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1.
Int J Cancer ; 152(2): 123-136, 2023 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-35904874

RESUMO

Data on diet and survival among people with metastatic colorectal cancer are limited. We examined dietary fat in relation to all-cause mortality and cancer progression or death among 1149 people in the Cancer and Leukemia Group B (Alliance)/Southwest Oncology Group (SWOG) 80405 trial who completed a food frequency questionnaire at initiation of treatment for advanced or metastatic colorectal cancer. We examined saturated, monounsaturated, total and specific types (n-3, long-chain n-3 and n-6) of polyunsaturated fat, animal and vegetable fats. We hypothesized higher vegetable fat intake would be associated with lower risk of all-cause mortality and cancer progression. We used Cox proportional hazards regression to estimate adjusted hazard ratios (HR) and 95% confidence intervals (CI). Over median follow-up of 6.1 years (interquartile range [IQR]: 5.3, 7.2 y), we observed 974 deaths and 1077 events of progression or death. Participants had a median age of 59 y; 41% were female and 86% identified as White. Moderate or higher vegetable fat was associated with lower risk of mortality and cancer progression or death (HRs comparing second, third and fourth to first quartile for all-cause mortality: 0.74 [0.62, 0.90]; 0.75 [0.61, 0.91]; 0.79 [0.63, 1.00]; P trend: .12; for cancer progression or death: 0.74 [0.62, 0.89]; 0.78 [0.64, 0.95]; 0.71 [0.57, 0.88]; P trend: .01). No other fat type was associated with all-cause mortality and cancer progression or death. Moderate or higher vegetable fat intake may be associated with lower risk of cancer progression or death among people with metastatic colorectal cancer.


Assuntos
Doenças Cardiovasculares , Neoplasias do Colo , Neoplasias Retais , Feminino , Animais , Masculino , Gorduras na Dieta , Dieta , Causas de Morte
2.
Sci Total Environ ; 856(Pt 1): 159118, 2023 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-36181805

RESUMO

The health risk and burden of disease induced by exposure to inorganic arsenic (iAs) through drinking water and foodstuffs in Iran were assessed. The iAs levels in drinking water and foodstuffs (15 food groups) in the country were determined through systematic review of three international databases (PubMed, Scopus, and Web of Science) and meta-analysis. Based on the results of the systematic review and meta-analysis, the average iAs levels in drinking water and all the food groups at the national level were lower than the maximum permissible levels. The total average non-carcinogenic risk of dietary exposure to iAs in terms of hazard index (HI) was 3.4. The average incremental lifetime cancer risk (ILCR) values of dietary exposure to iAs were determined to be 1.5 × 10-3 for skin cancer, 1.0 × 10-3 for lung cancer, and 4.0 × 10-4 for bladder cancer. Over two-thirds of the non-carcinogenic and carcinogenic risk of dietary exposure to iAs was attributed to bread and cereals, drinking water, and rice. The total annual cancer incidence, deaths, disability-adjusted life years (DALYs), death rate, and DALY rate (per 100,000 people) were assessed to be 3347 (95 % uncertainty interval: 1791 to 5999), 1302 (697 to 2336), 72,606 (38,833 to 130,228), 1.6 (0.87 to 2.9), and 91 (49 to 160). The contribution of mortality in the attributable burden of disease was 95.1 %. The contributions of the causes in the attributable burden of disease were 72 % for lung cancer, 16 % for bladder cancer, and 12 % for skin cancer. Due to the significant attributable burden of disease, national and subnational action plans consisting of multi-disciplinary approaches for risk management of dietary exposure to iAs, especially for the higher arsenic-affected areas and high-risk population groups in the country are recommended.


Assuntos
Arsênio , Água Potável , Neoplasias Pulmonares , Neoplasias Cutâneas , Neoplasias da Bexiga Urinária , Humanos , Água Potável/análise , Arsênio/efeitos adversos , Arsênio/análise , Irã (Geográfico)/epidemiologia , Anos de Vida Ajustados pela Incapacidade , Causas de Morte , Medição de Risco , Exposição Ambiental/análise
3.
J Surg Res ; 281: 338-344, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35945037

RESUMO

INTRODUCTION: Examining burden of diseases could shed light on priorities of public health interventions and research funding. This study examined trends of the U.S. top leading causes of death from 1981 to 2019 using the total number of deaths, age-adjusted death rate, and years of potential life lost (YPLLs). METHODS: Data were from the Web-based Injury Statistics Query and Reporting System. This study gathered total number of deaths, age-adjusted death rates per 100,000 people, and YPLLs under 70 y of age (YPLL-70) from 1981 to 2019 for the top 10 leading causes of death and human immunodeficiency virus/acquired immunodeficiency syndrome (AIDS) for each year. The 39 y from 1981 to 2019 were evenly divided into three study periods: 1981-1993, 1994-2006, and 2007-2019. The percent change of YPLL-70 over three time periods for the top ten leading causes of death and AIDS was calculated. Trends of age-adjusted death rates and YPLL-70 of the top five leading causes of death based on the 2018-2019 death data were also reported by graphing them against time from 1981 to 2019 to highlight major mortality causes. Age-adjusted death rates for the top five leading causes of deaths and the National Institutes of Health (NIH) annual funding level in 2019 were graphed together to illustrate funding discrepancy in injury research and prevention. RESULTS: The total number of deaths caused by malignant neoplasms in 2019 was 244,994, followed by 183,442 deaths of heart diseases, 121,476 deaths of unintentional injuries, and 41,051 suicide deaths. Despite an initial -22.20% drop of YPPL-70 during 1981-1993, unintentional injuries experienced significant increases of 19.38% and 18.59% of YPLL-70 in 1994-2006 and 2007-2019, respectively. The age-adjusted death rate for unintentional injuries was 1182 per 100,000 people in 2019, and the NIH funding in the same year was $897 million. In comparison, the age-adjusted death rate for cancer, heart disease, and human immunodeficiency virus/AIDS was 786, 649, and 30 per 100,000 people while the NIH funding was $2,560, $2,394, and $3037 million, respectively. CONCLUSIONS: Unintentional injuries, suicide, and homicide were consistently among the top leading causes of death and YPLL-70, so they should be prioritized in public health planning, research, and federal funding allocation. Injury and trauma research is severely underfunded by the U.S. premier funding agency.


Assuntos
Síndrome de Imunodeficiência Adquirida , Infecções por HIV , Cardiopatias , Ferimentos e Lesões , Estados Unidos/epidemiologia , Humanos , Causas de Morte , Homicídio , Causalidade , Infecções por HIV/epidemiologia , Expectativa de Vida
4.
Front Endocrinol (Lausanne) ; 13: 997260, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36452317

RESUMO

Background: Diabetes mellitus (DM) or cognitive impairment (CI) is known to be strongly associated with mortality. DM commonly coexists with CI and proportionally increases with age. However, little is known about the combined effect of cognitive function and diabetes on mortality. This study aimed to evaluate the combined effects of DM and CI on all-cause and cause-specific mortality in Chinese older adults. Methods: This prospective population-based cohort study was based on the Beijing Elderly Comprehensive Health Cohort Study. A total of 4,499 older adults were included. Cox's proportional hazard models were utilized to calculate the effect of DM and CI on all-cause, cardiovascular disease (CVD) mortality and cancer mortality, and a multiplicative term was introduced to study a potential interaction between DM and CI on outcomes. Results: During a median follow-up of 6.8 years (ranging from 6.6 to 11.7 years), 667 (14.8%) participants died from all causes, 292 from CVD, and 215 from cancer. In the fully adjusted model, participants with coexisting DM and CI had the highest risk of all-cause mortality [hazard ratios (HRs), 3.08; 95% confidence intervals (CIs), 2.30,4.11] and CVD mortality (HRs, 3.85; 95% CIs, 2.60,5.71) compared with individuals with normal cognition and non-DM. We also found a multiplicative interaction between DM and CI in respect to all-cause (HRs, 2.46; 95% CI, 1.87,3.22) and CVD mortality (HRs, 3.15 95% CI, 2.19,4.55). In the diabetic population, CI was associated with an increased risk of all-cause mortality (HRs, 2.09; 95% CIs, 1.51,2.89) and CVD mortality (HRs, 3.16; 95% CIs, 2.02,5.05) compared with the normal cognition group. Restricted cubic spline revealed a linear inverse association between Mini-Mental State Examination (MMSE) score and all-cause, CVD mortality in the total sample and participants without diabetes. However, a nearly reverse J association was observed between MMSE and mortality from all causes and CVD in the diabetes group. Conclusion: The findings highlighted that cognitive impairment concomitant with diabetes further increases the risk of mortality. In addition to strengthening routine screening of cognitive functioning in older adults with early-stage diabetes, more extensive assessment of prognostic risks has high clinical value for developing comprehensive treatment plans.


Assuntos
Doenças Cardiovasculares , Disfunção Cognitiva , Diabetes Mellitus , Idoso , Humanos , Estudos de Coortes , Causas de Morte , Estudos Prospectivos , Disfunção Cognitiva/epidemiologia , Diabetes Mellitus/epidemiologia , Doenças Cardiovasculares/complicações , China/epidemiologia
5.
Nutrients ; 14(21)2022 Nov 03.
Artigo em Inglês | MEDLINE | ID: mdl-36364891

RESUMO

OBJECTIVES: The role of Vitamin D (VD) in calcium balance and bone health makes VD a vital factor in osteoarthritis (OA). Studies that have evaluated the effect of VD on OA patients have mainly been performed on a short-term basis. In this analysis, we aimed to evaluate whether VD was associated with mortality, a long-term outcome, in OA patients. METHODS: Participants with self-reported OA from NHANES III and NHANES 2001-2018 were included. Associations of 25(OH)D concentrations with mortality risk were assessed continuously using restricted cubic splines and by categories (i.e., <25.0, 25.0-49.9, 50.0-74.9, and ≥75.0 nmol/L) using the Cox regression model. Sensitivity and stratified analyses were performed to evaluate the robustness of the results. RESULTS: A total of 4570 patients were included, of which 1388 died by 31 December 2019. An L-shaped association was observed between 25(OH)D concentrations and all-cause mortality, whereas an inverse association was found for cardiovascular disease (CVD) mortality. The adjusted hazard ratios (95% confidence intervals) across four categories were 1.00 (reference), 0.49 (0.31, 0.75), 0.45 (0.29, 0.68), and 0.43 (0.27, 0.69) for all-cause mortality and 1.00 (reference), 0.28 (0.14, 0.59), 0.25 (0.12, 0.51), and 0.24 (0.11, 0.49) for CVD-specific mortality; no significant associations were found for cancer-specific mortality. Similar results were observed when stratified and sensitivity analyses were performed. CONCLUSIONS: Compared with patients with insufficient or deficient serum 25(OH)D, those with sufficient 25(OH)D concentrations had a lower risk of all-cause and CVD mortality, supporting a beneficial role of VD on a long-term basis.


Assuntos
Doenças Cardiovasculares , Osteoartrite , Deficiência de Vitamina D , Humanos , Vitamina D , Inquéritos Nutricionais , Causas de Morte , Vitaminas , Osteoartrite/complicações
6.
Rofo ; 194(12): 1287-1290, 2022 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-36446362
7.
BMJ Glob Health ; 7(11)2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36368766

RESUMO

During 2020 and 2021, Australia implemented relatively stringent government restrictions yet had few COVID-19 deaths. This provides an opportunity to understand the effects of lockdowns and quarantining restrictions on short-term mortality and to help provide evidence in understanding how such public health policies can impact on health. Our analysis is based on preliminary mortality data collected by the Australian Bureau of Statistics. Rates were estimated by disease and over time and compared with mortality statistics in the period 2015-2019. Comparing deaths in 2020-2021 with 2015-2019 show the annual mortality rate (per 100 000 people) fell by 5.9% from 528.4 in 2015-2019 to 497.0 in 2020-2021. Declines in mortality are across many disease categories including respiratory diseases (down 9.4 deaths per 100 000), cancer (down 7.5 deaths per 100 000) and heart disease (down 8.4 deaths per 100 000). During 2020 and 2021, Australian age-standardised mortality rates fell by 6%. This drop was similar for men and women, and was driven by a reduction in both communicable and non-communicable causes of death. Such evidence can help inform public health policies designed to both control COVID-19 and other infectious diseases.


Assuntos
COVID-19 , Doenças Transmissíveis , Masculino , Humanos , Feminino , Causas de Morte , Austrália/epidemiologia , Controle de Doenças Transmissíveis
8.
BMJ Open ; 12(11): e058714, 2022 11 15.
Artigo em Inglês | MEDLINE | ID: mdl-36379646

RESUMO

OBJECTIVES: Never-smoking women in Xuanwei (XW), China, have some of the highest lung cancer rates in the country. This has been attributed to the combustion of smoky coal used for indoor cooking and heating. The aim of this study was to evaluate the spectrum of cause-specific mortality in this unique population, including among those who use smokeless coal, considered 'cleaner' coal in XW, as this has not been well-characterised. DESIGN: Cohort study. SETTING: XW, a rural region of China where residents routinely burn coal for indoor cooking and heating. PARTICIPANTS: Age-adjusted, cause-specific mortality rates between 1976 and 2011 were calculated and compared among lifetime smoky and smokeless coal users in a cohort of 42 420 men and women from XW. Mortality rates for XW women were compared with those for a cohort of predominately never-smoking women in Shanghai. RESULTS: Mortality in smoky coal users was driven by cancer (41%), with lung cancer accounting for 88% of cancer deaths. In contrast, cardiovascular disease (CVD) accounted for 32% of deaths among smokeless coal users, with 7% of deaths from cancer. Total cancer mortality was four times higher among smoky coal users relative to smokeless coal users, particularly for lung cancer (standardised rate ratio (SRR)=17.6). Smokeless coal users had higher mortality rates of CVD (SRR=2.9) and pneumonia (SRR=2.5) compared with smoky coal users. These patterns were similar in men and women, even though XW women rarely smoked cigarettes. Women in XW, regardless of coal type used, had over a threefold higher rate of overall mortality, and most cause-specific outcomes were elevated compared with women in Shanghai. CONCLUSIONS: Cause-specific mortality burden differs in XW based on the lifetime use of different coal types. These observations provide evidence that eliminating all coal use for indoor cooking and heating is an important next step in improving public health particularly in developing countries.


Assuntos
Poluição do Ar em Ambientes Fechados , Doenças Cardiovasculares , Neoplasias Pulmonares , Masculino , Feminino , Humanos , Poluição do Ar em Ambientes Fechados/efeitos adversos , Carvão Mineral/efeitos adversos , Carvão Mineral/análise , Fumaça/análise , China/epidemiologia , Estudos de Coortes , Causas de Morte , Lobelina , Fumar , Neoplasias Pulmonares/epidemiologia
10.
Gac. sanit. (Barc., Ed. impr.) ; 36(6): 520-525, nov.-dic. 2022. tab
Artigo em Inglês | IBECS | ID: ibc-LC-237

RESUMO

Objective: To analyse the gap in life expectancy by educational level in the city of Barcelona from 2004 to 2018 and to decompose this gap by age and causes of death. Method: We computed abridged life tables at the age of 25 years by sex from 2004 to 2018 using standard methods. Educational level was categorised in two groups (lower secondary or less vs. upper secondary or higher education). The life expectancy gap was further decomposed by age and by causes of death based in Arriaga's method in 5-year age blocks up to the age of ≥ 90 years and broad causes of death using ICD-10 codes. Results: The life expectancy gap at 25 years by educational level oscillated without trend at around 3.08 years for men and 1.93 years for women. Decomposition by age showed a favourable significant shift in the contribution to this gap from young to older ages for men, with few changes for women. Decomposition by causes of death showed that the diseases concentrating the largest share of the contribution were neoplasms and respiratory and circulatory disease. There was a significant downward trend in external causes for men and in infectious diseases for both men and women but a significant upward trend for respiratory disease for both sexes. Conclusions: The stability of the life expectancy gap by educational level during the period analysed resulted from a combination of divergent trends by age and causes of death among high and low educational levels. (AU)


Objetivo: Analizar la brecha en la esperanza de vida por nivel educativo en la ciudad de Barcelona desde 2004 hasta 2018, y descomponer esta brecha por edad y causas de muerte. Método: Se calcularon tablas de vida abreviadas a la edad de 25 años por sexo desde 2004 hasta 2018 utilizando métodos estándar. El nivel educativo se clasificó en dos grupos: secundaria inferior o menor frente a secundaria superior o educación superior. La brecha de la esperanza de vida se descompuso además por edad y por causas de muerte según el método de Arriaga en bloques de edad de 5 años hasta la edad de ≥90 años y causas amplias de muerte utilizando los códigos de la CIE-10. Resultados: La brecha de la esperanza de vida a los 25 años por nivel educativo osciló sin tendencia en torno a los 3,08 años para los hombres y 1,93 años para las mujeres. La descomposición por edad mostró un cambio favorable a esta brecha desde las edades jóvenes a las mayores en los hombres, con pocos cambios en las mujeres. La descomposición por causas de muerte mostró una mayor contribución de las neoplasias y las enfermedades respiratorias y circulatorias. Hubo una tendencia a la baja en las causas externas en los hombres, y en las enfermedades infecciosas tanto en los hombres como en las mujeres, pero al alza en las enfermedades respiratorias para ambos sexos. Conclusiones: La estabilidad de la brecha de la esperanza de vida por nivel educativo durante el periodo analizado fue el resultado de una combinación de tendencias divergentes por edad y causas de muerte entre los niveles educativos altos y bajos. (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Expectativa de Vida , Fatores Socioeconômicos , Causas de Morte , Classificação Internacional de Doenças , Escolaridade
11.
Gac. sanit. (Barc., Ed. impr.) ; 36(6): 553-556, nov.-dic. 2022. mapas, graf, tab
Artigo em Espanhol | IBECS | ID: ibc-LC-242

RESUMO

Objetivo: Los Registros de Mortalidad (RM) codifican las causas de muerte para la elaboración de la estadística de defunciones según la causa de muerte del Instituto Nacional de Estadística (INE). Esta actividad puede mejorarse por búsqueda documental y formación médica. Nuestro objetivo fue analizar el perfil profesional y las actividades de los RM. Método: Se diseñó una encuesta que fue distribuida en febrero de 2021. Sus dominios fueron perfil profesional, actividades de mejora, docencia y publicación. Participaron 16/18 RM. Se realizó un análisis de agrupamientos. Resultados: Once RM pertenecen a Salud Pública. Cinco disponen de convenio con el INE. El 39% impartieron formación. El 56% realizaban publicaciones. Diez mejoraban las causas de muerte. El 17% verificaban la codificación automática. El análisis de agrupaciones partió de 5/16 grupos. Conclusiones: Los RM son heterogéneos en cuanto a profesionales, calidad y publicaciones. Homogenizar implicaría la búsqueda documental, un único convenio con el INE e impartir formación médica sistémica. (AU)


Objective: The mortality registries (MR) code death causes for the elaboration of the mortality statistics of the Spanish National Institute of Statistics (INE). Documentary research and medical training can improve this activity. Our objective was to analyse the professional profile and activities of the MR. Method: A survey was designed and distributed in February 2021. Professional profile, quality activities, medical training, and regular publications were the major topics. 16/18 MR participated. A cluster analysis was performed. Results: Eleven registries belong to Public Health. Five have an INE agreement, 39% provided training, and 56% made regular publications. Ten improved the causes of death, and 17% reviewed the automatic coding. The cluster analysis started from 5/16 groups of registries. Conclusions: The MR were heterogeneous in professionals, quality and publications. Homogeneity implies documentary search, a sole INE agreement, and providing systemic medical training. (AU)


Assuntos
Humanos , Descrição de Cargo , Registros de Mortalidade , Causas de Morte , Espanha , Inquéritos e Questionários
12.
Microb Cell Fact ; 21(1): 245, 2022 Nov 23.
Artigo em Inglês | MEDLINE | ID: mdl-36419091

RESUMO

The remains of the heart tissue of Thaddeus Kosciuszko have been investigated as the possible cause of disease and death of the hero of Polish and American nations. Three specimens, DNA isolated from scrappings of wax surface, from the surface of a wooden plate, and from the linen cloth that have had contact with the object were subjected to nanosequencing. From the first two, among all reads identified, only one classified as Propionibacterium acnes (synonymous current name Cutibacterium acnes), had a purported clinical significance. The observed identity between the P. acnes sequences and reference was 89-90% consistent with the hypothesis that the identified reads represent the ancient P. acnes DNA (aDNA), which underwent fragmentation and sequence changes caused by its long-time presence in the environmental conditions conducive to degradation. We present a reasonable and entirely new hypothesis that the analyzed samples could reflect the presence of the bacteria in the original Kosciuszko's heart tissue and that the process of C. acnes infection was progressing inside the organ (endocarditis), not on its surface (pericarditis) leading to rapid deterioration of health and eventually death. We again point out that normal skin and mucosal membranes commensal, a causative agent of common skin acne, may be associated with various severe organ infections posing a threat to health and life.


Assuntos
Endocardite , Propionibacterium acnes , Humanos , Causas de Morte , Polônia
13.
BMC Public Health ; 22(1): 2133, 2022 11 21.
Artigo em Inglês | MEDLINE | ID: mdl-36411468

RESUMO

OBJECTIVE: Through the study of death characteristics and trend prediction, it is hoped that key populations, regions and seasons can be identified, thereby providing evidence support for the efficient prevention and control management of unintentional injury deaths. METHOD: We collected information on 8630 unintentional deaths of children under age 5 from local surveillance systems, analyzed by chi-square test and predicted by the seasonal ARIMA model. RESULTS: About 33.1% of child deaths were under the age of 1, 60.5% were boys, 37.6% were in urban areas, 2.6% were among ethnic Tibetans, 6.8% were among ethnic Yi, and 46.6% died inside houses. The top three of total deaths were accidental drowning (35.0%), accidental suffocation (32.7%) and traffic accident (15.5%). The ratio of males to females in traffic accidents (1.28:1) and poisoning (1.30:1) deaths was relatively lower than accidental falls (1.62:1) and drowning (1.85:1). The causes of death ratio in rural and urban areas were: drowning (1.83:1), poisoning (1.75:1), suffocation (1.62:1), traffic (1.41:1), and falling (1.24:1). Children's deaths of ethnic minority groups of Tibetan and Yi increased year by year (χ2=75.261, P< 0.001). Tibetan and Yi groups had the most deaths in summer, and Han in winter (χ2=29.093, P< 0.001). Accidental suffocation accounted for 78.2 percent of the total unintentional deaths of children under age 1. And drowning accounted for only 2.4 percent. The model SERIMA (1, 1, 2) (2, 0, 0) [12] is suitable for describing and predicting unintentional injury deaths of children under age 5. CONCLUSION: We should combine death surveillance with qualitative investigation or in-depth quantitative investigation to further analyze unintentional injury deaths in children.


Assuntos
Afogamento , Criança , Masculino , Feminino , Humanos , Pré-Escolar , Lactente , Asfixia , Etnicidade , Causas de Morte , Grupos Minoritários , China/epidemiologia
14.
BMJ Open ; 12(11): e064777, 2022 11 18.
Artigo em Inglês | MEDLINE | ID: mdl-36400734

RESUMO

OBJECTIVE: This study reported the prevalence and sociodemographic distribution of mortalities attributed to injuries in Papua New Guinea (PNG). SETTING: As part of a longitudinal study, mortality data were collected from the population who live in eight surveillance sites of the Comprehensive Health and Epidemiological Surveillance System, established in six major provinces in PNG. Verbal autopsy (VA) interviews were conducted by the surveillance team with close relatives of the deceased, using the WHO 2016 VA instrument from January 2018 to December 2020. PARTICIPANT AND INTERVENTION: Mortality data from 926 VA interviews were analysed, using the InterVA-5 diagnostic tool to assign specific cause of death (COD). Distributions of injury-attributed mortality were calculated and multinomial logistic regression analyses were conducted to identify sociodemographic factors and provide ORs, 95% CIs of estimates and p values. RESULT: Injury-attributed deaths accounted for 13% of the total deaths recorded in the surveillance population, with the highest proportion in Madang (22%), followed by Port Moresby and Central Province (13%). Road traffic accidents were the leading COD, accounting for 43% of the total injury-attributed deaths, followed by assaults (25%) and accidental falls (10%). Young adults (aged 15-24 years) accounted the largest proportion of injury-attributed deaths (34%) and were nearly six times more likely to die from injuries than those aged 75+ years (OR: 5.89 (95% CI: 2.18 to 15.9); p<0.001). Males were twice more likely to die from injuries than females (OR: 2.0 (95% CI: 1.19 to 3.36); p=0.009). Another significant sociodemographic factor associated with the increased injury-attributed mortalities included urban versus rural residence (OR: 2.0 (95% CI: 1.01 to 3.99); p=0.048). CONCLUSION: Young adults, particularly those who live in urban areas, were at the highest risk of dying from injuries. Public health policies and interventions are needed to reduce premature mortality from injuries in PNG.


Assuntos
População Rural , Determinantes Sociais da Saúde , Humanos , Adulto Jovem , Masculino , Feminino , Papua Nova Guiné/epidemiologia , Estudos Longitudinais , Causas de Morte
15.
Health Aff (Millwood) ; 41(11): 1550-1558, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36343324

RESUMO

There were almost 700,000 excess deaths in the US from March 1, 2020, through February 28, 2021, resulting from two often counterbalancing mechanisms: those predicted by changes in unemployment rates occurring during this period, referred to here as the "recession effect," and those predicted by the "pandemic effect," which reflects direct consequences of SARS-CoV-2 infections and COVID-19, accompanying impacts on health and medical care, and other changes in mortality not caused by greater joblessness. Using data from the Centers for Disease Control and Prevention, this study decomposed total mortality in this period into pandemic and recession effects, with additional estimates by sex, race and ethnicity, age, and fourteen causes. Although the pandemic effect increased many types of mortality, the recession effect reduced most types of mortality. Without the recession effect, there would have been nearly 40,000 more deaths than actually occurred. However, there were disparate impacts, particularly for external causes. Vehicular and alcohol-related fatalities and homicides rose because of strong pandemic effects. In contrast, the recession effect accounted for a greater share of the rise in drug mortality. Offsetting pandemic and recession effects resulted in a decrease in the number of suicides. Understanding these diverse impacts provides useful lessons for policy efforts to mitigate the current and future health pandemics.


Assuntos
COVID-19 , Suicídio , Humanos , Pandemias , SARS-CoV-2 , Causas de Morte , Mortalidade
16.
Philos Ethics Humanit Med ; 17(1): 14, 2022 Nov 23.
Artigo em Inglês | MEDLINE | ID: mdl-36414959

RESUMO

When considering the manner of death, two categories can be distinguished, namely natural death and unnatural death. Though most physicians think that the distinction between the two is evident, this is not the case.When comparing the Netherlands, Belgium, England and Germany it is noticed that the terms natural and unnatural might be used in law but are not defined by law. In practice, the term unnatural death is used when there is an external cause of death, but even that turns out to not be sufficient in making an obvious difference between the two terms. Different countries may even label the same death differently. A, at times philosophical and semantic, discussion shows that when it comes to causes of death a very large grey area exists between natural and unnatural causes of death. The Netherlands, Belgium and Germany even have the possibility to label a death as natural (or unnatural) without actually knowing the cause of death.In conclusion, we recommend a new system in which the circumstances surrounding a death are properly investigated. This should lead to a report to an independent legal expert, who is able to decide if and what conclusion can be drawn, from a judicial and a public point of view, thereby, making the distinction and the use of the terms natural and unnatural/nonnatural obsolete.


Assuntos
Médicos , Humanos , Causas de Morte , Alemanha , Causalidade , Inglaterra
17.
Eur J Med Res ; 27(1): 230, 2022 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-36329537

RESUMO

Surgery is one of the most important treatments for bladder cancer, including local tumor excision and radical cystectomy. At present, studies on the causes of death for contemporary survivors, especially women, who have received different surgical treatments are limited. Therefore, the study used a population-based cohort study in the United States from 2000 to 2017 to analyze causes of death for women who underwent local tumor excision or radical cystectomy stratified by demographics and tumor stage. standardized mortality ratios (SMRs) were calculated based on general population data. In total, 24,040 female patients who underwent surgical treatments were assessed. Of those 20,780 patients undergoing local tumor excision, 36.6% died of bladder cancer, while 63.4% died of other causes. The risk of death from all causes increased in comparation with the general population (SMR 1.85; 95% CI 1.82-1.87), and the most common non-tumor cause of death was from heart diseases (16.2%; SMR 1.13; 95% CI 1.09-1.16). Among women who receive radical cystectomy, 82.3% of deaths occurred within 5 years after surgery. 66.9% deaths resulted from bladder cancer, and the risk of death from all causes significantly higher than that in the general people (SMR 4.67; 95% CI 4.51-4.84). Moreover, the risk of death from non- bladder cancer causes also increased, in particular, such as septicemia (SMR 3.09; 95% CI 2.13-4.34). Causes of death during bladder cancer survivorship after surgery vary by patient and tumor characteristics, and these data provide information regarding primary care for women during postoperative cancer survivorship.


Assuntos
Cistectomia , Neoplasias da Bexiga Urinária , Humanos , Feminino , Estados Unidos/epidemiologia , Cistectomia/efeitos adversos , Cistectomia/métodos , Neoplasias da Bexiga Urinária/cirurgia , Causas de Morte , Bexiga Urinária/patologia , Estudos de Coortes , Estudos Retrospectivos
18.
Epidemiol Prev ; 46(5-6): In press, 2022.
Artigo em Italiano | MEDLINE | ID: mdl-36341583

RESUMO

BACKGROUND: as a result of the SARS-CoV-2 pandemic, a generalised mortality excess was recorded in 2020. However, the mortality for COVID-19 cannot fully explain the observed excesses. The analysis of cause-specific mortality could contribute to estimate the direct and indirect effects of the SARS-CoV-2 outbreak and to the monitoring mortality trends. OBJECTIVES: to describe the impact of the SARS-CoV-2 epidemic in overall and cause-specific mortality in population residing in the Agency for Health Protection (ATS) of Milan. Descriptive analysis of cause-specific mortality within thirty days of SARS-COV-2 infection. DESIGN: descriptive analysis of overall and cause-specific mortality in the ATS of Milan area in 2020 and comparison with a reference period (2015-2019). SETTING AND PARTICIPANTS: overall deaths in ATS of Milan in 2020 were collected, using the Local Registry of Causes of Death, and were classified according to the ICD-10 codes. MAIN OUTCOME MEASURES: total and weekly overall and cause-specific mortality, by age. RESULTS:  in 2020, 44,757 deaths for all causes were observed in people residing in the ATS of Milan with percentage change of 35%. The leading cause of death in 2020 were cardiovascular disease and neoplasm; COVID-19 infection was the third cause. An excess of mortality was observed for most of all causes of deaths. Starting from 40-49-year age group, an increase of mortality was observed; the largest increase was observed in the group 70+ years. The largest increases were observed for endocrine, respiratory, and hypertensive diseases. On the contrary, for neoplasm, infectious (not COVID-19) diseases, traffic-related mortality, and cerebrovascular disease and ictus, a decrease of mortality was observed. The greater mortality increase was observed during the first pandemic wave. The leading cause of death after positive swab was COVID-19 infection, with little variation with age class. Other frequent causes of death were respiratory diseases, cardiovascular diseases, and neoplasm. CONCLUSIONS: the study showed a generalised increase for most causes of death; observed mortality trends may indicate delay in access to health care system, in diagnosis and treatment.


Assuntos
COVID-19 , Neoplasias , Humanos , Causas de Morte , SARS-CoV-2 , Itália/epidemiologia , Mortalidade
19.
MMWR Morb Mortal Wkly Rep ; 71(45): 1449-1456, 2022 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-36355615

RESUMO

On May 17, 2022, the Massachusetts Department of Health announced the first suspected case of monkeypox associated with the global outbreak in a U.S. resident. On May 23, 2022, CDC launched an emergency response (1,2). CDC's emergency response focused on surveillance, laboratory testing, medical countermeasures, and education. Medical countermeasures included rollout of a national JYNNEOS vaccination strategy, Food and Drug Administration (FDA) issuance of an emergency use authorization to allow for intradermal administration of JYNNEOS, and use of tecovirimat for patients with, or at risk for, severe monkeypox. During May 17-October 6, 2022, a total of 26,384 probable and confirmed* U.S. monkeypox cases were reported to CDC. Daily case counts peaked during mid-to-late August. Among 25,001 of 25,569 (98%) cases in adults with information on gender identity,† 23,683 (95%) occurred in cisgender men. Among 13,997 cisgender men with information on recent sexual or close intimate contact,§ 10,440 (75%) reported male-to-male sexual contact (MMSC) ≤21 days preceding symptom onset. Among 21,211 (80%) cases in persons with information on race and ethnicity,¶ 6,879 (32%), 6,628 (31%), and 6,330 (30%) occurred in non-Hispanic Black or African American (Black), Hispanic or Latino (Hispanic), and non-Hispanic White (White) persons, respectively. Among 5,017 (20%) cases in adults with information on HIV infection status, 2,876 (57%) had HIV infection. Prevention efforts, including vaccination, should be prioritized among persons at highest risk within groups most affected by the monkeypox outbreak, including gay, bisexual, and other men who have sex with men (MSM); transgender, nonbinary, and gender-diverse persons; racial and ethnic minority groups; and persons who are immunocompromised, including persons with advanced HIV infection or newly diagnosed HIV infection.


Assuntos
Infecções por HIV , Varíola dos Macacos , Minorias Sexuais e de Gênero , Adulto , Estados Unidos/epidemiologia , Humanos , Masculino , Feminino , Homossexualidade Masculina , Etnicidade , Infecções por HIV/prevenção & controle , Varíola dos Macacos/epidemiologia , Grupos Minoritários , Identidade de Gênero , Causas de Morte , Surtos de Doenças
20.
BMJ Open ; 12(11): e049689, 2022 11 25.
Artigo em Inglês | MEDLINE | ID: mdl-36428010

RESUMO

OBJECTIVES: To quantify the burden of death that COVID-19 contributes relative to the top three causes of death for all countries. DESIGN: We performed uncertainty analyses and created contour plots for COVID-19 mortality to place the number of COVID-19 deaths in context relative to the top three causes of death in each country, across a plausible range of values for two key parameters: case fatality rate and magnitude of under-reporting. SETTING: All countries that have reported COVID-19 cases to the WHO and are included in the Global Burden of Disease Study by the Institute of Health Metrics and Evaluation. MAIN OUTCOMES AND MEASURES: Monthly number of deaths caused by COVID-19 and monthly number of deaths caused by the top three causes of death for every country. RESULTS: For countries that were particularly hard hit during the outbreak in 2020, most combinations of model parameters resulted in COVID-19 ranking within the top three causes of death. For countries not as hard hit on a per-capita basis, such as China and India, COVID-19 did not rank higher than the third leading cause of death at any combination of the model parameters within the given ranges. Up-to-date ranking of COVID-19 deaths relative to the top three causes of death for all countries globally is provided in an interactive online application. CONCLUSIONS: Estimating the country-level burden of death that COVID-19 contributes relative to the top three causes of death is feasible through contour graphs, even when the actual number of deaths or cases is unknown. This method can help convey importance by placing the magnitude of COVID-related deaths in context relative to more familiar causes of death by communicating when COVID-related deaths rank among the top three causes of death.


Assuntos
COVID-19 , Humanos , Causas de Morte , Causalidade , Surtos de Doenças , Incerteza
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