[Project of mortality statistics in Vienna].
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The results of a special survey of cancer mortality statistics in selected areas of the Ober- and Unterland of Württemberg in the period 1908--1912 were compared with the official mortality statistics of the same region for 1969--1972. In the Oberland, formerly part of an area of high cancer mortality comprising the adjacent regions of Bavaria, Austria, Switzerland, and Baden, the overall cancer mortality showed a marked fall in both sexes. In the Unterland, where cancer mortality was previously low, the overall death rate increased in men and did not change in women. These variations are largely accounted for by changes in mortality from cancer of the stomach and bronchus. The death rates from gastric cancer observed around 1900 in the Oberland of Württemberg and adjacent regions of the neighbouring countries are among the highest recorded even in the world. Since the fall of gastric cancer noted is very marked and this disease is still the leading cause of death from cancer today, the Oberland of Württemberg seems to be uniquely suited for the search of environmental factors which associate with this decline. In theremainder of cancer sites changes over time were less striking and/or observed already in other countries.
Mortality from kidney cancer in the United States declined dramatically over the period 1940-1969. This trend was nearly proportional to the increases in survival for 644 U.S. children reported to the End Results Group, National Cancer Institute. The improvements in survival occurred for all stages of disease and appeared to result from therapeutic advances rather than earlier detection. Total incidence trends showed no consistent change, but a shift toward female preponderance resembled that seen in the mortality statistics and suggests sex differences in etiology.
PURPOSE: The Island Sign (IS) is a radiological finding observed in patients with intracerebral hemorrhage (ICH). This meta-analysis aimed to evaluate the association between IS and both hematoma expansion (HE) and functional outcomes by comparing ICH patients with and without IS. METHODS: We searched PubMed, Embase and Cochrane Library for studies of intracerebral hemorrhage reporting the IS. The primary outcomes were functional status and hematoma expansion, secondary outcome was mortality. Statistical analysis was performed using RStudio, effect sizes were calculated as odds ratios (ORs) with 95% confidence interval (95% CIs), and heterogeneity was assessed with I2 statistics. In addition, meta-regression and sensitivity analyses were performed, and publication bias was assessed through funnel plots and Egger's regression test. RESULTS: We included 21 observational studies with a total of 9,459 patients with spontaneous ICH, 1,769 of them had IS, while 7,690 did not. The mean age was 63.5 ± 13.2 and 5,835 (61.7%) were male. Poor functional outcomes (OR 2.77, 95% CI: 2.14-3.58, p < 0.0001, I2 = 4.9%) and hematoma expansion (OR 2.75, 95% CI: 1.87-4.03, p < 0.0001, I2 = 77.4%) were substantially higher in patients with IS, as well as the overall mortality rate (OR 2.54, 95% CI: 1.55-4.17, p = 0.0002, I2 = 0%). Meta-regression analysis showed no statistically significant association between imaging-related timing variables and hematoma expansion. Furthermore, the leave-one-out sensitivity analyses showed that no single study exerted a disproportionate influence on the overall effect for the examined outcomes, and Egger's linear regression tests were not statistically significant for both outcomes. CONCLUSION: Patients with the Island Sign are associated with higher rates of poor functional outcomes and hematoma expansion. Thus, IS is a relevant radiological finding with potential to support early risk stratification and optimize patient management and treatment selection.
Generally, recent reports on the side effects of estrogen therapy for prostatic cancer have concerned mortality statistics, relatively little attention having been paid to the quality of life of individual patients. We herein propose an assessment of treatment regimens based on the concept of the time during which a patient remains free of tumor progression or serious side effects. A particular regimen has been examined in relation to the hormonal effects of endocrine ablation, and to the dosage and type of estrogen therapy used in 59 men with prostatic cancer. Although no significant difference among treatment methods has emerged in this small group (except for the more frequent occurrence of fluid retention with the stilbestrol dosage, 30 versus 15 mg. per day) and no correlation between the degree of testosterone suppression and length of remission has emerged so far, this method of assessment proved useful and should be applicable widely. It was confirmed that gonadotropin levels remained in the normal range in patients whose testosterone levels were suppressed with chlorotrianisene.
There is sharp disagreement as to what constitutes the proper surgical approach to localized carcinoma of the prostate. We have performed 31 radical perineal prostatectomies in a six-year period with no mortality and minimal morbidity. Thirteen of these patients were understaged preoperatively and had extraprostatic cancer; however, only one has died from his tumor. One patient is incontinent but none has troublesome local symptoms. These patients required an average of 15 postoperative days, none required more than two units of blood, and careful preoperative consultation has minimized the psychologic stress of impotence. These data contrast sharply with the published morbidity and mortality statistics associated with a preliminary staging lymphadenectomy and a definitive radical retropubic prostatectomy. Also, we are convinced that our patients with stage C cancer have been done a real service by removing the prostate gland even though cancer remains in the stumps of the seminal vesicles. Unless the advocates of the staged procedure can demonstrate an improvement in the patients' survival data, we believe the radical perineal prostatectomy remains the procedure of choice for the cure of localized prostatic cancer and we would advocate this operation as an acceptable palliative approach to selected patients with stage C lesions.
The Korean Genome and Epidemiology Study (KoGES) is a large prospective cohort study established to investigate determinants of chronic disease. To evaluate overall and cause-specific mortality, KoGES records were linked to the official Causes of Death Statistics compiled by Statistics Korea. Of 211,562 participants the KoGES population-based cohorts, 211,428 were successfully linked to official mortality data through December 31, 2023, using resident registration numbers. Over a mean follow-up of 14.9 years, the linked cohort had an overall mortality rate of 5.8 deaths per 1,000 person-years; the rate was higher among men than among women (9.6 vs. 3.9 deaths per 1,000 person-years). Malignant neoplasms, heart disease, and cerebrovascular disease were the leading causes of death. As the cohort aged, deaths from causes such as pneumonia increased substantially, a pattern consistent with national mortality statistics. This linked dataset provides a basis for longitudinal analyses of chronic disease progression, survival outcomes, and cause-specific mortality using repeated epidemiologic measurements collected over more than 2 decades of follow-up.
The incidence of coronary heart diseases in France is estimated from three sources of information. Mortality statistics underestimate the number of deaths from coronary heart diseases. An evaluation of this number is proposed, but with a rather important lack of precision; for example, between 10 and 20% of male mortality between age 45 and 64. These French coronary death rates are inferior to those of numerous other European or Anglo-Saxon countries, but are comparable with those of some mediterranean countries. The incidence of coronary heart diseases measured in the Paris Prospective Study is inferior by half to that of the Framingham Study and is also inferior to those of several male populations from the 7 Countries Study, in the same age limits. Three French registers give similar results about the incidence of acute myocardial infarction. This incidence is equal to the lower limit of those measured in 21 foreign registers. These concording data suggest that the incidence of coronary heart diseases is relatively moderate in France. Etiological hypotheses are planned and the interest in a surveillance of French sanitary data is reminded.
The mortality statistics due to tuberculosis drawn up by INSERM for the years 1968-1973 show the rate to be 0.86% in the Paris region. A study based on autopsy results of 7,400 adults gave a rate of 3.3%. The causes of this discrepancy are analysed.
Much discussion has taken place over the recently published mortality statistics for infants and young children. These statistics are critically examined and conclusions reached. Suggestions with regard to the improving of Child Health Services are made.
On the basis of data available from two representative samples of lung cancer deaths in the United States as well as national mortality statistics and other epidemiologic studies, the lung cancer mortality rate has risen substantially between 1914 and 1968 among persons who never smoked cigarettes. For white males the relative increase for ages 35--84 years has been about 15-fold; the relative increase for ages 65--84 years has been about 30-fold. For white females the relative increase for ages 35--84 years has been about sevenfold. Most of the relative increase occurred before 1935 and was probably due to changes in diagnostic criteria. However, increases have continued up to the present for male nonsmokers, who now apparently have an annual age-adjusted lung cancer death rate of about 25 per 100,000 persons between the ages 35--84 years. The rising lung cancer rate among nonsmokers indicates that factors in addition to personal cigarette smoking have had a significant effect on the mortality rate from this disease. In spite of the limited quality of these data, they suggest that a more complete understanding of lung cancer etiology is needed.
THE MAIN OBJECTIVES OF INFLUENZA SURVEILLANCE ARE: to measure the impact of the disease by collection and analysis of epidemiological information on morbidity and mortality, and to anticipate future epidemics and pandemics by the collection and analysis of influenza viruses. The World Health Organization's influenza programme is based on the collaboration of 98 national influenza centres in 70 countries and the 2 WHO Collaborating Centres in Atlanta and London.Epidemiological information may be based on morbidity figures derived from a variety of sources such as returns from physicians or hospitals; mortality statistics or new claims for sickness benefit; school or industrial absenteeism, etc.The laboratory aspects of influenza epidemiology are certainly more uniformly covered than the statistical aspects. Since the advent of the A/Hong Kong/1/68 (H3N2) influenza virus A subtype there have been a number of variants with antigenic "drift" but only three succeeded in causing widespread epidemics: A/England/42/72, A/Port Chalmers/1/73, and A/Victoria/3/75. In 1972, the influenza B virus also showed some antigenic "drift", the new variants being characterized by B/Hong Kong/5/72.Whenever a new variant appears, the degree of protection afforded to the population by the available vaccine is assessed. In the light of these data, WHO publishes annually in the Weekly epidemiological record recommendations formulated by the WHO Collaborating Centres on vaccine composition.
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This paper considers the problem of analyzing disease prevalence data from survival experiments in which there may also be some serial sacrifice. The assumptions needed for "standard" analyses are reviewed in the context of a general model recently proposed by the authors. This model is then reparametrized in log-linear form, and a generalized EM algorithm is utilized to obtain maximum likelihood estimates of the parameters for a broad class of unsaturated models. Tests based on the relative likelihood are proposed to investigate the effects of treatment, time, and the presence of other diseases on the prevalences and lethalities of specific diseases of interest. An example is given, using data from a large experiment to investigate the effects of low-level radiation on laboratory mice. Finally, some possible directions for future research are indicated.