Biomedical subjects
Publications and source records attributed to C Vutuc.
The incidence of Haemophilus influenza meningitis was analysed for the first time in Austria. In 1990 a total of 55 cases occurred, representing an incidence of 0.71/10(5). Most of the patients were children aged less than 5 years (n = 42, 76.4%). The incidence in the age group 0-4 years was 9.48/10(5), in each of the other 5-year age groups the incidence was lower than 1/10(5).
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The incidence of hepatitis A, treated at hospitals in Austria in the year 1990, was 4,3/10(5) (n = 326), of hepatitis B 3,47/10(5). In hepatitis A the highest incidence was observed in children (5-9 years: 14.3/10(5)). Two peaks were observed in hepatitis B; 20-24 years: 5.93/10(5) and 60-64 years: 3.84/10(5). Both disease had the highest incidence in the district of Vorarlberg (hepatitis A 12.4/10(5), hepatitis B 6.86/10(5)), the lowest in the district of Burgenland (0.37/10(5) and no case of hepatitis B).
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The significance of tobacco smoking, alcohol consumption and occupation as risk factors for the development of vocal chord dysplasia was evaluated in a case-control study. Twenty-seven male patients with dysplasia of the vocal chords were chosen from the I. ENT-University Clinic in Vienna (1985-1988) and compared with 54 controls. The main results are: The relative risk (RR) of a smoker compared to that of a non-smoker for vocal chord dysplasia is 7.27 (6.81-7.73); the RR adjusted for occupation is 3.58 (2.31-4.84). The most important risk factor, however, is occupational exposure. The relative risk of a blue collar worker compared to that of a white collar worker is 11.04 (10.61-11.46), which is reduced only to 10.02 (10.61-11.46) after stratification according to smoking habits.
Among the 15.998 live births recorded in Upper Austria in the year 1985, a representative malformation rate of 1.79, respectively a representative incidence of 17.94 in 1000 live births is reported. The incidences of characteristic malformations and of single malformations combined in malformation groups are determined. An instrument of investigation, especially developed for and successfully used in this examination in form of an illustrated questionnaire is introduced.
Between 1966 and 1982, age-standardized lung cancer mortality rates in Austria showed a slightly decreasing trend in men and an increasing trend in women. Differences between male and female lung cancer rates and different trends among particular age groups, especially male, can be understood as a function of the difference in past smoking habits: in men, the lung cancer epidemic had already passed its peak. Mortality will continually decrease, with the possibility of a slight and short-lasting future increase, when 1917 to 1931 birth cohorts reach an older age. In women, lung cancer mortality will increase steadily as a consequence of the increasing epidemic of cigarette smoking among young women. But it will never reach the same proportion as in men, because high tar cigarettes have not played the same role in female smoking habits as in male.
Among 145 cases of maternal deaths from the period 1975 to 1983, whose data had been collected in a nationwide survey, 30 cases (21%) were classified as associated causes of maternal deaths. 10 deaths (33%) occurred at the birth of the child, 11 (37%) within 6 weeks after delivery, 4 (13%) within the first trimester and 5 (17%) within the second trimester. The disease that was in causal relation to the complication leading to death was known in 16 cases (53%), unknown in 13 cases (43%); in one case information is missing. In 11 cases (37%) it was a cardiac disease, in 6 cases (20%) a cerebrovascular disease and in 4 cases (13%) a disease of the lung. All other diseases leading to the death of the mother were rare diseases. It can be concluded that more emphasis should be given to the diagnosis of cardiovascular diseases during pregnancy and further to the clarification of uncertain conditions in the postnatal period. In case of a disease with high maternal risk, sterilisation should be considered.
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Cytological screening has reduced mortality of cervical cancer in Austria. It has cut mortality of carcinoma of the uterus by one third from 1966 to 1982. In causes of deaths screening has mainly reduced mortality from cancer of other and unspecified parts of uterus. A new nomenclature introduced in 1969 has strengthened the decreasing trend with regard to cancer of other and unspecified parts of uterus and has compensated the screening effect in mortality from cervical carcinoma (the decreasing trend was preceded by an increase). This shift of cervix cancer deaths cases from the position mortality from cancer of other and unspecified parts of uterus to mortality from cervical cancer is the reason that the latter does not reflect the real trend of cervical cancer mortality. The analysis of cervical cancer by birth cohort and age at death (1966-1981) show the effect of screening in the younger births cohorts of age groups 40-44, 45-49 and 50-54 and in older ages of cohorts born in 1927-1932, 1932-1936 and 1937-1941 respectively.
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The exposure of passive smokers to cigarette smoke is estimated to be equivalent to 0.1-1.0 cigarette/day actively smoked. According to the reported relationships of dose and time, lung cancer incidence and other relative risk figures relating to nonsmokers have been calculated for ages 40, 50, 60, 70, and 79. Risks for smokers with a daily consumption of 0.1-1.0 cigarette were found to be in the range of R = 1.03 to 1.36. As it applies to passive smokers, this range of exposure may be neglected because it has no major effect on lung cancer incidence. The results of four previous studies dealing with passive smoking and lung cancer are compared with the current calculated risks, and the differences are discussed.
55 deaths following a Caesarean section occurred in Austria during 1975-1982 (41,7% of all maternal deaths). 45 deaths (82%) were directly related to the Caesarean section, in 9 cases (16%) a severe underlying disease was found which had contributed to the fatal outcome (indirect deaths). In one case the diagnosis could not be clarified. Among the direct deaths the indication for the Caesarean section was in 12 cases (27%) severe bleeding, in 12 cases gestosis, in 12 cases predominantly foetal causes, in 6 cases previous Caesarean section and in 3 cases poor obstetric history. Complications were in 18 cases (40%) severe bleeding, in 7 cases (16%) pulmonary embolism, in 4 cases complications as a consequence of anaesthesia and in 4 cases abdominal infections. In 14 cases (31%) post Caesarean hysterectomy was performed. The mortality of Caesarean section during 1975 to 1982 was 6.3/100.000 live births, whereas case fatality was 0.1%.
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According to age-standardized mortality rates (European standard population, Fig. 1) and mortality rates by birth cohort and age at death (Fig. 2-7) the trends of mortality of stomach and colorectal cancer (1966-1981/82) were analysed for men and women. In a further step it was examined how far these trends could be explained by the hypothesis "diet and cancer" (western diet). Under the postulation that the manifestation of western diet has reduced the risk of stomach cancer drastically, the risk of colorectal cancer has not increased to the same extent. Moreover, rectal cancer has shown only a slight increase and might even decrease in years to come. Having in mind the increasing risk, diet has no major impact so far. The differences in trends according to age groups and birth cohorts indicate the influence of other factors than diet. Furthermore, it is necessary to deal with colon and rectal cancer separately because of the differences in their trends.