Articles: mortality.
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This paper quantifies the contribution of leading causes of death to mortality change between 1991 and 2005 for people aged 50 years and over in England. Between 1971 and 2005 the life expectancy of men aged 50 years increased by more than in the whole of the rest of the 20(th) century. The ageing population has not only had an important impact on health and social services, but was responsible for sparking the pensions crisis affecting both the public and commercial sector. ⋯ The trends of decreasing mortality rates from ischaemic heart disease and stroke have continued into the 21(st) century, however both causes continue to be the biggest killers in England. They are projected to remain so, and consequently, to contribute significantly to the burden of disease in the population.The steady increase in liver disease mortality identified highlights the importance of tackling alcohol misuse as a public health priority.
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In-hospital hypernatremia develops usually iatrogenically from inadequate or inappropriate fluid prescription. In severely burned patient an extensive initial fluid resuscitation is necessary for burn shock survival. After recovering of cellular integrity the circulating volume has to be normalized. Hereby extensive water and electrolyte shifts can provoke hypernatremia. ⋯ Burned patients with an in-hospital acquired hypernatremia have an increased mortality risk. In case of a hypernatremic state early intervention is obligatory. There is a need of a fluid removal strategy in severely burned patient to avoid water imbalance.
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This article reports research carried out to inform possible methods of describing seasonal mortality in relation to extremes of temperature. In particular, since different methods are currently used to assess excess winter mortality and heatwave related mortality, we aimed to find out whether a single method could be used to measure all seasonal mortality in relation to temperature. In order to do this the project investigated whether there are temperatures above or below which excess deaths occur, and explored whether it is possible to predict reliably how many deaths would occur at extreme temperatures. ⋯ There is a weak but significant relationship between temperature and mortality in both the summer and winter months. While in winter mortality does increase as it gets colder, winter mortality is variable and high mortality can occur on relatively mild days. Similarly, in the summer high temperatures are often associated with relatively increased mortality, but a single hot day does not always lead to excess deaths. Daily mortality cannot be predicted from temperature alone: the prevalence of influenza in winter and factors such as air pollution in summer should also be considered.
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Diffused endothelial dysfunction in sepsis leads to an increase in systemic capillary permeability, the renal component manifesting as microalbuminuria. The degree of microalbuminuria correlates with the severity of the acute insult, the quantification of which may serve to predict sepsis and mortality in critically ill patients. ⋯ Absence of significant microalbuminuria on ICU admission is unlikely to be associated with sepsis. At 24 hours, absence of elevated levels of microalbuminuria is strongly predictive of ICU survival, equivalent to the time-tested APACHE II scores.
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Dermatomyositis (DM) and polymyositis (PM) are rare systemic autoimmune rheumatic diseases with high fatality rates. There have been few population-based mortality studies of dermatomyositis and polymyositis in the world, and none have been conducted in Brazil. The objective of the present study was to employ multiple-cause-of-death methodology in the analysis of trends in mortality related to dermatomyositis and polymyositis in the state of São Paulo, Brazil, between 1985 and 2007. ⋯ Our study using multiple cause of deaths found that DM/PM were identified as the underlying cause of death in only 55.2% of the deaths, indicating that both diseases were underestimated in the primary mortality statistics. We observed a predominance of deaths in women and in older individuals, as well as a trend toward stability in the mortality rates. We have confirmed that the risk of death is greater when either disease is accompanied by neoplasm, albeit to lesser degree in individuals with PM. The investigation of the underlying and associated causes of death related to DM/PM broaden the knowledge of the natural history of both diseases and could help integrate mortality data for use in the evaluation of control measures for DM/PM.