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Background: The 'Deutscher Herzbericht 2016' [German Heart Report] reported a strongly increasing mortality rate from cardiac arrhythmia in Germany from 1990 to 2014. The increase was higher in women than in men and was rated as 'paradoxical' in light of improved diagnostic and therapeutic procedures. The aim of this paper is to explore the mortality data for cardiac arrhythmias in detail and to generate an explanatory approach., Methods: We extracted the number of deaths from cardiac arrhythmia (ICD-10 codes I44-I49) for each sex, 5-year-age group and each federal state for 2000-2014 (www.gbe-bund.de). Crude as well as age-specific and age-standardized (standard: Germany census 2011) mortality rates were calculated., Results: While the crude mortality rates increased considerably between 2000 and 2014 (men: 18 to 26, women: 23 to 38 pro 100,000), the age-standardized mortality rates showed only a small increase (men: 31 to 32, women: 22 to 27 per 100,000 person years). This increase was attributable to an increasing mortality rate from atrial fibrillation and flutter (ICD-10: I48) in men and women aged 80 years and older. In younger age groups and in other subgroups of cardiac arrhythmia, no relevant increases were seen., Conclusion: The increase of mortality rates from cardiac arrhythmia as reported in 'Deutscher Herzbericht 2016' is largely attributable to the demographic changes in the German population. After age-standardization, there still remains an increase in the mortality rates, but this is smaller. From an epidemiologic perspective, it is a common problem in the interpretation involving crude mortality data. Moreover, the validity of mortality rates for cardiac arrhythmia is limited due to several reasons., Competing Interests: Andreas Stang berät die Herausgeber bei der Erstellung des ‚Deutscher Herzbericht‛., (© Georg Thieme Verlag KG Stuttgart · New York.)

Purpose: The complaints of patients suffering from pneumoconiosis and the decrease in cardio-respiratory function tests are related to the major complications, emphysema or bronchitis, resp. to a lesser degree the complaints are directly influenced by the silicotic process itself. Up to now, no large study has analysed the correlation of different types and severity of emphysema with the ILO-classification of pneumoconiosis in miners., Material and Methods: In 104 miners the severity of pneumoconiosis was classified by ILO. By HR-CT the type and severity of emphysema was analysed using a 4-point-scale. The correlation of emphysema with the ILO-classification was tested with Pearson-correlation., Results: The centrolobular emphysema was the dominant type with 59 %, but there was no dependence on the severity of pneumoconiosis. Only the paracicatricial emphysema had a significant correlation (p < 0.05) with the degree of large opacities. On the other hand, the paracicatricial emphysema was only detected in 32 %; under quantitative aspects it was seen to be less common than the centrolobular, the parapleural and the paraseptal emphysema (46 %). There was no significant correlation with the size and distribution of the small opacities and the different types of emphysema., Conclusions: Only the large opacities had a significant correlation with the appearance of paracicatricial emphysema. The other types of emphysema, especially, the dominant centrolobular type had no obvious association with pneumoconiosis. The multifactoral genesis of emphysema has to be taken into account.

Age-standardised mortality rates are often used in epidemiologic studies to describe the dimension of social inequalities in mortality. This, however, conceals any age-dependence of social inequality. In an ecologic study, all causes and cause-specific mortality of all citizens of Bochum, FRG, who died 1988-1990, were evaluated using 13.171 death certificates. Data was aggregated on census tract level. The social status of a census tract was determined using 6 variables from the census 1987 describing the socio-economic situation in each census tract. Census tracts were grouped into quintiles according to their social status. Age and sex-specific mortality rates as well as rate ratios, using the quintile with the highest social status as reference, were calculated. Results for men (n = 6.288) indicate that social inequality is age-dependent for total mortality. Social differentials are especially marked for the age groups 35-64 years. For age group < 35 years and > 84 years no social differentiation in mortality is visible. Similar patterns are found with mortality from cardiovascular diseases (ICD-9: 390-459) and cancer (ICD-9: 140-208). Mortality from diseases related to health behaviour such as lung cancer or diseases associated with high alcohol intake are characterised by social inequalities above average in the middle age groups. For total mortality in women (n = 6.883) large social differentials are found for age groups 25-34 years and 45-54 years. Efforts to reduce social inequality on community level should especially be aimed at adolescents and young adults living in underprivileged areas.