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Highest Mortality Rate (highest + mortality_rate)
Selected AbstractsCultural barriers in the education of cardiovascular disease patients in IranINTERNATIONAL NURSING REVIEW, Issue 3 2008M.A. Farahani bscn Background:, Cardiovascular diseases are responsible for the highest mortality rate in Iran; however, there is a lack of evidence for cultural factors influencing patient education. Such information is important for the provision of effective patient care. Aim:, To identify key issues relating to cultural factors influencing education of cardiovascular disease patients in Iran. Methods:, The qualitative research approach was used in this study, with open-ended interviews used to gather data. Eighteen nurses, four cardiovascular specialists, nine patients with cardiovascular disease and four family members were interviewed at two educational hospitals in Tehran. Interviews were taped, transcribed and analysed using constant comparative analysis. Findings:, Participants expressed a range of cultural factors influencing patient education. Five themes emerged from the analysis: (a) patients' lifestyle, (b) beliefs about disease and treatment, (c) concealment of true diagnosis, (d) different opinions regarding the preferred instructor, and (e) ineffective communication. Conclusion:, Findings show that cultural beliefs may act as risk factors for, or serve to intensify, cardiovascular disease. Consideration of these factors is essential for the success of patient education programmes. [source] A study of the susceptibility of Atlantic halibut, Hippoglossus hippoglossus (L.), to viral haemorrhagic septicaemia virus isolated from turbot, Scophthalmus maximus (L.)JOURNAL OF FISH DISEASES, Issue 4 2003T J Bowden Abstract The susceptibility of Atlantic halibut, Hippoglossus hippoglossus (L.), to viral haemorrhagic septicaemia virus (VHSV) was tested. Juvenile halibut of approximately 5 g weight were subjected to challenge by intraperitoneal injection, cohabitation and immersion to a VHSV isolate from an outbreak of the disease in turbot, Scophthalmus maximus (L.). The intraperitoneal injection gave the highest mortality rate of 28% after 50 days. The cohabitee group suffered 19% mortality rate and the immersion group only 2%. Control groups included turbot exposed either by intraperitoneal injection or immersion which suffered mortality rates of 93 and 50%, respectively. The results suggest that halibut are markedly less susceptible to VHSV than turbot. [source] Ice-storm disturbance and long-term forest dynamics in the Adirondack MountainsJOURNAL OF VEGETATION SCIENCE, Issue 2 2004Charles W. Lafon Ice storms cause periodic disturbance to temperate forests of eastern North America. They are the primary agents of disturbance in some eastern forests. In this paper, a forest gap model is employed to explore consequences of ice storms for the long-term dynamics of Tsuga canadensis-northem hardwoods forests. The gap model LINKAGES was modified to simulate periodic ice storm disturbance in the Adirondack Mountains of New York. To adapt the gap model for this purpose, field data on ice storm disturbance are used to develop a polytomous logistic regression model of tree damage. The logistic regression model was then incorporated into the modified forest gap model, LINK ADIR, to determine the type of damage sustained by each simulated tree. The logistic regression model predicts high probabilities of bent boles or severe bole damage (leaning, snapping, or uprooting) in small-diameter trees, and increasing probability of canopy damage as tree size increases. Canopy damage is most likely on gentle slopes; the probability of severe bole damage increases with increasing slope angle. In the LINKADIR simulations, tree damage type determines the probability of mortality; trees with severe bole damage are assigned the highest mortality rate. LINKADIR predicts Tsuga canadensis dominance in mesophytic old-growth forests not disturbed by ice storms. When ice storms are simulated, the model predicts Acer saccharum -dominated forests with higher species richness. These results suggest that ice storms may function as intermediate disturbances that enhance species richness in forested Adirondack landscapes. [source] RISK FACTORS IN SURGICAL MANAGEMENT OF THORACIC EMPYEMA IN ELDERLY PATIENTSANZ JOURNAL OF SURGERY, Issue 6 2008Ming-Ju Hsieh Background: Although elderly patients with thoracic disease were considered to be poor candidates for thoracotomy before, recent advances in preoperative and postoperative care as well as surgical techniques have improved outcomes of thoracotomies in this patient group. The aim of this study was to investigate surgical risk factors and results in elderly patients (aged ,70 years) with thoracic empyema. Methods: Seventy-one elderly patients with empyema thoracis were enrolled and evaluated from July 2000 to April 2003. The following characteristics and clinical data were analysed: age, sex, aetiology of empyema, comorbid diseases, preoperative conditions, postoperative days of intubation, length of hospital stay after surgery, complications and mortality. Results: Surgical intervention, including total pneumonolysis and evacuation of the pleura empyema cavity, was carried out in all patients. Possible influent risk factors on the outcome were analysed. The sample group included 54 men and 17 women with an average age of 76.8 years. The causes of empyema included parapneumonic effusion (n = 43), lung abscess (n = 8), necrotizing pneumonitis (n = 8), malignancy (n = 5), cirrhosis (n = 2), oesophageal perforation (n = 2), post-traumatic empyema (n = 2) and post-thoracotomy complication (n = 1). The 30-day mortality rate was 11.3% and the in-hospital mortality rate was 18.3% (13 of 71). Mean follow up was 9.4 months and mean duration of postoperative hospitalization was 35.8 days. Analysis of risk factors showed that patients with necrotizing pneumonitis or abscess had the highest mortality rate (10 of 18, 62.6%). The second highest risk factor was preoperative intubation or ventilator-dependency (8 of 18, 44.4%). Conclusion: This study presents the clinical features and outcomes of 71 elderly patients with empyema thoracis who underwent surgical treatment. The 30-day surgical mortality rate was 11.3%. Significant risk factors in elderly patients with empyema thoracis were necrotizing pneumonitis, abscess and preoperative intubation/ventilation. This study also suggested that surgical treatment of empyema thoracic in elderly patients is recommended after failed conservative treatment because of the acceptably postoperative complication and mortality rate. [source] Candidemia in patients with hematologic malignancies in the era of new antifungal agents (2001-2007)CANCER, Issue 20 2009Stable incidence but changing epidemiology of a still frequently lethal infection Abstract BACKGROUND: The incidence, epidemiology, Candida species distribution, resistance patterns, and outcome of candidemia in high-risk hematologic malignancy and/or stem cell transplantation patients have not been extensively described since the introduction of new antifungal agents. METHODS: In this retrospective study, the authors reviewed the medical records and microbiologic data of hematologic malignancy patients with candidemia at The University of Texas M. D. Anderson Cancer Center from March 2001 to February 2007. RESULTS: The authors analyzed 173 episodes of candidemia (170 patients), 125 (72%) of which were breakthrough cases after prior antifungal agents, mainly fluconazole (28 [22%]), caspofungin (25 [20%]), and voriconazole (18 [14%]). The incidence of candidemia (per 100,000 inpatient days) remained relatively stable, from 13.9 in 2001 to 19.2 in 2006. However, compared with the findings of previous studies at the authors' institution, the frequency of Candida glabrata and C. krusei infection decreased (to 5% and 17%, respectively) and C. parapsilosis (24%) and C. tropicalis (21%) increased. C. parapsilosis fungemia was associated with prior caspofungin use (P < .001). The overall 30-day crude mortality rate was 38%, and the attributable mortality rate was 19%, similar to previous findings at the authors' institution. The Candida species associated with the highest mortality rate was C. glabrata. CONCLUSIONS: Despite the widespread use of antifungal prophylaxis and the introduction of new antifungal agents, the incidence and associated mortality rates of candidemia remained stable in high-risk hematologic malignancy patients. However, its epidemiological characteristics have shifted, with C. parapsilosis and C. tropicalis becoming more common. Cancer 2009. © 2009 American Cancer Society. [source] Poisoning in Zimbabwe: a survey of eight major referral hospitalsJOURNAL OF APPLIED TOXICOLOGY, Issue 2 2002D. Tagwireyi Abstract A retrospective study of the pattern of poisoning cases admitted to eight major urban referral hospitals in Zimbabwe over a 2-year period (1998,1999 inclusive) was conducted to describe the pattern of poisoning at these centres. There were a total of 2764 hospital admissions due to poisoning, involving a total of 2846 toxic agents. Accidental poisoning (AP) and deliberate self-poisoning (DSP) accounted for 48.9% (1352 cases) and 41.3% (1142 cases), respectively. With AP, the highest number of cases (45.9%) occurred in children below the age of 5 years, with half of these due to chemicals, mainly paraffin. In the DSP group, however, more than 60% of all cases occurred in the 16,25-year age group. In addition, twice as many females as males were admitted for DSP compared with an overall male/female ratio of 1 : 1.2. Pesticides (31.4%) and pharmaceuticals (30.4%) were the most common groups of toxic agents responsible for the hospital admissions. Unknown toxins, natural toxins and pesticides showed the highest mortality rates (15.4%, 8.3% and 6.7%, respectively). Compared with the last major survey of poisoning in Zimbabwe, the pattern of poisoning at referral hospitals has changed over the last decade, with an increase in pesticide and pharmaceutical cases and a marked fall in cases of traditional medicine poisoning. Educational and legislative interventions may be required to address these changes. There is the need also to investigate further the high mortality rates associated with traditional medicine poisoning. Copyright © 2002 John Wiley & Sons, Ltd. [source] Pyrethroid resistance/susceptibility and differential urban/rural distribution of Anopheles arabiensis and An. gambiae s.s. malaria vectors in Nigeria and GhanaMEDICAL AND VETERINARY ENTOMOLOGY, Issue 3 2003M. Kristan Abstract., Resistance to pyrethroid insecticides and DDT caused by the kdr gene in the malaria vector Anopheles gambiae Giles s.s. (Diptera: Culicidae) has been reported in several West African countries. To test for pyrethroid resistance in two more countries, we sampled populations of the An. gambiae complex from south-western Ghana and from urban and rural localities in Ogun State, south-west Nigeria. Adult mosquitoes, reared from field-collected larvae, were exposed to the WHO-recommended discriminating dosage of exposure for 1 h to DDT 4%, deltamethrin 0.05% or permethrin 0.75% and mortality was recorded 24 h post-exposure. Susceptibility of An. gambiae s.l. to DDT was 94,100% in Ghana and 72,100% in Nigeria, indicating low levels of DDT resistance. Deltamethrin gave the highest mortality rates: 97,100% in Ghana, 95,100% in Nigeria. Ghanaian samples of An. gambiae s.l. were fully susceptible to permethrin, whereas some resistance to permethrin was detected at 4/5 Nigerian localities (percentage mortalities 75, 82, 88, 90 and 100%), with survivors including both An. arabiensis Patton and An. gambiae s.s. identified by PCR assay. Even so, the mean knockdown time was not significantly different from a susceptible reference strain, indicating absence or low frequency of kdr -type resistance. Such low levels of pyrethroid resistance are unlikely to impair the effectiveness of pyrethroid-impregnated bednets against malaria transmission. Among Nigerian samples of An. gambiae s.l., the majority from two urban localities were identified as An. arabiensis, whereas the majority from rural localities were An. gambiae s.s. These findings are consistent with those of M. Coluzzi et al. (1979). Differences of ecological distribution between molecular forms of An. gambiae s.s. were also found, with rural samples almost exclusively of the S-form, whereas the M-form predominated in urban samples. It is suggested that ,urban island' populations of An. arabiensis and of An. gambiae s.s. M-form in the rainforest belt of West Africa might be appropriate targets for elimination of these malaria vectors by the sterile insect technique. [source] | |||||||||||||