low birth weight, and early neonatal mortality. Stillbirths, infants weighing less than 1000 g or born before 28 weeks of gestation, and those with lethal malformations were excluded. 5142 newborns met the inclusion criteria. 1701 deliveries (33%) were cesarean. 550 of the newborns (10.7%) were low birth weight, and 338 (6.6%) were premature. The early neonatal mortality rate was 17/1000. Low birth weight infants accounted for 66.2% of early neonatal mortality. 10.7% of low birth weight infants died within the first week of life, and their relative risk of early neonatal death was 16.42. 64% of all infants dying in their first week of life were also premature. The specific mortality rate for premature infants was 168.6/1000 live births. The relative risk was 25.32 for premature infants. Low birth weight infants born at term had an early neonatal mortality rate of 24.6/1000 live births, compared to 5.5/1000 for term births of adequate weight.

  13. Mortality due to Respiratory Syncytial Virus. Burden and Risk Factors.

    PubMed

    Geoghegan, Sarah; Erviti, Anabella; Caballero, Mauricio T; Vallone, Fernando; Zanone, Stella M; Losada, Juan Ves; Bianchi, Alejandra; Acosta, Patricio L; Talarico, Laura B; Ferretti, Adrian; Grimaldi, Luciano Alva; Sancilio, Andrea; Dueñas, Karina; Sastre, Gustavo; Rodriguez, Andrea; Ferrero, Fernando; Barboza, Edgar; Gago, Guadalupe Fernández; Nocito, Celina; Flamenco, Edgardo; Perez, Alberto Rodriguez; Rebec, Beatriz; Ferolla, F Martin; Libster, Romina; Karron, Ruth A; Bergel, Eduardo; Polack, Fernando P

    2017-01-01

    Respiratory syncytial virus (RSV) is the most frequent cause of hospitalization and an important cause of death in infants in the developing world. The relative contribution of social, biologic, and clinical risk factors to RSV mortality in low-income regions is unclear. To determine the burden and risk factors for mortality due to RSV in a low-income population of 84,840 infants. This was a prospective, population-based, cross-sectional, multicenter study conducted between 2011 and 2013. Hospitalizations and deaths due to severe lower respiratory tract illness (LRTI) were recorded during the RSV season. All-cause hospital deaths and community deaths were monitored. Risk factors for respiratory failure (RF) and mortality due to RSV were assessed using a hierarchical, logistic regression model. A total of 2,588 (65.5%) infants with severe LRTI were infected with RSV. A total of 157 infants (148 postneonatal) experienced RF or died with RSV. RSV LRTI accounted for 57% fatal LRTI tested for the virus. A diagnosis of sepsis (odds ratio [OR], 17.03; 95% confidence interval [CI], 13.14-21.16 for RF) (OR, 119.39; 95% CI, 50.98-273.34 for death) and pneumothorax (OR, 17.15; 95% CI, 13.07-21.01 for RF) (OR, 65.49; 95% CI, 28.90-139.17 for death) were the main determinants of poor outcomes. RSV was the most frequent cause of mortality in low-income postneonatal infants. RF and death due to RSV LRTI, almost exclusively associated with prematurity and cardiopulmonary diseases in industrialized countries, primarily affect term infants in a developing world environment. Poor outcomes at hospitals are frequent and associated with the cooccurrence of bacterial sepsis and clinically significant pneumothoraxes.

  14. [Labor productivity losses attributable to premature deaths due to traffic injuries between 2002 and 2012].

    PubMed

    Cubí-Mollá, Patricia; Peña-Longobardo, Luz María; Casal, Bruno; Rivera, Berta; Oliva-Moreno, Juan

    2015-09-01

    To estimate the years of potential life lost, years of potential productive life lost and the labor productivity losses attributable to premature deaths due to traffic injuries between 2002 and 2012 in Spain. Several statistical sources were combined (Spanish Registry of Deaths, Labor Force Survey and Wage Structure Survey) to develop a simulation model based on the human capital approach. This model allowed us to estimate the loss of labor productivity caused by premature deaths following traffic injuries from 2002 to 2012. In addition, mortality tables with life expectancy estimates were used to compute years of potential life lost and years of potential productive life lost. The estimated loss of labour productivity caused by fatal traffic injuries between 2002 and 2012 in Spain amounted to 9,521 million euros (baseline year 2012). The aggregate number of years of potential life lost in the period amounted to 1,433,103, whereas the years of potential productive life lost amounted to 875,729. Throughout the period analyzed, labor productivity losses and years of life lost diminished substantially. Labor productivity losses due to fatal traffic injuries decreased throughout the period analyzed. Nevertheless, the cumulative loss was alarmingly high. Estimation of the economic impact of health problems can complement conventional indicators of distinct dimensions and be used to support public policy making. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

  15. The Fall and Rise of US Inequities in Premature Mortality: 1960–2002

    PubMed Central

    Krieger, Nancy; Rehkopf, David H; Chen, Jarvis T; Waterman, Pamela D; Marcelli, Enrico; Kennedy, Malinda

    2008-01-01

    Background Debates exist as to whether, as overall population health improves, the absolute and relative magnitude of income- and race/ethnicity-related health disparities necessarily increase—or derease. We accordingly decided to test the hypothesis that health inequities widen—or shrink—in a context of declining mortality rates, by examining annual US mortality data over a 42 year period. Methods and Findings Using US county mortality data from 1960–2002 and county median family income data from the 1960–2000 decennial censuses, we analyzed the rates of premature mortality (deaths among persons under age 65) and infant death (deaths among persons under age 1) by quintiles of county median family income weighted by county population size. Between 1960 and 2002, as US premature mortality and infant death rates declined in all county income quintiles, socioeconomic and racial/ethnic inequities in premature mortality and infant death (both relative and absolute) shrank between 1966 and 1980, especially for US populations of color; thereafter, the relative health inequities widened and the absolute differences barely changed in magnitude. Had all persons experienced the same yearly age-specific premature mortality rates as the white population living in the highest income quintile, between 1960 and 2002, 14% of the white premature deaths and 30% of the premature deaths among populations of color would not have occurred. Conclusions The observed trends refute arguments that health inequities inevitably widen—or shrink—as population health improves. Instead, the magnitude of health inequalities can fall or rise; it is our job to understand why. PMID:18303941

  16. Modelling small-area inequality in premature mortality using years of life lost rates

    NASA Astrophysics Data System (ADS)

    Congdon, Peter

    2013-04-01

    Analysis of premature mortality variations via standardized expected years of life lost (SEYLL) measures raises questions about suitable modelling for mortality data, especially when developing SEYLL profiles for areas with small populations. Existing fixed effects estimation methods take no account of correlations in mortality levels over ages, causes, socio-ethnic groups or areas. They also do not specify an underlying data generating process, or a likelihood model that can include trends or correlations, and are likely to produce unstable estimates for small-areas. An alternative strategy involves a fully specified data generation process, and a random effects model which "borrows strength" to produce stable SEYLL estimates, allowing for correlations between ages, areas and socio-ethnic groups. The resulting modelling strategy is applied to gender-specific differences in SEYLL rates in small-areas in NE London, and to cause-specific mortality for leading causes of premature mortality in these areas.

  17. Premature mortality patterns among American Indians in South Dakota, 2000-2010.

    PubMed

    Christensen, Mathew; Kightlinger, Lon

    2013-05-01

    American Indians in South Dakota have the highest mortality rates in the nation compared to other racial and ethnic groups and American Indians in other states. Cause-related and age-specific mortality patterns among American Indians in South Dakota are identified to guide prevention planning and policy efforts designed to reduce mortality within this population, in both South Dakota and other parts of the U.S. Death certificate data from South Dakota (2000-2010), on 5738 American Indians and 70,580 whites, were used to calculate age-specific mortality rates and rate ratios. These values were examined in order to identify patterns among the leading causes of death. Analyses were completed in 2011 and 2012. Within the South Dakota population, 70% of American Indians died before reaching age 70 years, compared to 25% of whites. Fatal injuries and chronic diseases were the leading causes of premature mortality. Nine leading causes of death showed consistent patterns of mortality disparity between American Indians and whites, with American Indians having significantly higher rates of mortality at lower ages. Premature mortality among American Indians in South Dakota is a serious public health problem. Unified efforts at the federal, tribal, state, and local levels are needed to reduce premature death within this population. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  18. The impact of pharmaceutical innovation on premature cancer mortality in Canada, 2000-2011.

    PubMed

    Lichtenberg, Frank R

    2015-09-01

    The premature cancer mortality rate has been declining in Canada, but there has been considerable variation in the rate of decline across cancer sites. I analyze the effect that pharmaceutical innovation had on premature cancer mortality in Canada during the period 2000-2011, by investigating whether the cancer sites that experienced more pharmaceutical innovation had larger declines in the premature mortality rate, controlling for changes in the incidence rate. Premature mortality before age 75 is significantly inversely related to the cumulative number of drugs registered at least 10 years earlier. Since mean utilization of drugs that have been marketed for less than 10 years is only one-sixth as great as mean utilization of drugs that have been marketed for at least a decade, it is not surprising that premature mortality is strongly inversely related only to the cumulative number of drugs that had been registered at least ten years earlier. Premature mortality before age 65 and 55 is also strongly inversely related to the cumulative number of drugs that had been registered at least ten years earlier. None of the estimates of the effect of incidence on mortality are statistically significant. Controlling for the cumulative number of drugs, the cumulative number of chemical subgroups does not have a statistically significant effect on premature mortality. This suggests that drugs (chemical substances) within the same class (chemical subgroup) are not therapeutically equivalent. During the period 2000-2011, the premature (before age 75) cancer mortality rate declined by about 9 %. The estimates imply that, in the absence of pharmaceutical innovation during the period 1985-1996, the premature cancer mortality rate would have increased about 12 % during the period 2000-2011. A substantial decline in the "competing risk" of death from cardiovascular disease could account for this. The estimates imply that pharmaceutical innovation during the period 1985-1996 reduced

  19. Premature Mortality from Cardiovascular Disease in the Americas – Will the Goal of a Decline of “25% by 2025” be Met?

    PubMed Central

    Ordunez, Pedro; Prieto-Lara, Elisa; Pinheiro Gawryszewski, Vilma; Hennis, Anselm J. M.; Cooper, Richard S.

    2015-01-01

    Background Cardiovascular diseases (CVD) are the underlying cause 1.6 million deaths per year in the Americas, accounting for 30% of total mortality and 38% of by non-communicable deaths diseases (NCDs). A 25% reduction in premature mortality due four main NCDs was targeted by the 2011 High-level Meeting of the General Assembly on the Prevention and Control of NCDs. While overall CVD mortality fell in the Americas during the past decade, trends in premature CVD mortality during the same period have not been described, particularly in the countries of Latin America and the Caribbean. Methods This is a population-based trend-series study based on a total of 6,133,666 deaths to describe the trends and characteristics of premature mortality due to CVD and to estimates of the average annual percentage of change during the period 2000–2010 in the Americas. Findings Premature mortality due to CVD in the Americas fell by 21% in the period 2000–2010 with a -2.5% average annual rate of change in the last 5 year—a statistically significant reduction of mortality—. Mortality from ischemic diseases, declined by 25% - 24% among men and 26% among women. Cerebrovascular diseases declined by 27% -26% among men and 28% among women. Guyana, Trinidad and Tobago, the Dominican Republic, Bahamas, and Brazil had CVD premature mortality rates over 200 per 100,000 population, while the average for the Region was 132.7. US and Canada will meet the 25% reduction target before 2025. Mexico, Costa Rica, Venezuela, Dominican Republic, Panama, Guyana, and El Salvador did not significantly reduce premature mortality among men and Guyana, the Dominican Republic, and Panama did not achieve the required annual reduction in women. Conclusions Trends in premature mortality due to CVD observed in last decade in the Americas would indicate that if these trends continue, the Region as a whole and a majority of its countries will be able to reach the goal of a 25% relative reduction in premature

  20. The contribution of outdoor air pollution sources to premature mortality on a global scale.

    PubMed

    Lelieveld, J; Evans, J S; Fnais, M; Giannadaki, D; Pozzer, A

    2015-09-17

    Assessment of the global burden of disease is based on epidemiological cohort studies that connect premature mortality to a wide range of causes, including the long-term health impacts of ozone and fine particulate matter with a diameter smaller than 2.5 micrometres (PM2.5). It has proved difficult to quantify premature mortality related to air pollution, notably in regions where air quality is not monitored, and also because the toxicity of particles from various sources may vary. Here we use a global atmospheric chemistry model to investigate the link between premature mortality and seven emission source categories in urban and rural environments. In accord with the global burden of disease for 2010 (ref. 5), we calculate that outdoor air pollution, mostly by PM2.5, leads to 3.3 (95 per cent confidence interval 1.61-4.81) million premature deaths per year worldwide, predominantly in Asia. We primarily assume that all particles are equally toxic, but also include a sensitivity study that accounts for differential toxicity. We find that emissions from residential energy use such as heating and cooking, prevalent in India and China, have the largest impact on premature mortality globally, being even more dominant if carbonaceous particles are assumed to be most toxic. Whereas in much of the USA and in a few other countries emissions from traffic and power generation are important, in eastern USA, Europe, Russia and East Asia agricultural emissions make the largest relative contribution to PM2.5, with the estimate of overall health impact depending on assumptions regarding particle toxicity. Model projections based on a business-as-usual emission scenario indicate that the contribution of outdoor air pollution to premature mortality could double by 2050.

  1. The contribution of outdoor air pollution sources to premature mortality on a global scale

    NASA Astrophysics Data System (ADS)

    Lelieveld, J.; Evans, J. S.; Fnais, M.; Giannadaki, D.; Pozzer, A.

    2015-09-01

    Assessment of the global burden of disease is based on epidemiological cohort studies that connect premature mortality to a wide range of causes, including the long-term health impacts of ozone and fine particulate matter with a diameter smaller than 2.5 micrometres (PM2.5). It has proved difficult to quantify premature mortality related to air pollution, notably in regions where air quality is not monitored, and also because the toxicity of particles from various sources may vary. Here we use a global atmospheric chemistry model to investigate the link between premature mortality and seven emission source categories in urban and rural environments. In accord with the global burden of disease for 2010 (ref. 5), we calculate that outdoor air pollution, mostly by PM2.5, leads to 3.3 (95 per cent confidence interval 1.61-4.81) million premature deaths per year worldwide, predominantly in Asia. We primarily assume that all particles are equally toxic, but also include a sensitivity study that accounts for differential toxicity. We find that emissions from residential energy use such as heating and cooking, prevalent in India and China, have the largest impact on premature mortality globally, being even more dominant if carbonaceous particles are assumed to be most toxic. Whereas in much of the USA and in a few other countries emissions from traffic and power generation are important, in eastern USA, Europe, Russia and East Asia agricultural emissions make the largest relative contribution to PM2.5, with the estimate of overall health impact depending on assumptions regarding particle toxicity. Model projections based on a business-as-usual emission scenario indicate that the contribution of outdoor air pollution to premature mortality could double by 2050.

  2. Gender patterns of socioeconomic differences in premature mortality: follow-up of the Hungarian Epidemiological Panel.

    PubMed

    Kopp, Mária S; Skrabski, Arpád; László, Krisztina D; Janszky, Imre

    2011-03-01

    Gender differences in premature mortality rates and in the size of socioeconomic inequalities in mortality vary across countries. We aimed to quantify the gender differences in the association between socioeconomic status (SES) and premature all-cause mortality and to analyse whether psychosocial factors might associate between SES and mortality among men and women separately in the middle-aged Hungarian population. Men (n = 1130) and women (n = 1529), aged 40-69 years, participants in the Hungarian Epidemiological Panel (2002) were followed up for 3.5 years for total mortality. Cox proportional hazard models were used to evaluate the association between several socioeconomic measures and total death. During the follow-up, 99 men (8.8%) and 53 women (3.5%) died. The age-adjusted hazard ratios and the Rothman's synergy indexes showed that each measure of socioeconomic position was more deleterious in men compared with women. When investigating potential explanatory factors for the SES-mortality association, we found that adjustment for severe depression resulted in the most pronounced reduction in the regression coefficients for the association between most socioeconomic factors and male premature death. There was no indication that depression would mediate between SES and mortality in women. Work stress factors, poor lifestyle and low social support also contributed to the explanation of the link between socioeconomic disadvantage and premature death in men. Middle-aged Hungarian men seem to be considerably more vulnerable to the chronic stress of material disadvantage than women. This effect modification by gender might partly be explained by a stronger connection between low SES and depressive symptoms in men.

  3. Rising premature mortality in the U.K.'s persistently deprived areas: only a Scottish phenomenon?

    PubMed

    Norman, Paul; Boyle, Paul; Exeter, Daniel; Feng, Zhiqiang; Popham, Frank

    2011-12-01

    In the international literature, many studies find strong relationships between area-based measures of deprivation and mortality. In the U.K., mortality rates have generally fallen in recent decades but the life expectancy gap between the most and least deprived areas has widened, with a number of Scottish studies highlighting increased mortality rates in deprived areas especially in Glasgow. However, these studies relate health outcomes at different time points against period-specific measures of deprivation which may not be comparable over time. Using longitudinal deprivation measures where levels of area deprivation are made comparable over time, a recent study demonstrated how levels of mortality change in relation to changing or persistent levels of (non-) deprivation over time. The results showed that areas which were persistently deprived in Scotland experienced a rise in premature mortality rates by 9.5% between 1981 and 2001. Here, focussing on persistently deprived areas we extended the coverage to the whole of the U.K. to assess whether, between 1991 and 2001, rising premature mortality rates in persistently deprived areas are a Scottish only phenomenon or whether similar patterns are evident elsewhere and for men and women separately. We found that male premature mortality rates rose by over 14% in Scotland over the 10-year period between the early 1990s and 2000s in persistently deprived areas. We found no significant rise in mortality elsewhere in the U.K. and that the rise among men in Scotland was driven by results for Glasgow where mortality rates rose by over 15% during the decade. Our analyses demonstrate the importance of identifying areas experiencing persistent poverty. These results justify even more of a public health focus on Glasgow and further work is needed to understand the demographic factors, such as health selective migration, immobility and population residualisation, which may contribute to these findings.

  4. Estimation of premature mortality from oral cancer in Japan, 1995 and 2005.

    PubMed

    Ibayashi, Haruhisa; Pham, Truong-Minh; Fujino, Yoshihisa; Kubo, Tatsuhiko; Ozasa, Kotaro; Matsuda, Shinya; Yoshimura, Takesumi

    2011-08-01

    To better understand the picture of premature death from oral cancer, we estimated years of life lost (YLL) and average years of life lost (AYLL) of this cancer for the years 1995 and 2005 in Japan. We obtained the mortality data for 5-year age groups from the Vital Statistics of Japan for the years 1995 and 2005, an interval of 10 years. Age-standardized rates (ASRs) per 100,000 persons were calculated for each subset of oral cancer. We estimated YLL and AYLL according to life tables in Japan to reflect premature mortality. For both men and women combined, 4099 and 5679 deaths due to oral cancer were recorded for the years 1995 and 2005. In men, cancer of tongue, oropharynx, and hypopharynx were the most frequently observed anatomic sites. We observed a total of 51,339.1 years of life lost in 1995 and 68,630.4 years in 2005, corresponding to an overall AYLL for all oral cancer deaths combined of 17.2 and 16.5 years earlier than life expectancy, respectively. The greatest AYLL was seen for deaths from nasopharyngeal cancer, with AYLL of 21.1 years in 1995 and 20.3 years in 2005. In women, cancer of the tongue and gum were the most affected anatomic sites. Total numbers of YLL were 18,884.8 years in 1995 and 24,765.7 in 2005, corresponding to an overall AYLL of 16.9 and 16.2 years earlier than life expectancy. The greatest AYLL was seen for deaths from nasopharyngeal cancer, with AYLL of 22.4 years and 20.4 years in 1995 and 2005, respectively. The present study shows that cancer of pharynx, tongue, and gum were the most frequent oral cancers in both sexes in both 1995 and 2005, and responsible for a remarkable number of years of life expectancy lost. Deaths due to those cancer sites occurred about 16-21 years earlier than expected in men, and 14-22 years in women. Copyright © 2011 Elsevier Ltd. All rights reserved.

  5. Premature Mortality In Poor Health And Low Income Adults With Epilepsy

    PubMed Central

    Kaiboriboon, Kitti; Schiltz, Nicholas K.; Bakaki, Paul M.; Lhatoo, Samden D.; Koroukian, Siran M.

    2014-01-01

    SUMMARY Objective To examine mortality and causes of death (COD) in socioeconomically disadvantaged persons with epilepsy (PWE) in the US. Methods We performed a retrospective open cohort analysis using Ohio Medicaid claims data between 1992 and 2008 to assess mortality and COD in 68,785 adult Medicaid beneficiaries with epilepsy. Case fatality (CF), mortality rates (MRs), standardized mortality ratios (SMRs), and years of potential life lost (YPLL) were calculated. The SMRs were estimated to compare risk of death in PWE with that in the general Medicaid population with and without disabilities. Proportionate mortality ratios (PMRs), YPLLs, and SMRs for specific COD were also obtained. Results There were 12,630 deaths in PWE. CF was 18.4%, the age-race-sex adjusted MR was 18.6/1,000 person-years (95% CI, 18.3–18.9). The SMR was 1.8 (95% CI, 1.8 – 1.9) when compared to the general Medicaid population, and was 1.4 (95% CI, 1.3–1.6) when compared to those with disabilities. The average YPLL was 16.9 years (range, 1–47 years). Both epilepsy and comorbid conditions significantly contributed to premature mortality in PWE. Cardiovascular diseases, cancer, and unintentional injuries were the most common COD and account for a large proportion of YPLL. Deaths from epilepsy-related causes occurred in about 10% of the cases. Significance Socioeconomically deprived PWE, especially young adults, experience high mortality and die 17 years prematurely. The high mortality in Medicaid beneficiaries with epilepsy affirms that comorbid conditions and epilepsy play a crucial role in premature death. Management of comorbid conditions is, at a minimum, as important as epilepsy management, and therefore deserves more attention from physicians, particularly those who care for Medicaid individuals with epilepsy. PMID:25244361

  6. Premature mortality in Belgium in 1993-2009: leading causes, regional disparities and 15 years change.

    PubMed

    Renard, Françoise; Tafforeau, Jean; Deboosere, Patrick

    2014-01-01

    Reducing premature mortality is a crucial public health objective. After a long gap in the publication of Belgian mortality statistics, this paper presents the leading causes and the regional disparities in premature mortality in 2008-2009 and the changes since 1993. All deaths occurring in the periods 1993-1999 and 2003-2009, in people aged 1-74 residing in Belgium were included. The cause of death and population data for Belgium were provided by Statistics Belgium , while data for international comparisons were extracted from the WHO mortality database. Age-adjusted mortality rates and Person Year of Life Lost (PYLL) were calculated. The Rate Ratios were computed for regional and international comparisons, using the region or country with the lowest rate as reference; statistical significance was tested assuming a Poisson distribution of the number of deaths. The burden of premature mortality is much higher in men than in women (respectively 42% and 24% of the total number of deaths). The 2008-9 burden of premature mortality in Belgium reaches 6410 and 3440 PYLL per 100,000, respectively in males and females, ranking 4th and 3rd worst within the EU15. The disparities between Belgian regions are substantial: for overall premature mortality, respective excess of 40% and 20% among males, 30% and 20% among females are observed in Wallonia and Brussels as compared to Flanders. Also in cause specific mortality, Wallonia experiences a clear disadvantage compared to Flanders. Brussels shows an intermediate level for natural causes, but ranks differently for external causes, with less road accidents and suicide and more non-transport accidents than in the other regions. Age-adjusted premature mortality rates decreased by 29% among men and by 22% among women over a period of 15 years. Among men, circulatory diseases death rates decreased the fastest (-43.4%), followed by the neoplasms (-26.6%), the other natural causes (-21.0%) and the external causes (-20.8%). The larger

  7. Jim Crow and Premature Mortality Among the US Black and White Population, 1960–2009

    PubMed Central

    Krieger, Nancy; Chen, Jarvis T.; Coull, Brent A.; Beckfield, Jason; Kiang, Mathew V.; Waterman, Pamela D.

    2016-01-01

    Background Scant research has analyzed the health impact of abolition of Jim Crow (ie, legal racial discrimination overturned by the US 1964 Civil Rights Act). Methods We used hierarchical age–period–cohort models to analyze US national black and white premature mortality rates (death before 65 years of age) in 1960–2009. Results Within a context of declining US black and white premature mortality rates and a persistent 2-fold excess black risk of premature mortality in both the Jim Crow and non-Jim Crow states, analyses including random period, cohort, state, and county effects and fixed county income effects found that, within the black population, the largest Jim Crow-by-period interaction occurred in 1960–1964 (mortality rate ratio [MRR] = 1.15 [95% confidence interval = 1.09–1.22), yielding the largest overall period-specific Jim Crow effect MRR of 1.27, with no such interactions subsequently observed. Furthermore, the most elevated Jim Crow-by-cohort effects occurred for birth cohorts from 1901 through 1945 (MRR range = 1.05–1.11), translating to the largest overall cohort-specific Jim Crow effect MRRs for the 1921–1945 birth cohorts (MRR ~ 1.2), with no such interactions subsequently observed. No such interactions between Jim Crow and either period or cohort occurred among the white population. Conclusion Together, the study results offer compelling evidence of the enduring impact of both Jim Crow and its abolition on premature mortality among the US black population, although insufficient to eliminate the persistent 2-fold black excess risk evident in both the Jim Crow and non-Jim Crow states from 1960 to 2009. PMID:24825344

  8. [Premature rupture of membranes: maternal - perinatal morbidity and mortality in the Dominican Republic].

    PubMed

    Garrido Calderon, G; Perdomo, E M; Perez Vilorio, J B; Caputo Antonio, A

    1990-01-01

    Premature rupture of membranes is defined as expulsion of the amniotic liquid occurring at least 1 hour before initiation of uterine contractions and without apparent cervical changes. According to the literature, premature rupture of membranes occurs in 2-15% of all pregnancies, with an average of 10%. The etiology is considered multifactorial, and treatment remains controversial. A retrospective review was conducted to determine the occurrence of maternal or perinatal morbidity and mortality in 230 cases of premature rupture of membranes in a social security hospital in Santo Domingo, Dominican Republic, observed between 1983-88. Premature rupture occurred in 3.5% of cases according to the records. 37.4% of affected mothers were 21-25 years old and 69.6% were 21.30. 62.9% of the women were nulliparas. 2.2% had had no prenatal care, 59.1% had insufficient prenatal care, defined as 1-5 visits and only 36.1% had 6 or more visits. 81.3% of ruptures occurred at 37-42 weeks of gestation. In 64.8% of cases the pregnancy was terminated within 1-24 hours and 35.2% were considered prolonged. Prematurity and low birth weight was the most common perinatal disorders, affecting 10.9%. Respiratory difficulty syndrome affected 4.3%. 60% of infants with respiratory problems were born at less than 37 weeks gestation. Neonatal sepsis occurred in 3% of cases and prolapse of the umbilical cord in 1.3%. Perinatal mortality averaged 2.6%. Prematurity was a factor in all cases. Respiratory distress syndrome and neonatal sepsis were each present in 50% of cases and hyperbilirubinemia in 33%. 8.7% of the mothers developed chorioamnionitis. Only 23.9% terminated their pregnancies spontaneously. Oxytocin was used to induce labor in 30.4% and cesareans were performed in 44.8%.

  9. The unclosing premature mortality gap in gout: a general population-based study.

    PubMed

    Fisher, Mark C; Rai, Sharan K; Lu, Na; Zhang, Yuqing; Choi, Hyon K

    2017-07-01

    Gout, the most common inflammatory arthritis, is associated with premature mortality. Whether this mortality gap has improved over time, as observed in rheumatoid arthritis (RA), is unknown. Using an electronic medical record database representative of the UK general population, we identified incident gout cases and controls between 1999 and 2014. The gout cohort was divided based on year of diagnosis into early (1999-2006) and late (2007-2014) cohorts. We compared the mortality rates and HRs, adjusting for potential confounders between the cohorts. We conducted sensitivity analyses among patients with gout who received at least one prescription for urate-lowering therapy, which has been found to have a validity of 90%. In both cohorts, patients with gout showed similar levels of excess mortality compared with their corresponding comparison cohort (ie, 29.1 vs 23.5 deaths/1000 person-years and 23.0 vs 18.8 deaths/1000 person-years in the early and late cohorts, respectively). The corresponding mortality HRs were 1.25 (95% CI 1.21 to 1.30) and 1.24 (95% CI 1.20 to 1.29), and the multivariable HRs were 1.10 (95% CI 1.06 to 1.15) and 1.09 (95% CI 1.05 to 1.13), respectively (both p values for interaction >0.72). Our sensitivity analyses showed similar findings (both p values for interaction >0.88). This general population-based cohort study indicates that the level of premature mortality among patients with gout remains unimproved over the past 16 years, unlike RA during the same period. This unclosing premature mortality gap calls for improved management of gout and its comorbidities. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  10. Impacts of fine particulate matter on premature mortality under future climate change

    NASA Astrophysics Data System (ADS)

    Park, S.; Allen, R.; Lim, C. H.

    2016-12-01

    Climate change modulates concentration of fine particulate matter (PM2.5) via modifying atmospheric circulation and the hydrological cycle. Furthermore, surface PM2.5 is significantly associated with respiratory diseases and premature mortality. In this study, we assess the response of PM2.5 concentration to climate change in the future (end of 21st century) and its effects on year of life lost (YLL) and premature mortality. We use outputs from five models participating in the Atmospheric Chemistry and Climate Model Intercomparison Project (ACCMIP) to evaluate climate change effects on PM2.5: for present climate with current aerosol emissions and greenhouse gas concentrations, and for future climate, also with present-day aerosol emissions, but with end-of-the century greenhouse gas concentrations, sea surface temperatures and sea-ice. The results show that climate change is associated with an increase in PM2.5 concentration. Combined with global future population data from the United Nation (UN), we also find an increase in premature mortality and YLL.

  11. Novel mechanism of premature battery failure due to lithium cluster formation in implantable cardioverter-defibrillators.

    PubMed

    Pokorney, Sean D; Greenfield, Ruth Ann; Atwater, Brett D; Daubert, James P; Piccini, Jonathan P

    2014-12-01

    Battery failure is an uncommon complication of implantable cardioverter-defibrillators (ICDs), but unanticipated battery depletion can have life-threatening consequences. The purpose of this study was to describe the prevalence of a novel mechanism of battery failure in St. Jude Medical Fortify and Unify ICDs. Cases of premature Fortify battery failure from a single center are reported. A search (January 1, 2010 through November 30, 2013) for Fortify and Unify premature batter failure was conducted of the Food and Drug Administration's Manufacturer and User Facility Device Experience Database (MAUDE). These findings were supplemented with information provided by St. Jude Medical. Premature battery failure for 2 Fortify ICDs in our practice were attributed to the presence of lithium clusters near the cathode, causing a short circuit and high current drain. The prevalence of this mechanism of premature battery failure was 0.6% in our practice. A MAUDE search identified 39 cases of Fortify (30) and Unify (9) premature battery depletion confirmed by the manufacturer, representing a 0.03% prevalence. Four additional Fortify and 2 Unify cases were identified in MAUDE as suspected premature battery depletion, but in these cases the pulse generator was not returned to the manufacturer for evaluation. St. Jude Medical identified 10 cases of premature battery failure due to lithium clusters in Fortify devices (9) and Unify devices (1), representing a 0.004% prevalence. The deposition of lithium clusters near the cathode is a novel mechanism of premature battery failure. The prevalence of this problem is unknown. Providers should be aware of this mechanism for patient management. Copyright © 2014 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  12. Premature adult mortality in urban Zambia: a repeated population-based cross-sectional study.

    PubMed

    Rathod, Sujit D; Timæus, Ian M; Banda, Richard; Thankian, Kusanthan; Chilengi, Roma; Banda, Andrew; Lemba, Musonda; Stringer, Jeffrey S A; Chi, Benjamin H

    2016-03-03

    To measure the sex-specific and community-specific mortality rates for adults in Lusaka, Zambia, and to identify potential individual-level, household-level and community-level correlates of premature mortality. We conducted 12 survey rounds of a population-based cross-sectional study between 2004 and 2011, and collected data via a structured interview with a household head. Households in Lusaka District, Zambia, 2004-2011. 43,064 household heads (88% female) who enumerated 123,807 adult household members aged between 15 and 60 years. Premature adult mortality. The overall mortality rate was 16.2/1000 person-years for men and 12.3/1000 person-years for women. The conditional probability of dying between age 15 and 60 (45q15) was 0.626 for men and 0.537 for women. The top three causes of death for men and women were infectious in origin (ie, tuberculosis, HIV and malaria). We observed an over twofold variation of mortality rates between communities. The mortality rate was 1.98 times higher (95% CI 1.57 to 2.51) in households where a family member required nursing care, 1.44 times higher (95% CI 1.22 to 1.71) during the cool dry season, and 1.28 times higher (95% CI 1.06 to 1.54) in communities with low-cost housing. To meet Zambia's development goals, further investigation is needed into the factors associated with adult mortality. Mortality can potentially be reduced through focus on high-need households and communities, and improved infectious disease prevention and treatment services. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  13. Sensitivity of air pollution-induced premature mortality to precursor emissions under the influence of climate change.

    PubMed

    Tagaris, Efthimios; Liao, Kuo-Jen; DeLucia, Anthony J; Deck, Leland; Amar, Praveen; Russell, Armistead G

    2010-05-01

    The relative contributions of PM(2.5) and ozone precursor emissions to air pollution-related premature mortality modulated by climate change are estimated for the U.S. using sensitivities of air pollutants to precursor emissions and health outcomes for 2001 and 2050. Result suggests that states with high emission rates and significant premature mortality increases induced by PM(2.5) will substantially benefit in the future from SO(2), anthropogenic NO(X) and NH(3) emissions reductions while states with premature mortality increases induced by O(3) will benefit mainly from anthropogenic NO(X) emissions reduction. Much of the increase in premature mortality expected from climate change-induced pollutant increases can be offset by targeting a specific precursor emission in most states based on the modeling approach followed here.

  14. An Estimate of the Global Burden of Anthropogenic Ozone and Fine Particulate Matter on Premature Human Mortality Using Atmospheric Modeling

    PubMed Central

    Anenberg, Susan C.; Horowitz, Larry W.; Tong, Daniel Q.; West, J. Jason

    2010-01-01

    Background Ground-level concentrations of ozone (O3) and fine particulate matter [≤ 2.5 μm in aerodynamic diameter (PM2.5)] have increased since preindustrial times in urban and rural regions and are associated with cardiovascular and respiratory mortality. Objectives We estimated the global burden of mortality due to O3 and PM2.5 from anthropogenic emissions using global atmospheric chemical transport model simulations of preindustrial and present-day (2000) concentrations to derive exposure estimates. Methods Attributable mortalities were estimated using health impact functions based on long-term relative risk estimates for O3 and PM2.5 from the epidemiology literature. Using simulated concentrations rather than previous methods based on measurements allows the inclusion of rural areas where measurements are often unavailable and avoids making assumptions for background air pollution. Results Anthropogenic O3 was associated with an estimated 0.7 ± 0.3 million respiratory mortalities (6.3 ± 3.0 million years of life lost) annually. Anthropogenic PM2.5 was associated with 3.5 ± 0.9 million cardiopulmonary and 220,000 ± 80,000 lung cancer mortalities (30 ± 7.6 million years of life lost) annually. Mortality estimates were reduced approximately 30% when we assumed low-concentration thresholds of 33.3 ppb for O3 and 5.8 μg/m3 for PM2.5. These estimates were sensitive to concentration thresholds and concentration–mortality relationships, often by > 50%. Conclusions Anthropogenic O3 and PM2.5 contribute substantially to global premature mortality. PM2.5 mortality estimates are about 50% higher than previous measurement-based estimates based on common assumptions, mainly because of methodologic differences. Specifically, we included rural populations, suggesting higher estimates; however, the coarse resolution of the global atmospheric model may underestimate urban PM2.5 exposures. PMID:20382579

  15. Modeled global effects of airborne desert dust on air quality and premature mortality

    NASA Astrophysics Data System (ADS)

    Giannadaki, D.; Pozzer, A.; Lelieveld, J.

    2014-01-01

    Fine particulate matter is one of the most important factors contributing to air pollution. Epidemiological studies have related increased levels of atmospheric particulate matter to premature human mortality caused by cardiopulmonary disease and lung cancer. However, a limited number of investigations have focused on the contribution of airborne desert dust particles. Here we assess the effects of dust particles with an aerodynamic diameter smaller than 2.5 μm (DU2.5) on human mortality for the year 2005. We used the EMAC atmospheric-chemistry general circulation model at high resolution to simulate global atmospheric dust concentrations. We applied a health impact function to estimate premature mortality for the global population of 30 yr and older, using parameters from epidemiological studies. We estimate a global cardiopulmonary mortality of about 402 000 in 2005. The associated years of life lost are about 3.47 million per year. We estimate the global fraction of the cardiopulmonary deaths caused by atmospheric desert dust to be about 1.8%, though in the 20 countries most affected by dust this is much higher, about 15-50%. These countries are primarily found in the so-called "dust belt" from North Africa across the Middle East and South Asia to East Asia

  16. Similar support for three different life course socioeconomic models on predicting premature cardiovascular mortality and all-cause mortality

    PubMed Central

    Rosvall, Maria; Chaix, Basile; Lynch, John; Lindström, Martin; Merlo, Juan

    2006-01-01

    Background There are at least three broad conceptual models for the impact of the social environment on adult disease: the critical period, social mobility, and cumulative life course models. Several studies have shown an association between each of these models and mortality. However, few studies have investigated the importance of the different models within the same setting and none has been performed in samples of the whole population. The purpose of the present study was to study the relation between socioeconomic position (SEP) and mortality using different conceptual models in the whole population of Scania. Methods In the present investigation we use socioeconomic information on all men (N = 48,909) and women (N = 47,688) born between 1945 and 1950, alive on January, 1st,1990, and living in the Region of Scania, in Sweden. Focusing on three specific life periods (i.e., ages 10–15, 30–35 and 40–45), we examined the association between SEP and the 12-year risk of premature cardiovascular mortality and all-cause mortality. Results There was a strong relation between SEP and mortality among those inside the workforce, irrespective of the conceptual model used. There was a clear upward trend in the mortality hazard rate ratios (HRR) with accumulated exposure to manual SEP in both men (p for trend < 0.001 for both cardiovascular and all-cause mortality) and women (p for trend = 0.01 for cardiovascular mortality) and (p for trend = 0.003 for all-cause mortality). Inter- and intragenerational downward social mobility was associated with an increased mortality risk. When applying similar conceptual models based on workforce participation, it was shown that mortality was affected by the accumulated exposure to being outside the workforce. Conclusion There was a strong relation between SEP and cardiovascular and all-cause mortality, irrespective of the conceptual model used. The critical period, social mobility, and cumulative life course models, showed the same

  17. Historical Trends in PM2.5-Related Premature Mortality during 1990–2010 across the Northern Hemisphere

    PubMed Central

    Wang, Jiandong; Xing, Jia; Mathur, Rohit; Pleim, Jonathan E.; Wang, Shuxiao; Hogrefe, Christian; Gan, Chuen-Meei; Wong, David C.; Hao, Jiming

    2016-01-01

    Background: Air quality across the northern hemisphere over the past two decades has witnessed dramatic changes, with continuous improvement in developed countries in North America and Europe, but a contrasting sharp deterioration in developing regions of Asia. Objective: This study investigates the historical trend in the long-term exposure to PM2.5 and PM2.5-related premature mortality (PM2.5-mortality) and its response to changes in emission that occurred during 1990–2010 across the northern hemisphere. Implications for future trends in human exposure to air pollution in both developed and developing regions of the world are discussed. Methods: We employed the integrated exposure–response model developed by Health Effects Institute to estimate the PM2.5-mortality. The 1990–2010 annual average PM2.5 concentrations were obtained from the simulations using the WRF-CMAQ model. Emission mitigation efficiencies of sulfur dioxide (SO2), nitrogen oxides (NOx), ammonia (NH3), and primary PM are estimated from the PM2.5-mortality responses to the emission variations. Results: Estimated PM2.5-mortalities in East Asia and South Asia increased by 21% and 85% respectively, from 866,000 and 578,000 in 1990, to 1,048,000 and 1,068,000 in 2010. PM2.5-mortalities in developed regions (i.e., Europe and high-income North America) decreased substantially by 67% and 58% respectively. Conclusions: Over the past two decades, correlations between population and PM2.5 have become weaker in Europe and North America due to air pollution controls but stronger in East Asia due to deteriorating air quality. Mitigation of primary PM appears to be the most efficient way for increasing health benefits (i.e., providing the largest mortality reduction per unit emissions). However, reductions in emissions of NH3 are needed to maximize the effectiveness of NOx emission controls. Citation: Wang J, Xing J, Mathur R, Pleim JE, Wang S, Hogrefe C, Gan CM, Wong DC, Hao J. 2017. Historical trends in

  18. [Rehabilitation prognosis in the patient with bilateral cortipathy due to prematurity].

    PubMed

    Trejo Rayón, S; Peñaloza, Y; Balderas Gil, A

    1979-01-01

    Thirty cases of bilateral corticopathy due to prematurity were studied at the Instituto Nacional de la Comunicación Humana. Taking into account all predisposing features, it is concluded that with adequate preventive measures, it is possible to avoid this pathology and thus obtain a favorable rehabilitation prognosis.

  19. Mortality due to noncommunicable diseases in Brazil, 1990 to 2015, according to estimates from the Global Burden of Disease study.

    PubMed

    Malta, Deborah Carvalho; França, Elisabeth; Abreu, Daisy Maria Xavier; Perillo, Rosângela Durso; Salmen, Maíra Coube; Teixeira, Renato Azeredo; Passos, Valeria; Souza, Maria de Fátima Marinho; Mooney, Meghan; Naghavi, Mohsen

    2017-01-01

    Noncommunicable diseases (NCDs) are the leading health problem globally and generate high numbers of premature deaths and loss of quality of life. The aim here was to describe the major groups of causes of death due to NCDs and the ranking of the leading causes of premature death between 1990 and 2015, according to the Global Burden of Disease (GBD) 2015 study estimates for Brazil. Cross-sectional study covering Brazil and its 27 federal states. This was a descriptive study on rates of mortality due to NCDs, with corrections for garbage codes and underreporting of deaths. This study shows the epidemiological transition in Brazil between 1990 and 2015, with increasing proportional mortality due to NCDs, followed by violence, and decreasing mortality due to communicable, maternal and neonatal causes within the global burden of diseases. NCDs had the highest mortality rates over the whole period, but with reductions in cardiovascular diseases, chronic respiratory diseases and cancer. Diabetes increased over this period. NCDs were the leading causes of premature death (30 to 69 years): ischemic heart diseases and cerebrovascular diseases, followed by interpersonal violence, traffic injuries and HIV/AIDS. The decline in mortality due to NCDs confirms that improvements in disease control have been achieved in Brazil. Nonetheless, the high mortality due to violence is a warning sign. Through maintaining the current decline in NCDs, Brazil should meet the target of 25% reduction proposed by the World Health Organization by 2025.

  20. Inequalities in premature mortality in Britain: observational study from 1921 to 2007

    PubMed Central

    Dorling, Danny; Smith, George Davey

    2010-01-01

    Objective To report on the extent of inequality in premature mortality as measured between geographical areas in Britain. Design Observational study of routinely collected mortality data and public records. Population subdivided by age, sex, and geographical area (parliamentary constituencies from 1991 to2007, pre-1974 local authorities over a longer time span). Setting Great Britain. Participants Entire population aged under 75 from 1990 to 2007, and entire population aged under 65 in the periods 1921-39, 1950-3, 1959-63, 1969-73, and 1981-2007. Main outcome measure Relative index of inequality (RII) and ratios of inequality in age-sex standardised mortality ratios under ages 75 and 65. The relative index of inequality is the relative rate of mortality for the hypothetically worst-off compared with the hypothetically best-off person in the population, assuming a linear association between socioeconomic position and risk of mortality. The ratio of inequality is the ratio of the standardised mortality ratio of the most deprived 10% to the least deprived 10%. Results When measured by the relative index of inequality, geographical inequalities in age-sex standardised rates of mortality below age 75 have increased every two years from 1990-1 to 2006-7 without exception. Over this period the relative index of inequality increased from 1.61 (95% confidence interval 1.52 to 1.69) in 1990-1 to 2.14 (2.02 to 2.27) in 2006-7. Simple ratios indicated a brief period around 2001 when a small reduction in inequality was recorded, but this was quickly reversed and inequalities up to the age of 75 have now reached the highest levels reported since at least 1990. Similarly, inequalities in mortality ratios under the age of 65 improved slightly in the early years of this century but the latest figures surpass the most extreme previously reported. Comparison of crudely age-sex standardised rates for those below age 65 from historical records showed that geographical inequalities in

  1. Historical Trends in PM2.5-Related Premature Mortality during 1990$-$2010 across the Northern Hemisphere

    DOE PAGES

    Wang, Jiandong; Xing, Jia; Mathur, Rohit; ...

    2016-08-19

    Air quality across the northern hemisphere over the past two decades has witnessed dramatic changes, with continuous improvement in developed countries in North America and Europe, but a contrasting sharp deterioration in developing regions of Asia. Objective: This study investigates the historical trend in the long-term exposure to PM2.5 and PM2.5-related premature mortality (PM2.5-mortality) and its response to changes in emission that occurred during 1990-2010 across the northern hemisphere. Implications for future trends in human exposure to air pollution in both developed and developing regions of the world are discussed. Methods: We employed the integrated exposure-response model developed by Healthmore » Effects Institute to estimate the PM2.5-mortality. The 1990-2010 annual-average PM2.5 concentrations were obtained from the simulations using WRF-CMAQ model. Emission mitigation efficiencies of SO2, NOx, NH3 and primary PM are estimated from the PM2.5-mortality responses to the emission variations. Results: Estimated PM2.5-mortalities in East Asia and South Asia increased by 21% and 85% respectively, from 866,000 and 578,000 in 1990, to 1,048,000 and 1,068,000 in 2010. PM2.5-mortalities in developed regions, i.e., Europe and high-income North America decreased substantially by 67% and 58% respectively. Conclusions: Over the past two decades, correlations between population and PM2.5 have become weaker in Europe and North America due to air pollution controls but stronger in East Asia due to deteriorating air quality. Mitigation of primary PM appears to be the most efficient way for increasing health benefits, i.e., providing the largest mortality reduction per unit emissions. However, reductions in emissions of NH3 are needed to maximize the effectiveness of NOx emission controls.« less

  2. Fetal Alcohol Spectrum Disorders: A Population Based Study of Premature Mortality Rates in the Mothers

    PubMed Central

    Li, Qing; Fisher, Wayne W.; Peng, Chun-Zi; Williams, Andrew D.

    2017-01-01

    Fetal alcohol spectrum disorders (FASD) are associated with an increase in risk for mortality for people with an FASD and their siblings. In this study we examine mortality rates of birth mothers of children with FASD, using a retrospective case control methodology. We utilized the North Dakota FASD Registry to locate birth certificates for children with FASD which we used to identify birth mothers. We then searched for mothers’ death certificates. We then compared the mortality rates of the birth mothers with an age matched control group comprised of all North Dakota women who were born and died in the same year as the birth mother. The birth mothers of children with FASD had a mortality rate of 15/304 = 4.93%; (95% CI 2.44–7.43%). The mortality rate for control mothers born in same years as the FASD mothers was 126/114,714 = 0.11% (95% CI 0.09–0.13%). Mothers of children with an FASD had a 44.82 fold increase in mortality risk and 87% of the deaths occurred in women under the age of 50. Three causes of death (cancer, injuries, and alcohol related disease) accounted for 67% of the deaths in the mothers of children with FASD. A diagnosis of FASD is an important risk marker for premature death in the mothers of children diagnosed with an FASD. These women should be encouraged to enter substance abuse treatment. PMID:21710184

  3. Fetal alcohol spectrum disorders: a population based study of premature mortality rates in the mothers.

    PubMed

    Li, Qing; Fisher, Wayne W; Peng, Chun-Zi; Williams, Andrew D; Burd, Larry

    2012-08-01

    Fetal alcohol spectrum disorders (FASD) are associated with an increase in risk for mortality for people with an FASD and their siblings. In this study we examine mortality rates of birth mothers of children with FASD, using a retrospective case control methodology. We utilized the North Dakota FASD Registry to locate birth certificates for children with FASD which we used to identify birth mothers. We then searched for mothers' death certificates. We then compared the mortality rates of the birth mothers with an age matched control group comprised of all North Dakota women who were born and died in the same year as the birth mother. The birth mothers of children with FASD had a mortality rate of 15/304 = 4.93%; (95% CI 2.44-7.43%). The mortality rate for control mothers born in same years as the FASD mothers was 126/114,714 = 0.11% (95% CI 0.09-0.13%). Mothers of children with an FASD had a 44.82 fold increase in mortality risk and 87% of the deaths occurred in women under the age of 50. Three causes of death (cancer, injuries, and alcohol related disease) accounted for 67% of the deaths in the mothers of children with FASD. A diagnosis of FASD is an important risk marker for premature death in the mothers of children diagnosed with an FASD. These women should be encouraged to enter substance abuse treatment.

  4. Twenty years of socioeconomic inequalities in premature mortality in Barcelona: The influence of population and neighbourhood changes.

    PubMed

    Rodríguez-Sanz, Maica; Gotsens, Mercè; Marí-Dell'Olmo, Marc; Mehdipanah, Roshanak; Borrell, Carme

    2016-05-01

    The objective of this study was to analyse trends in socioeconomic inequalities in premature mortality in Barcelona from 1992 to 2011, accounting for population changes. We conducted a repeated cross-sectional study of the Barcelona population (25-64 years) using generalized linear mixed models for trend analysis, and found that socioeconomic inequalities in premature mortality persisted between neighbourhoods, but tended to diminish. However, the reduction in inequality was related to an increase in the number of foreign-born individuals mainly in socioeconomic disadvantaged neighbourhoods, in which the decrease in premature mortality was more marked. To study trends in geographical inequalities in mortality, it is essential to understand demographic changes occurred in different places related to local levels of deprivation.

  5. The relationship between incarceration and premature adult mortality: gender specific evidence.

    PubMed

    Massoglia, Michael; Pare, Paul-Philippe; Schnittker, Jason; Gagnon, Alain

    2014-07-01

    We examine the relationship between incarceration and premature mortality for men and women. Analyses using the National Longitudinal Survey of Youth (NLSY79) reveal strong gender differences. Using two different analytic procedures the results show that women with a history of incarceration are more likely to die than women without such a history, even after controlling for health status and criminal behavior prior to incarceration, the availability of health insurance, and other socio-demographic factors. In contrast, there is no relationship between incarceration and mortality for men after accounting for these factors. The results point to the importance of examining gender differences in the collateral consequences of incarceration. The results also contribute to a rapidly emerging literature linking incarceration to various health hazards. Although men constitute the bulk of inmates, future research should not neglect the special circumstances of female former inmates and their rapidly growing numbers.

  6. Role of gender in morbidity and mortality of extremely premature neonates.

    PubMed

    Binet, Marie-Eve; Bujold, Emmanuel; Lefebvre, Francine; Tremblay, Yves; Piedboeuf, Bruno

    2012-03-01

    We investigated the effect of gender on survival and short-term outcomes of extremely premature infants (≤27 weeks) born in Canada. The records of infants admitted between 2000 and 2005 to a neonatal intensive care unit participating in the Canadian Neonatal Network were reviewed for infant gender, birth weight, gestational age, outborn status, Score for Neonatal Acute Physiology II, and antenatal corticosteroid exposure. The following outcomes were recorded: survival at final discharge, necrotizing enterocolitis, bronchopulmonary dysplasia (BPD), intraventricular hemorrhage grade ≥3, retinopathy grade ≥3, days on ventilation, and length of hospital stay. Among 2744 extremely premature infants, 1480 (54%) were male and 1264 (46%) were female. Mean birth weight of female neonates was significantly lower at each week of gestational age. Although no significant difference in survival at discharge was found between genders overall, the prevalence of BPD, combined adverse outcomes, and mortality for infants born between 24 and 26 weeks were significantly higher in males. This study suggests that, in the postsurfactant era, males remain at higher risk of respiratory complications and may have higher mortality when born between 24 and 26 weeks of gestation.

  7. Socioeconomic inequalities in premature mortality in Colombia, 1998-2007: The double burden of non-communicable diseases and injuries

    PubMed Central

    Arroyave, Ivan; Burdorf, Alex; Cardona, Doris; Avendano, Mauricio

    2014-01-01

    Objectives Non-communicable diseases have become the leading cause of death in middle-income countries, but mortality from injuries and infections remains high. We examined the contribution of specific causes to disparities in adult premature mortality (ages 25-64) by educational level from 1998 to 2007 in Colombia. Methods Data from mortality registries were linked to population censuses to obtain mortality rates by educational attainment. We used Poisson regression to model trends in mortality by educational attainment and estimated the contribution of specific causes to the Slope Index of Inequality. Results Men and women with only primary education had higher premature mortality than men and women with post-secondary education (RRmen=2·60, 95% confidence interval [CI]:2·56, 2·64; RRwomen=2·36, CI:2·31, 2·42). Mortality declined in all educational groups, but declines were significantly larger for higher-educated men and women. Homicide explained 55·1% of male inequalities while non-communicable diseases explained 62·5% of female inequalities and 27·1% of male inequalities. Infections explained a small proportion of inequalities in mortality. Conclusion Injuries and non-communicable diseases contribute considerably to disparities in premature mortality in Colombia. Multi-sector policies to reduce both interpersonal violence and non-communicable disease risk factors are required to curb mortality disparities. PMID:24674854

  8. Premature delivery due to intrauterine Candida infection that caused neonatal congenital cutaneous candidiasis: a case report.

    PubMed

    Ito, Fumitake; Okubo, Tomoharu; Yasuo, Tadahiro; Mori, Taisuke; Iwasa, Koichi; Iwasaku, Kazuhiro; Kitawaki, Jo

    2013-01-01

    Congenital cutaneous candidiasis is a very rare disease with less than 100 cases published in the medical literature. Neonates having this disease present with systemic skin lesions caused by intrauterine Candida infections. We present a case of threatened premature delivery due to Candida chorioamnionitis, which caused both maternal postpartum endometritis and neonatal congenital cutaneous candidiasis. A 34-year-old woman who was admitted for fetal membrane bulging at 20 weeks of gestation underwent McDonald cervical cerclage. We diagnosed threatened premature delivery due to intrauterine infection; therefore, we terminated the gestation by cesarean section at 24 weeks of gestation. Fungi-like yeast was detected in infantile gastric juice. Histopathological findings of the placenta revealed that Candida albicans mycelium invaded the placenta, chorioamniotic membrane and umbilical cord.

  9. Maternal Obesity During Pregnancy Associates With Premature Mortality and Major Cardiovascular Events in Later Life.

    PubMed

    Lee, Kuan Ken; Raja, Edwin A; Lee, Amanda J; Bhattacharya, Sohinee; Bhattacharya, Siladitya; Norman, Jane E; Reynolds, Rebecca M

    2015-11-01

    One in 5 pregnant women is obese but the impact on later health is unknown. We aimed to determine whether maternal obesity during pregnancy associates with increased premature mortality and later life major cardiovascular events. Maternity records of women who gave birth to their first child between 1950 and 1976 (n=18 873) from the Aberdeen Maternity and Neonatal databank were linked to the National Register of Deaths, Scotland and Scottish Morbidity Record. The effect of maternal obesity at first antenatal visit on death and hospital admissions for cardiovascular events was tested using time-to-event analysis with Cox proportional hazard regression to compare outcomes of mothers in underweight, overweight, or obese body mass index (BMI) categories compared with normal BMI. Median follow-up was at 73 years. All-cause mortality was increased in women who were obese during pregnancy (BMI>30 kg/m(2)) versus normal BMI after adjustment for socioeconomic status, smoking, gestation at BMI measurement, preeclampsia, and low birth weight (hazard ratio, 1.35; 95% confidence interval, 1.02-1.77). In adjusted models, overweight and obese mothers had increased risk of hospital admission for a cardiovascular event (1.16; 1.06-1.27 and 1.26; 1.01-1.57) compared with normal BMI mothers. Adjustment for parity largely unchanged the hazard ratios (mortality: 1.43, 1.09-1.88; cardiovascular events overweight: 1.17, 1.07-1.29; and obese: 1.30, 1.04-1.62). In conclusion, maternal obesity is associated with increased risk of premature death and cardiovascular disease. Pregnancy and early postpartum could represent an opportunity for interventions to identify obesity and reduce its adverse consequences.

  10. UK asbestos imports and mortality due to idiopathic pulmonary fibrosis.

    PubMed

    Barber, C M; Wiggans, R E; Young, C; Fishwick, D

    2016-03-01

    Previous studies have demonstrated that the rising mortality due to mesothelioma and asbestosis can be predicted from historic asbestos usage. Mortality due to idiopathic pulmonary fibrosis (IPF) is also rising, without any apparent explanation. To compare mortality due to these conditions and examine the relationship between mortality and national asbestos imports. Mortality data for IPF and asbestosis in England and Wales were available from the Office for National Statistics. Data for mesothelioma deaths in England and Wales and historic UK asbestos import data were available from the Health & Safety Executive. The numbers of annual deaths due to each condition were plotted separately by gender, against UK asbestos imports 48 years earlier. Linear regression models were constructed. For mesothelioma and IPF, there was a significant linear relationship between the number of male and female deaths each year and historic UK asbestos imports. For asbestosis mortality, a similar relationship was found for male but not female deaths. The annual numbers of deaths due to asbestosis in both sexes were lower than for IPF and mesothelioma. The strength of the association between IPF mortality and historic asbestos imports was similar to that seen in an established asbestos-related disease, i.e. mesothelioma. This finding could in part be explained by diagnostic difficulties in separating asbestosis from IPF and highlights the need for a more accurate method of assessing lifetime occupational asbestos exposure. © Crown copyright 2015.

  11. UK asbestos imports and mortality due to idiopathic pulmonary fibrosis

    PubMed Central

    Wiggans, R. E.; Young, C.; Fishwick, D.

    2016-01-01

    Background Previous studies have demonstrated that the rising mortality due to mesothelioma and asbestosis can be predicted from historic asbestos usage. Mortality due to idiopathic pulmonary fibrosis (IPF) is also rising, without any apparent explanation. Aims To compare mortality due to these conditions and examine the relationship between mortality and national asbestos imports. Methods Mortality data for IPF and asbestosis in England and Wales were available from the Office for National Statistics. Data for mesothelioma deaths in England and Wales and historic UK asbestos import data were available from the Health & Safety Executive. The numbers of annual deaths due to each condition were plotted separately by gender, against UK asbestos imports 48 years earlier. Linear regression models were constructed. Results For mesothelioma and IPF, there was a significant linear relationship between the number of male and female deaths each year and historic UK asbestos imports. For asbestosis mortality, a similar relationship was found for male but not female deaths. The annual numbers of deaths due to asbestosis in both sexes were lower than for IPF and mesothelioma. Conclusions The strength of the association between IPF mortality and historic asbestos imports was similar to that seen in an established asbestos-related disease, i.e. mesothelioma. This finding could in part be explained by diagnostic difficulties in separating asbestosis from IPF and highlights the need for a more accurate method of assessing lifetime occupational asbestos exposure. PMID:26511746

  12. Predictive factors of perinatal mortality in transfused fetuses due to maternal alloimmunization: what really matters?

    PubMed

    Osanan, Gabriel Costa; Silveira Reis, Zilma Nogueira; Apocalypse, Isabela Gomes; Lopes, Ana Paula Brum; Pereira, Alamanda Kfoury; da Silva Ribeiro, Orquidea Maria; Vieira Cabral, Antônio Carlos

    2012-08-01

    Alloimmunization is the main cause of fetal anemia. There are not many consistent analyses associating antenatal parameters to perinatal mortality in transfused fetuses due to maternal alloimmunization. The study aimed to determine the prognostic variables related to perinatal death. A cohort study analyzed 128 fetuses treated with intrauterine transfusion (IUT), until the early neonatal period. Perinatal mortality was associated with prognostic conditions related to prematurity, severity of fetal anemia and IUT procedure by univariated logistic regression. Multiple logistic regression was used to compute the odds ratio (OR) for adjusting the hemoglobin deficit at the last IUT, gestational age at birth, complications of IUT, antenatal corticosteroid and hydrops. Perinatal mortality rate found in this study was 18.1%. The hemoglobin deficit at the last IUT (OR: 1.26, 95% CI: 1.04-1.53), gestational age at birth (OR: 0.53, 95% CI: 0.38-0.74) and the presence of transfusional complications (OR: 5.43, 95% CI: 142-20.76) were significant in predicting fetal death. Perinatal mortality prediction in transfused fetuses is not associated only to severity of anemia, but also to the risks of IUT and prematurity.

  13. Premature mortality in people with epilepsy in rural China: a prospective study.

    PubMed

    Ding, Ding; Wang, Wenzhi; Wu, Jianzhong; Ma, Guangyu; Dai, Xiuying; Yang, Bin; Wang, Taiping; Yuan, Chenglin; Hong, Zhen; de Boer, Hanneke M; Prilipko, Leonid; Sander, Josemir W

    2006-10-01

    In China, few studies have described annual mortality associated with epilepsy in a general population and these have provided a range of 3.0-7.9 deaths per 100,000 people. We calculated the case fatality rate (CFR), proportional mortality rate (PMR), and standardised mortality ratio (SMR) to assess mortality in people with epilepsy in rural China. The target population was people with epilepsy who participated in an assessment of epilepsy management at primary health level in rural China. Neurologists confirmed the diagnosis using strict criteria in all participants who were then treated with phenobarbital. Demographic data and putative cause of death were recorded for each person whose death was reported. PMRs for each cause of death and SMRs were estimated on the basis of the 2004 Chinese population. Case fatality rate was 1.4% (35 deaths) among 2455 people with epilepsy. The age-adjusted PMRs for injury, stroke, neoplasm, myocardial infarction, and pneumonia were 30%, 30%, 15%, 6%, and 5%, respectively. The SMR was 3.9 (95% CI 3.8-3.9). Patients aged 15-29 years had higher mortality ratios than did those in other age-groups, with SMRs exceeding 23. Risk for premature death is three to four times higher in people with epilepsy than in the general Chinese population. Furthermore, the risk in young people with epilepsy in China is much higher than previously reported. Injury, stroke, myocardial infarction, and pneumonia are among the leading putative causes of death in patients with epilepsy in rural China.

  14. Ethnic and Gender Disparities in Premature Adult Mortality in Belize 2008-2010

    PubMed Central

    Hambleton, Ian R.; Unwin, Nigel

    2016-01-01

    Background Data on disparities in mortality within low and middle income countries are limited, with little published data from the Caribbean or Central America. Our aim was to investigate disparities in overall and cause specific premature adult mortality in the multi-ethnic middle income country of Belize. Methods Mortality data from Belize 2008–2010 classified using the International Classification of Diseases 10 and the 2010 census stratified by age and ethnicity were used to calculate age, sex, and ethnic specific mortality rates for those 15–59 years, and life table analysis was used to estimate the probability of death between the ages of 15 and 59 (45q15). Results The probability of death among those aged 15 to 59 years was 18.1% (women 13.5%, men 22.7%). Creole and Garifuna ethnic groups have three times the 45q15 probability of death compared to Mayan and Mestizo groups (Creole 31.2%, Garifuna 31.1%, Mayan 10.2%, Mestizo 12.0%). This pattern of ethnic disparity existed in both sexes but was greater in men. The probability of death from injuries was 14.8% among Creole men, more than twice the rate of other ethnicities and peaks among young Creole men. These deaths are dominated by homicides and unspecified deaths involving firearms Conclusions Marked disparities in mortality between ethnic groups exist in this Central American/Caribbean country, from rates that are typical of high-income countries to those of low-income countries. The pattern of these extreme differences likely suggests that they reflect underlying social determinants rooted in the country’s colonial past. PMID:27643696

  15. Joint Consideration of Distal and Proximal Predictors of Premature Mortality among Serious Juvenile Offenders

    PubMed Central

    Chassin, Laurie; Piquero, Alex R.; Losoya, Sandra H.; Mansion, Andre D.; Schubert, Carol A.

    2012-01-01

    Purpose Juvenile offenders are at heightened risk of death in adolescence and young adulthood compared to adolescents in the general population. The current study extends previous research by testing the joint contributions of distal (historical and demographic characteristics) and proximal (closer to the time of the death) predictors of mortality. We also tested and whether proximal variables were potential mediators of the effects of distal variables on mortality. Methods Participants were 1,354 serious juvenile offenders, 45 (3.32%) of whom were deceased by the completion of the study. Data were collected through self-reports and official records. Results Significant distal predictors of mortality were being African-American and having a history of substance use disorder. Proximal predictors that added significantly to prediction included gun carrying, gang membership, and substance use problems. Potential mediators of the effects of substance use disorder history were continuing substance use problems and gang membership. However, proximal variables could not explain the heightened risk for African-Americans. Conclusions Gang membership, gun carrying, and substance use problems are risk factors for early mortality among juvenile offenders, but they do not explain the elevated risk for death among African Americans. Thus, further research is needed to understand the mechanisms underlying risk for premature death among African-American adolescent offenders. Implications and contributions Findings suggest that interventions to reduce substance use problems, gang membership, and gun carrying have the potential to reduce risk of mortality for serious juvenile offenders. However, these factors cannot explain the heightened risk for death among African-American participants. PMID:23415755

  16. The politics of preventable deaths: local spending, income inequality, and premature mortality in US cities.

    PubMed

    Ronzio, C R; Pamuk, E; Squires, G D

    2004-03-01

    To examine the association between (1) local political party, (2) urban policies, measured by spending on local programmes, and (3) income inequality with premature mortality in large US cities. Cross sectional ecological study. All cause death rates and death rates attributable to preventable or immediate causes for people under age 75. PREDICTOR MEASURES: Income inequality, city spending, and social factors. All central cities in the US with population equal to or greater than 100 000. Income inequality is the most significant social variable associated with preventable or immediate death rates, and the relation is very strong: a unit increase in the Gini coefficient is associated with 37% higher death rates. Spending on police is associated with 23% higher preventable death rates compared with 14% lower death rates in cities with high spending on roads. Cities with high income inequality and poverty are so far unable to reduce their mortality through local expenditures on public goods, regardless of the mayoral party. Longitudinal data are necessary to determine if city spending on social programmes reduces mortality over time.

  17. The politics of preventable deaths: local spending, income inequality, and premature mortality in US cities

    PubMed Central

    Ronzio, C; Pamuk, E; Squires, G

    2004-01-01

    Objective: To examine the association between (1) local political party, (2) urban policies, measured by spending on local programmes, and (3) income inequality with premature mortality in large US cities. Design: Cross sectional ecological study. Outcome measures: All cause death rates and death rates attributable to preventable or immediate causes for people under age 75. Predictor measures: Income inequality, city spending, and social factors. Setting: All central cities in the US with population equal to or greater than 100 000. Results: Income inequality is the most significant social variable associated with preventable or immediate death rates, and the relation is very strong: a unit increase in the Gini coefficient is associated with 37% higher death rates. Spending on police is associated with 23% higher preventable death rates compared with 14% lower death rates in cities with high spending on roads. Conclusions: Cities with high income inequality and poverty are so far unable to reduce their mortality through local expenditures on public goods, regardless of the mayoral party. Longitudinal data are necessary to determine if city spending on social programmes reduces mortality over time. PMID:14966226

  18. Comparative analysis of premature mortality among urban immigrants in Bremen, Germany: a retrospective register-based linkage study

    PubMed Central

    Makarova, Nataliya; Brand, Tilman; Brünings-Kuppe, Claudia; Pohlabeln, Hermann; Luttmann, Sabine

    2016-01-01

    Objectives The main objective of this study was to explore differences in mortality patterns among two large immigrant groups in Germany: one from Turkey and the other from the former Soviet Union (FSU). To this end, we investigated indicators of premature mortality. Design This study was conducted as a retrospective population-based study based on mortality register linkage. Using mortality data for the period 2004–2010, we calculated age-standardised death rates (SDR) and standardised mortality ratios (SMR) for premature deaths (premature mortality. Setting and participants In this study, we made use of the unique possibilities of register-based research in relation to migration and health. Analyses were performed in three population groups in the federal state of Bremen, Germany: immigrants from Turkey, those from the FSU and the general population. Results The SDRs for premature deaths of the two immigrant groups were lower compared to those of the general population. The SMRs remained under 1. Using the indicator of YPLL, we observed higher age-standardised YPLL rates among immigrant populations, particularly among males from the FSU compared to females and population groups 4238/100 000, 95% CI (4119 to 4358). Regarding main causes of premature death, we found larger contributions of infant mortality and diseases of the respiratory system among Turkish immigrants, and of injuries and poisonings, and mental and behavioural disorders among immigrants from the FSU. Conclusions While the overall trends favour the immigrant populations, the indicator of YPLL and cause-specific results indicate areas where the healthcare systems responsiveness may need to be improved, including preventive services. Further work with broader databases providing a similar level of differentiation is necessary to substantiate these findings. PMID:27000782

  19. Effect of fluconazole prophylaxis on candidiasis and mortality in premature infants: A randomized clinical trial

    PubMed Central

    Benjamin, Daniel K.; Hudak, Mark L.; Duara, Shahnaz; Randolph, David A.; Bidegain, Margarita; Mundakel, Gratias T.; Natarajan, Girija; Burchfield, David J.; White, Robert D.; Shattuck, Karen E.; Neu, Natalie; Bendel, Catherine M.; Kim, M. Roger; Finer, Neil N.; Stewart, Dan L.; Arrieta, Antonio C.; Wade, Kelly C.; Kaufman, David A.; Manzoni, Paolo; Prather, Kristi O.; Testoni, Daniela; Berezny, Katherine Y.; Smith, P. Brian

    2014-01-01

    IMPORTANCE Invasive candidiasis in premature infants causes mortality and neurodevelopmental impairment. Fluconazole prophylaxis reduces candidiasis, but its effect on mortality and the safety of fluconazole is unknown. OBJECTIVE To evaluate the efficacy and safety of fluconazole in preventing death or invasive candidiasis in extremely low-birth-weight infants. DESIGN, SETTING, AND PATIENTS This study was a randomized, blinded, placebo-controlled trial of fluconazole in premature infants. Infants weighing less than 750 g at birth (N = 361) from 32 neonatal intensive care units (NICUs) in the United States were randomly assigned to receive either fluconazole or placebo twice weekly for 42 days. Surviving infants were evaluated at 18 to 22 months corrected age for neurodevelopmental outcomes. The study was conducted between November 2008 and February 2013. INTERVENTIONS Fluconazole (6 mg/kg of body weight) or placebo. MAIN OUTCOMES AND MEASURES The primary end point was a composite of death or definite or probable invasive candidiasis prior to study day 49 (1 week after completion of study drug). Secondary and safety outcomes included invasive candidiasis, liver function, bacterial infection, length of stay, intracranial hemorrhage, periventricular leukomalacia, chronic lung disease, patent ductus arteriosus requiring surgery, retinopathy of prematurity requiring surgery, necrotizing enterocolitis, spontaneous intestinal perforation, and neurodevelopmental outcomes—defined as a Bayley-III cognition composite score of less than 70, blindness, deafness, or cerebral palsy at 18–22-months corrected age. RESULTS Among infants receiving fluconazole, the composite primary end point of death or invasive candidiasis was 16% (95% CI, 11%–22%) vs 21% in the placebo group (95% CI, 15%–28%; odds ratio 0.73 [95% CI 0.43–1.23]; P=.24; treatment difference −5% [95% CI, −13%–3%]). Invasive candidiasis occurred less frequently in the fluconazole group (3% [95% CI, 1%

  20. Decreasing income inequality and emergence of the association between income and premature mortality: Spain, 1970-2010.

    PubMed

    Regidor, Enrique; Santos, Juana M; Ortega, Paloma; Calle, María E; Astasio, Paloma; Martínez, David

    2014-05-01

    This study evaluates the relationship between income and mortality in Spain over a long period of declining in income inequality. The ratio between income in the richest and poorest provinces was 2.74 in 1970 and 2.10 in 2010. Pearson correlation coefficients for the association between provincial income and the measures of mortality were estimated, as well as absolute and relative differences between the mortality rates of the poorest and richest provinces. The correlation coefficient between income and infant mortality decreased from -0.59 in 1970 to -0.17 in 2010, and lost significance from 1995 onwards. The coefficient for premature all-cause mortality increased from -0.04 in 1970 to -0.40 in 2010, and acquired significance beginning in 2005. The coefficient also increased in mortality from cardiovascular, respiratory and digestive diseases. No association was found between provincial income and cancer mortality or mortality from injuries. The findings on premature mortality do not support the theory that decreasing income inequality will lead to reduced inequalities in mortality. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Mortality trends due to chronic obstructive pulmonary disease in Brazil.

    PubMed

    Graudenz, Gustavo Silveira; Gazotto, Gabriel Pereira

    2014-01-01

    The purpose of this study was to update and analyze data on mortality trend due to chronic obstructive pulmonary disease (COPD) in Brazil. Initially, the specific COPD mortality rates were calculated from 1989 to 2009 using data collected from DATASUS (Departamento de Informática do SUS - Brazilian Health System Database). Then, the polynomial regression models from the observed functional relation were estimated based on mortality coefficients and study years. We verified that the general mortality rates due to COPD in Brazil showed an increasing trend from 1989 to 2004, and then decreased. Both genders showed the same increasing tendencies until 2004 and decreased thereafter. The age group under 35 years old showed a linear decreasing trend. All other age groups showed quadratic tendencies, with increases until the years of 1998-1999 and then decreasing. The South and Southeast regions showed the highest COPD mortality rates with increasing trends until the years 2001-2002 and then decreased. The North, Northeast and Central-West regions showed lower mortality rates but increasing trend. This is the first report of COPD mortality stabilization in Brazil since 1980.

  2. Morbidity and mortality trends in very-very low birth weight premature infants in light of recent changes in obstetric care.

    PubMed

    Varga, Péter; Berecz, Botond; Gasparics, Ákos; Dombi, Zsófia; Varga, Zsuzsa; Jeager, Judit; Magyar, Zsófia; Rigó, János; Joó, József Gábor; Kornya, László

    2017-04-01

    In this study, we describe trends in morbidity and mortality of preterm infants with less than 500mg birth weight in the changing landscape of obstetric and neonatal care. During a ten year study period between 2006 and 2016 we assessed outcome data for all neonates with less than 500mg birth weight born at our Neonatal Intensive Care Unit. We divided study subjects into two groups based on whether their birth date fell in the first half (2006-2010; n=39) versus the second half (2011-2015; n=27) of the study period comparing clinical outcomes in the two groups. We also assessed several clinical parameters for association with postnatal survival by comparing relative frequencies for each clinical parameter among surviving infants versus mortality cases. Survival rate for preterm neonates with less than 500mg birth weight born between 2006 and 2010 was 30.8%. This survival rate rose to 70.4% in the second half of the study period between 2011 and 2015 (p<0.05). Among surviving babies premature birth was found to be predominantly associated with maternal hypertension or intrauterine growth restriction while in those who died premature birth due to premature rupture of membranes and spontaneous preterm labor were significantly more common. All surviving infants with less than 500mg birth weight were born via cesarean section whereas among those who died cesarean section had been performed in only 80% and vaginal delivery in 20% representing a significant difference between the groups (p<0.05). The majority (90.3%) of surviving infants with less than 500mg birth weight had received surfactant therapy while the proportion of neonates receiving surfactant therapy among mortality cases was significantly lower (65.2%; p<0.05). Our findings suggest that among premature neonates with less than 500mg birth weight preterm delivery due to premature rupture of membranes and intrauterine infections represents the worse mortality risk. Steroid prophylaxis and measures to prevent

  3. Premature mortality resilience and wellbeing within urban Māori communities.

    PubMed

    Waa, Andrew M; Pearson, Amber L; Ryks, John L

    2017-01-01

    Māori (the indigenous peoples of Aotearoa New Zealand) experience of colonisation has negatively affected access to many of the resources (e.g. income, adequate housing) that enable health and well-being. However Māori have actively responded to the challenges they have faced. With the majority of the Māori population now living in urban settings this exploratory study aimed to understand factors contributing to mortality resilience despite exposure to socio-economic adversity with reference to Māori well-being. Resilient urban neighborhoods were defined as those that had lower than expected premature mortality among Māori residents despite high levels of socio-economic adversity. Selected resilience indicators theoretically linked to a Māori well-being framework were correlated with the novel Māori_RINZ resilience index. Of the selected indicators, only exposure to crime showed a clear gradient across the resilience index as predicted by the Māori well-being framework. Future research is needed as unclear trends for other indicators may reflect limitations in the indicators used or the need to develop a more comprehensive measure of well-being. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. The burden of premature mortality of epilepsy in high-income countries: A systematic review from the Mortality Task Force of the International League Against Epilepsy.

    PubMed

    Thurman, David J; Logroscino, Giancarlo; Beghi, Ettore; Hauser, W Allen; Hesdorffer, Dale C; Newton, Charles R; Scorza, Fulvio Alexandre; Sander, Josemir W; Tomson, Torbjörn

    2017-01-01

    Since previous reviews of epidemiologic studies of premature mortality among people with epilepsy were completed several years ago, a large body of new evidence about this subject has been published. We aim to update prior reviews of mortality in epilepsy and to reevaluate and quantify the risks, potential risk factors, and causes of these deaths. We systematically searched the Medline and Embase databases to identify published reports describing mortality risks in cohorts and populations of people with epilepsy. We reviewed relevant reports and applied criteria to identify those studies likely to accurately quantify these risks in representative populations. From these we extracted and summarized the reported data. All population-based studies reported an increased risk of premature mortality among people with epilepsy compared to general populations. Standard mortality ratios are especially high among people with epilepsy aged <50 years, among those whose epilepsy is categorized as structural/metabolic, those whose seizures do not fully remit under treatment, and those with convulsive seizures. Among deaths directly attributable to epilepsy or seizures, important immediate causes include sudden unexpected death in epilepsy (SUDEP), status epilepticus, unintentional injuries, and suicide. Epilepsy-associated premature mortality imposes a significant public health burden, and many of the specific causes of death are potentially preventable. These require increased attention from healthcare providers, researchers, and public health professionals.

  5. Effect of fluconazole prophylaxis on candidiasis and mortality in premature infants: a randomized clinical trial.

    PubMed

    Benjamin, Daniel K; Hudak, Mark L; Duara, Shahnaz; Randolph, David A; Bidegain, Margarita; Mundakel, Gratias T; Natarajan, Girija; Burchfield, David J; White, Robert D; Shattuck, Karen E; Neu, Natalie; Bendel, Catherine M; Kim, M Roger; Finer, Neil N; Stewart, Dan L; Arrieta, Antonio C; Wade, Kelly C; Kaufman, David A; Manzoni, Paolo; Prather, Kristi O; Testoni, Daniela; Berezny, Katherine Y; Smith, P Brian

    2014-05-07

    Invasive candidiasis in premature infants causes death and neurodevelopmental impairment. Fluconazole prophylaxis reduces candidiasis, but its effect on mortality and the safety of fluconazole are unknown. To evaluate the efficacy and safety of fluconazole in preventing death or invasive candidiasis in extremely low-birth-weight infants. This study was a randomized, blinded, placebo-controlled trial of fluconazole in premature infants. Infants weighing less than 750 g at birth (N = 361) from 32 neonatal intensive care units (NICUs) in the United States were randomly assigned to receive either fluconazole or placebo twice weekly for 42 days. Surviving infants were evaluated at 18 to 22 months corrected age for neurodevelopmental outcomes. The study was conducted between November 2008 and February 2013. Fluconazole (6 mg/kg of body weight) or placebo. The primary end point was a composite of death or definite or probable invasive candidiasis prior to study day 49 (1 week after completion of study drug). Secondary and safety outcomes included invasive candidiasis, liver function, bacterial infection, length of stay, intracranial hemorrhage, periventricular leukomalacia, chronic lung disease, patent ductus arteriosus requiring surgery, retinopathy of prematurity requiring surgery, necrotizing enterocolitis, spontaneous intestinal perforation, and neurodevelopmental outcomes-defined as a Bayley-III cognition composite score of less than 70, blindness, deafness, or cerebral palsy at 18 to 22 months corrected age. Among infants receiving fluconazole, the composite primary end point of death or invasive candidiasis was 16% (95% CI, 11%-22%) vs 21% in the placebo group (95% CI, 15%-28%; odds ratio, 0.73 [95% CI, 0.43-1.23]; P = .24; treatment difference, -5% [95% CI, -13% to 3%]). Invasive candidiasis occurred less frequently in the fluconazole group (3% [95% CI, 1%-6%]) vs the placebo group (9% [95% CI, 5%-14%]; P = .02; treatment difference, -6% [95% CI, -11

  6. Estimating Potential Reductions in Premature Mortality in New York City From Raising the Minimum Wage to $15

    PubMed Central

    Konty, Kevin J.; Van Wye, Gretchen; Barbot, Oxiris; Hadler, James L.; Linos, Natalia; Bassett, Mary T.

    2016-01-01

    Objectives. To assess potential reductions in premature mortality that could have been achieved in 2008 to 2012 if the minimum wage had been $15 per hour in New York City. Methods. Using the 2008 to 2012 American Community Survey, we performed simulations to assess how the proportion of low-income residents in each neighborhood might change with a hypothetical $15 minimum wage under alternative assumptions of labor market dynamics. We developed an ecological model of premature death to determine the differences between the levels of premature mortality as predicted by the actual proportions of low-income residents in 2008 to 2012 and the levels predicted by the proportions of low-income residents under a hypothetical $15 minimum wage. Results. A $15 minimum wage could have averted 2800 to 5500 premature deaths between 2008 and 2012 in New York City, representing 4% to 8% of total premature deaths in that period. Most of these avertable deaths would be realized in lower-income communities, in which residents are predominantly people of color. Conclusions. A higher minimum wage may have substantial positive effects on health and should be considered as an instrument to address health disparities. PMID:27077350

  7. Estimating Potential Reductions in Premature Mortality in New York City From Raising the Minimum Wage to $15.

    PubMed

    Tsao, Tsu-Yu; Konty, Kevin J; Van Wye, Gretchen; Barbot, Oxiris; Hadler, James L; Linos, Natalia; Bassett, Mary T

    2016-06-01

    To assess potential reductions in premature mortality that could have been achieved in 2008 to 2012 if the minimum wage had been $15 per hour in New York City. Using the 2008 to 2012 American Community Survey, we performed simulations to assess how the proportion of low-income residents in each neighborhood might change with a hypothetical $15 minimum wage under alternative assumptions of labor market dynamics. We developed an ecological model of premature death to determine the differences between the levels of premature mortality as predicted by the actual proportions of low-income residents in 2008 to 2012 and the levels predicted by the proportions of low-income residents under a hypothetical $15 minimum wage. A $15 minimum wage could have averted 2800 to 5500 premature deaths between 2008 and 2012 in New York City, representing 4% to 8% of total premature deaths in that period. Most of these avertable deaths would be realized in lower-income communities, in which residents are predominantly people of color. A higher minimum wage may have substantial positive effects on health and should be considered as an instrument to address health disparities.

  8. Mortality due to cardiovascular diseases in the Americas by region, 2000-2009.

    PubMed

    Gawryszewski, Vilma Pinheiro; Souza, Maria de Fatima Marinho de

    2014-01-01

    Cardiovascular diseases are the leading cause of death worldwide. The aim here was to evaluate trends in mortality due to cardiovascular diseases in three different regions of the Americas. This was a time series study in which mortality data from three different regions in the Americas from 2000 to the latest year available were analyzed. The source of data was the Mortality Information System of the Pan-American Health Organization (PAHO). Data from 27 countries were included. Joinpoint regression analysis was used to analyze trends. During the study period, the age-adjusted mortality rates for men were higher than those of females in all regions. North America (NA) showed lower rates than Latin America countries (LAC) and the Non-Latin Caribbean (NLC). Premature deaths (30-69 years old) accounted for 22.8% of all deaths in NA, 38.0% in LAC and 41.8% in NLC. The trend analysis also showed a significant decline in the three regions. NA accumulated the largest decline. The average annual percentage change (AAPC) and 95% confidence interval was -3.9% [-4.2; -3.7] in NA; -1.8% [-2.2; -1.5] in LAC; and -1.8% [-2.7; -0.9] in NLC. Different mortality rates and reductions were observed among the three regions.

  9. Cause-specific premature death from ambient PM2.5 exposure in India: Estimate adjusted for baseline mortality.

    PubMed

    Chowdhury, Sourangsu; Dey, Sagnik

    2016-05-01

    In India, more than a billion population is at risk of exposure to ambient fine particulate matter (PM2.5) concentration exceeding World Health Organization air quality guideline, posing a serious threat to health. Cause-specific premature death from ambient PM2.5 exposure is poorly known for India. Here we develop a non-linear power law (NLP) function to estimate the relative risk associated with ambient PM2.5 exposure using satellite-based PM2.5 concentration (2001-2010) that is bias-corrected against coincident direct measurements. We show that estimate of annual premature death in India is lower by 14.7% (19.2%) using NLP (integrated exposure risk function, IER) for assumption of uniform baseline mortality across India (as considered in the global burden of disease study) relative to the estimate obtained by adjusting for state-specific baseline mortality using GDP as a proxy. 486,100 (811,000) annual premature death in India is estimated using NLP (IER) risk functions after baseline mortality adjustment. 54.5% of premature death estimated using NLP risk function is attributed to chronic obstructive pulmonary disease (COPD), 24.0% to ischemic heart disease (IHD), 18.5% to stroke and the remaining 3.0% to lung cancer (LC). 44,900 (5900-173,300) less premature death is expected annually, if India achieves its present annual air quality target of 40μgm(-3). Our results identify the worst affected districts in terms of ambient PM2.5 exposure and resulting annual premature death and call for initiation of long-term measures through a systematic framework of pollution and health data archive. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Selection due to nonretention mortality in gillnet fisheries for salmon.

    PubMed

    Baker, Matthew R; Kendall, Neala W; Branch, Trevor A; Schindler, Daniel E; Quinn, Thomas P

    2011-05-01

    Fisheries often exert selective pressures through elevated mortality on a nonrandom component of exploited stocks. Selective removal of individuals will alter the composition of a given population, with potential consequences for its size structure, stability and evolution. Gillnets are known to harvest fish according to size. It is not known, however, whether delayed mortality due to disentanglement from gillnets exerts selective pressures that reinforce or counteract harvest selection. We examined gillnet disentanglement in exploited populations of sockeye salmon (Oncorhynchus nerka) in Bristol Bay, Alaska, to characterize the length distribution of fish that disentangle from gillnets and determine whether nonretention mortality reinforces harvest selection and exerts common pressures according to sex and age. We also evaluated discrete spawning populations to determine whether nonretention affects populations with different morphologies in distinct ways. In aggregate, nonretention mortality in fish that disentangle from gillnets counters harvest selection but with different effects by sex and age. At the level of individual spawning populations, nonretention mortality may exert stabilizing, disruptive, or directional selection depending on the size distribution of a given population. Our analyses suggest nonretention mortality exerts significant selective pressures and should be explicitly included in analyses of fishery-induced selection.

  11. Selection due to nonretention mortality in gillnet fisheries for salmon

    PubMed Central

    Baker, Matthew R; Kendall, Neala W; Branch, Trevor A; Schindler, Daniel E; Quinn, Thomas P

    2011-01-01

    Fisheries often exert selective pressures through elevated mortality on a nonrandom component of exploited stocks. Selective removal of individuals will alter the composition of a given population, with potential consequences for its size structure, stability and evolution. Gillnets are known to harvest fish according to size. It is not known, however, whether delayed mortality due to disentanglement from gillnets exerts selective pressures that reinforce or counteract harvest selection. We examined gillnet disentanglement in exploited populations of sockeye salmon (Oncorhynchus nerka) in Bristol Bay, Alaska, to characterize the length distribution of fish that disentangle from gillnets and determine whether nonretention mortality reinforces harvest selection and exerts common pressures according to sex and age. We also evaluated discrete spawning populations to determine whether nonretention affects populations with different morphologies in distinct ways. In aggregate, nonretention mortality in fish that disentangle from gillnets counters harvest selection but with different effects by sex and age. At the level of individual spawning populations, nonretention mortality may exert stabilizing, disruptive, or directional selection depending on the size distribution of a given population. Our analyses suggest nonretention mortality exerts significant selective pressures and should be explicitly included in analyses of fishery-induced selection. PMID:25567993

  12. Global burden of mortalities due to chronic exposure to ambient PM2.5 from open combustion of domestic waste

    NASA Astrophysics Data System (ADS)

    Kodros, John K.; Wiedinmyer, Christine; Ford, Bonne; Cucinotta, Rachel; Gan, Ryan; Magzamen, Sheryl; Pierce, Jeffrey R.

    2016-12-01

    Uncontrolled combustion of domestic waste has been observed in many countries, creating concerns for air quality; however, the health implications have not yet been quantified. We incorporate the Wiedinmyer et al (2014 Environ. Sci. Technol. 48 9523-30) emissions inventory into the global chemical-transport model, GEOS-Chem, and provide a first estimate of premature adult mortalities from chronic exposure to ambient PM2.5 from uncontrolled combustion of domestic waste. Using the concentration-response functions (CRFs) of Burnett et al (2014 Environ. Health Perspect. 122 397-403), we estimate that waste-combustion emissions result in 270 000 (5th-95th: 213 000-328 000) premature adult mortalities per year. The confidence interval results only from uncertainty in the CRFs and assumes equal toxicity of waste-combustion PM2.5 to all other PM2.5 sources. We acknowledge that this result is likely sensitive to choice of chemical-transport model, CRFs, and emission inventories. Our central estimate equates to 9% of adult mortalities from exposure to ambient PM2.5 reported in the Global Burden of Disease Study 2010. Exposure to PM2.5 from waste combustion increases the risk of premature mortality by more than 0.5% for greater than 50% of the population. We consider sensitivity simulations to uncertainty in waste-combustion emission mass, the removal of waste-combustion emissions, and model resolution. A factor-of-2 uncertainty in waste-combustion PM2.5 leads to central estimates ranging from 138 000 to 518 000 mortalities per year for factors-of-2 reductions and increases, respectively. Complete removal of waste combustion would only avoid 191 000 (5th-95th: 151 000-224 000) mortalities per year (smaller than the total contributed premature mortalities due to nonlinear CRFs). Decreasing model resolution from 2° × 2.5° to 4° × 5° results in 16% fewer mortalities attributed to waste-combustion PM2.5, and over Asia, decreasing resolution from 0.5° × 0.666° to 2° × 2

  13. Premature loss of primary anterior teeth due to trauma--potential short- and long-term sequelae.

    PubMed

    Holan, Gideon; Needleman, Howard L

    2014-04-01

    Traumatic dental injuries (TDIs) can result in the premature loss of primary anterior teeth due to an immediate avulsion, extraction later after the injury because of poor prognosis or late complications, or early exfoliation. There are a number of potential considerations or sequelae as a result of this premature loss that have been cited in the dental literature, which include esthetics, quality of life, eating, speech development, arch integrity (space loss), development and eruption of the permanent successors, and development of oral habits. This article provides a comprehensive review of the dental literature on the possible consequences of premature loss of maxillary primary incisors following TDI.

  14. The impact of new (orphan) drug approvals on premature mortality from rare diseases in the United States and France, 1999-2007.

    PubMed

    Lichtenberg, Frank R

    2013-02-01

    This paper investigates the impact of the introduction of new orphan drugs on premature mortality from rare diseases using longitudinal, disease-level data obtained from a number of major databases. The analysis is performed using data from two countries: the United States (during the period 1999-2006) and France (during the period 2000-2007). For both countries, we estimate models using two alternative definitions of premature mortality, several alternative criteria for inclusion in the set of rare diseases, and several values of the potential lag between new drug approvals and premature mortality reduction. Both the United States and French estimates indicate that, overall, premature mortality from rare diseases is unrelated to the cumulative number of drugs approved 0-2 years earlier but is significantly inversely related to the cumulative number of drugs approved 3-4 years earlier. This delay is not surprising, since most patients probably do not have access to a drug until several years after it has been launched. Although the estimates for the two countries are qualitatively similar, the estimated magnitudes of the US coefficients are about four times as large as the magnitudes of the French coefficients. This may be partly due to greater errors in measuring dates of drug introduction in France. Also, access to new drugs may be more restricted in France than it is in the United States. Our estimates indicate that, in the United States, potential years of life lost to rare diseases before age 65 (PYLL65) declined at an average annual rate of 3.3% and that, in the absence of lagged new drug approvals, PYLL65 would have increased at a rate of 0.9%. Since the US population aged 0-64 was increasing at the rate of 1.0% per year, this means that PYLL65 per person under 65 would have remained approximately constant. The reduction in the US growth rate of PYLL65 attributable to lagged new drug approvals was 4.2%. In France, PYLL65 declined at an average annual rate of

  15. [The fate of very early premature babies. Mortality, morbidity and 2-year follow-up in a population of 96 very early premature babies].

    PubMed

    Lenclen, R; Paupe, A; Carbajal, R; Blanc, P; Hoenn, E; Olivier-Martin, M

    1992-11-01

    The neonatal fate, and outcome at 2 years in a population of 96 premature babies born after no more than 28 weeks of amenorrhea is described. Mortality was directly influenced by the gestational age (< 26 WA = 52% vs. > or = 26 WA = 21.1%, p < 0.01) and the birth weight (< 1,000 g = 41.5% vs. > 1,000 g = 20%, p < 0.05). Two other factors with a harmful impact were identified: retarded growth (neonatal mortality doubled) and fetal multiplicity (increased fourfold). Investigation of the neonatal morbidity highlights the importance of respiratory, neurological and digestive problems. Assessment of the longer-term outcome has shown an 11.3 p. cent incidence of handicap. An estimation of the prognosis on the basis of gestational age is proposed.

  16. Reducing Premature Mortality in the Mentally Ill Through Health Promotion Programs.

    PubMed

    Price, James H; Khubchandani, Jagdish; Price, Joy A; Whaley, Cathy; Bowman, Sharon

    2016-09-01

    Nearly half of the U.S. adult population will have a major mental illness during their lifetimes. At any point in time, almost a fifth of all American adults have a serious mental illness (SMI). Too many in our society do not understand mental illnesses, placing the blame for the illness on those with the illness, resulting in isolation, marginalization, or incarceration of individuals with SMIs. They may experience stigma, inadequate and delayed health and mental health care, and major socioeconomic disadvantages. They may struggle with activities of daily living, lose many of their resources, and spiral down into poverty. The disadvantages and decreased ability to function experienced by individuals with SMIs lead to increased unhealthy behaviors, reduced participation in wellness-related activities, and premature morbidity and mortality. The general and physical health of individuals with SMIs poses greater challenges from both practice and research standpoints. However, health educators are poised uniquely to provide health promotion programs, conduct research, and advocate for the health and well-being of individuals with SMIs. In this review, we summarize the challenges and opportunities for health promotion in individuals with SMIs.

  17. [Fetal lung development on MRT. Normal course and impairment due to premature rupture of membranes].

    PubMed

    Kasprian, G; Brugger, P C; Helmer, H; Langer, M; Balassy, C; Prayer, D

    2006-02-01

    A well-organized interplay between many molecular factors as well as mechanical forces influence fetal lung development. At the end of this complex process a sufficiently sized and structurally mature organ should ensure the postnatal survival of the newborn. Besides prenatal ultrasonography, magnetic resonance imaging (MRI) can now be used to investigate normal and pathological human lung growth in utero. Oligohydramnios, due to premature rupture of membranes (PROM), is an important risk factor for compromised fetal lung growth. In these situations MR volumetry can be used to measure the size of the fetal lung quite accurately. Together with the evaluation of lung signal intensities on T2-weighted sequences, fetuses with pulmonary hypoplasia can be readily detected.

  18. Mortality Due to Cardiovascular Disease Among Apollo Lunar Astronauts.

    PubMed

    Reynolds, Robert J; Day, Steven M

    2017-05-01

    Recent research has postulated increased cardiovascular mortality for astronauts who participated in the Apollo lunar missions. The conclusions, however, are based on small numbers of astronauts, are derived from methods with known weaknesses, and are not consistent with prior research. Records for NASA astronauts and U.S. Air Force astronauts were analyzed to produce standardized mortality ratios. Lunar astronauts were compared to astronauts who have never flown in space (nonflight astronauts), those who have only flown missions in low Earth orbit (LEO astronauts), and the U.S. general population. Lunar astronauts were significantly older at cohort entry than other astronaut group and lunar astronauts alive as of the end of 2015 were significantly older than nonflight astronauts and LEO astronauts. No significant differences in cardiovascular disease (CVD) mortality rates between astronaut groups was observed, though lunar astronauts were noted to be at significantly lower risk of death by CVD than are members of the U.S. general population (SMR = 13, 95% CI = 3-39). The differences in age structure between lunar and nonlunar astronauts and the deaths of LEO astronauts from external causes at young ages lead to confounding in proportional mortality studies of astronauts. When age and follow-up time are properly taken into account using cohort-based methods, no significant difference in CVD mortality rates is observed. Care should be taken to select the correct study design, outcome definition, exposure classification, and analysis when answering questions involving rare occupational exposures.Reynolds RJ, Day SM. Mortality due to cardiovascular disease among Apollo lunar astronauts. Aerosp Med Hum Perform. 2017; 88(5):492-496.

  19. Age at death and linear enamel hypoplasias: testing the effects of childhood stress and adult socioeconomic circumstances in premature mortality.

    PubMed

    Amoroso, Alexandra; Garcia, Susana J; Cardoso, Hugo F V

    2014-01-01

    The aim of this study was to test the association between linear enamel hypolasias and adult socioeconomic circumstances with age at death in a modern skeletal sample of known age. Specifically, this study wishes to test whether there is a relationship between early life stressors, environmental quality in adult life and premature mortality. The presence/absence of LEH and the number of LEH episodes were recorded in 113 adult males from the Lisbon identified skeletal collection. The association between LEH and age was quantified using linear regression and binary logistic regression models, calculating crude and adjusted linear regression coefficients and odds ratios. The models were adjusted for year of birth, socioeconomic and migration status, and cause of death. The presence and number of LEH were related to premature mortality. Individuals expressing at least one enamel defect survived 9.0 years less or were 2.5 times more likely to die before 53 years of age compared to individuals with no LEH. However, when controlling for the confounding factors considered, the association between LEH and age became nonsignificant. The results indicate that although early life stressors, identified as LEH, seem strongly associated with premature mortality, adulthood socioeconomic circumstances accounts for most of the decreased longevity. This suggests that either macroscopically identified LEH in the permanent canine do not measure stressors early in life, or that a cumulative adversity model is a more adequate explanation. Copyright © 2014 Wiley Periodicals, Inc.

  20. Premature mortality of epilepsy in low- and middle-income countries: A systematic review from the Mortality Task Force of the International League Against Epilepsy.

    PubMed

    Levira, Francis; Thurman, David J; Sander, Josemir W; Hauser, W Allen; Hesdorffer, Dale C; Masanja, Honorati; Odermatt, Peter; Logroscino, Giancarlo; Newton, Charles R

    2017-01-01

    To determine the magnitude of risk factors and causes of premature mortality associated with epilepsy in low- and middle-income countries (LMICs). We conducted a systematic search of the literature reporting mortality and epilepsy in the World Bank-defined LMICs. We assessed the quality of the studies based on representativeness; ascertainment of cases, diagnosis, and mortality; and extracted data on standardized mortality ratios (SMRs) and mortality rates in people with epilepsy. We examined risk factors and causes of death. The annual mortality rate was estimated at 19.8 (range 9.7-45.1) deaths per 1,000 people with epilepsy with a weighted median SMR of 2.6 (range 1.3-7.2) among higher-quality population-based studies. Clinical cohort studies yielded 7.1 (range 1.6-25.1) deaths per 1,000 people. The weighted median SMRs were 5.0 in male and 4.5 in female patients; relatively higher SMRs within studies were measured in children and adolescents, those with symptomatic epilepsies, and those reporting less adherence to treatment. The main causes of death in people with epilepsy living in LMICs include those directly attributable to epilepsy, which yield a mean proportional mortality ratio (PMR) of 27.3% (range 5-75.5%) derived from population-based studies. These direct causes comprise status epilepticus, with reported PMRs ranging from 5 to 56.6%, and sudden unexpected death in epilepsy (SUDEP), with reported PMRs ranging from 1 to 18.9%. Important causes of mortality indirectly related to epilepsy include drowning, head injury, and burns. Epilepsy in LMICs has a significantly greater premature mortality, as in high-income countries, but in LMICs the excess mortality is more likely to be associated with causes attributable to lack of access to medical facilities such as status epilepticus, and preventable causes such as drowning, head injuries, and burns. This excess premature mortality could be substantially reduced with education about the risk of death and

  1. [Mortality due to disasters in Brazil: what the data reveals].

    PubMed

    Carmo, Roberto Luiz do; Anazawa, Tathiane Mayumi

    2014-09-01

    This work presents and analyzes the main databases on mortality due to disasters in Brazil: EM-DAT - Emergency Events Database and the Brazilian Atlas of Natural Disasters, as well as the Mortality Information System (SIM, Ministry of Health) and the Yearbook of Natural Disasters (Ministry of National Integration). These databases were addressed using two basic methodological procedures: descriptive analysis of systematic information and comparative analysis, by means of the construction of tables that helped to analyze the information selected. The comparison revealed that with the current databases it is not possible to affirm if disasters and mortality due to disasters are increasing in Brazil, since there are variations in the intensity of the events that occur each year. The information available shows the importance of the mega disaster that occurred in the mountainous region of Rio de Janeiro in 2011, especially in the municipality of Nova Friburgo. In this case the disaster affected the various age groups in both sexes in different ways: the 5 to 9-year-old age group was the most affected among men and women, as well as the 20 to 24-year-old age group (for women) and the 30 to 34-year-old age group (for men).

  2. Prevention of blindness due to retinopathy of prematurity: a national movement.

    PubMed

    Azad, Rajvardhan

    2014-12-01

    Retinopathy of Prematurity (ROP) has been a blinding disorder and a preventable cause of childhood blindness. With growing interest in pediatric ophthalmology and vitreo-retinal subspecialty, ROP has become increasingly recognized in India. Recently, with rise in number of children admitted to NICU's across India, there has been an increase in number of preterm babies with ROP due to variable neonatal practices. An effort to prevent the disease was taken up by WHO and Ministry of Health & Family Welfare by conducting workshops across India piloted by R.P. Centre, AIIMS. These workshops have gone a long way in spreading awareness amongst both neonatologists and ophthalmologists in paired sessions. Both neonatologists and ophthalmologists complemented each other, discussed ROP prevention and issued ROP screening and good neonatal care guidelines which were different from the American guidelines. Treatment strategies have also undergone a huge change from cryotherapy and laser to anti-vascular endothelial growth factor (Anti-VEGF) drugs which have shown promising results, although caution is to be taken due to lack of data on long-term safety. Overall impact of these workshops led to inclusion of ROP in priority list of blindness control programme of Government of India. Still, ROP prevention needs integration of both governmental and non-governmental agencies, each sharing the load in a complementing way aiding in downward trends of ROP cases.

  3. Lack of housing, hospital treatment and premature mortality: a cohort study of people in Counties Manukau district.

    PubMed

    Thornley, Simon; Marshall, Roger

    2016-08-19

    We considered risk factors for mortality in people admitted to Counties Manukau inpatient facilities, who were also identified by medical staff to have insufficient housing. A cohort study of people aged 15 to 75 years admitted to Counties Manukau inpatient facilities were selected between 2002 and 2014, with ICD-10 codes for insufficient housing. Diagnostic records identified people with substance use and other clinical conditions. Mortality records were used to track survival. During the study period, 1,182 individuals were identified, 126 (10.7%) of whom died during a median follow-up of 5.7 years. Median survival of the cohort was 63.5 years (95% confidence interval (CI): 58.7 to 69.9) which is about 20 years less than the general population. Of the cohort, the strongest associations with premature mortality were among people with cannabis-related disorders (adjusted hazard ratio [aHR] 2.15; 95% CI: 1.10 to 4.22), diabetes (aHR 1.75; 95% CI: 1.05 to 2.93) and Maaori, compared to European and other ethnic groups, except Asian and Pacific (aHR 1.80; 95% CI: 1.14 to 2.85). This population has high mortality. Within this group, Māori and people diagnosed with substance use and diabetes are at even higher risk of premature death.

  4. Update on Blindness Due to Retinopathy of Prematurity Globally and in India.

    PubMed

    Blencowe, Hannah; Moxon, Sarah; Gilbert, Clare

    2016-11-07

    Retinopathy of prematurity (ROP), a well-known complication of preterm birth that can result in avoidable blindness and visual impairment, is especially sensitive to the quality of neonatal inpatient care and appropriate, well-monitored oxygen. In 2010, the annual incidence of blindness and visual impairment from ROP was estimated to be 32,200 cases worldwide. The greatest burden is seen in middle-income countries, particularly where coverage of neonatal inpatient care has expanded without due attention to the quality of care provided, and the neonatal nursing skills and training of those providing this care. India accounted for nearly 10% of all estimated worldwide visual impairment following ROP in 2010, with at least 5,000 developing severe disease and 2,900 children surviving with visual impairment related to ROP. Screening all those at risk and providing treatment for those with severe disease will require investment to increase the capacities and competencies of eye-care providers. Scale-up of neonatal services must be coupled with implementation of standards for high quality care, including safe oxygen management, and detection and treatment of ROP. Otherwise the number of children surviving preterm birth with visual impairment secondary to ROP will continue to increase in India and worldwide.

  5. [Differentiation of the premature mortality caused by the cardiovascular diseases in the chosen districts of the Upper Silesia region].

    PubMed

    Wozniak-Holecka, Joanna; Kasperczyk, Janusz; Holecki, Tomasz

    2007-01-01

    Environmental factors are a significant cause of many civilization-related diseases, including diseases of the circulatory system which have been the main causes of death in Poland for years. The aim of the research was evaluation of the intensity and changes in premature deaths due to diseases of the circulatory system in the population of the Upper Silesia Region at the beginning of the XXI century within particular districts. For the needs of the analysis, the premature deaths are represented by deaths before the age of 65 years. The premature death date was calculated as a quotient of the number of total deaths, which occurred before the age of 65 years and the number of inhabitants at the ages from 0-64 years in given districts. The research was planned as an analysis of secondary epidemiological data obtained from the State Office of Statistics. The results were prepared using the Statistics v.6.0i program and have been placed in tables and graphs separately for general and premature deaths. Deaths due to diseases of the circulatory system are still the main causes of death both for the crude and the premature ones in districts selected for research. The worst health situation can be noted in Katowice where both the rate of crude and premature deaths has considerably risen. The diseases of the circulatory system are the most frequent causes of death among women who begin suffering from heart diseases on average several years later then men. Such an alarming health situation in the population of Silesia requires organized preventive actions such as introduction of prevention and promotion health programs on a mass scale.

  6. Type A behavior pattern is not a predictor of premature mortality.

    PubMed

    Šmigelskas, Kastytis; Žemaitienė, Nida; Julkunen, Juhani; Kauhanen, Jussi

    2015-04-01

    Type A personality was introduced in the 1950s and was defined as an action-emotion complex characterized by excessive competitive drive, intense striving for achievement, easily provoked hostility, aggressiveness, impatience, and exaggerated sense of time urgency. Despite many positive findings earlier, almost 50 years of studies have not yielded conclusive results regarding Type A as a risk factor for negative health outcomes and early death. This may partly be due to methodological weaknesses such as small and selected samples, short follow-up times, and varying ways to assess Type A across studies. We re-examined the association between the Type A concept with cardiovascular (CVD) and non-cardiovascular (non-CVD) mortality by using a long follow-up (on average 20.6 years) of a large population-based sample of elderly males (N = 2,682), by applying multiple Type A measures at baseline, and looking separately at early and later follow-up years. The study sample were the participants of the Kuopio Ischemic Heart Disease Risk Factor Study, (KIHD), which includes a randomly selected representative sample of Eastern Finnish men, aged 42-60 years at baseline in the 1980s. They were followed up until the end of 2011 through linkage with the National Death Registry. Four self-administered scales, Bortner Short Rating Scale, Framingham Type A Behavior Pattern Scale, Jenkins Activity Survey, and Finnish Type A Scale, were used for Type A assessment at the start of follow-up. Type A measures were inconsistently associated with cardiovascular mortality, and most associations were non-significant. Some scales suggested slightly decreased, rather than increased, risk of CVD death during the follow-up. Associations with non-cardiovascular deaths were even weaker. Our findings further suggest that there is no evidence to support the Type A as a risk factor for CVD and non-CVD mortality.

  7. Incidence and mortality due to snakebite in the Americas

    PubMed Central

    2017-01-01

    Background Better knowledge of the epidemiological characteristics of snakebites could help to take measures to improve their management. The incidence and mortality of snakebites in the Americas are most often estimated from medical and scientific literature, which generally lack precision and representativeness. Methodology/Principal findings Authors used the notifications of snakebites treated in health centers collected by the Ministries of Health of the American countries to estimate their incidence and mortality. Data were obtained from official reports available on-line at government sites, including those of the Ministry of Health in each country and was sustained by recent literature obtained from PubMed. The average annual incidence is about 57,500 snake bites (6.2 per 100,000 population) and mortality is close to 370 deaths (0.04 per 100,000 population), that is, between one third and half of the previous estimates. The incidence of snakebites is influenced by the abundance of snakes, which is related to (i) climate and altitude, (ii) specific preferences of the snake for environments suitable for their development, and (iii) human population density. Recent literature allowed to notice that the severity of the bites depends mainly on (i) the snake responsible for the bite (species and size) and (ii) accessibility of health care, including availability of antivenoms. Conclusions/Significances The main limitation of this study could be the reliability and accuracy of the notifications by national health services. However, the data seemed consistent considering the similarity of the incidences on each side of national boundaries while the sources are distinct. However, snakebite incidence could be underestimated due to the use of traditional medicine by the patients who escaped the reporting of cases. However, gathered data corresponded to the actual use of the health facilities, and therefore to the actual demand for antivenoms, which should make it

  8. Visual impairment due to retinopathy of prematurity (ROP) in New Zealand: a 22-year review.

    PubMed

    Tan, Zachary; Chong, CheeFoong; Darlow, Brian; Dai, Shuan

    2015-06-01

    To evaluate retinopathy of prematurity (ROP)-related visual impairment in New Zealand children. 22-year retrospective review of medical records of children with moderate to severe visual impairment registered with the Blind and Low Vision Education Network New Zealand. The cohort was divided into two periods (1991-2004; 2005-2012) for analysis. 232 children with ROP were treated in the study period (109 in period 1, 123 in period 2). 36 children, 63.9% of whom were of male sex, were identified with subsequent significant visual impairment (27 in period 1, 9 in period 2). The incidence of new cases of visual impairment from ROP declined from 271.6 infants/100 000 live very preterm births per annum (period 1) to 146.1 per annum (period 2). Mean gestational age and mean birth weight were comparable between the two study periods. 75% of children with visual impairment from ROP received treatment for their condition (period 1, 74.1%; period 2, 77.8%) and modalities used changed significantly over time. The modal visual outcome overall was Snellen visual acuity <6/18-6/60 (55.6%) (period 1, 51.9%; period 2, 66.7%). The proportion of children with no light perception bilaterally decreased over time (period 1, 3.7%; period 2, 0%). There has been a reduction in the incidence of infants with significant visual impairment from ROP over time in New Zealand, likely due to progress in clinical management of ROP. Our study suggests the current ROP screening criteria of <31 weeks' gestation or <1250 g are of sufficient breadth. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  9. What is past is prologue: A population-based case-control study of repeat victimization, premature mortality, and homicide.

    PubMed

    Pridemore, William Alex; Berg, Mark T

    2017-04-01

    We examined risk of male premature mortality associated with recent criminal victimization. Prior victimization is among the most consistent predictors of future risk but the explanation of repeat victimization remains elusive. Two general perspectives frame this debate. According to the state-dependence perspective, repeat victimization is forged through intervening processes connecting an initial with a subsequent violent victimization. According to the risk-heterogeneity perspective, this association is spurious because all victimization events for a person result from underlying individual traits. Research on health outcomes and premature mortality provides related, but often overlooked, conceptual assumptions about the co-occurring health burden of preventable injuries and disease. We extend and apply each of these perspectives in the current study to assess the nature and sources of repeat violent victimization. Data were from the Izhevsk (Russia) Family Study, a large-scale population-based case-control study. Cases (n = 1750) were all male deaths aged 25-54 living in Izhevsk between October 2003 and October 2005. Controls (n = 1750) were randomly selected from a city population register. Key independent variables were prior year prevalence of violent, property, and residential victimization. We used logistic regression to estimate mortality odds ratios. Results provided evidence for state dependence. We found that (i) after controlling for indicators of risk heterogeneity men who had been victims of violence (but not property or residential crime) within the past year were 2.6 times more likely than those who had not to die prematurely; and (ii) the only type of death for which risk was higher was homicide. Aggr. Behav. 43:176-189, 2017. © 2016 Wiley Periodicals, Inc.

  10. Mortality due to cirrhosis, liver cancer, and disorders attributed to alcohol use: Global Burden of Disease in Brazil, 1990 and 2015.

    PubMed

    Melo, Ana Paula Souto; França, Elisabeth Barboza; Malta, Deborah Carvalho; Garcia, Leila Posenato; Mooney, Meghan; Naghavi, Mohsen

    2017-05-01

    Alcohol use is one of the main preventable risk factors affecting mortality and premature disability. To describe the estimates of mortality and years of life lost as a result of premature death (YLL) due to cirrhosis, liver cancer, and disorders attributed to alcohol use in Brazil and its federated units in 1990 and 2015. Descriptive study using data from the Global Burden of Disease Study (2015) and the Mortality Information System (SIM). Statistical models were used to obtain corrected mortality estimates for selected causes. Rates were standardized by age. In 1990, 16,226 deaths were estimated for the three conditions (17.0/100 thousand inhabitants), while in 2015 there were 28,337 deaths (15.7/100 thousand inhabitants). There was a reduction in mortality (per 100 thousand) due to cirrhosis (from 11.4 to 9.5), stability in mortality rates related to liver cancer (1.5 and 1.9), and stability in mortality rates caused by alcohol use disorders (4.1 and 4.3). Mortality rates were 5.1 times higher among men, and the five states with the highest mortality rates and YLL were from the Northeast Region: Sergipe, Ceará, Pernambuco, Paraíba, and Alagoas. Mortality and YLL rates for the three conditions studied increased in the ranking of causes of death in both sexes, with the exception of cirrhosis in the female population. The three conditions studied are responsible for a significant burden of premature mortality in Brazil, especially among men and residents of the northeast region. These results reinforce the urgent need for public policies that address harmful alcohol consumption in Brazil.

  11. Economic impact of reduced mortality due to increased cycling.

    PubMed

    Rutter, Harry; Cavill, Nick; Racioppi, Francesca; Dinsdale, Hywell; Oja, Pekka; Kahlmeier, Sonja

    2013-01-01

    Increasing regular physical activity is a key public health goal. One strategy is to change the physical environment to encourage walking and cycling, requiring partnerships with the transport and urban planning sectors. Economic evaluation is an important factor in the decision to fund any new transport scheme, but techniques for assessing the economic value of the health benefits of cycling and walking have tended to be less sophisticated than the approaches used for assessing other benefits. This study aimed to produce a practical tool for estimating the economic impact of reduced mortality due to increased cycling. The tool was intended to be transparent, easy to use, reliable, and based on conservative assumptions and default values, which can be used in the absence of local data. It addressed the question: For a given volume of cycling within a defined population, what is the economic value of the health benefits? The authors used published estimates of relative risk of all-cause mortality among regular cyclists and applied these to levels of cycling defined by the user to produce an estimate of the number of deaths potentially averted because of regular cycling. The tool then calculates the economic value of the deaths averted using the "value of a statistical life." The outputs of the tool support decision making on cycle infrastructure or policies, or can be used as part of an integrated economic appraisal. The tool's unique contribution is that it takes a public health approach to a transport problem, addresses it in epidemiologic terms, and places the results back into the transport context. Examples of its use include its adoption by the English and Swedish departments of transport as the recommended methodologic approach for estimating the health impact of walking and cycling.

  12. A population-based study of premature mortality in relation to neighbourhood density of alcohol sales and cheque cashing outlets in Toronto, Canada.

    PubMed

    Matheson, Flora I; Creatore, Maria Isabella; Gozdyra, Piotr; Park, Alison L; Ray, Joel G

    2014-12-17

    Alcohol overuse and poverty, each associated with premature death, often exist within disadvantaged neighbourhoods. Cheque cashing places (CCPs) may be opportunistically placed in disadvantaged neighbourhoods, where customers abound. We explored whether neighbourhood density of CCPs and alcohol outlets are each related to premature mortality among adults. Retrospective population-based study. 140 neighbourhoods in Toronto, Ontario, 2005-2009. Adults aged 20-59 years. Our primary outcome was premature all-cause mortality among adults aged 20-59 years. Across neighbourhoods we explored neighbourhood density, in km(2), of CCPs and alcohol outlets, and the relation of each to premature mortality. Poisson regression provided adjusted relative risks (aRRs) and 95% CIs, adjusting for material deprivation quintile (Q), crime Q and number of banks. Intentional self-harm, accidental poisoning and liver disease were among the top five causes of premature death among males aged 20-59 years. The overall premature mortality rate was 96.3/10,000 males and 55.9/10,000 females. Comparing the highest versus lowest CCP density Q, the aRR for death was 1.25 (95% CI 1.15 to 1.36) among males and 1.11 (95% CI 0.99 to 1.24) among females. The corresponding aRR comparing the highest Q versus lowest Q alcohol outlet density in relation to premature mortality was 1.36 (95% CI 1.25 to 1.48) for males and 1.11 (95% CI 1.00 to 1.24) for females. The pattern of the relation between either CCPs or alcohol outlet density and premature mortality was typically J shaped. There is a J-shaped relation between CCP or alcohol outlet density and premature mortality, even on controlling for conventional measures of poverty. Formal banking and alcohol reduction strategies might be added to health promotion policies aimed at reducing premature mortality in highly affected neighbourhoods. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please

  13. A population-based study of premature mortality in relation to neighbourhood density of alcohol sales and cheque cashing outlets in Toronto, Canada

    PubMed Central

    Matheson, Flora I; Creatore, Maria Isabella; Gozdyra, Piotr; Park, Alison L; Ray, Joel G

    2014-01-01

    Objective Alcohol overuse and poverty, each associated with premature death, often exist within disadvantaged neighbourhoods. Cheque cashing places (CCPs) may be opportunistically placed in disadvantaged neighbourhoods, where customers abound. We explored whether neighbourhood density of CCPs and alcohol outlets are each related to premature mortality among adults. Design Retrospective population-based study. Setting 140 neighbourhoods in Toronto, Ontario, 2005–2009. Participants Adults aged 20–59 years. Measures Our primary outcome was premature all-cause mortality among adults aged 20–59 years. Across neighbourhoods we explored neighbourhood density, in km2, of CCPs and alcohol outlets, and the relation of each to premature mortality. Poisson regression provided adjusted relative risks (aRRs) and 95% CIs, adjusting for material deprivation quintile (Q), crime Q and number of banks. Results Intentional self-harm, accidental poisoning and liver disease were among the top five causes of premature death among males aged 20–59 years. The overall premature mortality rate was 96.3/10 000 males and 55.9/10 000 females. Comparing the highest versus lowest CCP density Q, the aRR for death was 1.25 (95% CI 1.15 to 1.36) among males and 1.11 (95% CI 0.99 to 1.24) among females. The corresponding aRR comparing the highest Q versus lowest Q alcohol outlet density in relation to premature mortality was 1.36 (95% CI 1.25 to 1.48) for males and 1.11 (95% CI 1.00 to 1.24) for females. The pattern of the relation between either CCPs or alcohol outlet density and premature mortality was typically J shaped. Conclusions There is a J-shaped relation between CCP or alcohol outlet density and premature mortality, even on controlling for conventional measures of poverty. Formal banking and alcohol reduction strategies might be added to health promotion policies aimed at reducing premature mortality in highly affected neighbourhoods. PMID:25518874

  14. Mental ability across childhood in relation to risk factors for premature mortality in adult life: the 1970 British Cohort Study.

    PubMed

    Batty, G David; Deary, Ian J; Schoon, Ingrid; Gale, Catharine R

    2007-11-01

    To examine the relation of scores on tests of mental ability across childhood with established risk factors for premature mortality at the age of 30 years. A prospective cohort study based on members of the British Cohort Study born in Great Britain in 1970 who had complete data on IQ scores at five (N = 8203) or 10 (N = 8171) years of age and risk factors at age 30 years. In sex-adjusted analyses, higher IQ score at age 10 years was associated with a reduced prevalence of current smoking (OR(per 1 SD advantage in IQ) 0.84; 95% CI 0.80, 0.88), overweight (0.88; 0.84, 0.92), obesity (0.84; 0.79, 0.92), and hypertension (0.90; 0.83, 0.98), and an increased likelihood of having given up smoking by the age of 30 years (1.25; 1.18, 1.24). These gradients were attenuated after adjustment for markers of socioeconomic circumstances across the life course, particularly education. There was no apparent relationship between IQ and diabetes. Essentially the same pattern of association was evident when the predictive value of IQ scores at five years of age was examined. The mental ability-risk factor gradients reported in the present study may offer some insights into the apparent link between low pre-adult mental ability and premature mortality.

  15. Trends in inequalities in premature cancer mortality by educational level in Colombia, 1998–2007

    PubMed Central

    de Vries, Esther; Arroyave, Ivan; Pardo, Constanza; Wiesner, Carolina; Murillo, Raul; Forman, David; Burdorf, Alex; Avendaño, Mauricio

    2015-01-01

    Background There is paucity of studies on socioeconomic inequalities in cancer mortality in developing countries. We examined trends in inequalities in cancer mortality by educational attainment in Colombia during a period of epidemiological transition and a rapid expansion of health insurance coverage. Methods Population mortality data (1998–2007) were linked to census data to obtain age-standardised cancer mortality rates by educational attainment at ages 25–64 years for stomach, cervical, prostate, lung, colorectal, breast and other cancers. We used Poisson regression to model mortality by educational attainment and estimated the contribution of specific cancers to the Slope Index of Inequality in cancer mortality. Results We observed large educational inequalities in cancer mortality, particularly for cancer of the cervix (RR primary versus tertiary groups=5.75, contributing 51% of cancer inequalities), stomach (RR=2.56 for males, contributing 49% of total cancer inequalities, and RR=1.98 for females, contributing 14% to total cancer inequalities), and lung (RR=1.64 for males contributing 17% of total cancer inequalities, and 1.32 for females contributing 5% to total cancer inequalities). Total cancer mortality rates declined faster among those with higher education, with the exception of mortality from cervical cancer, which declined more rapidly in the lower educational groups. Conclusion There are large socioeconomic inequalities in preventable cancer mortality in Colombia, which underscore the need for intensifying prevention efforts. Reducing cervical cancer through reducing HPV infection, early detection and improved access to treatment of preneoplasic lesions. Reinforcing anti-tobacco measures may be particularly important to curb inequalities in cancer mortality. PMID:25492898

  16. The Prevention of Prematurity: A Strategy to Reduce Infant Mortality in the District of Columbia.

    ERIC Educational Resources Information Center

    Maxwell, Joan

    The infant mortality rate in the District of Columbia is higher than that for any other state. This high rate stems from the great number of infants born seriously underweight and reflects the area's high percentage of births to impoverished black women. Efforts to reduce the mortality rate have centered around the medical treatment approach,…

  17. The Prevention of Prematurity: A Strategy to Reduce Infant Mortality in the District of Columbia.

    ERIC Educational Resources Information Center

    Maxwell, Joan

    The infant mortality rate in the District of Columbia is higher than that for any other state. This high rate stems from the great number of infants born seriously underweight and reflects the area's high percentage of births to impoverished black women. Efforts to reduce the mortality rate have centered around the medical treatment approach,…

  18. [The age and sex indicators of mortality of population and years of life lost as a result of premature mortality in the Russian Federation in 2012].

    PubMed

    Boiytsov, S A; Samorodskaya, I V

    2014-01-01

    The age-specific mortality coefficients and years of life lost as a result of premature mortality are among important medical demographic characteristics of population health. The study analyzed age and sex indicators of mortality of population in the Russian Federation. The number of years of life lost as a result of premature mortality is calculated. The comparison of values of years of life lost in various subjects of the Russian Federation was carried out. The data of Rosstat concerning population size and number of the deceased in year age groups in the Russian Federation and subjects of the Russian Federation in 2012 was used. The indicator was calculated on the basis of technique included into "The global burden of diseases report" (2010). The minimal indicators of mortality of males are noted at the age of 11 years (25.4 per 100 000 of population) and females at the age of 10 years (18.2 per 100 000 of population). The maximal differences in indicators of mortality of males and females are marked in the age group 20-29 years (314.5 of males and 92.3 of females per 100 000 of population). The percentage of deceased prior 70 years consists 63.2% among males and 29.9% among females. The total number of years of life lost in the Russian Federation consisted 36 864 309 and out of them 24 321 992 (65.9%) as a result of death of males and 12 542 317 (34.1%) as a result of death of females. The maximum percentage of years of life lost among males is marked in the age group of 51-60 years (24.61%) and among females in the age group of 71-80 years (22.38%). The indicator of years of life lost per 100 000 of population consisted 25769 for total population, 36 753 for male population and 16 314 for female population. The highest rate of indicator of years of life lost is marked in the Chukchi Autonomous Okrug and the lowest rate in the Republics of the Northern Caucasus and Moscow. However, in all subjects of the Russian Federation indicator of years of life lost is

  19. Family history of premature cardiovascular disease: blood pressure control and long-term mortality outcomes in hypertensive patients.

    PubMed

    Williamson, Catherine; Jeemon, Panniyammakal; Hastie, Claire E; McCallum, Linsay; Muir, Scott; Dawson, Jesse; Walters, Matthew; Sloan, William; Morrison, David; Dominiczak, Anna F; Pell, Jill; Padmanabhan, Sandosh

    2014-03-01

    Current guidelines recommend early referral and initiation of intensive cardiovascular (CV) risk reduction in individuals with a positive family history of coronary heart disease (CHD). We hypothesized that a family history of premature CHD and stroke [CV disease (CVD)] would lead to earlier referral of hypertensive patients to secondary care clinic, leading to better control of risk factors, mitigating the excess risk seen in these individuals. We studied the association of a positive family history of CVD in 10 787 individuals with longitudinal changes in risk factors and long-term cause-specific mortality in the Glasgow Blood Pressure Clinic using generalized estimating equations and the Cox proportional hazard models, respectively. The total time at risk was 193 756 person-years with a median survival time of 29.2 years. A positive family history of CVD was associated with an earlier presentation to the clinic, a lower burden of traditional CV risk factors, and similar longitudinal blood pressure reduction and drug adherence compared with those without. But despite these positive features, all-cause [hazard ratio (HR) = 1.12, 95% confidence interval 1.01-1.25] and CV (HR = 1.20, 1.04-1.38) mortality independent of baseline risk factors were worse. Consistent results were observed in propensity score-matched analysis. Inclusion of family history of CVD did not improve mortality risk discrimination over and above traditional risk factors. Our study suggests that despite earlier referral and treatment of individuals with a positive family history of premature CVD, excess risk persists, indicating the need for continued and sustained efforts to reduce risk factors and drug adherence in these individuals.

  20. The role of population change in the increased economic differences in mortality: a study of premature death from all causes and major groups of causes of death in Spain, 1980-2010.

    PubMed

    Martínez, David; Giráldez-García, Carolina; Miqueleiz, Estrella; Calle, María E; Santos, Juana M; Regidor, Enrique

    2015-04-02

    An increase has been observed in differences in mortality between the richest and poorest areas of rich countries. This study assesses whether one of the proposed explanations, i.e., population change, might be responsible for this increase in Spain. Observational study based on average income, population change and mortality at provincial level. The premature mortality rate (ages 0-74 years) was estimated for all causes and for cancer, cardiovascular disease and external causes across the period 1980-2010. In the years analysed, provinces were grouped into tertiles based on provincial income, with the mortality rate ratio (MMR) being estimated by taking the tertile of highest-income provinces as reference. Population change was then controlled for to ascertain whether it would modify the rate ratio. In all-cause mortality, the magnitude of the MRR for provinces in the poorest versus the richest tertile was 1.01 in 1980 and 1.12 in 2010; in cardiovascular mortality, the MMRs for these same years were 1.08 and 1.31 respectively; and in the case of cancer and external-cause mortality, MMR magnitude was similar in 1980 and 2010. The magnitude of the MMR remained unchanged in response to adjustment for population change, with the single exception of 1980, when it increased in all-cause and cardiovascular mortality. The increase in the difference in premature mortality between the richest and poorest areas in Spain is due to the increased difference in cardiovascular mortality. This increase is not accounted for by population change. In rich countries, more empirical evidence is thus needed to test other alternative explanations for the increase in economic differences in mortality.

  1. Body mass index in young adulthood, obesity trajectory, and premature mortality.

    PubMed

    Hirko, Kelly A; Kantor, Elizabeth D; Cohen, Sarah S; Blot, William J; Stampfer, Meir J; Signorello, Lisa B

    2015-09-01

    Although much research has been conducted on the role adult body mass index (BMI) plays in mortality, there have been fewer studies that evaluated the associations of BMI in young adulthood and adult weight trajectory with mortality, and it remains uncertain whether associations differ by race or sex. We prospectively examined the relationships of BMI in young adulthood (21 years of age) and adult obesity trajectory with later-life mortality rates among 75,881 men and women in the Southern Community Cohort Study. Study participants were enrolled between 2002 and 2009 at ages 40-79 years and were followed through December, 2011. Multivariable Cox proportional hazards models were used to estimate hazard ratios and 95% confidence intervals. There were 7,301 deaths in the 474,970 person-years of follow-up. Participants who reported being overweight or obese as young adults had mortality rates that were 19% (95% confidence interval: 12, 27) and 64% (95% confidence interval: 52, 78) higher, respectively, than those of their normal weight counterparts. The results did not significantly differ by race or sex. Participants who reported being obese in young adulthood only or in both young and middle adulthood experienced mortality rates that were 40%-90% higher than those of participants who were nonobese at either time. These results suggest that obesity in young adulthood is associated with higher mortality risk regardless of race, sex, and obesity status in later life.

  2. Body Mass Index in Young Adulthood, Obesity Trajectory, and Premature Mortality

    PubMed Central

    Hirko, Kelly A.; Kantor, Elizabeth D.; Cohen, Sarah S.; Blot, William J.; Stampfer, Meir J.; Signorello, Lisa B.

    2015-01-01

    Although much research has been conducted on the role adult body mass index (BMI) plays in mortality, there have been fewer studies that evaluated the associations of BMI in young adulthood and adult weight trajectory with mortality, and it remains uncertain whether associations differ by race or sex. We prospectively examined the relationships of BMI in young adulthood (21 years of age) and adult obesity trajectory with later-life mortality rates among 75,881 men and women in the Southern Community Cohort Study. Study participants were enrolled between 2002 and 2009 at ages 40–79 years and were followed through December, 2011. Multivariable Cox proportional hazards models were used to estimate hazard ratios and 95% confidence intervals. There were 7,301 deaths in the 474,970 person-years of follow-up. Participants who reported being overweight or obese as young adults had mortality rates that were 19% (95% confidence interval: 12, 27) and 64% (95% confidence interval: 52, 78) higher, respectively, than those of their normal weight counterparts. The results did not significantly differ by race or sex. Participants who reported being obese in young adulthood only or in both young and middle adulthood experienced mortality rates that were 40%–90% higher than those of participants who were nonobese at either time. These results suggest that obesity in young adulthood is associated with higher mortality risk regardless of race, sex, and obesity status in later life. PMID:25977515

  3. Lost life years due to premature deaths caused by diseases of the digestive system in Poland in 2013

    PubMed

    Paciej, Paulina; Ciabiada, Beata; Maniecka-Bryła, Irena

    In order to evaluate the health status of a population, besides indicators measuring the incidence of diseases and deaths, potential measures are becoming more frequently used, ie. measures that take into account life-time potential of the individuals in the population. They can particularly by applied to analyse the problem of premature mortality, which is measured by lost life years. The aim of the study was to evaluate life years lost due to diseases of digestive system in Polish population in 2013. The study was based on a dataset containing 387,312 death certificates of Poles who died in 2013, provided by the Central Statistical Office in Poland. Data on deaths caused by diseases of digestive system (K00-K93 by ICD-10) were used in the study – that were 16,543 records (4.3% of all the deaths). Lost life years were assessed with the measures: SEYLL (Standard Expected Years of Life Lost), SEYLLp (Standard Expected Years of Life Lost per living person), SEYLLd (Standard Expected Years of Life Lost per death). In the analysed year among men there were 9,275 deaths caused by diseases of digestive system and in women 7,268 deaths. SEYLL in the group of men amounted to 102 230.7 and in the group of women it was 53,475.5. The number of lost life years calculated per 10 000 male inhabitants was 54.9, and for 10,000 females it was 26.9. The highest share in lost life years had alcoholic liver disease (SEYLLp for men – 20.87, for women – 6.1), fibrosis and cirrhosis of the liver (SEYLLp for men- 9.7, for women- 5.6) and acute pancreatitis (SEYLLp for men – 5.3, for women – 2.1). The results of the study indicate that diseases of digestive system have an important contribution to the loss of life-time potential in Polish population (6.6% of all SEYLL in 2013). The dominant role in this class of diseases played alcoholic liver disease – K70, fibrosis and cirrhosis of the liver – K74 and acute pancreatitis – K85.

  4. The Impact of Individual Anthropogenic Emissions Sectors on the Global Burden of Human Mortality due to Ambient Air Pollution.

    PubMed

    Silva, Raquel A; Adelman, Zachariah; Fry, Meridith M; West, J Jason

    2016-11-01

    Exposure to ozone and fine particulate matter (PM2.5) can cause adverse health effects, including premature mortality due to cardiopulmonary diseases and lung cancer. Recent studies quantify global air pollution mortality but not the contribution of different emissions sectors, or they focus on a specific sector. We estimated the global mortality burden of anthropogenic ozone and PM2.5, and the impact of five emissions sectors, using a global chemical transport model at a finer horizontal resolution (0.67° × 0.5°) than previous studies. We performed simulations for 2005 using the Model for Ozone and Related Chemical Tracers, version 4 (MOZART-4), zeroing out all anthropogenic emissions and emissions from specific sectors (All Transportation, Land Transportation, Energy, Industry, and Residential and Commercial). We estimated premature mortality using a log-linear concentration-response function for ozone and an integrated exposure-response model for PM2.5. We estimated 2.23 (95% CI: 1.04, 3.33) million deaths/year related to anthropogenic PM2.5, with the highest mortality in East Asia (48%). The Residential and Commercial sector had the greatest impact globally-675 (95% CI: 428, 899) thousand deaths/year-and in most regions. Land Transportation dominated in North America (32% of total anthropogenic PM2.5 mortality), and it had nearly the same impact (24%) as Residential and Commercial (27%) in Europe. Anthropogenic ozone was associated with 493 (95% CI: 122, 989) thousand deaths/year, with the Land Transportation sector having the greatest impact globally (16%). The contributions of emissions sectors to ambient air pollution-related mortality differ among regions, suggesting region-specific air pollution control strategies. Global sector-specific actions targeting Land Transportation (ozone) and Residential and Commercial (PM2.5) sectors would particularly benefit human health. Citation: Silva RA, Adelman Z, Fry MM, West JJ. 2016. The impact of individual

  5. The Impact of Individual Anthropogenic Emissions Sectors on the Global Burden of Human Mortality due to Ambient Air Pollution

    PubMed Central

    Silva, Raquel A.; Adelman, Zachariah; Fry, Meridith M.; West, J. Jason

    2016-01-01

    Background: Exposure to ozone and fine particulate matter (PM2.5) can cause adverse health effects, including premature mortality due to cardiopulmonary diseases and lung cancer. Recent studies quantify global air pollution mortality but not the contribution of different emissions sectors, or they focus on a specific sector. Objectives: We estimated the global mortality burden of anthropogenic ozone and PM2.5, and the impact of five emissions sectors, using a global chemical transport model at a finer horizontal resolution (0.67° × 0.5°) than previous studies. Methods: We performed simulations for 2005 using the Model for Ozone and Related Chemical Tracers, version 4 (MOZART-4), zeroing out all anthropogenic emissions and emissions from specific sectors (All Transportation, Land Transportation, Energy, Industry, and Residential and Commercial). We estimated premature mortality using a log-linear concentration–response function for ozone and an integrated exposure–response model for PM2.5. Results: We estimated 2.23 (95% CI: 1.04, 3.33) million deaths/year related to anthropogenic PM2.5, with the highest mortality in East Asia (48%). The Residential and Commercial sector had the greatest impact globally—675 (95% CI: 428, 899) thousand deaths/year—and in most regions. Land Transportation dominated in North America (32% of total anthropogenic PM2.5 mortality), and it had nearly the same impact (24%) as Residential and Commercial (27%) in Europe. Anthropogenic ozone was associated with 493 (95% CI: 122, 989) thousand deaths/year, with the Land Transportation sector having the greatest impact globally (16%). Conclusions: The contributions of emissions sectors to ambient air pollution–related mortality differ among regions, suggesting region-specific air pollution control strategies. Global sector-specific actions targeting Land Transportation (ozone) and Residential and Commercial (PM2.5) sectors would particularly benefit human health. Citation: Silva RA

  6. Educational inequalities in premature mortality in Poland, 2002–2011: a population-based cross-sectional study

    PubMed Central

    Pikala, Małgorzata; Burzyn´ska, Monika; Pikala, Robert; Bryła, Marek; Maniecka-Bryła, Irena

    2016-01-01

    Background The aim of the study is to evaluate the differences in premature mortality between educational groups of Polish inhabitants in 2002 and 2011. Methods The analysis included all deaths among inhabitants of Poland, aged 25–64 years, which occurred in 2002 (N=97 004) and 2011 (N=104 598). We calculated age-standardised death rates (SDRs) and summary measures on inequalities. The relative index of inequality (RII) was calculated with Poisson regression. Results The SDR for Poland decreased from 285.7 per 100 000 in 2002 to 246.0 in 2011 among males with higher education and increased from 1141.0 in 2002 to 1183.0 in 2011 among males with lower secondary or less education (the rate ratio increased from 4.0 to 4.8). With regard to females with higher education, the SDR decreased from 127.2 per 100 000 in 2002 to 115.6 in 2011. Among females with lower secondary or less education, the SDR increased from 375.8 per 100 000 in 2002 to 423.1 in 2011 (the rate ratio increased from 3.0 to 3.7). The RII increased from 5.8 to 9.7 in the male group and from 4.4 to 8.3 in the female group. The greatest educational inequalities in 2011 were observed in females who died of cardiovascular diseases (RII=14.9) and lung cancer (RII=6.6) and in males who died of suicides (RII=19.3) and lung cancer (RII=11.9). Conclusions Educational inequalities in premature mortality in Poland are growing. There is a need to implement health education programmes targeted at groups of the most poorly educated Polish inhabitants, especially for diseases resulting from smoking and excessive alcohol consumption. PMID:27678532

  7. Historical Trends in PM2.5-Related Premature Mortality during 1990$-$2010 across the Northern Hemisphere

    SciTech Connect

    Wang, Jiandong; Xing, Jia; Mathur, Rohit; Pleim, Jonathan E.; Wang, Shuxiao; Hogrefe, Christian; Gan, Chuen-Meei; Wong, David C.; Hao, Jiming

    2016-08-19

    Air quality across the northern hemisphere over the past two decades has witnessed dramatic changes, with continuous improvement in developed countries in North America and Europe, but a contrasting sharp deterioration in developing regions of Asia. Objective: This study investigates the historical trend in the long-term exposure to PM2.5 and PM2.5-related premature mortality (PM2.5-mortality) and its response to changes in emission that occurred during 1990-2010 across the northern hemisphere. Implications for future trends in human exposure to air pollution in both developed and developing regions of the world are discussed. Methods: We employed the integrated exposure-response model developed by Health Effects Institute to estimate the PM2.5-mortality. The 1990-2010 annual-average PM2.5 concentrations were obtained from the simulations using WRF-CMAQ model. Emission mitigation efficiencies of SO2, NOx, NH3 and primary PM are estimated from the PM2.5-mortality responses to the emission variations. Results: Estimated PM2.5-mortalities in East Asia and South Asia increased by 21% and 85% respectively, from 866,000 and 578,000 in 1990, to 1,048,000 and 1,068,000 in 2010. PM2.5-mortalities in developed regions, i.e., Europe and high-income North America decreased substantially by 67% and 58% respectively. Conclusions: Over the past two decades, correlations between population and PM2.5 have become weaker in Europe and North America due to air pollution controls but stronger in East Asia due to deteriorating air quality. Mitigation of primary PM appears to be the most efficient way for increasing health benefits, i.e., providing the largest mortality reduction per unit emissions. However, reductions in emissions of NH3 are needed to maximize the effectiveness of NOx emission controls.

  8. Deficits in Top-Down Sensory Prediction in Infants At Risk due to Premature Birth.

    PubMed

    Emberson, Lauren L; Boldin, Alex M; Riccio, Julie E; Guillet, Ronnie; Aslin, Richard N

    2017-02-06

    A prominent theoretical view is that the brain is inherently predictive [1, 2] and that prediction helps drive the engine of development [3, 4]. Although infants exhibit neural signatures of top-down sensory prediction [5, 6], in order to establish that prediction supports development, it must be established that deficits in early prediction abilities alter trajectories. We investigated prediction in infants born prematurely, a leading cause of neuro-cognitive impairment worldwide [7]. Prematurity, independent of medical complications, leads to developmental disturbances [8-12] and a broad range of developmental delays [13-17]. Is an alteration in early prediction abilities the common cause? Using functional near-infrared spectroscopy (fNIRS), we measured top-down sensory prediction in preterm infants (born <33 weeks gestation) before infants exhibited clinically identifiable developmental delays (6 months corrected age). Whereas preterm infants had typical neural responses to presented visual stimuli, they exhibited altered neural responses to predicted visual stimuli. Importantly, a separate behavioral control confirmed that preterm infants detect pattern violations at the same rate as full-terms, establishing selectivity of this response to top-down predictions (e.g., not in learning an audiovisual association). These findings suggest that top-down sensory prediction plays a crucial role in development and that deficits in this ability may be the reason why preterm infants experience altered developmental trajectories and are at risk for poor developmental outcomes. Moreover, this work presents an opportunity for establishing a neuro-biomarker for early identification of infants at risk and could guide early intervention regimens.

  9. Municipal mortality due to thyroid cancer in Spain

    PubMed Central

    Lope, Virginia; Pollán, Marina; Pérez-Gómez, Beatriz; Aragonés, Nuria; Ramis, Rebeca; Gómez-Barroso, Diana; López-Abente, Gonzalo

    2006-01-01

    Background Thyroid cancer is a tumor with a low but growing incidence in Spain. This study sought to depict its spatial municipal mortality pattern, using the classic model proposed by Besag, York and Mollié. Methods It was possible to compile and ascertain the posterior distribution of relative risk on the basis of a single Bayesian spatial model covering all of Spain's 8077 municipal areas. Maps were plotted depicting standardized mortality ratios, smoothed relative risk (RR) estimates, and the posterior probability that RR > 1. Results From 1989 to 1998 a total of 2,538 thyroid cancer deaths were registered in 1,041 municipalities. The highest relative risks were mostly situated in the Canary Islands, the province of Lugo, the east of La Coruña (Corunna) and western areas of Asturias and Orense. Conclusion The observed mortality pattern coincides with areas in Spain where goiter has been declared endemic. The higher frequency in these same areas of undifferentiated, more aggressive carcinomas could be reflected in the mortality figures. Other unknown genetic or environmental factors could also play a role in the etiology of this tumor. PMID:17173668

  10. Tree mortality risk of oak due to gypsy moth

    Treesearch

    K.W. Gottschalk; J.J. Colbert; D.L. Feicht

    1998-01-01

    We present prediction models for estimating tree mortality resulting from gypsy moth, Lymantria dispar, defoliation in mixed oak, Quercus sp., forests. These models differ from previous work by including defoliation as a factor in the analysis. Defoliation intensity, initial tree crown condition (crown vigour), crown position, and...

  11. Thinking about Pregnancy After Premature Birth

    MedlinePlus

    ... research Research grants Prematurity research Birth defects research Infant health research Prematurity research centers For providers NICU ... babies by preventing birth defects, premature birth and infant mortality. Solving premature birth Featured articles Accomplishments and ...

  12. Normal overall mortality rate in Addison's disease, but young patients are at risk of premature death.

    PubMed

    Erichsen, Martina M; Løvås, Kristian; Fougner, Kristian J; Svartberg, Johan; Hauge, Erik R; Bollerslev, Jens; Berg, Jens P; Mella, Bjarne; Husebye, Eystein S

    2009-02-01

    Primary adrenal insufficiency (Addison's disease) is a rare autoimmune disease. Until recently, life expectancy in Addison's disease patients was considered normal. To determine the mortality rate in Addison's disease patients. i) Patients registered with Addison's disease in Norway during 1943-2005 were identified through search in hospital diagnosis registries. Scrutiny of the medical records provided diagnostic accuracy and age at diagnosis. ii) The patients who had died were identified from the National Directory of Residents. iii) Background mortality data were obtained from Statistics Norway, and standard mortality rate (SMR) calculated. iv) Death diagnoses were obtained from the Norwegian Death Cause Registry. Totally 811 patients with Addison's disease were identified, of whom 147 were deceased. Overall SMR was 1.15 (95% confidence intervals (CI) 0.96-1.35), similar in females (1.18 (0.92-1.44)) and males (1.10 (0.80-1.39)). Patients diagnosed before the age of 40 had significantly elevated SMR at 1.50 (95% CI 1.09-2.01), most pronounced in males (2.03 (1.19-2.86)). Acute adrenal failure was a major cause of death; infection and sudden death were more common than in the general population. The mean ages at death for females (75.7 years) and males (64.8 years) were 3.2 and 11.2 years less than the estimated life expectancy. Addison's disease is still a potentially lethal condition, with excess mortality in acute adrenal failure, infection, and sudden death in patients diagnosed at young age. Otherwise, the prognosis is excellent for patients with Addison's disease.

  13. Premature infant

    MedlinePlus

    ... infant is a baby born before 37 completed weeks of gestation (more than 3 weeks before the due date). ... one of the following: Premature (less than 37 weeks gestation) Full term (37 to 42 weeks gestation) ...

  14. [Mortality due to bronchopulmonary cancers in workers of 2 foundries].

    PubMed

    Moulin, J J; Lafontaine, M; Mantout, B; Belanger, A; Michel, M; Wild, P; Clavel, T; Fournier, M; Fontana, J M

    1995-01-01

    A mortality study was carried out in two factories producing stainless steel in order to assess lung cancer risk among workers employed in coke oven, blast and open hearth furnaces, foundry, electric furnace, hot and cold rolling mills and pickling areas. Occupational exposures of interest were chromium compounds, nickel compounds, polycyclic aromatic hydrocarbons (PAH), silica and asbestos. All male workers having at least one year of employment between 01.01.1960 and 31.12.1990 were followed up for mortality. The vital status was assessed from birth place registries. Complete job histories since date of first employment were abstracted from the company files. The smoking habits of 50% of the cohort members were known from medical records. The observed number of deaths (obs) were compared with the expected ones based on regional rates with adjustment for age, sex and calendar time (Standardized Mortality Ratio, SMR). The cohorts included 6324 (factory 1) and 5270 (factory 2) workers. The overall mortality did not differ markedly from that expected in both factories: SMR = 0.95 (obs = 1540, p = 0.05) in factory 1 and SMR = 1.06 (obs = 916, non-significant) in factory 2. SMRs for lung cancer did not differ from unity, respectively 0.99 (obs = 105) and 1.00 (obs = 54), in whole cohorts. Non-significant lung cancer excesses were observed among workers of some workshops where exposures of interest might have occurred: coke oven (SMR = 2.04), blast furnace (SMR = 1.36), open hearth furnace (SMR = 1.75), hot rolling mills (SMR = 1.29). These processes, however, are no longer involved in the study factories. Furthermore, no lung cancer excess was observed among workers employed in current workshops: electric furnaces and cold rolling mills.

  15. Present and potential future contributions of sulfate, black and organic carbon aerosols from China to global air quality, premature mortality and radiative forcing

    NASA Astrophysics Data System (ADS)

    Saikawa, E.; Naik, V.; Horowitz, L. W.; Liu, J.; Mauzerall, D. L.

    2008-12-01

    Aerosols are harmful to human health and have both direct and indirect effects on climate. China is a major contributor to global emissions of sulfur dioxide (SO2), a sulfate (SO42-) precursor, organic carbon (OC), and black carbon (BC) aerosols. Although increasingly examined, the effect of present and potential future levels of these emissions on global premature mortality and climate change has not been well quantified. Through both direct and indirect effects, SO42- and OC exert negative radiative forcing (cooling) while BC exerts positive forcing (warming). We analyze the effect of China's emissions of SO2, SO42-, OC and BC in 2000 and for three emission scenarios in 2030 on global surface aerosol concentrations, premature mortality, and radiative forcing. Using global models of chemical transport (MOZART-2) and radiative transfer (GFDL RTM), and combining simulation results with gridded population data, mortality rates, and concentration-response relationships from the epidemiological literature, we estimate the contribution of Chinese aerosols to global annual premature mortality and to radiative forcing in 2000 and 2030. In 2000, we estimate these aerosols cause 385,320 premature deaths in China and an additional 18 240 globally. In 2030, aggressive emission controls lead to a reduction in premature deaths to 200,370 in China and 7,740 elsewhere, while under a high emissions scenario premature deaths would increase to 602,950 in China and to 29,750 elsewhere. Because the negative radiative forcing from SO42- and OC is larger than the positive forcing from BC, the Chinese aerosols lead to global net direct radiative forcing of -74 mW m-2 in 2000 and between -15 and -97 mW m-2 in 2030 based on the emissions scenario. Our analysis suggests that environmental policies that simultaneously improve public health and mitigate climate change would be highly beneficial (eg. reductions in BC emissions).

  16. Obesity or obesities? Controversies on the association between body mass index and premature mortality.

    PubMed

    Bosello, Ottavio; Donataccio, Maria Pia; Cuzzolaro, Massimo

    2016-06-01

    Obesity is still defined on the basis of body mass index (BMI) and BMI in itself is generally accepted as a strong predictor of overall early mortality. However, an inverse association between BMI and mortality has been reported in patients with many disease states and in several clinical settings: hemodialysis, cardiovascular diseases, hypertension, stroke, diabetes, chronic obstructive pulmonary disease, surgery, etc. This unexpected phenomenon is usually called obesity-survival paradox (OP). The contiguous concepts of metabolically healthy obesity (MHO, a phenotype having BMI ≥ 30 but not having any metabolic syndrome component and having a homeostasis model assessment of insulin resistance, HOMA, <2.5) and metabolically obese normal weight (MONW, normal-weight individuals displaying obesity-related phenotypic characteristics) have received a great deal of attention in recent years. The interactions that link MHO, MONW and OP with body composition, fat distribution, aging and cardiorespiratory fitness are other crucial areas of research. The article is an introductory narrative overview of the origin and current use of the concepts of MHO, MONW and OP. These phenomena are very controversial and appear as a consequence of the frail current diagnostic definition of obesity based only on BMI. A new commonly established characterization and classification of obesities based on a number of variables is needed urgently.

  17. Premature seizure of traffic flow due to the introduction of evolutionary games

    NASA Astrophysics Data System (ADS)

    Perc, Matjaz

    2007-01-01

    We study the impact of evolutionary games on the flow of traffic. Since traffic participants do not always conform to the imposed rules, the introduction of games, i.e. set of strategies defining the behavioural pattern of agents on the road, appears justified. With this motivation, and the fact that individuals can change their strategy in the course of time, the evolutionary prisoner's dilemma game is introduced between neighbouring agents, enabling them to choose between cooperation and defection. Mutual cooperation enables forwarding to both agents for one step, while the defector is able to advance two steps when facing a cooperator, whereby the latter is forced to go one step backwards. Two defectors end up in a halt until the next iteration. Irrespective of their strategy, however, agents can move only if the road ahead is free. Jumps are never allowed. We show that this simple and plausible supplementation of the discrete cellular automaton Biham Middleton Levine (BML) model induces a traffic flow seizure by a substantially lower initial density of cars as in the absence of evolutionary games. The phenomenon is explained by studying the one-dimensional variant of the BML model with different advancement steps on the circular ring. In view of the proposed explanation, findings are generalized also to other types of games, such is the snowdrift game, and some statistical properties of gridlock formation in the presence of evolutionary rules are outlined. Our findings suggest that 'bending the law' results in a premature occurrence of traffic jams and thus unnecessarily burdens the transportation system.

  18. Educational inequalities in premature mortality in Poland, 2002-2011: a population-based cross-sectional study.

    PubMed

    Pikala, Małgorzata; Burzyn Ska, Monika; Pikala, Robert; Bryła, Marek; Maniecka-Bryła, Irena

    2016-09-27

    The aim of the study is to evaluate the differences in premature mortality between educational groups of Polish inhabitants in 2002 and 2011. The analysis included all deaths among inhabitants of Poland, aged 25-64 years, which occurred in 2002 (N=97 004) and 2011 (N=104 598). We calculated age-standardised death rates (SDRs) and summary measures on inequalities. The relative index of inequality (RII) was calculated with Poisson regression. The SDR for Poland decreased from 285.7 per 100 000 in 2002 to 246.0 in 2011 among males with higher education and increased from 1141.0 in 2002 to 1183.0 in 2011 among males with lower secondary or less education (the rate ratio increased from 4.0 to 4.8). With regard to females with higher education, the SDR decreased from 127.2 per 100 000 in 2002 to 115.6 in 2011. Among females with lower secondary or less education, the SDR increased from 375.8 per 100 000 in 2002 to 423.1 in 2011 (the rate ratio increased from 3.0 to 3.7). The RII increased from 5.8 to 9.7 in the male group and from 4.4 to 8.3 in the female group. The greatest educational inequalities in 2011 were observed in females who died of cardiovascular diseases (RII=14.9) and lung cancer (RII=6.6) and in males who died of suicides (RII=19.3) and lung cancer (RII=11.9). Educational inequalities in premature mortality in Poland are growing. There is a need to implement health education programmes targeted at groups of the most poorly educated Polish inhabitants, especially for diseases resulting from smoking and excessive alcohol consumption. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  19. [Mortality due to bicycle accidents in Pernambuco, Brazil].

    PubMed

    Galvão, Pauliana Valéria Machado; Pestana, Luciana Pinto; Pestana, Valter Mário; Spíndola, Michelline Oliveira Pedrosa; Campello, Reginaldo Inojosa Carneiro; de Souza, Eliane Helena Alvim

    2013-05-01

    The scope of this paper was to conduct a quantitative analysis of deaths resulting from bicycle accidents in the state of Pernambuco by studying secondary data between 2001 and 2010. The sample consisted of all the Deaths recorded in the Mortality Information System of the Unified Health System Database that reported bicycle accidents between 2001 and 2010. Descriptive measures were determined for all variables. Socio-demographic variables were paired with the basic cause of death in order to find a statistical correlation. In Pernambuco, the aforementioned information system recorded 517 deaths resulting from bicycle accidents, with greater frequency in men between 25 and 59 years of age, Afro-Brazilians, single and of unknown schooling. The mean age was 36.82 years (SD = 17.026), and the minimum and maximum age of 4 and 86 years old, respectively. The findings highlight the need for the creation of adequate infrastructure and effective legal measures to prevent traffic accidents involving this type of vehicle, relying on the evidence of distribution of cases in most Pernambuco municipalities.

  20. [Analysis of the trend and impact of mortality due to external causes: Mexico, 2000-2013].

    PubMed

    Dávila Cervantes, Claudio Alberto; Pardo Montaño, Ana Melisa

    2016-01-01

    The objective of this study was to analyze mortality due to the main external causes of death (traffic accidents, other accidents, homicides and suicides) in Mexico, calculating the years of life lost between 0 and 100 years of age and their contribution to the change in life expectancy between 2000 and 2013, at the national level, by sex and age group. Data came from mortality vital statistics of the Instituto Nacional de Estadística y Geografía (INEGI) [National Institute of Statistics and Geography]. The biggest impact in mortality due to external causes occurred in adolescent and adult males 15-49 years of age; mortality due to these causes remained constant in males and slightly decreased in females. Mortality due to traffic accidents and other accidents decreased, with a positive contribution to life expectancy, but this effect was canceled out by the increase in mortality due to homicides and suicides. Mortality due to external causes can be avoided through interventions, programs and prevention strategies as well as timely treatment. It is necessary to develop multidisciplinary studies on the dynamics of the factors associated with mortality due to these causes.

  1. Suicide, fatal injuries, and other causes of premature mortality in patients with traumatic brain injury: a 41-year Swedish population study.

    PubMed

    Fazel, Seena; Wolf, Achim; Pillas, Demetris; Lichtenstein, Paul; Långström, Niklas

    2014-03-01

    : Longer-term mortality in individuals who have survived a traumatic brain injury (TBI) is not known. To examine the relationship between TBI and premature mortality, particularly by external causes, and determine the role of psychiatric comorbidity. We studied all persons born in 1954 or later in Sweden who received inpatient and outpatient International Classification of Diseases-based diagnoses of TBI from 1969 to 2009 (n = 218,300). We compared mortality rates 6 months or more after TBI to general population controls matched on age and sex (n = 2,163,190) and to unaffected siblings of patients with TBI (n = 150,513). Furthermore, we specifically examined external causes of death (suicide, injury, or assault). We conducted sensitivity analyses to investigate whether mortality rates differed by sex, age at death, severity (including concussion), and different follow-up times after diagnosis. Adjusted odds ratios (AORs) of premature death by external causes in patients with TBI compared with general population controls. Among those who survived 6 months after TBI, we found a 3-fold increased odds of mortality (AOR, 3.2; 95% CI, 3.0-3.4) compared with general population controls and an adjusted increased odds of mortality of 2.6 (95% CI, 2.3-2.8) compared with unaffected siblings. Risks of mortality from external causes were elevated, including for suicide (AOR, 3.3; 95% CI, 2.9-3.7), injuries (AOR, 4.3; 95% CI, 3.8-4.8), and assault (AOR, 3.9; 95% CI, 2.7-5.7). Among those with TBI, absolute rates of death were high in those with any psychiatric or substance abuse comorbidity (3.8% died prematurely) and those with solely substance abuse (6.2%) compared with those without comorbidity (0.5%). Traumatic brain injury is associated with substantially elevated risks of premature mortality, particularly for suicide, injuries, and assaults, even after adjustment for sociodemographic and familial factors. Current clinical guidelines may need revision to

  2. Severe hemolytic disease of the premature newborn due to RH1 incompatibility: a case report

    PubMed Central

    UWINGABIYE, JEAN; ZAHID, HAFID; LABRINI, FAYÇAL; EL KHAZRAJI, ABDELHAK; YAHYAOUI, ANASS; HADEF, RACHID; MESSAOUDI, NEZHA

    2016-01-01

    We report a case of dramatic outcome of severe hemolytic disease in a newborn due to RH1 incompatibility. A newborn with A RH1 blood group was admitted in the Mohammed V Military Teaching Hospital for the problem of hydrops fetalis associated with RH1 incompatibility. The blood group of his mother, aged 31, was AB RH1-negative and that of his 37 year old father was A RH1. The mother had a history of 4 term deliveries, 3 abortions, and 1 living child. There was no prevention by anti-D immunoglobulin postpartum. The mother’s irregular agglutinin test was positive and the pregnancy was poorly monitored. The laboratory tests of the newborn showed a high total serum bilirubin level (30 mg/L) and macrocytic regenerative anemia (Hemoglobin=4 g/dL, mean corpuscular volume = 183 fL, reticulocytes count =176600/m3). The blood smear showed 1256 erythroblasts per 100 leukocytes, Howell–Jolly bodies and many macrocytes. The direct antiglobulin test was positive. He was transfused with red blood cell concentrates and treated with conventional phototherapy. The evolution was unfavourable; he died three days after the death of his mother. The monitoring of these high-risk pregnancies requires specialized centers and a close collaboration between the gynaecologist and the blood transfusion specialist to strengthen the prevention, as well as clinico-biological monitoring in patients with a history of RH1 fetomaternal alloimunization. PMID:27857529

  3. Reduced Hospital Mortality With Surgical Ligation of Patent Ductus Arteriosus in Premature, Extremely Low Birth Weight Infants: A Propensity Score-matched Outcome Study.

    PubMed

    Tashiro, Jun; Perez, Eduardo A; Sola, Juan E

    2016-03-01

    To evaluate outcomes after surgical ligation (SL) of patent ductus arteriosus (PDA) in premature, extremely low birth weight (ELBW) infants. Optimal management of PDA in this specialized population remains undefined. Currently, surgical therapy is largely reserved for infants failing medical management. To date, a large-scale, risk-matched population-based study has not been performed to evaluate differences in mortality and resource utilization. Data on identified premature (<37 weeks) and ELBW (<1000  g) infants with PDA (International Classification of Diseases, 9th revision, Clinical Modification, 747.0) and respiratory distress (769) were obtained from Kids' Inpatient Database (2003-2009). Overall, 12,470 cases were identified, with 3008 undergoing SL. Propensity score-matched analysis of 1620 SL versus 1584 non-SL found reduced mortality (15% vs 26%) and more routine disposition (48% vs 41%) for SL (P < 0.001). SL had longer length of stay and higher total cost (P < 0.001). On multivariate analysis, SL mortality predictors were necrotizing enterocolitis (NEC; surgical odds ratio, 5.95; medical odds ratio, 4.42) and sepsis (3.43) (P < 0.006). Length of stay increased with bronchopulmonary dysplasia (BPD; 1.77), whereas total cost increased with surgical NEC (1.82) and sepsis (1.26) (P < 0.04). Non-SL mortality predictors were NEC (surgical, 76.3; medical, 6.17), sepsis (2.66), and intraventricular hemorrhage (1.97) (P < 0.005). Length of stay increased with BPD (2.92) and NEC (surgical, 2.04; medical, 1.28) (P < 0.03). Total cost increased with surgical NEC (2.06), medical NEC (1.57), sepsis (1.43), and BPD (1.30) (P < 0.001). Propensity score-matched analysis demonstrates reduced mortality in premature/ELBW infants with SL for PDA. NEC and sepsis are predictors of mortality and resource utilization.

  4. Present and potential future contributions of sulfate, black and organic carbon aerosols from China to global air quality, premature mortality and radiative forcing

    NASA Astrophysics Data System (ADS)

    Saikawa, Eri; Naik, Vaishali; Horowitz, Larry W.; Liu, Junfeng; Mauzerall, Denise L.

    Aerosols are harmful to human health and have both direct and indirect effects on climate. China is a major contributor to global emissions of sulfur dioxide (SO 2), a sulfate (SO 42-) precursor, organic carbon (OC), and black carbon (BC) aerosols. Although increasingly examined, the effect of present and potential future levels of these emissions on global premature mortality and climate change has not been well quantified. Through both direct radiative effects and indirect effects on clouds, SO 42- and OC exert negative radiative forcing (cooling) while BC exerts positive forcing (warming). We analyze the effect of China's emissions of SO 2, SO 42-, OC and BC in 2000 and for three emission scenarios in 2030 on global surface aerosol concentrations, premature mortality, and radiative forcing (RF). Using global models of chemical transport (MOZART-2) and radiative transfer (GFDL RTM), and combining simulation results with gridded population data, mortality rates, and concentration-response relationships from the epidemiological literature, we estimate the contribution of Chinese aerosols to global annual premature mortality and to RF in 2000 and 2030. In 2000, we estimate these aerosols cause approximately 470 000 premature deaths in China and an additional 30 000 deaths globally. In 2030, aggressive emission controls lead to a 50% reduction in premature deaths from the 2000 level to 240 000 in China and 10 000 elsewhere, while under a high emissions scenario premature deaths increase 50% from the 2000 level to 720 000 in China and to 40 000 elsewhere. Because the negative RF from SO 42- and OC is larger than the positive forcing from BC, Chinese aerosols lead to global net direct RF of -74 mW m -2 in 2000 and between -15 and -97 mW m -2 in 2030 depending on the emissions scenario. Our analysis indicates that increased effort to reduce greenhouse gases is essential to address climate change as China's anticipated reduction of aerosols will result in the

  5. Chapter 26: Mortality of Marbled Murrelets Due to Oil Pollution in North America

    Treesearch

    Harry R. Carter; Katherine J. Kuletz

    1995-01-01

    Mortality of Marbled Murrelets (Brachyramphus marmoratus) due to oil pollution is one of the major threats to murrelet populations. Mortality from large spills and chronic oil pollution has been occurring for several decades but has been documented poorly throughout their range; it probably has contributed to declines in populations, in conjunction...

  6. Estimating premature mortality attributable to PM2.5 exposure and benefit of air pollution control policies in China for 2020.

    PubMed

    Maji, Kamal Jyoti; Dikshit, Anil Kumar; Arora, Mohit; Deshpande, Ashok

    2017-08-31

    In past decade of rapid industrial development and urbanization, China has witnessed increasingly persistent severe haze and smog episodes, posing serious health hazards to the Chinese population, especially in densely populated cities. Quantification of health impacts attributable to PM2.5 (particulates with aerodynamic diameter≤2.5μm) has important policy implications to tackle air pollution. The Chinese national monitoring network has recently included direct measurements of ground level PM2.5, providing a potentially more reliable source for exposure assessment. This study reports PM2.5-related long-term mortality of year 2015 in 161 cities of nine regions across China using integrated exposure risk (IER) model for PM2.5 exposure-response functions (ERF). It further provides an estimate of the potential health benefits by year 2020 with a realization of the goals of Air Pollution Prevention and Control Action Plan (APPCAP) and the three interim targets (ITs) and Air Quality Guidelines (AQG) for PM2.5 by the World Health Organization (WHO). PM2.5-related premature mortality in 161 cities was 652 thousand, about 6.92% of total deaths in China during year 2015. Among all premature deaths, contributions of cerebrovascular disease (stroke), ischemic heart disease (IHD), chronic obstructive pulmonary disease (COPD), lung cancer (LC) and acute lower respiratory infections (ALRIs) were 51.70, 26.26, 11.77, 9.45 and 0.82%, respectively. The premature mortality in densely populated cities is very high, such as Tianjin (12,533/year), Beijing (18,817/year), Baoding (10,932/year), Shanghai (18,679/year), Chongqing (23,561/year), Chengdu (11,809/year), Harbin (9037/year) and Linyi (9141/year). The potential health benefits will be 4.4, 16.2, 34.5, 63.6 and 81.5% of the total present premature mortality when PM2.5 concentrations in China meet the APPCAP, WHO IT-1, IT-2, IT-3 and AQG respectively, by the year 2020. In the current situation, by the end of year 2030, even if

  7. [Mortality due to influenza and pneumonia in Mexico between 1990 and 2005].

    PubMed

    Kuri-Morales, Pablo; Galván, Fernando; Cravioto, Patricia; Zárraga Rosas, Luis Alberto; Tapia-Conyer, Roberto

    2006-01-01

    To estimate the impact of influenza vaccine in infants less than two years of age and in elders more than sixty-five years of age, through the analysis of mortality due to influenza and pneumonia in Mexico, between 1990 and 2005. To determine the seasonal pattern of mortality, the tendency of mortality by volume of deaths per seasonal period, and the speed rate of mortality. Data were taken from the Epidemiological and Statistical Mortality System (SEED-SSA per its abbreviation in Spanish). The analysis showed there is a tendency of deaths decrease at a rate of 509 deaths less per year in the infants group and 29 deaths less in the elders group. Also, the ascending tendency of mortality was interrupted by vaccination. The vaccination intervention has a positive economic effect and also helps improve the quality of life.Therefore, its implementation is expected to lower hospital admissions and deaths.

  8. Living with uncertainty: a Swedish qualitative interview study of women at home on sick leave due to premature labour.

    PubMed

    Höglund, Eva; Dykes, Anna-Karin

    2013-05-01

    to highlight the experiences of pregnant women, experiencing preterm labour, being on sick leave at home and how they handled their daily life. qualitative, descriptive using open interviews. 10 antenatal clinics in the south of Sweden. 15 pregnant women who were on sick leave for premature labour. four categories were identified: how to interpret unpredictable contractions in the uterus? Having concern regarding premature labour of their child, handling the new situation and finding a balance, and from work to sick leave. to be on sick leave for premature contractions can be compared with enduring a situation of inactivity. The woman finds herself in a stressful situation which she must learn to handle this and find a balance. it appears that supportive information offers the women in premature labour the opportunity of increased participation and responsibility which thereby positively affects her well-being. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. Predictive Factors of Hospital Mortality Due to Myocardial Infarction: A Multilevel Analysis of Iran's National Data

    PubMed Central

    Ahmadi, Ali; Soori, Hamid; Mehrabi, Yadollah; Etemad, Koorosh; Sajjadi, Homeira; Sadeghi, Mehraban

    2015-01-01

    Background: Regarding failure to establish the statistical presuppositions for analysis of the data by conventional approaches, hierarchical structure of the data as well as the effect of higher-level variables, this study was conducted to determine the factors independently associated with hospital mortality due to myocardial infarction (MI) in Iran using a multilevel analysis. Methods: This study was a national, hospital-based, and cross-sectional study. In this study, the data of 20750 new MI patients between April, 2012 and March, 2013 in Iran were used. The hospital mortality due to MI was considered as the dependent variable. The demographic data, clinical and behavioral risk factors at the individual level and environmental data were gathered. Multilevel logistic regression models with Stata software were used to analyze the data. Results: Within 1-year of study, the frequency (%) of hospital mortality within 30 days of admission was derived 2511 (12.1%) patients. The adjusted odds ratio (OR) of mortality with (95% confidence interval [CI]) was derived 2.07 (95% CI: 1.5–2.8) for right bundle branch block, 1.5 (95% CI: 1.3–1.7) for ST-segment elevation MI, 1.3 (95% CI: 1.1–1.4) for female gender, and 1.2 (95% CI: 1.1–1.3) for humidity, all of which were considered as risk factors of mortality. But, OR of mortality was 0.7 for precipitation (95% CI: 0.7–0.8) and 0.5 for angioplasty (95% CI: 0.4–0.6) were considered as protective factors of mortality. Conclusions: Individual risk factors had independent effects on the hospital mortality due to MI. Variables in the province level had no significant effect on the outcome of MI. Increasing access and quality to treatment could reduce the mortality due to MI. PMID:26730342

  10. Spectrum of excess mortality due to carbapenem-resistant Klebsiella pneumoniae infections.

    PubMed

    Hauck, C; Cober, E; Richter, S S; Perez, F; Salata, R A; Kalayjian, R C; Watkins, R R; Scalera, N M; Doi, Y; Kaye, K S; Evans, S; Fowler, V G; Bonomo, R A; van Duin, D

    2016-06-01

    Patients infected or colonized with carbapenem-resistant Klebsiella pneumoniae (CRKp) are often chronically and acutely ill, which results in substantial mortality unrelated to infection. Therefore, estimating excess mortality due to CRKp infections is challenging. The Consortium on Resistance against Carbapenems in K. pneumoniae (CRACKLE) is a prospective multicenter study. Here, patients in CRACKLE were evaluated at the time of their first CRKp bloodstream infection (BSI), pneumonia or urinary tract infection (UTI). A control cohort of patients with CRKp urinary colonization without CRKp infection was constructed. Excess hospital mortality was defined as mortality in cases after subtracting mortality in controls. In addition, the adjusted hazard ratios (aHR) for time-to-hospital-mortality at 30 days associated with infection compared with colonization were calculated in Cox proportional hazard models. In the study period, 260 patients with CRKp infections were included in the BSI (90 patients), pneumonia (49 patients) and UTI (121 patients) groups, who were compared with 223 controls. All-cause hospital mortality in controls was 12%. Excess hospital mortality was 27% in both patients with BSI and those with pneumonia. Excess hospital mortality was not observed in patients with UTI. In multivariable analyses, BSI and pneumonia compared with controls were associated with aHR of 2.59 (95% CI 1.52-4.50, p <0.001) and 3.44 (95% CI 1.80-6.48, p <0.001), respectively. In conclusion, in patients with CRKp infection, pneumonia is associated with the highest excess hospital mortality. Patients with BSI have slightly lower excess hospital mortality rates, whereas excess hospital mortality was not observed in hospitalized patients with UTI. Copyright © 2016 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  11. Respiratory severity score on day of life 30 is predictive of mortality and the length of mechanical ventilation in premature infants with protracted ventilation.

    PubMed

    Malkar, Manish B; Gardner, William P; Mandy, George T; Stenger, Michael R; Nelin, Leif D; Shepherd, Edward G; Welty, Stephen E

    2015-04-01

    We tested the hypothesis that Respiratory Severity Score (RSS) on day of life 30 is predictive of mortality and length of mechanical ventilation in premature infants on prolonged mechanical ventilation. A retrospective chart review was performed using the Nationwide Children's Hospital medical record and Vermont-Oxford Network databases. The primary outcome variable was survival to hospital discharge and the secondary outcome was length of mechanical ventilation after day of life 30. We identified 199 neonates admitted to Nationwide Children's Hospital between 2004 and 2007 with birth weight less than 1,500 g that received prolonged mechanical ventilation in the first 30 days of their life. A total of 184 infants were included in the analysis, excluding 14 patients with congenital anomalies and one infant with incomplete data. RSS on day of life 30 was significantly greater in the group of infants that died compared to those that survived (P = 0.003, 95% CI = [0.08, 0.40]). Further analysis demonstrated that the maximum difference in mortality was obtained with a threshold RSS of 6. Of the 109 patients who had RSS less than 6 on day of life 30, mortality rate was 4.6% (5/109) while those greater than or equal to 6 had a mortality rate of 21.3% (16/75). Both Kaplan-Meier survival curves comparing mortality and length of mechanical ventilation in infants with RSS < 6 versus those with RSS ≥ 6 demonstrated strong associations between RSS on day of life 30 and survival (P = 0.002) and length of ventilation after day of life 30 (P < 0.001). RSS ≥ 6 on day of life 30 is associated with higher mortality and longer period of mechanical ventilation in premature infants requiring mechanical ventilation through 30 days of life. © 2014 Wiley Periodicals, Inc.

  12. Increased mortality in amateur radio operators due to lymphatic and hematopoietic malignancies

    SciTech Connect

    Milham, S. Jr.

    1988-01-01

    To search for potentially carcinogenic effects of electromagnetic field exposures, the author conducted a population-based study of mortality in US amateur radio operators. Ascertainment of Washington State and California amateur radio operators (67,829 persons) was done through the 1984 US Federal Communications Commission Amateur Radio Station and/or Operator License file. A total of 2485 deaths were located for the period from January 1, 1979 through December 31, 1984, in a population of amateur radio operators which accumulated 232,499 person-years at risk. The all-cause standardized mortality ratio (SMR) was 71, but a statistically significant increased mortality was seen for cancers of the other lymphatic tissues (SMR = 162), a rubric which includes multiple myeloma and non-Hodgkin's lymphomas. The all-leukemia standardized mortality ratio was slightly, but nonsignificantly, elevated (SMR = 124). However, mortality due to acute myeloid leukemia was significantly elevated (SMR = 176).

  13. [Analysis of the impact of mortality due to suicides in Mexico, 2000-2012].

    PubMed

    Dávila Cervantes, Claudio Alberto; Ochoa Torres, María del Pilar; Casique Rodríguez, Irene

    2015-12-01

    The objective of this study was to analyze the burden of disease due to suicide in Mexico using years of life lost (YLL) between 2000 and 2012 by sex, age group (for those under 85 years of age) and jurisdiction. Vital statistics on mortality and population estimates were used to calculate standardized mortality rates and years of life lost due to suicide. Between 2000 and 2012 a sustained increase in the suicide mortality rate was observed in Mexico. The age group with the highest rate was 85 years of age or older for men, and 15-19 years of age for women. The highest impact in life expectancy due to suicide occurred at 20 to 24 years of age in men and 15 to 19 years of age in women. The states with the highest mortality due to suicide were located in the Yucatan Peninsula (Yucatan, Quintana Roo and Campeche). Mortality due to suicide in Mexico has increased continually. As suicides are preventable, the implementation of health public policies through timely identification, integral prevention strategies and the detailed study of associated risk factors is imperative.

  14. [Motives of requirement for health care consultations and factors associated to mortality due to poisoning].

    PubMed

    Villa-Manzano, Alberto Iram; Lamas-Flores, Sofía; Méndez-Cervantes, Diana; Villa-Manzano, Rebeca; Cabrera-Pivaral, Carlos E; Rojo-Contreras, Wendoline

    2009-01-01

    The poisoning is a public health problem. This problem requires continuous evaluation to decrease it. Our objective was to identify causes of requirement for health care consults and factors associated to mortality due to poisoning. We assessed the requirements for health care consults during one year and the outcomes of these consultations in a center of toxicology. Odds ratios (OR) were used as risk estimator. There were 3116 consultations due to poisons. From these 79% required hospitalization. The identified causes were: be bite and wound inflected by poisonous animals in 57 % (44 % of these were due to scorpions); medications in 15 %; agrochemicals in 5 % and in 4 % prohibit substances (marihuana or cocaine). A poisoning caused by suicidal attempt was observed in 28 %. Mortality rate was 3/1000, and the mortality rate for suicidal attempt was 0.7 % meaning an OR = 6 (95 % CI = 1.3 to 31) compared with the overall mortality rate. The most frequent cause of mortality was organophosphorates poisoning (OR = 30, 95 % CI = 2.86-759). The poisoning secondary to animals represented the most frequent cause for consultation. The suicidal attempt and organophosphorates intoxication were associated with higher mortality.

  15. Mortality Due to Malignant and Non-Malignant Diseases in Korean Professional Emergency Responders

    PubMed Central

    Ahn, Yeon-Soon; Jeong, Kyoung Sook

    2015-01-01

    Objective This study was conducted to estimate the cause-specific mortality in male emergency responders (ER), compare with that of Korean men. Mortality was also compared between more experienced firefighters (i.e., firefighters employed ≥20 years and firefighters employed ≥10 to <20 years) and less experienced firefighters and non-firefighters (i.e., firefighters employed <10 years and non-firefighters) to investigate associations between mortality and exposure to occupational hazards. Methods The cohort was comprised of 33,442 males who were employed as ERs between 1980 and 2007 and not deceased as of 1991. Work history was merged with the death registry from the National Statistical Office of Korea to follow-up on mortality between 1992 and 2007. Standardized mortality ratios (SMR) for ERs were calculated in reference to the Korean male population. Adjusted relative risks (ARRs) of mortalities for firefighters employed ≥20 years and ≥10 years to <20 years were calculated in reference to non-firefighters and firefighters employed < 10 years. Results Overall (SMR=0.43, 95%CI=0.39–0.47) and some kinds of cause-specific mortalities were significantly lower among ERs compared with the Korean male population. No significant increase in mortality was observed across the major ICD-10 classifications among ERs. Mortality due to exposure to smoke, fire, and flames (SMR=3.11, 95% CI=1.87–4.85), however, was significantly increased among ERs. All-cause mortality (ARR=1.46, 95% CI=1.13–1.89), overall cancer mortality (ARR=1.54, 95% CI=1.02–2.31) and mortality of external injury, poisoning and external causes (ARR=3.13, 95% CI=1.80–5.46) were significantly increased among firefighters employed ≥20 years compared to those of non-firefighters and firefighters employed < 10 years. Conclusions An increase in mortality due to all cancer and external injury, poisoning, and external causes in firefighters employed ≥20 years compared with non-firefighters and

  16. Analysis of mortality trends due to cardiovascular diseases in Panama, 2001–2014

    PubMed Central

    Carrión Donderis, María; Moreno Velásquez, Ilais; Castro, Franz; Zúñiga, Julio; Gómez, Beatriz; Motta, Jorge

    2016-01-01

    Objective Cardiovascular diseases (CVDs) are still the leading cause of death worldwide despite the recent decline in mortality rates attributable to CVD in Western Europe and the Americas. The aim of this study is to investigate mortality trends due to ischaemic heart disease (IHD) and stroke in Panama from 2001 to 2014, as well as the mortality differences by sex and age groups. Methods Data were obtained from the National Mortality Register. The International Classification of Diseases 10th revision codes (ICD-10) I20–I25 and I60–I69 were used for IHD and stroke, respectively. Age-adjusted mortality rates were calculated using the world population of the WHO as standard. Trends were analysed using Joinpoint Regression Program and annual percentage changes (APC) were estimated. Results From 2010, the IHD mortality trend began to decline in the whole population of Panama (APC −4.7%, p<0.05). From 2001 to 2014, a decline in the trend for IHD mortality was observed (APC −1.7%, p<0.05) in women, but not in men. Stroke mortality showed a significant annual decline during the study period (APC −3.8%, p<0.05) and it was more pronounced in women (APC −4.5%, p<0.05) than in men (APC −3.3%, p<0.05). Conclusions In Panama, the mortality rates from IHD and stroke have declined in recent years. Better access to healthcare, improved treatment of acute IHD and stroke, low tobacco consumption and better control of hypertension probably account for a significant part of this mortality reduction. PMID:28123756

  17. Occupation and smoking adjusted mortality due to asthma among Swedish men.

    PubMed

    Torén, K; Hörte, L G; Järvholm, B

    1991-05-01

    The study aims to survey the mortality from asthma in different occupations among Swedish men. The design was a register based cohort study where the smoking adjusted mortality due to asthma among Swedish men 1971-80 was investigated. For each occupation a smoking adjusted standardised mortality ratio (SMR) was calculated based on a linkage between official mortality statistics 1971-80 and occupational information in the 1970 national census. The information about the smoking habits among different occupations was obtained from a smoking survey carried out in 1963. In the statistical analysis only occupations with more than 10 deaths were considered. A significantly increased mortality from asthma was found among farmers (smoking adjusted SMR 137, 95% confidence interval (95% CI) 115-156), farm workers (smoking adjusted SMR 170, 95% CI 107-235), woodworking machine operators (smoking adjusted SMR 226, 95% CI 108-344), clerical workers (smoking adjusted SMR 161, 95% CI 102-220), packers and labellers (smoking adjusted SMR 144, 95% CI 100-188), and watchmen (smoking adjusted SMR 212, 95% CI 104-320). Exposure to organic dust, such as fresh wood dust and dusts in the farming environment, may cause increased mortality due to asthma.

  18. Occupation and smoking adjusted mortality due to asthma among Swedish men.

    PubMed Central

    Torén, K; Hörte, L G; Järvholm, B

    1991-01-01

    The study aims to survey the mortality from asthma in different occupations among Swedish men. The design was a register based cohort study where the smoking adjusted mortality due to asthma among Swedish men 1971-80 was investigated. For each occupation a smoking adjusted standardised mortality ratio (SMR) was calculated based on a linkage between official mortality statistics 1971-80 and occupational information in the 1970 national census. The information about the smoking habits among different occupations was obtained from a smoking survey carried out in 1963. In the statistical analysis only occupations with more than 10 deaths were considered. A significantly increased mortality from asthma was found among farmers (smoking adjusted SMR 137, 95% confidence interval (95% CI) 115-156), farm workers (smoking adjusted SMR 170, 95% CI 107-235), woodworking machine operators (smoking adjusted SMR 226, 95% CI 108-344), clerical workers (smoking adjusted SMR 161, 95% CI 102-220), packers and labellers (smoking adjusted SMR 144, 95% CI 100-188), and watchmen (smoking adjusted SMR 212, 95% CI 104-320). Exposure to organic dust, such as fresh wood dust and dusts in the farming environment, may cause increased mortality due to asthma. PMID:2039744

  19. Increasing U.S. Mortality Due to Accidental Poisoning: The Role of the Baby Boom Cohort

    PubMed Central

    Miech, Richard; Koester, Steve; Dorsey-Holliman, Brook

    2014-01-01

    Aims In this study we examine whether the recent, sharp increase in mortality due to accidental poisoning since the year 2000 is the result of the aging of the baby boom cohort, or instead, a historical trend apparent among decedents of all ages. Design We conduct an age-period-cohort analysis using data from the U.S. Vital Statistics and the U.S. Census covering the period 1968–2007. Setting and Participants The United States population aged 15–64. Findings The increase in mortality due to accidental poisoning since the year 2000 stems primarily from a historical period effect across all ages for whites, but results in large part from a rate spike in the baby boom cohort among blacks. For all demographic groups baby boomers had higher odds of death due to accidental poisoning than the cohorts that came before them and after them. Historical influences acting across all ages led to an increase in accidental poisoning mortality that was almost tenfold for whites and threefold for blacks over the study period. Conclusions While the recent, sharp increase in accidental poisoning mortality stems in part from the aging of the baby boom cohort, substantially more of the increase results from influences unique to recent years that have affected all age groups. These results point to the need to bolster overdose prevention programs and policies as the historical increase in accidental poisoning mortality appears to continue unabated. PMID:21205051

  20. [Trend in inequalities in mortality due to external causes among the municipalities of Antioquia (Colombia)].

    PubMed

    Caicedo-Velásquez, Beatriz; Álvarez-Castaño, Luz Stella; Marí-Dell'Olmo, Marc; Borrell, Carme

    2016-01-01

    To analyse the trend in inequalities in mortality due to external causes among municipalities in Antioquia, department of Colombia, from 2000 to 2010, and its association with socioeconomic conditions. External causes included violent deaths, such as homicides, suicides and traffic accidents, among others. Ecological design of mortality trends, with the 125 municipalities of Antioquia as the unit of analysis. The age-adjusted smoothed standardized mortality ratio (SMR) was estimated for each of the municipalities by using an empirical Bayesian model. Differences in the SMR between the poorest and least poor municipalities were estimated by using a two-level hierarchical model (level-1: year, level-2: municipality). Mortality due to external causes showed a downward trend in the department in the period under review, although the situation was not similar in all municipalities. The findings showed that the risk of death from external causes significantly increased in poor and underdeveloped municipalities. Intervention is required through policies that take into account local differences in mortality due to external causes. Copyright © 2016 SESPAS. Published by Elsevier Espana. All rights reserved.

  1. Trends of mortality due to septicemia in Greece: an 8-year analysis.

    PubMed

    Falagas, Matthew E; Korbila, Ioanna P; Kapaskelis, Anastasios; Manousou, Kyriaki; Leontiou, Lili; Tansarli, Giannoula S

    2013-01-01

    Infectious diseases are among the major causes of death worldwide. We evaluated the trends of mortality due to septicemia in Greece and compared it with mortality due to other infections. Data on mortality stratified by cause of death during 2003-2010 was obtained from the Hellenic Statistical Authority. Deaths caused by infectious diseases were grouped by site of infection and analyzed using SPSS 17.0 software. 45,451 deaths due to infections were recorded in Greece during the 8-year period of time, among which 12.2% were due to septicemia, 69.7% pneumonia, 1.5% pulmonary tuberculosis, 0.2% influenza, 0.5% other infections of the respiratory tract, 7.9% intra-abdominal infections (IAIs), 2.5% urinary tract infections (UTIs), 2.2% endocarditis or pericarditis or myocarditis, 1.6% hepatitis, 1% infections of the central nervous system, and 0.7% other infections. A percentage of 99.4% of deaths due to septicemia were caused by bacteria that were not reported on the death certificate (noted as indeterminate septicemia). More deaths due to indeterminate septicemia were observed during 2007-2010 compared to 2003-2006 (3,558 versus 1,966; p<0.05). Despite the limitations related to the quality of death certificates, this study shows that the mortality rate due to septicemia has almost doubled after 2007 in Greece. Proportionally, septicemia accounted for a greater increase in the mortality rate within the infectious causes of death for the same period of time. The emergence of resistance could partially explain this alarming phenomenon. Therefore, stricter infection control measures should be urgently applied in all Greek healthcare facilities.

  2. National mortality burden due to communicable, non-communicable, and other diseases in Ethiopia, 1990-2015: findings from the Global Burden of Disease Study 2015.

    PubMed

    Misganaw, Awoke; Haregu, Tilahun N; Deribe, Kebede; Tessema, Gizachew Assefa; Deribew, Amare; Melaku, Yohannes Adama; Amare, Azmeraw T; Abera, Semaw Ferede; Gedefaw, Molla; Dessalegn, Muluken; Lakew, Yihunie; Bekele, Tolesa; Mohammed, Mesoud; Yirsaw, Biruck Desalegn; Damtew, Solomon Abrha; Krohn, Kristopher J; Achoki, Tom; Blore, Jed; Assefa, Yibeltal; Naghavi, Mohsen

    2017-01-01

    Ethiopia lacks a complete vital registration system that would assist in measuring disease burden and risk factors. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015) estimates to describe the mortality burden from communicable, non-communicable, and other diseases in Ethiopia over the last 25 years. GBD 2015 mainly used cause of death ensemble modeling to measure causes of death by age, sex, and year for 195 countries. We report numbers of deaths and rates of years of life lost (YLL) for communicable, maternal, neonatal, and nutritional (CMNN) disorders, non-communicable diseases (NCDs), and injuries with 95% uncertainty intervals (UI) for Ethiopia from 1990 to 2015. CMNN causes of death have declined by 65% in the last two-and-a-half decades. Injury-related causes of death have also decreased by 70%. Deaths due to NCDs declined by 37% during the same period. Ethiopia showed a faster decline in the burden of four out of the five leading causes of age-standardized premature mortality rates when compared to the overall sub-Saharan African region and the Eastern sub-Saharan African region: lower respiratory infections, tuberculosis, HIV/AIDS, and diarrheal diseases; however, the same could not be said for ischemic heart disease and other NCDs. Non-communicable diseases, together, were the leading causes of age-standardized mortality rates, whereas CMNN diseases were leading causes of premature mortality in 2015. Although lower respiratory infections, tuberculosis, and diarrheal disease were the leading causes of age-standardized death rates, they showed major declines from 1990 to 2015. Neonatal encephalopathy, iron-deficiency anemia, protein-energy malnutrition, and preterm birth complications also showed more than a 50% reduction in burden. HIV/AIDS-related deaths have also decreased by 70% since 2005. Ischemic heart disease, hemorrhagic stroke, and ischemic stroke were among the top causes of premature mortality and age

  3. National mortality burden due to communicable, non-communicable, and other diseases in Ethiopia, 1990-2015: findings from the Global Burden of Disease Study 2015.

    PubMed

    Misganaw, Awoke; Haregu, Tilahun N; Deribe, Kebede; Tessema, Gizachew Assefa; Deribew, Amare; Melaku, Yohannes Adama; Amare, Azmeraw T; Abera, Semaw Ferede; Gedefaw, Molla; Dessalegn, Muluken; Lakew, Yihunie; Bekele, Tolesa; Mohammed, Mesoud; Yirsaw, Biruck Desalegn; Damtew, Solomon Abrha; Krohn, Kristopher J; Achoki, Tom; Blore, Jed; Assefa, Yibeltal; Naghavi, Mohsen

    2017-07-21

    Ethiopia lacks a complete vital registration system that would assist in measuring disease burden and risk factors. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015) estimates to describe the mortality burden from communicable, non-communicable, and other diseases in Ethiopia over the last 25 years. GBD 2015 mainly used cause of death ensemble modeling to measure causes of death by age, sex, and year for 195 countries. We report numbers of deaths and rates of years of life lost (YLL) for communicable, maternal, neonatal, and nutritional (CMNN) disorders, non-communicable diseases (NCDs), and injuries with 95% uncertainty intervals (UI) for Ethiopia from 1990 to 2015. CMNN causes of death have declined by 65% in the last two-and-a-half decades. Injury-related causes of death have also decreased by 70%. Deaths due to NCDs declined by 37% during the same period. Ethiopia showed a faster decline in the burden of four out of the five leading causes of age-standardized premature mortality rates when compared to the overall sub-Saharan African region and the Eastern sub-Saharan African region: lower respiratory infections, tuberculosis, HIV/AIDS, and diarrheal diseases; however, the same could not be said for ischemic heart disease and other NCDs. Non-communicable diseases, together, were the leading causes of age-standardized mortality rates, whereas CMNN diseases were leading causes of premature mortality in 2015. Although lower respiratory infections, tuberculosis, and diarrheal disease were the leading causes of age-standardized death rates, they showed major declines from 1990 to 2015. Neonatal encephalopathy, iron-deficiency anemia, protein-energy malnutrition, and preterm birth complications also showed more than a 50% reduction in burden. HIV/AIDS-related deaths have also decreased by 70% since 2005. Ischemic heart disease, hemorrhagic stroke, and ischemic stroke were among the top causes of premature mortality and age

  4. Cause-Specific Mortality Due to Malignant and Non-Malignant Disease in Korean Foundry Workers

    PubMed Central

    Yoon, Jin-Ha; Ahn, Yeon-Soon

    2014-01-01

    Background Foundry work is associated with serious occupational hazards. Although several studies have investigated the health risks associated with foundry work, the results of these studies have been inconsistent with the exception of an increased lung cancer risk. The current study evaluated the mortality of Korean foundry workers due to malignant and non-malignant diseases. Methods This study is part of an ongoing investigation of Korean foundry workers. To date, we have observed more than 150,000 person-years in male foundry production workers. In the current study, we stratified mortality ratios by the following job categories: melting-pouring, molding-coremaking, fettling, and uncategorized production work. We calculated standard mortality ratios (SMR) of foundry workers compare to general Korean men and relative risk (RR) of mortality of foundry production workers reference to non-production worker, respectively. Results Korean foundry production workers had a significantly higher risk of mortality due to malignant disease, including stomach (RR: 3.96; 95% CI: 1.41–11.06) and lung cancer (RR: 2.08; 95% CI: 1.01–4.30), compared with non-production workers. High mortality ratios were also observed for non-malignant diseases, including diseases of the circulatory (RR: 1.92; 95% CI: 1.18–3.14), respiratory (RR: 1.71; 95% CI: 1.52–21.42 for uncategorized production worker), and digestive (RR: 2.27; 95% CI: 1.22–4.24) systems, as well as for injuries (RR: 2.36; 95% CI: 1.52–3.66) including suicide (RR: 3.64; 95% CI: 1.32–10.01). Conclusion This study suggests that foundry production work significantly increases the risk of mortality due to some kinds of malignant and non-malignant diseases compared with non-production work. PMID:24505454

  5. Ranolazine is an Effective and Safe Treatment of Adults with Symptomatic Premature Ventricular Contractions due to Triggered Ectopy.

    PubMed

    Murray, Gary L

    2016-12-01

    Early and delayed afterdepolarizations (EAD/DAD) cause triggered ventricular ectopy. Because ranolazine (RAN) suppresses EAD/DAD, we postulated that RAN might be effective in reducing premature ventricular contractions (PVCs). To assess the effect of RAN in patients with symptomatic PVCs due to triggered ectopy and its safety and tolerability. A total of 59 patients with symptomatic PVCs were identified from full-disclosure Holters. Doses of 500 and 1,000 mg offlabel RAN, daily, were given to 34 and 66% patients, respectively, and repeat Holters were performed prospectively during mean followup of 3.1 months. The two Holters were retrospectively compared. Congestive heart failure (CHF) was defined as symptoms including dyspnea, orthopnea, paroxysmal nocturnal dyspnea, and fatigue, with a brain natriuretic peptide > 400. Systolic (heart failure with reduced ejection fraction) versus diastolic (heart failure with preserved ejection fraction, HFpEF) CHF depended upon an echocardiographic left ventricular ejection fraction (LVEF) at least 50% by apical two- and four-chamber Simpson's method (HFpEF). The mean age of the patients was 63 years, 60% were males, mean left ventricular ejection fraction was 60%, with 34% having coronary artery disease, 73% were hypertensive, 24% had type 2 diabetic, and 34% were on beta blockers. Upon repeat Holters at a mean of 3.1 months after initiating RAN, 95% (56/59) of the patients had their PVC count reduced as follows: 24% (14/59) had more than 90% decrease, 34% (20/59) had 71 to 90% decrease, and 17% (10/59) had 50 to 70% decrease. In the entire group, RAN reduced PVCs by 71% (mean: 13,329 to 3,837; p < 0.001). Ventricular bigeminy was reduced by 80% (4,168 to 851; p < 0.001), ventricular coupletswere reduced by 78% (374 to 81; p < 0.001), and ventricular tachycardiawas reduced by 91% (56 to 5; p < 0.001). The PVC reduction was dose dependent. Off-label RAN offers an effective and safe pharmacologic treatment for

  6. Childhood IQ in relation to risk factors for premature mortality in middle-aged persons: the Aberdeen Children of the 1950s study.

    PubMed

    Batty, G David; Deary, Ian J; Macintyre, Sally

    2007-03-01

    A series of studies have shown an association between high childhood IQ scores and reduced rates of total mortality in adulthood. Several mechanisms have been advanced to explain these relationships, including mediation via established risk factors. This study examines the association between childhood IQ and a range of established physiological and behavioural risk factors for premature mortality in adulthood. In 1962, 12,150 children took part in a school-based survey when their IQ scores were extracted from educational records. When re-surveyed forty years later (n = 7183; 63.7% response), they self-reported information on risk factors for premature mortality (smoking, heavy alcohol consumption, obesity, height, hypertension and diabetes). In sex-adjusted analyses based on an analytical sample of 5340 (2687 women), higher childhood IQ scores were associated with a decreased prevalence of ever having smoked regularly in adulthood (OR(per SD increase in IQ) (95% CI): 0.77 (0.73 to 0.81)), heavy alcohol consumption (0.89 (0.84 to 0.94)), obesity (0.78 (0.72 to 0.83)) and overweight (0.86 (0.81 to 0.91)). Higher IQ scores were similarly related to a reduced prevalence of short stature and higher rates of smoking cessation in smokers; effects that were stronger in women (p value for interaction: < or =0.04). Adjusting for indicators of early and, particularly, later-life socioeconomic circumstances led to heavy attenuation of these gradients with statistical significance at conventional levels lost in most analyses. The IQ-risk factor gradients reported may offer some insights into the apparent link between high pre-adult IQ and reduced mortality rates.

  7. Effect of job loss due to plant closure on mortality and hospitalization.

    PubMed

    Browning, Martin; Heinesen, Eskil

    2012-07-01

    We investigate whether job loss due to plant closure causes an increased risk of (cause-specific) mortality and hospitalization for male workers having strong labour market attachment. We use administrative data: a panel of all persons in Denmark in the period 1980-2006, containing records on health and work status, and a link from workers to plants. We use propensity score weighting combined with non-parametric duration analysis. We find that job loss increases the risk of overall mortality and mortality caused by circulatory disease; of suicide and suicide attempts; and of death and hospitalization due to traffic accidents, alcohol-related disease, and mental illness. Copyright © 2012 Elsevier B.V. All rights reserved.

  8. Projection of future temperature-related mortality due to climate and demographic changes.

    PubMed

    Lee, Jae Young; Kim, Ho

    2016-09-01

    Understanding the effects of global climate change from both environmental and human health perspectives has gained great importance. Particularly, studies on the direct effect of temperature increase on future mortality have been conducted. However, few of those studies considered population changes, and although the world population is rapidly aging, no previous study considered the effect of society aging. Here we present a projection of future temperature-related mortality due to both climate and demographic changes in seven major cities of South Korea, a fast aging country, until 2100; we used the HadGEM3-RA model under four Representative Concentration Pathway (RCP) scenarios (RCP 2.6, 4.5, 6.0, and 8.5) and the United Nations world population prospects under three fertility scenarios (high, medium, and low). The results showed markedly increased mortality in the elderly group, significantly increasing the overall future mortality. In 2090s, South Korea could experience a four- to six-time increase in temperature-related mortality compared to that during 1992-2010 under four different RCP scenarios and three different fertility variants, while the mortality is estimated to increase only by 0.5 to 1.5 times assuming no population aging. Therefore, not considering population aging may significantly underestimate temperature risks.

  9. Analysis of the female mortality trend due to assault in Brazil, States and Regions.

    PubMed

    Leite, Franciele Marabotti Costa; Mascarello, Keila Cristina; Almeida, Ana Paula Santana Coelho; Fávero, Juliana Lopes; Santos, Andréia Soprani Dos; Silva, Inácio Crochemore Mohnsam da; Wehrmeister, Fernando César

    2017-09-01

    This study aimed to analyze time trend of female mortality due to assault in Brazil, regions and states from 2002 to 2012. This is an ecological times series study with secondary data from women aged 20-59 years who died due to assault. Mortality rates were analyzed by simple linear regression and stratified by region, Gini Index and Human Development Index (HDI). The trend of female rate of mortality due to assault was stable in the country, with differences between states and regions. The Midwest had the highest rates and stagnation trend. There was an increased trend in the North, Northeast and South and a decreased trend in the Southeast. The states of the tertile with the highest HDI evidenced a declining trend and stabilization in the first and second tertiles. An increased mortality rate was recorded in states with greater social inequality. Notwithstanding the national stabilization behavior, results point to the need for social policies appropriate to the specificities of states and regions.

  10. Mortality due to Japanese oak wilt disease and surrounding forest compositions.

    PubMed

    Oguro, Michio; Imahiro, Sawako; Saito, Shoichi; Nakashizuka, Tohru

    2015-12-01

    Japanese oak wilt (Raffaelea quercivora) is a vector-borne disease transmitted by the flying ambrosia beetle, Platypus quercivorus, and causes mass mortality in the fagaceous species of Japan. The data described in this article are available in Mendeley Data, DOI: 10.17632/xwj98nb39r.1 [1] and include the mortality status of 1089 Quercus crispula and 846 Quercus serrata trees and surrounding forest conditions. The findings using this dataset were published in M. Oguro, S. Imahiro, S. Saito, T. Nakashizuka, Relative importance of multiple scale factors to oak tree mortality due to Japanese oak wilt disease, For. Ecol. Manag. (2015) doi:10.1016/j.foreco.2015.07.016 [2].

  11. The impact of past and future climate change on global human mortality due to ozone and PM2.5 outdoor air pollution

    NASA Astrophysics Data System (ADS)

    Silva, R.; West, J.; Anenberg, S.; Lamarque, J.; Shindell, D. T.; Bergmann, D. J.; Berntsen, T.; Cameron-Smith, P. J.; Collins, B.; Ghan, S. J.; Josse, B.; Nagashima, T.; Naik, V.; Plummer, D.; Rodriguez, J. M.; Szopa, S.; Zeng, G.

    2012-12-01

    Climate change can adversely affect air quality, through changes in meteorology, atmospheric chemistry, and emissions. Future changes in air pollutant emissions will also profoundly influence air quality. These changes in air quality can affect human health, as exposure to ground-level ozone and fine particulate matter (PM2.5) has been associated with premature human mortality. Here we will quantify the global mortality impacts of past and future climate change, considering the effects of climate change on air quality isolated from emission changes. The Atmospheric Chemistry and Climate Model Intercomparison Project (ACCMIP) has simulated the past and future surface concentrations of ozone and PM2.5 from each of several GCMs, for emissions from 1850 ("preindustrial") to 2000 ("present-day"), and for the IPCC AR5 Representative Concentration Pathways (RCPs) scenarios to 2100. We will use ozone and PM2.5 concentrations from simulations from five or more global models of atmospheric dynamics and chemistry, for a base year (present-day), pre-industrial conditions, and future scenarios, considering changes in climate and emissions. We will assess the mortality impacts of past climate change by using one simulation ensemble with present emissions and climate and one with present emissions but 1850 climate. We will similarly quantify the potential impacts of future climate change under the four RCP scenarios in 2030, 2050 and 2100. All model outputs will be regridded to the same resolution to estimate multi-model medians and range in each grid cell. Resulting premature deaths will be calculated using these medians along with epidemiologically-derived concentration-response functions, and present-day or future projections of population and baseline mortality rates, considering aging and transitioning disease rates over time. The spatial distributions of current and future global premature mortalities due to ozone and PM2.5 outdoor air pollution will be presented separately

  12. Mortality of Rocky Mountain elk in Michigan due to meningeal worm.

    PubMed

    Bender, Louis C; Schmitt, Stephen M; Carlson, Elaine; Haufler, Jonathan B; Beyer, Dean E

    2005-01-01

    Mortality from cerebrospinal parelaphostrongylosis caused by the meningeal worm (Parelaphostrongylus tenuis) has been hypothesized to limit elk (Cervus elaphus nelsoni) populations in areas where elk are conspecific with white-tailed deer (Odocoileus virginianus). Elk were reintroduced into Michigan (USA) in the early 1900s and subsequently greatly increased population size and distribution despite sympatric high-density (>or=12/km2) white-tailed deer populations. We monitored 100 radio-collared elk of all age and sex classes from 1981-94, during which time we documented 76 mortalities. Meningeal worm was a minor mortality factor for elk in Michigan and accounted for only 3% of mortalities, fewer than legal harvest (58%), illegal kills (22%), other diseases (7%), and malnutrition (4%). Across years, annual cause-specific mortality rates due to cerebrospinal parelaphostrongylosis were 0.033 (SE=0.006), 0.029 (SE=0.005), 0.000 (SE=0.000), and 0.000 (SE=0.000) for calves, 1-yr-old, 2-yr-old, and >or=3-yr-old, respectively. The overall population-level mortality rate due to cerebrospinal parelaphostrongylosis was 0.009 (SE=0.001). Thus, meningeal worm had little impact on elk in Michigan during our study despite greater than normal precipitation (favoring gastropods) and record (>or=14 km2) deer densities. Further, elk in Michigan have shown sustained population rates-of-increase of >or=18%/yr and among the highest levels of juvenile production and survival recorded for elk in North America, indicating that elk can persist in areas with meningeal worm at high levels of population productivity. It is likely that local ecologic characteristics among elk, white-tailed deer, and gastropods, and degree of exposure, age of elk, individual and population experience with meningeal worm, overall population vigor, and moisture determine the effects of meningeal worm on elk populations.

  13. Mortality of rocky mountain elk in Michigan due to meningeal worm

    USGS Publications Warehouse

    Bender, L.C.; Schmitt, S.M.; Carlson, E.; Haufler, J.B.; Beyer, D.E.

    2005-01-01

    Mortality from cerebrospinal parelaphostrongylosis caused by the meningeal worm (Parelaphostrongylus tenuis) has been hypothesized to limit elk (Cervus elaphus nelsoni) populations in areas where elk are conspecific with white-tailed deer (Odocoileus virginianus). Elk were reintroduced into Michigan (USA) in the early 1900s and subsequently greatly increased population size and distribution despite sympatric high-density (???12/km2) white-tailed deer populations. We monitored 100 radio-collared elk of all age and sex classes from 1981-94, during which time we documented 76 mortalities. Meningeal worm was a minor mortality factor for elk in Michigan and accounted for only 3% of mortalities, fewer than legal harvest (58%), illegal kills (22%), other diseases (7%), and malnutrition (4%). Across years, annual cause-specific mortality rates due to cerebrospinal parelaphostrongylosis were 0.033 (SE=0.006), 0.029 (SE=0.005), 0.000 (SE=0.001), and 0.000 (SE=0.000) for calves, 1-yr-old, 2-yr-old, and ???3-yr-old, respectively. The overall population-level mortality rate due to cerebrospinal parelaphostrongylosis was 0.009 (SE=0.001). Thus, meningeal worm had little impact on elk in Michigan during our study despite greater than normal precipitation (favoring gastropods) and record (???14 km2) deer densities. Further, elk in Michigan have shown sustained population rates-of-increase of ???18%/yr and among the highest levels of juvenile production and survival recorded for elk in North America, indicating that elk can persist in areas with meningeal worm at high levels of population productivity. it is likely that local ecologic characteristics among elk, white-tailed deer, and gastropods, and degree of exposure, age of elk, individual and population experience with meningeal worm, overall population vigor, and moisture determine the effects of meningeal worm on elk populations. ?? Wildlife Disease Association 2005.

  14. Underestimation of mortality due to chronic obstructive pulmonary disease (COPD) in Kentucky.

    PubMed

    Hughes, Therese S; Muldoon, Susan B; Tollerud, David J

    2006-08-01

    Chronic obstructive pulmonary disease (COPD) mortality may be underestimated because it is frequently listed as a contributory cause of death, rather then the underlying cause of death, on state death certificates. Contributory causes of death are not counted in mortality statistics. This may underestimate the true burden of disease. Determine the frequency in which COPD is listed as a contributory cause of death, rather than the underlying cause of death, per state mortality records for a one-year period, year 2000. 15,036 mortality records from Kentucky death certificates were examined for year 2000 for all deaths due to diseases most often associated with COPD; notably, heart disease, pneumonia/influenza, and asthma. Cases in which COPD was listed as a contributory cause of death for asthma, pneumonia and influenza was small (less than 1%). Cases in which COPD was listed as a contributory cause of death for heart disease was much higher at 6.8% (824 out of 12,084). Counting these cases increases the COPD age-adjusted mortality rate 39%, from 52.4 to 72.7/ 100,000 people. This study provided evidence to generate and support the hypothesis that COPD mortality is underestimated in Kentucky when the underlying cause of death is heart disease, thus underestimating the true burden of disease. COPD is a chronic, often severe disease commonly associated with comorbid conditions such as heart disease that ultimately lead to death, but which may not be accurately reflected in mortality statistics. Accurate reporting is essential for health planning, education, research, and treatment options.

  15. Increases in external cause mortality due to high and low temperatures: evidence from northeastern Europe

    NASA Astrophysics Data System (ADS)

    Orru, Hans; Åström, Daniel Oudin

    2017-05-01

    The relationship between temperature and mortality is well established but has seldom been investigated in terms of external causes. In some Eastern European countries, external cause mortality is substantial. Deaths owing to external causes are the third largest cause of mortality in Estonia, after cardiovascular disease and cancer. Death rates owing to external causes may reflect behavioural changes among a population. The aim for the current study was to investigate if there is any association between temperature and external cause mortality, in Estonia. We collected daily information on deaths from external causes (ICD-10 diagnosis codes V00-Y99) and maximum temperatures over the period 1997-2013. The relationship between daily maximum temperature and mortality was investigated using Poisson regression, combined with a distributed lag non-linear model considering lag times of up to 10 days. We found significantly higher mortality owing to external causes on hot (the same and previous day) and cold days (with a lag of 1-3 days). The cumulative relative risks for heat (an increase in temperature from the 75th to 99th percentile) were 1.24 (95% confidence interval, 1.14-1.34) and for cold (a decrease from the 25th to 1st percentile) 1.19 (1.03-1.38). Deaths due to external causes might reflect changes in behaviour among a population during periods of extreme hot and cold temperatures and should therefore be investigated further, because such deaths have a severe impact on public health, especially in Eastern Europe where external mortality rates are high.

  16. Increases in external cause mortality due to high and low temperatures: evidence from northeastern Europe

    NASA Astrophysics Data System (ADS)

    Orru, Hans; Åström, Daniel Oudin

    2016-11-01

    The relationship between temperature and mortality is well established but has seldom been investigated in terms of external causes. In some Eastern European countries, external cause mortality is substantial. Deaths owing to external causes are the third largest cause of mortality in Estonia, after cardiovascular disease and cancer. Death rates owing to external causes may reflect behavioural changes among a population. The aim for the current study was to investigate if there is any association between temperature and external cause mortality, in Estonia. We collected daily information on deaths from external causes (ICD-10 diagnosis codes V00-Y99) and maximum temperatures over the period 1997-2013. The relationship between daily maximum temperature and mortality was investigated using Poisson regression, combined with a distributed lag non-linear model considering lag times of up to 10 days. We found significantly higher mortality owing to external causes on hot (the same and previous day) and cold days (with a lag of 1-3 days). The cumulative relative risks for heat (an increase in temperature from the 75th to 99th percentile) were 1.24 (95% confidence interval, 1.14-1.34) and for cold (a decrease from the 25th to 1st percentile) 1.19 (1.03-1.38). Deaths due to external causes might reflect changes in behaviour among a population during periods of extreme hot and cold temperatures and should therefore be investigated further, because such deaths have a severe impact on public health, especially in Eastern Europe where external mortality rates are high.

  17. [Mortality and hospital utilization due to breast cancer in Extremadura, Spain (2002-2004)].

    PubMed

    López-Jurado, Casimiro Fermin; Martínez-Sánchez, Jose Maria; Anes Del Amo, Yolanda; Ramos-Aceitero, Julian Mauro

    2008-01-01

    To provide an update on breast cancer mortality and hospital utilization in the autonomous region of Extremadura (Spain). We performed a retrospective, cross-sectional study of breast cancer in Extremadura, using the minimum data set and the death register as data sources. The means and standard deviation (SD) are presented. Crude, age-specific, and standardized mortality rates were calculated and expressed as rates per 100,000 women. The potential years of life lost were also calculated. In the period studied, there were 413 deaths, 1,233 hospital admissions, and 1,809 discharges due to malignant breast disease. The mean age at the time of death and hospital discharge was 70.0 years (SD 14.9) and 59.9 years (SD 14.3), respectively. The mean length of hospital stay was 8.9 days (SD 6.3). A total of 3,423 potential years of life were lost. The highest mortality rates of breast cancer were observed in the health area of Llerena and the lowest in the health area of Coria. The pattern of breast cancer mortality in Extremadura is typical of developed countries with higher mortality among older age groups. The aged-adjusted rate in Extremadura is lower than that in Spain for the period 1996-2000.

  18. Pregnancy-related deaths due to pulmonary embolism: findings from two state-based mortality reviews.

    PubMed

    Heyl, Peter S; Sappenfield, William M; Burch, Deborah; Hernandez, Leticia E; Kavanaugh, Victoria M; Hill, Washington C

    2013-09-01

    This report presents findings from two state-based pregnancy-related reviews of deaths due to pulmonary embolism to describe prevalence, risk factors, and timing of symptoms and fatal events (N = 46). We examined the utility of state-based maternal mortality review teams as a means to gain more complete data on maternal deaths from which guidelines for prevention and intervention can be developed. The Florida Pregnancy-Associated Mortality Review Team and Virginia Maternal Mortality Review Team collaborated on findings from 9 years of pregnancy-related mortality review conducted in each state. Pregnancy-related deaths due to pulmonary embolism occurring within 42 days of pregnancy between 1999 and 2007 in Florida and Virginia were identified. Retrospective review of records was conducted to obtain data on timing of the fatal event in relation to the pregnancy, risk factors, and the presence and timing of symptoms suggestive of pulmonary embolism. Forty-six cases of pregnancy-related death due to pulmonary embolism were identified. The combined pregnancy-related mortality ratio (PRMR) was 1.6/100,000 live births. The PRMR for patients undergoing cesarean section delivery was 2.8 compared to 0.2 among those with vaginal deliveries (95 % CI = 1.8-4.2 and 0.1-0.5 respectively). Women aged 35 and older had the highest PRMR at 2.6/100,000 live births. BMI over 30 kg/m(2) and presence of chronic conditions were frequently identified risk factors. One in five decedents (21.7 %) reported at least two symptoms suggestive of pulmonary embolism in the days before death. This combined state-based maternal death review confirms age over 35 years, obesity, and the presence of chronic conditions are risk factors for pregnancy-related mortality due to venous thromboembolism in the US. Expanding and standardizing the process of state-based reviews offers the potential for reducing pregnancy-related mortality in the US.

  19. Increasing US mortality due to accidental poisoning: the role of the baby boom cohort.

    PubMed

    Miech, Richard; Koester, Steve; Dorsey-Holliman, Brook

    2011-04-01

    In this study we examine whether the recent, sharp increase in mortality in the United States due to accidental poisoning since 2000 is the result of the aging of the baby boom cohort or, instead, a historical trend apparent among decedents of all ages. We conducted an age-period-cohort analysis using data from the US Vital Statistics and the US Census covering the period 1968-2007. The United States population aged 15-64 years. Cause of death and demographic data as recorded on death certificates. The increase in mortality due to accidental poisoning since the year 2000 stems primarily from a historical period effect across all ages for whites, but results in large part from a rate spike in the baby boom cohort among blacks. For all demographic groups baby boomers had higher odds of death due to accidental poisoning than the cohorts that came before and after them. Historical influences acting across all ages led to an increase in accidental poisoning mortality that was almost 10-fold for whites and threefold for blacks over the study period. While the recent, sharp increase in accidental poisoning mortality stems in part from the aging of the baby boom cohort, substantially more of the increase results from influences unique to recent years that have affected all age groups. These results point to the need to bolster overdose prevention programs and policies as the historical increase in accidental poisoning mortality appears to continue unabated. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

  20. Mortality due to trauma in cats attending veterinary practices in central and south-east England.

    PubMed

    McDonald, J L; Cleasby, I R; Brodbelt, D C; Church, D B; O'Neill, D G

    2017-10-01

    To identify important demographic and spatial factors associated with the risk of trauma and, more specifically, road traffic accident-related mortality, relative to other diagnoses in cats. A sample of 2738 cats with mortality data derived from the VetCompass primary-care veterinary database was selected for detailed study. Generalised linear models investigated risk factors for mortality due to trauma and due to road traffic accidents versus other causes. A greater proportion of younger cats died through traumatic and road traffic accident-attributed causes relative to other causes of mortality. There was no apparent association of trauma- or road traffic accident-related death with urban environments or areas where there is increased human population density. These findings highlight that veterinary advice which aims to reduce the likelihood of death through trauma, and specifically road traffic accidents, should focus on demographic attributes including age. All geographical locations should be considered as of equal risk. © 2017 British Small Animal Veterinary Association.

  1. [Morbidity-mortality due to exchange transfusion in a general hospital. A prospective study].

    PubMed

    Thompson-Chagoyán, O C; Rabiela, O L; Austria-Morales, A; Solano-Priego, B L; García-Vigil, J L; Díaz-Peyra, S E

    1992-08-01

    In this prospective study, the complications and mortality appeared in 50 exchange transfusions (ET) were analyzed. The ET were performed in 84% of the cases through a catheter in the umbilical vessels, 22 through both vessels, 10 by vein and 10 by umbilical artery; in the rest of cases by central vein. We found complications in 33% of the cases. Cardiac arrhythmia (23 cases) was the most frequent complication; also metabolic complications in 20 cases, septic complications in 10 cases (8 cases of omphalitis and 4 of sepsis were included), 8 cases of necrotizing enterocolitis and 3 of bleeding were found. Some of the newborns has 2 or more complications at the same time. The total lethality rate was 4% which occurred in 2 preterm infants with critical state. Our finding suggest that morbidity due to ET is highest than previously reports and maybe the mortality is due to the critical state of patients more than the ET.

  2. Trends in mortality due to diabetes in Brazil, 1996-2011.

    PubMed

    Schmidt, Maria Inês; Duncan, Bruce B; Ishitani, Lenice; da Conceição Franco, Glaura; de Abreu, Daisy Maria Xavier; Lana, Gustavo C; França, Elisabeth

    2015-01-01

    Over recent decades, Brazilian mortality registration has undergone increasing improvement in terms of completeness and quality in cause of death reporting. These improvements, however, complicate the description of mortality trends over this period. We aim to characterize the trend in diabetes mortality in Brazil and its five regions in adults (30-69 years), from 1996 to 2011 after corrections for underreporting of deaths and redistribution of ill-defined causes and "garbage codes". Starting with official data from the Brazilian Mortality Information System (SIM) for adults aged 30-69 in the period 1996 to 2011 for diabetes (ICD-10 codes E10-14), we redistributed garbage codes using methods based on the Global Burden of Disease Study (2010), redistributed ill-defined causes based on recent Brazilian investigations of similar cases and corrected for underreporting using official estimates of deaths. With these corrections, age-standardized mortality fell approximately 1.1 %/year for men and 2.2 %/year for women from 1996 to 2011. The rate of decline first accelerated and then decelerated, reaching stable rates in men and minimal declines in women from 2005 onward. Regional inequalities decreased during the period in both relative and absolute terms. Mortality due to diabetes declined in Brazil from 1996 to 2011, minimally in men and considerably in women. The lesser declines in recent years may reflect the increasing prevalence of diabetes, and suggest that current efforts to prevent diabetes and minimize the impact of its complications need to be reinforced to ensure that declines will continue.

  3. Causes of the excessive rates of perinatal mortality and prematurity in pregnancies complicated by maternal urinary-tract infections.

    PubMed

    Naeye, R L

    1979-04-12

    The study was undertaken to determine the causes of the more frequent pre-term deliveries, fetal and neonatal deaths associated with maternal urinary-tract infections during pregnancy. The combined perinatal mortality rate for eight common placental and fetal disorders was 42 per thousand births in the infected vs. 21 per thousand in the noninfected, owing to a greater mortality from noninfectious placental and fetal disorders in the gestations with the urinary-tract infections (P less than 0.001). All the mortality excess took place when the urinary-tract infections occurred within 15 days of delivery. Death rates were highest when the urinary-tract infections coexisted with maternal hypertension and acetonuria.Hydramnios, amniotic-fluid bacterial infections and abruptio placentae were responsible for two thirds of the more frequent preterm deliveries in the pregnancies complicated by urinary-tract infections.

  4. Long-term trend and spatial pattern of PM2.5 induced premature mortality in China.

    PubMed

    Xie, Rong; Sabel, Clive E; Lu, Xi; Zhu, Weimo; Kan, Haidong; Nielsen, Chris P; Wang, Haikun

    2016-12-01

    With rapid economic growth, China has witnessed increasingly frequent and severe haze and smog episodes over the past decade, posing serious health impacts to the Chinese population, especially those in densely populated city clusters. Quantification of the spatial and temporal variation of health impacts attributable to ambient fine particulate matter (PM2.5) has important implications for China's policies on air pollution control. In this study, we evaluated the spatial distribution of premature deaths in China between 2000 and 2010 attributable to ambient PM2.5 in accord with the Global Burden of Disease based on a high resolution population density map of China, satellite retrieved PM2.5 concentrations, and provincial health data. Our results suggest that China's anthropogenic ambient PM2.5 led to 1,255,400 premature deaths in 2010, 42% higher than the level in 2000. Besides increased PM2.5 concentration, rapid urbanization has attracted large population migration into the more developed eastern coastal urban areas, intensifying the overall health impact. In addition, our analysis implies that health burdens were exacerbated in some developing inner provinces with high population density (e.g. Henan, Anhui, Sichuan) because of the relocation of more polluting and resource-intensive industries into these regions. In order to avoid such national level environmental inequities, China's regulations on PM2.5 should not be loosened in inner provinces. Furthermore policies should create incentive mechanisms that can promote transfer of advanced production and emissions control technologies from the coastal regions to the interior regions.

  5. The effects of maximising the UK's tobacco control score on inequalities in smoking prevalence and premature coronary heart disease mortality: a modelling study.

    PubMed

    Allen, Kirk; Kypridemos, Chris; Hyseni, Lirije; Gilmore, Anna B; Diggle, Peter; Whitehead, Margaret; Capewell, Simon; O'Flaherty, Martin

    2016-04-01

    Smoking is more than twice as common among the most disadvantaged socioeconomic groups in England compared to the most affluent and is a major contributor to health-related inequalities. The United Kingdom (UK) has comprehensive smoking policies in place: regular tax increases; public information campaigns; on-pack pictorial health warnings; advertising bans; cessation; and smoke-free areas. This is confirmed from its high Tobacco Control Scale (TCS) score, an expert-developed instrument for assessing the strength of tobacco control policies. However, room remains for improvement in tobacco control policies. Our aim was to evaluate the cumulative effect on smoking prevalence of improving all TCS components in England, stratified by socioeconomic circumstance. Effect sizes and socioeconomic gradients for all six types of smoking policy in the UK setting were adapted from systematic reviews, or if not available, from primary studies. We used the IMPACT Policy Model to link predicted changes in smoking prevalence to changes in premature coronary heart disease (CHD) mortality for ages 35-74. Health outcomes with a time horizon of 2025 were stratified by quintiles of socioeconomic circumstance. The model estimated that improving all smoking policies to achieve a maximum score on the TCS might reduce smoking prevalence in England by 3% (95% Confidence Interval (CI): 1-4%), from 20 to 17% in absolute terms, or by 15% in relative terms (95% CI: 7-21%). The most deprived quintile would benefit more, with absolute reductions from 31 to 25%, or a 6% reduction (95% CI: 2-7%). There would be some 3300 (95% CI: 2200-4700) fewer premature CHD deaths between 2015-2025, a 2% (95% CI: 1.4-2.9%) reduction. The most disadvantaged quintile would benefit more, reducing absolute inequality of CHD mortality by about 4 % (95% CI: 3-9%). Further, feasible improvements in tobacco control policy could substantially improve population health, and reduce health-related inequalities in England.

  6. Multi-scale predictions of massive conifer mortality due to chronic temperature rise

    USGS Publications Warehouse

    McDowell, Nathan G.; Williams, A.P.; Xu, C.; Pockman, W. T.; Dickman, L. T.; Sevanto, S.; Pangle, R.; Limousin, J.; Plaut, J.J.; Mackay, D.S.; Ogee, J.; Domec, Jean-Christophe; Allen, Craig D.; Fisher, Rosie A.; Jiang, X.; Muss, J.D.; Breshears, D.D.; Rauscher, Sara A.; Koven, C.

    2016-01-01

    Global temperature rise and extremes accompanying drought threaten forests1, 2and their associated climatic feedbacks3, 4. Our ability to accurately simulate drought-induced forest impacts remains highly uncertain5, 6 in part owing to our failure to integrate physiological measurements, regional-scale models, and dynamic global vegetation models (DGVMs). Here we show consistent predictions of widespread mortality of needleleaf evergreen trees (NET) within Southwest USA by 2100 using state-of-the-art models evaluated against empirical data sets. Experimentally, dominant Southwest USA NET species died when they fell below predawn water potential (Ψpd) thresholds (April–August mean) beyond which photosynthesis, hydraulic and stomatal conductance, and carbohydrate availability approached zero. The evaluated regional models accurately predicted NET Ψpd, and 91% of predictions (10 out of 11) exceeded mortality thresholds within the twenty-first century due to temperature rise. The independent DGVMs predicted ≥50% loss of Northern Hemisphere NET by 2100, consistent with the NET findings for Southwest USA. Notably, the global models underestimated future mortality within Southwest USA, highlighting that predictions of future mortality within global models may be underestimates. Taken together, the validated regional predictions and the global simulations predict widespread conifer loss in coming decades under projected global warming.

  7. [Trends in incidence and mortality due to occupational accidents in Brazil, 1998-2008].

    PubMed

    Almeida, Flávia Souza e Silva de; Morrone, Luiz Carlos; Ribeiro, Karina Braga

    2014-09-01

    The objective was to evaluate trends in incidence and mortality due to occupational accidents in Brazil from 1998 to 2008. This was a time-trend series study that included cases of occupational accidents recorded in official Federal government statistics. The authors calculated annual percentage changes (APC) in incidence and mortality rates with the Joinpoint method using the calendar year as a regressor variable. There was a significant downward trend in incidence rates of occupational accidents, and the same trend was observed in typical occupational accidents. However, the number of cases increased during this period. There was a statistically significant upward trend in the incidence and number of cases of commuting accidents. The number of deaths and mortality rates showed a downward trend. Several factors may have contributed to the decline in incidence and mortality rates for occupational accidents, including improvement in working conditions, a shift in the economy from industry to services, underreporting of occupational accidents, and outsourcing of services. The increase in commuting accidents suggests the influence of violence in urban areas.

  8. Multi-scale predictions of massive conifer mortality due to chronic temperature rise

    NASA Astrophysics Data System (ADS)

    McDowell, N. G.; Williams, A. P.; Xu, C.; Pockman, W. T.; Dickman, L. T.; Sevanto, S.; Pangle, R.; Limousin, J.; Plaut, J.; Mackay, D. S.; Ogee, J.; Domec, J. C.; Allen, C. D.; Fisher, R. A.; Jiang, X.; Muss, J. D.; Breshears, D. D.; Rauscher, S. A.; Koven, C.

    2016-03-01

    Global temperature rise and extremes accompanying drought threaten forests and their associated climatic feedbacks. Our ability to accurately simulate drought-induced forest impacts remains highly uncertain in part owing to our failure to integrate physiological measurements, regional-scale models, and dynamic global vegetation models (DGVMs). Here we show consistent predictions of widespread mortality of needleleaf evergreen trees (NET) within Southwest USA by 2100 using state-of-the-art models evaluated against empirical data sets. Experimentally, dominant Southwest USA NET species died when they fell below predawn water potential (Ψpd) thresholds (April-August mean) beyond which photosynthesis, hydraulic and stomatal conductance, and carbohydrate availability approached zero. The evaluated regional models accurately predicted NET Ψpd, and 91% of predictions (10 out of 11) exceeded mortality thresholds within the twenty-first century due to temperature rise. The independent DGVMs predicted >=50% loss of Northern Hemisphere NET by 2100, consistent with the NET findings for Southwest USA. Notably, the global models underestimated future mortality within Southwest USA, highlighting that predictions of future mortality within global models may be underestimates. Taken together, the validated regional predictions and the global simulations predict widespread conifer loss in coming decades under projected global warming.

  9. A multicenter study of septic shock due to candidemia: outcomes and predictors of mortality.

    PubMed

    Bassetti, Matteo; Righi, Elda; Ansaldi, Filippo; Merelli, Maria; Trucchi, Cecilia; Cecilia, Trucchi; De Pascale, Gennaro; Diaz-Martin, Ana; Luzzati, Roberto; Rosin, Chiara; Lagunes, Leonel; Trecarichi, Enrico Maria; Sanguinetti, Maurizio; Posteraro, Brunella; Garnacho-Montero, Jose; Sartor, Assunta; Rello, Jordi; Rocca, Giorgio Della; Antonelli, Massimo; Tumbarello, Mario

    2014-06-01

    Candida is the most common cause of severe yeast infections worldwide, especially in critically ill patients. In this setting, septic shock attributable to Candida is characterized by high mortality rates. The aim of this multicenter study was to investigate the determinants of outcome in critically ill patients with septic shock due to candidemia. This was a retrospective study in which patients with septic shock attributable to Candida who were treated during the 3-year study period at one or more of the five participating teaching hospitals in Italy and Spain were eligible for enrolment. Patient characteristics, infection-related variables, and therapy-related features were reviewed. Multiple logistic regression analysis was performed to identify the risk factors significantly associated with 30-day mortality. A total of 216 patients (mean age 63.4 ± 18.5 years; 58.3 % males) were included in the study. Of these, 163 (75 %) were admitted to the intensive care unit. Overall 30-day mortality was 54 %. Significantly higher Acute Physiology and Chronic Health Evaluation (APACHE) II scores, dysfunctional organs, and inadequate antifungal therapy were compared in nonsurvivors and survivors. No differences in survivors versus nonsurvivors were found in terms of the time from positive blood culture to initiation of adequate antifungal therapy. Multivariate logistic regression identified inadequate source control, inadequate antifungal therapy, and 1-point increments in the APACHE II score as independent variables associated with a higher 30-day mortality rate.

  10. Effect of vitamin B supplementation on cancer incidence, death due to cancer, and total mortality

    PubMed Central

    Zhang, Sui-Liang; Chen, Ting-Song; Ma, Chen-Yun; Meng, Yong-Bin; Zhang, Yu-Fei; Chen, Yi-Wei; Zhou, Yu-Hao

    2016-01-01

    Abstract Background: Observational studies have suggested that vitamin B supplementation is associated with cancer risk, but this association remains controversial. A pooled data-based meta-analysis was conducted to summarize the evidence from randomized controlled trials (RCTs) investigating the effects of vitamin B supplementation on cancer incidence, death due to cancer, and total mortality. Methods: PubMed, EmBase, and the Cochrane Library databases were searched to identify trials to fit our analysis through August 2015. Relative risk (RR) was used to measure the effect of vitamin B supplementation on the risk of cancer incidence, death due to cancer, and total mortality using a random-effect model. Cumulative meta-analysis, sensitivity analysis, subgroup analysis, heterogeneity tests, and tests for publication bias were also conducted. Results: Eighteen RCTs reporting the data on 74,498 individuals were included in the meta-analysis. Sixteen of these trials included 4103 cases of cancer; in 6 trials, 731 cancer-related deaths occurred; and in 15 trials, 7046 deaths occurred. Vitamin B supplementation had little or no effect on the incidence of cancer (RR: 1.04; 95% confidence interval [CI]: 0.98–1.10; P = 0.216), death due to cancer (RR, 1.05; 95% CI: 0.90–1.22; P = 0.521), and total mortality (RR, 1.00; 95% CI: 0.94–1.06; P = 0.952). Upon performing a cumulative meta-analysis for cancer incidence, death due to cancer, and total mortality, the nonsignificance of the effect of vitamin B persisted. With respect to specific types of cancer, vitamin B supplementation significantly reduced the risk of skin melanoma (RR, 0.47; 95% CI: 0.23–0.94; P = 0.032). Conclusion: Vitamin B supplementation does not have an effect on cancer incidence, death due to cancer, or total mortality. It is associated with a lower risk of skin melanoma, but has no effect on other cancers. PMID:27495015

  11. Mortality due to Hymenoptera stings in Costa Rica, 1985-2006.

    PubMed

    Prado, Mónica; Quirós, Damaris; Lomonte, Bruno

    2009-05-01

    To analyze mortality due to Hymenoptera stings in Costa Rica during 1985-2006. Records of deaths due to Hymenoptera stings in 1985-2006 were retrieved from Instituto Nacional de Estadística y Censos (National Statistics and Census Institute). Mortality rates were calculated on the basis of national population reports, as of 1 July of each year. Information for each case included age, gender, and the province in which the death occurred. In addition, reports of Hymenoptera sting accidents received by the Centro Nacional de Intoxicaciones (National Poison Center, CNI) in 1995-2006 were obtained to assess exposure to these insects. Over the 22-year period analyzed, 52 fatalities due to Hymenoptera stings were recorded. Annual mortality rates varied from 0-1.73 per 1 million inhabitants, with a mean of 0.74 (95% confidence interval: 0.46-0.93). The majority of deaths occurred in males (88.5%), representing a male to female ratio of 7.7:1. A predominance of fatalities was observed in the elderly (50 years of age and older), as well as in children less than 10 years of age. The province with the highest mortality rate was Guanacaste. The CNI documented 1,591 reports of Hymenoptera stings (mostly by bees) in 1995-2006, resulting in an annual average of 133 cases, with only a slight predominance of males over females (1.4:1). Stings by Hymenoptera, mostly by bees, constitute a frequent occurrence in Costa Rica that can be life-threatening in a small proportion of cases, most often in males and the elderly. The annual number of fatalities fluctuated from 0-6, averaging 2.4 deaths per year. Awareness should be raised not only among the general population, but also among health care personnel that should consider this risk in the clinical management of patients stung by Hymenoptera.

  12. Projecting future summer mortality due to ambient ozone concentration and temperature changes

    NASA Astrophysics Data System (ADS)

    Lee, Jae Young; Lee, Soo Hyun; Hong, Sung-Chul; Kim, Ho

    2017-05-01

    Climate change is known to affect the human health both directly by increased heat stress and indirectly by altering environments, particularly by altering the rate of ambient ozone formation in the atmosphere. Thus, the risks of climate change may be underestimated if the effects of both future temperature and ambient ozone concentrations are not considered. This study presents a projection of future summer non-accidental mortality in seven major cities of South Korea during the 2020s (2016-2025) and 2050s (2046-2055) considering changes in temperature and ozone concentration, which were predicted by using the HadGEM3-RA model and Integrated Climate and Air Quality Modeling System, respectively. Four Representative Concentration Pathway (RCP) scenarios (RCP 2.6, 4.5, 6.0, and 8.5) were considered. The result shows that non-accidental summer mortality will increase by 0.5%, 0.0%, 0.4%, and 0.4% in the 2020s, 1.9%, 1.5%, 1.2%, and 4.4% in the 2050s due to temperature change compared to the baseline mortality during 2001-2010, under RCP 2.6, 4.5, 6.0, and 8.5, respectively, whereas the mortality will increase by 0.0%, 0.5%, 0.0%, and 0.5% in the 2020s, and 0.2%, 0.2%, 0.4%, and 0.6% in the 2050s due to ozone concentration change. The projection result shows that the future summer morality in South Korea is increased due to changes in both temperature and ozone, and the magnitude of ozone-related increase is much smaller than that of temperature-related increase, especially in the 2050s.

  13. High mortality due to sepsis in Native Hawaiians and African Americans: The Multiethnic Cohort

    PubMed Central

    Shvetsov, Yurii B.; Dugay, Chase; Haiman, Christopher A.; Le Marchand, Loic; Wilkens, Lynne R.; Maskarinec, Gertraud

    2017-01-01

    Background/Objectives Sepsis is a severe systemic response to infection with a high mortality rate. A higher incidence has been reported for older people, in persons with a compromised immune system including cancer patients, and in ethnic minorities. We analyzed sepsis mortality and its predictors by ethnicity in the Multiethnic Cohort (MEC). Subjects/Methods Among 191,561 white, African American, Native Hawaiian, Japanese American, and Latino cohort members, 49,347 deaths due to all causes and 345 deaths due to sepsis were recorded during follow-up from 1993–96 until 2010. Cox proportional hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated and adjusted for relevant confounders. In addition, national death rates were analyzed to compare mortality by state. Results Age-adjusted rates of sepsis death were 5-times higher for Hawaii than Los Angeles (14.4 vs. 2.7 per 100,000). By ethnicity, Native Hawaiians had the highest rate in Hawaii (29.0 per 100,000) and African Americans in Los Angeles (5.2 per 100,000). In fully adjusted models, place of residence was the most important predictor of sepsis mortality (HR = 7.18; 95%CI: 4.37–11.81 Hawaii vs. Los Angeles). African Americans showed the highest risk (HR = 2.08; 95% CI: 1.16–3.75) followed by Native Hawaiians (HR = 1.88; 95% CI: 1.34–2.65) as compared to whites. Among cohort members with cancer (N = 49,794), the 2-fold higher sepsis mortality remained significant in Native Hawaiians only. The geographic and ethnic differences in the MEC agreed with results for national death data. Conclusions The finding that African Americans and Native Hawaiians experience a higher mortality risk due to sepsis than other ethnic groups suggest ethnicity-related biological factors in the predisposition of cancer patients and other immune-compromising conditions to develop sepsis, but regional differences in health care access and death coding may also be important. PMID:28558016

  14. Does sickness absence due to psychiatric disorder predict cause-specific mortality? A 16-year follow-up of the GAZEL occupational cohort study.

    PubMed

    Melchior, Maria; Ferrie, Jane E; Alexanderson, Kristina; Goldberg, Marcel; Kivimaki, Mika; Singh-Manoux, Archana; Vahtera, Jussi; Westerlund, Hugo; Zins, Marie; Head, Jenny

    2010-09-15

    Mental disorders are a frequent cause of morbidity and sickness absence in working populations; however, the status of psychiatric sickness absence as a predictor of mortality is not established. The authors tested the hypothesis that psychiatric sickness absence predicts mortality from leading medical causes. Data were derived from the French GAZEL cohort study (n = 19,962). Physician-certified sickness absence records were extracted from administrative files (1990-1992) and were linked to mortality data from France's national registry of mortality (1993-2008, mean follow-up: 15.5 years). Analyses were conducted by using Cox regression models. Compared with workers with no sickness absence, those absent due to psychiatric disorder were at increased risk of cause-specific mortality (hazard ratios (HRs) adjusted for age, gender, occupational grade, other sickness absence-suicide: 6.01, 95% confidence interval (CI): 3.07, 11.75; cardiovascular disease: 1.84, 95% CI: 1.10, 3.08; and smoking-related cancer: 1.65, 95% CI: 1.07, 2.53). After full adjustment, the excess risk of suicide remained significant (HR = 5.13, 95% CI: 2.60, 10.13) but failed to reach statistical significance for fatal cardiovascular disease (HR = 1.59, 95% CI: 0.95, 2.66) and smoking-related cancer (HR = 1.31, 95% CI: 0.85, 2.03). Psychiatric sickness absence records could help identify individuals at risk of premature mortality and serve to monitor workers' health.

  15. Does Sickness Absence Due to Psychiatric Disorder Predict Cause-specific Mortality? A 16-Year Follow-up of the GAZEL Occupational Cohort Study

    PubMed Central

    Melchior, Maria; Ferrie, Jane E.; Alexanderson, Kristina; Goldberg, Marcel; Kivimaki, Mika; Singh-Manoux, Archana; Vahtera, Jussi; Westerlund, Hugo; Zins, Marie; Head, Jenny

    2010-01-01

    Mental disorders are a frequent cause of morbidity and sickness absence in working populations; however, the status of psychiatric sickness absence as a predictor of mortality is not established. The authors tested the hypothesis that psychiatric sickness absence predicts mortality from leading medical causes. Data were derived from the French GAZEL cohort study (n = 19,962). Physician-certified sickness absence records were extracted from administrative files (1990–1992) and were linked to mortality data from France's national registry of mortality (1993–2008, mean follow-up: 15.5 years). Analyses were conducted by using Cox regression models. Compared with workers with no sickness absence, those absent due to psychiatric disorder were at increased risk of cause-specific mortality (hazard ratios (HRs) adjusted for age, gender, occupational grade, other sickness absence—suicide: 6.01, 95% confidence interval (CI): 3.07, 11.75; cardiovascular disease: 1.84, 95% CI: 1.10, 3.08; and smoking-related cancer: 1.65, 95% CI: 1.07, 2.53). After full adjustment, the excess risk of suicide remained significant (HR = 5.13, 95% CI: 2.60, 10.13) but failed to reach statistical significance for fatal cardiovascular disease (HR = 1.59, 95% CI: 0.95, 2.66) and smoking-related cancer (HR = 1.31, 95% CI: 0.85, 2.03). Psychiatric sickness absence records could help identify individuals at risk of premature mortality and serve to monitor workers’ health. PMID:20732935

  16. Infant Mortality

    MedlinePlus

    ... Control and Prevention. (2013). CDC health disparities and inequalities report—United States, 2013. Morbidity and Mortality Weekly ... M. (2008). The fall and rise of U.S. inequalities in premature mortality: 1960–2002. PLOS Medicine, 5 ( ...

  17. Refusal of intensive care unit admission due to a full unit: impact on mortality.

    PubMed

    Robert, René; Reignier, Jean; Tournoux-Facon, Caroline; Boulain, Thierry; Lesieur, Olivier; Gissot, Valérie; Souday, Vincent; Hamrouni, Mouldi; Chapon, Cécile; Gouello, Jean-Paul

    2012-05-15

    Intensive care unit (ICU) beds are a scarce resource, and patients denied intensive care only because the unit is full may be at increased risk of death. To compare mortality after first ICU referral in admitted patients and in patients denied admission because the unit was full. Prospective observational multicenter cohort study of consecutive patients referred for ICU admission during two 45-day periods, conducted in 10 ICUs. Of 1,762 patients, 430 were excluded from the study, 116 with previously denied admission to another ICU and 270 because they were deemed too sick or too well to benefit from ICU admission. Of the remaining 1,332 patients, 1,139 were admitted, and 193 were denied admission because the unit was full (65 were never admitted, 39 were admitted after bumping of another patient, and 89 were admitted on subsequent referral). Crude Day 28 and Day 60 mortality rates in the nonadmitted and admitted groups were 30.1 versus 24.3% (P = 0.07) and 33.3 versus 27.2% (P = 0.06), respectively. Day 28 mortality adjusted on age, previous disease, Glasgow scale score less than or equal to 8, shock, creatinine level greater than or equal to 250 μmol/L, and prothrombin time greater than or equal to 30 seconds was nonsignificantly higher in patients refused ICU admission only because of a full unit compared with patients admitted immediately. Patients admitted after subsequent referral had higher mortality rates on Day 28 (P = 0.05) and Day 60 (P = 0.04) compared with directly admitted patients. Delayed ICU admission due to a full unit at first referral is associated with increased mortality.

  18. Violent crime, suicide, and premature mortality in patients with schizophrenia and related disorders: a 38-year total population study in Sweden

    PubMed Central

    Fazel, Seena; Wolf, Achim; Palm, Camilla; Lichtenstein, Paul

    2014-01-01

    Summary Background People with schizophrenia and related disorders are at an increased risk of adverse outcomes, including conviction of a violent offence, suicide, and premature mortality. However, the rates of, and risk factors for, these outcomes need clarification as a basis for population-based and targeted interventions. We aimed to determine rates and risk factors for these outcomes, and investigate to what extent they are shared across outcomes and are specific to schizophrenia and related disorders. Methods We undertook a total population cohort study in Sweden of 24 297 patients with schizophrenia and related disorders between January, 1972 and December, 2009. Patients were matched by age and sex to people from the general population (n=485 940) and also to unaffected sibling controls (n=26 357). First, we investigated rates of conviction of a violent offence, suicide, and premature mortality, with follow-up until conviction of a violent offence, emigration, death, or end of follow-up (Dec 31, 2009), whichever occurred first. Second, we analysed associations between these adverse outcomes and sociodemographic, individual, familial, and distal risk factors, for men and women separately, with Cox proportional hazards models. Finally, we assessed time trends in adverse outcomes between 1972 and 2009, for which we compared patients with unaffected siblings, and analysed associations with changes in the number of nights spent in inpatient beds in psychiatric facilities nationwide. Findings Within 5 years of their initial diagnosis, 13·9% of men and 4·7% of women with schizophrenia and related disorders had a major adverse outcome (10·7% of men and 2·7% of women were convicted of a violent offence, and 3·3% of men and 2·0% of women died prematurely of any cause). During the study, the adjusted odds ratio of any adverse outcomes for patients compared with general population controls was 7·5 (95% CI 7·2–7·9) in men and 11·1 (10·2–12·1) in

  19. Morbidity and Mortality Due to Bordetella pertussis: A Significant Pathogen in West Africa?

    PubMed Central

    Kampmann, Beate; Mackenzie, Grant

    2016-01-01

    In the absence of specific surveillance platforms for pertussis and availability of suitable diagnostics at the hospital level, reliable data that describe morbidity and mortality from pertussis are difficult to obtain in any setting, as is the case in West Africa. Here, we summarize the available evidence of the burden of pertussis in the region, given historical data, and describe recent and ongoing epidemiological studies that offer opportunities for additional data collection. The available seroepidemiological data provide evidence of ongoing circulation of Bordetella pertussis in the region. Due to the lack of systematic and targeted surveillance with laboratory confirmation of B. pertussis infection, we cannot definitively conclude that pertussis disease is well controlled in West Africa. However, based on observations by clinicians and ongoing demographic surveillance systems that capture morbidity and mortality data in general terms, currently there is no evidence that pertussis causes a significant burden of disease in young children in West Africa. PMID:27838666

  20. Reproductive failure in moose (Alces alces) due to embryonic mortality and unfertilized oocytes.

    PubMed

    Malmsten, Jonas; Dalin, Anne-Marie

    2014-01-01

    Knowledge on reproductive success is vital for successful management of large ungulates and is often measured by means of observing surviving offspring. In harvested ungulates, postmortem investigations of reproductive organs are used to estimate reproductive potential by obtaining ovulation rates and fetus numbers. However, there are differences in numbers of offspring observed, fetal/embryo counts, and ovulation rates. We hypothesize that the discrepancy between estimated reproductive potential and reproductive outcome in large ungulates is not only due to ova loss but also due to embryonic mortality. We investigated reproductive status in early pregnancy by sampling hunter-harvested moose (Alces alces) in southern Sweden from 2007 to 2011. In all, 213 reproductive organs were examined postmortem, and in confirmed pregnant moose (n = 53), 25 % (19 of 76) embryos were nonviable and 6 % of ova was unfertilized. The discrepancy between the ovulation rate of all pregnant moose (1.49) and the number of expected offspring per pregnant female, when embryonic mortality and unfertilized oocytes were accounted for (1.08), was 27.5 %. An association between inflammation of the inner mucous membrane (endometritis) of the moose's uterus and embryonic mortality was observed. This is the first comprehensive report of embryonic mortality and endometritis in moose. The observed discrepancy between ovulation rates and early embryonic development/survival shows that ovulation rates are indicative but not accurate estimates of moose reproductive rate. The use of ovulation rates as a sole estimator of future offspring rates may lead to an overharvest of a managed moose population.

  1. A predictive neonatal mortality score for women with premature rupture of membranes after 22-27 weeks of gestation.

    PubMed

    Toukam, Michèle Eve; Luisin, Marion; Chevreau, Julien; Lanta-Delmas, Ségolène; Gondry, Jean; Tourneux, Pierre

    2017-09-26

    Premature rupture of the membranes (PROM) remains a leading cause of neonatal morbidity. The objectives of the present study were to analyze the outcomes of pregnancies complicated by PROM between 22 and 27(+6) weeks of gestation (WG) and to study antepartum risk factors that might predict neonatal death. One hundred and seven pregnancies were analyzed over a 3-year period in a tertiary maternity hospital. The collected maternal and neonatal data were used to model and predict the outcome of PROM. Prevalence of PROM (for live births) was 1.08%, and the overall survival rate was 59.8%. From preselected candidate variables, gestational age (GA) at PROM (p = .0002), a positive vaginal culture for pathogenic bacteria (p = .01), primiparity (p = .02), and the quantity of amniotic fluid (p = .03) were included in a multivariable logistic regression analysis. The corresponding adjusted odds ratios [95% confidence interval] were, respectively, 0.91 [0.87-0.96], 11.08 [1.65-74.42], 0.55 [0.33-0.91], and 0.97 [0.95-0.99]. These parameters were used to build a predictive score for neonatal death. The survival rate after PROM at 22-27(+6) weeks of gestation was 59.8%. Our predictive model (built using multivariable logistic regression) may be of value for obstetricians and neonatologists counseling couples after PROM.

  2. Dose-response relationship of physical activity to premature and total all-cause and cardiovascular disease mortality in walkers.

    PubMed

    Williams, Paul T

    2013-01-01

    To assess the dose-response relationships between cause-specific mortality and exercise energy expenditure in a prospective epidemiological cohort of walkers. The sample consisted of the 8,436 male and 33,586 female participants of the National Walkers' Health Study. Walking energy expenditure was calculated in metabolic equivalents (METs, 1 MET = 3.5 ml O2/kg/min), which were used to divide the cohort into four exercise categories: category 1 (≤ 1.07 MET-hours/d), category 2 (1.07 to 1.8 MET-hours/d), category 3 (1.8 to 3.6 MET-hours/d), and category 4 (≥ 3.6 MET-hours/d). Competing risk regression analyses were use to calculate the risk of mortality for categories 2, 3 and 4 relative to category 1. 22.9% of the subjects were in category 1, 16.1% in category 2, 33.3% in category 3, and 27.7% in category 4. There were 2,448 deaths during the 9.6 average years of follow-up. Total mortality was 11.2% lower in category 2 (P = 0.04), 32.4% lower in category 3 (P<10(-12)) and 32.9% lower in category 4 (P = 10(-11)) than in category 1. For underlying causes of death, the respective risk reductions for categories 2, 3 and 4 were 23.6% (P = 0.008), 35.2% (P<10(-5)), and 34.9% (P = 0.0001) for cardiovascular disease mortality; 27.8% (P = 0.18), 20.6% (P = 0.07), and 31.4% (P = 0.009) for ischemic heart disease mortality; and 39.4% (P = 0.18), 63.8% (P = 0.005), and 90.6% (P = 0.002) for diabetes mortality when compared to category 1. For all related mortality (i.e., underlying and contributing causes of death combined), the respective risk reductions for categories 2, 3 and 4 were 18.7% (P = 0.22), 42.5% (P = 0.001), and 57.5% (P = 0.0001) for heart failure; 9.4% (P = 0.56), 44.3% (P = 0.0004), and 33.5% (P = 0.02) for hypertensive diseases; 11.5% (P = 0.38), 41.0% (P<10(-4)), and 35.5% (P = 0.001) for dysrhythmias: and 23.2% (P = 0.13), 45.8% (P = 0.0002), and 41.1% (P = 0.005) for

  3. Years of life lost due to malignant neoplasms characterized by the highest mortality rate

    PubMed Central

    Pikala, Malgorzata

    2014-01-01

    Introduction The analysis of premature deaths measured with years of life lost between the studied and referential populations helps to emphasize the social and economic aspect of a loss caused by deaths due to malignant neoplasms. The aim of the study was to analyze years of life lost by inhabitants of the Lodz province due to malignant neoplasms. Material and methods The study material included a database which contained information gathered from 313,144 death certificates (including 66,899 people who died of malignant neoplasms) of inhabitants of the Lodz province who died between 1999 and 2008. The SEYLLp (Standard Expected Years of Life Lost per living person) method was used to determine years of life lost. Jointpoint models were used to analyze time trends. Results In males the diseases which mostly contributed to death were tracheal, bronchial and lung malignant neoplasms (SEYLLp = 170.7) and cancer of the large intestine, rectum and anus (SEYLLp = 47.5). In females the principal diseases were tracheal, bronchial and lung malignant neoplasms (SEYLLp = 61.6), breast cancer (SEYLLp = 60.4) and cancer of the large intestine, rectum and anus (SEYLLp = 42.3). The years of life lost were growing in the period under study. Conclusions The number of years lost due to malignant neoplasms in the Lodz province between 1999 and 2008 was growing. The main reasons for deaths in females were tracheal, bronchial and lung malignant neoplasms as well as breast cancer and in males – cancer of the large intestine, rectum and anus as well as prostate cancer. PMID:25395953

  4. [Evolution and regional differences in mortality due to suicide in Peru, 2004-2013].

    PubMed

    Hernández-Vásquez, Akram; Azañedo, Diego; Rubilar-González, Juan; Huarez, Bertha; Grendas, Leandro

    2016-01-01

    The aim of this study was to estimate and analyze the evolution of mortality rates due to suicide in Peru between 2004 and 2013. National death records from the Peruvian Ministry of Health were analyzed, calculating the regional mortality rates due to suicide standardized by age. Similarly, rates grouped in 5-year periods were geospatially projected. There were 3,162 cases of suicide (67.2% men); the age range with the highest incidence was 20 to 29 years (28.7%) and 49.2% were due to poisoning. Suicide rates increased from 0.46 (95% confidence interval [CI] = 0.38-0.55) to 1.13 (95% CI = 1.01-1.25) per 100,000 people from 2004 to 2013, respectively. The highest rates of suicide were identified in Pasco, Junín, Tacna, Moquegua, and Huánuco. The suicide issue in Peru requires a comprehensive approach that entails not just identifying the areas with the highest risk, but also studying its associated factors that may explain the regional variability observed.

  5. Assessment of short-term PM2.5-related mortality due to different emission sources in the Yangtze River Delta, China

    NASA Astrophysics Data System (ADS)

    Wang, Jiandong; Wang, Shuxiao; Voorhees, A. Scott; Zhao, Bin; Jang, Carey; Jiang, Jingkun; Fu, Joshua S.; Ding, Dian; Zhu, Yun; Hao, Jiming

    2015-12-01

    Air pollution is a major environmental risk to health. In this study, short-term premature mortality due to particulate matter equal to or less than 2.5 μm in aerodynamic diameter (PM2.5) in the Yangtze River Delta (YRD) is estimated by using a PC-based human health benefits software. The economic loss is assessed by using the willingness to pay (WTP) method. The contributions of each region, sector and gaseous precursor are also determined by employing brute-force method. The results show that, in the YRD in 2010, the short-term premature deaths caused by PM2.5 are estimated to be 13,162 (95% confidence interval (CI): 10,761-15,554), while the economic loss is 22.1 (95% CI: 18.1-26.1) billion Chinese Yuan. The industrial and residential sectors contributed the most, accounting for more than 50% of the total economic loss. Emissions of primary PM2.5 and NH3 are major contributors to the health-related loss in winter, while the contribution of gaseous precursors such as SO2 and NOx is higher than primary PM2.5 in summer.

  6. [Predictive variables for mortality in elderly patients hospitalized due to heart failure with preserved ejection fraction].

    PubMed

    Carrasco-Sánchez, Francisco Javier; Páez-Rubio, María Inmaculada; García-Moreno, Juana María; Vázquez-García, Irene; Araujo-Sanabria, Joaquín; Pujo-de la Llave, Emilio

    2013-11-16

    The prevalence of heart failure (HF) increases with age. Even though the mortality of patients ≥ 80 years of age with HF and preserved left ventricle ejection fraction (LVEF) is very high, the predictor variables are not well-known. The main goal of this study was to evaluate the mortality predictor factors in this subgroup of the elderly population. An observational and prospective study of patients hospitalized due to HF with preserved LVEF has been conducted. The demographic, clinical, functional and analytic factors were evaluated when the patients were admitted with special attention to the co-morbidities. The primary endpoint was the total mortality in the subgroup of patients ≥ 80 years of age after a year of follow-up. The predictor variables were studied by means of a multivariate Cox regression model. From a total of 218 patients with an average age of 75.6 (±8.7) years of age, 75 patients (34.4%) were ≥ 80 years. The mortality rate of patients ≥ 80 years of age totaled 42.7%, in relation to 26.6% for the lower age group (log-rank<.001). After a multivariate analysis using the Cox regression model in patients ≥ 80, the serum urea levels above the average (hazard ratio [HR] 3.93; 95% confidence interval [95% CI] 1.58-9.75; P = .003), the age (HR 1.17; 95% CI 1.07-1.28; P<.001), the hyponatremia (HR 3.19; 95% CI 1.51-6.74; P = .002) and a lower score on the Barthel index (BI) (HR 1.016; 95% CI 1.002-1.031; P = .034) were independent mortality predictors after an one-year follow-up. Serum urea levels, age, hyponatremia and a low BI score could be proposed as independent mortality predictors in patients ≥ 80 of age hospitalized for HF with preserved LVEF. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  7. Auditing Neonatal Intensive Care: Is PREM a Good Alternative to CRIB for Mortality Risk Adjustment in Premature Infants?

    PubMed

    Guenther, Kilian; Vach, Werner; Kachel, Walter; Bruder, Ingo; Hentschel, Roland

    2015-01-01

    Comparing outcomes at different neonatal intensive care units (NICUs) requires adjustment for intrinsic risk. The Clinical Risk Index for Babies (CRIB) is a widely used risk model, but it has been criticized for being affected by therapeutic decisions. The Prematurity Risk Evaluation Measure (PREM) is not supposed to be prone to treatment bias, but has not yet been validated. We aimed to validate the PREM, compare its accuracy to that of the original and modified versions of the CRIB and CRIB-II, and examine the congruence of risk categorization. Very-low-birth-weight (VLBW) infants with a gestational age (GA) <33 weeks, who were admitted to NICUs in Baden-Württemberg from 2003 to 2008, were identified from the German neonatal quality assurance program. CRIB, CRIB-II and PREM scores were calculated and modified. Omitting variables that directly reflected therapeutic decisions [the applied fraction of inspired oxygen (FiO2)] or that may have been prone to early-treatment bias (base excess and temperature), non-NICU-therapy-influenced scores were obtained. Score performance was assessed by the area under their ROC curve (AUC). The CRIB showed the largest AUC (0.89), which dropped significantly (to 0.85) after omitting the FiO2. The PREM birth condition model, PREM(bcm) (AUC 0.86), and the PREM birth model, PREM(bm) (AUC 0.82), also demonstrated good discrimination. PREM(bm) was superior to other non-therapy-affected scores and to GA, particularly in infants with <750 g birth weight. Congruence of risk categorization was low, especially among higher-risk cases. The CRIB score had the largest AUC, resulting from its inclusion of FiO2. PREM(bm), as the most accurate score among those unaffected by early treatment, seems to be a good alternative for strict risk adjustment in NICU auditing. It could be useful to combine scores. © 2015 S. Karger AG, Basel.

  8. Abrupt Increases in Amazonian Tree Mortality Due to Drought-Fire Interactions

    NASA Technical Reports Server (NTRS)

    Brando, Paulo Monteiro; Balch, Jennifer K.; Nepstad, Daniel C.; Morton, Douglas C.; Putz, Francis E.; Coe, Michael T.; Silverio, Divino; Macedo, Marcia N.; Davidson, Eric A.; Nobrega, Caroline C.; Alencar, Ane; Soares-Filho, Britaldo S.

    2014-01-01

    Interactions between climate and land-use change may drive widespread degradation of Amazonian forests. High-intensity fires associated with extreme weather events could accelerate this degradation by abruptly increasing tree mortality, but this process remains poorly understood. Here we present, to our knowledge, the first field-based evidence of a tipping point in Amazon forests due to altered fire regimes. Based on results of a large-scale, longterm experiment with annual and triennial burn regimes (B1yr and B3yr, respectively) in the Amazon, we found abrupt increases in fire-induced tree mortality (226 and 462%) during a severe drought event, when fuel loads and air temperatures were substantially higher and relative humidity was lower than long-term averages. This threshold mortality response had a cascading effect, causing sharp declines in canopy cover (23 and 31%) and aboveground live biomass (12 and 30%) and favoring widespread invasion by flammable grasses across the forest edge area (80 and 63%), where fires were most intense (e.g., 220 and 820 kW x m(exp -1)). During the droughts of 2007 and 2010, regional forest fires burned 12 and 5% of southeastern Amazon forests, respectively, compared with less than 1% in nondrought years. These results show that a few extreme drought events, coupled with forest fragmentation and anthropogenic ignition sources, are already causing widespread fire-induced tree mortality and forest degradation across southeastern Amazon forests. Future projections of vegetation responses to climate change across drier portions of the Amazon require more than simulation of global climate forcing alone and must also include interactions of extreme weather events, fire, and land-use change.

  9. Abrupt increases in Amazonian tree mortality due to drought–fire interactions

    PubMed Central

    Brando, Paulo Monteiro; Balch, Jennifer K.; Nepstad, Daniel C.; Morton, Douglas C.; Putz, Francis E.; Coe, Michael T.; Silvério, Divino; Macedo, Marcia N.; Davidson, Eric A.; Nóbrega, Caroline C.; Alencar, Ane; Soares-Filho, Britaldo S.

    2014-01-01

    Interactions between climate and land-use change may drive widespread degradation of Amazonian forests. High-intensity fires associated with extreme weather events could accelerate this degradation by abruptly increasing tree mortality, but this process remains poorly understood. Here we present, to our knowledge, the first field-based evidence of a tipping point in Amazon forests due to altered fire regimes. Based on results of a large-scale, long-term experiment with annual and triennial burn regimes (B1yr and B3yr, respectively) in the Amazon, we found abrupt increases in fire-induced tree mortality (226 and 462%) during a severe drought event, when fuel loads and air temperatures were substantially higher and relative humidity was lower than long-term averages. This threshold mortality response had a cascading effect, causing sharp declines in canopy cover (23 and 31%) and aboveground live biomass (12 and 30%) and favoring widespread invasion by flammable grasses across the forest edge area (80 and 63%), where fires were most intense (e.g., 220 and 820 kW⋅m−1). During the droughts of 2007 and 2010, regional forest fires burned 12 and 5% of southeastern Amazon forests, respectively, compared with <1% in nondrought years. These results show that a few extreme drought events, coupled with forest fragmentation and anthropogenic ignition sources, are already causing widespread fire-induced tree mortality and forest degradation across southeastern Amazon forests. Future projections of vegetation responses to climate change across drier portions of the Amazon require more than simulation of global climate forcing alone and must also include interactions of extreme weather events, fire, and land-use change. PMID:24733937

  10. Abrupt increases in Amazonian tree mortality due to drought-fire interactions.

    PubMed

    Brando, Paulo Monteiro; Balch, Jennifer K; Nepstad, Daniel C; Morton, Douglas C; Putz, Francis E; Coe, Michael T; Silvério, Divino; Macedo, Marcia N; Davidson, Eric A; Nóbrega, Caroline C; Alencar, Ane; Soares-Filho, Britaldo S

    2014-04-29

    Interactions between climate and land-use change may drive widespread degradation of Amazonian forests. High-intensity fires associated with extreme weather events could accelerate this degradation by abruptly increasing tree mortality, but this process remains poorly understood. Here we present, to our knowledge, the first field-based evidence of a tipping point in Amazon forests due to altered fire regimes. Based on results of a large-scale, long-term experiment with annual and triennial burn regimes (B1yr and B3yr, respectively) in the Amazon, we found abrupt increases in fire-induced tree mortality (226 and 462%) during a severe drought event, when fuel loads and air temperatures were substantially higher and relative humidity was lower than long-term averages. This threshold mortality response had a cascading effect, causing sharp declines in canopy cover (23 and 31%) and aboveground live biomass (12 and 30%) and favoring widespread invasion by flammable grasses across the forest edge area (80 and 63%), where fires were most intense (e.g., 220 and 820 kW ⋅ m(-1)). During the droughts of 2007 and 2010, regional forest fires burned 12 and 5% of southeastern Amazon forests, respectively, compared with <1% in nondrought years. These results show that a few extreme drought events, coupled with forest fragmentation and anthropogenic ignition sources, are already causing widespread fire-induced tree mortality and forest degradation across southeastern Amazon forests. Future projections of vegetation responses to climate change across drier portions of the Amazon require more than simulation of global climate forcing alone and must also include interactions of extreme weather events, fire, and land-use change.

  11. Abrupt Increases in Amazonian Tree Mortality Due to Drought-Fire Interactions

    NASA Technical Reports Server (NTRS)

    Brando, Paulo Monteiro; Balch, Jennifer K.; Nepstad, Daniel C.; Morton, Douglas C.; Putz, Francis E.; Coe, Michael T.; Silverio, Divino; Macedo, Marcia N.; Davidson, Eric A.; Nobrega, Caroline C.; hide

    2014-01-01

    Interactions between climate and land-use change may drive widespread degradation of Amazonian forests. High-intensity fires associated with extreme weather events could accelerate this degradation by abruptly increasing tree mortality, but this process remains poorly understood. Here we present, to our knowledge, the first field-based evidence of a tipping point in Amazon forests due to altered fire regimes. Based on results of a large-scale, longterm experiment with annual and triennial burn regimes (B1yr and B3yr, respectively) in the Amazon, we found abrupt increases in fire-induced tree mortality (226 and 462%) during a severe drought event, when fuel loads and air temperatures were substantially higher and relative humidity was lower than long-term averages. This threshold mortality response had a cascading effect, causing sharp declines in canopy cover (23 and 31%) and aboveground live biomass (12 and 30%) and favoring widespread invasion by flammable grasses across the forest edge area (80 and 63%), where fires were most intense (e.g., 220 and 820 kW x m(exp -1)). During the droughts of 2007 and 2010, regional forest fires burned 12 and 5% of southeastern Amazon forests, respectively, compared with less than 1% in nondrought years. These results show that a few extreme drought events, coupled with forest fragmentation and anthropogenic ignition sources, are already causing widespread fire-induced tree mortality and forest degradation across southeastern Amazon forests. Future projections of vegetation responses to climate change across drier portions of the Amazon require more than simulation of global climate forcing alone and must also include interactions of extreme weather events, fire, and land-use change.

  12. Retinopathy of Prematurity.

    ERIC Educational Resources Information Center

    Trief, E.; And Others

    1989-01-01

    Retinopathy of prematurity (ROP) has increased due to a high incidence of premature, low birthweight infants. Stages of severity range from no visual damage to total blindness, and educational problems of ROP children parallel those of other visually impaired children, early intervention being crucial. Treatments are either pharmacological or…

  13. Retinopathy of Prematurity.

    ERIC Educational Resources Information Center

    Trief, E.; And Others

    1989-01-01

    Retinopathy of prematurity (ROP) has increased due to a high incidence of premature, low birthweight infants. Stages of severity range from no visual damage to total blindness, and educational problems of ROP children parallel those of other visually impaired children, early intervention being crucial. Treatments are either pharmacological or…

  14. Premature Menopause

    PubMed Central

    Okeke, TC; Anyaehie, UB; Ezenyeaku, CC

    2013-01-01

    Premature menopause affects 1% of women under the age of 40 years. The women are at risk of premature death, neurological diseases, psychosexual dysfunction, mood disorders, osteoporosis, ischemic heart disease and infertility. There is need to use simplified protocols and improved techniques in oocyte donation to achieve pregnancy and mother a baby in those women at risk. Review of the pertinent literature on premature menopause, selected references, internet services using the PubMed and Medline databases were included in this review. In the past, pregnancy in women with premature menopause was rare but with recent advancement in oocyte donation, women with premature menopause now have hoped to mother a child. Hormone replacement therapy is beneficial to adverse consequences of premature menopause. Women with premature menopause are at risk of premature death, neurological diseases, psychosexual dysfunction, mood disorders, osteoporosis, ischemic heart disease and infertility. Public enlightenment and education is important tool to save those at risk. PMID:23634337

  15. Bark beetle-induced tree mortality alters stand energy budgets due to water budget changes

    NASA Astrophysics Data System (ADS)

    Reed, David E.; Ewers, Brent E.; Pendall, Elise; Frank, John; Kelly, Robert

    2016-10-01

    Insect outbreaks are major disturbances that affect a land area similar to that of forest fires across North America. The recent mountain pine bark beetle (D endroctonus ponderosae) outbreak and its associated blue stain fungi (Grosmannia clavigera) are impacting water partitioning processes of forests in the Rocky Mountain region as the spatially heterogeneous disturbance spreads across the landscape. Water cycling may dramatically change due to increasing spatial heterogeneity from uneven mortality. Water and energy storage within trees and soils may also decrease, due to hydraulic failure and mortality caused by blue stain fungi followed by shifts in the water budget. This forest disturbance was unique in comparison to fire or timber harvesting because water fluxes were altered before significant structural change occurred to the canopy. We investigated the impacts of bark beetles on lodgepole pine (Pinus contorta) stand and ecosystem level hydrologic processes and the resulting vertical and horizontal spatial variability in energy storage. Bark beetle-impacted stands had on average 57 % higher soil moisture, 1.5 °C higher soil temperature, and 0.8 °C higher tree bole temperature over four growing seasons compared to unimpacted stands. Seasonal latent heat flux was highly correlated with soil moisture. Thus, high mortality levels led to an increase in ecosystem level Bowen ratio as sensible heat fluxes increased yearly and latent heat fluxes varied with soil moisture levels. Decline in canopy biomass (leaf, stem, and branch) was not seen, but ground-to-atmosphere longwave radiation flux increased, as the ground surface was a larger component of the longwave radiation. Variability in soil, latent, and sensible heat flux and radiation measurements increased during the disturbance. Accounting for stand level variability in water and energy fluxes will provide a method to quantify potential drivers of ecosystem processes and services as well as lead to greater

  16. U.S. Mortality Due to Carbon Monoxide Poisoning, 1999-2014. Accidental and Intentional Deaths.

    PubMed

    Hampson, Neil B

    2016-10-01

    Carbon monoxide (CO) poisoning accounts for hundreds of deaths and thousands of emergency department visits in the United States annually. Development of initiatives to reduce CO mortality through poisoning prevention requires a comprehensive understanding of the condition. To describe U.S. mortality from 1999 to 2014 due to CO poisoning from all sources except fires, to examine the epidemiology of accidental and intentional exposures, and to identify trends. The CDC WONDER database was used to extract and analyze data from the CDC's Multiple Cause of Death 1999-2014 file. The file contains mortality data derived from all death certificates filed in the United States. Information on deaths, crude death rate, age-adjusted death rate, intent of exposure, and characteristics of exposures from CO poisoning was extracted. Total deaths by CO poisoning decreased from 1,967 in 1999 to 1,319 in 2014 (P < 0.001). Crude and adjusted death rates fell accordingly. Accidental poisoning accounted for 13% fewer deaths per year in 2014 than in 1999 (P < 0.001). The number of intentional deaths by CO poisoning decreased by 47% over the same period (P < 0.001). The rate of decline in combined adjusted death rates from 1999 to 2014 in the 19 states that required residential CO alarms by 2010 was not different from that for the 31 states that did not require residential alarms (P = 0.982). Numbers of deaths and death rates, both accidental and intentional, due to CO poisoning significantly declined in the United States from 1999 to 2014. Continued public education about CO toxicity should be emphasized. Additional study is needed to demonstrate the efficacy of residential CO alarms.

  17. [Descriptive study of morbidity and mortality due to asthma at a Health Sector institution].

    PubMed

    Segura Méndez, N H; Salas Ramírez, M; Martínez-Cairo Cueto, S

    1994-01-01

    The objective of this study was to determine the morbidity and mortality rate due to asthma from a Health Institution, which represents the majority of working population. Asthma data were obtained from the National Institute of Informatical, Geography and Statistics (INEGI), Mexican Health Secretary (SS) and Mexican Social Security Institute (IMSS). The underlying cause of death hospitalization or visit were obtained. Asthma was coded according to the International Classification of Disease (ninth revision). Asthma death rate was adjusted by age using direct method. In the IMSS, asthma death rate increased from 3.24/200,000 in 1980 to 12.76/100,000 in 1990. The asthma letality increased from 0.34 in 1980 to 1.23 in 1990. The average length of hospital stay was 3.96 days in 1990; there was noy significant differences by sex the most affected groups were children under 4 years of age and persons older than 65 years of age. In conclusion, from 1980 to 1990, the morbidity and mortality rate due to asthma in IMSS increased. It suggests that future health policy efforts should be focused to reduce the morbidity, mainly in high risk groups.

  18. Association of physical job demands, smoking and alcohol abuse with subsequent premature mortality: a 9-year follow-up population-based study.

    PubMed

    Bourgkard, Eve; Wild, Pascal; Massin, Nicole; Meyer, Jean-Pierre; Otero Sierra, Carmen; Fontana, Jean-Marc; Benamghar, Lahoucine; Mur, Jean-Marie; Ravaud, Jean-François; Guillemin, Francis; Chau, Nearkasen

    2008-01-01

    This study assessed the relationships of physical job demands (PJD), smoking, and alcohol abuse, with premature mortality before age 70 (PM-70) among the working or inactive population. The sample included 4,268 subjects aged 15 or more randomly selected in north-eastern France. They completed a mailed questionnaire (birth date, sex, weight, height, job, PJD, smoking habit, alcohol abuse (Deta questionnaire)) in 1996 and were followed for mortality until 2004 (9 yr). PJD score was defined by the cumulative number of the following high job demands at work: hammer, vibrating platform, pneumatic tools, other vibrating hand tools, screwdriver, handling objects, awkward posture, tasks at heights, machine tools, pace, working on a production line, standing about and walking. The data were analyzed using the Poisson regression model. Those with PM-70 were 126 (3.81 per 1,000 person-years). The leading causes of death were cancers (46.4% in men, 57.1% in women), cardiovascular diseases (20.2% and 11.9%), suicide (9.5% and 7.1%), respiratory diseases (6.0% and 4.8%), and digestive diseases (2.4% and 4.8%). PJD3, smoker, and alcohol abuse had adjusted risk ratios of 1.71 (95% CI 1.02-2.88), 1.76 (1.08-2.88), and 2.07 (1.31-3.26) respectively for all-cause mortality. Manual workers had a risk ratio of 1.84 (1.00-3.37) compared to the higher socio-economic classes. The men had a two-fold higher mortality rate than the women; this difference became non-significant when controlling for job, PJD, smoker and alcohol abuse. For cancer mortality the factors PJD3, smoker, and alcohol abuse had adjusted risk ratios of 2.00 (1.00-3.99), 2.34 (1.19-4.63), and 2.22 (1.17-4.20), respectively. Health promotion efforts should be directed at structural measures of task redesign and they should also concern lifestyle.

  19. Child mortality estimation: methods used to adjust for bias due to AIDS in estimating trends in under-five mortality.

    PubMed

    Walker, Neff; Hill, Kenneth; Zhao, Fengmin

    2012-01-01

    In most low- and middle-income countries, child mortality is estimated from data provided by mothers concerning the survival of their children using methods that assume no correlation between the mortality risks of the mothers and those of their children. This assumption is not valid for populations with generalized HIV epidemics, however, and in this review, we show how the United Nations Inter-agency Group for Child Mortality Estimation (UN IGME) uses a cohort component projection model to correct for AIDS-related biases in the data used to estimate trends in under-five mortality. In this model, births in a given year are identified as occurring to HIV-positive or HIV-negative mothers, the lives of the infants and mothers are projected forward using survivorship probabilities to estimate survivors at the time of a given survey, and the extent to which excess mortality of children goes unreported because of the deaths of HIV-infected mothers prior to the survey is calculated. Estimates from the survey for past periods can then be adjusted for the estimated bias. The extent of the AIDS-related bias depends crucially on the dynamics of the HIV epidemic, on the length of time before the survey that the estimates are made for, and on the underlying non-AIDS child mortality. This simple methodology (which does not take into account the use of effective antiretroviral interventions) gives results qualitatively similar to those of other studies.

  20. Progression of Mortality due to Diseases of the Circulatory System and Human Development Index in Rio de Janeiro Municipalities.

    PubMed

    Soares, Gabriel Porto; Klein, Carlos Henrique; Silva, Nelson Albuquerque de Souza E; Oliveira, Glaucia Maria Moraes de

    2016-10-01

    Diseases of the circulatory system (DCS) are the major cause of death in Brazil and worldwide. To correlate the compensated and adjusted mortality rates due to DCS in the Rio de Janeiro State municipalities between 1979 and 2010 with the Human Development Index (HDI) from 1970 onwards. Population and death data were obtained in DATASUS/MS database. Mortality rates due to ischemic heart diseases (IHD), cerebrovascular diseases (CBVD) and DCS adjusted by using the direct method and compensated for ill-defined causes. The HDI data were obtained at the Brazilian Institute of Applied Research in Economics. The mortality rates and HDI values were correlated by estimating Pearson linear coefficients. The correlation coefficients between the mortality rates of census years 1991, 2000 and 2010 and HDI data of census years 1970, 1980 and 1991 were calculated with discrepancy of two demographic censuses. The linear regression coefficients were estimated with disease as the dependent variable and HDI as the independent variable. In recent decades, there was a reduction in mortality due to DCS in all Rio de Janeiro State municipalities, mainly because of the decline in mortality due to CBVD, which was preceded by an elevation in HDI. There was a strong correlation between the socioeconomic indicator and mortality rates. The HDI progression showed a strong correlation with the decline in mortality due to DCS, signaling to the relevance of improvements in life conditions.

  1. Progression of Mortality due to Diseases of the Circulatory System and Human Development Index in Rio de Janeiro Municipalities

    PubMed Central

    Soares, Gabriel Porto; Klein, Carlos Henrique; Silva, Nelson Albuquerque de Souza e; de Oliveira, Glaucia Maria Moraes

    2016-01-01

    Background Diseases of the circulatory system (DCS) are the major cause of death in Brazil and worldwide. Objective To correlate the compensated and adjusted mortality rates due to DCS in the Rio de Janeiro State municipalities between 1979 and 2010 with the Human Development Index (HDI) from 1970 onwards. Methods Population and death data were obtained in DATASUS/MS database. Mortality rates due to ischemic heart diseases (IHD), cerebrovascular diseases (CBVD) and DCS adjusted by using the direct method and compensated for ill-defined causes. The HDI data were obtained at the Brazilian Institute of Applied Research in Economics. The mortality rates and HDI values were correlated by estimating Pearson linear coefficients. The correlation coefficients between the mortality rates of census years 1991, 2000 and 2010 and HDI data of census years 1970, 1980 and 1991 were calculated with discrepancy of two demographic censuses. The linear regression coefficients were estimated with disease as the dependent variable and HDI as the independent variable. Results In recent decades, there was a reduction in mortality due to DCS in all Rio de Janeiro State municipalities, mainly because of the decline in mortality due to CBVD, which was preceded by an elevation in HDI. There was a strong correlation between the socioeconomic indicator and mortality rates. Conclusion The HDI progression showed a strong correlation with the decline in mortality due to DCS, signaling to the relevance of improvements in life conditions. PMID:27849263

  2. Mortality due to intestinal infectious diseases in Latin America and the Caribbean, 1965-1990.

    PubMed

    1991-01-01

    Life expectancy has increased in Latin America and the nonLatin Caribbean (LA/CA) from 51.8-66.6 years and 56.4-72.4 years between 1950-1955 and 1985-1990 respectively. Reduction in mortality due to infectious and parasitic diseases had the most significant effect on this rise in life expectancy. Indeed since the actual number of intestinal infection related deaths did fall while the populations grew considerably, there was a true reduced risk of death from these infections. Improved nutrition, potable water and waste disposal availability, immunizations, and safer food handling directly impacted on this reduction while the downward trend of the birth rate, increased literacy (especially among women), and mass media indirectly prompted the decline. Nevertheless these improvements have not yet reached the levels of the US and Canada during 1965-1970 (.07/1000) and have not been equitably divided among the different population groups. Indeed the technology existed 2 decades earlier to achieve zero deaths from diarrhea, yet deaths rates in LA/CA continued to range from .17-9.83/1000 during 1985-1990. Costa Rica and Chile experienced more of a decline in mortality from intestinal infections than most other countries. For example, the number of deaths fell about 90% for about the entire population and 93% and 95% respectively for children 5 years old. Even though there was a 95% reduction in the number of deaths for 5 year old children in Chile, the 64% reduction in Mexico resulted in more lives saved (355 vs. 529). Further data analysis showed that the death rate for 5 old children was the most valid indicator to analyze changes in mortality from intestinal infections. Over the 25 year period the countries with the least reduction in death rates from diarrhea included Guatemala, Honduras, and Nicaragua.

  3. Premature ovarian failure.

    PubMed

    Kalantaridou, S N; Davis, S R; Nelson, L M

    1998-12-01

    In 1% of women, premature ovarian failure develops by 40 years of age, a condition causing amenorrhea, infertility, sex steroid deficiency, and elevated gonadotropins. Early loss of ovarian function has significant psychosocial sequelae and major health implications. These young women have a nearly two-fold age-specific increase in mortality rate. Among women with spontaneous premature ovarian failure who have a normal karyotype, half have ovarian follicles remaining in the ovary that function intermittently. Indeed, pregnancies have occurred after the diagnosis of premature ovarian failure. Thus, premature ovarian failure should not be considered as a premature menopause. Young women with this disorder have a 5% to 10% chance for spontaneous pregnancy. Attempts at ovulation induction using various regimens fail to induce ovulation rates greater than those seen in untreated patients; however, oocyte donation for women desiring fertility is an option. Young women with premature ovarian failure need a thorough assessment, sex steroid replacement, and long-term surveillance to monitor therapy. Estrogen-progestin replacement therapy should be instituted as soon as the diagnosis is made. Androgen replacement should also be considered for women with low libido, persistent fatigue, and poor well-being despite taking adequate estrogen replacement. Women with premature ovarian failure should be followed up for the presence of associated autoimmune endocrine disorders such as hypothyroidism, adrenal insufficiency, and diabetes mellitus.

  4. Climate and mortality changes due to reductions in household cooking emissions

    NASA Astrophysics Data System (ADS)

    Bergman, Tommi; Mielonen, Tero; Arola, Antti; Kokkola, Harri

    2016-04-01

    Household cooking is a significant cause for health and environmental problems in the developing countries. There are more than 3 billion people who use biomass for fuel in cooking stoves in their daily life. These cooking stoves use inadequate ventilation and expose especially women and children to indoor smoke. To reduce problems of the biomass burning, India launched an initiative to provide affordable and clean energy solutions for the poorest households by providing clean next-generation cooking stoves. The improved cooking stoves are expected to improve outdoor air quality and to reduce the climate-active pollutants, thus simultaneously slowing the climate change. Previous research has shown that the emissions of black carbon can be decreased substantially, as much as 90 % by applying better technology in cooking stoves. We have implemented reasonable (50% decrease) and best case (90% decrease) scenarios of the reductions in black and organic carbon due to improved cooking stoves in India into ECHAM-HAMMOZ aerosol-climate model. The global simulations of the scenarios will be used to study how the reductions of emissions in India affect the pollutant concentrations and radiation. The simulated reductions in particulate concentrations will also be used to estimate the decrease in mortality rates. Furthermore, we will study how the emission reductions would affect the global climate and mortality if a similar initiative would be applied in other developing countries.

  5. Maternal obesity during pregnancy and premature mortality from cardiovascular event in adult offspring: follow-up of 1 323 275 person years

    PubMed Central

    Allan, Keith M; Raja, Edwin A; Bhattacharya, Sohinee; McNeill, Geraldine; Hannaford, Philip C; Sarwar, Nadeem; Lee, Amanda J; Bhattacharya, Siladitya; Norman, Jane E

    2013-01-01

    Objectives To determine whether maternal obesity during pregnancy is associated with increased mortality from cardiovascular events in adult offspring. Design Record linkage cohort analysis. Setting Birth records from the Aberdeen Maternity and Neonatal databank linked to the General Register of Deaths, Scotland, and the Scottish Morbidity Record systems. Population 37 709 people with birth records from 1950 to present day. Main outcome measures Death and hospital admissions for cardiovascular events up to 1 January 2012 in offspring aged 34-61. Maternal body mass index (BMI) was calculated from height and weight measured at the first antenatal visit. The effect of maternal obesity on outcomes in offspring was tested with time to event analysis with Cox proportional hazard regression to compare outcomes in offspring of mothers in underweight, overweight, or obese categories of BMI compared with offspring of women with normal BMI. Results All cause mortality was increased in offspring of obese mothers (BMI >30) compared with mothers with normal BMI after adjustment for maternal age at delivery, socioeconomic status, sex of offspring, current age, birth weight, gestation at delivery, and gestation at measurement of BMI (hazard ratio 1.35, 95% confidence interval 1.17 to 1.55). In adjusted models, offspring of obese mothers also had an increased risk of hospital admission for a cardiovascular event (1.29, 1.06 to 1.57) compared with offspring of mothers with normal BMI. The offspring of overweight mothers also had a higher risk of adverse outcomes. Conclusions Maternal obesity is associated with an increased risk of premature death in adult offspring. As one in five women in the United Kingdom is obese at antenatal booking, strategies to optimise weight before pregnancy are urgently required. PMID:23943697

  6. Airway Tissue Plasminogen Activator Prevents Acute Mortality Due to Lethal Sulfur Mustard Inhalation

    PubMed Central

    Veress, Livia A.; Anderson, Dana R.; Hendry-Hofer, Tara B.; Houin, Paul R.; Rioux, Jacqueline S.; Garlick, Rhonda B.; Loader, Joan E.; Paradiso, Danielle C.; Smith, Russell W.; Rancourt, Raymond C.; Holmes, Wesley W.; White, Carl W.

    2015-01-01

    Rationale: Sulfur mustard (SM) is a chemical weapon stockpiled today in volatile regions of the world. SM inhalation causes a life-threatening airway injury characterized by airway obstruction from fibrin casts, which can lead to respiratory failure and death. Mortality in those requiring intubation is more than 80%. No therapy exists to prevent mortality after SM exposure. Our previous work using the less toxic analog of SM, 2-chloroethyl ethyl sulfide, identified tissue plasminogen activator (tPA) an effective rescue therapy for airway cast obstruction (Veress, L. A., Hendry-Hofer, T. B., Loader, J. E., Rioux, J. S., Garlick, R. B., and White, C. W. (2013). Tissue plasminogen activator prevents mortality from sulfur mustard analog-induced airway obstruction. Am. J. Respir. Cell Mol. Biol. 48, 439–447). It is not known if exposure to neat SM vapor, the primary agent used in chemical warfare, will also cause death due to airway casts, and if tPA could be used to improve outcome. Methods: Adult rats were exposed to SM, and when oxygen saturation reached less than 85% (median: 6.5 h), intratracheal tPA or placebo was given under isoflurane anesthesia every 4 h for 48 h. Oxygen saturation, clinical distress, and arterial blood gases were assessed. Microdissection was done to assess airway obstruction by casts. Results: Intratracheal tPA treatment eliminated mortality (0% at 48 h) and greatly improved morbidity after lethal SM inhalation (100% death in controls). tPA normalized SM-associated hypoxemia, hypercarbia, and lactic acidosis, and improved respiratory distress. Moreover, tPA treatment resulted in greatly diminished airway casts, preventing respiratory failure from airway obstruction. Conclusions: tPA given via airway more than 6 h after exposure prevented death from lethal SM inhalation, and normalized oxygenation and ventilation defects, thereby rescuing from respiratory distress and failure. Intra-airway tPA should be considered as a life

  7. Invasive infections due to filamentous fungi other than Aspergillus: epidemiology and determinants of mortality.

    PubMed

    Slavin, M; van Hal, S; Sorrell, T C; Lee, A; Marriott, D J; Daveson, K; Kennedy, K; Hajkowicz, K; Halliday, C; Athan, E; Bak, N; Cheong, E; Heath, C H; Orla Morrissey, C; Kidd, S; Beresford, R; Blyth, C; Korman, T M; Owen Robinson, J; Meyer, W; Chen, S C-A

    2015-05-01

    The epidemiology of invasive fungal disease (IFD) due to filamentous fungi other than Aspergillus may be changing. We analysed clinical, microbiological and outcome data in Australian patients to determine the predisposing factors and identify determinants of mortality. Proven and probable non-Aspergillus mould infections (defined according to modified European Organization for Research and Treatment of Cancer/Mycoses Study Group criteria) from 2004 to 2012 were evaluated in a multicentre study. Variables associated with infection and mortality were determined. Of 162 episodes of non-Aspergillus IFD, 145 (89.5%) were proven infections and 17 (10.5%) were probable infections. The pathogens included 29 fungal species/species complexes; mucormycetes (45.7%) and Scedosporium species (33.3%) were most common. The commonest comorbidities were haematological malignancies (HMs) (46.3%) diabetes mellitus (23.5%), and chronic pulmonary disease (16%); antecedent trauma was present in 21% of cases. Twenty-five (15.4%) patients had no immunocompromised status or comorbidity, and were more likely to have acquired infection following major trauma (p <0.01); 61 (37.7%) of cases affected patients without HMs or transplantation. Antifungal therapy was administered to 93.2% of patients (median 68 days, interquartile range 19-275), and adjunctive surgery was performed in 58.6%. The all-cause 90-day mortality was 44.4%; HMs and intensive-care admission were the strongest predictors of death (both p <0.001). Survival varied by fungal group, with the risk of death being significantly lower in patients with dematiaceous mould infections than in patients with other non-Aspergillus mould infections. Non-Aspergillus IFD affected diverse patient groups, including non-immunocompromised hosts and those outside traditional risk groups; therefore, definitions of IFD in these patients are required. Given the high mortality, increased recognition of infections and accurate identification of the

  8. [Analysis of the mortality due to diarrhea in younger children, before and after the introduction of rotavirus vaccine].

    PubMed

    Esparza-Aguilar, Marcelino; Bautista-Márquez, Aurora; González-Andrade, María del Carmen; Richardson-López-Collada, Vesta Louise

    2009-01-01

    To analyze the mortality due to acute diarrhea in children younger than five years old, before and after the introduction of rotavirus vaccine in Mexico. Number of deaths and mortality rates due to acute diarrhea were compared by children's age and states' vaccine status using annual percentage differences before (2000-2005) and after (2006-2007) the introduction of the HRV. From 2000-2007, deaths due to acute diarrhea in children under five years of age dropped 42%. In those states that received the HRV early in 2006, diarrhea mortality decreased between 2006-2007 15.8% in children younger than one year old and 22.7% in children 1-4 years old. The observed reduction in mortality due to acute diarrhea in children under five years of age after 2005 can be, in part, attributed to the HRV.

  9. Premature Ejaculation

    MedlinePlus

    ... may help men who have premature ejaculation. Some antidepressants seem to help delay ejaculation, including antidepressants called selective serotonin reuptake inhibitors (SSRIs). These antidepressants ...

  10. Burden of diarrhea, hospitalization and mortality due to cryptosporidial infections in Indian children.

    PubMed

    Sarkar, Rajiv; Tate, Jacqueline E; Ajjampur, Sitara S R; Kattula, Deepthi; John, Jacob; Ward, Honorine D; Kang, Gagandeep

    2014-07-01

    Cryptosporidium spp. is a common, but under-reported cause of childhood diarrhea throughout the world, especially in developing countries. A comprehensive estimate of the burden of cryptosporidiosis in resource-poor settings is not available. We used published and unpublished studies to estimate the burden of diarrhea, hospitalization and mortality due to cryptosporidial infections in Indian children. Our estimates suggest that annually, one in every 6-11 children <2 years of age will have an episode of cryptosporidial diarrhea, 1 in every 169-633 children will be hospitalized and 1 in every 2890-7247 children will die due to cryptosporidiosis. Since there are approximately 42 million children <2 years of age in India, it is estimated that Cryptosporidium results in 3.9-7.1 million diarrheal episodes, 66.4-249.0 thousand hospitalizations, and 5.8-14.6 thousand deaths each year. The findings of this study suggest a high burden of cryptosporidiosis among children <2 years of age in India and makes a compelling case for further research on transmission and prevention modalities of Cryptosporidium spp. in India and other developing countries.

  11. Burden of Diarrhea, Hospitalization and Mortality Due to Cryptosporidial Infections in Indian Children

    PubMed Central

    Sarkar, Rajiv; Tate, Jacqueline E.; Ajjampur, Sitara S. R.; Kattula, Deepthi; John, Jacob; Ward, Honorine D.; Kang, Gagandeep

    2014-01-01

    Background Cryptosporidium spp. is a common, but under-reported cause of childhood diarrhea throughout the world, especially in developing countries. A comprehensive estimate of the burden of cryptosporidiosis in resource-poor settings is not available. Methodology/Principal Findings We used published and unpublished studies to estimate the burden of diarrhea, hospitalization and mortality due to cryptosporidial infections in Indian children. Our estimates suggest that annually, one in every 6–11 children <2 years of age will have an episode of cryptosporidial diarrhea, 1 in every 169–633 children will be hospitalized and 1 in every 2890–7247 children will die due to cryptosporidiosis. Since there are approximately 42 million children <2 years of age in India, it is estimated that Cryptosporidium results in 3.9–7.1 million diarrheal episodes, 66.4–249.0 thousand hospitalizations, and 5.8–14.6 thousand deaths each year. Conclusions/Significance The findings of this study suggest a high burden of cryptosporidiosis among children <2 years of age in India and makes a compelling case for further research on transmission and prevention modalities of Cryptosporidium spp. in India and other developing countries. PMID:25058664

  12. Avian wildlife mortality events due to salmonellosis in the United States, 1985-2004

    USGS Publications Warehouse

    Hall, A.J.; Saito, E.K.

    2008-01-01

    Infection with Salmonella spp. has long been recognized in avian wildlife, although its significance in causing avian mortality, and its zoonotic risk, is not well understood. This study evaluates the role of Salmonella spp. in wild bird mortality events in the United States from 1985 through 2004. Analyses were performed to calculate the frequency of these events and the proportional mortality by species, year, month, state, and region. Salmonellosis was a significant contributor to mortality in many species of birds; particularly in passerines, for which 21.5% of all mortality events involved salmonellosis. The proportional mortality averaged a 12% annual increase over the 20-yr period, with seasonal peaks in January and April. Increased salmonellosis-related mortality in New England, Southeastern, and Mountain-Prairie states was identified. Based on the results of this study, salmonellosis can be considered an important zoonotic disease of wild birds. ?? Wildlife Disease Association 2008.

  13. The effect of grid resolution on estimates of the burden of ozone and fine particulate matter on premature mortality in the United States

    PubMed Central

    Punger, Elizabeth M.; West, J. Jason

    2013-01-01

    Assessments of human health impacts associated with outdoor air pollution often use air quality models to represent exposure, but involve uncertainties due to coarse model resolution. Here we quantify how estimates of mortality in the United States attributable to ozone (O3) and fine particulate matter (PM2.5) at coarse resolution differ from those at finer resolution. Using the finest modeled concentrations (12 km), we estimate that 66,000 (95% CI, 39,300 – 84,500) all-cause and 21,400 (5,600 – 34,200) respiratory deaths per year are attributable to PM2.5 and O3 concentrations above low-concentration thresholds, respectively. Using model results at 36 km resolution gives mortality burdens that are 11% higher for PM2.5 and 12% higher for O3 than the 12 km estimates, suggesting a modest positive bias. We also scale modeled concentrations at 12 km to coarser resolutions by simple averaging, and repeat the mortality assessment at multiple resolutions from 24 to 408 km, including the resolutions of global models; in doing so, we account for the effect of resolution on population exposure. Coarse grid resolutions produce mortality estimates that are substantially biased low for PM2.5 (30–40% lower than the 12 km estimate at >250 km resolution), but less than 6% higher for O3 at any resolution. Mortality estimates for primary PM2.5 species show greater bias at coarse resolution than secondary species. These results suggest that coarse resolution global models (>100 km) are likely biased low for PM2.5 health effects. For ozone, biases due to coarse resolution may be much smaller, and the effect on modeled chemistry likely dominates. PMID:24348882

  14. [Analysis and Forecasting of Population Mortality and Life Lost Trend due to 
Lung Cancer among Xiamen Residents].

    PubMed

    Lin, Yilan; Wu, Xiaoqing; Lin, Tianquan

    2016-02-01

    In recent years, the incidence and mortality of lung cancer is rising. It has become the leading cause of death of malignant tumors in China. The aim of this study is to explore the trend of mortality and years of life lost due to lung cancer in residents in Xiamen, so as to provide the basis data on preventing lung cancer in Xiamen. The data of residents in Xiamen dying of lung cancer from 2005 to 2014 was collected and cleared up to calculate the evaluation indexes including the mortality rate, the average potential life lost (AYLL), and the average percentage change (APC) of mortality rate. GM(1,1) model was used to predict the future mortality and AYLL. From 2005 to 2014, the average mortality rate of lung cancer in residents in Xiamen was 28.58 per 100,000 persons, of which in male was 2.90 times as that in female. The APC was 4.86%. The AYLL, which was 7.8 years, had decline trend from 2005 to 2014. The mean absolute percentage errors between observed values and fitted values were 2.16%-8.83%. The mortality rate and AYLL of lung cancer in residents in Xiamen would increase from 2015 to 2019. The mortality of lung cancer increased year by year in Xiamen. There are both increasing trend of mortality and years of life lost in future. So we should pay more attentions on preventing and curing of lung cancer.

  15. Oocyte cryopreservation for fertility preservation in postpubertal female children at risk for premature ovarian failure due to accelerated follicle loss in Turner syndrome or cancer treatments.

    PubMed

    Oktay, K; Bedoschi, G

    2014-12-01

    To preliminarily study the feasibility of oocyte cryopreservation in postpubertal girls aged between 13 and 15 years who were at risk for premature ovarian failure due to the accelerated follicle loss associated with Turner syndrome or cancer treatments. Retrospective cohort and review of literature. Academic fertility preservation unit. Three girls diagnosed with Turner syndrome, 1 girl diagnosed with germ-cell tumor. and 1 girl diagnosed with lymphoblastic leukemia. Assessment of ovarian reserve, ovarian stimulation, oocyte retrieval, in vitro maturation, and mature oocyte cryopreservation. Response to ovarian stimulation, number of mature oocytes cryopreserved and complications, if any. Mean anti-müllerian hormone, baseline follical stimulating hormone, estradiol, and antral follicle counts were 1.30 ± 0.39, 6.08 ± 2.63, 41.39 ± 24.68, 8.0 ± 3.2; respectively. In Turner girls the ovarian reserve assessment indicated already diminished ovarian reserve. Ovarian stimulation and oocyte cryopreservation was successfully performed in all female children referred for fertility preservation. A range of 4-11 mature oocytes (mean 8.1 ± 3.4) was cryopreserved without any complications. All girls tolerated the procedure well. Oocyte cryopreservation is a feasible technique in selected female children at risk for premature ovarian failure. Further studies would be beneficial to test the success of oocyte cryopreservation in young girls. Copyright © 2014 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  16. Micafungin in Premature and Non-premature Infants

    PubMed Central

    Wu, Chunzhang; Tweddle, Lorraine; Roilides, Emmanuel

    2014-01-01

    Background: Invasive fungal infections cause excessive morbidity and mortality in premature neonates and severely ill infants. Methods: Safety and efficacy outcomes of micafungin were compared between prematurely and non-prematurely born infants <2 years of age. Data were obtained from all completed phase I–III clinical trials with micafungin that had enrolled infants (<2 years of age) that were listed in the Astellas Clinical Study Database. Demographics, adverse events, hepatic function tests and treatment success data were extracted and validated by the Astellas biostatistical group for all micafungin-treated patients, <2 years of age, using the unique patient identifier. Results: One-hundred and sixteen patients included in 9 clinical trials, 48% premature [birth weight (BW) <2500 g and/or gestational age <37 weeks], 52% non-premature, received ≥1 dose of micafungin. Among premature patients, 14.5% were low BW (1500–2499 g), 36.4% very low BW (1000–1499 g) and 49.1% extremely low BW (<1000 g). Ninety patients (78%) completed the studies; 13 [11% (4 premature)] died. Significantly more non-premature than premature patients discontinued treatment (P = 0.003). Treatment-related adverse events were recorded in 23% of patients with no difference between groups. More extremely low BW (n = 4, 15%) and very low BW (n = 8, 40%) infants experienced treatment-related adverse events than low BW (n = 0) and there was no relation to micafungin dose or duration. For a subgroup of 30 patients with invasive candidiasis, treatment success was achieved in 73% in both premature and non-premature groups. Prophylaxis was successful in 4/5 non-premature hematopoietic stem cell transplant patients. Conclusion: Micafungin has a safe profile in premature and non-premature infants with substantial efficacy. PMID:24892849

  17. Socio-economic inequalities in mortality due to injuries in small areas of ten cities in Spain (MEDEA Project).

    PubMed

    Gotsens, Mercè; Marí-Dell'Olmo, Marc; Martínez-Beneito, Miguel Ángel; Pérez, Katherine; Pasarín, M Isabel; Daponte, Antonio; Puigpinós-Riera, Rosa; Rodríguez-Sanz, Maica; Audicana, Covadonga; Nolasco, Andreu; Gandarillas, Ana; Serral, Gemma; Domínguez-Berjón, Felicitas; Martos, Carmen; Borrell, Carme

    2011-09-01

    To analyse socio-economic inequalities in mortality due to injuries among census tracts of ten Spanish cities by sex and age in the period 1996-2003. This is a cross-sectional ecological study where the units of analysis are census tracts. The study population consisted of people residing in the cities during the period 1996-2003. For each census tract we obtained an index of socio-economic deprivation, and estimated standardized mortality ratios using hierarchical Bayesian models which take into account the spatial structure of the data. In the majority of the cities, the geographical pattern of total mortality from injuries is similar to that of the socio-economic deprivation index. There is an association between mortality due to injuries and the deprivation index in the majority of the cities which is more important among men and among those younger than 45 years. In these groups, traffic injuries and overdoses are the causes most often associated with deprivation in the cities. The percentage of excess mortality from injuries related to socio-economic deprivation is higher than 20% in the majority of the cities, the cause with the highest percentage being drug overdose. In most cities, there are socio-economic inequalities in mortality due to overdose and traffic injuries. In contrast, few cities have found association between suicide mortality and deprivation. Finally, no association was found between deprivation and deaths due to falls. Inequalities are higher in men and those under 45 years of age. These results highlight the importance of intra-urban inequalities in mortality due to injuries. Copyright © 2011 Elsevier Ltd. All rights reserved.

  18. Dirty air, dirty power. Mortality and health damage due to air pollution from power plants

    SciTech Connect

    Schneider, Conrad G.; Padian, M.

    2004-06-15

    The Clean Air Task Force commissioned Abt Associates, the consulting firm relied upon by US EPA to assess the health benefits of many of the agency's air regulatory programs. The report documents the asthma attacks, hospitalisations, lost work and school days, and premature deaths linked to pollution from power plants. A first report was released in 2000. The 2004 report documents for the first time the number of heart attacks and lung cancer deaths that would be caused by power plants in 2010 and 2020. It compares the premature deaths that would result under the Bush administration's air pollution plan, the existing US Clean Air Act, and a proposal sponsored by Senator Jim Jeffords to strengthen the Clean Air Act. In general it was found that the administration's plan would produce the fewest benefits. The full study is available from the EPA, abstracted separately on the Coal Abstracts database. 65 refs., 2 apps.

  19. Mortality due to Vegetation Fire–Originated PM2.5 Exposure in Europe—Assessment for the Years 2005 and 2008

    PubMed Central

    Kollanus, Virpi; Prank, Marje; Gens, Alexandra; Soares, Joana; Vira, Julius; Kukkonen, Jaakko; Sofiev, Mikhail; Salonen, Raimo O.; Lanki, Timo

    2016-01-01

    Background: Vegetation fires can release substantial quantities of fine particles (PM2.5), which are harmful to health. The fire smoke may be transported over long distances and can cause adverse health effects over wide areas. Objective: We aimed to assess annual mortality attributable to short-term exposures to vegetation fire–originated PM2.5 in different regions of Europe. Methods: PM2.5 emissions from vegetation fires in Europe in 2005 and 2008 were evaluated based on Moderate Resolution Imaging Spectroradiometer (MODIS) satellite data on fire radiative power. Atmospheric transport of the emissions was modeled using the System for Integrated modeLling of Atmospheric coMposition (SILAM) chemical transport model. Mortality impacts were estimated for 27 European countries based on a) modeled daily PM2.5 concentrations and b) population data, both presented in a 50 × 50 km2 spatial grid; c) an exposure–response function for short-term PM2.5 exposure and daily nonaccidental mortality; and d) country-level data for background mortality risk. Results: In the 27 countries overall, an estimated 1,483 and 1,080 premature deaths were attributable to the vegetation fire–originated PM2.5 in 2005 and 2008, respectively. Estimated impacts were highest in southern and eastern Europe. However, all countries were affected by fire-originated PM2.5, and even the lower concentrations in western and northern Europe contributed substantially (~ 30%) to the overall estimate of attributable mortality. Conclusions: Our assessment suggests that air pollution caused by PM2.5 released from vegetation fires is a notable risk factor for public health in Europe. Moreover, the risk can be expected to increase in the future as climate change proceeds. This factor should be taken into consideration when evaluating the overall health and socioeconomic impacts of these fires. Citation: Kollanus V, Prank M, Gens A, Soares J, Vira J, Kukkonen J, Sofiev M, Salonen RO, Lanki T. 2017. Mortality

  20. Risk assessment for cardiovascular and respiratory mortality due to air pollution and synoptic meteorology in 10 Canadian cities.

    PubMed

    Vanos, Jennifer K; Hebbern, Christopher; Cakmak, Sabit

    2014-02-01

    Synoptic weather and ambient air quality synergistically influence human health. We report the relative risk of mortality from all non-accidental, respiratory-, and cardiovascular-related causes, associated with exposure to four air pollutants, by weather type and season, in 10 major Canadian cities for 1981 through 1999. We conducted this multi-city time-series study using Poisson generalized linear models stratified by season and each of six distinctive synoptic weather types. Statistically significant relationships of mortality due to short-term exposure to carbon monoxide, nitrogen dioxide, sulphur dioxide, and ozone were found, with significant modifications of risk by weather type, season, and mortality cause. In total, 61% of the respiratory-related mortality relative risk estimates were significantly higher than for cardiovascular-related mortality. The combined effect of weather and air pollution is greatest when tropical-type weather is present in the spring or summer. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

  1. Premature menarche

    PubMed Central

    Murram, D; Dewhurst, John; Grant, D B

    1983-01-01

    Follow-up information was obtained from 12 women aged 16-34 years who had been seen previously because of premature isolated menstrual bleeding (premature menarche) starting between ages 9 months and 9 years. All the women reported normal regular menses and fertility was normal in the 6 women who had married. PMID:6830291

  2. Huntingtons Disease Mice Infected with Toxoplasma gondii Demonstrate Early Kynurenine Pathway Activation, Altered CD8+ T-Cell Responses, and Premature Mortality

    PubMed Central

    Donley, David W.; Olson, Andrew R.; Raisbeck, Merl F.; Fox, Jonathan H.; Gigley, Jason P.

    2016-01-01

    Huntington's disease (HD) is a progressive neurodegenerative disorder caused by a polyglutamine-repeat expansion in the huntingtin protein. Activation of the kynurenine pathway of tryptophan degradation is implicated in the pathogenesis of HD. Indoleamine-2,3-dioxygenase (IDO) catalyzes the oxidation of tryptophan to kynurenine, the first step in this pathway. The prevalent, neuroinvasive protozoal pathogen Toxoplasma gondii (T. gondii) results in clinically silent life-long infection in immune-competent individuals. T. gondii infection results in activation of IDO which provides some protection against the parasite by depleting tryptophan which the parasite cannot synthesize. The kynurenine pathway may therefore represent a point of synergism between HD and T. gondii infection. We show here that IDO activity is elevated at least four-fold in frontal cortex and striata of non-infected N171-82Q HD mice at 14-weeks corresponding to early–advanced HD. T. gondii infection at 5 weeks resulted in elevation of cortical IDO activity in HD mice. HD-infected mice died significantly earlier than wild-type infected and HD control mice. Prior to death, infected HD mice demonstrated decreased CD8+ T-lymphocyte proliferation in brain and spleen compared to wild-type infected mice. We demonstrate for the first time that HD mice have an altered response to an infectious agent that is characterized by premature mortality, altered immune responses and early activation of IDO. Findings are relevant to understanding how T. gondii infection may interact with pathways mediating neurodegeneration in HD. PMID:27611938

  3. Is perceived nervousness and anxiety a predictor of premature mortality and severe morbidity? A longitudinal follow up of the Swedish survey of living conditions.

    PubMed

    Ringbäck Weitoft, Gunilla; Rosén, Måns

    2005-09-01

    To find out if people perceiving nervousness, uneasiness, and anxiety have excess risks of premature death and severe morbidity. Random samples of the Swedish population aged 16-74 years in 1980-81, 1988-89, and 1995-96 were followed up for 5 and 10 years with regard to deaths and hospital admissions for different causes. Relative risks were estimated by Poisson regression, comparing those who reported perceived nervousness, uneasiness, and anxiety with those who did not and adjustments were made for baseline characteristics as age, education, smoking, and longstanding illness. Perceived nervousness, uneasiness, and anxiety was strongly related to subsequent risks of suicide attempt and psychiatric disease. Those perceiving severe complaints of anxiety had a relative risk (fully adjusted) for suicide attempt of 9.2 (95% CI 3.0 to 28.8) for men and 3.1 (1.4 to 7.1) for women. Even for less severe complaints, there was a significant, but less pronounced excess risk. These negative feelings were also associated with later risks for all cause mortality, hospital care, and ischaemic heart disease, although to a lesser extent and more strongly among men. Unchanged relative risks over time shows no trend in response attitude and perceived anxiety seems to be a better predictor of a negative health outcome than self reported longstanding illness. Positive responses to self report survey questions about anxiety/nervousness are associated with adverse health outcomes, particularly hospital admission for deliberate self harm. This is an alarming signal bearing in mind the rapid increase in prevalence of perceived anxiety in the Swedish society.

  4. Is perceived nervousness and anxiety a predictor of premature mortality and severe morbidity? A longitudinal follow up of the Swedish survey of living conditions

    PubMed Central

    Ringback, W; Rosen, M.

    2005-01-01

    Study objective: To find out if people perceiving nervousness, uneasiness, and anxiety have excess risks of premature death and severe morbidity. Design, setting, participants: Random samples of the Swedish population aged 16–74 years in 1980–81, 1988–89, and 1995–96 were followed up for 5 and 10 years with regard to deaths and hospital admissions for different causes. Relative risks were estimated by Poisson regression, comparing those who reported perceived nervousness, uneasiness, and anxiety with those who did not and adjustments were made for baseline characteristics as age, education, smoking, and longstanding illness. Main results: Perceived nervousness, uneasiness, and anxiety was strongly related to subsequent risks of suicide attempt and psychiatric disease. Those perceiving severe complaints of anxiety had a relative risk (fully adjusted) for suicide attempt of 9.2 (95% CI 3.0 to 28.8) for men and 3.1 (1.4 to 7.1) for women. Even for less severe complaints, there was a significant, but less pronounced excess risk. These negative feelings were also associated with later risks for all cause mortality, hospital care, and ischaemic heart disease, although to a lesser extent and more strongly among men. Unchanged relative risks over time shows no trend in response attitude and perceived anxiety seems to be a better predictor of a negative health outcome than self reported longstanding illness. Conclusions: Positive responses to self report survey questions about anxiety/nervousness are associated with adverse health outcomes, particularly hospital admission for deliberate self harm. This is an alarming signal bearing in mind the rapid increase in prevalence of perceived anxiety in the Swedish society. PMID:16100319

  5. Huntingtons Disease Mice Infected with Toxoplasma gondii Demonstrate Early Kynurenine Pathway Activation, Altered CD8+ T-Cell Responses, and Premature Mortality.

    PubMed

    Donley, David W; Olson, Andrew R; Raisbeck, Merl F; Fox, Jonathan H; Gigley, Jason P

    2016-01-01

    Huntington's disease (HD) is a progressive neurodegenerative disorder caused by a polyglutamine-repeat expansion in the huntingtin protein. Activation of the kynurenine pathway of tryptophan degradation is implicated in the pathogenesis of HD. Indoleamine-2,3-dioxygenase (IDO) catalyzes the oxidation of tryptophan to kynurenine, the first step in this pathway. The prevalent, neuroinvasive protozoal pathogen Toxoplasma gondii (T. gondii) results in clinically silent life-long infection in immune-competent individuals. T. gondii infection results in activation of IDO which provides some protection against the parasite by depleting tryptophan which the parasite cannot synthesize. The kynurenine pathway may therefore represent a point of synergism between HD and T. gondii infection. We show here that IDO activity is elevated at least four-fold in frontal cortex and striata of non-infected N171-82Q HD mice at 14-weeks corresponding to early-advanced HD. T. gondii infection at 5 weeks resulted in elevation of cortical IDO activity in HD mice. HD-infected mice died significantly earlier than wild-type infected and HD control mice. Prior to death, infected HD mice demonstrated decreased CD8+ T-lymphocyte proliferation in brain and spleen compared to wild-type infected mice. We demonstrate for the first time that HD mice have an altered response to an infectious agent that is characterized by premature mortality, altered immune responses and early activation of IDO. Findings are relevant to understanding how T. gondii infection may interact with pathways mediating neurodegeneration in HD.

  6. The impact of widowhood on Irish mortality due to suicide and accidents.

    PubMed

    Corcoran, Paul

    2009-12-01

    The impact of widowhood on suicide and accident mortality in Ireland was investigated using Poisson regression analysis applied to routine data relating to all 10 561 suicidal and accidental deaths of married or widowed persons aged at least 35 years in Ireland during 1986-2005. Mortality rates were almost always higher among the widowed and often by a 2-fold, statistically significant difference. The excess mortality was equivalent to 2083 or 57.6% of all suicidal or accidental deaths of widowed persons in 1986-2005. Routine contact with recently widowed persons by public health professionals may be warranted with a view to reducing their excess mortality.

  7. Raptor mortality due to West Nile virus in the United States, 2002.

    PubMed

    Saito, Emi K; Sileo, Louis; Green, D Earl; Meteyer, Carol U; McLaughlin, Grace S; Converse, Kathryn A; Docherty, Douglas E

    2007-04-01

    West Nile virus (WNV) has affected many thousands of birds since it was first detected in North America in 1999, but the overall impact on wild bird populations is unknown. In mid-August 2002, wildlife rehabilitators and local wildlife officials from multiple states began reporting increasing numbers of sick and dying raptors, mostly red-tailed hawks (Buteo jamaicensis) and great horned owls (Bubo virginianus). Commonly reported clinical signs were nonspecific and included emaciation, lethargy, weakness, inability to perch, fly or stand, and nonresponse to danger. Raptor carcasses from 12 states were received, and diagnostic evaluation of 56 raptors implicated WNV infection in 40 (71%) of these cases. Histologically, nonsuppurative encephalitis and myocarditis were the salient lesions (79% and 61%, respectively). Other causes of death included lead poisoning, trauma, aspergillosis, and Salmonella spp. and Clostridium spp. infections. The reason(s) for the reported increase in raptor mortality due to WNV in 2002 compared with the previous WNV seasons is unclear, and a better understanding of the epizootiology and pathogenesis of the virus in raptor populations is needed.

  8. Raptor mortality due to West Nile virus in the United States, 2002

    USGS Publications Warehouse

    Saito, E.K.; Sileo, L.; Green, D.E.; Meteyer, C.U.; McLaughlin, G.S.; Converse, K.A.; Docherty, D.E.

    2007-01-01

    West Nile virus (WNV) has affected many thousands of birds since it was first detected in North America in 1999, but the overall impact on wild bird populations is unknown. In mid-August 2002, wildlife rehabilitators and local wildlife officials from multiple states began reporting increasing numbers of sick and dying raptors, mostly red-tailed hawks (Buteo jamaicensis) and great horned owls (Bubo virginianus. Commonly reported clinical signs were nonspecific and included emaciation, lethargy, weakness, inability to perch, fly or stand, and nonresponse to danger. Raptor carcasses from 12 states were received, and diagnostic evaluation of 56 raptors implicated WNV infection in 40 (71%) of these cases. Histologically, nonsuppurative encephalitis and myocarditis were the salient lesions (79% and 61%, respectively). Other causes of death included lead poisoning, trauma, aspergillosis, and Salmonella spp. and Clostridium spp. infections. The reason(s) for the reported increase in raptor mortality due to WNV in 2002 compared with the previous WNV seasons is unclear, and a better understanding of the epizootiology and pathogenesis of the virus in raptor populations is needed. ?? Wildlife Disease Association 2007.

  9. Preventive zinc supplementation in developing countries: impact on mortality and morbidity due to diarrhea, pneumonia and malaria

    PubMed Central

    2011-01-01

    Background Zinc deficiency is commonly prevalent in children in developing countries and plays a role in decreased immunity and increased risk of infection. Preventive zinc supplementation in healthy children can reduce mortality due to common causes like diarrhea, pneumonia and malaria. The main objective was to determine all-cause mortality and cause-specific mortality and morbidity in children under five in developing countries for preventive zinc supplementation. Data sources/ review methods A literature search was carried out on PubMed, the Cochrane Library and the WHO regional databases to identify RCTs on zinc supplementation for greater than 3 months in children less than 5 years of age in developing countries and its effect on mortality was analyzed. Results The effect of preventive zinc supplementation on mortality was given in eight trials, while cause specific mortality data was given in five of these eight trials. Zinc supplementation alone was associated with a statistically insignificant 9% (RR = 0.91; 95% CI: 0.82, 1.01) reduction in all cause mortality in the intervention group as compared to controls using a random effect model. The impact on diarrhea-specific mortality of zinc alone was a non-significant 18% reduction (RR = 0.82; 95% CI: 0.64, 1.05) and 15% for pneumonia-specific mortality (RR = 0.85; 95% CI: 0.65, 1.11). The incidence of diarrhea showed a 13% reduction with preventive zinc supplementation (RR = 0.87; 95% CI: 0.81, 0.94) and a 19% reduction in pneumonia morbidity (RR = 0.81; 95% CI: 0.73, 0.90). Keeping in mind the direction of effect of zinc supplementation in reducing diarrhea and pneumonia related morbidity and mortality; we considered all the outcomes for selection of effectiveness estimate for inclusion in the LiST model. After application of the CHERG rules with consideration to quality of evidence and rule # 6, we used the most conservative estimates as a surrogate for mortality. We, therefore, conclude that zinc

  10. [Mortality related to alcohol consumption in Spain: 1981-1990].

    PubMed

    Prada Puentes, C; del Río Gracia, M C; Yáñez, J L; Alvarez González, F J

    1996-01-01

    The aim of this study was to assess the overall contribution of alcohol to Spanish mortality during 1981 to 1990, as well as the impact on the premature death. To this purpose we have used the sources of data furnished by the 'Movimiento Natural de la Población' that provides data of causes of death. Figures of proportional mortality, adjusted mortality and years of potential life lost were calculated, as well as trend analysis. 6.3% (mean in the ten years period) of the mortality was due to alcohol. This mortality was higher among males than females. Adjusted mortality show a light increase during the period. The most important category referring to years of potential life lost was unintentional injuries. In this category, motor vehicle accidents were responsible for the majority of premature death. This study shows the importance of alcohol related mortality in our country and the large premature death.

  11. The burden of COPD mortality due to ambient air pollution in Guangzhou, China

    NASA Astrophysics Data System (ADS)

    Li, Li; Yang, Jun; Song, Yun-Feng; Chen, Ping-Yan; Ou, Chun-Quan

    2016-05-01

    Few studies have investigated the chronic obstructive pulmonary disease (COPD) mortality fraction attributable to air pollution and modification by individual characteristics of air pollution effects. We applied distributed lag non-linear models to assess the associations between air pollution and COPD mortality in 2007–2011 in Guangzhou, China, and the total COPD mortality fraction attributable to air pollution was calculated as well. We found that an increase of 10 μg/m3 in particulate matter with an aerodynamic diameter of 10 μm or less (PM10), sulfur dioxide (SO2) and nitrogen dioxide (NO2) was associated with a 1.58% (95% confidence interval (CI): 0.12–3.06%), 3.45% (95% CI: 1.30–5.66%) and 2.35% (95% CI: 0.42–4.32%) increase of COPD mortality over a lag of 0–15 days, respectively. Greater air pollution effects were observed in the elderly, males and residents with low educational attainment. The results showed 10.91% (95% CI: 1.02–9.58%), 12.71% (95% CI: 5.03–19.85%) and 13.38% (95% CI: 2.67–22.84%) COPD mortality was attributable to current PM10, SO2 and NO2 exposure, respectively. In conclusion, the associations between air pollution and COPD mortality differed by individual characteristics. There were remarkable COPD mortality burdens attributable to air pollution in Guangzhou.

  12. The burden of COPD mortality due to ambient air pollution in Guangzhou, China.

    PubMed

    Li, Li; Yang, Jun; Song, Yun-Feng; Chen, Ping-Yan; Ou, Chun-Quan

    2016-05-19

    Few studies have investigated the chronic obstructive pulmonary disease (COPD) mortality fraction attributable to air pollution and modification by individual characteristics of air pollution effects. We applied distributed lag non-linear models to assess the associations between air pollution and COPD mortality in 2007-2011 in Guangzhou, China, and the total COPD mortality fraction attributable to air pollution was calculated as well. We found that an increase of 10 μg/m(3) in particulate matter with an aerodynamic diameter of 10 μm or less (PM10), sulfur dioxide (SO2) and nitrogen dioxide (NO2) was associated with a 1.58% (95% confidence interval (CI): 0.12-3.06%), 3.45% (95% CI: 1.30-5.66%) and 2.35% (95% CI: 0.42-4.32%) increase of COPD mortality over a lag of 0-15 days, respectively. Greater air pollution effects were observed in the elderly, males and residents with low educational attainment. The results showed 10.91% (95% CI: 1.02-9.58%), 12.71% (95% CI: 5.03-19.85%) and 13.38% (95% CI: 2.67-22.84%) COPD mortality was attributable to current PM10, SO2 and NO2 exposure, respectively. In conclusion, the associations between air pollution and COPD mortality differed by individual characteristics. There were remarkable COPD mortality burdens attributable to air pollution in Guangzhou.

  13. Impact of Biofuel Poplar Cultivation on Ground-Level Ozone and Premature Human Mortality Depends on Cultivar Selection and Planting Location.

    PubMed

    Ashworth, Kirsti; Wild, Oliver; Eller, Allyson S D; Hewitt, C Nick

    2015-07-21

    Isoprene and other volatile organic compounds emitted from vegetation play a key role in governing the formation of ground-level ozone. Emission rates of such compounds depend critically on the plant species. The cultivation of biofuel feedstocks will contribute to future land use change, altering the distribution of plant species and hence the magnitude and distribution of emissions. Here we use relationships between biomass yield and isoprene emissions derived from experimental data for 29 commercially available poplar hybrids to assess the impact that the large-scale cultivation of poplar for use as a biofuel feedstock will have on air quality, specifically ground-level ozone concentrations, in Europe. We show that the increases in ground-level ozone across Europe will increase the number of premature deaths attributable to ozone pollution each year by up to 6%. Substantial crop losses (up to ∼9 Mt y(-1) of wheat and maize) are also projected. We further demonstrate that these impacts are strongly dependent on the location of the poplar plantations, due to the prevailing meteorology, the population density, and the dominant crop type of the region. Our findings indicate the need for a concerted and centralized decision-making process that considers all aspects of future land use change in Europe, and not just the effect on greenhouse gas emissions.

  14. Reduction of maternal mortality due to preeclampsia in Colombia--an interrupted time-series analysis.

    PubMed

    Herrera, Julián A; Herrera-Medina, Rodolfo; Herrera-Escobar, Juan Pablo; Nieto-Díaz, Aníbal

    2014-01-01

    Preeclampsia is the most important cause of maternal mortality in developing countries. A comprehensive prenatal care program including bio-psychosocial components was developed and introduced at a national level in Colombia. We report on the trends in maternal mortality rates and their related causes before and after implementation of this program. General and specific maternal mortality rates were monitored for nine years (1998-2006). An interrupted time-series analysis was performed with monthly data on cases of maternal mortality that compared trends and changes in national mortality rates and the impact of these changes attributable to the introduction of a bio-psychosocial model. Multivariate analyses were performed to evaluate correlations between the interventions. Five years after (2002 - 2006) its introduction the general maternal mortality rate was significantly reduced to 23% (OR=0.77, CI 95% 0.71-0.82).The implementation of BPSM also reduced the incidence of preeclampsia in 22% (OR= 0.78, CI 95% 0.67-0.88), as also the labor complications by hemorrhage in 25% (OR=0.75, CI 95% 0.59-0.90) associated with the implementation of red code. The other causes of maternal mortality did not reveal significant changes. Biomedical, nutritional, psychosocial assessments, and other individual interventions in prenatal care were not correlated to maternal mortality (p= 0.112); however, together as a model we observed a significant association (p= 0.042). General maternal mortality was reduced after the implementation of a comprehensive national prenatal care program. Is important the evaluation of this program in others populations.

  15. Reduction of maternal mortality due to preeclampsia in Colombia-an interrupted time-series analysis

    PubMed Central

    Herrera-Medina, Rodolfo; Herrera-Escobar, Juan Pablo; Nieto-Díaz, Aníbal

    2014-01-01

    Introduction: Preeclampsia is the most important cause of maternal mortality in developing countries. A comprehensive prenatal care program including bio-psychosocial components was developed and introduced at a national level in Colombia. We report on the trends in maternal mortality rates and their related causes before and after implementation of this program. Methods: General and specific maternal mortality rates were monitored for nine years (1998-2006). An interrupted time-series analysis was performed with monthly data on cases of maternal mortality that compared trends and changes in national mortality rates and the impact of these changes attributable to the introduction of a bio-psychosocial model. Multivariate analyses were performed to evaluate correlations between the interventions. Results: Five years after (2002 - 2006) its introduction the general maternal mortality rate was significantly reduced to 23% (OR=0.77, CI 95% 0.71-0.82).The implementation of BPSM also reduced the incidence of preeclampsia in 22% (OR= 0.78, CI 95% 0.67-0.88), as also the labor complications by hemorrhage in 25% (OR=0.75, CI 95% 0.59-0.90) associated with the implementation of red code. The other causes of maternal mortality did not reveal significant changes. Biomedical, nutritional, psychosocial assessments, and other individual interventions in prenatal care were not correlated to maternal mortality (p= 0.112); however, together as a model we observed a significant association (p= 0.042). Conclusions: General maternal mortality was reduced after the implementation of a comprehensive national prenatal care program. Is important the evaluation of this program in others populations. PMID:24970956

  16. Driver Mortality in Paired Side Impact Collisions Due to Incompatible Vehicle Types

    PubMed Central

    Crandall, C.S.

    2003-01-01

    Using a matched case control design, this study measured the mortality associated with paired passenger car-sport utility vehicle side impact (‘T-bone’) collisions using FARS data. Survival versus fatal outcome within the matched crash pairs was measured with matched pair odds ratios. Conditional logistic regression adjusted for multiple effects. Overall, passenger car drivers experienced greater mortality than did SUV drivers, regardless if they were in the struck or striking vehicle (odds ratio: 10.0; 95% confidence interval: 7.9, 12.5). Differential mortality persisted after adjustment for confounders. Efforts should be sought to improve passenger car side impact crashworthiness and to reduce SUV aggressivity. PMID:12941243

  17. [Maternal mortality due to pre-eclampsia/eclampsia in a state in southern Brazil].

    PubMed

    Soares, Vânia Muniz Néquer; de Souza, Kleyde Ventura; Freygang, Tatiana Claumann; Correa, Vanessa; Saito, Maria Rialto

    2009-11-01

    to identify the profile, tendency and causes of maternal death by pre-eclampsia/eclampsia in Paraná. descriptive, transversal cohort study on maternal death by pre-eclampsia/eclampsia from 1997 to 2005. Data were obtained from case studies prepared by Maternal Death Committees that employ the Reproductive Age Mortality Survey Method to examine all the cases of death among women in fertile age. The general and specific maternal death rate (MDR) by pre-eclampsia/eclampsia were considered. To evaluate the tendency, triennial periods have been compared, two by two, taking into consideration the MDR of each period (p<0.05). In the triennial period from 2003 to 2005, 56 deaths by pre-eclampsia/eclampsia were analyzed. The variables focused were: age, income, schooling, gestation number and complications, pre-natal conditions, signs and symptoms related to the condition, delivery route, the time gestation was interrupted, the newborn conditions, access and treatment, ability to avoid and prevention measures. the general triennial MDR has presented significant decline, with 64.3/100,000 born-alive babies. There has been stability along the period for MDR by hypertensive disorder, with MDR of 11.8/100,000 born-alive. Primiparous women, women over 40 and with low socio-economical status have presented higher risks. In relation to the treatment, there has been underuse or inadequate use of conventional medicines for severe pre-eclampsia and eclampsia. The committees' analysis indicated that all the maternal death due to these conditions could have been avoided. actions aiming at minimizing the set of causes that lead to death by pre-eclampsia in Paraná should be enforced, including the training and monitoring of health professionals in order to apply the treatment protocols, besides the formalization of a reference net of clinics and hospitals, qualified for the care of high risk pregnancy and its intercurrences, to which pre-natal pregnant women are enrolled.

  18. Transgenic mice overexpressing glia maturation factor-β, an oxidative stress inducible gene, show premature aging due to Zmpste24 down-regulation.

    PubMed

    Imai, Rika; Asai, Kanae; Hanai, Jun-ichi; Takenaka, Masaru

    2015-07-01

    Glia Maturation Factor-β (GMF), a brain specific protein, is induced by proteinuria in renal tubules. Ectopic GMF overexpression causes apoptosisin vitro via cellular vulnerability to oxidative stress. In order to examine the roles of GMF in non-brain tissue, we constructed transgenic mice overexpressing GMF (GMF-TG). The GMF-TG mice exhibited appearance phenotypes associated with premature aging. The GMF-TG mice also demonstrated short lifespans and reduced hair regrowth, suggesting an accelerated aging process. The production of an abnormal lamin A, a nuclear envelope protein, plays a causal role in both normal aging and accelerated aging diseases, known as laminopathies. Importantly, we identified the abnormal lamin A (prelamin A), accompanied by a down-regulation of a lamin A processing enzyme (Zmpste24) in the kidney of the GMF-TG mice. The GMF-TG mice showed accelerated aging in the kidney, compared with wild-type mice, showing increased TGF-β1, CTGF gene and serum creatinine. The gene expression of p21/waf1 was increased at an earlier stage of life, at 10 weeks, which was in turn down-regulated at a later stage, at 60 weeks. In conclusion, we propose that GMF-TG mice might be a novel mouse model of accelerated aging, due to the abnormal lamin A.

  19. The age distribution of mortality due to influenza: pandemic and peri-pandemic

    PubMed Central

    2012-01-01

    Background Pandemic influenza is said to 'shift mortality' to younger age groups; but also to spare a subpopulation of the elderly population. Does one of these effects dominate? Might this have important ramifications? Methods We estimated age-specific excess mortality rates for all-years for which data were available in the 20th century for Australia, Canada, France, Japan, the UK, and the USA for people older than 44 years of age. We modeled variation with age, and standardized estimates to allow direct comparison across age groups and countries. Attack rate data for four pandemics were assembled. Results For nearly all seasons, an exponential model characterized mortality data extremely well. For seasons of emergence and a variable number of seasons following, however, a subpopulation above a threshold age invariably enjoyed reduced mortality. 'Immune escape', a stepwise increase in mortality among the oldest elderly, was observed a number of seasons after both the A(H2N2) and A(H3N2) pandemics. The number of seasons from emergence to escape varied by country. For the latter pandemic, mortality rates in four countries increased for younger age groups but only in the season following that of emergence. Adaptation to both emergent viruses was apparent as a progressive decrease in mortality rates, which, with two exceptions, was seen only in younger age groups. Pandemic attack rate variation with age was estimated to be similar across four pandemics with very different mortality impact. Conclusions In all influenza pandemics of the 20th century, emergent viruses resembled those that had circulated previously within the lifespan of then-living people. Such individuals were relatively immune to the emergent strain, but this immunity waned with mutation of the emergent virus. An immune subpopulation complicates and may invalidate vaccine trials. Pandemic influenza does not 'shift' mortality to younger age groups; rather, the mortality level is reset by the virulence

  20. Premature Babies

    MedlinePlus

    ... or preemies. A premature birth is when a baby is born before 37 completed weeks of pregnancy. ... early, preemies weigh much less than full-term babies. They may have health problems because their organs ...

  1. A case study of the impact of inaccurate cause-of-death reporting on health disparity tracking: New York City premature cardiovascular mortality.

    PubMed

    Johns, Lauren E; Madsen, Ann M; Maduro, Gil; Zimmerman, Regina; Konty, Kevin; Begier, Elizabeth

    2013-04-01

    Heart disease death overreporting is problematic in New York City (NYC) and other US jurisdictions. We examined whether overreporting affects the premature (< 65 years) heart disease death rate disparity between non-Hispanic Blacks and non-Hispanic Whites in NYC. We identified overreporting hospitals and used counts of premature heart disease deaths at reference hospitals to estimate corrected counts. We then corrected citywide, age-adjusted premature heart disease death rates among Blacks and Whites and a White-Black premature heart disease death disparity. At overreporting hospitals, 51% of the decedents were White compared with 25% at reference hospitals. Correcting the heart disease death counts at overreporting hospitals decreased the age-adjusted premature heart disease death rate 10.1% (from 41.5 to 37.3 per 100,000) among Whites compared with 4.2% (from 66.2 to 63.4 per 100,000) among Blacks. Correction increased the White-Black disparity 6.1% (from 24.6 to 26.1 per 100,000). In 2008, NYC's White-Black premature heart disease death disparity was underestimated because of overreporting by hospitals serving larger proportions of Whites. Efforts to reduce overreporting may increase the observed disparity, potentially obscuring any programmatic or policy-driven advances.

  2. [Mortality and years of potential life lost due to homicide in Colombia, 1985-2006].

    PubMed

    Moreno, Claudia; Cendales, Ricardo

    2011-10-01

    Describe the mortality patterns, burden of disease, and mechanisms of injury by homicide in Colombia between 1985 and 2006. The official population and mortality databases in Colombia were used. Equivalencies of the underlying cause of death were identified and grouped according to the shortlists of the Ninth and Tenth Revision of the International Classification of Diseases. The years of potential life lost (YPLL), indices of YPLL, and crude, adjusted, and specific mortality rates associated with major causes and external causes for each sex were calculated. The homicide mechanisms were described. During the study period, a total of 523 870 homicides were recorded (484 475 in men and 39 395 in women). Homicides accounted for 13.8% of total mortality (21.4% of mortality in men and 2.6% in women) and generated 24.2% of YPLL (35.2% in men and 5.8% in women). The highest rates in men were found in the 20-44-year age range, with specific rates of up to 366.9 per 100 000 population, and in women in the 15-40 years age range with specific rates of up to 24.9 per 100 000 population. The most frequent homicide mechanism in both sexes was firearms. Homicides represent a significant burden of disease in Colombia, particularly affecting the young male population. Mortality from homicide has trended downward in recent years.

  3. Mortality due to diseases of the circulatory system among the elderly population in Brazilian Amazon: temporal and spatial analysis.

    PubMed

    Nunes, Karine Vila Real; Neves, Sandra Mara Alves da Silva; Ignotti, Eliane

    2013-12-01

    Circulatory Diseases (CD) are the major cause of death among the elderly population in Brazilian Amazon. to analyze standardized mortality rates of diseases of the circulatory system (DCS), according to the main causes of death among the elderly, in microregions of the Brazilian Amazon, in the period of 1998 - 2007. ecological study of mortality rates distribution standardized by CD and corrected by deaths from poorly defined causes among the elderly (> 65 years of age) who lived in Brazilian Amazon in the period of 1998 - 2007. The analysis were carried out by the linear regression, trend, and spatial distribution of Kernel. We verified an increasing trend in mortality by CD (β1 = 28.34 p = 0.01), due to the increasing trend in the States of Maranhão and Tocantins. The central region of Mato Grosso, Northern Tocantins, Eastern Pará and Southwestern Maranhão present hot spots with the highest mortality rates. Males present higher rates when compared to females all over the region; rates of mortality due to acute myocardial infarction and hypertensive disease present the same spatial standard of the CD group and the rates of cerebrovascular diseases present a different spatial distribution standard. Increment in mortality rates according to age was observed: the greater the age, the higher is mortality by CD. The Brazilian Amazon presents an increasing trend with high rates of mortality by the circulatory diseases, and the geographic areas with the highest rates are around the Brazilian Amazon, in the states of Tocantins, Maranhão and Mato Grosso.

  4. Effect of case management on neonatal mortality due to sepsis and pneumonia

    PubMed Central

    2011-01-01

    Background Each year almost one million newborns die from infections, mostly in low-income countries. Timely case management would save many lives but the relative mortality effect of varying strategies is unknown. We have estimated the effect of providing oral, or injectable antibiotics at home or in first-level facilities, and of in-patient hospital care on neonatal mortality from pneumonia and sepsis for use in the Lives Saved Tool (LiST). Methods We conducted systematic searches of multiple databases to identify relevant studies with mortality data. Standardized abstraction tables were used and study quality assessed by adapted GRADE criteria. Meta-analyses were undertaken where appropriate. For interventions with biological plausibility but low quality evidence, a Delphi process was undertaken to estimate effectiveness. Results Searches of 2876 titles identified 7 studies. Among these, 4 evaluated oral antibiotics for neonatal pneumonia in non-randomised, concurrently controlled designs. Meta-analysis suggested reductions in all-cause neonatal mortality (RR 0.75 95% CI 0.64- 0.89; 4 studies) and neonatal pneumonia-specific mortality (RR 0.58 95% CI 0.41- 0.82; 3 studies). Two studies (1 RCT, 1 observational study), evaluated community-based neonatal care packages including injectable antibiotics and reported mortality reductions of 44% (RR= 0.56, 95% CI 0.41-0.77) and 34% (RR =0.66, 95% CI 0.47-0.93), but the interpretation of these results is complicated by co-interventions. A third, clinic-based, study reported a case-fatality ratio of 3.3% among neonates treated with injectable antibiotics as outpatients. No studies were identified evaluating injectable antibiotics alone for neonatal pneumonia. Delphi consensus (median from 20 respondents) effects on sepsis-specific mortality were 30% reduction for oral antibiotics, 65% for injectable antibiotics and 75% for injectable antibiotics on pneumonia-specific mortality. No trials were identified assessing effect

  5. The burden of COPD mortality due to ambient air pollution in Guangzhou, China

    PubMed Central

    Li, Li; Yang, Jun; Song, Yun-Feng; Chen, Ping-Yan; Ou, Chun-Quan

    2016-01-01

    Few studies have investigated the chronic obstructive pulmonary disease (COPD) mortality fraction attributable to air pollution and modification by individual characteristics of air pollution effects. We applied distributed lag non-linear models to assess the associations between air pollution and COPD mortality in 2007–2011 in Guangzhou, China, and the total COPD mortality fraction attributable to air pollution was calculated as well. We found that an increase of 10 μg/m3 in particulate matter with an aerodynamic diameter of 10 μm or less (PM10), sulfur dioxide (SO2) and nitrogen dioxide (NO2) was associated with a 1.58% (95% confidence interval (CI): 0.12–3.06%), 3.45% (95% CI: 1.30–5.66%) and 2.35% (95% CI: 0.42–4.32%) increase of COPD mortality over a lag of 0–15 days, respectively. Greater air pollution effects were observed in the elderly, males and residents with low educational attainment. The results showed 10.91% (95% CI: 1.02–9.58%), 12.71% (95% CI: 5.03–19.85%) and 13.38% (95% CI: 2.67–22.84%) COPD mortality was attributable to current PM10, SO2 and NO2 exposure, respectively. In conclusion, the associations between air pollution and COPD mortality differed by individual characteristics. There were remarkable COPD mortality burdens attributable to air pollution in Guangzhou. PMID:27195597

  6. Future trends and inequalities in premature coronary deaths in England: Modelling study.

    PubMed

    Allen, Kirk; Gillespie, Duncan O S; Guzman-Castillo, Maria; Diggle, Peter J; Capewell, Simon; O'Flaherty, Martin

    2016-01-15

    Coronary heart disease (CHD) is a major cause of premature mortality, particularly in deprived groups. Might recent declines in overall mortality obscure different rates of decline among social strata, creating potentially misleading views on inequalities? We used a Bayesian analysis of an age-period-cohort model for the English population. We projected age-specific premature CHD mortality (ages 35-74) by gender and area-based deprivation status for the period 2007-2035, using 1982-2006 as the input. Deprivation status was measured by Index of Multiple Deprivation quintiles, which aggregate seven types of deprivation, including health and income. We analysed inequality in premature CHD mortality. We investigated the annual changes in inequality and the contributions of changes in each IMDQ to the overall annual changes, using both absolute (probability) and relative (logit) scales. We quantified inequality using the statistical variance in the probability of premature death among deprivation quintiles. The overall premature CHD mortality trends conceal marked heterogeneities. Our models predict more rapid declines in premature CHD mortality for the most affluent quintiles than for the most deprived (annualized rate of decline 2006-2025, 7.5% [95% Credible Interval 4.3-10.5%] versus 5.4% [2.2-8.7%] for men, and 6.3% [3.0-9.9%] versus 5.9% [1.5-10.8%] for women). For men, the posterior probability that the rate of decline is greater for the most affluent was 82%. Variance in premature CHD mortality across deprivation quintiles was projected to decrease by approximately 81% [28-95%] among men and by 89% [30-99%] among women. This decrease was particularly driven by the most deprived groups due to their higher premature death rates. However, relative inequality was projected to rise by 93% among men [81-125%] and rise by 13% [-25-58%] among women. These increases are also mostly influenced by the most deprived, reflecting their slower declines in premature deaths

  7. Relevance of Candida and other mycoses for morbidity and mortality in severe sepsis and septic shock due to peritonitis.

    PubMed

    Lichtenstern, Christoph; Herold, Christina; Mieth, Markus; Brenner, Thorsten; Decker, Sebastian; Busch, Cornelius J; Hofer, Stefan; Zimmermann, Stefan; Weigand, Markus A; Bernhard, Michael

    2015-07-01

    This single-centre retrospective cohort study evaluated the incidence and outcome of mycoses in critical ill patients (n = 283) with sepsis due to peritonitis. Overall mortality was 41.3%, and the 28-day mortality was 29.3%. Fungal pathogens were found in 51.9%. The common first location was the respiratory tract (66.6%), followed by the abdominal site (19.7%). Candida colonisation was found in 64.6%, and invasive Candida infection in 34.0%. Identified fungi were Candida spp. in 98.6% and Aspergillus spp. in 6.1%. Patients with fungal pathogens showed a higher rate of postoperative peritonitis, APACHE II and tracheotomy. In comparison to patients without fungal pathogens, these patients showed a longer duration on mechanical ventilation, and a higher overall mortality. Patients with Candida-positive swabs from abdominal sites had more fascia dehiscence and anastomosis leakage. Seventy-two patients (48.9%) received antifungal therapy, 26 patients were treated empirically. Antifungal therapy was not associated with a decrease in mortality. Age and renal replacement therapy were associated with mortality. In conclusion, fungi are common pathogens in critically ill patients with peritonitis, and detection of fungi is associated with an increase in overall mortality. Particularly, Candida-positive abdominal swabs are associated with an increase in morbidity. However, we were not able to demonstrate a survival benefit for antifungal therapy in peritonitis patients. © 2015 Blackwell Verlag GmbH.

  8. Excess mortality due to indirect health effects of the 2011 triple disaster in Fukushima, Japan: a retrospective observational study.

    PubMed

    Morita, Tomohiro; Nomura, Shuhei; Tsubokura, Masaharu; Leppold, Claire; Gilmour, Stuart; Ochi, Sae; Ozaki, Akihiko; Shimada, Yuki; Yamamoto, Kana; Inoue, Manami; Kato, Shigeaki; Shibuya, Kenji; Kami, Masahiro

    2017-10-01

    Evidence on the indirect health impacts of disasters is limited. We assessed the excess mortality risk associated with the indirect health impacts of the 2011 triple disaster (earthquake, tsunami and nuclear disaster) in Fukushima, Japan. The mortality rates in Soma and Minamisoma cities in Fukushima from 2006 to 2015 were calculated using vital statistics and resident registrations. We investigated the excess mortality risk, defined as the increased mortality risk between postdisaster and predisaster after excluding direct deaths attributed to the physical force of the disaster. Multivariate Poisson regression models were used to estimate the relative risk (RR) of mortality after adjusting for city, age and year. There were 6163 and 6125 predisaster and postdisaster deaths, respectively. The postdisaster mortality risk was significantly higher in the first month following the disaster (March 2011) than in the same month during the predisaster period (March 2006-2010). RRs among men and women were 2.64 (95% CI 2.16 to 3.24) and 2.46 (95% CI 1.99 to 3.03), respectively, demonstrating excess mortality risk due to the indirect health effects of the disaster. Age-specific subgroup analyses revealed a significantly higher mortality risk in women aged ≥85 years in the third month of the disaster compared with predisaster baseline, with an RR (95% CI) of 1.73 (1.23 to 2.44). Indirect health impacts are most severe in the first month of the disaster. Early public health support, especially for the elderly, can be an important factor for reducing the indirect health effects of a disaster. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  9. Effectiveness of two systemic insecticides for protecting western conifers from mortality due to bark beetle attack

    Treesearch

    D.M. Grosman; C.J. Fettig; C.L. Jorgensen; A.S. Munson

    2010-01-01

    Bark beetles (Coleoptera: Curculionidae, Scolytinae) are important tree mortality agents in western coniferous forests. Protection of individual trees from bark beetle attack has historically involved applications of liquid formulations of contact insecticides to the tree bole using hydraulic sprayers. More recently, researchers looking for more portable and...

  10. Mortality Due to Chagas Disease in Brazil According to a Specific Cause

    PubMed Central

    da Nóbrega, Aglaêr Alves; de Araújo, Wildo Navegantes; Vasconcelos, Ana Maria Nogales

    2014-01-01

    A century after its discovery, Chagas disease (CD) is still considered a public health problem. Mortality caused by CD between 2000 and 2010 was described according to the specific underlying cause, year of occurrence, gender, age range, and region of Brazil. The standardized mortality rate decreased 32.4%, from 3.4% in 2000 to 2.3% in 2010. Most of the deaths (85.9%) occurred in male patients who were > 60 years of age caused by cardiac involvement. The mortality rate caused by cardiac involvement decreased in all regions of Brazil, except in the North region, where it increased by 1.6%. The Northeast had the smallest and the Central-West had the largest decrease. The mortality rate caused by a compromised digestive tract increased in all regions. Despite the control of transmission by vector and blood transfusions, CD should remain on the list of priority diseases for the public health service in Brazil, and surveillance actions cannot be interrupted. PMID:25002301

  11. Is lodgepole pine mortality due to mountain pine beetle linked to the North American Monsoon?

    Treesearch

    Sara A. Goeking; Greg C. Liknes

    2012-01-01

    Regional precipitation patterns may have influenced the spatial variability of tree mortality during the recent mountain pine beetle (Dendroctonus ponderosa) (MPB) outbreak in the western United States. Data from the Forest Inventory and Analysis (FIA) Program show that the outbreak was especially severe in the state of Colorado where over 10 million lodgepole pines (...

  12. European seasonal mortality and influenza incidence due to winter temperature variability

    NASA Astrophysics Data System (ADS)

    Ballester, Joan; Rodó, Xavier; Robine, Jean-Marie; Herrmann, François Richard

    2016-10-01

    Recent studies have vividly emphasized the lack of consensus on the degree of vulnerability (see ref. ) of European societies to current and future winter temperatures. Here we consider several climate factors, influenza incidence and daily numbers of deaths to characterize the relationship between winter temperature and mortality in a very large ensemble of European regions representing more than 400 million people. Analyses highlight the strong association between the year-to-year fluctuations in winter mean temperature and mortality, with higher seasonal cases during harsh winters, in all of the countries except the United Kingdom, the Netherlands and Belgium. This spatial distribution contrasts with the well-documented latitudinal orientation of the dependency between daily temperature and mortality within the season. A theoretical framework is proposed to reconcile the apparent contradictions between recent studies, offering an interpretation to regional differences in the vulnerability to daily, seasonal and long-term winter temperature variability. Despite the lack of a strong year-to-year association between winter mean values in some countries, it can be concluded that warmer winters will contribute to the decrease in winter mortality everywhere in Europe.

  13. [Mortality trend due to ischemic heart diseases in the city of Curitiba--Brazil, from 1980 to 1998].

    PubMed

    Daniel, Edevar; Germiniani, Helio; Nazareno, Eleusis Ronconi de; Braga, Simone Viana; Winkler, Anderson Marcelo; Cunha, Claudio L Pereira da

    2005-08-01

    To assess mortality trends due to ischemic heart diseases, per sex, and acute myocardial infarction, per sex and age range, from 1980 to 1998, in the city of Curitiba. Data of death due to ischemic heart disease and acute myocardial infarction from Sistema de Informação sobre Mortalidade do Ministério da Saúde (Information System on Mortality of Ministry of Health), per sex, age range and domicile location in Curitiba were used. Population data were obtained from Fundação Instituto Brasileiro de Geografia e Estatística (Brazilian Institute of Geography and Statistics Foundation). Mortality rates were adjusted per age through direct method, by using the population of Curitiba, in 1980, as reference. The analysis of trend was calculated through simple linear regression, with a significance level of 5%. Mortality rates due to ischemic heart diseases showed a decrease trend among both sexes. In age ranges of acute myocardial infarction, male sex showed a decrease until 79 years of age, among female sex individuals, the decrease was until 59 years of age. They were shown stable after those periods. Among the remaining ischemic diseases, female sex individuals showed a greater decrease than male sex ones. The study demonstrates a trend of reduction of mortality due to ischemic heart diseases, in both sexes, in the city of Curitiba, from 1980 to 1998. In acute myocardial infarction, such reduction has been happening in a more pronounced way among men, achieving stability, from 60 years of age, among women. The reasons for differentiated reduction trend between sexes are not clear, remaining as na important matter for new investigations.

  14. Mortality due to infectious hematopoietic necrosis of sockeye salmon (Oncorhynchus nerka) fry in streamside egg incubation boxes

    USGS Publications Warehouse

    Mulcahy, D.; Pascho, R.J.; Jenes, C.K.

    1983-01-01

    Infectious hematopoietic necrosis virus caused mortality of sockeye salmon (Oncorhynchus nerka) in streamside egg incubation boxes. Virus was not detectable in eggs or alevins; its first isolation coincided with the appearance of dead fish in a trap on the outflow from the box. Mortality due to the virus did not occur in every egg box studied. However, when fry from the boxes were held in the laboratory, epizootics began as much as 3 wk later, with total mortality exceeding 90%. More than 96% of the dead fry had titers exceeding 105 plaque-forming units per gram. The peak incidence of virus in fry migrating in the river coincided with the arrival of hatchery-produced fry, although some fry believed to have been produced by natural spawning were also infected.Englis

  15. Estimating mortality, morbidity and disability due to malaria among Africa's non-pregnant population.

    PubMed Central

    Snow, R. W.; Craig, M.; Deichmann, U.; Marsh, K.

    1999-01-01

    The contribution of malaria to morbidity and mortality among people in Africa has been a subject of academic interest, political advocacy, and speculation. National statistics for much of sub-Saharan Africa have proved to be an unreliable source of disease-specific morbidity and mortality data. Credible estimates of disease-specific burdens are required for setting global and national priorities for health in order to rationalize the use of limited resources and lobby for financial support. We have taken an empirical approach to defining the limits of Plasmodium falciparum transmission across the continent and interpolated the distributions of projected populations in 1995. By combining a review of the literature on malaria in Africa and models of acquired functional immunity, we have estimated the age-structured rates of the fatal, morbid and disabling sequelae following exposure to malaria infection under different epidemiological conditions. PMID:10516785

  16. Influence of a multidisciplinary alert strategy on mortality due to left-sided infective endocarditis.

    PubMed

    Carrasco-Chinchilla, Fernando; Sánchez-Espín, Gemma; Ruiz-Morales, Josefa; Rodríguez-Bailón, Isabel; Melero-Tejedor, Jose M; Ivanova-Georgieva, Rada; García-López, Victoria; Muñoz-García, Antonio; Gómez-Doblas, Juan J; de Teresa-Galván, Eduardo

    2014-05-01

    Mortality from left-sided infective endocarditis remains very high. The aim of this study was to assess the impact of a multidisciplinary alert strategy (AMULTEI), based on clinical, echocardiographic and microbiological findings, implemented in 2008 in a tertiary hospital. Cohort study comparing our historical data series (1996-2007) with the number of patients diagnosed with left-sided endocarditis from 2008-2011 (AMULTEI). The AMULTEI cohort included 72 patients who were compared with 155 patients in the historical cohort. AMULTEI patients were significantly older (62.5 vs 57.9 years in the historical cohort; P=.047) and had higher comorbidity (Charlson index, 3.33 vs 2.58 in the historical cohort; P=.023). There was also a trend toward more enterococcal etiology in the AMULTEI group (20.8% vs 11.6% in the historical cohort; P=.067). In the AMULTEI group, early surgery was more frequently performed (48.6% vs 23.2%; P<.001) during hospitalization, the incidence of septic shock was significantly lower (9.7% vs 24.5%; P=.009) and there was a trend toward reductions in neurological complications (19.4% vs 29.0%; P=.25) and severe heart failure (12.5% vs 18.7%; P=.24). In-hospital mortality and mortality during the first month of follow-up were significantly lower in the AMULTEI group (16.7% vs 36.1%; P=.003). Despite the trend toward older age and more comorbidity measured by the Charlson index, early mortality was significantly lower in patients treated with the AMULTEI strategy. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  17. Latin American Clinical Epidemiology Network Series - Paper 5: Years of life lost due to premature death in traffic accidents in Bogota, Colombia.

    PubMed

    Quitian-Reyes, Hoover; Gómez-Restrepo, Carlos; Gómez, Maria Juliana; Naranjo, Salome; Heredia, Patricia; Villegas, John

    2017-06-01

    This study aimed to quantify the number of years of life lost in traffic accidents in Bogota, Colombia. The years of life lost were calculated using the 'age-standardized expected years of life lost' method, the table of Japanese adjusted life expectancy and the database of the Institute of Legal Medicine and Forensic Science between September 2012 and August 2013. During a period of 1 year, 430 people died and 10,056.3 years of life were lost in Bogota due to traffic accidents. The mortality burden of traffic accidents in Bogota is high. Further studies are required in order to characterize the accidents and develop effective policy decisions. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Increases in external cause mortality due to high and low temperatures: evidence from northeastern Europe.

    PubMed

    Orru, Hans; Åström, Daniel Oudin

    2016-11-17

    The relationship between temperature and mortality is well established but has seldom been investigated in terms of external causes. In some Eastern European countries, external cause mortality is substantial. Deaths owing to external causes are the third largest cause of mortality in Estonia, after cardiovascular disease and cancer. Death rates owing to external causes may reflect behavioural changes among a population. The aim for the current study was to investigate if there is any association between temperature and external cause mortality, in Estonia. We collected daily information on deaths from external causes (ICD-10 diagnosis codes V00-Y99) and maximum temperatures over the period 1997-2013. The relationship between daily maximum temperature and mortality was investigated using Poisson regression, combined with a distributed lag non-linear model considering lag times of up to 10 days. We found significantly higher mortality owing to external causes on hot (the same and previous day) and cold days (with a lag of 1-3 days). The cumulative relative risks for heat (an increase in temperature from the 75th to 99th percentile) were 1.24 (95% confidence interval, 1.14-1.34) and for cold (a decrease from the 25th to 1st percentile) 1.19 (1.03-1.38). Deaths due to external causes might reflect changes in behaviour among a population during periods of extreme hot and cold temperatures and should therefore be investigated further, because such deaths have a severe impact on public health, especially in Eastern Europe where external mortality rates are high.

  19. Towns with extremely low mortality due to ischemic heart disease in Spain

    PubMed Central

    2012-01-01

    Background The cause of coronary disease inframortality in Spain is unknown. The aim of this study is to identify Spanish towns with very low ischemic heart disease mortality, describe their health and social characteristics, and analyze the relationship with a series of contextual factors. Methods We obtained the number of deaths registered for each of 8,122 Spanish towns in the periods 1989-1998 and 1999-2003. Expected deaths, standardized mortality ratio (SMR), smoothed Relative Risk (RR), and Posterior Probability (PP) of RR > 1 were calculated using Bayesian hierarchical models. Inframortality was defined as any town that displayed an RR below the 10th percentile, an SMR of under 1 for both sexes, and a PP of RR > 1 less than or equal to 0.002 for male and 0.005 for female mortality, during the two periods covered. All the remaining towns, except for those with high mortality classified as "tourist towns", were selected as controls. The association among socioeconomic, health, dietary, lifestyle and vascular risk factors was analyzed using sequential mixed logistic regression models, with province as the random-effects variable. Results We identified 32 towns in which ischemic heart disease mortality was half the national rate and four times lower than the European Union rate, situated in lightly populated provinces spread across the northern half of Spain, and revealed a surprising pattern of geographic aggegation for 23 of the 32 towns. Variables related with inframortality were: a less aged population (OR 0.93, 95% CI 0.89-0.99); a contextual dietary pattern marked by a high fish content (OR 2.13, 95% CI 1.38-3.28) and wine consumption (OR 1.50, 95% CI 1.08-2.07); and a low prevalence of obesity (OR 0.47, 95% CI 0.22-1.01); and, in the case of towns of over 1000 inhabitants, a higher physician-population ratio (OR 3.80, 95% CI 1.17-12.3). Conclusions Results indicate that dietary and health care factors have an influence on inframortality. The geographical

  20. Mortality due to respiratory diseases in the elderly after influenza vaccination campaigns in the Federal District, Brazil, 1996-2009 *

    PubMed Central

    Scoralick, Francisca Magalhães; Piazzolla, Luciana Paganini; Pires, Liana Laura; Neri, Cleudsom; de Paula, Wladimir Kummer

    2013-01-01

    OBJECTIVE: To compare mortality rates due to respiratory diseases among elderly individuals residing in the Federal District of Brasília, Brazil, prior to and after the implementation of a national influenza vaccination campaign. METHODS: This was an ecological time series analysis. Data regarding the population of individuals who were over 60 years of age between 1996 and 2009 were obtained from official databases. The variables of interest were the crude mortality rate (CMR), the mortality rate due to the respiratory disease (MRRD), and the proportional mortality ratio (PMR) for respiratory diseases. We performed a qualitative analysis of the data for the period prior to and after the implementation of the vaccination campaign (1996-1999 and 2000-2009, respectively). RESULTS: The CMR increased with advancing age. Over the course of the study period, we observed reductions in the CMR in all of the age brackets studied, particularly among those aged 80 years or older. Reductions in the MRRD were also found in all of the age groups, especially in those aged 80 years or older. In addition, there was a decrease in the PMR for respiratory diseases in all age groups throughout the study period. The most pronounced decrease in the PMR for respiratory diseases in the ≥ 70 year age bracket occurred in 2000 (immediately following the implementation of the national vaccination campaign); in 2001, that rate increased in all age groups, despite the greater adherence to the vaccination campaign in comparison with that recorded for 2000. CONCLUSIONS: Influenza vaccination appears to have a positive impact on the prevention of mortality due to respiratory diseases, particularly in the population aged 70 or over. PMID:23670505

  1. Impacts of individual fish movement patterns on estimates of mortality due to dissolved gas supersaturation in the Columbia River Basin.

    SciTech Connect

    Scheibe, Timothy D.; Richmond, Marshall C.; Fidler, Larry E.

    2002-12-31

    Spatial and temporal distributions of dissolved gases in the Columbia and Snake rivers vary due to many factors including river channel and dam geometries, operational decisions, and natural variations in flow rates. As a result, the dissolved gas exposure histories experienced by migrating juvenile salmonids can vary significantly among individual fish. A discrete, particle-based model of individual fish movements and dissolved gas exposure history has been developed and applied to examine the effects of such variability on estimates of fish mortality. The model, called the Fish Individual-based Numerical Simulator or FINS, is linked to a two-dimensional (vertically-averaged) hydrodynamic simulator that quantifies local water velocity, temperature, and dissolved gas levels as a function of river flow rates and dam operations. Simulated gas exposure histories are then input to biological mortality models to predict the effects of various river configurations on fish injury and mortality due to dissolved gas supersaturation. This model framework provides a critical linkage between hydrodynamic models of the river system and models of biological effects. FINS model parameters were estimated and validated based on observations of individual fish movements collected using radiotelemetry methods during 1997 and 1998. The model was then used to simulate exposure histories under selected operational scenarios. We compare mortality rates estimated using the FINS model approach (incorporating individual behavior and spatial and temporal variability) to those estimated using average exposure times and levels as is done in traditional lumped-parameter model approaches.

  2. Rates of thoracic trauma and mortality due to accidents in Brazil.

    PubMed

    Cury, Francisco; Baitello, André Luciano; Echeverria, Rodrigo Florêncio; Espada, Paulo César; Pereira de Godoy, José Maria

    2009-01-01

    To report on the causes of trauma, indexes of trauma, and mortality related to thoracic trauma in one region of Brazil. This prospective study was performed at the Regional Trauma Center in São José do Rio Preto over a 1-year period, from 1(st) July 2004 to 30(th) June 2005. We included all patients attending the center's emergency room with thoracic trauma and an anatomic injury scale (AIS) ≥ 2. We collected data using a protocol completed on arrival in hospital utilizing the AIS. We studied the types of accidents as well as the mortality and the AIS scores. Prevalence rates were calculated and the paired t-test and logistic regression were employed for the statistical analysis. There were a total of 373 casualties with AIS ≥ 2 and there were 45 (12%) deaths. The causes of thoracic trauma among the 373 casualties were as follows: 91 (24.4%) car crashes, 75 (20.1%) falls, 46 (12.3%) motorbike accidents, 40 (10.7%) stabbings, 22 (5.9%) accidents involving pedestrians, 21 (5.6%) bicycle accidents, 17 (4.6%) shootings, and 54 (14.5%) other types of accident. The severity of the injuries was classified according to the AIS: 224 (60%) were grade 2, 101 (27%) were grade 3, 27 (7.2%) were grade 4, 18 (4.9%) were grade 5, and 3 were (0.8%) grade 6. With respect to thoracic trauma, pedestrians involved in accidents and victims of shootings had mortality rates that were significantly higher than that of those involved in other types of accidents. Road accidents are the main cause of thoracic injury, with accidents involving pedestrians and shootings being associated with a greater death rate.

  3. Trends in the incidence of myocardial infarction and in mortality due to coronary heart disease, 1987 to 1994.

    PubMed

    Rosamond, W D; Chambless, L E; Folsom, A R; Cooper, L S; Conwill, D E; Clegg, L; Wang, C H; Heiss, G

    1998-09-24

    To clarify the determinants of contemporary trends in mortality from coronary heart disease (CHD), we conducted surveillance of hospital admissions for myocardial infarction and of in-hospital and out-of-hospital deaths due to CHD among 35-to-74-year-old residents of four communities of varying size in the United States (a total of 352,481 persons in 1994). Between 1987 and 1994, we estimate that there were 11,869 hospitalizations for myocardial infarction (on the basis of 8572 hospitalizations sampled) and 3407 fatal coronary events (3023 sampled). The largest average annual decrease in mortality due to CHD occurred among white men (change in mortality, -4.7 percent; 95 percent confidence interval, -2.2 to -7.1 percent), followed by white women (-4.5 percent; 95 percent confidence interval, -0.7 to -8.2 percent), black women (-4.1 percent; 95 percent confidence interval, -10.3 to +2.5 percent), and black men (-2.5 percent; 95 percent confidence interval, -6.9 to +2.2 percent). Overall, in-hospital mortality from CHD fell by 5.1 percent per year, whereas out-of-hospital mortality declined by 3.6 percent per year. There was no evidence of a decline in the incidence of hospitalization for a first myocardial infarction among either men or women; in fact, such hospital admissions increased by 7.4 percent per year (95 percent confidence interval for the change, +0.5 to +14.8 percent) among black women and 2.9 percent per year (95 percent confidence interval, -3.6 to +9.9 percent) among black men. Rates of recurrent myocardial infarction decreased, and survival after myocardial infarction improved. From 1987 to 1994, we observed a stable or slightly increasing incidence of hospitalization for myocardial infarction. Nevertheless, there were significant annual decreases in mortality from CHD. The decline in mortality in the four communities we studied may be due largely to improvements in the treatment and secondary prevention of myocardial infarction.

  4. [Infant mortality due to avoidable causes in a city in Northeastern Brazil].

    PubMed

    do Nascimento, Suelayne Gonçalves; de Oliveira, Conceição Maria; Sposito, Verônica; Ferreira, Daniela Karina da Silva; do Bonfim, Cristine Vieira

    2014-01-01

    This is a cross-sectional study that aimed to describe the occurrence of infant mortality in Recife (PE) between 2000 and 2009, second to avoidable causes. The population composed of cases of deaths between 2000 and 2009 among the infants of mothers living in Recife. Deaths were classified as avoidable by using the List of avoidable causes of deaths resulting from interventions within the Brazilian National Health System (SUS). Descriptive statistics were used for data analysis. A decrease in the infant mortality coefficient from 20.4 to 12.1 per 1.000 live births was observed (reduction of 40.6%). From the total of 3.743 deaths registered, 2.861 (76.4%) were classified as avoidable. It was notable that 61.2% of the deaths could have been avoided through appropriate care for the woman during the pregnancy. An approach in which avoidability is analyzed may assist in discussions relating to organization, quality and access to healthcare service, and in identifying deaths that could have been avoided through appropriate mother-child healthcare.

  5. Desert bighorn sheep mortality due to presumptive type C botulism in California

    USGS Publications Warehouse

    Swift, P.K.; Wehausen, J.D.; Ernest, H.B.; Singer, R.S.; Pauli, A.M.; Kinde, H.; Rocke, T.E.; Bleich, V.C.

    2000-01-01

    During a routine telemetry flight of the Mojave Desert (California, USA) in August 1995, mortality signals were detected from two of 12 radio-collared female desert bighorn sheep (Ovis canadensis) in the vicinity of Old Dad Peak in San Bernardino County (California). A series of field investigations determined that at least 45 bighorn sheep had died near two artificial water catchments (guzzlers), including 13 bighorn sheep which had presumably drowned in a guzzler tank. Samples from water contaminated by decomposing bighorn sheep carcasses and hemolyzed blood from a fresh bighorn sheep carcass were tested for the presence of pesticides, heavy metals, strychnine, blue-green algae, Clostridium botulinum toxin, ethylene glycol, nitrates, nitrites, sodium, and salts. Mouse bioassay and enzyme-linked immunosorbent assay detected type C botulinum toxin in the hemolyzed blood and in fly larvae and pupae. This, coupled with negative results from other analyses, led us to conclude that type C botulinum poisoning was most likely responsible for the mortality of bighorn sheep outside the guzzler tank.

  6. In-hospital mortality due to acute myocardial infarction. relevance of type of hospital and care provided. RECALCAR study.

    PubMed

    Bertomeu, Vicente; Cequier, Ángel; Bernal, José L; Alfonso, Fernando; Anguita, Manuel P; Muñiz, Javier; Barrabés, José A; García-Dorado, David; Goicolea, Javier; Elola, Francisco J

    2013-12-01

    To investigate the relationship between in-hospital mortality due to acute myocardial infarction and type of hospital, discharge service, and treatment provided. Retrospective analysis of 100 993 hospital discharges with a principal diagnosis of myocardial infarction in hospitals of the Spanish National Health Service. In-hospital mortality was adjusted for risk following the models of the Institute for Clinical Evaluative Sciences (Canada) and the Centers for Medicare & Medicaid Services (United States). Hospital characteristics are relevant to explain the variation in the individual probability of dying from myocardial infarction (median odds ratio: 1.3561). The risk-adjusted in-hospital mortality in cluster 3 and especially in cluster 4 hospitals (500 beds to 1000 beds and medium-high complexity) was significantly lower than in hospitals with less than 200 beds. Cluster 5 (more than 1000 beds), which includes a diverse group of hospitals, had a higher mortality rate than clusters 3 and 4. The adjusted mortality in the groups with the best and worst outcomes was 6.74% (cluster 4) and 8.49% (cluster 1), respectively. Mortality was also lower when the cardiology unit was responsible for the discharge or when angioplasty had been performed. The typology of the hospital, treatment in a cardiology unit, and percutaneous coronary intervention are significantly associated with the survival of a patient hospitalized for myocardial infarction. We recommend that the Spanish National Health Service establish health care networks that favor percutaneous coronary intervention and the participation of cardiology units in the management of patients with acute myocardial infarction. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  7. Evaluating the Long-Term Health and Economic Impacts of Central Residential Air Filtration for Reducing Premature Mortality Associated with Indoor Fine Particulate Matter (PM2.5) of Outdoor Origin.

    PubMed

    Zhao, Dan; Azimi, Parham; Stephens, Brent

    2015-07-21

    Much of human exposure to fine particulate matter (PM2.5) of outdoor origin occurs in residences. High-efficiency particle air filtration in central heating, ventilating, and air-conditioning (HVAC) systems is increasingly being used to reduce concentrations of particulate matter inside homes. However, questions remain about the effectiveness of filtration for reducing exposures to PM2.5 of outdoor origin and adverse health outcomes. Here we integrate epidemiology functions and mass balance modeling to estimate the long-term health and economic impacts of HVAC filtration for reducing premature mortality associated with indoor PM2.5 of outdoor origin in residences. We evaluate 11 classifications of filters (MERV 5 through HEPA) using six case studies of single-family home vintages and ventilation system combinations located in 22 U.S. cities. We estimate that widespread use of higher efficiency filters would reduce premature mortality by 0.002-2.5% and increase life expectancy by 0.02-1.6 months, yielding annual monetary benefits ranging from $1 to $1348 per person in the homes and locations modeled herein. Large differences in the magnitude of health and economic impacts are driven largely by differences in rated filter efficiency and building and ventilation system characteristics that govern particle infiltration and persistence, with smaller influences attributable to geographic location.

  8. Evaluating the Long-Term Health and Economic Impacts of Central Residential Air Filtration for Reducing Premature Mortality Associated with Indoor Fine Particulate Matter (PM2.5) of Outdoor Origin

    PubMed Central

    Zhao, Dan; Azimi, Parham; Stephens, Brent

    2015-01-01

    Much of human exposure to fine particulate matter (PM2.5) of outdoor origin occurs in residences. High-efficiency particle air filtration in central heating, ventilating, and air-conditioning (HVAC) systems is increasingly being used to reduce concentrations of particulate matter inside homes. However, questions remain about the effectiveness of filtration for reducing exposures to PM2.5 of outdoor origin and adverse health outcomes. Here we integrate epidemiology functions and mass balance modeling to estimate the long-term health and economic impacts of HVAC filtration for reducing premature mortality associated with indoor PM2.5 of outdoor origin in residences. We evaluate 11 classifications of filters (MERV 5 through HEPA) using six case studies of single-family home vintages and ventilation system combinations located in 22 U.S. cities. We estimate that widespread use of higher efficiency filters would reduce premature mortality by 0.002–2.5% and increase life expectancy by 0.02–1.6 months, yielding annual monetary benefits ranging from $1 to $1348 per person in the homes and locations modeled herein. Large differences in the magnitude of health and economic impacts are driven largely by differences in rated filter efficiency and building and ventilation system characteristics that govern particle infiltration and persistence, with smaller influences attributable to geographic location. PMID:26197328

  9. Preventing infant and child morbidity and mortality due to maternal depression.

    PubMed

    Surkan, Pamela J; Patel, Shivani A; Rahman, Atif

    2016-10-01

    This review provides an overview of perinatal depression and its impacts on the health of mothers, their newborns, and young children in low- and middle-income countries (LMICs). We define and describe the urgency and scope of the problem of perinatal depression for mothers, while highlighting some specific issues such as suicidal ideation and decreased likelihood to seek health care. Pathways through which stress may link maternal depression to childhood growth and development (e.g., the hypo-pituitary axis) are discussed, followed by a summary of the adverse effects of depression on birth outcomes, parenting practices, and child growth and development. Although preliminary studies on the association between maternal depressive symptoms and maternal and child mortality exist, more research on these topics is needed. We describe the available interventions and suggest strategies to reduce maternal depressive symptoms in LMICs, including integration of services with existing primary health-care systems.

  10. Premature Aging in Fibromyalgia.

    PubMed

    Hassett, Afton L; Clauw, Daniel J; Williams, David A

    2015-01-01

    Chronic pain is highly prevalent in older adults, and until recently, was considered to be common but relatively "benign." Mounting evidence, however, suggests that some of the 116 million US adults who suffer from chronic pain are also at an increased risk for developing age-related diseases prematurely, suffering earlier cognitive and physical decline, and experiencing earlier mortality. Given the aging US population and the prevalence of chronic pain along with related healthcare consequences, there is a critical need to better understand the relationship between aging and chronic pain. Herein, we focus on one chronic pain state, fibromyalgia, and provide an overview of the evidence suggesting that individuals with this chronic pain condition show signs of premature aging.

  11. Estimating PM2.5-associated mortality increase in California due to the Volkswagen emission control defeat device

    NASA Astrophysics Data System (ADS)

    Wang, Tianyang; Jerrett, Michael; Sinsheimer, Peter; Zhu, Yifang

    2016-11-01

    The Volkswagen Group of America (VW) was found by the US Environmental Protection Agency (EPA) and the California Air Resources Board (CARB) to have installed "defeat devices" and emit more oxides of nitrogen (NOx) than permitted under current EPA standards. In this paper, we quantify the hidden NOx emissions from this so-called VW scandal and the resulting public health impacts in California. The NOx emissions are calculated based on VW road test data and the CARB Emission Factors (EMFAC) model. Cumulative hidden NOx emissions from 2009 to 2015 were estimated to be over 3500 tons. Adult mortality changes were estimated based on ambient fine particulate matter (PM2.5) change due to secondary nitrate formation and the related concentration-response functions. We estimated that hidden NOx emissions from 2009 to 2015 have resulted in a total of 12 PM2.5-associated adult mortality increases in California. Most of the mortality increase happened in metropolitan areas, due to their high population and vehicle density.

  12. [Incidence and mortality due to cancer in Navarre, 1998-2002. Trends in the last 30 years].

    PubMed

    Ardanaz, E; Moreno-Iribas, C; Pérez de Rada, M E; Ezponda, C; Floristán, Y; Navaridas, N; Martínez-Peñuela, J M; Puras, A; Santamaría, M; Ezpeleta, I; Valerdi, J J; Pardo, F J; Monzón, F J; Lizarraga, J; Ortigosa, C; Resano, J; Barricarte, A

    2007-01-01

    Between 1998-2002, 16,952 new cases of cancer were registered in Navarre. In men, the most frequently diagnosed cancers were in the following order: prostate, lung, colon and rectum, bladder and stomach, which accounted for 63.2%. In women, the sites were breast, colon and rectum, corpus uteri, stomach and ovary, which accounted for 57.6% of the cases. In the same period, 1998-2002, 4,127 men and 2,470 women died from cancer. Sixty percent of all deaths due to malign tumours in men were due to cancer of the lung, prostate, colon and rectum, stomach and bladder. In women this was due to cancers of colon and rectum, breast, stomach, pancreas and lung, which accounted for 49% of the cases. In men in Navarre there has been an increase in the incidence rates of cancer of the prostate, kidney and non-Hodgkin lymphoma. Avoidable cancers such as those related to smoking (lung, oral cavity and pharynx or pancreas) continue to rise, and represent a greater global risk of dying from cancer in the latest period studied than in the decades of the 1970s and 1980s. From 1995 up to the present, mortality due to cancer has moved from occupying the second place to become the first cause of death among men in Navarre. The global risk of death due to cancer in men is now equal to the first period studied, 1975-1977. Amongst women the global risk of death due to cancer fell by 25% between 1975 and 2002, basically at the cost of breast and stomach cancer. Tumours related to smoking increased both in mortality and in incidence and appear as a significant health problem amongst women in Navarre. Breast cancer has increased in incidence, with lower mortality figures than those of the first period 1975-1977. Invasive cancer of the cervix remains at very low rates in comparison with many European countries, including Spain. In both sexes colorectal and skin cancer has increased, while the incidence and mortality of stomach cancer continues to fall.

  13. [Postoperative morbidity and in-hospital mortality of gastrectomy due to gastric adenocarcinoma: a report of 50 years].

    PubMed

    Ruiz, Eloy; Payet, Carlos; Montalbetti, Juan Antonio; Celis, Juan; Payet, Eduardo; Berrospi, Francisco; Chavez, Ivan; Young, Frank

    2004-01-01

    Determine the postoperative morbidity and in-hospital mortality of gastrectomy due to gastric cancer. The study involved the review of the clinical records of all patients with histologically confirmed diagnostic of gastric adenocarcinoma, which underwent a gastrectomy at the Peruvian Institute of Neoplastic Diseases between January 1950 and December 1999. During that period, 2,033 gastrectomies were performed, 503 of which were total gastrectomies and 1,447 were distal subtotal gastrectomies. Postoperative morbidity of total and distal subtotal gastrectomy dropped from 23.7% and 14.3% during the 1950 decade, to 19.8% and 7.4% during the 1990 decade, respectively, while the in-hospital mortality of total and subtotal gastrectomy dropped from 28.9% and 19.4% during the 50s to 4.4% and 2.2% during the 90's. The most common complications were the esophagojejunal, gastrojejunal and duodenal fistulas, respiratory infections, intra-abdominal abscesses, pancreatic fistula, early intestinal obstruction, hemorrhage from the anastomosis site and surgical site infection. Multivariate logistics regression analysis showed that the risk factors for in-hospital mortality of total gastrectomy were hypoalbuminemia, intraoperative blood transfusion and re-resection (OR: 2.4, 5.9 and 1.7, respectively). For distal subtotal gastrectomy, the risk factors for in-hospital mortality were hypoalbuminemia, intraoperative blood transfusion, splenectomy and re-resection (OR: 2.6, 2.46, 2.42 and 6.3, respectively). Based on our results, the in-hospital mortality risk depends on the postoperative variables (hypoalbuminemia, intraoperative blood transfusion, splenectomy and re-resection) more than on the pre-operative variables, beyond the surgeon's control (age, sex, clinical stage, etc.).

  14. Quantifying and Adjusting for Disease Misclassification Due to Loss to Follow-Up in Historical Cohort Mortality Studies

    PubMed Central

    Scott, Laura L. F.; Maldonado, George

    2015-01-01

    The purpose of this analysis was to quantify and adjust for disease misclassification from loss to follow-up in a historical cohort mortality study of workers where exposure was categorized as a multi-level variable. Disease classification parameters were defined using 2008 mortality data for the New Zealand population and the proportions of known deaths observed for the cohort. The probability distributions for each classification parameter were constructed to account for potential differences in mortality due to exposure status, gender, and ethnicity. Probabilistic uncertainty analysis (bias analysis), which uses Monte Carlo techniques, was then used to sample each parameter distribution 50,000 times, calculating adjusted odds ratios (ORDM-LTF) that compared the mortality of workers with the highest cumulative exposure to those that were considered never-exposed. The geometric mean ORDM-LTF ranged between 1.65 (certainty interval (CI): 0.50–3.88) and 3.33 (CI: 1.21–10.48), and the geometric mean of the disease-misclassification error factor (εDM-LTF), which is the ratio of the observed odds ratio to the adjusted odds ratio, had a range of 0.91 (CI: 0.29–2.52) to 1.85 (CI: 0.78–6.07). Only when workers in the highest exposure category were more likely than those never-exposed to be misclassified as non-cases did the ORDM-LTF frequency distributions shift further away from the null. The application of uncertainty analysis to historical cohort mortality studies with multi-level exposures can provide valuable insight into the magnitude and direction of study error resulting from losses to follow-up. PMID:26501295

  15. Mortality due to acute adverse drug reactions in Galicia: 1997-2011.

    PubMed

    Miguel-Arias, Domingo; Pereiro Gómez, César; Bermejo Barrera, Ana M; López de Abajo Rodríguez, Benito; Sobrido Prieto, María

    2016-03-02

    The aim of this research is to study all people who died in the Autonomous Community of Galicia from acute death after drugconsumption (ADR) in which there was judicial intervention during the period from 1997 to 2011, according to inclusion and exclusión criteria established by the National Drug Plan for the entire national territory. Sociodemographic and clinical characteristics of deceased subjects were studied, in order to identify key risk factors and/or vulnerable populations.A total of 805 deaths were recorded. The distribution by provinces and municipalities corresponds to the areas of greatest population, incidence of consumption and proximity to the coast. The average age of these patients was 34.34 years, with a gradual increase over years. Most of them were male (91.2%) and single (47.7). 43.5% of the deceased habitually used the parenteral route of administration and 36.4% had positive HIV serology. The most frequently-detected substances corresponded to opiates (heroin: 61.3%, methadone: 35.6%), followed by cocaine (53.7%), although the most common pattern was that of poly-consumption. ADR mortality figures remain relatively stable throughout the study period. The predominant pattern is that of males, opiates and a long history of consumption.

  16. [Epidemiological profile of mortality due to human influenza A (H1N1) in Mexico].

    PubMed

    Fajardo-Dolci, Germán E; Hernández-Torres, Francisco; Santacruz-Varela, Javier; Rodríguez-Suárez, Javier; Lamy, Philippe; Arboleya-Casanova, Heberto; Gutiérrez-Vega, Rafael; Manuell-Lee, Gabriel; Córdova-Villalobos, José Angel

    2009-01-01

    To carry out the epidemiological analysis of 122 influenza A (H1N1) deaths confirmed by laboratory and help to improve the diagnosis and timely managing of cases. A total of 122 clinical records were analyzed of patients with confirmed influenza A (H1N1) virus infection who died. Fifty-one percent of patients were female and 49% were male. A total of 45.l% who died were between 20 and 39 years old. Overall fatality was 2.2% and ranged between 0.3% for the l0 to l9 year-old group to 6.3% for the 50 to 59 year-old group. Forty-three percent of deaths were concentrated in only two of the thirty-two states and 5l% received medical attention in social security institutions. Only l7% received hospital attention within 72 hours and 42% died within 72 hours of hospital attention. Novel Influenza A (H1N1) virus produces higher mortality in young people whereas seasonal influenza has a greater impact on young children and older people. Delay in medical care and the associated morbidity were relevant factors for death.

  17. Epidemiological features of calf mortality due to hemophilosis in a large feedlot

    PubMed Central

    Van Donkersgoed, Joyce; Janzen, Eugene D.; Harland, Richard J.

    1990-01-01

    Hemophilosis was the most significant cause of mortality in fall-placed calves in a large feedlot in Saskatchewan, despite routine single immunization of calves with a commercial Haemophilus somnus bacterin on arrival. Common manifestations of fatal H. somnus infection were myocarditis and pleuritis; occasionally, thrombotic meningoencephalomyelitis (TME), peracute septicemia, and pneumonia were observed. Circumstantial evidence suggested that H. somnus may be a pathogen in polyarthritis. Death from pneumonia mainly occurred during the first five weeks in the feedlot. Death from myocarditis, pleuritis, TME, and septicemia, and euthanasia because of polyarthritis, occurred mainly after the third week in the feedlot. The median fatal disease onset (FDO) for pneumonia was day 12; for septicemia, day 17; for polyarthritis, day 18; for myocarditis and pleuritis, day 22; and for TME, day 29. Calves that died from myocarditis frequently were found dead in their “home” pen; however, 88% of these animals had been treated previously. Fifty-seven percent of the calves that died from pleuritis were never treated, and those that died from TME or septicemia were either never treated or died shortly after initial treatment. PMID:17423705

  18. Increased mortality and morbidity due to acute myocardial infarction in a public hospital, in Feira de Santana, Bahia.

    PubMed

    Ferreira, Graça Maria Tavares de Melo; Correia, Luis Cláudio; Reis, Helena; Ferreira Filho, Carlos Brandão; Freitas, Francisco; Ferreira, Guilherme Melo; Júnior, Ivan; Oliveira, Nelson; Guimarães, Armênio Costa

    2009-08-01

    Factors related to socioeconomic status and health care quality and management may influence mortality and morbidity rates due to acute myocardial infarction (AMI). To compare mortality and morbidity in patients with AMI hospitalized in public and private hospitals. An observational study, with comparison groups. Clinical evaluation on admission, and recording of diagnostic, therapeutic and evolution data until discharge or death. Comparison of clinical characteristics by univariate analysis followed by bivariate analysis, evaluating the combination of predictors with death and morbidity (Killip> I), SPSS, version 13.0. 150 patients were evaluated, 63 (42.0%) of private hospitals and 87 (58.0%) of public hospitals, with 63.1% and 62.1% of males, aged 61.1 +/- 13.8 and 60.0 +/- 11.6 years, respectively. The mortality from AMI was 19.5% in public hospitals vs 4.8% in private hospitals (p = 0.001), and morbidity (Killip class> I) was 34.3% in public hospitals vs 15.0% in private hospitals (p = 0.012). There was a significant difference between public and private patients, due to lower family income and education (70.1% with one to two salaries vs 19.0%, p <0.001, and 49.4% of illiterates vs 6.3%, p <0.001, respectively ); late arrival at the hospital (HAT> 1 hour: 76.9% vs 48.6%, p = 0.003); and a longer period of time before being medicated (AMT > 15 minutes: 47.1% vs 8.0%; p <0.001); ICU for 8% of the patients in public hospitals vs 94% in private hospitals; and thrombolysis for 20.6% vs 54.0%, respectively (p <0.001). Mortality and morbidity were greater among public patients, which presented more serious conditions, arrived later at the hospital and received lower quality treatment.

  19. Mortality due to cutaneous melanoma in south region of Brazil: a spatial approach*

    PubMed Central

    Ferreira, Flávia Regina; Nascimento, Luiz Fernando Costa

    2016-01-01

    Background Cutaneous melanoma is a skin cancer with low incidence but high mortality rates. The South region of Brazil has the highest death rates by melanoma per 100,000 inhabitants of the country. Little is known about the spatial distribution of this malignancy in southern Brazil. Objectives Identify the spatial patterns of deaths from cutaneous melanoma in South region of Brazil, using geoprocessing tools. Methods This is an ecological and exploratory study of death information by cutaneous melanoma obtained from portal Datasus, for Brazil's southern region, from January 2008 to December 2012. Deaths were separated by gender and rates per 100,000 inhabitants were calculated and used to compile thematic maps, Moran maps and Kernel maps, using TerraView software. It was adopted an alpha = 5%. Results There were data on 2378 deaths from cutaneous melanoma in the study period. High rates were identified in the northern and littoral regions of Rio Grande do Sul; the northeast of Santa Catarina; and west of Paraná - for the total population, with minor differences detected and indicated regarding gender. The global Moran index presented p-values of 0.03, 0.04 and 0.03, respectively, for male, female and overall deaths. All the micro-regions that showed high priority for intervention were detected in the Rio Grande do Sul. Conclusion Spatial clusters of micro-regions with high death rates from cutaneous melanoma in South region of Brazil were identified, serving as an important tool for health managers. PMID:27579737

  20. Abruption-associated prematurity

    PubMed Central

    Han, Christina S.; Schatz, Frederick; Lockwood, Charles J.

    2011-01-01

    SYNOPSIS Chronic, subacute decidual hemorrhage (i.e., abruptio placenta and retrochorionic hematoma formation) is an important contributor to preterm parturition. Such hemorrhage induces thrombin from decidual tissue factor, which play a pivotal role in the development of preterm premature rupture of membranes and preterm delivery by acting through protease-activated receptors to promote the production of pro-inflammatory cytokines, and matrix-degrading metalloproteinases. Severe, acute abruption can lead to maternal and fetal mortality. Current management of abruption is individualized based on severity of disease, underlying etiology, and gestational age. PMID:21890016

  1. Neonatal mortality due to preterm birth at 28-36 weeks' gestation in China, 2003-2008.

    PubMed

    Liang, Juan; Mao, Meng; Dai, Li; Li, Xiaohong; Miao, Lei; Li, Qi; He, Chunhua; Li, Mingrong; Wang, He; Zhu, Jun; Wang, Yanping

    2011-11-01

    Almost all (99%) neonatal deaths occur in developing countries, where the progress in reducing neonatal mortality rates (NMR) has been small; the Millennium Development Goal for child survival cannot be met if this situation continues. China is among the 10 countries that have the largest numbers of neonatal deaths. In order to provide effective interventions to reduce the national NMR for government policy makers, we analyse the trends, causes and characteristics of the neonatal deaths of preterm babies in different regions of China during the period 2003-2008. The data for this retrospective study were retrieved from the population-based Maternal and Child Health Surveillance System of China. The Cochran-Armitage trend test was used to analyse the trend of NMRs due to immaturity. The national NMR due to immaturity has decreased by 38.7% in 6 years. However, the proportion of preterm births among the causes of neonatal death has increased significantly from 33.6% in 2003 to 40.9% in 2008. The relative risk of neonatal death among preterm babies has shown significant regional disparity. In 2008, the adjusted relative risk was 1.30 [95% confidence interval (CI) 0.95, 1.78] in the inland regions and 2.37 [95% CI 1.56, 3.60] in the remote regions, both compared with the coastal regions. The proportion of neonatal deaths with a gestational age <32 weeks or a birthweight <1500 g was highest among the coastal regions. Most neonatal deaths of preterm babies in remote areas were born at home and were not treated before death. Our study suggests that preterm birth is the leading cause of neonatal death in China and neonatal mortality due to immaturity displayed regional differences. The Chinese government should implement major effective strategies for reducing the mortality of preterm infants to further decrease the total NMR. Priority interventions should be region-specific, depending on the availability of economic and health care resources.

  2. Occupational exposure to particulate air pollution and mortality due to ischaemic heart disease and cerebrovascular disease

    PubMed Central

    Torén, Kjell; Bergdahl, Ingvar A; Nilsson, Tohr; Järvholm, Bengt

    2007-01-01

    Objectives A growing number of epidemiological studies are showing that ambient exposure to particulate matter air pollution is a risk factor for cardiovascular disease; however, whether occupational exposure increases this risk is not clear. The aim of the present study was to examine whether occupational exposure to particulate air pollution increases the risk for ischaemic heart disease and cerebrovascular disease. Methods The study population was a cohort of 176 309 occupationally exposed Swedish male construction workers and 71 778 unexposed male construction workers. The definition of exposure to inorganic dust (asbestos, man‐made mineral fibres, dust from cement, concrete and quartz), wood dust, fumes (metal fumes, asphalt fumes and diesel exhaust) and gases and irritants (organic solvents and reactive chemicals) was based on a job‐exposure matrix with focus on exposure in the mid‐1970s. The cohort was followed from 1971 to 2002 with regard to mortality to ischaemic heart disease and cerebrovascular disease. Relative risks (RR) were obtained by the person‐years method and from Poisson regression models adjusting for baseline values of blood pressure, body mass index, age and smoking habits. Results Any occupational particulate air pollution was associated with an increased risk for ischemic heart disease (RR 1.13, 95% CI 1.07 to 1.19), but there was no increased risk for cerebrovascular disease (RR 0.97, 95% CI 0.88 to 1.07). There was an increased risk for ischaemic heart disease and exposure to inorganic dust (RR 1.07, 95% CI 1.03 to 1.12) and exposure to fumes (RR 1.05, 95% CI 1.00 to 1.10), especially diesel exhaust (RR 1.18, 95% CI 1.13 to 1.24). There was no significantly increased risk for cerebrovascular disease and exposure to inorganic dust, fumes or wood dust. Conclusions Occupational exposure to particulate air pollution, especially diesel exhaust, among construction workers increases the risk for ischaemic heart disease. PMID

  3. Premature Needle Loss of Spruce

    Treesearch

    Jennifer Juzwik; Joseph G. O Brien

    1990-01-01

    Premature needle loss on white, black and Norway spruce has been observed in forest plantations in Wisconsin and Minnesota during the past six years. Symptoms vary by species but usually appear first in 2-4-year old needles on lower branches. Infected needles are dropped, resulting in branch mortality that progresses upward through the crown, sometimes killing even...

  4. Severe mortality in wild Atlantic salmon Salmo salar due to proliferative kidney disease (PKD) caused by Tetracapsuloides bryosalmonae (myxozoa).

    PubMed

    Sterud, Erik; Forseth, Torbjørn; Ugedal, Ola; Poppe, Trygve T; Jørgensen, Anders; Bruheim, Torkjell; Fjeldstad, Hans-Petter; Mo, Tor Atle

    2007-10-15

    Extensive mortality in Atlantic salmon fry was reported in the River Aelva from 2002 to 2004. Dead fish were collected in late summer 2006, and live fish were sampled by electrofishing in September the same year. At autopsy and in histological sections, the fish kidneys were found to be pale and considerably enlarged. Proliferative lesions with characteristic PKX cells were seen in a majority of the fish. DNA from kidney samples of diseased fish was subjected to PCR and sequencing, and the amplified sequences matched those of Tetracapsuloides bryosalmonae. We concluded that this myxozoan transmitted from bryozoans was the main cause of the observed mortality in salmon fry in 2006. Results from quantitative electrofishing in 2005 and 2006, combined with the observed fry mortality from 2002 to 2004, show that the smolt production in the river is severely reduced and that T. bryosalmonae is the most likely explanation for this decline. The present study is the first to report a considerable negative population effect in wild Atlantic salmon due to proliferative kidney disease (PKD). It also represents the northernmost PKD outbreak in wild fish. The river is regulated for hydroelectric power purposes, causing reduced water flow and elevated summer temperatures, and the present PKD outbreak may serve as an example of increased disease vulnerability of northern fish populations in a warmer climate.

  5. Increased Mortality in Schizophrenia Due to Cardiovascular Disease – A Non-Systematic Review of Epidemiology, Possible Causes, and Interventions

    PubMed Central

    Ringen, Petter Andreas; Engh, John A.; Birkenaes, Astrid B.; Dieset, Ingrid; Andreassen, Ole A.

    2014-01-01

    Background: Schizophrenia is among the major causes of disability worldwide and the mortality from cardiovascular disease (CVD) is significantly elevated. There is a growing concern that this health challenge is not fully understood and efficiently addressed. Methods: Non-systematic review using searches in PubMed on relevant topics as well as selection of references based on the authors’ experience from clinical work and research in the field. Results: In most countries, the standardized mortality rate in schizophrenia is about 2.5, leading to a reduction in life expectancy between 15 and 20 years. A major contributor of the increased mortality is due to CVD, with CVD mortality ranging from 40 to 50% in most studies. Important causal factors are related to lifestyle, including poor diet, lack of physical activity, smoking, and substance abuse. Recent findings suggest that there are overlapping pathophysiology and genetics between schizophrenia and CVD-risk factors, further increasing the liability to CVD in schizophrenia. Many pharmacological agents used for treating psychotic disorders have side effects augmenting CVD risk. Although several CVD-risk factors can be effectively prevented and treated, the provision of somatic health services to people with schizophrenia seems inadequate. Further, there is a sparseness of studies investigating the effects of lifestyle interventions in schizophrenia, and there is little knowledge about effective programs targeting physical health in this population. Discussion: The risk for CVD and CVD-related deaths in people with schizophrenia is increased, but the underlying mechanisms are not fully known. Coordinated interventions in different health care settings could probably reduce the risk. There is an urgent need to develop and implement effective programs to increase life expectancy in schizophrenia, and we argue that mental health workers should be more involved in this important task. PMID:25309466

  6. Insulation workers in Belfast. A further study of mortality due to asbestos exposure (1940-75).

    PubMed Central

    Elmes, P C; Simpson, M J

    1977-01-01

    A follow-up study of 162 men already working as insulators (laggers) in 1940 has been extended from 1965 to 1975. By the end of 1975 there were 40 survivors when 108 had been expected. Until 1965 there had been an overall excess of deaths; these were due to asbestosis with or without tuberculosis and to alimentary cancer, as well as to bronchial carcinoma and mesothelioma. From 1965 onwards the overall death rate among survivors is not so excessive but there is still a marked excess of deaths from bronchial cancer and mesothelioma. The continued risk of death attributable to malignancy after asbestosis had ceased to contribute directly, does not appear to be caused by any changes which occurred before 1940 in the conditions at work. PMID:911687

  7. Prevention of foal mortality due to Rhodococcus equi pneumonia on an endemically affected farm

    PubMed Central

    Prescott, John F.; Machang'u, Robert; Kwiecien, Jacek; Delaney, Kathy

    1989-01-01

    Over the course of one summer, foals on a horse breeding farm where Rhodococcus equi infection was endemic were examined clinically twice weekly for evidence of R. equi pneumonia. Examination usually commenced from the week of birth and continued for up to 14 weeks of age. Affected animals were treated with a variety of antimicrobial drugs and such treatment was often prolonged. For descriptive purposes, we regarded a foal as developing R. equi pneumonia if the rectal temperature rose above 39°C, the respiratory rate was over 40 per min, there were characteristic associated changes in respiratory sounds on auscultation, and the foal responded to antimicrobial treatment. In a group of 16 foals followed in this way, R. equi pneumonia developed in at least 14. Seven of these foals developed antibodies to equi factors as determined in a neutralizing antibody assay. Mean age of onset of these 14 foals was 3.4 weeks. Three foals developed the disease between 1.5-2.5 weeks of age, and 12 of 14 before four weeks of age. In previous years four to six foals died on the farm each summer of R. equi pneumonia; only one foal died of R. equi pneumonia on the farm during the summer of this study, and this foal did not form part of the study group. Early clinical recognition and treatment of R. equi pneumonia in foals on endemically affected farms may be an effective way to prevent deaths due to this infection. PMID:17423454

  8. Causes of mortality due to rheumatic diseases in Jerez de los Caballeros (Badajoz) during the 19th century.

    PubMed

    Peral Pacheco, Diego; Suárez-Guzmán, Francisco Javier

    2016-01-01

    A total of 26,203 of the deaths in Jerez de los Caballeros (Badajoz) during the 19th century were collected and grouped according to the Bertillon's Classification, in order to study the causes of death from rheumatic diseases. An analysis was made using the Death Registers, those located in the Parish Archives, and files of the Municipal Archives. There were a total of 31 deaths due to rheumatic diseases, with the 65-74 years age group being most frequent. The lack of records may be due to the inaccuracy of the diagnoses. September was the month of increased mortality. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  9. Mortality due to a retained circle hook in a longfin mako shark Isurus paucus (Guitart-Manday).

    PubMed

    Adams, D H; Borucinska, J D; Maillett, K; Whitburn, K; Sander, T E

    2015-07-01

    A female longfin mako shark Isurus paucus (Guitart-Manday, 1966) was found moribund on the Atlantic Ocean beach near Canaveral National Seashore, Florida; the shark died shortly after stranding. Macroscopic lesions included a partially healed bite mark on the left pectoral fin, a clefted snout, pericardial effusion and a pericardial mass surrounding a 12/0 circle fishing hook. The heart, pericardial mass, gills, ovary, oviduct, shell gland, epigonal organ, liver, kidney and intrarenal and interrenal glands were processed for histopathology and examined by brightfield microscopy. Microscopic examination revealed chronic proliferative and pyogranulomatous pericarditis and myocarditis with rhabdomyolysis, fibrosis and thrombosis; scant bacteria and multifocal granular deposits of iron were found intralesionally. In addition, acute, multifocal infarcts within the epigonal organ and gill filaments were found in association with emboli formed by necrocellular material. The ovary had high numbers of atretic follicles, and the liver had diffuse, severe hepatocellular degeneration, multifocal spongiosis and moderate numbers of melanomacrophage cells. This report provides evidence of direct mortality due to systemic lesions associated with retained fishing gear in a prohibited shark species. Due to the large numbers of sharks released from both recreational and commercial fisheries worldwide, impact of delayed post-release mortality on shark populations is an important consideration.

  10. [Mortality due to traffic injuries and its impact on life expectancy: a comparison between Mexico and Spain].

    PubMed

    González-Pérez, Guillermo Julián; Vega-López, María Guadalupe; Cabrera-Pivaral, Carlos Enrique

    2015-09-01

    To determine the impact of mortality due to motor vehicle traffic injuries (MVTI) compared with other causes of death on life expectancy in Mexico and Spain during the three-year periods 2000-2002 and 2010-2012 and the weight of the different age groups in years of life expectancy lost (YLEL) due to this cause. Based on official death and population data, abridged life tables in Mexico and Spain were constructed for the three-year periods studied. Temporary life expectancy and YLEL for persons aged 15 to 75 years were calculated by selected causes (MVTI, diabetes mellitus, malignant neoplasms and ischemic heart diseases) and age groups in each three-year period. In Spain, YLEL decreased in both sexes from all the causes studied, especially MVTI; this reduction was greater in the younger ages. In addition, temporary life expectancy increased. In Mexico, YLEL due to MVTI increased in men, mainly in young people, and remained unchanged among women. Temporary life expectancy declined in men but increased slightly among women. The reduction in YLEL due to MVTI in Spain has contributed to increased life expectancy. By contrast, the increase in YLEL due to MVTI among Mexican men has contributed to the decline in male life expectancy. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

  11. Estimating source-attributable health impacts of ambient fine particulate matter exposure: global premature mortality from surface transportation emissions in 2005

    NASA Astrophysics Data System (ADS)

    Chambliss, S. E.; Silva, R.; West, J. J.; Zeinali, M.; Minjares, R.

    2014-10-01

    Exposure to ambient fine particular matter (PM2.5) was responsible for 3.2 million premature deaths in 2010 and is among the top ten leading risk factors for early death. Surface transportation is a significant global source of PM2.5 emissions and a target for new actions. The objective of this study is to estimate the global and national health burden of ambient PM2.5 exposure attributable to surface transportation emissions. This share of health burden is called the transportation attributable fraction (TAF), and is assumed equal to the proportional decrease in modeled ambient particulate matter concentrations when surface transportation emissions are removed. National population-weighted TAFs for 190 countries are modeled for 2005 using the MOZART-4 global chemical transport model. Changes in annual average concentration of PM2.5 at 0.5 × 0.67 degree horizontal resolution are based on a global emissions inventory and removal of all surface transportation emissions. Global population-weighted average TAF was 8.5 percent or 1.75 μg m-3 in 2005. Approximately 242 000 annual premature deaths were attributable to surface transportation emissions, dominated by China, the United States, the European Union and India. This application of TAF allows future Global Burden of Disease studies to estimate the sector-specific burden of ambient PM2.5 exposure. Additional research is needed to capture intraurban variations in emissions and exposure, and to broaden the range of health effects considered, including the effects of other pollutants.

  12. Death, Disease, and Dirty Power. Mortality and health damage due to air pollution from power plants

    SciTech Connect

    Schneider, Conrad G.

    2000-10-01

    The Clean Air Task Force, on behalf of the Clear the Air campaign, commissioned Abt Associates to quantify the health impacts of fine particle air pollution, commonly known as soot, from power plants, as well as the expected benefits (avoidable deaths, hospitalizations, etc.) of policies that would reduce fine particle pollution from power plants. The health effects analyzed include death, hospitalizations, emergency room visits, asthma attacks, and a variety of lesser respiratory symptoms. This report summarizes the findings of the Abt Associates study, reviews the contribution of power plants to fine particle pollution, and discusses policies that will reduce power plant fine particle pollution and thus save thousands of lives. Key findings include: Fine particle pollution from US power plants cuts short the lives of over 30,000 people each year. In more polluted areas, fine particle pollution can shave several years off its victims' lives. Hundreds of thousands of Americans suffer from asthma attacks, cardiac problems and upper and lower respiratory problems associated with fine particles from power plants. The elderly, children, and those with respiratory disease are most severely impacted by fine particle pollution from power plants. Metropolitan areas with large populations near coal-fired power plants feel their impacts most acutely - their attributable death rates are much higher than in areas with few or no coal-fired power plants. Power plants outstrip all other polluters as the largest source of sulfates - the major component of fine particle pollution - in the US Approximately two-thirds (over 18,000) of the deaths due to fine particle pollution from power plants could be avoided by implementing policies that cut power plant sulfur dioxide and nitrogen oxide pollution 75 percent below 1997 emission levels. Fine particle pollution is responsible for increased risk of death and shortened life spans. Abt Associates' findings are based on a body of well

  13. Trend and Seasonal Patterns of Injuries and Mortality Due to Motorcyclists Traffic Accidents; A Hospital-Based Study.

    PubMed

    Hosseinpour, Marjan; Mohammadian-Hafshejani, Abdollah; Esmaeilpour Aghdam, Mohammad; Mohammadian, Mahdi; Maleki, Farzad

    2017-01-01

    To investigate trend and seasonal pattern of occurrence and mortality of motorcycle accidents in patients referred to hospitals of Isfahan. This cross-sectional study was carried out using traffic accidents data of Isfahan province, extracted from Ministry of Health (MOH) database from 2006 to 2010. During the study period, 83648 people injured due to motorcycle traffic accidents were referred to hospitals, all of them entered in the study. Logistic regression model was used to calculate the hospital mortality odds ratio, and Cochrane-Armitage test was used for assessment of linear trend. During the study period, the hospital admission for motorcycle accident was 83,648 and 89.3% (74743) of them were men. Mean age in accidents time was 26.41±14.3 years. The injuries and death sex ratio were 8.4 and 16.9, respectively. Lowest admission rate was during autumn and highest during summer. The injury mortality odds ratio was 1.01 (CI 95% 0.73-1.39) in the Spring, 1.34 (CI95% 1.01-1.79) in summer and 1.17 (CI95% 0.83-1.63). It was also calculated to be 2.51 (CI95% 1.36-4.64) in age group 40-49, 2.39 (CI95% 1.51-5.68) in 50-59 and 4.79 (CI95% 2.49-9.22) in 60-69 years. The mortality odds ratio was 3.53 (CI95% 2.77-4.5) in rural place, 1.33 (CI95% 1.15-1.54) in men, and 2.44 (CI95% 2.09-2.85) in the road out of town and village. In addition, trend of motorcycle accidents mortality was increasing (p<0.001). Motorcycle accidents injuries are more common in men, summer, young age and rural roads. These high risk groups need more attention, care and higher training.

  14. Trend and Seasonal Patterns of Injuries and Mortality Due to Motorcyclists Traffic Accidents; A Hospital-Based Study

    PubMed Central

    Hosseinpour, Marjan; Mohammadian-Hafshejani, Abdollah; Esmaeilpour Aghdam, Mohammad; Mohammadian, Mahdi; Maleki, Farzad

    2017-01-01

    Objective: To investigate trend and seasonal pattern of occurrence and mortality of motorcycle accidents in patients referred to hospitals of Isfahan. Methods: This cross-sectional study was carried out using traffic accidents data of Isfahan province, extracted from Ministry of Health (MOH) database from 2006 to 2010. During the study period, 83648 people injured due to motorcycle traffic accidents were referred to hospitals, all of them entered in the study. Logistic regression model was used to calculate the hospital mortality odds ratio, and Cochrane-Armitage test was used for assessment of linear trend. Results: During the study period, the hospital admission for motorcycle accident was 83,648 and 89.3% (74743) of them were men. Mean age in accidents time was 26.41±14.3 years. The injuries and death sex ratio were 8.4 and 16.9, respectively. Lowest admission rate was during autumn and highest during summer. The injury mortality odds ratio was 1.01 (CI 95% 0.73-1.39) in the Spring, 1.34 (CI95% 1.01-1.79) in summer and 1.17 (CI95% 0.83-1.63). It was also calculated to be 2.51 (CI95% 1.36-4.64) in age group 40-49, 2.39 (CI95% 1.51-5.68) in 50-59 and 4.79 (CI95% 2.49-9.22) in 60-69 years. The mortality odds ratio was 3.53 (CI95% 2.77-4.5) in rural place, 1.33 (CI95% 1.15-1.54) in men, and 2.44 (CI95% 2.09-2.85) in the road out of town and village. In addition, trend of motorcycle accidents mortality was increasing (p<0.001). Conclusion: Motorcycle accidents injuries are more common in men, summer, young age and rural roads. These high risk groups need more attention, care and higher training. PMID:28246624

  15. Mortality of spruce and fir in Maine in 1976-78 due to the spruce budworm outbreak

    Treesearch

    Donald W. Seegrist; Stanford L. Arner

    1982-01-01

    The spruce budworm population in Maine's spruce-fir forests has been at epidemic levels since the early 1970's. Spruce-fir mortality in 1976-78 is compared with predictions of what mortality would have been had the natural mortality rates remained at the levels experienced before the budworm outbreak. It appears that mortality of spruce and fir has increased...

  16. "Oxygen with love" and diode laser treatment decreases comorbidity and avoidable blindness due to retinopathy of prematurity: results achieved in the past 12 years.

    PubMed

    Garcia-Serrano, Jose Luis; Uberos Fernández, José; Anaya-Alaminos, Roberto; Jerez-Calero, Antonio; Padilla-Torres, José Francisco; Ramírez-Garcia, Maria Carmen; Piñar-Molina, Raquel

    2013-12-01

    To determine whether the "Oxygen with Love" (OWL) and diode laser treatment provided in a neonatal intensive care unit has reduced the risk of avoidable blindness caused by retinopathy of prematurity (ROP) over the past decade. A prospective observational cohort study was performed, in which 351 infants were examined for ROP. The inclusion conditions were as follows: preterm infants, birthweight <1500 g or <32 weeks' gestational age, and birth between 1 Jan 2000 to 31 August 2012. From mid-2009, the OWL program was implemented and the ventilation protocols for such infants were amended. We tested whether the incidence of unfavorable structural outcomes of ROP had decreased following these changes. From 2004 to 2012, the survival rates of younger children increased (p < 0.003). From 2005 to 2012, laser treatment rather than cryotherapy was applied, and the incidence of unfavorable structural outcomes of ROP fell from 13% to 5.6% (not significant). From 2009 to 2012, the incidence of ROP decreased from 55% to 29% (p < 0.002). From 1 August 2009 to 31 August 2012, there was less need for ablative treatment for premature infants, with the rate falling from 11.81% to 3.9% (p < 0.03). This improvement was significantly associated with a reduction in the number of days of intubation (p < 0.0017), lower rates of sepsis (p < 0.003), and improvements in postnatal weight gain (p < 0.0002). The introduction of the OWL program, together with lower rates of sepsis, improvements in postnatal weight gain, and the use of diode laser treatment, has reduced the incidence of unfavorable structural outcomes of ROP. Copyright © 2013. Published by Elsevier B.V.

  17. Childhood mortality due to drowning in rural Matlab of Bangladesh: magnitude of the problem and proposed solutions.

    PubMed

    Iqbal, Anwarul; Shirin, Tahmina; Ahmed, Tahmeed; Ahmed, Sirajuddin; Islam, Noor; Sobhan, Arif; Siddique, A K

    2007-09-01

    Drowning is an important cause of mortality among children in rural Bangladesh. Children aged 1-4 year(s) are at a high risk of death from drowning. Although deaths of children due to drowning in Bangladesh are acknowledged as an important cause of death, little effort has been made to address the issue of preventing deaths from this cause. This study has attempted to describe the problem and suggests possible prevention strategies, which may contribute to reducing childhood mortality from drowning. Data presented in this study were collected from Matlab where ICDDR,B has been maintaining a demographic surveillance since 1966. During the study period from 1985 to 2000, 989 deaths from drowning were reported, of which 796 (80.5%) were children in the age-group of 1-4 year(s), 48 (4.8%) were in the age-group of less than one year, and 145 (14.7%) in the age-group of 5-19 years. During 1985-2000, death rate per 1,000 children due to all causes among children of 1-4-year age-group decreased appreciably from 20.7% to 5.2%, while drowning-related deaths did not. Forty-five percent (n = 359) of drowning-related deaths occurred in ponds, 16.8% (n = 134) in ditches, 8.1% (n = 64) in canals, and 4.4% (n = 35) in rivers. The sites of more than 25% of drowning-associated deaths were not recorded. Analysis of seasonal variation revealed that most deaths due to drowning occurred during April-October, i.e. mostly during the monsoon months. It was also observed that the majority (67%) of mothers of victims had no formal education. Deaths due to drowning were mostly associated with children aged 1-4 year(s) and were 20% more common among boys than among girls (odds ratio = 1.2, 95% confidence interval 1.04-1.38, p < 0.012). The paper recommends some interventions to reduce the number of deaths due to drowning in rural Bangladesh, which include: (a) increasing awareness among mothers and close family members about the risk of drowning, (b) door-fencing, and (c) filling of unused

  18. Childhood Mortality Due to Drowning in Rural Matlab of Bangladesh: Magnitude of the Problem and Proposed Solutions

    PubMed Central

    Iqbal, Anwarul; Shirin, Tahmina; Ahmed, Tahmeed; Ahmed, Sirajuddin; Islam, Noor; Sobhan, Arif; Siddique, A.K.

    2007-01-01

    Drowning is an important cause of mortality among children in rural Bangladesh. Children aged 1–4 year(s) are at a high risk of death from drowning. Although deaths of children due to drowning in Bangladesh are acknowledged as an important cause of death, little effort has been made to address the issue of preventing deaths from this cause. This study has attempted to describe the problem and suggests possible prevention strategies, which may contribute to reducing childhood mortality from drowning. Data presented in this study were collected from Matlab where ICDDR, B has been maintaining a demographic surveillance since 1966. During the study period from 1985 to 2000, 989 deaths from drowning were reported, of which 796 (80.5%) were children in the age-group of 1–4 year(s), 48 (4.8%) were in the age-group of less than one year, and 145 (14.7%) in the age-group of 5–19 years. During 1985–2000, death rate per 1,000 children due to all causes among children of 1–4-year age-group decreased appreciably from 20.7% to 5.2%, while drowning-related deaths did not. Forty-five percent (n=359) of drowning-related deaths occurred in ponds, 16.8% (n=134) in ditches, 8.1% (n=64) in canals, and 4.4% (n=35) in rivers. The sites of more than 25% of drowning-associated deaths were not recorded. Analysis of seasonal variation revealed that most deaths due to drowning occurred during April-October, i.e. mostly during the monsoon months. It was also observed that the majority (67%) of mothers of victims had no formal education. Deaths due to drowning were mostly associated with children aged 1–4 year(s) and were 20% more common among boys than among girls (odds ratio=1.2, 95% confidence interval 1.04–1.38, p<0.012). The paper recommends some interventions to reduce the number of deaths due to drowning in rural Bangladesh, which include: (a) increasing awareness among mothers and close family members about the risk of drowning, (b) door-fencing, and (c) filling of unused

  19. Sensitivity of Global Mortality to Sulfate Geoengineering

    NASA Astrophysics Data System (ADS)

    Eastham, S. D.; Weisenstein, D.; Keith, D.; Barrett, S. R. H.

    2016-12-01

    Geoengineering with stratospheric aerosol injection (SAI) may be an effective measure to manage climate risks associated with anthropogenic greenhouse gases. However, although many studies of SAI have examined the consequences for the climate and ozone layer, to date none have quantified the associated impacts on human health. We combine prior estimates of the climate response to SAI, a microphysical aerosol model, and a global chemistry-transport model to estimate changes in global mortality resulting from SAI due to its effects on air quality and surface UV exposure. We find that SAI sufficient to produce 1 K of global cooling in 2040 would result in between -30,000 and +79,000 premature air quality and UV-related mortalities per year. This is equivalent to approximately 1% of global premature mortality attributable to surface air quality degradation in 2014. Reduced temperatures result in increased formation of inorganic aerosol, and therefore an average of 26,000 additional premature mortalities per year. Reductions in precipitation also increase aerosol burdens, resulting in a further 13,000 premature mortalities per year. Injected aerosol descending to the surface increases annual mortality by 7,400, while the net impact of photochemical changes reduces annual mortality by 20,000. Uncertainty in the response functions relating exposure to mortality are responsible for 95% of the variance in the result, with only 5% attributable to climate sensitivity. However, this total does not include other benefits and effects of SAI such as reducing near-term mortality associated with increased mean and extreme temperatures, which may be an order of magnitude larger than the impacts of SAI we compute here.

  20. Dead fish swimming: a review of research on the early migration and high premature mortality in adult Fraser River sockeye salmon Oncorhynchus nerka.

    PubMed

    Hinch, S G; Cooke, S J; Farrell, A P; Miller, K M; Lapointe, M; Patterson, D A

    2012-07-01

    Adult sockeye salmon Oncorhynchus nerka destined for the Fraser River, British Columbia are some of the most economically important populations but changes in the timing of their homeward migration have led to management challenges and conservation concerns. After a directed migration from the open ocean to the coast, this group historically would mill just off shore for 3-6 weeks prior to migrating up the Fraser River. This milling behaviour changed abruptly in 1995 and thereafter, decreasing to only a few days in some years (termed early migration), with dramatic consequences that have necessitated risk-averse management strategies. Early migrating fish consistently suffer extremely high mortality (exceeding 90% in some years) during freshwater migration and on spawning grounds prior to spawning. This synthesis examines multidisciplinary, collaborative research aimed at understanding what triggers early migration, why it results in high mortality, and how fisheries managers can utilize these scientific results. Tissue analyses from thousands of O. nerka captured along their migration trajectory from ocean to spawning grounds, including hundreds that were tracked with biotelemetry, have revealed that early migrants are more reproductively advanced and ill-prepared for osmoregulatory transition upon their entry into fresh water. Gene array profiles indicate that many early migrants are also immunocompromised and stressed, carrying a genomic profile consistent with a viral infection. The causes of these physiological changes are still under investigation. Early migration brings O. nerka into the river when it is 3-6° C warmer than historical norms, which for some late-run populations approaches or exceeds their critical maxima leading to the collapse of metabolic and cardiac scope, and mortality. As peak spawning dates have not changed, the surviving early migrants tend to mill in warm lakes near to spawning areas. These results in the accumulation of many more

  1. Trends in mortality due to motor vehicle traffic accident injuries between 1987 and 2011 in a Spanish region (Comunitat Valenciana).

    PubMed

    Melchor, Inmaculada; Nolasco, Andreu; Moncho, Joaquín; Quesada, José A; Pereyra-Zamora, Pamela; García-Senchermés, Carmen; Tamayo-Fonseca, Nayara; Martínez-Andreu, Purificación; Valero, Socorro; Salinas, Manuel

    2015-04-01

    To analyse the time evolution of the rates of mortality due to motor vehicle traffic accidents (MVTA) injuries that occurred among the general population of Comunitat Valenciana between 1987 and 2011, as well as to identify trend changes by sex and age group. An observational study of annual mortality trends between 1987 and 2011. We studied all deaths due to MVTA injuries that occurred during this period of time among the non-institutionalised population residing in Comunitat Valenciana (a Spanish Mediterranean region that had a population of 5,117,190 inhabitants in 2011). The rates of mortality due to MVTA injuries were calculated for each sex and year studied. These rates were standardised by age for the total population and for specific age groups using the direct method (age-standardised rate - ASR). Joinpoint regression models were used in order to detect significant trend changes. Additionally, the annual percentage change (APC) of the ASRs was calculated for each trend segment, which is reflected in statistically significant joinpoints. For all ages, ASRs decrease greatly in both men and women (70% decrease between 1990 and 2011). In 1990 and 2011, men have rates of 36.5 and 5.2 per 100,000 men/year, respectively. In the same years, women have rates of 8.0 and 0.9 per 100,000 women/year, respectively. This decrease reaches up to 90% in the age group 15-34 years in both men and women. ASR ratios for men and women increased over time for all ages: this ratio was 3.9 in 1987; 4.6 in 1990; and 5.8 in 2011. For both men and women, there is a first significant segment (p<0.05) with an increasing trend between 1987 and 1989-1990. After 1990, there are 3 segments with a significant decreasing APC (1990-1993, 1993-2005 and 2005-2011, in the case of men; and 1989-1996, 1999-2007 and 2007-2011, in the case of women). The risk of death due to motor vehicle traffic accidents injuries has decreased significantly, especially in the case of women, for the last 25 years in

  2. Comparative study on mortality due to cardiovascular diseases in São Caetano do Sul, São Paulo, Brazil, between 1980 and 2010.

    PubMed

    Luz, Fernanda Eugenio da; Santos, Brigitte Rieckmann Martins Dos; Sabino, Wilson

    2017-01-01

    Analysis of the mortality due to cardiovascular diseases (CVD) can provide subsidies for preventive and control measures. The goal of this article is to compare CVD mortality rates in São Caetano do Sul, the state of São Paulo and the country as a whole. Standardized mortality and mortality due to CVD were calculated for the 1980-2010 period. We found a significant reduction in cardiovascular mortality in all three study units during this period, with the largest reduction in CVD in São Caetano do Sul. The largest mortality rate was found in the state of São Paulo. In adults 30 to 59, the CVD mortality rate in São Caetano do Sul was three times as high in men as in women, yet among adults 60 and older, CVD mortality was higher in women than in men. The lower rate is the result of implementing different healthcare policies. However, specific interventions are required that focus on changes in lifestyle, especially among adult men and the elderly.

  3. Premature rupture of membranes.

    PubMed Central

    Poma, P. A.

    1996-01-01

    The management of patients with premature rupture of membranes has changed markedly in the past several years. The basis for this is a combination of a better understanding of newborn physiology, improved neonatal care, refinements in antibiotic therapy, and the widespread use of maternal and fetal monitoring. The best outcome for both mother and infant undoubtedly reflects data based on a combination of factors, among which are gestational age survival, evidence of fetal distress, presence or absence of labor and sepsis, and of course, the cervical condition as it is related to labor-readiness. An important recent advance is the recognition that an active observation management program is associated with less morbidity and mortality than the classic management course of delivery within 12 hours of membrane rupture. The fact that preterm premature rupture of membranes tends to recur in subsequent pregnancies offers an opportunity for prevention. Moreover, advances in perinatal and neonatal care will continue to improve the outcomes of these women and their children. PMID:8583489

  4. Factors associated with mortality due to neonatal pneumonia in India: a protocol for systematic review and planned meta-analysis.

    PubMed

    Nair, N Sreekumaran; Lewis, Leslie Edward; Lakiang, Theophilus; Godinho, Myron; Murthy, Shruti; Venkatesh, Bhumika T

    2017-09-06

    India contributes to the highest number of neonatal deaths globally. It also has the greatest number of pneumonia-related neonatal deaths in the developing world. We aim to systematically review the evidence for the factors associated with mortality due to neonatal pneumonia in the Indian context, to address the lack of consolidated evidence on this important issue. This protocol is part of a series of three reviews on neonatal pneumonia in India. Observational studies reporting on outcome of neonatal pneumonia in the Indian context, and published in English in peer-reviewed and indexed journals will be eligible for inclusion. Outcomes of this review will be the factors determining mortality due to neonatal pneumonia. A total of nine databases will be searched. Electronic and hand searching of published and grey literature will be performed. Selection of studies will be done in title, abstract and full text screening stages. Risk of bias, independently assessed by two authors, will be evaluated. Meta-analysis will be performed and heterogeneity assessed. Pooled effect estimates will be stated with 95% confidence intervals. Narrative synthesis will be done where meta-analysis cannot be performed. Publication bias will be evaluated and sensitivity analysis performed according to study quality. Quality of this review will be evaluated using AMSTAR (Assessing the Methodological quality of Systematic Reviews) and GRADE (Grades of Recommendation, Assessment, Development & Evaluation). A summary of findings table will be reported using GRADEPro. Since this is a review involving analysis of secondary data which is available in the public domain, and does not involve human participants, ethical approval was not required. The findings of the study will be shared with all stakeholders of this research. Knowledge dissemination workshops will be conducted with relevant stakeholders to transfer the evidence, tailored to the stakeholder (eg, policy briefs, publications

  5. Excess mortality due to Depression and Anxiety in the United States: Results from a Nationally Representative Survey

    PubMed Central

    Druss, Benjamin G; Manderscheid, Ronald W.; Walker, Elizabeth R.

    2016-01-01

    Objectives We compared the mortality of persons with and without anxiety and depression in a nationally representative survey and examined the role of socioeconomic factors, chronic diseases, and health behaviors in explaining excess mortality. Methods The 1999 National Health Interview Survey was linked with mortality data through 2011. We calculated the hazard ratio (HR) for mortality by presence or absence of anxiety/depression and evaluated potential mediators. We calculated the population attributable risk of mortality for anxiety/depression. Results Persons with anxiety/depression died 7.9 years earlier than other persons. At a population level, 3.5% of deaths were attributable to anxiety/depression. Adjusting for demographic factors, anxiety/depression was associated with an elevated risk of mortality (HR=1.61, 95% confidence interval [CI]=1.40, 1.84). Chronic diseases and health behaviors explained much of the elevated risk. Adjusting for demographic factors, people with past-year contact with a mental health professional did not demonstrate excess mortality associated with anxiety/depression while those without contact did. Conclusions Anxiety/depression presents a mortality burden at both an individual and population level. Our findings are consistent with targeting health behaviors and physical illnesses as strategies for reducing this excess mortality among people with anxiety/depression. PMID:26791259

  6. Proportional Mortality due to Heart Failure and Ischemic Heart Diseases in the Brazilian Regions from 2004 to 2011.

    PubMed

    Gaui, Eduardo Nagib; Klein, Carlos Henrique; Oliveira, Glaucia Maria Moraes de

    2016-09-01

    Heart failure (HF) and ischemic heart diseases (IHD) are important causes of death in Brazil. To assess proportional mortality (PM) due to HF and IHD as underlying causes stratified by sex and age groups in the Brazilian geoeconomic regions from 2004 to 2011. Data from death certificates were obtained in the DATASUS site under the following International Statistical Classification of Diseases and Related Health Problems codes, 10th Revision: 1) from chapter IX: I20 to I24 for acute IHD, I25 for chronic IHD, and I50 for HF; and 2) from chapter XVIII, for ill-defined causes (IDC). Proportional mortality due to HF increased with age in both sexes and all regions, the highest percentages being found among elderly women. Among men, the highest percentages were observed in the West-Central region up to the ninth decade, but, among the eldest individuals, the highest percentages were identified in the Southern region. Among women, the regions did not differ up to the age group of 70-79 years, although the West-Central region took the lead from 50 to 79 years; however, from the age of 80 years on, the Southern region showed the highest PM due to HF. Proportional mortality due to acute IHD in all Brazilian regions and in both sexes increased up to the age group of 60-69 years, from which it decreased. Among men, the Southeastern region had the highest percentages in the age group of 50-59 years, while women had lower PM due to acute IHD than men in all regions. In both sexes, PM due to chronic IHD increased with age in the Southern and Southeastern regions, which did not happen in the others, while the Southern region had the highest rate of all regions for all age groups. Regional differences were more prominent at more advanced ages, especially when deaths due to IDC were excluded. Insuficiência cardíaca (IC) e doenças isquêmicas do coração (DIC) são importantes causas de morte no Brasil. Avaliar a mortalidade proporcional (MP) por IC e DIC, como causas b

  7. Time trends and geographical variations in mortality due to suicide and causes of undetermined intent in Spain, 1991-2008.

    PubMed

    Salmerón, Diego; Cirera, Lluís; Ballesta, Mónica; Navarro-Mateu, Fernando

    2013-06-01

    This study analyses the trends, geographical variations, seasonal patterns and methods of mortality due to the combination of suicide and causes of undetermined intent in Spain between 1991 and 2008. Age-adjusted suicide rates were calculated. Poisson models were used to estimate rate ratios and annual percentage changes. Suicide rates decreased in all age groups with the exception of the 35-44 and 45-54 age groups. There were important geographic variations in suicide rates. Spring and summer were the seasons with the highest suicide rates. Suicide rates for hanging decreased, although the rates increased in the 35-44 age group of males. A significant upward trend in suicide by jumping was observed for males aged 15-54 and for females aged 25-64. There were almost no differences when the deaths of undetermined intent were excluded. Suicide rates decreased in both males and females, although the downward trend was not observed in males and females aged 35-44 or in females in the 45-54 age group. A significant upward trend in suicide rates for jumping was observed in some age groups. Substantial geographical variations in suicide rates were observed. The highest rates were observed in the warmest months.

  8. Effect of multiple endocrine neoplasia type 1 (MEN1) gene mutations on premature mortality in familial MEN1 syndrome with founder mutations.

    PubMed

    Ebeling, T; Vierimaa, O; Kytölä, S; Leisti, J; Salmela, P I

    2004-07-01

    Estimation of mortality and the natural course of a disease is usually based on information of carefully studied individuals with or at risk for a specific disease. Genealogical information has rarely been accurate enough for such studies. With the help of church records and multiple endocrine neoplasia type 1 (MEN1) family information of the two founder MEN1 mutations in Northern Finland (1466del12 and 1657insC), we could trace back common ancestors born in the beginning of the 1700s (1466del12) and approximately 1850 (1657insC) and find 67 probable gene carriers born between 1728 and 1929, which were identified among their offspring. Information was gathered from 34 obligatory MEN1 gene carriers and 31 spouses. The mean age (+/- sd) of death of affected males (n = 16) was 61.1 +/- 12.0 yr vs. 65.8 +/- 15.3 yr for unaffected males (n = 16) and for affected females (n = 16) was 67.2 +/- 10.7 yr vs. 67.7 +/- 14.7 yr for unaffected females (n = 13). The ages of death of the obligatory heterozygotes did not differ from that of the spouses in sex groups or from the sex-matched life expectancy estimates derived from Finnish national statistics. Causes of death differed significantly between female probands and spouses. In conclusion, obligatory MEN1 gene carrier status did not show a harmful effect on survival in this retrospective analysis tracing back to almost 300 yr.

  9. Differential Atmospheric Controls on Transpiration of Boreal Trees: A Potential Factor in Pre-mature Tree Mortality in Green-Tree Retention Strategies

    NASA Astrophysics Data System (ADS)

    Bladon, K. D.; Silins, U.; Lieffers, V. J.

    2004-05-01

    Green-tree retention, a harvesting strategy that involves the preservation of isolated and interconnected patches of live trees within the boundaries of harvested areas, is assumed to emulate natural disturbance, while preserving forest canopy continuity for wildlife habitat, maintaining forest biodiversity, and many other landscape level objectives. Unfortunately, many of the retention trees die within a few years after harvesting, thus much of the desired function of these trees is lost. This research focuses on understanding the relationship between changes in micro-climate following harvesting and transpiration, potentially leading to drought-induced mortality of aspen, balsam poplar, white spruce, and white birch. Continuous measurements of whole-tree water use (sap flow) and micro-climate were taken before and after harvesting of two adjacent boreal mixedwood stands in west-central Alberta in the summer of 2003. Differences in micro-climate including radiation, air temperature, relative humidity and wind penetration into the canopy produced large differences in atmospheric moisture demand (PET) between partially harvested (green-tree retention) and undisturbed forest canopies. The variability in atmospheric conditions created large differences in sap flow velocity and transpiration rates among these four boreal species. Differential transpiration rates among species will be discussed in context of atmospheric controls on water use and drought tolerance of boreal trees with differing autecology and/or hydraulic architecture.

  10. Outcomes for extremely premature infants.

    PubMed

    Glass, Hannah C; Costarino, Andrew T; Stayer, Stephen A; Brett, Claire M; Cladis, Franklyn; Davis, Peter J

    2015-06-01

    Premature birth is a significant cause of infant and child morbidity and mortality. In the United States, the premature birth rate, which had steadily increased during the 1990s and early 2000s, has decreased annually for 7 years and is now approximately 11.39%. Human viability, defined as gestational age at which the chance of survival is 50%, is currently approximately 23 to 24 weeks in developed countries. Infant girls, on average, have better outcomes than infant boys. A relatively uncomplicated course in the intensive care nursery for an extremely premature infant results in a discharge date close to the prenatal estimated date of confinement. Despite technological advances and efforts of child health experts during the last generation, the extremely premature infant (less than 28 weeks gestation) and extremely low birth weight infant (<1000 g) remain at high risk for death and disability with 30% to 50% mortality and, in survivors, at least 20% to 50% risk of morbidity. The introduction of continuous positive airway pressure, mechanical ventilation, and exogenous surfactant increased survival and spurred the development of neonatal intensive care in the 1970s through the early 1990s. Routine administration of antenatal steroids during premature labor improved neonatal mortality and morbidity in the late 1990s. The recognition that chronic postnatal administration of steroids to infants should be avoided may have improved outcomes in the early 2000s. Evidence from recent trials attempting to define the appropriate target for oxygen saturation in preterm infants suggests arterial oxygen saturation between 91% and 95% (compared with 85%-89%) avoids excess mortality; however, final analyses of data from these trials have not been published, so definitive recommendations are still pending. The development of neonatal neurocritical intensive care units may improve neurocognitive outcomes in this high-risk group. Long-term follow-up to detect and address

  11. Outcomes for Extremely Premature Infants

    PubMed Central

    Glass, Hannah C.; Costarino, Andrew T.; Stayer, Stephen A.; Brett, Claire; Cladis, Franklyn; Davis, Peter J.

    2015-01-01

    Premature birth is a significant cause of infant and child morbidity and mortality. In the United States, the premature birth rate, which had steadily increased during the 1990s and early 2000s, has decreased annually for four years and is now approximately 11.5%. Human viability, defined as gestational age at which the chance of survival is 50%, is currently approximately 23–24 weeks in developed countries. Infant girls, on average, have better outcomes than infant boys. A relatively uncomplicated course in the intensive care nursery for an extremely premature infant results in a discharge date close to the prenatal EDC. Despite technological advances and efforts of child health experts during the last generation, the extremely premature infant (less than 28 weeks gestation) and extremely low birth weight infant (ELBW) (< 1000 grams) remain at high risk for death and disability with 30–50% mortality and, in survivors, at least 20–50% risk of morbidity. The introduction of CPAP, mechanical ventilation, and exogenous surfactant increased survival and spurred the development of neonatal intensive care in the 1970s through the early 1990s. Routine administration of antenatal steroids during premature labor improved neonatal mortality and morbidity in the late 1990s. The recognition that chronic postnatal administration of steroids to infants should be avoided may have improved outcomes in the early 2000s. Evidence from recent trials attempting to define the appropriate target for oxygen saturation in preterm infants suggests arterial oxygen saturation between 91–95% (compared to 85–89%) avoids excess mortality. However, final analyses of data from these trials have not been published, so definitive recommendations are still pending The development of neonatal neurocognitive care visits may improve neurocognitive outcomes in this high-risk group. Long-term follow up to detect and address developmental, learning, behavioral, and social problems is critical for

  12. The basics of prematurity.

    PubMed

    Kelly, Michelle M

    2006-01-01

    Prematurity is the greatest single risk factor for death within the first year of life. The March of Dimes and Centers for Disease Control and Prevention define prematurity as birth before the completion of 37 weeks' gestation. In 2002, one in eight babies were delivered prematurely. This manuscript is Part I of a three-part series on premature infants. The overall goal of this series is to educate pediatric primary care providers regarding topics specific to delivering care to premature infants after discharge. Part I addresses the incidence of prematurity and the terminology used in neonatal literature and provides an overview of common comorbidities associated with prematurity. Part II will focus on the primary care management of uncomplicated premature infants. Part III will highlight issues of primary care for medically complex premature infants.

  13. [Burden of mortality due to diabetes mellitus in Latin America 2000-2011: the case of Argentina, Chile, Colombia, and Mexico.

    PubMed

    Agudelo-Botero, Marcela; Dávila-Cervantes, Claudio Alberto

    2015-03-05

    To analyze trends in mortality in Argentina, Chile, Colombia and Mexico, between 2000 and 2011, by sex and 5-year age groups (between 20 and 79 years of age). Mortality vital statistics and census data or projected population estimates were used for each country. Age-specific mortality rates and the years of life lost were calculated. Among the countries analyzed, Mexico had the highest mortality rate and lost the most years of life due to diabetes. Between 2000 and 2011, Mexicans lost an average of 1.13 years of life, while Colombia (0.24), Argentina (0.21) and Chile (0.18) lost considerably fewer life years. In general, deaths from diabetes were higher in men than in women except in Colombia. Nearly 80% of years of life lost due to diabetes occurred between 50 and 74 years of age in the four countries. Diabetes is a huge challenge for Latin America, especially in Mexico where mortality due to diabetes is accelerating. Even though the proportion of deaths due to diabetes in Argentina, Chile and Colombia is smaller, this disease figures among the main causes of death in these countries. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

  14. Intracellular retention of thyroglobulin in the absence of the low-density lipoprotein receptor-associated protein (RAP) is likely due to premature binding to megalin in the biosynthetic pathway.

    PubMed

    Lisi, S; Botta, R; Rotondo Dottore, G; Leo, M; Latrofa, F; Vitti, P; Marinò, M

    2016-09-01

    The low-density lipoprotein receptor associated protein (RAP) is expressed by thyroid epithelial cells (TEC) in a TSH-dependent manner. In the thyroid RAP functions as a molecular chaperone for the thyroglobulin (Tg) endocytic receptor megalin/LRP2, which is retained intracellularly in RAP KO mice rather than being expressed on the apical membrane of TEC, its usual location. RAP binds also to Tg, which is also retained intracellularly in RAP KO mice, thereby suggesting a role of RAP in Tg secretion. Here we investigated whether Tg intracellular retention in the absence of RAP is due to premature Tg-megalin interactions during the biosynthetic pathway or to a direct action of RAP on Tg secretion. We performed immunoprecipitation experiments in thyroid extracts from RAP KO and WT mice. In addition, we investigated Tg secretion in COS-7 cells co-transfected with human RAP (hRAP) and mouse Tg (mTg). An anti-megalin megalin precipitated greater amounts of Tg in thyroid extracts from RAP KO than from WT mice, suggesting increased intracellular interactions between megalin and Tg in the absence of RAP. COS-7 cells transiently transfected with hRAP, mTg or both, expressed the two proteins accordingly. RAP was found almost exclusively in cell extracts, whereas Tg was found both in extracts and media, as expected from the knowledge that RAP is ER-resident and that Tg is secreted. Regardless of whether cells were transfected with mTg alone or were co-transfected with hRAP, similar proportions of the total Tg synthesized were detected in cell extracts and media. The intracellular retention of Tg in the absence of RAP is likely due to its premature interaction with megalin, whereas RAP does not seem to affect Tg secretion directly.

  15. Premature ventricular contractions associated with isotretinoin use*

    PubMed Central

    Alan, Sevil; Ünal, Betül; Yildirim, Aytül

    2016-01-01

    Isotretinoin has been considered a unique drug for acne treatment. However, it is associated with numerous adverse effects. Isotretinoin can trigger premature ventricular contractions. This report describes a 33-year-old-woman who presented with palpitations for 1 week while undergoing 1-month isotretinoin treatment for mild-moderate facial acne. An electrocardiogram and Holter monitoring showed premature ventricular contractions during isotretinoin (Roaccutane, Roche) treatment. Isotretinoin-related premature ventricular contractions were strongly suggested in this case due to the existence of documented premature ventricular contractions on electrocardiograms and the disappearance of these premature ventricular contractions two weeks after termination of the treatment To the authors' knowledge, there has been 1 reported case of premature ventricular contractions linked to isotretinoin use; this report describes a second such case. PMID:28099609

  16. [Evaluation of the quality of drinking water in Senigallia (Italy), including the presence of asbestos fibres, and of morbidity and mortality due to gastrointestinal tumours].

    PubMed

    Fiorenzuolo, Giovanni; Moroni, Vania; Cerrone, Tiziana; Bartolucci, Elena; Rossetti, Siro; Tarsi, Riccardo

    2013-01-01

    The aim was to evaluate the organoleptic quality of drinking water conducted in asbestos cement piping, in eleven towns in the Marche region (Italy) and the presence of asbestos fibres. A descriptive survey was also conducted to assess possible health effects in the population, in particular morbidity and mortality due to gastrointestinal (GI) cancer. Study results show a very low concentration of free asbestos fibres in water samples examined. No differences in mortality and morbidity due to GI cancers were detected compared to the national population.

  17. Increased Risk of Mortality Due to Interpersonal Violence in Foreign-Born Women of Reproductive Age: A Swedish Register-Based Study.

    PubMed

    Fernbrant, Cecilia; Essén, Birgitta; Esscher, Annika; Östergren, Per-Olof; Cantor-Graae, Elizabeth

    2016-10-01

    Violence against women is an increasing public health concern, with assault leading to death as the most extreme outcome. Previous findings indicate that foreign-born women living in Sweden are more exposed to interpersonal violence than Swedish-born women. The current study investigates mortality due to interpersonal violence in comparison with other external causes of death among women of reproductive age in Sweden, with focus on country of birth. Foreign-born women and especially those from countries with low and very low gender equity levels had increased risk of mortality due to interpersonal violence, thus implicating lack of empowerment as a contributing factor. © The Author(s) 2016.

  18. [Analysis of premature labor and its causes in the Republic of Georgia].

    PubMed

    Kintraia, N P

    2006-09-01

    The premature labor is the main index of perinatal morbidity and mortality of mother and newborn. The aim of our trial was, to study the real situation on premature labor in the Republic of Georgia, to determine the specific gravity of stress factors in epidemiology of this problem and to find optimal preventive measures. It is found that in those regions, which are close to military conflict areas, where people are under permanent "expectancy-stress", the rate of premature labor is significantly higher. We have found that the rate of premature labor in the Republic of Georgia is about 11.2%+/-2.1. 75% of still-born babies are premature. The rate of perinatal mortality for the last 3 years was 28.9, where about 75.3% is due to preterm labor. Stress endured by a pregnant woman affects psycho-emotional sphere of a newborn, which is revealed in its high neural reflex excitement. Chronic stress in a pregnant woman causes retention of the fetus development which later results in prenatal hypotrophy and morphofunctional immaturity.

  19. Modeling of the relationship between the environmental air pollution, clinical risk factors, and hospital mortality due to myocardial infarction in Isfahan, Iran

    PubMed Central

    Sadeghi, Mehraban; Ahmadi, Ali; Baradaran, Azar; Masoudipoor, Neda; Frouzandeh, Soleiman

    2015-01-01

    Background: This study aimed to determine the relationship between the environmental factor, clinical risk factors, and individual variables with mortality due to acute myocardial infarction (MI) in Isfahan. Materials and Methods: This cross-sectional study was performed between April 2012 and March 2013. The data on the patients’ mortality due to MI in Isfahan were obtained from the MI National Registry. The international classification system (ICD10: I21-I22) was used to diagnose MI. The air quality indicators and environmental variables were used to measure the air pollution. Multilevel logistic regression in the Stata software was used to determine the factors associated with mortality in patients and odds ratios (ORs) were calculated. Results: Six hundred eleven patients with MI were studied during 1-year. 444 (72.2%) patients were male and the rest were female. 4.7% of the patients died due to MI. The mean age at MI incidence was 62.2 ± 13 years. Of the air pollution parameters, PM10 had the maximum mean concentration (49.113 ppm), followed by NOX, NO, NO2, CO, SO2, and O3. The adjusted OR of mortality was derived 2.07 (95% CI: 1.5-2.85) for right bundle branch block, 1.5 (95% CI: 1.3-1.7) for ST-segment elevation MI, 1.84 (95% CI: 1.13-3) for age, 1.06 (95% CI: 1.01-1.20) for CO, 1.1 (95% CI: 1.03-1.30) for O3, and 1.04 (95% CI: 1.01-1.4) for SO2, all of which were considered as the risk factors of mortality. However, OR of mortality was 0.79 for precipitation (95% CI: 0.74-0.84) and 0.52 for angioplasty (95% CI: 0.4-0.68) were considered as protective factors of mortality. The individual characteristics including age, history of MI in the immediate family, hypertension, and diabetes were significantly associated with mortality from MI. The indices of air pollution including SO2, CO, O3, and environmental factors such as the precipitation and temperature were the determinants of mortality in patients with MI. Conclusion: With regards to the factors

  20. Size-related mortality due to gnathiid isopod micropredation correlates with settlement size in coral reef fishes

    NASA Astrophysics Data System (ADS)

    Grutter, A. S.; Blomberg, S. P.; Fargher, B.; Kuris, A. M.; McCormick, M. I.; Warner, R. R.

    2017-06-01

    The transition between the planktonic and the benthic habitat is a critical period for the larvae of many demersal marine organisms. Understanding the potential constraints on the timing of this habitat transition, called settlement, is important to understanding their biology. Size-specific mortality can set the limits on lifestyle and help explain ontogenetic habitat shifts. We examined whether size-based mortality risks after settlement may include micropredation by ectoparasites by testing whether survival of settlement-stage fish varies with fish size when exposed to a reef-associated micropredator. Fish (14 species) were exposed to one blood-sucking gnathiid isopod overnight, with appropriate controls; gnathiid feeding success and survival, and fish mortality were recorded relative to fish size. After adjusting for fish relatedness, we found the relationship between fish mortality and size differed with gnathiid exposure: for gnathiid-exposed fish, the mean mortality of the smallest fish was much higher (57%) than unexposed controls (10%), and decreased to 0% for fish >12 mm standard length (SL); mortality was almost nil in controls. Thus, a predicted optimal size to switch habitat and reduce mortality risk from micropredation should be >12 mm SL. We then asked what species might be at greater risk and if the steep increase in survival at 12 mm SL might coincide with settlement at larger sizes among fishes. Across 102 other species (32 families), 61% settled at ≥12 mm SL. After adjusting for relatedness, mean fish settlement size was 15.0 mm and this was not significantly different from 12 mm. Thus, settlement size clusters around the minimum fish size threshold our gnathiid experiment predicted would be large enough to survive a gnathiid encounter. These results suggest micropredators may contribute to size-selective mortality during settlement processes and are consistent with the hypothesis that the pelagic phase provides fish an escape from certain

  1. Effect of appropriate combination therapy on mortality of patients with bloodstream infections due to carbapenemase-producing Enterobacteriaceae (INCREMENT): a retrospective cohort study.

    PubMed

    Gutiérrez-Gutiérrez, Belén; Salamanca, Elena; de Cueto, Marina; Hsueh, Po-Ren; Viale, Pierluigi; Paño-Pardo, José Ramón; Venditti, Mario; Tumbarello, Mario; Daikos, George; Cantón, Rafael; Doi, Yohei; Tuon, Felipe Francisco; Karaiskos, Ilias; Pérez-Nadales, Elena; Schwaber, Mitchell J; Azap, Özlem Kurt; Souli, Maria; Roilides, Emmanuel; Pournaras, Spyros; Akova, Murat; Pérez, Federico; Bermejo, Joaquín; Oliver, Antonio; Almela, Manel; Lowman, Warren; Almirante, Benito; Bonomo, Robert A; Carmeli, Yehuda; Paterson, David L; Pascual, Alvaro; Rodríguez-Baño, Jesús

    2017-07-01

    The best available treatment against carbapenemase-producing Enterobacteriaceae (CPE) is unknown. The objective of this study was to investigate the effect of appropriate therapy and of appropriate combination therapy on mortality of patients with bloodstream infections (BSIs) due to CPE. In this retrospective cohort study, we included patients with clinically significant monomicrobial BSIs due to CPE from the INCREMENT cohort, recruited from 26 tertiary hospitals in ten countries. Exclusion criteria were missing key data, death sooner than 24 h after the index date, therapy with an active antibiotic for at least 2 days when blood cultures were taken, and subsequent episodes in the same patient. We compared 30 day all-cause mortality between patients receiving appropriate (including an active drug against the blood isolate and started in the first 5 days after infection) or inappropriate therapy, and for patients receiving appropriate therapy, between those receiving active monotherapy (only one active drug) or combination therapy (more than one). We used a propensity score for receiving combination therapy and a validated mortality score (INCREMENT-CPE mortality score) to control for confounders in Cox regression analyses. We stratified analyses of combination therapy according to INCREMENT-CPE mortality score (0-7 [low mortality score] vs 8-15 [high mortality score]). INCREMENT is registered with ClinicalTrials.gov, number NCT01764490. Between Jan 1, 2004, and Dec 31, 2013, 480 patients with BSIs due to CPE were enrolled in the INCREMENT cohort, of whom we included 437 (91%) in this study. 343 (78%) patients received appropriate therapy compared with 94 (22%) who received inappropriate therapy. The most frequent organism was Klebsiella pneumoniae (375 [86%] of 437; 291 [85%] of 343 patients receiving appropriate therapy vs 84 [89%] of 94 receiving inappropriate therapy) and the most frequent carbapenemase was K pneumoniae carbapenemase (329 [75%]; 253 [74%] vs 76

  2. [Music therapy for prematures].

    PubMed

    Haus, R; Hennecke, K-H

    2003-01-01

    More than ever before the neonatal care besides the medical and nursing work has to been balanced between protecting the child against over extension due to the concept of "minimal handling" and on the other hand the necessary fostering of the young patients psychic and sensomotor development during the long stationary treatment. In addition to known approaches of auditive stimulation as receptive music therapy a concept of active music therapy methods based on the Nordoff/Robbins creative music-therapy (University Witten/Herdecke) is presented in a case-report. The report describes in a single case-report the music-therapeutic work with a premature of the 23 + 3 (th) week of pregnancy at the neonatological unit of the Vestische Kinder- und Jugendklinik Datteln, Universität Witten/Herdecke. The main focus was the observation of the prematures reactions on specific synchronisation of motoric, sensor and acoustical stimulation. Positive reactions allow to presume the effectiveness of music therapy with early born children as they are already shown in clinical studies about receptive music therapy. On the level of involuntary motional actions in the area of head-, face- and hand movements increased directly reactions of awareness on the coordination of sensomotor and acoustical stimulation have been observed. Temporary increase of oxygen partial pressure and reduction of heart/pulse rate seem to cause positive physiological effects. Active music therapeutic treatment does not seem to be an other risk of over-tension for prematures, but offers through the coordination of different levels of perception an adequate development fostering stimulation.

  3. Premature ovarian failure

    PubMed Central

    Beck-Peccoz, Paolo; Persani, Luca

    2006-01-01

    Premature ovarian failure (POF) is a primary ovarian defect characterized by absent menarche (primary amenorrhea) or premature depletion of ovarian follicles before the age of 40 years (secondary amenorrhea). It is a heterogeneous disorder affecting approximately 1% of women <40 years, 1:10,000 women by age 20 and 1:1,000 women by age 30. The most severe forms present with absent pubertal development and primary amenorrhea (50% of these cases due to ovarian dysgenesis), whereas forms with post-pubertal onset are characterized by disappearance of menstrual cycles (secondary amenorrhea) associated with premature follicular depletion. As in the case of physiological menopause, POF presents by typical manifestations of climacterium: infertility associated with palpitations, heat intolerance, flushes, anxiety, depression, fatigue. POF is biochemically characterized by low levels of gonadal hormones (estrogens and inhibins) and high levels of gonadotropins (LH and FSH) (hypergonadotropic amenorrhea). Beyond infertility, hormone defects may cause severe neurological, metabolic or cardiovascular consequences and lead to the early onset of osteoporosis. Heterogeneity of POF is also reflected by the variety of possible causes, including autoimmunity, toxics, drugs, as well as genetic defects. POF has a strong genetic component. X chromosome abnormalities (e.g. Turner syndrome) represent the major cause of primary amenorrhea associated with ovarian dysgenesis. Despite the description of several candidate genes, the cause of POF remains undetermined in the vast majority of the cases. Management includes substitution of the hormone defect by estrogen/progestin preparations. The only solution presently available for the fertility defect in women with absent follicular reserve is ovum donation. PMID:16722528

  4. Mortality and case fatality due to visceral leishmaniasis in Brazil: a nationwide analysis of epidemiology, trends and spatial patterns.

    PubMed

    Martins-Melo, Francisco Rogerlândio; Lima, Mauricélia da Silveira; Ramos, Alberto Novaes; Alencar, Carlos Henrique; Heukelbach, Jorg

    2014-01-01

    Visceral leishmaniasis (VL) is a significant public health problem in Brazil and several regions of the world. This study investigated the magnitude, temporal trends and spatial distribution of mortality related to VL in Brazil. We performed a study based on secondary data obtained from the Brazilian Mortality Information System. We included all deaths in Brazil from 2000 to 2011, in which VL was recorded as cause of death. We present epidemiological characteristics, trend analysis of mortality and case fatality rates by joinpoint regression models, and spatial analysis using municipalities as geographical units of analysis. In the study period, 12,491,280 deaths were recorded in Brazil. VL was mentioned in 3,322 (0.03%) deaths. Average annual age-adjusted mortality rate was 0.15 deaths per 100,000 inhabitants and case fatality rate 8.1%. Highest mortality rates were observed in males (0.19 deaths/100,000 inhabitants), <1 year-olds (1.03 deaths/100,000 inhabitants) and residents in Northeast region (0.30 deaths/100,000 inhabitants). Highest case fatality rates were observed in males (8.8%), ≥ 70 year-olds (43.8%) and residents in South region (17.7%). Mortality and case fatality rates showed a significant increase in Brazil over the period, with different patterns between regions: increasing mortality rates in the North (Annual Percent Change--APC: 9.4%; 95% confidence interval--CI: 5.3 to 13.6), and Southeast (APC: 8.1%; 95% CI: 2.6 to 13.9); and increasing case fatality rates in the Northeast (APC: 4.0%; 95% CI: 0.8 to 7.4). Spatial analysis identified a major cluster of high mortality encompassing a wide geographic range in North and Northeast Brazil. Despite ongoing control strategies, mortality related to VL in Brazil is increasing. Mortality and case fatality vary considerably between regions, and surveillance and control measures should be prioritized in high-risk clusters. Early diagnosis and treatment are fundamental strategies for reducing case fatality

  5. Retinopathy of Prematurity

    ERIC Educational Resources Information Center

    Steinweg, Sue Byrd; Griffin, Harold C.; Griffin, Linda W.; Gingras, Happy

    2005-01-01

    The eyes of premature infants are especially vulnerable to injury after birth. A serious complication is called retinopathy of prematurity (ROP), which is abnormal growth of the blood vessels in an infant's eye. Retinopathy of prematurity develops when abnormal blood vessels grow and spread throughout the retina, which is the nerve tissue at the…

  6. Retinopathy of Prematurity

    ERIC Educational Resources Information Center

    Steinweg, Sue Byrd; Griffin, Harold C.; Griffin, Linda W.; Gingras, Happy

    2005-01-01

    The eyes of premature infants are especially vulnerable to injury after birth. A serious complication is called retinopathy of prematurity (ROP), which is abnormal growth of the blood vessels in an infant's eye. Retinopathy of prematurity develops when abnormal blood vessels grow and spread throughout the retina, which is the nerve tissue at the…

  7. Long-Term Exposure to Ambient Air Pollution and Mortality Due to Cardiovascular Disease and Cerebrovascular Disease in Shenyang, China

    PubMed Central

    Sun, Baijun; Zhang, Liwen; Chen, Xi; Ma, Nannan; Yu, Fei; Guo, Huimin; Huang, Hui; Lee, Yungling Leo; Tang, Naijun; Chen, Jie

    2011-01-01

    Background The relationship between ambient air pollution exposure and mortality of cardiovascular and cerebrovascular diseases in human is controversial, and there is little information about how exposures to ambient air pollution contribution to the mortality of cardiovascular and cerebrovascular diseases among Chinese. The aim of the present study was to examine whether exposure to ambient-air pollution increases the risk for cardiovascular and cerebrovascular disease. Methodology/Principal Findings We conducted a retrospective cohort study among humans to examine the association between compound-air pollutants [particulate matter <10 µm in aerodynamic diameter (PM10), sulfur dioxide (SO2) and nitrogen dioxide (NO2)] and mortality in Shenyang, China, using 12 years of data (1998–2009). Also, stratified analysis by sex, age, education, and income was conducted for cardiovascular and cerebrovascular mortality. The results showed that an increase of 10 µg/m3 in a year average concentration of PM10 corresponds to 55% increase in the risk of a death cardiovascular disease (hazard ratio [HR], 1.55; 95% confidence interval [CI], 1.51 to 1.60) and 49% increase in cerebrovascular disease (HR, 1.49; 95% CI, 1.45 to 1.53), respectively. The corresponding figures of adjusted HR (95%CI) for a 10 µg/m3 increase in NO2 was 2.46 (2.31 to 2.63) for cardiovascular mortality and 2.44 (2.27 to 2.62) for cerebrovascular mortality, respectively. The effects of air pollution were more evident in female that in male, and nonsmokers and residents with BMI<18.5 were more vulnerable to outdoor air pollution. Conclusion/Significance Long-term exposure to ambient air pollution is associated with the death of cardiovascular and cerebrovascular diseases among Chinese populations. PMID:21695220

  8. Association between air pollution and daily mortality and hospital admission due to ischaemic heart diseases in Hong Kong

    NASA Astrophysics Data System (ADS)

    Tam, Wilson Wai San; Wong, Tze Wai; Wong, Andromeda H. S.

    2015-11-01

    Ischaemic heart disease (IHD) is one of the leading causes of death worldwide. The effects of air pollution on IHD mortalities have been widely reported. Fewer studies focus on IHD morbidities and PM2.5, especially in Asia. To explore the associations between short-term exposure to air pollution and morbidities and mortalities from IHD, we conducted a time series study using a generalized additive model that regressed the daily numbers of IHD mortalities and hospital admissions on daily mean concentrations of the following air pollutants: nitrogen dioxide (NO2), particulate matter with an aerodynamic diameter less than 10 μm (PM10), particulate matter with an aerodynamic diameter less than 2.5 μm (PM2.5), ozone (O3), and sulfur dioxide (SO2). The relative risks (RR) of IHD deaths and hospital admissions per 10 μg/m3 increase in the concentration of each air pollutant were derived in single pollutant models. Multipollutant models were also constructed to estimate their RRs controlling for other pollutants. Significant RRs were observed for all five air pollutants, ranging from 1.008 to 1.032 per 10 μg/m3 increase in air pollutant concentrations for IHD mortality and from 1.006 to 1.021 per 10 μg/m3 for hospital admissions for IHD. In the multipollutant model, only NO2 remained significant for IHD mortality while SO2 and PM2.5 was significantly associated with hospital admissions. This study provides additional evidence that mortalities and hospital admissions for IHD are significantly associated with air pollution. However, we cannot attribute these health effects to a specific air pollutant, owing to high collinearity between some air pollutants.

  9. Prematurity and potential predictors.

    PubMed

    Field, Tiffany; Diego, Miguel; Hernandez-Reif, Maria

    2008-02-01

    Prematurity continues to be the leading cause of neonatal death and developmental disability, highlighting the importance of identifying potential predictors of prematurity as well as interventions that can be linked to the predictors. This review covers recent research on potential psychological, physiological, and biochemical predictors. Among the psychological stressors are depression, anxiety, difficult relationships, and lack of social support. Biochemical predictors include corticotropin-releasing hormone, cortisol, and fetal fibronectin. A program of research that links an intervention for prematurity with a predictor for prematurity, that is, massage therapy to reduce cortisol and, in turn, reduce prematurity, is then presented.

  10. Effects of atmospheric transport and trade on air pollution mortality in China

    NASA Astrophysics Data System (ADS)

    Zhao, Hongyan; Li, Xin; Zhang, Qiang; Jiang, Xujia; Lin, Jintai; Peters, Glen G.; Li, Meng; Geng, Guannan; Zheng, Bo; Huo, Hong; Zhang, Lin; Wang, Haikun; Davis, Steven J.; He, Kebin

    2017-09-01

    Air quality is a major environmental concern in China, where premature deaths due to air pollution have exceeded 1 million people per year in recent years. Here, using a novel coupling of economic, physical and epidemiological models, we estimate the premature mortality related to anthropogenic outdoor PM2. 5 air pollution in seven regions of China in 2010 and show for the first time how the distribution of these deaths in China is determined by a combination of economic activities and physical transport of pollution in the atmosphere. We find that 33 % (338 600 premature deaths) of China's PM2. 5-related premature mortality in 2010 were caused by pollutants emitted in a different region of the country and transported in the atmosphere, especially from north to south and from east to west. Trade further extended the cross-regional impact; 56 % of (568 900 premature deaths) China's PM2. 5-related premature mortality was related to consumption in another region, including 423 800 (42 % of total) and 145 100 (14 %) premature deaths from domestic consumption and international trade respectively. Our results indicate that multilateral and multi-stage cooperation under a regional sustainable development framework is in urgent need to mitigate air pollution and related health impacts, and efforts to reduce the health impacts of air pollution in China should be prioritized according to the source and location of emissions, the type and economic value of the emitting activities, and the related patterns of consumption.

  11. [FREQUENCY AND MEDICAL SOCIAL ASPECTS PREMATURE BIRTH].

    PubMed

    Sandeva, M; Uchikova, E

    2016-01-01

    Premature birth (PB) remains an unresolved problem, despite progress in prenatal medicine and the introduction of new methods and techniques of prolonged respiratory resuscitation in recent decades. Premature birth is the cause of 70% of neonatal mortality and 50% of long-term neurological complications in newborns, many of whom debilitating. Notwithstanding the significant progress prenatal care in the last twenty years in developed countries is a trend towards a gradual and continuous increase in premature births. PB is not only medical but also social problem. Despite the efforts of the scientific and practical obstetrics and modern tocolytic therapy, the rate of premature births in the last decade reduced. The causes of preterm birth are multifactorial and vary depending on gestational age, genetic factors and environmental factors. The long-term consequences of premature birth bear behind not only economic but also social problems. In many developing countries, premature birth is a major cause of disability. Clinical studies in recent years have been aimed at creating a comprehensive therapeutic algorithm behavior in premature births in order to reduce their frequency, especially for those born weighing less than 1000g.

  12. Electrocardiographic Predictors of Cardiovascular Mortality

    PubMed Central

    Mozos, Ioana; Caraba, Alexandru

    2015-01-01

    Cardiovascular diseases are the main causes of mortality. Sudden cardiac death may also appear in athletes, due to underlying congenital or inherited cardiac abnormalities. The electrocardiogram is used in clinical practice and clinical trials, as a valid, reliable, accessible, inexpensive method. The aim of the present paper was to review electrocardiographic (ECG) signs associated with cardiovascular mortality and the mechanisms underlying those associations, providing a brief description of the main studies in this area, and consider their implication for clinical practice in the general population and athletes. The main ECG parameters associated with cardiovascular mortality in the present paper are the P wave (duration, interatrial block, and deep terminal negativity of the P wave in V1), prolonged QT and Tpeak-Tend intervals, QRS duration and fragmentation, bundle branch block, ST segment depression and elevation, T waves (inverted, T wave axes), spatial angles between QRS and T vectors, premature ventricular contractions, and ECG hypertrophy criteria. PMID:26257460

  13. 7 CFR 29.1050 - Prematurity.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... leaves of the tobacco plant. Premature leaves have some appearance of ripeness due to a process of starvation caused by translocation of plant food elements from these leaves to other leaves higher on the...

  14. 7 CFR 29.1050 - Prematurity.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... leaves of the tobacco plant. Premature leaves have some appearance of ripeness due to a process of starvation caused by translocation of plant food elements from these leaves to other leaves higher on the...

  15. 7 CFR 29.1050 - Prematurity.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... leaves of the tobacco plant. Premature leaves have some appearance of ripeness due to a process of starvation caused by translocation of plant food elements from these leaves to other leaves higher on the...

  16. Preventing newborn deaths due to prematurity.

    PubMed

    Azad, Kishwar; Mathews, Jiji

    2016-10-01

    Preterm births (PTBs), defined as births before 37 weeks of gestation account for the majority of deaths in the newborn period. Prediction and prevention of PTB is challenging. A history of preterm labour or second trimester losses and accurate measurement of cervical length help to identify women who would benefit from progesterone and cerclage. Fibronectin estimation in the cervicovaginal secretions of a symptomatic woman with an undilated cervix can predict PTB within 10 days of testing. Antibiotics should be given to women with preterm prelabour rupture of membranes but tocolysis has a limited role in the management of preterm labour. Antenatal corticosteroids to prevent complications in the neonate should be given only when gestational age assessment is accurate PTB is considered imminent, maternal infection and the preterm newborn can receive adequate care. Magnesium sulphate for fetal neuroprotection should be given when delivery is imminent. After birth, most babies respond to simple interventions essential newborn care, basic care for feeding support, infections and breathing difficulties. Newborns weighing 2000 g or less, benefit from KMC. Babies, who are clinically unstable or cannot be given KMC may be nursed in an incubator or under a radiant warmer. Treatment modalities include oxygen therapy, CPAP, surfactant and assisted ventilation. Copyright © 2016. Published by Elsevier Ltd.

  17. Autopsy after death due to extreme prematurity.

    PubMed

    Elder, D E; Zuccollo, J M

    2005-05-01

    Autopsy reports for 29 very preterm infants dying at <28 days of age were reviewed. New findings were discovered in 79% and resulted in a significant change in diagnoses in 28%. Iatrogenic lesions were identified in 41% of cases and were the main cause of death in 14%.

  18. Mortality from congenital abnormality in Malaysia 1991-1997: the effect of economic development on death due to congenital heart disease.

    PubMed

    Ho, J J

    2001-06-01

    An analysis was done of available data from the Department of Statistics Malaysia, on the type of congenital abnormality contributing to death, to determine whether progress in health care over recent years was associated with any decline in mortality from congenital abnormality. A significant decline in death due to congenital abnormality was observed between 1991 and 1996. This was attributable to a decline in deaths due to congenital heart disease occurring because of improvements in cardiac surgical services for infants. In 1997 death due to congenital heart disease increased significantly. This could be attributed to improvements in the diagnosis of congenital heart disease in the neonate.

  19. Age-Period-Cohort analysis of mortality due to ischemic heart disease in Japan, 1955 to 2000.

    PubMed

    Ma, Enbo; Iso, Hiroyasu; Takahashi, Hideto; Yamagishi, Kazumasa; Tanigawa, Takeshi

    2008-06-01

    Mortality from ischemic heart disease (IHD) has been showing a marked decline in Japan. The objective of this study was to clarify the effects of age, time period, and cohort on mortality from IHD in Japan from 1955 to 2000. IHD death data from vital statistics and national population surveys were tabulated for 11 5-year age groups (from 30-34 to 80-84) and 10 quinquennial demographic profiles (from 1955 to 2000), to yield 20 5-year birth cohorts (mid-years from 1873 to 1968). The stratified Age-Period-Cohort model with 7 age classes shows: (1) mainly linear age trends for men with IHD, but effects below the linear age trends for women in middle-aged groups (40-74 years); (2) a decline in the effect of time period on IHD for both men and women from 1970 to 1990, and a sharp increase between 1990 and 1995 along with the change of the International Classification of Diseases Code; and (3) 2 patterns for both sexes for non-linear birth cohort effects, an increase (1873-1928) and a decrease (1928-1968) for men, and an increase (1873-1923) and a decrease (1923-1968) for women, with a stronger effect for women than for men born between 1893 and 1938, but the reverse for men and women born between 1938 and 1968. Declining effects of birth cohort on mortality rates of IHD for young and middle-aged people suggest that mortality rates are likely to continue to decrease in Japan.

  20. Predictors of the incidence of all-cause mortality and deaths due to diabetes and renal diseases among patients newly prescribed antihypertensive agents: a cohort study.

    PubMed

    Wong, Martin C S; Tam, Wilson W S; Wang, Harry H X; Cheung, Clement S K; Tong, Ellen L H; Sek, Antonio C H; Cheung, N T; Yan, Bryan P Y; Yu, C M; Leeder, Stephen R; Griffiths, Sian M

    2013-10-12

    Randomized trials have shown that the major antihypertensive drug classes are similarly effective to reduce mortality, but whether these drug class difference exists in clinical practice has been scarcely explored. This study evaluated the association between antihypertensive drug class, all-cause mortality and deaths due to diabetes or renal disease in real-life clinical settings. A clinical database in Hong Kong included all patients who were prescribed their first-ever antihypertensive agents between 2001 and 2005 from the public healthcare sector. All patients were followed up for five years, and grouped according to the initial antihypertensive prescription. The associations between antihypertensive drug class, all-cause mortality or combined diabetes and renal mortality, respectively, were evaluated by Cox proportional hazard models. From 218,047 eligible patients, 33,288 (15.3%) died within five years after their first-ever antihypertensive prescription and among which 1055 patients (0.48%) died of diabetes or renal disease. After adjusted for age, gender, socioeconomic status, service settings, district of residence, medication adherence, and the number of comorbidities, each drug class was similarly likely to be associated with mortality due to diabetes or renal disease [Adjusted Hazard Ratios (AHR) ranged from 0.92 to 1.73, p=0.287-0.939] and all-cause mortality (AHR ranged from 0.83 to 1.02) except for beta-blockers (AHR=0.815, 95% C.I. 0.68-0.87, p=0.024) when ACEI was used as a reference group in propensity score-adjusted analysis. These findings provide real-life evidence reinforcing that any major antihypertensive drug class is suitable as a first-line agent for management of hypertension as recommended by international guidelines. © 2013.

  1. Predicted risks of second malignant neoplasm incidence and mortality due to secondary neutrons in a girl and boy receiving proton craniospinal irradiation

    PubMed Central

    Taddei, Phillip J; Mahajan, Anita; Mirkovic, Dragan; Zhang, Rui; Giebeler, Annelise; Kornguth, David; Harvey, Mark; Woo, Shiao; Newhauser, Wayne D

    2010-01-01

    The purpose of this study was to compare the predicted risks of second malignant neoplasm (SMN) incidence and mortality from secondary neutrons for a 9-year-old girl and a 10-year-old boy who received proton craniospinal irradiation (CSI). SMN incidence and mortality from neutrons were predicted from equivalent doses to radiosensitive organs for cranial, spinal and intracranial boost fields. Therapeutic proton absorbed dose and equivalent dose from neutrons were calculated using Monte Carlo simulations. Risks of SMN incidence and mortality in most organs and tissues were predicted by applying risks models from the National Research Council of the National Academies to the equivalent dose from neutrons; for non-melanoma skin cancer, risk models from the International Commission on Radiological Protection were applied. The lifetime absolute risks of SMN incidence due to neutrons were 14.8% and 8.5%, for the girl and boy, respectively. The risks of a fatal SMN were 5.3% and 3.4% for the girl and boy, respectively. The girl had a greater risk for any SMN except colon and liver cancers, indicating that the girl’s higher risks were not attributable solely to greater susceptibility to breast cancer. Lung cancer predominated the risk of SMN mortality for both patients. This study suggests that the risks of SMN incidence and mortality from neutrons may be greater for girls than for boys treated with proton CSI. PMID:21076189

  2. Predicted risks of second malignant neoplasm incidence and mortality due to secondary neutrons in a girl and boy receiving proton craniospinal irradiation.

    PubMed

    Taddei, Phillip J; Mahajan, Anita; Mirkovic, Dragan; Zhang, Rui; Giebeler, Annelise; Kornguth, David; Harvey, Mark; Woo, Shiao; Newhauser, Wayne D

    2010-12-07

    The purpose of this study was to compare the predicted risks of second malignant neoplasm (SMN) incidence and mortality from secondary neutrons for a 9-year-old girl and a 10-year-old boy who received proton craniospinal irradiation (CSI). SMN incidence and mortality from neutrons were predicted from equivalent doses to radiosensitive organs for cranial, spinal and intracranial boost fields. Therapeutic proton absorbed dose and equivalent dose from neutrons were calculated using Monte Carlo simulations. Risks of SMN incidence and mortality in most organs and tissues were predicted by applying risks models from the National Research Council of the National Academies to the equivalent dose from neutrons; for non-melanoma skin cancer, risk models from the International Commission on Radiological Protection were applied. The lifetime absolute risks of SMN incidence due to neutrons were 14.8% and 8.5%, for the girl and boy, respectively. The risks of a fatal SMN were 5.3% and 3.4% for the girl and boy, respectively. The girl had a greater risk for any SMN except colon and liver cancers, indicating that the girl's higher risks were not attributable solely to greater susceptibility to breast cancer. Lung cancer predominated the risk of SMN mortality for both patients. This study suggests that the risks of SMN incidence and mortality from neutrons may be greater for girls than for boys treated with proton CSI.

  3. Predicted risks of second malignant neoplasm incidence and mortality due to secondary neutrons in a girl and boy receiving proton craniospinal irradiation

    NASA Astrophysics Data System (ADS)

    Taddei, Phillip J.; Mahajan, Anita; Mirkovic, Dragan; Zhang, Rui; Giebeler, Annelise; Kornguth, David; Harvey, Mark; Woo, Shiao; Newhauser, Wayne D.

    2010-12-01

    The purpose of this study was to compare the predicted risks of second malignant neoplasm (SMN) incidence and mortality from secondary neutrons for a 9-year-old girl and a 10-year-old boy who received proton craniospinal irradiation (CSI). SMN incidence and mortality from neutrons were predicted from equivalent doses to radiosensitive organs for cranial, spinal and intracranial boost fields. Therapeutic proton absorbed dose and equivalent dose from neutrons were calculated using Monte Carlo simulations. Risks of SMN incidence and mortality in most organs and tissues were predicted by applying risks models from the National Research Council of the National Academies to the equivalent dose from neutrons; for non-melanoma skin cancer, risk models from the International Commission on Radiological Protection were applied. The lifetime absolute risks of SMN incidence due to neutrons were 14.8% and 8.5%, for the girl and boy, respectively. The risks of a fatal SMN were 5.3% and 3.4% for the girl and boy, respectively. The girl had a greater risk for any SMN except colon and liver cancers, indicating that the girl's higher risks were not attributable solely to greater susceptibility to breast cancer. Lung cancer predominated the risk of SMN mortality for both patients. This study suggests that the risks of SMN incidence and mortality from neutrons may be greater for girls than for boys treated with proton CSI.

  4. Termination of breastfeeding after 12 months of age due to a new pregnancy and other causes is associated with increased mortality in Guinea-Bissau.

    PubMed

    Jakobsen, M S; Sodemann, M; Mølbak, K; Alvarenga, I J; Nielsen, J; Aaby, P

    2003-02-01

    As part of an assessment of breastfeeding and child health in Guinea-Bissau, we investigated the impact of mother's reason for weaning on subsequent child mortality. Children were identified and followed by the demographic health surveillance system of the Bandim Health Project in Guinea-Bissau. Breastfeeding status and survival were ascertained by 3-monthly follow-up home visits. At termination of breastfeeding mothers were interviewed about her reasons for weaning. In all, 1423 children who terminated breastfeeding after 12 months of age were followed to 3 years of age. Median length of breastfeeding was 22 months. Following termination of breastfeeding, 66 children died before 36 months of age. In all, 62% (879/1423) were weaned because they were 'healthy'. Compared with the 'healthy' children, all other causes of weaning were associated with a higher mortality (mortality ratio [MR] = 2.97, 95% CI: 1.54-5.73). For 237 children weaned due to a new pregnancy the MR was 3.25 (95% CI: 1.45-7.30). Seventy-five children weaned because of illness had a 2.98 (95% CI: 0.95-9.39) fold excess mortality compared with children considered healthy. Excess deaths in the 'non-healthy' group accounted for 44% (29/66) of post-weaning deaths. Median length of spacing between an index child and a new sibling was 28 months irrespective of whether the index child survived or died before 3 years of age. The majority of the deaths occurred before birth of the new sibling. Popular rationalizations of abstinence during breastfeeding emphasizes, as we observed, that weaning due to new pregnancy of the mother is associated with higher mortality. This was not due to a shorter breastfeeding period of the child weaned due to a new pregnancy. Generally children weaned for other reasons than 'being healthy' had higher mortality. The mother's reason for weaning could potentially be used as screening criteria in child monitoring programmes in areas with high mortality.

  5. Relationship between risk factors and in-hospital mortality due to myocardial infarction by educational level: a national prospective study in Iran.

    PubMed

    Ahmadi, Ali; Khaledifar, Arsalan; Sajjadi, Homeira; Soori, Hamid

    2014-11-27

    Since no hospital-based, nationwide study has been yet conducted on the association between risk factors and in-hospital mortality due to myocardial infarction (MI) by educational level in Iran, the present study was conducted to investigate relationship between risk factors and in-hospital mortality due to MI by educational level. In this nationwide hospital-based, prospective analysis, follow-up duration was from definite diagnosis of MI to death. The cohort of the patients was defined in view of the date at diagnosis, hospitalization and the date at discharge (recovery or in-hospital death due to MI). 20750 patients hospitalized for newly diagnosed MI between April, 2012 and March, 2013 comprised sample size. Totally, 2511 deaths due to MI were obtained. The data on education level (four-level) were collected based on years of schooling. To determine in-hospital mortality rate and the associated factors with mortality, seven statistical models were developed using Cox proportional hazards models. Of the studied patients, 9611 (6.1%) had no education. in-hospital mortality rate was 8.36 (95% CI: 7.81-8.9) in women and 6.12 (95% CI: 5.83-6.43) in men per 100 person-years. This rate was 5.56 in under 65-year-old patients and 8.37 in over 65-year-old patients. This rate in the patients with no, primary, high school, and academic education was respectively 8.11, 6.11, 4.85 and 5.81 per 100 person-years. Being woman, chest pain prior to arriving in hospital, lack of thrombolytic therapy, right bundle branch block, ventricular tachycardia, smoking and ST-segment elevation myocardial infarction were significantly associated with increased hazard ratio (HR) of death. The adjusted HR of mortality was 1.27 (95% CI: 1.06-1.52), 0.93 (95% CI: 0.77-1.13), 0.72 (95% CI: 0.57-0.91) and 0.82 (95% CI: 0.66-1.01) in the patients with respectively illiterate, primary, secondary and high school education compared to academic education. A disparity was noted in post-MI mortality

  6. Liver Abscess: Increasing Occurrence in Premature Newborns

    PubMed Central

    Bosnalı, Oktav; Moralıoğlu, Serdar; Pektaş, Osman

    2013-01-01

    Neonatal liver abscess is a very rare condition associated with high morbidity and mortality rates. There seems to be an increasing trend of this rare condition amongst the newborns admitted to neonatal intensive care units. We report a case of liver abscess in a premature newborn and briefly review the literature and discuss its management. PMID:26023443

  7. Mortality due to coronary heart disease and kidney disease among middle-aged and elderly men and women with gout in the Singapore Chinese Health Study.

    PubMed

    Teng, Gim Gee; Ang, Li-Wei; Saag, Kenneth G; Yu, Mimi C; Yuan, Jian-Min; Koh, Woon-Puay

    2012-06-01

    Whether the link between gout and mortality is causal or confounded by lifestyle factors or comorbidities remains unclear. Studies in Asia are warranted due to the rapid modernisation of the locale and ageing of the population. The association between gout and mortality was examined in a prospective cohort, the Singapore Chinese Health Study, comprising 63 257 Singapore Chinese individuals, aged 45-74 years during the enrolment period of 1993-8. All enrollees were interviewed in person on lifestyle factors, current diet and medical histories. All surviving cohort members were contacted by telephone during 1999-2004 to update selected exposure and medical histories (follow-up I interview), including the history of physician-diagnosed gout. Cause-specific mortality in the cohort was identified via record linkage with the nationwide death registry, up to 31 December 2009. Out of 52 322 participants in the follow-up I interview, 2117 (4.1%) self-reported a history of physician-diagnosed gout, with a mean age at diagnosis of 54.7 years. After a mean follow-up period of 8.1 years, there were 6660 deaths. Relative to non-gout subjects, subjects with gout had a higher risk of death (HR 1.18; 95% CI 1.06 to 1.32), and specifically from death due to coronary heart disease (CHD) (HR 1.38, 95% CI 1.10 to 1.73) and kidney disease (HR 5.81, 95% CI 3.61 to 9.37). All gout-mortality risk associations were present in both genders but the risk estimates appeared higher for women. Gout is an independent risk factor for mortality, and specifically for death due to CHD and kidney disease.

  8. Mortality due to coronary heart disease and kidney disease among middle-aged and elderly men and women with gout in the Singapore Chinese Health Study

    PubMed Central

    Teng, Gim Gee; Ang, Li-Wei; Saag, Kenneth G; Yu, Mimi C; Yuan, Jian-Min; Koh, Woon-Puay

    2012-01-01

    Objectives Whether the link between gout and mortality is causal or confounded by lifestyle factors or comorbidities remains unclear. Studies in Asia are warranted due to the rapid modernisation of the locale and ageing of the population. Methods The association between gout and mortality was examined in a prospective cohort, the Singapore Chinese Health Study, comprising 63 257 Singapore Chinese individuals, aged 45–74 years during the enrolment period of 1993–8. All enrollees were interviewed in person on lifestyle factors, current diet and medical histories. All surviving cohort members were contacted by telephone during 1999–2004 to update selected exposure and medical histories (follow-up I interview), including the history of physician-diagnosed gout. Cause-specific mortality in the cohort was identified via record linkage with the nationwide death registry, up to 31 December 2009. Results Out of 52 322 participants in the follow-up I interview, 2117 (4.1%) self-reported a history of physician-diagnosed gout, with a mean age at diagnosis of 54.7 years. After a mean follow-up period of 8.1 years, there were 6660 deaths. Relative to non-gout subjects, subjects with gout had a higher risk of death (HR 1.18; 95% CI 1.06 to 1.32), and specifi cally from death due to coronary heart disease (CHD) (HR 1.38, 95% CI 1.10 to 1.73) and kidney disease (HR 5.81, 95% CI 3.61 to 9.37). All gout–mortality risk associations were present in both genders but the risk estimates appeared higher for women. Conclusion Gout is an independent risk factor for mortality, and specifically for death due to CHD and kidney disease. PMID:22172492

  9. IMPACT OF THE PEGYLATED-INTERFERON AND RIBAVIRIN THERAPY ON THE TREATMENT-RELATED MORTALITY OF PATIENTS WITH CIRRHOSIS DUE TO HEPATITIS C VIRUS

    PubMed Central

    DRESCH, Kelly Fernanda Nomura; de MATTOS, Angelo Alves; TOVO, Cristiane Valle; de ONOFRIO, Fernanda Quadros; CASAGRANDE, Leandro; FELTRIN, Alberi Adolfo; de BARROS, Iago Christofoli; de ALMEIDA, Paulo Roberto Lerias

    2016-01-01

    Although the protease inhibitors have revolutionized the therapy of chronic hepatitis C (CHC), the concomitant use of pegylated-interferon (PEG-IFN) and ribavirin (RBV) is associated to a high rate of adverse effects. In this study, we evaluated the consequences of PEG-IFN and RBV and their relationship with mortality in patients with cirrhosis. METHODS: Medical records of CHC who underwent treatment with PEG-IFN and RBV in a public hospital in Brazil were evaluated. All the patients with cirrhosis were selected, and their clinical and laboratory characteristics, response to treatment, side effects and mortality were evaluated. RESULTS: From the 1,059 patients with CHC, 257 cirrhotic patients were evaluated. Of these, 45 (17.5%) achieved sustained viral response (SVR). Early discontinuation of therapy occurred in 105 (40.8%) patients, of which 39 (15.2%) were due to serious adverse effects. The mortality rate among the 257 cirrhotic patients was 4.3%, occurring in 06/242 (2.4%) of the Child-A, and in 05/15 (33.3%) of the Child-B patients. In conclusion, the treatment of patients with cirrhosis due to HCV with PEG-IFN and RBV shows a low SVR rate and a high mortality, especially in patients with liver dysfunction. PMID:27253739

  10. [Maternal chorioamnionitis and neonatal conjunctive infection due to an infrequent pathogen].

    PubMed

    García-Agudo, Lidia; Segovia-de la Cruz, Raquel; Palomo-León, Ana Belén; Martino-Castañar, Victoria; Heredero-Gálvez, Eva

    2013-09-01

    Chorioamnionitis generates significant neonatal mortality and morbidity. Its incidence in premature birth can reach 30% and up to 30-40% of cases of premature rupture of membranes is due to this entity. We describe a case of chorioamnionitis by a commensal of the oral flora (Eikenella corrodens) in a pregnant woman with premature rupture of membranes and preterm delivery, which caused conjunctivitis in the newborn. On occasion of this case, we review the issue, delving into the diagnosis and clinical significance of this pathogen.

  11. Global mortality attributable to aircraft cruise emissions.

    PubMed

    Barrett, Steven R H; Britter, Rex E; Waitz, Ian A

    2010-10-01

    Aircraft emissions impact human health though degradation of air quality. The majority of previous analyses of air quality impacts from aviation have considered only landing and takeoff emissions. We show that aircraft cruise emissions impact human health over a hemispheric scale and provide the first estimate of premature mortalities attributable to aircraft emissions globally. We estimate ∼8000 premature mortalities per year are attributable to aircraft cruise emissions. This represents ∼80% of the total impact of aviation (where the total includes the effects of landing and takeoff emissions), and ∼1% of air quality-related premature mortalities from all sources. However, we note that the impact of landing and takeoff emissions is likely to be under-resolved. Secondary H(2)SO(4)-HNO(3)-NH(3) aerosols are found to dominate mortality impacts. Due to the altitude and region of the atmosphere at which aircraft emissions are deposited, the extent of transboundary air pollution is particularly strong. For example, we describe how strong zonal westerly winds aloft, the mean meridional circulation around 30-60°N, interaction of aircraft-attributable aerosol precursors with background ammonia, and high population densities in combination give rise to an estimated ∼3500 premature mortalities per year in China and India combined, despite their relatively small current share of aircraft emissions. Subsidence of aviation-attributable aerosol and aerosol precursors occurs predominantly around the dry subtropical ridge, which results in reduced wet removal of aviation-attributable aerosol. It is also found that aircraft NO(x) emissions serve to increase oxidation of nonaviation SO(2), thereby further increasing the air quality impacts of aviation. We recommend that cruise emissions be explicitly considered in the development of policies, technologies and operational procedures designed to mitigate the air quality impacts of air transportation.

  12. [Premature rupture of membranes one fetus from a multiple pregnancy].

    PubMed

    Malinowski, Witold

    2011-10-01

    In multiple gestation, premature rupture of fetal membranes (PROM) is an important risk factor for premature delivery and intrauterine infection. The incidence of PROM in twin gestations is threefold of that in singleton pregnancies. The incidence in triplets occurs even more frequently underlining the role of PROM as a leading cause of infant mortality and morbidity. Besides prematurity the complications of PROM include umbilical cord compression due to oligohydramnios, cord prolapse, placental abruption, and chorioamnionitis. Together with PROM, chorioamnionitis is held responsible for significant maternal and neonatal morbidity including endometritis and sepsis in the mother and early-onset sepsis, respiratory distress syndrome, inborn pneumonia, bronchopulmonary dysplasia, intraventricular hemorrhage, and periventricular white matter injury in the neonate. Furthermore, in twin gestations, PROM remains an independent risk factor for long-term neonatal care. An uncommon situation develops when in multiple gestation PROM affects only one of the fetuses. In such cases, the co-existence in the uterine cavity of the properly developing fetus(es) can be a challenge for the process of medical decision-making. In the present work, limited world literature on the topic was critically reviewed in search of the best possible recommendations for clinical management.

  13. North-South disparities in English mortality1965–2015: longitudinal population study

    PubMed Central

    Kontopantelis, Evangelos; Sperrin, Matthew; Doran, Tim

    2017-01-01

    Background Social, economic and health disparities between northern and southern England have persisted despite Government policies to reduce them. We examine long-term trends in premature mortality in northern and southern England across age groups, and whether mortality patterns changed after the 2008–2009 Great Recession. Methods Population-wide longitudinal (1965–2015) study of mortality in England's five northernmost versus four southernmost Government Office Regions – halves of overall population. Main outcome measure: directly age-sex adjusted mortality rates; northern excess mortality (percentage excess northern vs southern deaths, age-sex adjusted). Results From 1965 to 2010, premature mortality (deaths per 10 000 aged <75 years) declined from 64 to 28 in southern versus 72 to 35 in northern England. From 2010 to 2015 the rate of decline in premature mortality plateaued in northern and southern England. For most age groups, northern excess mortality remained consistent from 1965 to 2015. For 25–34 and 35–44 age groups, however, northern excess mortality increased sharply between 1995 and 2015: from 2.2% (95% CI –3.2% to 7.6%) to 29.3% (95% CI 21.0% to 37.6%); and 3.3% (95% CI –1.0% to 7.6%) to 49.4% (95% CI 42.8% to 55.9%), respectively. This was due to northern mortality increasing (ages 25–34) or plateauing (ages 35–44) from the mid-1990s while southern mortality mainly declined. Conclusions England's northern excess mortality has been consistent among those aged <25 and 45+ for the past five decades but risen alarmingly among those aged 25–44 since the mid-90s, long before the Great Recession. This profound and worsening structural inequality requires more equitable economic, social and health policies, including potential reactions to the England-wide loss of improvement in premature mortality. PMID:28790164

  14. [Socioeconomic inequalities in mortality due to all causes in the working age population of Poland in 2002 and 2011].

    PubMed

    Pikala, Małgorzata; Maniecka-Bryła, Irena

    2017-09-12

    The aim of the study was to evaluate the influence of education, marital status, employment status and place of residence on mortality in the working age population of Poland in 2002 and 2011. All deaths of Poland's inhabitants aged 25-64, in 2002 (N = 97 004) and 2011 (N = 104 598) were analyzed. For individual socio-economic groups standardized mortality rates (SDR) per 100 000 and rate ratio (RR) were calculated. In the group of economically inactive men SDR decreased from 2244.3 in 2002 to 1781.9 in 2011, while in the group of economically active population increased from 253.8 to 298.9 (RR drop from 8.8 to 6). In the group of economically inactive women SDR decreased from 579.5 to 495.2, and among the economically active women population it increased from 78.8 to 90.9 (RR drop from 7.4 to 5.4). In the group of men with higher education SDR decreased from 285.7 to 246, while among men with primary education it increased from 1141 to 1183 (RR increase from 4 to 4.8). In the group of women with higher education SDR decreased from 127.2 to 115.6 and among women with primary education it increased from 375.8 to 423.1 (RR increase from 3 to 3.7). In the group of divorced/separated SDR also increased - from 1521.4 to 1729.8 among men and from 365.5 to 410.8 among women. Future prevention and educational programs should be addressed primarily to the population economically inactive, with primary education and those divorced/separated. Med Pr 2017;68(6).

  15. Effect of vitamin B supplementation on cancer incidence, death due to cancer, and total mortality: A PRISMA-compliant cumulative meta-analysis of randomized controlled trials.

    PubMed

    Zhang, Sui-Liang; Chen, Ting-Song; Ma, Chen-Yun; Meng, Yong-Bin; Zhang, Yu-Fei; Chen, Yi-Wei; Zhou, Yu-Hao

    2016-08-01

    Observational studies have suggested that vitamin B supplementation is associated with cancer risk, but this association remains controversial. A pooled data-based meta-analysis was conducted to summarize the evidence from randomized controlled trials (RCTs) investigating the effects of vitamin B supplementation on cancer incidence, death due to cancer, and total mortality. PubMed, EmBase, and the Cochrane Library databases were searched to identify trials to fit our analysis through August 2015. Relative risk (RR) was used to measure the effect of vitamin B supplementation on the risk of cancer incidence, death due to cancer, and total mortality using a random-effect model. Cumulative meta-analysis, sensitivity analysis, subgroup analysis, heterogeneity tests, and tests for publication bias were also conducted. Eighteen RCTs reporting the data on 74,498 individuals were included in the meta-analysis. Sixteen of these trials included 4103 cases of cancer; in 6 trials, 731 cancer-related deaths occurred; and in 15 trials, 7046 deaths occurred. Vitamin B supplementation had little or no effect on the incidence of cancer (RR: 1.04; 95% confidence interval [CI]: 0.98-1.10; P = 0.216), death due to cancer (RR, 1.05; 95% CI: 0.90-1.22; P = 0.521), and total mortality (RR, 1.00; 95% CI: 0.94-1.06; P = 0.952). Upon performing a cumulative meta-analysis for cancer incidence, death due to cancer, and total mortality, the nonsignificance of the effect of vitamin B persisted. With respect to specific types of cancer, vitamin B supplementation significantly reduced the risk of skin melanoma (RR, 0.47; 95% CI: 0.23-0.94; P = 0.032). Vitamin B supplementation does not have an effect on cancer incidence, death due to cancer, or total mortality. It is associated with a lower risk of skin melanoma, but has no effect on other cancers.

  16. Family Perspectives on Prematurity

    ERIC Educational Resources Information Center

    Zero to Three (J), 2003

    2003-01-01

    In this article, seven families describe their experiences giving birth to and raising a premature baby. Their perspectives vary, one from another, and shift over time, depending on each family's circumstances and the baby's developmental course. Experiences discussed include premature labor, medical interventions and the NICU, bringing the baby…

  17. Family Perspectives on Prematurity

    ERIC Educational Resources Information Center

    Zero to Three (J), 2003

    2003-01-01

    In this article, seven families describe their experiences giving birth to and raising a premature baby. Their perspectives vary, one from another, and shift over time, depending on each family's circumstances and the baby's developmental course. Experiences discussed include premature labor, medical interventions and the NICU, bringing the baby…

  18. Mortality due to respiratory cancers in the coke oven plants of the Lorraine coalmining industry (Houillères du Bassin de Lorraine).

    PubMed Central

    Bertrand, J P; Chau, N; Patris, A; Mur, J M; Pham, Q T; Moulin, J J; Morviller, P; Auburtin, G; Figueredo, A; Martin, J

    1987-01-01

    The main activity of the Houillères du Bassin de Lorraine (Lorraine Collieries), employing 23,000 operatives and executives, is coalmining. The coke production is carried out by two coke oven plants with a workforce of respectively 747 and 552 workers. The coal coking process entails the emission of noxious products such as polycyclic aromatic hydrocarbons (PAH) from the ovens. The influence of occupational exposure on mortality due to respiratory cancers, and particularly to lung and upper respiratory and alimentary tracts cancer, was investigated among a cohort of 534 male workers from the two coke oven plants who had retired from work between 1963 and 1982. The job history of each subject has been precisely reconstructed by indicating the duration of exposure on the ovens, close to the ovens, and in maintenance occupations. The cohort mortality has been analysed according to the method of indirect standardisation with reference to the French male population and by a case-control study concerning the consumption of tobacco per cohort. The mortality due to lung cancer is 2.51 times higher than expected. This excess of mortality differs, but not significantly, between the two coke oven plants (standardised mortality ratio equals 3.05 and 1.75 respectively). It is not significantly higher among subjects exposed for more than five years, directly exposed on the ovens or working near the ovens or at maintenance occupations on the ovens (SMR = 2.78), than among those exposed for less than five years (SMR = 2.35) or those not exposed at all. Even taking into account the excess of mortality due to lung cancers in the Moselle district (1.6 time that of France), the excess of lung cancers does not seem to be explained by the regional factor, or by tobacco and alcohol consumption. Although no significant relation was offered between lung cancer and the duration of exposure to PAH, even when taking smoking habits into account, the carcinogenic role of occupational nuisances

  19. IL-1β, IL-6 promoter, TNF-α promoter and IL-1RA gene polymorphisms and the risk of preterm delivery due to preterm premature rupture of membranes in a population of Polish women

    PubMed Central

    Kalinka, Jaroslaw

    2010-01-01

    Introduction Our previous study revealed that anti-inflammatory cytokine gene polymorphisms increase the risk of spontaneous preterm delivery (PD) in a population of Polish women. Different genetic background of PD due to preterm premature rupture of membranes (pPROM) than PD without pPROM has been suggested. The aim of this study was to examine the relationship between the maternal carriage of polymorphic alleles of the following genes: interleukin 1β(IL-1β [+3953C>T]), interleukin 6 promoter (IL-6 [−174G>C]), tumour necrosis factor promoter (TNF-α [–308G>A]) and interleukin 1 receptor antagonist (IL-1RN) and the risk of PD caused exclusively by pPROM in a population of Polish women. Material and methods A case-control study. 95 Caucasian women were examined including 32 cases and 63 controls. Case subjects experienced a delivery at less than 36 weeks and 6 days of gestation due exclusively to pPROM while control subjects gave birth at term. Polymorphisms were determined by polymerase chain reaction-restriction fragment length polymorphism analysis (PCR-RFLP). Results No statistically significant relationship between polymorphisms of examined genes and risk of PD due to pPROM in a population of Polish women was found: OR = 0.84 (95% CI: 0.34-2.01) for IL-1β, OR = 0.77 (95% CI: 0.27-2.13) for IL-6, OR = 0.72 (95% CI: 0.26-1.90) for TNF-α and OR = 1.74 (95% CI: 0.66-4.64) for IL-1RN. Conclusions Maternal carriage of polymorphic alleles of IL-1β, IL-6 promoter, TNF-α promoter and IL-1RA seems to have no impact on the risk of PD due to pPROM in the population of Polish women.The genetic contribution and pathomechanism of PD related to pPROM seems to differ from those of spontaneous PD without pPROM. PMID:22371799

  20. Mortality rate and gross pathology due to tuberculosis in wild brushtail possums (Trichosurus vulpecula) following low dose subcutaneous injection of Mycobacterium bovis.

    PubMed

    Nugent, Graham; Yockney, Ivor; Whitford, Jackie; Cross, Martin L

    2013-04-01

    Gross pathology due to tuberculosis can be established experimentally in brushtail possums (Trichosurus vulpecula) within 7 weeks of injection of virulent Mycobacterium bovis into subcutaneous connective tissues of the peripheral limbs. This pathology involves lymphadenomegaly and development of gross lesions in peripheral lymph nodes, with subsequent gross lesions in the lungs and reticuloendothelial organs. Using this artificial infection model, we here assessed the mortality rate for possums in the wild, to provide new information on the likely survival period for New Zealand's major wildlife host. Possums were trapped and inoculated with <50 CFU of M. bovis, then fitted with mortality signal emitting radio tracking collars, released and re-tracked for 6 months. Possum survival probability was 89% up to 12 weeks post-injection (p.i.), but cumulative mortality was rapid from then on. The median survival period, based on study of 38 possums, was 18 weeks p.i.; this corresponds with a predicted time interval of 11 weeks between first presentation of TB as palpable lymphadenomegaly and death for an average possum, shorter than period values currently used in possum TB epidemiological modelling. We also examined gross pathology in 11 possums by post mortem necropsy, and confirmed lymphadenomegaly and tuberculous lesions at 7 and 12 weeks p.i. Extra-peripheral gross lesions were more frequent among possums at 12 weeks p.i. than at 7 weeks, while the occurrence of lung lesions (the most likely cause of disease-induced mortality) was apparent in animals at 12 weeks but not at 7 weeks p.i. Our results suggest that the time course of TB from development of gross lesions to mortality may be shorter than previously estimated from field studies of naturally tuberculous possums.

  1. [Prognostic factors of mortality during the episode of pneumonia due to Pneumocystis carinii in patients with HIV infection].

    PubMed

    Fernández Cruz, A; Pulido Ortega, F; Peña Sánchez De Rivera, J M; Sanz García, M; Lorenzo Hernández, A; González García, J; Rubio García, R

    2002-08-01

    Despite a steady decrease in its incidence, pneumonia caused by Pneumocystis carinii (PCP) are still diagnosed, and they occur frequently in patients unaware of being infected with the human immunodeficiency virus (HIV). Since it is a disease with a high mortality risk, its early diagnosis and therapy would allow these patients to benefit from the advantages afforded Pneumocystis carinii, neumonía, infecciones oportunistas relacionadas con el sida, pronóstico.by anti-retroviral therapy. Retrospective study, in which all adult HIV infected patients with microbiologically demonstrated PCP diagnosed at two tertiary-level hospitals in our country between 1985 and 1996 were included. The clinical records of patients were used as information source. The relative risks (RR) of death were estimated by the multivariant logistic regression. PCP was the first AIDS indicating disease in approximately 70 % of cases. Thirteen percent of patients died during the episode. Patients aged over 45 years had a death RR during the episode of 3.15 (95 % CI from 0.8 to 12.2); patients previously diagnosed of AIDS had a death RR of 3.4 (95 % CI from 1.3 to 9), and those with an alveolar-arterial oxygen gradient (pA-aO2) > 50 mmHg, a death RR of 3 (95% CI from 1.1 to 8). Factors independently related to survival to the PCP episode are age below 45 years, not to have had another AIDS indicating disease, and to have a pA-aO2 below 50 mmHg at diagnosis.

  2. Inaccurate Ascertainment of Morbidity and Mortality due to Influenza in Administrative Databases: A Population-Based Record Linkage Study

    PubMed Central

    Muscatello, David J.; Amin, Janaki; MacIntyre, C. Raina; Newall, Anthony T.; Rawlinson, William D.; Sintchenko, Vitali; Gilmour, Robin; Thackway, Sarah

    2014-01-01

    Background Historically, counting influenza recorded in administrative health outcome databases has been considered insufficient to estimate influenza attributable morbidity and mortality in populations. We used database record linkage to evaluate whether modern databases have similar limitations. Methods Person-level records were linked across databases of laboratory notified influenza, emergency department (ED) presentations, hospital admissions and death registrations, from the population (∼6.9 million) of New South Wales (NSW), Australia, 2005 to 2008. Results There were 2568 virologically diagnosed influenza infections notified. Among those, 25% of 40 who died, 49% of 1451 with a hospital admission and 7% of 1742 with an ED presentation had influenza recorded on the respective database record. Compared with persons aged ≥65 years and residents of regional and remote areas, respectively, children and residents of major cities were more likely to have influenza coded on their admission record. Compared with older persons and admitted patients, respectively, working age persons and non-admitted persons were more likely to have influenza coded on their ED record. On both ED and admission records, persons with influenza type A infection were more likely than those with type B infection to have influenza coded. Among death registrations, hospital admissions and ED presentations with influenza recorded as a cause of illness, 15%, 28% and 1.4%, respectively, also had laboratory notified influenza. Time trends in counts of influenza recorded on the ED, admission and death databases reflected the trend in counts of virologically diagnosed influenza. Conclusions A minority of the death, hospital admission and ED records for persons with a virologically diagnosed influenza infection identified influenza as a cause of illness. Few database records with influenza recorded as a cause had laboratory confirmation. The databases have limited value for estimating incidence

  3. Measuring mortality due to HIV-associated tuberculosis among adults in South Africa: Comparing verbal autopsy, minimally-invasive autopsy, and research data

    PubMed Central

    Tlali, Mpho; Fielding, Katherine L.; Charalambous, Salome; Chihota, Violet N.; Churchyard, Gavin J.; Hanifa, Yasmeen; Johnson, Suzanne; McCarthy, Kerrigan; Martinson, Neil A.; Omar, Tanvier; Kahn, Kathleen; Chandramohan, Daniel; Grant, Alison D.

    2017-01-01

    Background The World Health Organization (WHO) aims to reduce tuberculosis (TB) deaths by 95% by 2035; tracking progress requires accurate measurement of TB mortality. International Classification of Diseases (ICD) codes do not differentiate between HIV-associated TB and HIV more generally. Verbal autopsy (VA) is used to estimate cause of death (CoD) patterns but has mostly been validated against a suboptimal gold standard for HIV and TB. This study, conducted among HIV-positive adults, aimed to estimate the accuracy of VA in ascertaining TB and HIV CoD when compared to a reference standard derived from a variety of clinical sources including, in some, minimally-invasive autopsy (MIA). Methods and findings Decedents were enrolled into a trial of empirical TB treatment or a cohort exploring diagnostic algorithms for TB in South Africa. The WHO 2012 instrument was used; VA CoD were assigned using physician-certified VA (PCVA), InterVA-4, and SmartVA-Analyze. Reference CoD were assigned using MIA, research, and health facility data, as available. 259 VAs were completed: 147 (57%) decedents were female; median age was 39 (interquartile range [IQR] 33–47) years and CD4 count 51 (IQR 22–102) cells/μL. Compared to reference CoD that included MIA (n = 34), VA underestimated mortality due to HIV/AIDS (94% reference, 74% PCVA, 47% InterVA-4, and 41% SmartVA-Analyze; chance-corrected concordance [CCC] 0.71, 0.42, and 0.31, respectively) and HIV-associated TB (41% reference, 32% PCVA; CCC 0.23). For individual decedents, all VA methods agreed poorly with reference CoD that did not include MIA (n = 259; overall CCC 0.14, 0.06, and 0.15 for PCVA, InterVA-4, and SmartVA-Analyze); agreement was better at population level (cause-specific mortality fraction accuracy 0.78, 0.61, and 0.57, for the three methods, respectively). Conclusions Current VA methods underestimate mortality due to HIV-associated TB. ICD and VA methods need modifications that allow for more specific

  4. [Premature orgasm in the male].

    PubMed

    Köhn, F M

    2003-11-13

    To date, we have no uniform definition of ejaculatio praecox. In a qualitative approach, premature ejaculation is ascribed to a failure to control excitement. As causes, organic disorders and erectile dysfunction must be excluded. The majority of cases, however, are due to psychological or partnership problems. The history-taking should aim, in particular, to uncover possible anxiety in conjunction with premature orgasm, and also to establish the reactions of the partner. As therapy, medication (local anesthetics, antidepressive agents, PDE-5 inhibitors) and sexual-therapeutic measures are available. Since few sufferers take the initiative in seeking treatment, particular importance attaches to providing the public with information about the therapeutic options for treating this common disorder.

  5. Prevention of premature birth.

    PubMed

    Fuchs, F

    1980-03-01

    With six different groups of pharmacologic agents that potentially can inhibit undesirable uterine contractions, prevention of premature births should be increasingly successful. The rationale for the use of each of these agents and their advantages and disadvantages are discussed.

  6. Premature rupture of membranes

    MedlinePlus

    ... gov/ency/patientinstructions/000512.htm Premature rupture of membranes To use the sharing features on this page, ... water that surrounds your baby in the womb. Membranes or layers of tissue hold in this fluid. ...

  7. [Mortality in free living siskins (Spinus spinus Linnaeus, 1758) due to Salmonella typhimurium, phage type DT104 and DT013].

    PubMed

    Krüger, Alexandra; Redmann, Thomas; Sommer, Dagmar; Antakli, Ali; Kaleta, Erhard F

    2009-09-01

    This report deals with an enzootic due to Salmonella Typhimurium in two free living Eurasian siskins (Spinus spinus Linnaeus, 1758). Other birds in the vicinity of the siskins were not affected. Clinical signs consisted of non-specific symptoms such as ruffled plumage, apathy and reduced food intake. During necropsy, gross lesions were enlarged livers with focal necrosis, pale spleens, enlarged kidneys, pneumonia and enteritis. Salmonella Typhimurium was isolated from internal organs in pure culture. Using the polymerase chain reaction, the detection of Salmonella according to EN ISO 6579:2002 was confirmed. The detailed characterisation of both isolates in the Federal Institute for Risk Assessment and in the Robert Koch Institute yielded for the first siskin Salmonella Typhimurium, 4, 5, 12: i : 1, 2, LT DT104, BT a and for the second siskin Salmonella Typhimurium, 4,12 i : 1, 2, LT DT013, BT c. These phage types were identified for the first time in siskins. The detected phage types have importance as causes of disease not only for free living siskins but also as infectious and zoonotic agents for domestic poultry and poultry products.

  8. [Mortality due to ill-defined causes in Brazil (1979-2002) and a predictive model for age].

    PubMed

    Costa, Marli Ramos da; Marcopito, Luiz Francisco

    2008-05-01

    This study focused on the percentage of deaths due to ill-defined causes in Brazil, from 1979 to 2002. The objectives were to: (a) describe changes over the 24-year period; (b) identify the age group in which the percentage of ill-defined causes correlated most closely with the total percentage of ill-defined causes; (c) select a predictive model for the percentage of ill-defined causes in such age group, given the total percentage of ill-defined causes; (d) describe changes in the distributions of each age group in the total ill-defined causes; and (e) verify whether the percentage of deaths in-hospital shows any relationship to the percentage of ill-defined causes. Results showed that the total percentage of deaths from ill-defined causes decreased in Brazil. The percentage of ill-defined causes in the > 50-year age group correlated most closely with the total percentage of ill-defined causes, and cubic regression was the most appropriate predictive model. Age > 50 showed the highest increase in its share of total ill-defined causes from 1979 to 2002. The percentage of in-hospital deaths showed an inverse relationship with the percentage of deaths from ill-defined causes.

  9. Trends in Hospitalization and Mortality Rates Due to Acute Cardiovascular Disease in Castile and León, 2001 to 2015.

    PubMed

    López-Messa, Juan B; Andrés-de Llano, Jesús M; López-Fernández, Laura; García-Cruces, Jesús; García-Crespo, Julio; Prieto González, Miryam

    2017-07-31

    To analyze hospitalization and mortality rates due to acute cardiovascular disease (ACVD). We conducted a cross-sectional study of the hospital discharge database of Castile and León from 2001 to 2015, selecting patients with a principal discharge diagnosis of acute myocardial infarction (AMI), unstable angina, heart failure, or acute ischemic stroke (AIS). Trends in the rates of hospitalization/100 000 inhabitants/y and hospital mortality/1000 hospitalizations/y, overall and by sex, were studied by joinpoint regression analysis. A total of 239 586 ACVD cases (AMI 55 004; unstable angina 15 406; heart failure 111 647; AIS 57 529) were studied. The following statistically significant trends were observed: hospitalization: ACVD, upward from 2001 to 2007 (5.14; 95%CI, 3.5-6.8; P < .005), downward from 2011 to 2015 (3.7; 95%CI, 1.0-6.4; P < .05); unstable angina, downward from 2001 to 2010 (-12.73; 95%CI, -14.8 to -10.6; P < .05); AMI, upward from 2001 to 2003 (15.6; 95%CI, 3.8-28.9; P < .05), downward from 2003 to 2015 (-1.20; 95%CI, -1.8 to -0.6; P < .05); heart failure, upward from 2001 to 2007 (10.70; 95%CI, 8.7-12.8; P < .05), upward from 2007 to 2015 (1.10; 95%CI, 0.1-2.1; P < .05); AIS, upward from 2001 to 2007 (4.44; 95%CI, 2.9-6.0; P < .05). Mortality rates: downward from 2001 to 2015 in ACVD (-1.16; 95%CI, -2.1 to -0.2; P < .05), AMI (-3.37, 95%CI, -4.4 to -2, 3, P < .05), heart failure (-1.25; 95%CI, -2.3 to -0.1; P < .05) and AIS (-1.78; 95%CI, -2.9 to -0.6; P < .05); unstable angina, upward from 2001 to 2007 (24.73; 95%CI, 14.2-36.2; P < .05). The ACVD analyzed showed a rising trend in hospitalization rates from 2001 to 2015, which was especially marked for heart failure, and a decreasing trend in hospital mortality rates, which were similar in men and women. These data point to a stabilization and a decline in hospital mortality, attributable to established prevention measures. Copyright © 2017 Sociedad Española de Cardiología. Published by

  10. Time-dependent analysis of length of stay and mortality due to urinary tract infections in ten developing countries: INICC findings.

    PubMed

    Rosenthal, Victor D; Dwivedy, Arpita; Calderón, María Eugenia Rodríguez; Esen, Saban; Hernández, Héctor Torres; Abouqal, Rédouane; Medeiros, Eduardo A; Espinoza, Teodora Atencio; Kanj, S S; Gikas, Achilleas; Barnett, Adrian G; Graves, Nicholas

    2011-02-01

    To estimate the excess length of stay (LOS) and mortality in an intensive care unit (ICU) due to a Catheter associated urinary tract infections (CAUTI), using a statistical model that accounts for the timing of infection in 29 ICUs from 10 countries: Argentina, Brazil, Colombia, Greece, India, Lebanon, Mexico, Morocco, Peru, and Turkey. To estimate the extra LOS due to infection in a cohort of 69,248 admissions followed for 371,452 days in 29 ICUs, we used a multi-state model, including specific censoring to ensure that we estimate the independent effect of urinary tract infection, and not the combined effects of multiple infections. We estimated the extra length of stay and increased risk of death independently in each country, and then combined the results using a random effects meta-analysis. A CAUTI prolonged length of ICU stay by an average of 1.59 days (95% CI: 0.58, 2.59 days), and increased the risk of death by 15% (95% CI: 3, 28%). A CAUTI leads to a small increased LOS in ICU. The increased risk of death due to CAUTI may be due to confounding with patient morbidity. Copyright © 2011 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  11. Burden of disease due to cancer in Spain

    PubMed Central

    Fernández de Larrea-Baz, Nerea; Álvarez-Martín, Elena; Morant-Ginestar, Consuelo; Gènova-Maleras, Ricard; Gil, Ángel; Pérez-Gómez, Beatriz; López-Abente, Gonzalo

    2009-01-01

    Background Burden of disease is a joint measure of mortality and morbidity which makes it easier to compare health problems in which these two components enjoy different degrees of relative importance. The objective of this study is ascertaining the burden of disease due to cancer in Spain via the calculation of disability-adjusted life years (DALYs). Methods DALYs are the sum of years of life lost due to premature mortality and years lost due to disability. World Health Organization methodology and the following sources of data were used: the Mortality Register and Princeton Model Life Table for Years of life lost due to premature mortality and population, incidence estimates (Spanish tumour registries and fitting of generalized linear mixed models), duration (from data of survival in Spain from the EUROCARE-3 study and fitting of Weibull distribution function) and disability (weights published in the literature) for Years lost due to disability. Results There were 828,997 DALYs due to cancer (20.5 DALYs/1,000 population), 61% in men. Of the total, 51% corresponded to lung, colorectal, breast, stomach and prostate cancers. Mortality (84% of DALYs) predominated over disability. Subjects aged under 20 years accounted for 1.6% and those aged over 70 years accounted for 30.1% of DALYs. Conclusion Lung, colorectal and breast cancers are responsible for the highest number of DALYs in Spain. Even if the burden of disease due to cancer is predominantly caused by mortality, some cancers have a significant weight of disability. Information on 2000 burden of disease due to cancer can be useful to assess how it has evolved over time and the impact of medical advances on it in terms of mortality and disability. PMID:19183440

  12. Dapoxetine: in premature ejaculation.

    PubMed

    Hoy, Sheridan M; Scott, Lesley J

    2010-07-30

    Dapoxetine, a selective serotonin reuptake inhibitor, is the first oral pharmacological agent indicated for the treatment of men aged 18-64 years with premature ejaculation. In four randomized, double-blind, placebo-controlled, multicentre studies of 12-24 weeks' duration, oral dapoxetine 30 or 60 mg (administered as needed) was effective in the treatment of men with premature ejaculation, inducing significantly (p < 0.001) greater improvements from baseline than placebo in the primary efficacy endpoint (mean intravaginal ejaculatory latency time [IELT] or mean average IELT [defined as the average of IELT values over the previous 4 weeks], as measured by the female partner utilizing a stopwatch). For the most part, dapoxetine recipients achieved significantly better outcomes than placebo recipients with regard to the secondary endpoints, including the Premature Ejaculation Profile (PEP) domains and the Clinical Global Impression or Patient Global Impression ratings of change in premature ejaculation, across these clinical studies. The beneficial effects of dapoxetine therapy on the perceived control over ejaculation and satisfaction with sexual intercourse PEP domains were sustained in a 9-month noncomparative extension phase of two identical 12-week, double-blind studies. Oral dapoxetine therapy for up to 12 months was generally well tolerated in men with premature ejaculation, with the nature of treatment-emergent adverse events generally similar across the clinical studies and between dapoxetine and placebo.

  13. Prematurity: present and future

    PubMed Central

    Tsimis, M. E.; Al-Hamayel, N. Abu; Germaine, H.; Burd, I.

    2014-01-01

    The study of preterm labor and prematurity, as with any medical science, has undergone a major transformation in its approach from an inevitable part of obstetrics with few answers to one in which science has led to knowledge and clinical intervention. Despite these advancements, understanding of preterm labor and prevention of prematurity is still limited. In the current review, we begin the discussion with fetal viability, first from a historical perspective and then from the understanding of this issue from a prospective of various professional organizations. We then present the scope of the problem of preterm birth from various countries including the discrepancy between the US and Europe. We continue with updates on extreme prematurity and outcomes with two longitudinal studies from the past 2 years. We further review available interventions for prematurity and discuss the use of antenatal corticosteroids. First, we examine their use in the context of professional recommendations and then examine the trajectory of their continued use in the late preterm period. We focus on a European-based trial with preliminary results and an ongoing American counterpart. The current knowledge of molecular mechanisms behind preterm labor is presented with a focus on the multiple etiologies of preterm labor, both known and presumed, with updates in the basic science realm. Furthermore, up-to-date studies on prediction of preterm birth and prematurity-related morbidity are presented. PMID:25300768

  14. Increases in soil water content after the mortality of non-native trees in oceanic island forest ecosystems are due to reduced water loss during dry periods.

    PubMed

    Hata, Kenji; Kawakami, Kazuto; Kachi, Naoki

    2016-03-01

    The control of dominant, non-native trees can alter the water balance of soils in forest ecosystems via hydrological processes, which results in changes in soil water environments. To test this idea, we evaluated the effects of the mortality of an invasive tree, Casuarina equisetifolia Forst., on the water content of surface soils on the Ogasawara Islands, subtropical islands in the northwestern Pacific Ocean, using a manipulative herbicide experiment. Temporal changes in volumetric water content of surface soils at 6 cm depth at sites where all trees of C. equisetifolia were killed by herbicide were compared with those of adjacent control sites before and after their mortality with consideration of the amount of precipitation. In addition, the rate of decrease in the soil water content during dry periods and the rate of increase in the soil water content during rainfall periods were compared between herbicide and control sites. Soil water content at sites treated with herbicide was significantly higher after treatment than soil water content at control sites during the same period. Differences between initial and minimum values of soil water content at the herbicide sites during the drying events were significantly lower than the corresponding differences in the control quadrats. During rainfall periods, both initial and maximum values of soil water contents in the herbicided quadrats were higher, and differences between the maximum and initial values did not differ between the herbicided and control quadrats. Our results indicated that the mortality of non-native trees from forest ecosystems increased water content of surface soils, due primarily to a slower rate of decrease in soil water content during dry periods.

  15. The existence of standard-biased mortality ratios due to death certificate misclassification - a simulation study based on a true story.

    PubMed

    Deckert, Andreas

    2016-01-22

    Mortality statistics are used to compare health status of populations; optimally, they base on individual death certificates. However, determining cause of death is error-prone. E.g. cardiovascular disease (CVD) death determination is characterized by sensitivity (SE) and specificity (SP) lower than 85%. Furthermore, differential misclassification may be present in case of homogenous target populations. We investigate the bias of standardized mortality ratios (SMR), based on real-world data. CVD mortality of 6378 ethnic German repatriates was assessed and the SMR calculated. Non-differential age-dependent misclassification was introduced into data by scenarios of equal SE and SP in a range of 0.7 to 0.85. The bias between originally reported and actual SMR was calculated for each pair of values. Additionally, four differential misclassification scenarios were simulated, reflecting two extreme scenarios of both quality criteria varied in the cohort but fixed to either higher or lower in the reference, and two scenarios of crossed criteria values. In case of non-differential misclassification the bias is always towards the null-hypothesis. The lowest bias was 13.5% (SE, SP = 0.85 constantly), the maximum bias was 40% (SP = 0.7). However, in case of differential misclassification the observed SMR can be on the wrong track. If SP is high but SE low in the cohort, negative bias up to -10% can occur. In case SE is low but SP is high in the reference, the bias remains always positive. In the opposite case plus SP is high in the cohort, the bias can reach -30%. SMR values are always biased due to the diagnostic test character of death determination. In majority of epidemiological studies the bias should be towards the null-hypothesis (non-differential misclassification). However, caution is needed in case of differential misclassification, possibly experienced in studies on homogenous subgroups, and in large prospective cohorts with specifically trained personnel.

  16. Autoimmune premature ovarian failure

    PubMed Central

    2017-01-01

    Premature ovarian failure (POF), also termed as primary ovarian insufficiency (POI), is a highly heterogenous condition affecting 0.5-3.0% of women in childbearing age. These young women comprise quite a formidable group with unique physical and psychological needs that require special attention. Premature ovarian senescence (POS) in all of its forms evolves insidiously as a basically asymptomatic process, leading to complete loss of ovarian function, and POI/POF diagnoses are currently made at relatively late stages. Well-known and well-documented risk factors exist, and the presence or suspicion of autoimmune disorder should be regarded as an important one. Premature ovarian failure is to some degree predictable in its occurrence and should be considered while encountering young women with loss of menstrual regularity, especially when there is a concomitant dysfunction in the immune system. PMID:28250725

  17. Mortality from ship emissions: a global assessment.

    PubMed

    Corbett, James J; Winebrake, James J; Green, Erin H; Kasibhatla, Prasad; Eyring, Veronika; Lauer, Axel

    2007-12-15

    Epidemiological studies consistently link ambient concentrations of particulate matter (PM) to negative health impacts, including asthma, heart attacks, hospital admissions, and premature mortality. We model ambient PM concentrations from oceangoing ships using two geospatial emissions inventories and two global aerosol models. We estimate global and regional mortalities by applying ambient PM increases due to ships to cardiopulmonary and lung cancer concentration-risk functions and population models. Our results indicate that shipping-related PM emissions are responsible for approximately 60,000 cardiopulmonary and lung cancer deaths annually, with most deaths occurring near coastlines in Europe, East Asia, and South Asia. Under current regulation and with the expected growth in shipping activity, we estimate that annual mortalities could increase by 40% by 2012.

  18. Estimation of excess mortality due to long-term exposure to PM2.5 in Japan using a high-resolution model for present and future scenarios

    NASA Astrophysics Data System (ADS)

    Goto, Daisuke; Ueda, Kayo; Ng, Chris Fook Sheng; Takami, Akinori; Ariga, Toshinori; Matsuhashi, Keisuke; Nakajima, Teruyuki

    2016-09-01

    Particulate matter with a diameter of less than 2.5 μm, known as PM2.5, can affect human health, especially in elderly people. Because of the imminent aging of society in the near future in most developed countries, the human health impacts of PM2.5 must be evaluated. In this study, we used a global-to-regional atmospheric transport model to simulate PM2.5 in Japan with a high-resolution stretched grid system (∼10 km for the high-resolution model, HRM) for the present (the 2000) and the future (the 2030, as proposed by the Representative Concentrations Pathway 4.5, RCP4.5). We also used the same model with a low-resolution uniform grid system (∼100 km for the low-resolution model, LRM). These calculations were conducted by nudging meteorological fields obtained from an atmosphere-ocean coupled model and providing emission inventories used in the coupled model. After correcting for bias, we calculated the excess mortality due to long-term exposure to PM2.5 among the elderly (over 65 years old) based on different minimum PM2.5 concentration (MINPM) levels to account for uncertainty using the simulated PM2.5 distributions to express the health effect as a concentration-response function. As a result, we estimated the excess mortality for all of Japan to be 31,300 (95% confidence intervals: 20,700 to 42,600) people in 2000 and 28,600 (95% confidence intervals: 19,000 to 38,700) people in 2030 using the HRM with a MINPM of 5.8 μg/m3. In contrast, the LRM resulted in underestimates of approximately 30% (for PM2.5 concentrations in the 2000 and 2030), approximately 60% (excess mortality in the 2000) and approximately 90% (excess mortality in 2030) compared to the HRM results. We also found that the uncertainty in the MINPM value, especially for low PM2.5 concentrations in the future (2030) can cause large variability in the estimates, ranging from 0 (MINPM of 15 μg/m3 in both HRM and LRM) to 95,000 (MINPM of 0 μg/m3 in HRM) people.

  19. [Prenatal care, low birth weight and prematurity in São Paulo State, Brazil, 2000].

    PubMed

    Kilsztajn, Samuel; Rossbach, Anacláudia; do Carmo, Manuela Santos Nunes; Sugahara, Gustavo Toshiaki Lopes

    2003-06-01

    The historical evolution of infant mortality rate and neonatal mortality according to birth weight and term of delivery in the state of S o Paulo are presented to assess the role of the number of prenatal visits and others factors for determining mortality. Based on data available from the Seade Institute of Vital Statistics, four variables (maternal age, marital status, education, and childbirth order) were analyzed and divided into two categories according to the relative risk of low birth weight and/or preterm prevalence. Sixteen specific groups were created from crossing the four variables into two categories. Low birth weight and/or preterm prevalence per number of prenatal visits and the relative risk were calculated for all sixteen groups. For all sixteen groups, the higher the number of prenatal visits the lower the prevalence of low birth weight and/or prematurity. Additionally, there was an overall reduction of the difference of low birth weight and/or preterm prevalence among the 16 groups from 14% to 4% with an increase from 0-3 to 7 visits or more. Due to the current infant mortality composition in the state of Sao Paulo, increasing the number of prenatal visits and accessibility of women at risk would probably lead to a reduction in intrauterine growth retardation, prematurity, low birth weight and deaths associated to conditions originated in the perinatal period.

  20. An extra-uterine system to physiologically support the extreme premature lamb.

    PubMed

    Partridge, Emily A; Davey, Marcus G; Hornick, Matthew A; McGovern, Patrick E; Mejaddam, Ali Y; Vrecenak, Jesse D; Mesas-Burgos, Carmen; Olive, Aliza; Caskey, Robert C; Weiland, Theodore R; Han, Jiancheng; Schupper, Alexander J; Connelly, James T; Dysart, Kevin C; Rychik, Jack; Hedrick, Holly L; Peranteau, William H; Flake, Alan W

    2017-04-25

    In the developed world, extreme prematurity is the leading cause of neonatal mortality and morbidity due to a combination of organ immaturity and iatrogenic injury. Until now, efforts to extend gestation using extracorporeal systems have achieved limited success. Here we report the development of a system that incorporates a pumpless oxygenator circuit connected to the fetus of a lamb via an umbilical cord interface that is maintained within a closed 'amniotic fluid' circuit that closely reproduces the environment of the womb. We show that fetal lambs that are developmentally equivalent to the extreme premature human infant can be physiologically supported in this extra-uterine device for up to 4 weeks. Lambs on support maintain stable haemodynamics, have normal blood gas and oxygenation parameters and maintain patency of the fetal circulation. With appropriate nutritional support, lambs on the system demonstrate normal somatic growth, lung maturation and brain growth and myelination.

  1. An extra-uterine system to physiologically support the extreme premature lamb

    PubMed Central

    Partridge, Emily A.; Davey, Marcus G.; Hornick, Matthew A.; McGovern, Patrick E.; Mejaddam, Ali Y.; Vrecenak, Jesse D.; Mesas-Burgos, Carmen; Olive, Aliza; Caskey, Robert C.; Weiland, Theodore R.; Han, Jiancheng; Schupper, Alexander J.; Connelly, James T.; Dysart, Kevin C.; Rychik, Jack; Hedrick, Holly L.; Peranteau, William H.; Flake, Alan W.

    2017-01-01

    In the developed world, extreme prematurity is the leading cause of neonatal mortality and morbidity due to a combination of organ immaturity and iatrogenic injury. Until now, efforts to extend gestation using extracorporeal systems have achieved limited success. Here we report the development of a system that incorporates a pumpless oxygenator circuit connected to the fetus of a lamb via an umbilical cord interface that is maintained within a closed ‘amniotic fluid' circuit that closely reproduces the environment of the wo