193 results on '"Mortality -- Prevention"'
Search Results
2. Defibrillator implantation early after myocardial infarction
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Steinbeck, Gerhard, Andresen, Dietrich, Seidi, Karlheinz, Brachmann, Johannes, Hoffmann, Ellen, Wojciechowski, Dariusz, Kornacewicz-Jach, Zdzislawa, Sredniawa, Lupkovics, Hofgartner, Franz, Lubinski, Andrzej, Rosenqvist, Marten, Habets, Alphonsus, Wegscheider, Karl, and Senges, Jochen
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Heart attack -- Risk factors ,Implantable cardioverter-defibrillators -- Usage ,Mortality -- United States ,Mortality -- Prevention - Abstract
A study was conducted to evaluate the efficacy of the early use of an implantable cardioverter-defibrillator (ICD) in preventing mortality following myocardial infarction. Results indicated that early use of ICD was not effective in reducing overall mortality, and also placed them at an increased risk.
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- 2009
3. sGC[[alpha].sub.1][[beta].sub.1] attenuates cardiac dysfunction and mortality in murine inflammatory shock models
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Buys, Emmanuel S., Cauwels, Anje, Raher, Michael J., Passeri, Jonathan J., Hobai, Ion, Cawley, Sharon M., Rauwerdink, Kristen M., Thibault, Helene, Sips, Patrick Y., Thoonen, Robrecht, Scherrer-Crosbie, Marielle, Ichinose, Fumito, Brouckaert, Peter, and Bloch, Kenneth D.
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Cyclic guanylic acid -- Physiological aspects ,Cyclic guanylic acid -- Research ,Guanylate cyclase -- Physiological aspects ,Guanylate cyclase -- Research ,Heart diseases -- Risk factors ,Heart diseases -- Prevention ,Heart diseases -- Research ,Mortality -- Prevention ,Mortality -- Research ,Biological sciences - Abstract
Altered cGMP signaling has been implicated in myocardial depression, morbidity, and mortality associated with sepsis. Previous studies, using inhibitors of soluble guanylate cyclase (sGC), suggested that cGMP generated by sGC contributed to the cardiac dysfunction and mortality associated with sepsis. We used sGC[[alpha].sub.1]-deficient (sGC[[alpha].sub.1.sup.-/-]) mice to unequivocally determine the role of sGC[[alpha].sub.1][[beta].sub.1] in the development of cardiac dysfunction and death associated with two models of inflammatory shock: endotoxin- and TNF-induced shock. At baseline, echocardiographic assessment and invasive hemodynamic measurements of left ventricular (LV) dimensions and function did not differ between wild-type (WT) mice and sGC[[alpha].sub.1.sup.-/-] mice on the C57BL/6 background (sGC[[alpha].sub.1.sup.-/-B6] mice). At 14 h after endotoxin challenge, cardiac dysfunction was more pronounced in sGC[[alpha].sub.1.sup.-/-B6] than WT mice, as assessed using echocardiographic and hemodynamic indexes of LV function. Similarly, [Ca.sup.2+] handling and cell shortening were impaired to a greater extent in cardiomyocytes isolated from sGC[[alpha].sub.1.sup.-/-B6] than WT mice after endotoxin challenge. Importantly, morbidity and mortality associated with inflammatory shock induced by endotoxin or TNF were increased in sGC[[alpha].sub.1.sup.-/-B6] compared with WT mice. Together, these findings suggest that cGMP generated by sGC[[alpha].sub.1][[beta].sub.1] protects against cardiac dysfunction and mortality in murine inflammatory shock models. soluble guanylate cyclase; left ventricular function; sepsis; mice; nitric oxide
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- 2009
4. Intracerebral haemorrhage
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Qureshi, Adnan I., Mendelow, A David, and Hanley, Daniel F.
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Intracerebral hemorrhage -- Care and treatment ,Intracerebral hemorrhage -- Complications and side effects ,Intracerebral hemorrhage -- Patient outcomes ,Intracerebral hemorrhage -- Research ,Mortality -- United Kingdom ,Mortality -- United States ,Mortality -- Risk factors ,Mortality -- Prevention ,Mortality -- Research - Published
- 2009
5. Rosuvastatin and cardiovascular events in patients undergoing hemodialysis
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Fellstrom, Bengt C., Holdaas, Hallvard, Jardine, Alan G., Schmieder, Roland E., Bannister, Kym, Beutler, Jaap, Chae, Dong-Wan, Cobbe, Stuart M., Gronhagen-Riska, Carola, De Lima, Jose J., Lins, Robert, Chevaile, Alejandro, Mayer, Gert, Parving, Hans-Henrik, Remuzzi, Giuseppe, Samuelsson, Ola, McMahon, Alan W., Sonkodi, Sandor, Tsakiris, Dimitrios, Tesar, Vladimir, Todorov, Vasil, Suleymanlar, Gultekin, Wiecek, Andrzej, Gottlow, Mattis, Johnsson, Eva, Zannad, Faiez, and Wuthrich, Rudolf P.
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Rosuvastatin -- Usage ,Rosuvastatin -- Health aspects ,Cardiovascular diseases -- Care and treatment ,Mortality -- Prevention ,Hemodialysis -- Usage - Abstract
The study aims to evaluate the efficacy of the use of statins like rosuvastatin in reducing cardiovascular events in patients undergoing hemodialysis. The results indicate that rosuvastatin did reduce the LDL cholesterol level among such patients but did not help prevent mortality from cardiovascular causes.
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- 2009
6. Mortality results from a randomized prostrate-cancer screening trial
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Andriole, Gerald L., Grubb, Robert L. III, Buys, Saundra S., Chia, Davi, Church, Timothy R., Fouad Mona N., Gelmann, Edward P., Kvale, Paul A., Reding, Douglas J., Weissfeld, Joel L., Yokochi, Lance A., O'Brien, Barbara, Clapp, Jonathan D., Rathmell, Joshua M., Crawford, E. David, Riley,Thomas L., Kramer, Barnett S., Izmirlian, Grant, Hayes, Richard B., Miller, Anthony B., Pinsky, Paul F., Prorok, Philip C., Gohagan, John K., and Berg, Christine D.
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Market trend/market analysis ,Mortality -- Prevention ,Mortality -- Forecasts and trends ,Cancer -- Diagnosis ,Cancer -- Usage ,Cancer -- Health aspects - Abstract
A study was conducted to investigate the efficacy of screening for prostrate cancer in reducing the incidence of mortality from prostrate cancer. Results indicate that screening was associated with no reduction in death during the first 7 years and the rate was not very different with those not having undergone screening.
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- 2009
7. Screening and prostrate-cancer mortality in a randomized European study
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Schroder, Fritz H., Roobol, Monique J., Tammela , Teuvo L.J., Ciatto, Stefano, Hugosson, Jonas, Nelen, Vera, Kwiatkowski, Maciej, Lujan, Marcos, Lilja, Hans, Zappa, Marco, Denis, Louis J., Recker, Franz, Bereguer, Antonio, Maattanen, Liisa, Bangma, Chris H., Aus, Gunnar, Villers, Arnauld, Rebillard, Xavier, van der Kwast, Theodorus, Blinjenberg, Bert G., Moss, Sue M., de Koning, Harry J., and Auvinen, Anssi
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Mortality -- Control ,Mortality -- Prevention ,Cancer -- Prevention ,Cancer -- Risk factors ,Cancer -- Diagnosis ,Cancer -- Usage ,Cancer -- Health aspects - Abstract
The European randomized study attempts to investigate the efficacy of screening with prostrate-specific-antigen (PSA) on reducing the rate of mortality from prostrate cancer. The results indicate that PSA-based screening was effective in reducing the incidence of mortality by 20%, however, had a high risk of over diagnosis.
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- 2009
8. Intensive versus conventional glucose control in critically ill patients
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Critically ill -- Risk factors ,Critically ill -- Care and treatment ,Mortality -- Causes of ,Mortality -- Prevention ,Glucose tolerance tests -- Usage ,Glucose tolerance tests -- Health aspects - Abstract
A study was conducted to investigate whether intensive glucose control helps reduce the incidence of mortality among critically ill patients. Results indicated that intensive glucose tolerance increased mortality among adults in the ICU, and also that a glucose rate of 180mg per deciliter or lower resulted in reduced risk of mortality as compared to a rate of 80 to 108mg per deciliter.
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- 2009
9. Pre-referral rectal artesunate to prevent death and disability in severe malaria: a placebo-controlled trial
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Antimalarials -- Dosage and administration ,Malaria -- Drug therapy ,Mortality -- Switzerland ,Mortality -- Prevention - Published
- 2009
10. Differences in predicted catch composition between two widely used catch equation formulations
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Branch, Trevor A.
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Mortality -- Canada ,Mortality -- Prevention ,Fishing -- Methods ,Fishing -- Environmental aspects ,Earth sciences - Abstract
Fishing gear selectivity varies among different types of fish (e.g., species, age, sex, or length groups), but their relative catch composition also depends on the fishing process. The continuous (Baranov) formulation assumes that fishing mortality and natural mortality occur together during the fishing season and that there are multiple encounters between fish and fishing gear. For this formulation, predicted catch composition depends on fishing mortality, and at high fishing mortality levels the entire population can be caught provided the selectivity is nonzero for all age groups. In contrast, the discrete formulation assumes that fishing mortality occurs separately from natural mortality and that fish encounter at most only one set of fishing gear. The discrete formulation is easier to compute, but the predicted catch composition is independent of fishing mortality, and some of the population remains unexploitable. The correct choice of equations depends on the particular fishery and fishing mortality levels; at low fishing mortality levels the predictions differ little, but at high fishing mortality levels where multiple gear encounters could occur, the continuous formulation is preferable. La selectivite des engins de peche varie en fonction des divers types de poissons (d'apres l'espece, l'age, le sexe ou la classe de taille), mais la composition relative de la recolte depend aussi du processus de peche. La formulation continue (de Baranov) presuppose que la mortalite due a la peche et la mortalite naturelle vont de pair durant la saison de la peche et qu'il y a des rencontres multiples entre les poissons et les engins de peche. Dans cette formulation, la composition de la capture predite depend de la mortalite due a la peche et, aux taux eleves de mortalite due a la peche, toute lymphadenopathy population peut etre capturee a condition que la selectivite ne soit egale a zero pour aucune des classes d'age. En contraste, la formulation discontinue presuppose que la mortalite due a la peche peut survenir separement de la mortalite naturelle et que les poissons rencontrent au plus une serie d'engins de peche. La formulation discontinue est plus facile a calculer, mais la composition de la capture predite est independante de la mortalite due a la peche et une partie de la population reste a l'abri de l'exploitation. Le bon choix d'equations depend de la peche en question et de l'importance de la mortalite due a la peche; aux faibles taux de mortalite due a la peche, il y a peu de difference entre les predictions, mais aux forts taux de mortalite due a la peche lorsqu'il peut se faire des rencontres multiples d'engins de peche, la formulation continue est preferable. [Traduit par la Redaction], Introduction All types of fishing methods are selective to some extent (for species, sex, length, and age), and fisheries stock assessments must account for selectivity to accurately predict the effects [...]
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- 2009
11. Mortality, death interval, survivals, and herd factors for death in gilts and sows in commercial breeding herds
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Sasaki, Y. and Koketsu, Y.
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Sows -- Management ,Sows -- Health aspects ,Mortality -- United States ,Mortality -- Risk factors ,Mortality -- Prevention ,Mortality -- Forecasts and trends ,Swine -- Breeding ,Swine -- Research ,Company business management ,Market trend/market analysis ,Zoology and wildlife conservation - Abstract
The objectives of this study were to measure death intervals and survival, to determine mortality rate and mortality risks, and to investigate the association of herd factors with mortality risk in individual female pigs. This study was conducted by obtaining female data with lifetime records of 65,621 females born between 1999 and 2002, and herd data with mean measurements of 5 yr from 2000 to 2004 in 105 herds. Annualized mortality rate was calculated as the number of dead females divided by the sum of life days in all gilts and sows, multiplied by 365 d. Mortality risk was calculated as the number of dead females divided by the number of surviving females at farrowing in each parity. Death interval in gilts was defined as the number of days from birth to death, and that in sows was the number of days from the last farrowing to death. A Cox proportional hazards model was used to obtain the survival probability by parity. Logistic regression analyses were used to investigate the association of herd factors with mortality risk in individual females in each parity. Of the 65,621 females, the mortality risk was 9.9%, and the annualized mortality rate was 3.9%. Of the 6,501 dead females, death intervals in gilts and sows were 294.7 and 55.0 d, respectively. In gilts, survival probability rapidly decreased at 33 and 50 wk of age, around the first mating and the first parturition. In contrast, survival probability in sows decreased at wk 1 after farrowing, and rapidly decreased at wk 20 and 21 after farrowing in all parity groups that were around a subsequent peripartum period. The percentages of death on wk 0, 1, and 2 after the last farrowing in all the dead sows were 6.5, 23.5, and 10.1%, respectively. Approximately 10% of deaths also occurred from wk 20 to 21 after the last farrowing. Death interval in parity [greater than or equal to] 5 was the shortest among all parity groups (49.2 d; P < 0.05). Mortality risks in parities 0 and 1 were 1.44 and 1.83%, respectively. As parity increased from 2 to [greater than or equal to] 5, mortality risk increased from 1.63 to 5.90%. Herd factors (greater herd mortality, less herd productivity, and smaller herd size) were associated with greater mortality risk in individual females in parity 0 to [greater than or equal to] 5, parity 4 and [greater than or equal to] 5, and parity 1 to 4, respectively (P < 0.05). In conclusion, females in peripartum periods, gilts, and high-parity sows are at a greater risk of dying. Increased care should be implemented for prefarrowing females and early-lactating SOWS. Key words: death, management, mortality, sow, survival, well-being
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- 2008
12. Self-rated activity levels and longevity: evidence from a 20 year longitudinal study
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Mullee, Mark A., Coleman, Peter G., Briggs, Roger S.J., Stevenson, James E., and Turnbull, Joanne C.
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Longevity -- Research ,Mortality -- United Kingdom ,Mortality -- Prevention ,Mortality -- Risk factors ,Self-perception -- Health aspects ,Activities of daily living -- Health aspects ,Activities of daily living -- Surveys ,Health ,Seniors - Abstract
The study reports on factors predicting the longevity of 328 people over the age of 65 drawn from an English city and followed over 20 years. Both the reported activities score and the individual's comparative evaluation of their own level of activity independently reduced the risk of death, even when health and cognitive status were taken into account. The analysis has provided a strong test of the relevance of measures of reported activity and measures of self-perception to longevity. The study confirms the important predictive role of reported activity levels even when detailed health measures are taken into account. But in addition personal perception of one's own relative level of activity, and to a lesser extent subjective assessment of health, also predicted longevity.
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- 2008
13. Self-rated cardiovascular risk and 15-year cardiovascular mortality
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Gramling, Robert, Klein, William, Roberts, Mary, Waring, Molly E., Gramling, David, and Eaton, Charles B.
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Mortality -- United States ,Mortality -- Risk factors ,Mortality -- Prevention ,Mortality -- Research ,Cardiovascular diseases -- Casualties ,Cardiovascular diseases -- Diagnosis ,Cardiovascular diseases -- Research ,Self-evaluation -- Health aspects ,Self-evaluation -- Research ,Health ,Science and technology - Published
- 2008
14. Challenges to improving case management of childhood pneumonia at health facilities in resource-limited settings/ Difficultes pour ameliorer la prise en charge des cas de pneumonie chez l'enfant dans les establissements de soins des pays a ressources limitees/Retos para mejorar el manejo de los casos de neumonia en la ninez en los centros sanitarios en los entornos con recursos limitados
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Graham, Stephen M., English, Mike, Hazir, Tabish, Enarson, Penny, and Duke, Trevor
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Mortality -- Kenya ,Mortality -- France ,Mortality -- Risk factors ,Mortality -- Prevention ,Pneumonia in children -- Causes of ,Pneumonia in children -- Care and treatment ,Pneumonia in children -- Prevention - Abstract
Effective case management is an important strategy to reduce pneumonia-related morbidity and mortality in children. Guidelines based on sound evidence are avallable but are used variably. This review outlines current guidelines for childhood pneumonia management in the setting where most child pneumonia deaths occur and identifies challenges for improved management in a variety of settings and different "at-risk" groups. These include appropriate choice of antibiotic, clinical overlap with other conditions, prompt and appropriate referral for inpatient care, and management of treatment failure. Management of neonates, and of HIV-infected or severely malnourished children is more complicated. The influence of co-morbidities on pneumonia outcome means that pneumonia case management must be integrated within strategies to improve overall paediatric care. The greatest potential for reducing pneumonia-related deaths in health facilities is wider implementation of the current guidelines built around a few core activities: training, antibiotics and oxygen. This requires investment in human resources and in equipment for the optimal management of hypoxaemia. It is important to provide data from a variety of epidemiological settings for formal cost-effectiveness analyses. Improvements in the quality of case management of pneumonia can be a vehicle for overall improvements in child healthcare practices. La prise en charge efficace des cas joue un role important dans la reduction de la morbidite et de la mortalite dues a la pneumonie. Des recommandations reposant sur des elements factuels solides sont disponibles, mais sont appliquees diversement. Le present article expose dans leurs grandes lignes les recommandations actuelles pour la prise en charge de la pneumonie chez l'enfant dans les pays ou interviennent la plupart des deces d'enfants par pneumonie et identifie les difficultes pour ameliorer cette prise en charge dans divers pays et chez differents groupes << a risque >>. Ces recommandations concernent notamment le choix d'un antibiotique adapte, le recouvrement clinique avec d'autres pathologies, l'orientation rapide et appropriee vers des soins hospitaliers et la prise en charge des echecs therapeutiques. La prise en charge des nouveau-nes et des enfants infectes par le VIH ou gravement denutris est plus complexe. L'influence des comorbidites sur l'issue de la pneumonie implique que la prise en charge de cette maladie doit s'integrer dans des strategies d'amelioration des soins pediatriques en general. Le plus fort potentiel de reduction de la mortalite par pneumonie dans les etablissements de soins reside dans l'elargissement de l'application des recommandations actuelles, elaborees autour de quelques interventions centrales : formation, antibiotiques et oxygene. Cet elargissement necessite des investissements en ressources humaines et en equipements pour une prise en charge optimale de l'hypoxemie. Il est important de fournir des donnees provenant de divers contextes epidemiologiques pour etablir des analyses cout/efficacite formelles. L'amelioration en termes de qualite de la prise en charge de la pneumonie pourrait servir de moteur a des ameliorations globales des pratiques de soins pediatriques. Un manejo de casos eficaz constituye una estrategia importante para reducir la morbilidad y la mortalidad por neumonia en la ninez. Las directrices basadas en la evidencia de que se dispone se utilizan en diversa medida. En el presente analisis se describen las directrices actuales para el tratamiento de la neumonia en la ninez en las circunstancias que rodean la mayoria de las muertes por neumonia en la infancia y se senalan les retos que deben superarse para mejorar el tratamiento en diversos contextos y diferentes grupos en riesgo. Entre ellos cabe citar la eleccion apropiada del antibiotico, el solapamiento clinico con otras dolencias, la derivacion rapida y apropiada para dispensar atencion hospitalaria, y el manejo de les casos de fracaso terapeutico. El tratamiento de les recien nacidos y de les ninos infectados por el VIH o malnutridos es mis complicado. Dada la influencia de posibles comorbilidades en la evolucion de la neumonia, el tratamiento de les casos de esa enfermedad debe integrarse en estrategias orientadas a mejorar la atencion pediatrica en general. Las mayores posibilidades de reducir las defunciones relacionadas con la neumonia en les centros de salud son las que se derivan de una mis amplia aplicacion de las directrices actuales centradas en unas cuantas actividades basicas: capacitacion, antibioticos y oxigeno. Eso exige invertir en recursos humanos y en equipo para manejar optimamente la hipoxemia. Es importante aportar datos procedentes de diverses entornos epidemiologicos para poder realizar analisis formales de costo-eficacia. Las mejoras de la calidad del tratamiento de casos de neumonia pueden brindar la ocasion para introducir otras mejoras mas generales en las practicas de salud infantil. [TEXT NOT REPRODUCIBLE IN ASCII], Introduction Pneumonia is the leading cause of death in children worldwide and the great majority of these deaths occur in resource-limited settings. (1) WHO developed a case-management strategy in the [...]
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- 2008
15. Delayed care seeking for fatal pneumonia in children aged under five years in Uganda: a case-series study/ Recours aux soins trop tardif pour des cas de pneumonie mortelle touchant des enfants moins de cinq ans en Ouganda : etude cas-temoins/ Retraso en las busqueda de atencion para casos de neumonia mortal en menores de cinco anos en Uganda: estudio de serie de casos
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Kallander, Karin, Hildenwall, Helena, Waiswa, Peter, Galiwango, Edward, Peterson, Stefan, and Pariyo, George
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Antibiotics -- Dosage and administration ,Mortality -- Sweden ,Mortality -- Risk factors ,Mortality -- Prevention ,Pneumonia in children -- Causes of ,Pneumonia in children -- Care and treatment ,Pneumonia in children -- Casualties - Abstract
Objective To review individual case histories of children who had died of pneumonia in rural Uganda and to investigate why these children did not survive. Methods This case-series study was done in the Iganga/Mayuge demographic surveillance site, Uganda, where 67 000 people were visited once every 3 months for population-based data and vital events. Children aged 1-59 months from November 2005 to August 2007 were included. Verbal and social autopsies were done to determine likely cause of death and care-seeking actions. Findings Cause of death was assigned for 164 children, 27% with pneumonia. Of the pneumonia deaths, half occurred in hospital and one-third at home. Median duration of pneumonia illness was 7 days, and median time taken to seek care outside the home was 2 days. Most first received drugs at home: 52% antimalarials and 27% antibiotics. Most were taken for care outside the home, 36% of whom first went to public hospitals. One-third of those reaching the district hospital were referred to the regional hospital, and 19% reportedly improved after hospital treatment. The median treatment cost for a child with fatal pneumonia was US$ 5.8. Conclusion There was mistreatment with antimalarials, delays in seeking care and likely low quality of care for children with fatal pneumonia. To improve access to and quality of care, the feasibility and effect on mortality of training community health workers and drug vendors in pneumonia and malaria management with prepacked drugs should be tested. Resume Objectif Etudier les histoires cliniques individuelles d'enfants decedes d'une pneumonie dans la partie rurale de l'Ouganda et determiner pourquoi ces enfants n'ont pas survecu. Methodes Cette etude de serie de cas a ete realisee sur le site de surveillance demographique d'lganga/Mayuge, en Ouganda, ou 67 000 personnes sont visitees une fois tous les trimestres pour recueillir des donnees en population et des faits d'etat-civil. Les enfants ages de 1 a 59 mois entre novembre 2005 et aout 2007 ont ete inclus dans I'etude. Des autopsies verbales et sociales ont ete pratiquees pour determiner la cause probable de la mort et les tentatives de recours aux soins. Resultats Une cause du deces a ete affectee a 164 enfants, soit une pneumonie pour 27 % d'entre eux. Parmi les deces par pneumonie, la moitie se sont produits a I'hopital et un tiers a domicile. La duree mediane de la pneumonie etait de 7 jours et le delai median pour solliciter des soins a I'exterieur du domicile etait de 2 jours. La majorite des malades ont d'abord recu des medicaments a domicile : 52 % des antipaludiques et 27 % des antibiotiques. La plupart des cas ont etc admis dans un etablissement pour recevoir des soins, dont 36 % en premier lieu dans un hopital public. Un tiers des cas qui se sont presentes a I'hopital de district ont etc orientes vers I'hopital regional et 19 % ont ete signales comme ameliores apres le traitement hospitalier. Le cout de traitement median d'une pneumonie mortelle chez un enfant etait de US $ 5,8. Conclusion Il y a eu des traitements errones par des antipaludiques, des retards dans le recours aux soins et probablement des soins de qualite mediocre pour les enfants decedes d'une pneumonie modelle. Pour ameliorer I'acces aux soins et la qualite de ces prestations, il faudrait tester la faisabilite et les effets sur la mortalite de la formation des agents de sante communautaires et des vendeurs de medicaments a la prise en charge du paludisme et de la pneumonie avec des medicaments preconditionnes. Objetivo Examinar las historias clinicas de ninos que habian muerto de neumonia en la Uganda rural e investigar las razones de que no sobrevivieran. Metodos Este estudio de serie de casos se Ilevo a cabo en el centro de vigilancia demografica de Iganga/Mayuge, Uganda, donde se visita una vez cada tres meses a unas 67 000 personas para registrar datos poblacionales y eventos vitales. El estudio abarco a una serie de ninos de 1 a 59 meses fallecidos entre noviembre de 2005 y agosto de 2007. Se Ilevaron a cabo autopsias verbales y sociales para determinar la causa probable de defuncion y las medidas de busqueda de atencion. Resultados Se determino la causa de defuncion de 164 ninos, el 27% de ellos con neumonia. De todas las muertes por esta enfermedad, la mitad se produjeron en el hospital y una tercera parte en el hogar. La duracion mediana de la neumonia fue de 7 dias, y el tiempo mediano transcurrido hasta buscar atencion fuera del hogar fue de 2 dias. Los primeros medicamentos recibidos en el hogar fueron en su mayoria antimalaricos, 52%, y antibioticos, 27%. La mayoria fueron trasladados a otros lugares para recibir atencion, y entre ellos el 36% fueron ingresados de entrada en hospitales publicos. Una tercera parte de los que Ilegaron al hospital de distrito fueron derivados al hospital regional, y un 19% mejoraron al parecer despues del tratamiento hospitalario. El costo mediano del tratamiento de un nino con neumonia mortal fue de US$ 5,8. Conclusion Los ninos con neumonia mortal fueron tratados incorrectamente con antimalaricos, sufrieron retrasos en la busqueda de atencion, y recibieron probablemente una atencion de mala calidad. A fin de mejorar el acceso a la atencion y la calidad de la misma, deberian analizarse la viabilidad y el efecto en la mortalidad de la formacion de los agentes de salud comunitarios y los vendedores de medicamentos en materia de tratamiento de la neumonia y la malaria. [TEXT NOT REPRODUCIBLE IN ASCII], Background Reduction of childhood mortality due to acute respiratory infections is a worldwide health priority. (1) More than 2 million children die annually of acute respiratory infections, most often pneumonia. [...]
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- 2008
16. Tuberculosis in Africa - combating an HIV-driven crisis
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Chaisson, Richard E. and Martinson, Neil A.
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Company distribution practices ,Epidemics -- Reports ,Mortality -- Prevention ,Tuberculosis -- Prevention ,Tuberculosis -- Distribution ,Africa -- Health policy - Abstract
The growing rate of the tuberculosis epidemic in Africa is attributed to several factors and the most common is the HIV epidemic. Africa, to combat the mortality rate, desperately needs funding, facilities, personnel, drug supplies and laboratory capacity, as well as adopting new strategies for improving disease-control outcomes.
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- 2008
17. Plasma apolipoprotein CI protects against mortality from infection in old age
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Berbee, Jimmy F.P., Mooijaart, Simon P., de Craen, Anton J.M., Havekes, Louis M., van Heemst, Diana, Rensen, Patrick C.N., and Westendorp, Rudi G.J.
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Apolipoproteins -- Properties ,Apolipoproteins -- Influence ,Blood proteins -- Properties ,Blood proteins -- Influence ,Infection -- Prevention ,Mortality -- United States ,Mortality -- Prevention ,Aged -- Health aspects ,Aged -- Physiological aspects ,Health ,Seniors - Abstract
The high-density lipoprotein (HDL) constituent apolipoprotein CI (apoCI) protects mice against mortality in bacterial sepsis. We assessed whether high plasma apoCI levels protect against mortality from infection in humans. We determined plasma levels of apoCI, lipids, and C-reactive protein in 85-year-old participants of the prospective population-based Leiden 85-Plus Study (n 561). Participants were followed for specific causes of death. High apoCI levels were associated with 40% reduced risk of mortality from infection (hazard ratio [HR], 0.60; 95% confidence interval [CI], 0.42-0.86; p = .005) for every increase of 1 standard deviation in apoCI level. A similar association was observed for high HDL cholesterol (HR, 0.65; 95% CI, 0.46-).94; p = .022), but not for LDL cholesterol, triglycerides, and C-reactive protein levels. The association of apoCI was independent of HDL cholesterol, as multivariate analysis did not alter the association for apoCI (HR, 0.63; 95% CI, 0.44-0.90; p = .013), whereas for HDL cholesterol significance was lost. We conclude that high apoCI levels are associated with reduced mortality from infection, in line with experimental evidence in rodents. Key Words: Apolipoprotein CI--High-density lipoprotein--Infection.
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- 2008
18. Vaccination greatly reduces disease, disability, death and inequity worldwide/La vaccination reduit fortement la morbidite, les incapacites, la mortalite et les inegalites dans l'ensemble du monde/La vacunacion reduce considerablemente la morbilidad, las discapacidades, la mortalidad y las inequidades en todo el mundo
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Andre, F.E., Booy, R., Bock, H.L., Clemens, J., Datta, S.K., John, T.J., Lee, B.W., Lolekha, S., Peltola, H., Ruff, T.A., Santosham, M., and Schmitt, H.J.
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Vaccination -- Analysis ,Vaccination -- Usage ,Mortality -- Prevention ,Morbidity -- Prevention - Abstract
In low-income countries, infectious diseases still account for a large proportion of deaths, highlighting health inequities largely caused by economic differences. Vaccination can cut health-care costs and reduce these inequities. Disease control, elimination or eradication can save billions of US dollars for communities and countries. Vaccines have lowered the incidence of hepatocellular carcinoma and will control cervical cancer. Travellers can be protected against "exotic" diseases by appropriate vaccination. Vaccines are considered indispensable against bioterrorism. They can combat resistance to antibiotics in some pathogens. Noncommunicable diseases, such as ischaemic heart disease, could also be reduced by influenza vaccination. Immunization programmes have improved the primary care infrastructure in developing countries, lowered mortality in childhood and empowered women to better plan their families, with consequent health, social and economic benefits. Vaccination helps economic growth everywhere, because of lower morbidity and mortality. The annual return on investment in vaccination has been calculated to be between 12% and 18%. Vaccination leads to increased life expectancy. Long healthy lives are now recognized as a prerequisite for wealth, and wealth promotes health. Vaccines are thus efficient tools to reduce disparities in wealth and inequities in health. Dans les pays a faible revenu, les maladies infectieuses representent encore une forte proportion des deces, mettant en lumiere des inegalites sur le plan sanitaire resultant dans une large mesure d'ecarts economiques. La vaccination peut faire baisser les couts des soins de sante et reduire ces inegalites. La lutte contre les maladies, leur elimination ou leur eradication permettent aux communautes et aux pays d'epargner des milliards de doltars des Etats-Unis. Les vaccins ont egalement fait baisser l'incidence du carcinome hepatocellulaire et permettront d'endiguer le cancer du col uterin. Les voyageurs sont proteges contre les maladies << exotiques >> par une vaccination appropriee. Les vaccins sont consideres comme indispensables dans la lutte contre le bioterrorisme, lis peuvent s'opposer au developpement d'une resistance aux antibiotiques pour certains agents pathogenes. La vaccination antigrippale pourrait aussi faire reculer des maladies non transmissibles, comme les cardiopathies ischemiques. Les programmes de vaccination ont permis d'ameliorer l'infrastructure de soins de sante primaire dans les pays en developpement, de faire baisser la mortalite infanto-juvenile et de favoriser l'autonomie des femmes dans le cadre d'une meilleure planification familiale, avec des benefices sanitaires, sociaux et economiques consequents. La vaccination contribue partout a la croissance economique, grace aux baisses de morbidite et de mortalite. On a calcule que le retour annuel sur investissement de cette intervention se situait entre 12 et 18 %. Elle entraine egalement une augmentation de l'esperance de vie. Il est maintenant reconnu que des vies longues et en bonne sante sont un prealable a la richesse et la richesse favorise a son tour la sante. Les vaccins constituent ainsi des outils efficaces pour reduire les inegalites en matiere de richesse et de sante. En los paises de ingresos bajos, las enfermedades infecciosas representan todavia una gran proporcion de las defunciones, lo que pone de manifiesto unas inequidades sanitarias cuya causa fundamental son las desigualdades economicas. La vacunacion puede reducir los costos de la atencion de salud y reducir esas inequidades. El control, la eliminacion y la erradicacion de enfermedades permiten ahorrar miles de millones de dolares estadounidenses en beneficio de las comunidades y los paises. Las vacunas han reducido la incidencia de carcinoma hepatocelular y permitiran controlar el cancer cervicouterino. Los viajeros pueden protegerse contra enfermedades <> mediante la vacunacion apropiada. Las vacunas son un arma imprescindible contra el bioterrorismo. En el caso de algunos agentes patogenos, pueden dificultar la aparicion de resistencia a los antibioticos. Algunas enfermedades no transmisibles, como la cardiopatia isquemica, tambien podrian reducirse mediante la vacunacion contra la gripe. Los programas de inmunizacion han mejorado la infraestructura de atencion primaria en los paises en desarrollo, reducido la mortalidad en la ninez y empoderado a las mujeres para planificar mejor su familia, con los consiguientes beneficios sanitarios, sociales y economicos. La vacunacion contribuye al crecimiento economico en todas partes, debido a la menor morbilidad y mortalidad. Se estima que las ganancias que reportan anualmente las inversiones en inmunizacion ascienden a un 12%-18%. La vacunacion propicia una mayor esperanza de vida, y es un hecho admitido hoy dia que las vidas longevas y sanas son una condicion de la riqueza, y que esta favorece a su vez la salud. Las vacunas constituyen por consiguiente un instrumento eficiente para mitigar las disparidades de riqueza y las inequidades en salud. [TEXT NOT REPRODUCIBLE IN ASCII], Introduction Vaccination has greatly reduced the burden of infectious diseases. Only clean water, also considered to be a basic human right, performs better. (1) Paradoxically, a vociferous antivaccine lobby thrives [...]
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- 2008
19. Intermittent preventive treatment of malaria in pregnancy: a new delivery system and its effect on maternal health and pregnancy outcomes in Uganda/Traitement preventif intermittent du paludisme pendant la grossesse : effets d'un nouveau systeme de delivrance de ce traitement sur la sante maternelle et l'issue de la grossesse en Ouganda/Tratamiento preventivo intermitente de ..
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Mbonye, A.K., Bygbjerg, I.C., and Magnussen, P.
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Malaria -- Care and treatment ,Malaria -- Prevention ,Pregnant women -- Health aspects ,Pregnancy, Complications of -- Prevention ,Mortality -- Uganda ,Mortality -- Prevention - Abstract
Objective To assess whether traditional birth attendants, drug-shop vendors, community reproductive-health workers, or adolescent peer mobilizers could administer intermittent preventive treatment (IPTp) for malaria with sulfadoxine-pyrimethamine to pregnant women. Methods A non-randomized community trial was implemented in 21 community clusters (intervention) and four clusters where health units provided routine IPTp (control). The primary outcome measures were access and adherence to IPTp, number of malaria episodes, prevalence of anaemia, and birth weight. Numbers of live births, abortions, still births, and maternal and child deaths were secondary endpoints. Findings 1404 (67.5%) of 2081 with the new delivery system received two doses of sulfadoxine-pyrimethamine versus 281 (39.9%) of 704 with health units (P < 0.0001). The prevalence of malaria episodes decreased from 906 (49.5%) of 1830 to 160 (17.6%) of 909 (P < 0.001) with the new delivery system and from 161 (39.1%) of 412 to 13 (13.1%) of 99 (P< 0.001) with health units. Anaemia was significantly less prevalent in both arms. There was a lower proportion of low birth weight 6.0% with the new delivery system versus 8.3% with health units (P < 0.03). Few abortions and stillbirths were recorded in either arm. Fewer children and women who accessed IPTp with health units died than in the intervention group. Conclusion The new approaches were associated with early access and increased adherence to IPTp. Health units were, however, more effective in reducing parasitaemia and malaria episodes. We recommend further studies to assess programming modalities linking the new approaches and health units. Bulletin of the World Health Organization 2008;86:93-100. Une traduction en francais de ce resume figure a la fin de I'article. Al final del articulo se facilita una traduccion al espanol. Objectif Evaluer la possibilite de faire administrer aux femmes enceintes le traitement preventif intermittent antipaludique (TPI) a base de sulfadoxine-pyrimethamine par des accoucheuses traditionnelles, des vendeurs de medicaments, des agents de sante reproductive communautaires ou des mobilisateurs adolescents. Methodes Un essai en communaute non randomise a ete realise parmi 21 groupes communautaires (intervention) et quatre groupes dont les centres de sante dispensaient le TPI selon le mode habituel (temoins). Les principales mesures de resultat etaient I'acces au traitement et son observance, le nombre d'episodes palustres, la prevalence de I'anemie et le poids a la naissance. Les nombres de naissances vivantes, d'avortements, de mortinaissances et de deces maternels et infantiles constituaient des mesures secondaires. Resultats 1404 (67,5 %) des 2081 femmes beneficiant du nouveau systeme de delivrance ont recu deux doses de sulfadoxine-pyrimethamine contre 281 (39,9 %) des 704 femmes desservies par des centres de sante (p < 0,0001). La prevalence des episodes palustres a baisse de 906 sur 1830 (49,5 %) a 160 sur 909 (17,6 %) (p < 0,001) avec le nouveau systeme de delivrance et de 161 sur 412 (39,1%) a 13 sur 99 (13,1%) dans le cas de la desserte par des centres de sante. La prevalence de I'anemie etait sensiblement plus faible dans les deux bras de I'etude. La proportion de faibles poids a la naissance etait plus reduite (6 %) avec le nouveau systeme de delivrance qu'avec la delivrance par les centres de sante (p < 0,03). Dans I'un et I'autre bras de I'etude, on a enregistre peu d'avortements et de mortinaissances. Le nombre de meres et d'enfants decedes etait plus faible dans les groupes recevant le TPI des centres de sante que parmi les groupes temoins. Conclusion La nouvelle approche etait associee a un acces plus precoce au TPI et a une observance accrue de ce traitement. Les centres de sante se sont neanmoins reveles plus efficaces dans la reduction de la parasitemie et des episodes palustres. Nous recommandons la realisation d'etudes supplementaires afin d'evaluer les modalites programmatiques pour faire la liaison entre la nouvelle approche et celle s'appuyant sur les centres de sante. Objetivo Determinar si las parteras tradicionales, los vendedores de mediamentos, los agentes comunitarios de salud reproductiva y los movilizadores adolescentes podrian administrar tratamiento preventivo intermitente (TPI) contra la malaria con sulfadoxina-pirimetamina a las mujeres embarazadas. Metodos Se Ilevo a cabo un ensayo comunitario no aleatorizado en 21 conglomerados de comunidades (intervencion) y cuatro conglomerados donde el TPI se administro de la manera habitual en los puestos de salud (control). Las medidas de resultado principales fueron el acceso al TPI y la observancia del mismo, el numero de episodios de malaria, la prevalencia de anemia y el peso al nacer. Como criterios secundarios de valoracion se consideraron el numero de nacidos vivos, de abortos y de mortinatos y las defunciones maternoinfantiles. Resultados Un total de 1404 (67,5%) de las 2081 mujeres tratadas mediante el nuevo sistema recibieron dos dosis de sulfadoxina-pirimetamina, frente a 281 (39,9%) de las 704 tratadas en los puestos de salud (P < 0,0001). La prevalencia de episodios de malaria disminuyo de 906 (respecto a 1830, 49,5%) a 160 (respecto a 909, 17,6%) (P < 0,001) con el nuevo sistema de administracion, y de 161 (respecto a 412, 39,1%) a 13 (respecto a 99, 13,1%) (P < 0,001) en los puestos de salud. La anemia rue significativamente menos prevalente en ambos casos. Se detecto una menor proporcion de casos de bajo peso al nacer con el nuevo sistema de administracion en comparacion con los puestos de salud, 6,0% y 8,3% respectivamente (P < 0,03). En los dos casos se registraron pocos abortos y muertes prenatales. El numero de mujeres y ninos que accedieron al TPI en los puestos de salud y fallecieron fue menor que en el grupo de intervencion. Conclusion El nuevo sistema se asocio a un pronto acceso al TPI y un aumento de la observancia. Los puestos de salud, sin embargo, demostraron una mayor eficacia en Io tocante a reducir la parasitemia y los episodios de malaria. Recomendamos que se realicen mas estudios para evaluar modalidades de programas que vinculen el nuevo enfoque con los puestos de salud., Introduction Malaria is the leading cause of morbidity and mortality in Uganda. It mainly affects pregnant women and children age less than five years. (1,2) Surveillance reports show that proportionate [...]
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- 2008
20. Estimating the costs of achieving the WHO-UNICEF global immunization vision and strategy, 2006-2015/Estimation des courts pour realiser l'objectif de l'initiative OMS-UNICEF << La Vaccination dans le monde : vision et strategie >> pour la periode 2006-2015/Estimacion de los costos de llevar a termino la Vision y Estrategia Mundial de Immunizacion OMS-UNICEF, 2006-2015
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Wolfson, Lara J., Gasse, Francois, Lee-Martin, Shook-Pui, Lydon, Patrick, Magan, Ahmed, Tibouti, Abdelmajid, Johns, Benjamin, Hutubessy, Raymond, Salama, Peter, and Okwo-Bele, Jean-Marie
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Company financing ,Mortality -- Prevention ,Morbidity -- Prevention ,Immunization -- Finance - Abstract
Objective To estimate the cost of scaling up childhood immunization services required to reach the WHO-UNICEF Global Immunization Vision and Strategy (GIVS) goal of reducing mortality due to vaccine-preventable diseases by two-thirds by 2015. Methods A model was developed to estimate the total cost of reaching GIVS goals by 2015 in 117 Iow- and lower-middle-income countries. Current spending was estimated by analysing data from country planning documents, and scale-up costs were estimated using a bottom-up, ingredients-based approach. Financial costs were estimated by country and year for reaching 90% coverage with all existing vaccines; introducing a discrete set of new vaccines (rotavirus, conjugate pneumococcal, conjugate meningococcal A and Japanese encephalitis); and conducting immunization campaigns to protect at-risk populations against polio, tetanus, measles, yellow fever and meningococcal meningitis. Findings The 72 poorest countries of the world spent US$ 2.5 (range: US$1.8-4.2) billion on immunization in 2005, an increase from US$1.1 (range: US$ 0.9-1.6) billion in 2000. By 2015 annual immunization costs will on average increase to about US$ 4.0 (range US$ 2.9-6.7) billion. Total immunization costs for 2006-2015 are estimated at US$ 35 (range US$13-40) billion; of this, US$ 16.2 billion are incremental costs, comprised of US$ 5.6 billion for system scale-up and US$ 8.7 billion for vaccines; US$ 19.3 billion is required to maintain immunization programmes at 2005 levels. In all 117 low- and lower-middle-income countries, total costs for 2006-2015 are estimated at US$ 76 (range: US$ 23-110) billion, with US$ 49 billion for maintaining current systems and $27 billion for scaling-up. Conclusion In the 72 poorest countries, US$ 11-15 billion (30%-40%) of the overall resource needs are unmet if the GIVS goals are to be reached. The methods developed in this paper are approximate estimates with limitations, but provide a roadmap of financing gaps that need to be filled to scale up immunization by 2015. Resume Objectif Estimer le cout du developpement a plus grande echelle des services de vaccination infantile necessaires a la realisation de I'objectif de I'initiative OMS-UNICEF << La vaccination dans le monde : vision et strategie (GIVS) >>, consistant a reduire des deux-tiers d'ici 2015 la mortalite due aux maladies evitables par la vaccination. Methodes Un modele a ete elabore pour estimer le cout total de la realisation de I'objectif de cette initiative d'ici 2015 dans 117 pays a revenu faible ou faible a moyen. Les depenses actuelles ont ete estimees par une analyse des documents de planification nationale et les couts du passage a l'echelle superieure en utilisant une demarche partant de la base et des intrants. Les couts financiers pour atteindre une couverture vaccinale de 90 % ont ete estimes par pays et par annee pour tous les vaccins existants, dans le cas ou l'on introduirait une serie discrete de nouveaux vaccins (vaccins antirotavirus, antipneumococcique conjugue, contre le meningocoque de type A et contre l'encephalite japonaise) et dans celui ou l'on menerait des campagnes de vaccination pour proteger les populations a haut risque contre la polio, le tetanos, la rougeole, la fievre jaune et la meningite a meningocoque. Resultats Les 72 pays les plus pauvres du monde ont consacre US$ 2,5 milliards (plage de variation : US$1,8-4,2) a la vaccination en 2005, soit une augmentation de US$1,1 milliard (plage de variation : US$ 0,9-1,6) par rapport a l'annee 2000. D'ici 2015, les couts annuels de la vaccination augmenteront en moyenne d'environ US$ 4,0 milliards (plage de variation : US$ 2,9-6,7). Les couts totaux de la vaccination pour la periode 2006-2015 sont estimes a US$ 35 milliards (plage de variation : US$13-40), dont US$16,2 milliards de surcouts, se repartissant en US$ 5,6 milliards pour le passage a l'echelle superieure du systeme et US$ 8,7 milliards pour les vaccins. US$19,3 milliards seront necessaires pour maintenir les programmes de vaccination aux niveaux de 2005. Pour l'ensemble des 117 pays a revenu faible ou faible a moyen, les couts totaux pour la periode 2006-2015 sont estimes a US$ 76 milliards (plage de variation :US$ 23-110), dont US$ 49 milliards pour maintenir les systemes actuels et US$ 27 milliards pour passer a l'echelle superieure. Conclusion Pour les 72 pays les plus pauvres, 30 a 40 % (soit US$ 11 a 15 milliards) des besoins en ressources ne sont pas couverts s'il on veut atteindre l'objectif de la GIVS. Les methodes presentees dans cet article donnent des estimations approximatives et comportent des limites, mais elles permettent d'identifier les lacunes a combler sur le plan financier pour le passage a l'echelle superieure des programmes de vaccination d'ici 2015. Resumen Objetivo Estimar el costo de extender masivamente los servicios de inmunizacion infantil requeridos para alcanzar la meta de la Vision y Estrategia Mundial de Inmunizacion (GIVS) OMS-UNICEF de reducir la mortalidad por enfermedades prevenibles mediante vacunacion en dos tercios para 2015. Metodos Se elaboro un modelo para estimar el cesto total del logro de las metas de GIVS para 2015 en 117 paises de ingresos bajos o medios bajos. El gasto actual se estimo a partir de datos extraidos de los documentos de planificacion de los paises, y los costos de la extension masiva se estimaron mediante un metodo ascendente basado en componentes. Se calcularon los costos financieros requeridos por pais y ano para alcanzar una cobertura del 90% con todas las vacunas existentes; introducir un conjunto de vacunas nuevas (contra rotavirus, antineumococica conjugada, conjugada contra el meningococo A y contra la encefalitis japonesa); y realizar campanas de inmunizacion para proteger a las poblaciones de riesgo contra la poliomielitis, el tetanos, el sarampion, la fiebre amarilla y la meningitis meningococica. Resultados Los 72 paises mas pobres del mundo invirtieron US$ 2500 millones (intervalo: US$1800-4200 millones) en actividades de inmunizacion en 2005, lo que supone un aumento respecto a los US$1100 millones (intervalo: US$ 900-1600 millones) de 2000. Para 2015, los costos anuales de la inmunizacion aumentaran por termino medio a unos US$ 4000 millones (intervalo: US$ 2900-6700 millones). Los costos totales de la inmunizacion para 2006-2015 se estiman en US$ 35 000 millones (intervalo: US$13 000-40 000 millones); de esa cantidad, US$16 200 millones son costos adicionales, de los que US$ 5600 millones corresponden a la expansion del sistema y US$ 8700 millones a las vacunas; se necesitan US$19 300 millones para mantener los programas de inmunizacion a los niveles de 2005. En el conjunto de los 117 paises de ingresos bajos y medios bajos, se estima que los costos totales para 2006-2015 ascenderan a US$ 76 000 millones (intervalo: US$ 23 000110 000 millones): US$ 49 000 millones para mantener los sistemas actuales y US$ 27 000 millones para expandirlos. Conclusion Considerando los 72 paises mas pobres, se necesitan aun US$11 000-15 000 millones (30%-40% de los recursos globales necesarios) para poder alcanzar las metas de la GIVS. Los metodos desarrollados en este articulo arrojan estimaciones aproximadas que presentan limitaciones, pero proporcionan una hoja de ruta para financiar los deficits que hay que cubrir a fin de expandir la inmunizacion para 2015. [TEXT NOT REPRODUCIBLE IN ASCII.], Introduction In 2005, the World Health Assembly approved, and the United Nations Children's Fund (UNICEF) Executive Board endorsed, the Global Immunization Vision and Strategy (GIVS). (1,2) The primary objective of [...]
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- 2008
21. Outcome of neonatal screening for medium-chain acyl-CoA dehydrogenase deficiency in Australia: a cohort study
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Wilcken, Bridget, Haas, Marion, Joy, Pamela, Wiley, Veronica, Chaplin, Meredyth, Black, Carly, Fletcher, Janice, McGill, Jim, and Boneh, Avihu
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Fatty acid desaturases -- Health aspects ,Fatty acid desaturases -- Research ,Mortality -- Australia ,Mortality -- Prevention ,Morbidity -- Prevention ,Nutrition disorders -- Diagnosis ,Nutritionally induced diseases -- Diagnosis ,Infants (Newborn) -- Medical examination ,Infants (Newborn) -- Usage - Published
- 2007
22. Geographical inequalities in health in New Zealand, 1980-2001: the gap widens
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Pearce, Jamie, Dorling, Danny, Wheeler, Ben, Barnett, Ross, and Rigby, Jan
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New Zealand -- Health policy ,Public health -- Social aspects ,Public health -- Economic aspects ,Public health -- Laws, regulations and rules ,Mortality -- New Zealand ,Mortality -- Prevention ,Mortality -- Statistics ,Medical policy -- Interpretation and construction ,Government regulation ,Health - Abstract
Objective: To monitor geographical inequalities in health in New Zealand during the period 1980 to 2001, a time of rapid social and economic change in society. Methods: Age-standardised mortality rates were calculated using mortality records aggregated to a consistent set of geographical areas (the 2001 District Health Boards) for the periods 1980-82, 1985-87, 1990-92, 1995-97 and 1999-2001. In addition, the Relative Index of Inequality (RII) was calculated for each period to provide a robust measure of mortality rates over time. Results: Although overall mortality rates have declined through the period 1980 to 2001, the reduction has not been consistent for all areas of New Zealand. Indeed for a small number of DHBs, mortality rates have increased slightly. There has been an increase in the geographical inequalities in health as measured by the RII between each time period except for between 1986 and 1991, where there was a small reduction. Conclusions: At the start of the 21st century, geographical inequalities in health in New Zealand have reached very high levels and continue to increase. The excess mortality for the worst areas in New Zealand increased from 15% in 1981 to 25% in 2000. If policy makers are committed to reducing health inequalities then more redistributive economic policies are required.
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- 2006
23. Attributable fractions for premature mortality avoidable through public health action: updated estimates by Australian public health physicians
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Ward, Jeanette, Girgis, Seham, and Adily, Armita
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Public health -- Laws, regulations and rules ,Mortality -- New Zealand ,Mortality -- Australia ,Mortality -- Prevention ,Physicians -- Management ,Government regulation ,Company business management ,Health - Abstract
Objective: To determine whether previously published estimates of attributable fractions of primary avoidable mortality (PAM) and secondary avoidable mortality (SAM) were valid to Australian public health physicians. Design: Self-administered survey. Setting: Australia-wide survey. Participants: 331 Fellows of the Australasian Faculty of Public Health Medicine (71.8% response rate). Results: Tobias and Jackson's cited estimates for PAM and SAM for lung cancer were the least contested by respondents (62% 'no change' for PAM estimate; 67% 'no change' for SAM estimate). By contrast, 39% indicated that the PAM estimate of 30% for diabetes required change. Those most-contested PAM estimates also typically elicited significantly different responses by gender (breast cancer, diabetes and falls), age (breast cancer, stroke and diabetes) and training (stroke, diabetes, mental health). The proportion of respondents who agreed with the cited estimates either for PAM or SAM for any of the 10 selected conditions never differed significantly according to current primary role ('practitioner' v 'researcher' v 'other'). Conclusions: PAM and SAM represent the key action areas for public health. We conclude that the estimates of Tobias and Jackson are generally robust among Australian public health physicians, invoking confidence that their advocacy will engage practitioners, policy makers and citizens seeking better governance of health system performance.
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- 2006
24. Survival rate and risk factors of mortality among HIV/tuberculosis-coinfected patients with and without antiretroviral therapy
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Manosuthi, Weerawat, Chottanapand, Suthat, Thongyen, Supeda, Chaovavanich, Achara, and Sungkanuparph, Somnuek
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HIV infection -- Risk factors ,HIV infection -- Prognosis ,Tuberculosis -- Risk factors ,Tuberculosis -- Prognosis ,Highly active antiretroviral therapy -- Patient outcomes ,Mortality -- Prevention ,Health - Abstract
A retrospective cohort study was conducted among HIV-infected patients with tuberculosis (TB) to evaluate the impact of antiretroviral therapy (ART) on survival among 1003 patients coinfected with HIV and TB. The results concluded that ART substantially reduced mortality rate among HIV/TB-coinfected patients, and initiation of ART within 6 months of TB diagnosis was associated with greater survival.
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- 2006
25. Progress in reducing global measles deaths: 1999-2004/Reduction de la mortalite par rougeole dans le monde: progress en 1999-2004
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Mortality -- Prevention ,Measles -- Prevention -- Patient outcomes ,Developing countries -- Health aspects ,Government ,Health ,Prevention ,Patient outcomes ,Health aspects - Abstract
Measles remains an important cause of childhood mortality, especially in developing countries. In the joint strategic plan for measles mortality reduction, 2001-2005, (1) WHO and UNICEF targeted 45 priority countries [...]
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- 2006
26. Underlying disorders and their impact on the host response to infection
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Dhainaut, Jean-Francois, Claessens, Yann-Erick, Janes, Jonathan, and Nelson, David R.
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Sepsis -- Diagnosis ,Sepsis -- Care and treatment ,Sepsis -- Patient outcomes ,Mortality -- Prevention ,Mortality -- United States ,Mortality -- Risk factors ,Health ,Health care industry - Published
- 2005
27. Cost-effectiveness of implantable cardioverter-defibrillators
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Sanders, Gillian D., Hlatkey, Mark A., and Owens, Douglas K.
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Implantable cardioverter-defibrillators -- Usage ,Mortality -- Risk factors ,Mortality -- Prevention ,Mortality -- United States ,Quality of life - Abstract
The cost-effectiveness of an implantable cardioverter-defibrillator (ICD) in population represented in initial prevention trials is examined. The results display a cost-effectiveness ratio below $100,000 per quality-adjusted life-years (QALY) for prophylactic insertion of an ICD in populations, which show a noticeable device-connected decrease in mortality.
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- 2005
28. Benefits of inpatient initiation of beta-blockers
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Ventura, Hector O.
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Mortality -- Prevention ,Mortality -- United States ,Heart attack -- Drug therapy ,Adrenergic beta blockers -- Research ,Health - Published
- 2004
29. Social Willingness to Pay, Mortality Risks and Contingent Valuation
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Armantier, Olivier and Treich, Nicolas
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Human acts -- Analysis ,Human behavior -- Analysis ,Mortality -- United States ,Mortality -- Analysis ,Mortality -- Prevention ,Risk management -- Analysis ,Risk management ,Business, general - Abstract
Byline: Olivier Armantier (1), Nicolas Treich (2) Keywords: willingness-to-pay; value-of-life; contingent valuation; social benefit; heterogeneity Abstract: The Willingness-to-Pay approach is the basic justification for the use of the Contingent Valuation method to evaluate public mortality risk reduction programs. However, aggregating unweighted willingness-to-pay is a valid method only when individuals have the same marginal value of money, an unrealistic assumption in the presence of heterogeneity. We show that heterogeneity on wealth and baseline risk (respectively on risk reduction) leads to systematically overestimate (respectively underestimate) the social value of a risk reduction program. Using a recently published Contingent Valuation analysis, we find this overestimation to be quite modest though, approximately 15% in an upper bound case. Author Affiliation: (1) State University of New York at, Stony Brook, USA (2) Lerna-Inra, University of Toulouse, France Article History: Registration Date: 02/10/2004
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- 2004
30. Use of intravenous immunoglobulin in children with Stevens-Johnson syndrome and toxic epidermal necrolysis: seven cases and review of the literature
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Metry, Denise W., Jung, Peter, and Levy, Moise L.
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Adrenocortical hormones -- Adverse and side effects ,Adrenocortical hormones -- Health aspects ,Adrenocortical hormones -- Physiological aspects ,Bacterial infections -- Complications ,Bacterial infections -- Demographic aspects ,Bacterial infections -- Health aspects ,Clinical trials -- Analysis ,Immunoglobulins -- Health aspects ,Immunoglobulins -- Physiological aspects ,Mortality -- Causes of ,Mortality -- Demographic aspects ,Mortality -- Health aspects ,Mortality -- Prevention ,Pediatrics -- Research ,Sick children -- Care and treatment ,Sick children -- Drug therapy ,Sick children -- Health aspects ,Stevens-Johnson syndrome -- Care and treatment ,Stevens-Johnson syndrome -- Complications ,Stevens-Johnson syndrome -- Demographic aspects ,Stevens-Johnson syndrome -- Health aspects ,Toxic epidermal necrolysis -- Care and treatment ,Toxic epidermal necrolysis -- Complications ,Toxic epidermal necrolysis -- Demographic aspects ,Toxic epidermal necrolysis -- Health aspects ,Mortality -- United States - Abstract
Stevens-Johnson syndrome (SJS) an toxic epidermal necrolysis are the most severe cutaneous reactions that occur in children. Off-label use of human intravenous immunoglobulin (IVIG) has been reported in a number of autoimmune and cell-mediated blistering disorders of the skin, including severe cutaneous drug reactions. We review 28 previous reports in which IVIG was used in pediatric patients with SJS and toxic epidermal necrolysis and discuss our experience in 7 children with SJS, in whom no new blisters developed within 24 to 48 hours after IVIG administration and rapid recovery ensued. IVIG seems to be a useful and safe therapy for children with severe cutaneous drug reactions. Well-controlled, prospective, mulficenter clinical trials are needed to determine optimal dosing guidelines and to compare the efficacy and safety of IVIG with other potentially effective modalities. Pediatrics 2003;112:1430-1436; Stevens-Johnson syndrome, toxic epidermal necrolysis, intravenous immunoglobulin, IVIG., Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are the most severe cutaneous reactions that occur in pediatrics. Drugs are the predominant inciting agent in both entities. The combined incidence [...]
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- 2003
31. Invasive aspergillosis in the setting of cardiac transplantation
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Montoya, J.G., Chaparro, S.V., Celis, D., Cortes, J.A., Leung, A.N., Robbins, R.C., and Stevens, D.A.
- Subjects
Mortality -- Prevention ,Mortality -- Health aspects ,Mortality -- Causes of ,Aspergillosis -- Health aspects ,Aspergillosis -- Diagnosis ,Aspergillosis -- Prevention ,Aspergillosis -- Complications ,Hospital patients -- Health aspects ,Hospital patients -- Care and treatment ,Communicable diseases -- Research ,Communicable diseases -- Health aspects ,Communicable diseases -- Diagnosis ,Communicable diseases -- Prevention ,Mortality -- United States ,Health ,Health care industry ,Stanford University -- Research - Published
- 2003
32. Neonatal candidemia and end-organ damage: a critical appraisal of the literature using meta-analytic techniques
- Author
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Benjamin, Daniel K., Poole, Charles, Steinbach, William J., Rowen, Judith L., and Walsh, Thomas J.
- Subjects
Birth defects -- Health aspects ,Birth defects -- Causes of ,Birth defects -- Prevention ,Mortality -- Causes of ,Mortality -- Health aspects ,Mortality -- Prevention ,Mortality -- Demographic aspects ,Birth weight -- Health aspects ,Birth weight -- Prevention ,Birth weight -- Care and treatment ,Birth size -- Health aspects ,Birth size -- Prevention ,Birth size -- Care and treatment ,Infants -- Health aspects ,Infants -- Care and treatment ,Sick children -- Care and treatment ,Sick children -- Health aspects ,Pediatrics -- Research - Abstract
Objective. Neonatal candidemia is an increasing cause of infant morbidity and mortality. We evaluated the current medical literature in an effort to critique the literature and to document the reported prevalences of end-organ damage after neonatal candidemia. Methods. We analyzed all peer-reviewed articles of neonatal candidemia published in the English language; inclusion criteria included a cohort limited to all neonatal intensive care unit admissions or all episodes of candidemia in neonates. Articles that also incorporated older patients, did not define a numerator and a denominator for at least 1 form of end-organ damage, included patients from other reports, or did not include all episodes of candidemia in the source population were excluded from the analysis. Results. Thirty-four articles reported episodes of candidemia and mortality; 21 articles reported prevalence for at least 1 form of end-organ damage. Only 4 (19%) of 21 articles reported prevalence for >4 forms of end-organ damage from the following list: endophthalmitis, meningitis, brain parenchyma invasion, endocarditis, renal abscesses, positive cultures from other normally sterile body fluids, or hepatosplenic abscesses. The median reported prevalence of endophthalmitis was 3% (interquartile range [IQR]: 0%-17%), of meningitis was 15% (IQR: 3%-23%), of brain abscess or ventriculitis was 4% (IQR: 3%-21%), of endocarditis was 5% (IQR: 0%-13%), of positive renal ultrasound was 5% (IQR: 0%-14%), and of positive urine culture was 61% (IQR: 40%-76%). The medical literature concerning end-organ evaluation after episodes of neonatal candidemia is heterogeneous and consists largely of single-center retrospective studies. Year that the data were collected and prevalence of neonates infected with Candida albicans were associated with observed heterogeneity. Conclusions. Given the heterogeneity of the medical literature, precise estimates of the frequencies of end-organ damage are not possible and a prospective multicenter trial is warranted, but the data from the published literature suggest that the prevalence of neonates with end-organ damage not only is greater than 0 but also is high enough that until such a prospective trial is completed, end-organ studies should be considered before the conclusion of antifungal therapy. Pediatrics 2003;112: 634-640; invasive candidiasis, deep tissue., Neonatal candidemia occurs in 4% to 15% of extremely low birth weight infants (birth weight There has not been a large multicenter prospective study to outline the prevalence of end-organ [...]
- Published
- 2003
33. Persistent doppler flow predicts lack of response to multiple courses of indomethacin in premature infants with recurrent patent ductus arteriosus
- Author
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Keller, Roberta L. and Clyman, Ronald I.
- Subjects
Indomethacin -- Physiological aspects ,Mortality -- Causes of ,Mortality -- Health aspects ,Mortality -- Demographic aspects ,Mortality -- Prevention ,Ductus arteriosus -- Causes of ,Ductus arteriosus -- Health aspects ,Ductus arteriosus -- Prevention ,Ductus arteriosus -- Care and treatment ,Patent ductus arteriosus -- Demographic aspects ,Patent ductus arteriosus -- Health aspects ,Patent ductus arteriosus -- Care and treatment ,Pediatrics -- Research ,Infants -- Care and treatment ,Infants -- Health aspects ,Infants -- Drug therapy - Abstract
Objective. Although indomethacin produces ductus arteriosus constriction in extremely premature newborns, a recurrent symptomatic patent ductus arteriosus (PDA) frequently develops after the initial course of indomethacin. Currently, there is little information available to determine the effectiveness of a second course of indomethacin in producing permanent ductus closure. The objective of this study was to determine the rate of permanent ductus closure after a second course of indomethacin for a recurrent, symptomatic PDA and to identify the factors associated with permanent ductus closure. Methods. We identified 32 infants ( Results. After the second course of indomethacin, 56% (18 of 32) of the infants had persistent or recurrent PDA-related symptoms that were considered to be hemodynamically significant. The only significant predictor of failure of the second indomethacin course was the demonstration (by Doppler echocardiogram) of persistent ductus flow within 24 hours of completing the initial indomethacin course. All of the 9 newborns with persistent Doppler ductus flow after the initial indomethacin course failed the second course of indomethacin. In contrast, only 39% (9 of 23) of newborns with absent Doppler flow after the initial indomethacin course failed the second course of indomethacin. Conclusions. Newborns who are, Extremely premature neonates have a high incidence of patent ductus arteriosus (PDA). (1-3) A clinically symptomatic PDA is associated with significant morbidity in this population. (2-4) Indomethacin produces ductus constriction [...]
- Published
- 2003
34. Longitudinal changes in growth parameters are correlated with changes in pulmonary function in children with cystic fibrosis
- Author
-
Peterson, Michelle L., Jacobs, David R., Jr, and Milla, Carlos E.
- Subjects
Lung diseases -- Development and progression ,Lung diseases -- Causes of ,Lung diseases -- Prevention ,Lung diseases -- Care and treatment ,Mortality -- Prevention ,Mortality -- Health aspects ,Mortality -- Causes of ,Sick children -- Health aspects ,Sick children -- Care and treatment ,Cystic fibrosis -- Health aspects ,Cystic fibrosis -- Care and treatment ,Cystic fibrosis -- Diagnosis ,Cystic fibrosis -- Complications ,Cystic fibrosis -- Demographic aspects ,Pediatrics -- Research - Abstract
Objective. Nutritional status is associated with pulmonary health and survival in children with cystic fibrosis (CF). This study evaluated the weight gain pattern of children with CF in relation to the longitudinal trends of their pulmonary function. Our hypothesis was that children who experience continuous weight gain at a given rate will have better average forced expiratory volume in 1 second (FE[V.sub.1]) and change in FE[V.sub.1] than children who have weight gain patterns that deviate from this rate, even when total weight gain seems adequate. Methods. Prospectively collected data were examined in 319 children, aged 6 to 8, who were routinely followed at the Minnesota Cystic Fibrosis Center. One to 67 measurements of weight (kg), height (cm), and FE[V.sub.1] (mL) were taken per child during this 2-year period. The data were analyzed by repeated measure regression analysis and by growth pattern analysis. Results. At baseline, a 1-kg higher initial weight was associated with a 55-mL higher average FE[V.sub.1]. During the follow-up period, a 1-kg gain in weight was associated with an increase in FE[V.sub.1] by 32 mL. Children who had a steady weight gain tended to experience greater increases in FE[V.sub.1] than children who experienced periodic losses in weight. Conclusions. We established that children who weigh more and who gain weight at an appropriate and uninterrupted rate have a better FE[V.sub.1] trajectory. Aggressive nutritional support to maintain growth in these children may therefore improve FE[V.sub.1], which can be taken as a surrogate for better lung health, and may ultimately lead to better survival. Pediatrics 2003;112:588-592; cystic fibrosis, growth, pulmonary, function, longitudinal studies., Cystic fibrosis (CF) is the most common life-shortening disease in white individuals and is characterized by multiorgan involvement with primarily pulmonary and gastrointestinal manifestations, as well as abnormally high levels [...]
- Published
- 2003
35. Adverse effects of smoking on respiratory function in young adults born weighing less than 1000 grams
- Author
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Doyle, Lex W., Olinsky, Anthony, Faber, Brenda, and Callanan, Catherine
- Subjects
Mortality -- Causes of ,Mortality -- Health aspects ,Mortality -- Demographic aspects ,Mortality -- Prevention ,Passive smoking -- Health aspects ,Passive smoking -- Adverse and side effects ,Oxygen therapy -- Methods ,Oxygen therapy -- Health aspects ,Ventilators -- Usage ,Birth weight, Low -- Health aspects ,Birth weight, Low -- Complications ,Birth weight, Low -- Causes of ,Pediatrics -- Research - Abstract
Objective. To determine whether active smoking has an adverse impact on respiratory function of young adults of extremely low birth weight (ELBW; birth weight Methods. This was a cohort study of 60 consecutive ELBW survivors who were born during 1977-1980 at Royal Women's Hospital, Melbourne, Australia. Respiratory function was measured on 44 (73%) of the subjects at a mean age of 20.2 years (standard deviation: 1.0 year). Respiratory function had also been measured on 42 of the 44 subjects at 8 years of age. Respiratory function was compared between the 14 smokers and the 30 nonsmokers. Results. Several respiratory function variables reflecting airflow (the forced expired volume in 1 second [FE[V.sub.1]]/forced vital capacity [FVC] ratio; flow rates at 75%, 50%, and 25% of vital capacity; and mid-expiratory flow from 25% to 75% of vital capacity) were significantly diminished in smokers. The proportion with a clinically important reduction in the FE[V.sub.1]/FVC ratio ( Conclusions. Active smoking by young adult survivors of ELBW is associated with reduced respiratory function. Pediatrics 2003;112:565-569; smoking, respiratory function, extremely low birth weight., Many extremely low birth weight (ELBW; birth weight Inevitably, many ELBW survivors would actively smoke later in life, which is associated with reduced respiratory function in adulthood. (5,6) Even in [...]
- Published
- 2003
36. Empirical therapy for Neonatal candidemia in very low birth weight infants
- Author
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Benjamin, Daniel K., Jr, DeLong, Elizabeth R., Steinbach, William J., Cotton, Charles M., Walsh, Thomas J., and Clark, Reese H.
- Subjects
Mortality -- Demographic aspects ,Mortality -- Health aspects ,Mortality -- Prevention ,Birth weight -- Health aspects ,Birth weight -- Causes of ,Birth weight -- Prevention ,Birth size -- Health aspects ,Birth size -- Causes of ,Birth size -- Prevention ,Infection -- Health aspects ,Infection -- Causes of ,Infection -- Prevention ,Candidiasis -- Health aspects ,Candidiasis -- Demographic aspects ,Candidiasis -- Care and treatment ,Candidiasis -- Causes of ,Candidiasis -- Prevention ,Sick children -- Care and treatment ,Sick children -- Health aspects ,Pediatrics -- Research - Abstract
Objective. Neonatal candidemia is often fatal. Empirical antifungal therapy is associated with improved survival in neonates and patients with fever and neutropenia. Although guidelines for empirical therapy exist for patients with fever and neutropenia, these do not exist for neonates. Methods. A multicenter, retrospective, cohort study was conducted of neonatal intensive care unit patients (N = 6172) who had a blood culture (N = 21 233) after day of life 3 and whose birth weight was [less than or equal to] 1250 g. We performed multivariable conditional logistic regression of risk factors for candidemia. From the regression modeling coefficients, we developed a candidemia score. Results. In multivariable modeling, thrombocytopenia (odds ratio [OR]: 3.56; 95% confidence interval [CI]: 2.68-4.74) and cephalosporin or carbapenem use in the 7 days before obtaining the blood culture (OR: 1.77; 95% CI: 1.33-2.29) were risk factors for subsequent candidemia. Children who were 25 to 27 weeks' estimated gestational age (OR: 2.02; 95% CI: 1.52-3.05) and children who were born at Conclusions. We developed a clinical predictive model for neonatal candidemia with high sensitivity and moderate specificity for candidemia. On the basis of our model, when a physician obtains a blood culture, the physician should consider providing antifungal therapy to neonates who are, The incidence of candidemia is rising steadily, and Candida species are a leading cause of infectious mortality in the neonatal intensive care trait (NICU). (1) Incidence of candidemia in extremely [...]
- Published
- 2003
37. The effect of computerized physician order entry on medication errors and adverse drug events in pediatric inpatients
- Author
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King, W. James, Paice, Naomi, Rangrej, Jagadish, Forestell, Gregory J., and Swartz, Ron
- Subjects
Physicians -- Practice ,Mortality -- Health aspects ,Mortality -- Causes of ,Mortality -- Prevention ,Hospital patients -- Health aspects ,Medical errors -- Health aspects ,Medical errors -- Complications ,Sick children -- Care and treatment ,Sick children -- Health aspects ,Pediatrics -- Research ,Mortality -- Australia ,Mortality -- United Kingdom - Abstract
Objective. Computerized physician order entry (CPOE) has the potential to reduce patient injury resulting from medication errors. We assessed the impact of a CPOE system on medication errors and adverse drug events (ADEs) in pediatric inpatients. Design. A retrospective cohort study. Setting. Tertiary care pediatric hospital. Participants. Pediatric inpatients on 3 medical and 2 surgical wards. Intervention. CPOE system implemented on 2 medical wards and compared with 1 medical and 2 surgical wards that continued to use hand written orders. Outcome Measures. Rate of medication error and ADEs before and after CPOE implementation. Results. In 6 years, a total of 804 medication errors were identified with 18 ADEs, resulting in patient injury among 36 103 discharges and 179 183 patient days. The overall medication error rate (MER) was 4.49 per 1000 patient days. Before the introduction of CPOE, the MERs of the intervention versus control wards were indistinguishable (ratio = 0.93; 95% confidence interval [CI] = 0.76, 1.13). After the introduction of CPOE, the MER was 40% lower on the intervention than on the control wards (ratio = 0.60; 95% CI = 0.48, 0.74). On average, 490 patient days are required to see the benefit of one less medication error using CPOE. We did not demonstrate a similar effect of CPOE for ADEs (ratio of rate ratios = 1.30; 95% CI 0.47, 3.52). Conclusions. The introduction of a commercially available physician computer order entry system was associated with a significant decrease in the rate of medication errors but not ADEs in an inpatient pediatric population. Pediatrics 2003;112:506-509; computerized physician order entry, inpatients, medication error, injury., Medication errors are an internationally recognized source of significant morbidity and mortality in hospitalized patients. In the United States alone, the Institute of Medicine report To Err Is Human: Building [...]
- Published
- 2003
38. Serious cutaneous adverse drug reactions: pathomechanisms and their implications to treatment
- Author
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Inamdar, Arun C. and Palit, Aparna
- Subjects
Mortality -- Health aspects ,Mortality -- Causes of ,Mortality -- Prevention ,Toxic epidermal necrolysis -- Health aspects ,Toxic epidermal necrolysis -- Care and treatment ,Toxic epidermal necrolysis -- Diagnosis ,Toxic epidermal necrolysis -- Genetic aspects ,Stevens-Johnson syndrome -- Health aspects ,Stevens-Johnson syndrome -- Care and treatment ,Stevens-Johnson syndrome -- Genetic aspects ,Familial diseases -- Health aspects ,Familial diseases -- Care and treatment ,Familial diseases -- Genetic aspects ,Patients -- Health aspects ,Patients -- Care and treatment ,Patients -- Case studies ,Dermatology -- Research ,Mortality -- India - Abstract
Code Number: dv03003 Abstract Severe cutaneous adverse drug reactions pose diagnostic and therapeutic challenges to the medical community. Understanding the pathomechanisms can prevent their onset and improve their management, while [...]
- Published
- 2003
39. Increased risk of developing peripheral neuropathy in patients coinfected with HIV-1 and HTLV-2
- Author
-
Zehender, Gianguglielmo, Colasante, Chiara, Santambrogio, Sara, De Maddalena, Chiara, Massetto, Benedetta, Cavalli, Barbara, Jacchetti, Gaia, Fasan, Marco, Adorni, Fulvio, Osio, Maurizio, Moroni, Mauro, and Galli, Massimo
- Subjects
Polyneuropathies -- Prevention ,Polyneuropathies -- Causes of ,Polyneuropathies -- Health aspects ,HTLV-II infections -- Research ,HTLV-II infections -- Prevention ,HTLV-II infections -- Health aspects ,Epidemiology -- Statistics ,Epidemiology -- Research ,HIV patients -- Health aspects ,HIV patients -- Care and treatment ,HIV infection -- Prevention ,HIV infection -- Research ,HIV infection -- Health aspects ,Mortality -- Prevention ,Mortality -- Health aspects ,Mortality -- Causes of ,AIDS (Disease) -- Research ,Mortality -- Italy ,Health - Abstract
Research has been conducted on HIV-1/ HTLV-2-coinfected patients. The risk of developing neurologic disorders in these patients and the effect of HTLV-2 on AIDS progression and mortality have been investigated, and the results are reported.
- Published
- 2002
40. Trends in AIDS incidence and survival among racial/ethnic minority men who have sex with men, United States, 1990-1999
- Author
-
Blair, Janet M., Fleming, Patricia L., and Karon, John M.
- Subjects
Epidemiology -- Statistics ,Epidemiology -- Research ,HIV patients -- Demographic aspects ,HIV patients -- Case studies ,HIV patients -- Health aspects ,HIV patients -- Care and treatment ,HIV infection -- Demographic aspects ,HIV infection -- Prevention ,HIV infection -- Research ,HIV infection -- Health aspects ,Ethnic groups -- Health aspects ,Ethnic groups -- Sexual behavior ,Mortality -- Prevention ,Mortality -- Causes of ,Mortality -- Health aspects ,Antiviral agents -- Physiological aspects ,AIDS (Disease) -- Research ,Mortality -- United States ,Health - Abstract
Research has been conducted on AIDS survival and deaths among racial/ethnic minority men who have sex with men. Results demonstrate that the introduction of highly active antiretroviral therapy has contributed to the observed differences in trends in AIDS incidence and deaths among this group.
- Published
- 2002
41. Efficacy of whole-cell killed bacterial vaccines in preventing pneumonia and death during the 1918 influenza pandemic
- Author
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Chien, Yu-Wen, Klugman, Keith P., and Morens, David M.
- Subjects
Bacterial pneumonia -- Prevention ,Bacterial pneumonia -- Patient outcomes ,Pneumonia -- Prevention ,Pneumonia -- Patient outcomes ,Bacterial vaccines -- Usage ,Bacterial vaccines -- Patient outcomes ,Epidemics -- United States ,Epidemics -- Control ,Epidemics -- History ,Mortality -- United States ,Mortality -- Prevention ,Health - Published
- 2010
42. Educational inequalities in avoidable mortality in Europe
- Author
-
Stirbu, Irina, Kunst, Anton E., Bopp, Matthias, Leinsalu, Mall, Regidor, Enrique, Esnaola, Santiago, Costa, Giuseppe, Martikainen, Pekka, Borrell, Carme, Deboosere, Patrik, Kalediene, Ramune, Rychtarikova, Jitka, Artnik, Barbara, and Mackenbach, Johan P.
- Subjects
Mortality -- Prevention ,Mortality -- Demographic aspects ,Discrimination in medical care -- Prevention ,Medical care -- Management ,Company business management ,Health ,Social sciences - Published
- 2010
43. Association between ICU admission during morning rounds and mortality
- Author
-
Afessa, Bekele, Gajic, Ognjen, Morales, Ian J., Keegan, Mark T., Peters, Steve G., and Hubmayr, Rolf D.
- Subjects
Mortality -- United States ,Mortality -- Comparative analysis ,Mortality -- Prevention ,Intensive care units -- Management ,Hospitals -- Admission and discharge ,Hospitals -- Comparative analysis ,Hospitals -- Patient outcomes ,Company business management ,Health - Published
- 2009
44. Public health impact and cost effectiveness of mass vaccination with live attenuated human rotavirus vaccine (RIX4414) in India: model based analysis
- Author
-
Rose, Johnie, Hawthorn, Rachael L., Watts, Brook, and Singer, Mendel E.
- Subjects
Medical care, Cost of -- Management ,Mortality -- India ,Mortality -- Prevention ,Rotavirus infections -- Care and treatment ,Vaccination -- Usage ,Company business management - Published
- 2009
45. Reducing bladder cancer deaths: the preemptive cystectomy approach
- Author
-
Konety, Badrinath R.
- Subjects
Bladder cancer -- Care and treatment ,Bladder cancer -- Patient outcomes ,Mortality -- United States ,Mortality -- Prevention ,Cystectomy -- Patient outcomes ,Health - Published
- 2009
46. Colorectal cancer mortality in two areas of Tuscany with different screening exposures
- Author
-
Costantini, Adele Seniori, Martini, Andrea, Puliti, Donella, Ciatto, Stefano, Castiglione, Guido, Grazzini, Grazia, and Zappa, Marco
- Subjects
Colorectal cancer -- Diagnosis ,Colorectal cancer -- Patient outcomes ,Mortality -- Prevention ,Mortality -- Research ,Mortality -- Italy ,Health - Abstract
Several randomized trials have demonstrated the efficacy of colorectal cancer screening by the fecal occult blood test in reducing colorectal cancer mortality, but an evaluation of population-based screening programs is still lacking. We compared the colorectal cancer mortality rates (both adjusted rates and 3-year moving average rates) during 1985-2006 for two geographic areas in the provinces of Florence and Prato in the Tuscany region of Italy that began active population-based screening for colorectal cancer at different times: the Empolese--Mugello district, in the early 1980s, and the rest of the Florence and Prato provinces, in early 2000. A log-linear Poisson model was used to estimate the annual percent change in mortality and to examine whether geographic area modified the effect of calendar year on it, The Empolese--Mugello district had a greater decrease in colorectal cancer mortality than the rest of the Florence and Prato provinces (estimated annual percent change in age-adjusted colorectal cancer mortality rate, 2.7% decrease per year [95% confidence interval {CI} = 1.7% to 3.7%] vs 1.3% decrease per year [95% CI = 0.8% to 1.7%], respectively). The interaction between calendar period and area was statistically significant (P < .001). Our results support the hypothesis that the implementation of colorectal cancer screening in the early 1980s in the Empolese--Mugello district, where approximately 17500 people were tested each year with the fecal occult blood test, was associated with a larger reduction in colorectal cancer mortality than that observed in the rest of Florence and Prato provinces, where screening started 15-20 years later and where approximately 38000 people were screened each year beginning in 2000.
- Published
- 2008
47. Micronutrient supplementation has limited effects on intestinal infectious disease and mortality in a Zambian population of mixed HIV status: a cluster randomized trial
- Author
-
Kelly, Paul, Katubulushi, Max, Todd, Jim, Banda, Rose, Yambayamba, Vera, Fwoloshi, Mildred, Zulu, Isaac, Kafwembe, Emmanuel, Yavwa, Felistah, Sanderson, Ian R., and Tomkins, Andrew
- Subjects
Diarrhea -- Patient outcomes ,Diarrhea -- Research ,Diarrhea -- Care and treatment ,HIV patients -- Care and treatment ,Mortality -- Prevention ,Mortality -- Zambia ,Food/cooking/nutrition ,Health - Abstract
Background: Diarrheal disease remains a major contributor to morbidity and mortality in Africa, but host defense against intestinal infection is poorly understood and may depend on nutritional status. Objective: To test the hypothesis that defense against intestinal infection depends on micronutrient status, we undertook a randomized controlled trial of multiple micronutrient supplementation in a population where there is borderline micronutrient deficiency. Design: All consenting adults ([greater than or equal to] 18 y) living in a carefully defined sector of Misisi, Lusaka, Zambia, were included in a cluster-randomized (by household), double-blind, placebo-controlled trial with a midpoint crossover. There were no exclusion criteria. Participants were given a daily tablet containing 15 micronutrients at just above the recommended nutrient intake or placebo. The primary endpoint was the incidence of diarrhea; secondary endpoints were severe episodes of diarrhea, respiratory infection, nutritional status, CD4 count, and mortality. Results: Five hundred participants were recruited and followed up for 3.3 y (10 846 person-months). The primary endpoint, incidence of diarrhea (1.4 episodes/y per person), did not differ with treatment allocation. However, severe episodes of diarrhea were reduced in the supplementation group (odds ratio: 0.50: 95% CI: 0.26, 0.92: P = 0.017). Mortality was reduced in HIV-positive participants from 12 with placebo to 4 with supplementation (P = 0.029 by log-rank test), but this was not due to changes in CD4 count or nutritional status. Conclusion: Micronutrient supplementation with this formulation resulted in only modest reductions in severe diarrhea and reduced mortality in HIV-positive participants. The trial was registered as ISRCTN31173864.
- Published
- 2008
48. Angiotensin receptor blockers: current status and future prospects
- Author
-
Ram, C. Venkata S.
- Subjects
Angiotensin II receptor blockers -- Physiological aspects ,Angiotensin II receptor blockers -- Research ,Mortality -- Prevention ,Health ,Health care industry - Abstract
To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.amjmed.2008.02.038 Byline: C. Venkata S. Ram Keywords: Angiotensin receptor blockers; Hypertension; Heart failure; Renal disease; Diabetes; Stroke Abstract: Angiotensin receptor blockers (ARBs), through their physiological blockade of the renin-angiotensin system, reduce morbidity and mortality associated with hypertension, heart failure, myocardial infarction, stroke, diabetic nephropathy, and chronic kidney disease. Among many attributes, excellent tolerability, and their ability to control hypertension for 24 hours with a positive effect on renal function position them as a useful choice for hypertension and related conditions. Because of the widespread actions of the renin-angiotensin system on critical tissues, treatment with ARBs may be beneficial in special populations. Ongoing and future studies will be needed to conclusively determine if ARBs also improve outcomes in patients with heart failure and preserved systolic function, atrial fibrillation, cognitive dysfunction, and kidney transplant recipients. Preliminary clinical data also suggest that combining ARBs and angiotensin-converting enzyme inhibitors may provide a more optimal blockade of the renin-angiotensin system and, therefore, may offer greater cardio- and nephroprotection. Future data will help delineate which ARBs and angiotensin-converting enzyme inhibitors are best combined and which patient populations might benefit from the dual blockade of the renin-angiotensin system. Author Affiliation: Texas Blood Pressure Institute, Dallas Nephrology Associates, University of Texas Southwestern Medical School, Dallas.
- Published
- 2008
49. Postdischarge thromboprophylaxis and mortality risk after hip- or knee-replacement surgery
- Author
-
Rahme, Elham, Dasgupta, Kaberi, Burman, Mark, Yin, Hongjun, Bernatsky, Sasha, Berry, Greg, Nedjar, Hacene, and Kahn, Susan R.
- Subjects
Mortality -- Canada ,Mortality -- Risk factors ,Mortality -- Prevention ,Mortality -- Research ,Thromboembolism -- Research ,Thromboembolism -- Complications and side effects ,Thromboembolism -- Risk factors ,Thromboembolism -- Care and treatment - Abstract
ABSTRACT Background: Patients undergoing hip or knee replacement are at high risk of developing a postoperative venous thromboembolism even after discharge from hospital. We sought to identify hospital and patient [...]
- Published
- 2008
50. Antithrombin III (ATILL) replacement therapy in patients with sepsis and/or postsurgical complications: a controlled double-blind, randomized, multicenter study
- Author
-
Baudo, F., Caimi, T. M., deCataldo, F., Ravizza, A., Arlati, S., Casella, G., Carugo, D., Palareti, G., Legnani, C., Ridolfi, L., Rossi, R., D'Angelo, A., Crippa, L., Giudici, D., Gallioli, G., Wolfler, A., and Calori, G.
- Subjects
Antithrombin III -- Dosage and administration ,Mortality -- Italy ,Mortality -- Risk factors ,Mortality -- Prevention ,Sepsis -- Drug therapy ,Sepsis -- Patient outcomes ,Surgery -- Complications ,Surgery -- Drug therapy ,Surgery -- Patient outcomes ,Health care industry - Abstract
Byline: F. Baudo (1), T. M. Caimi (1), F. deCataldo (1), A. Ravizza (2), S. Arlati (2), G. Casella (2), D. Carugo (2), G. Palareti (3), C. Legnani (3), L. Ridolfi (4), R. Rossi (4), A. D'Angelo (5), L. Crippa (5), D. Giudici (6), G. Gallioli (6), A. Wolfler (6), G. Calori (7) Keywords: Acquired ATIII deficiency; ATIII replacement therapy; Septic shock Abstract: Background: ATIII is decreased in sepsis and/or shock and its baseline value correlates with mortality. The efficacy of ATIII therapy on mortality was assessed in a selected group of patients admitted to the intensive care unit (ICU) in a double-blind, randomized, multicenter study. Methods: 120 patients admitted to the ICU with an ATIII concentration < 70% were randomized to receive ATIII (total dose 24000 units) or placebo treatment for 5 days 56 patients had septic shock. Results: ATIII concentrations in the treated group remained constant throughout the treatment period (range 97--102%). The Kaplan-Meier analysis showed no difference in overall survival between the two groups: 50 and 46 % for ATIII and placebo, respectively. Septic shock and hemodynamic support were unbalanced in the two groups at admission. Therefore the Cox analysis was carried out after adjusting for these two variables. Treatment with ATIII decreases the risk of death with an odds ratio (OR) of 0.56. Of the covariates analyzed, septic shock and the baseline multiple organ failure score were negatively associated with survival and plasma activity level was positively associated with survival with an OR of 0.97 for each 1 % increase in the ATIII plasma concentration at baseline. Conclusions: The results of ATIII treatment in this population of patients suggests that replacement therapy reduces mortality in the subgroup of septic shock patients only. Author Affiliation: (1) Department of Hematology, Hemostasis and Thrombosis Unit, Ospedale Niguarda, Milano, Italy (2) Department of Intensive Care, Ospedale Niguarda, Milano, Italy (3) Department of Angiology, Ospedale S. Orsola, Bologna, Italy (4) Department of Intensive Care, Ospedale S. Orsola, Bologna, Italy (5) Hemostasis Laboratory, Ospedale S. Raffaele, Milano, Italy (6) Intensive Care Unit, Ospedale S. Raffaele, Milano, Italy (7) Epidemiology Unit, Ospedale S. Raffaele, Milano, Italy Article History: Registration Date: 23/03/2009 Received Date: 05/06/1997 Accepted Date: 06/01/1998
- Published
- 1998
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