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Biomedical subjects

J Kytir

Publications and source records attributed to J Kytir.

At least 19 recordsLinked to original sources
PubMed2001

Compression or expansion of morbidity? Trends in healthy-life expectancy in the elderly Austrian population between 1978 and 1998.

The aim of our study is to test the theories of compression or expansion of morbidity on the basis of data on the elderly population of Austria. Our data come from four microcensus surveys for the years 1978, 1983, 1991, and 1998. We use self-perceived health ratings to calculate healthy-life expectancy for the elderly population aged 60-89. Because our data are based on four cross-sectional surveys, we devote the first part of the paper to the consequences of possible sampling and non-sampling errors in our analysis of time trends. We come to the conclusion that, although the absolute number of years lived in good health may be overestimated, the time trend in healthy-life expectancy over the 20 years most probably is unbiased. The second part of the paper describes trends in healthy-life expectancy for the Austrian population. Our results suggest that both healthy-life expectancy and the ratio of healthy years to life expectancy increased between 1978 and 1998. Thus, in Austria ill health seems to be more and more compressed into the later years of life. Contrary to Fries's hypothesis, however, life expectancy does not seem to be approaching a maximum average life span in Austria, as mortality rates at older ages have been continuously decreasing over the last 20 years.

Aged↗
PubMed2000

[Child's sudden death in 20th century--hypothesis, dogmas, dead wood].

With the decline of the former main causes of death in early childhood--infections and starvation--sudden infant death syndrome (SIDS) has emerged as the most important single cause of postneonatal infant mortality. It has adopted the role of a major indicator for the standard of public health care. Despite extensive input into research, its pathophysiology has remained rather obscure. The resulting helplessness of scientists and health care professionals have lead to adherence to unconfirmed pathophysiological hypotheses and to pursuit of preventive strategies of doubtful efficacy. In this overview, the medical and technical background of five major hypotheses is being presented. A lot can be learnt from the history of their development, efforts to refute them, and the reasons for unreflected adherence to them. (1) Due to its illustrative nature, the so-called 'status thymico-lymphaticus', the theory of asphixation by an enlarged thymus, could not be eradicated although well-reknowned physicians--including the Austrian pathologist Paltauf--have repeatedly attempted to do so. (2) Assumed familiarity, an aspect which attracted the attention of pediatricians to SIDS initially has been excluded, but an increased risk of SIDS for the siblings of affected babies is still common belief. (3) The sleep-apnea-hypothesis has turned out a complete error with serious consequences, but home apnea monitors are still being widely recommended. (4) The rise of SIDS in the 80ies and its subsequent decline in the 90ies has been interpreted as the advent and successful control of an epidemic although significant numbers of cot death have been reported long before the turn of the century, and the apparent increase which paralleled the introduction of the 9th edition of the ICD code is most likely due to improved registration. (5) Finally, SIDS is still being considered a random event--ignoring all evidence of an obvious role of socioeconomical factors.

Austria↗
PubMed1998

Social inequalities in disability-free and healthy life expectancy in Austria.

The purpose of this study is to describe socioeconomic differences in the health status and mortality of the Austrian population. Socioeconomic differentials in disability and self-perceived health are studied on the basis of educational groups. The data are drawn from the 1991 Austrian micro-census on health and from linked death and census records for the years 1981/82. The maximum number of years lived between ages 30 and 75 is divided into years lost, years lived in disability or poor health and years lived without disability or in good health. Our findings clearly indicate a correlation between higher education and higher life expectancy and lower morbidity. Comparing the two indicators, more years are lived in poor health than in severe functional disability. The two concepts of health lead to different conclusions when results for men and women are compared: women live more years in disability than men but fewer years in poor health. Differences between educational groups are lower when the concept of self-perceived health is applied.

Activities of Daily Living↗
PubMed1996

[5 years neuroblastoma screening in Austria: rate of participation, results and a comparison with other screening areas].

In late 1990 a screening program for the early detection of neuroblastoma in infants was introduced in Austria. The program is performed on a voluntary basis in collaboration with general pediatricians and practitioners. Filter strips for urine collection are distributed to parents of infants aged seven to nine months on the occasion of a routine check up. The samples are sent to the laboratory by parents and analysed for vanillylmandelic acid (VMA) and homovanillic acid (HVA). Between January 1991 and December 1995 125,201 infants were screened. The compliance rate was 26.8% for Austria, but great differences were seen for different regions (65% in Carinthia, 10% in Vorarlberg). 30 children were admitted to hospital for investigation of repeatedly elevated urine catecholamines. A neuroblastoma was identified in 16 cases. In 12 of these cases at least one unfavorable prognostic factor was present (stage > or = 3, elevated LDH, unfavorable histology, N-myc amplification, di- or tetraploidy). Neuroblastoma screening of infants aged more than six months seems to detect predominantly those tumors which are unlikely to regress spontaneously. The observation of one false negative case, however, demonstrates that neuroblastomas which become clinically manifest at a later date may remain undetected by early screening. Possible advantages of shifting screening to a later age and repeated screening are discussed.

Austria↗
PubMed1996

[Incidence and regression of sudden infant death in Austria. Is the change in the SIDS incidence real or virtual?].

After the rise in incidence of the sudden infant death syndrome (SIDS) in the 1980s to a peak of 1.7/1000 live births in Austria in 1988, the SIDS rate more than halved to 0.79/1000 live births in 1994. This trend can be regarded as typical of the epidemiology of SIDS in most Western countries. It is commonly interpreted as a result of preventive measures. However, the decline in incidence of SIDS started several years before systematic preventive activities were undertaken in Austria. Graphical presentation shows that the dynamics of SIDS does not affect the almost linear decline in postneonatal mortality over the past 25 years, as would be expected from the fact that SIDS is the most important cause of death in the postneonatal period. A comparative analysis of trends of postneonatal SIDS and non-SIDS mortality reveals that in Austria the increase of SIDS was accompanied by a rapid fall of non-SIDS mortality, whereas, on the contrary, the decline of SIDS went along with relative increase of non-SIDS mortality. Changing awareness of coroners and forensic pathologists of SIDS, with the resultant changes in frequency and performance of postmortem examinations, and changes in coding practices of causes of death should be taken into consideration as determinants of SIDS incidence before interpreting trends as resulting from public health interventions.

Austria↗
PubMed1995

Historical regional patterns of infant mortality in Austria.

"First an overview is given of the secular decline of infant mortality in Austria between 1820 and 1950.... Second the study analyses the historical regional differences of infant mortality in Austria comparing data for all 99 political districts (Politische Bezirke) for the period 1900 to 1950. The most important results are: At the turn of the 19th century infant mortality rates were generally lower in Alpine than in non-Alpine regions and lower in cities than in their surrounding areas. This geographical pattern which remained constant until the 1950s was solely determined by differences in post-neonatal mortality rates. Plausible explanations for these regional differences are discussed." (SUMMARY IN FRE)

Austria↗
PubMed1995

Life expectancy at age 60--epidemiologic scenarios assuming delayed mortality for selected causes of death.

"The present analysis offers a projection of life expectancy at advanced ages in Austria for the year 2010. To estimate the gains in life expectancy the Simultaneous Multiple Cause-Delay (SIMCAD) method is used. This model takes into account the epidemiological concept of an additional delay in the onset of particular chronic-degenerative diseases. While the results of the SIMCAD method vary only slightly on the whole from the official projection of life expectancy at age 60, the similarity between the two projections decreases steadily with increasing age. The SIMCAD model predicts higher gains in life expectancy for the oldest age-groups of the population than do the official statistics." (SUMMARY IN FRE)

Adult↗
PubMed1995

[Sudden infant death (SIDS) in Austria. How reliable is the diagnosis?].

The sudden infant death syndrome (SIDS) is the most frequent cause of death during the postneonatal period (2-12 months) in Austria. A retrospective analysis of the SIDS cases registered between 1988 und 1992, however, shows marked differences between the provinces with regard to the relative proportion of SIDS against total infant mortality figures. The use of different definitions for SIDS seems to be responsible for local differences. Thus, a standardized investigation for all sudden unexpected deaths is required (autopsy, histological investigations, death scene investigation). Furthermore, a uniform classification for sudden unexpected infant death should be applied.

Austria↗
PubMed1994

The incidence of stairway injuries in Austria.

Stairs are among the most hazardous features of the everyday environment, yet stairway falls have received little research attention. A stratified random sample of Austrian residents was surveyed in person in 1989. Of over 55,000 respondents, 147 reported a stairway injury in the previous year that limited activity for at least one day. Thirty-seven percent of these injuries resulted in hospitalization. Extrapolating to the entire country of 8 million people, each year some 20,000 Austrians sustain serious stairway injuries resulting in over 7,500 hospitalizations. The incidence of stairway injury increases monotonically with age, and females are more at risk than males. The stereotypical stairway injury victim is an elderly woman, not highly educated, who is unmarried and living alone.

Accidental Falls↗
PubMed1992

[Unmarried, pre-nuptial and marital fertility: the family in process of change. An empirical analysis of Austrian women giving birth to their first child, 1950-1990].

"This analysis provides an outline of the changes in family formation behaviour in Austria in the years 1950 to 1990. Using vital statistical data and retrospective data of the 1981 census all women with their first confinement in the years 1950 to 1990 were classified into three distinct groups according to their form of family formation behaviour: 1. Mother is unmarried at date of birth...,2. mother marries during pregnancy, 3. mother is married at time of conception. Changes in family formation behaviour over time are discussed in detail, focussing on different age groups and on regional differences." (SUMMARY IN ENG)

Age Factors↗
PubMed1991

[World population today and tomorrow].

"In 1989/90 the world's population was approximately 5.2 billions. According to U.N.-projections (medium variant) every 10 to 11 years this figure will grow by one billion, corresponding to an increase of 100 [million] people per year.... This article discusses the causes for the population growth and the impact on the settlement system, the food-situation, the ecological system, and the development process in the Third World." (SUMMARY IN ENG)

Conservation of Natural Resources↗
PubMed1989

[Sudden infant death syndrome in Austria. 1: Incidence and regional distribution].

This paper analyzes the birth and death certificate data of infants who died from the Sudden Infant Death Syndrome (SIDS) before their first birthday. It investigates possible causes of differences in regional mortality and of the significant increase in the number of cases between 1980 and 1987. Moreover, the authors try to assess whether the number of SIDS cases registered by the Austrian Central Statistical Office is plausible. Between 1980 and 1987 the number of SIDS cases increased from 38 (= 2.9% of all infant mortality cases) to 141 (= 16.6%). Moreover, there are significant regional differences in SIDS mortality, varying between 0.3 per thousand in Upper Austria and 2.2 per thousand in Salzburg. Possible causes for these mortality differences are discussed (misclassifications, regional differences in the level of infant mortality). Finally, the authors look at the reliability of the official Austrian SIDS statistics and conclude that the officially announced number of SIDS cases may not give an accurate picture of the situation but is still the best estimate available.

Austria↗