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. Deaths occurring in the context of acquired haemophilia (AH) may be related to inter-connected causes and mechanisms including bleeding, specific or older patient co-morbidities or iatrogenic complications. However, their magnitude remains unknown. This study aimed to determine the respective weight and frequency of the various causes of death in AH. Multiple-cause analysis based on death certificates data is used in this purpose. Over a 10-year period (2000-2009), 121 deaths with AH as a cause were registered in France. All the deaths were of adults (extremes: 47 and 99 years; mean age: 80.7 years). The average number of causes per death certificate was 4.7. AH was the underlying cause of death (UCD) in 69.4% of the cases, and was more frequent in the older subjects. In contrast, before age of 75 years, AH was more often a contributing cause of death. No postpartum or obvious thromboembolism-related deaths were registered. Haemorrhagic shock was the most frequent direct cause of death (DCD), followed by infectious events, cardiac dysfunction, metabolic and nutritional disorders with muscle wasting and decubitus complications, and cancers (52.9%, 26.4%, 7.5%, 5.8% and 4.1%, respectively). However, when AH was not reported as an UCD, infections become the first DCD (32.4%) followed by bleeding events (16.2%). Best prophylactic and curative strategies for infections are particularly required to improve the prognosis in AH. Moreover, as several of its DCD correspond also to steroids side effects, best tolerated immunosuppressant regimen with steroid-sparing agents adjoining are particularly awaited in AH population. [ABSTRACT FROM AUTHOR]

Objectives: From August 1st to 20th, 2003, the mean maximum temperature in France exceeded the seasonal norm by 11–12°C on nine consecutive days. A major increase in mortality was then observed, which main epidemiological features are described herein. Methods: The number of deaths observed from August to November 2003 in France was compared to those expected on the basis of the mortality rates observed from 2000 to 2002 and the 2003 population estimates. Results: From August 1st to 20th, 2003, 15,000 excess deaths were observed. From 35 years age, the excess mortality was marked and increased with age. It was 15% higher in women than in men of comparable age as of age 45 years. Excess mortality at home and in retirement institutions was greater than that in hospitals. The mortality of widowed, single and divorced subjects was greater than that of married people. Deaths directly related to heat, heatstroke, hyperthermia and dehydration increased massively. Cardiovascular diseases, ill-defined morbid disorders, respiratory diseases and nervous system diseases also markedly contributed to the excess mortality. The geographic variations in mortality showed a clear age-dependent relationship with the number of very hot days. No harvesting effect was observed. Conclusions: Heat waves must be considered as a threat to European populations living in climates that are currently temperate. While the elderly and people living alone are particularly vulnerable to heat waves, no segment of the population may be considered protected from the risks associated with heat waves. [ABSTRACT FROM AUTHOR]

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Background Little representative information exists on the frequency of human immunodeficiency virus (HlV)-related diseases among the overall AIDS population. The objective of this research Is to assess the nature, frequency and characteristics of these diseases among AIDS patients during their last year of life and to analyse these frequencies according to the mode of transmission and other socio-demographic and medical characteristics. Background Little representative information exists on the frequency of human immunodeficiency virus (HlV)-related diseases among the overall AIDS population. The objective of this research Is to assess the nature, frequency and characteristics of these diseases among AIDS patients during their last year of life and to analyse these frequencies according to the mode of transmission and other socio-demographic and medical characteristics. Methods To obtain comprehensive data, we conducted an investigation based on retrospective collection of clinical Information on a representative sample (1203 deaths) of all AIDS deaths that occurred in France during 1992. Results The frequency of the diseases was markedly higher than the one described In the AIDS surveillance registers and varied between homosexuals and intravenous drug users (IVDU). After controlling for other variables (age, CD4 counts, survival times) by means of logistic regression, homosexuality remained a significant explaining factor for Kaposi's sarcoma, cytomegalovirus Infections, herpes simplex and cryptosporidiosis. In contrast, HIV encephalopathy, hepatitis, mental disorders, invasive candidlasis and cachexia were more frequent in male IVDU. Few differences were observed by sex. Conclusions Several factors may explain the differences: variation in exposure to infectious agents, general health status, use of medical care and direct influence of the mode of HIV transmission. These data are of particular value for medical services in planning the magnitude of health care needs among the AIDS population overall, for clinicians and researchers for advancing the understanding of the natural history of AIDS and in the definition of prophylactic strategies against opportunistic infections. [ABSTRACT FROM PUBLISHER]

Objective To measure and characterise deaths due to home and leisure injuries in France (63 million inhabitants) from 2000 to 2006. Method The data come from death certificates, collected exhaustively. Causes of death are coded by using the external causes of injury codes of the International Classification of Diseases, 10th revision. The results are expressed in numbers, crude death rates, and age-adjusted death rates. Results In 2006, 18 549 deaths due to home and leisure injuries occurred in France, that is, an age-adjusted death rate of 25.2/100 000. This death rate was 1.7 times higher for males than that for females: 32.2/100 000 versus 19.4/100 000. They are largely different with age: from a minimum of 1.3 among children aged 5–14 (99 deaths), to a maximum of 584 up to 85 years (7327 deaths). Three fourths of home and leisure injuries deaths occurred up to 65 years (13 950 deaths), among which 57% were due to falls. The leading causes of deaths were: falls, 11.9/100 000; suffocations, 3.8; drowning, 1.6; poisoning, 1.5; fire accidents, 0.7. Between 2000–2002 and 2004–2006, the age-adjusted death rate decreased by 11%. This decrease was the highest for people under 15 years of age, 24%. Up to 65 years, the decrease was 13% (minus 1358 deaths). Conclusion In spite of the decrease between 2000 and 2006, home and leisure injuries remain a significant cause of death in France. Most of these deaths could be avoided with adapted prevention and regulation measures. [ABSTRACT FROM PUBLISHER]