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Mortality Decreased (mortality + decreased)
Selected AbstractsSex-biased juvenile survival in a bird with extreme size dimorphism, the great bustard Otis tardaJOURNAL OF AVIAN BIOLOGY, Issue 3 2007Carlos A. Martín We explored sex-biased mortality patterns in a species showing the most extreme sexual dimorphism among birds, the great bustard Otis tarda. Between 1991 and 2005 we studied juvenile and immature survival in a sample of 361 great bustards radio-tagged at two different populations in Spain, Villafáfila and Madrid. Mortality decreased with age, from high rates during the first year (0.70), to 0.10 in the second year. Using the known-fate model in program MARK we found that monthly survival increased throughout the first year. Offspring showing higher body mass at marking, i.e. those hatched earlier in the season and those with better body condition, survived in higher proportion. This was probably related to the earlier breeding dates of more experienced mothers, as well as to the observed decrease in food availability as the season progresses. Monthly survival estimates were higher in females than in males, which suggests that juvenile males are more vulnerable to reduced food availability and other factors due to their much faster growth rates. The proportion of non-natural deaths increased with age, and was higher in the Madrid population, where illegal hunting and collision with powerlines showed a high incidence. The male-biased mortality found in young birds in this study explains the female-biased population sex ratios observed in great bustard populations. The different degrees of incidence of human-induced causes of mortality found between both populations studied suggest that such differences may contribute to the variation observed in the adult sex ratio among populations. [source] Mortality and incidence trends from esophagus cancer in selected geographic areas of China circa 1970,90INTERNATIONAL JOURNAL OF CANCER, Issue 3 2002Li Ke Abstract China was one of the countries with the highest esophagus cancer risk in the world during the 1970s. This report provides data on time trends of esophagus cancer incidence and mortality during the 1970s,90s in selected geographic areas of China. Information on newly diagnosed cancer cases and cancer deaths is based on data collected by local population-based registries and Disease Surveillance Points (DSP). For the whole country, esophagus cancer mortality decreased slightly, 17.4 per 105 populations during 1990,92 in contrast to 18.8 per 105 populations in 1973,75. In the Linxian area, trends in the incidence and mortality rates for esophagus+gastric cardia cancer reversed over time; incidence rates increased significantly during 1959,72 but were decreased significantly on average ,2.26% (95% Confidence Interval [CI]: ,1.74, ,2.77) and ,1.10% (95% CI = ,0.58, ,1.62) per year for males and females, respectively, during 1972,97. In urban Shanghai, incidence trend for esophagus cancer decreased monotonically and significantly on average by ,4.99% (95% CI = ,4.28, ,5.70) and ,5.18% (95% CI = ,4.99, ,5.70) per year for males and females, respectively. In Nanao islet, esophagus+gastric cardia cancer mortality rates increased during 1970,82 but decreased slowly from 1982,99 (,0.96% per year; 95% CI = ,0.14, ,1.78). Our study indicates that incidence and mortality rates for esophagus or esophagus+gastric cardia cancer are now decreasing in China. The declines may be due to an unplanned success of prevention, such as changes in population dietary patterns and food preservation methods. © 2002 Wiley-Liss, Inc. [source] The Poor Outcome of Ischemic Stroke in Very Old People: A Cohort Study of Its DeterminantsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 1 2010Licia Denti MD OBJECTIVES: To assess how much of the excess risk of poor outcome from stroke in people aged 80 and older aging per se explains, independent of other prognostic determinants. DESIGN: Cohort, observational. SETTING: University hospital. PARTICIPANTS: One thousand five hundred fifty-five patients with first-ever ischemic stroke consecutively referred to an in-hospital Clinical Pathway program were studied. MEASUREMENTS: The relationship between age and 1-month outcome (death, disability (modified Rankin Scale 3,5), and poor outcome (modified Rankin Scale 3,6)) was assessed, with adjustment for several prognostic factors. RESULTS: Six hundred twelve patients aged 80 and older showed worse outcome after 1 month than those who were younger, in terms of mortality (19% vs 5%, hazard ratio (HR)=3.85, 95% confidence interval (CI)=2.8,5.4) and disability (51% vs 33%, odds ratio (OR)=3.16, 95% CI=2.5,4.0), although in multivariate models, the adjusted HR for mortality decreased to 1.47 (95% CI=1.0,2.16) and the ORs for disability and poor outcome decreased to 1.76 (95% CI=1.32,2.3.) and 1.83 (95% CI=137,2.43), respectively. Stroke severity, the occurrence of at least one medical complication, and premorbid disability explained most of the risk excess in the oldest-old. CONCLUSION: Stroke outcome is definitely worse in very old people, and most of the excess risk of death and disability is attributable to the higher occurrences of the most-severe clinical stroke syndromes and of medical complications in the acute phase. These represent potential targets for preventive and therapeutical strategies specifically for elderly people. [source] Heart Transplantation in the United States, 1999,2008AMERICAN JOURNAL OF TRANSPLANTATION, Issue 4p2 2010M. R. Johnson This article features 1999,2008 trends in heart transplantation, as seen in data from the Organ Procurement and Transplantation Network (OPTN) and the Scientific Registry of Transplant Recipients (SRTR). Despite a 32% decline in actively listed candidates over the decade, there was a 20% increase from 2007 to 2008. There continues to be an increase in listed candidates diagnosed with congenital heart disease or retransplantation. The proportion of patients listed as Status 1A and 1B continues to increase, with a decrease in Status 2 listings. Waiting list mortality decreased from 2000 through 2007, but increased 18% from 2007 to 2008; despite the increase in waiting list death rates in 2008, waiting list mortality for Status 1A and Status 1B continues to decrease. Recipient numbers have varied by 10% over the past decade, with an increased proportion of transplants performed in infants and patients above 65 years of age. Despite the increase in Status 1A and Status 1B recipients at transplant, posttransplant survival has continued to improve. With the rise in infant candidates for transplantation and their high waiting list mortality, better means of supporting infants in need of transplant and allocation of organs to infant candidates is clearly needed. [source] Plasma Exchange Before Surgery for Left Ventricular Assist Device ImplantationARTIFICIAL ORGANS, Issue 6 2008Rajko Radovancevic Abstract:, Left ventricular assist device (LVAD) implantation in end-stage heart failure patients is frequently associated with hemorrhagic complications requiring reoperation. The preoperative coagulopathic profile includes prolonged prothrombin time (PT), partial thromboplastin time (PTT), and bleeding time; platelet dysfunction; decreased coagulation factor activity; and increased inflammatory markers. We compare outcomes in LVAD patients treated with preoperative plasma exchange with concurrent, nonrandomized control patients. We reviewed data from 68 consecutive elective patients who received LVADs at our institution. Thirty-five received LVADs after preoperative plasma exchange (replacement of one plasma volume of fresh frozen plasma), and 33 received LVADs without plasma exchange. Groups were comparable in age, sex, body weight, New York Heart Association class, intra-aortic balloon pump insertion, cardiac index, pulmonary capillary wedge pressure, creatinine, total bilirubin, hemoglobin levels, PT, international normalized ratio, PTT, and platelet count. Early mortality was lower in the plasma exchange group (0% [0/35] vs. 18% [6/33], P = 0.026), and postoperative chest tube drainage decreased by 33% (P = not significant). Blood transfusion requirements were similar.Perioperative mortality decreased in patients treated with plasma exchange before LVAD implantation. [source] Mortality trends for cervical squamous and adenocarcinoma in the United States,CANCER, Issue 6 2005Relation to incidence, survival Abstract BACKGROUND In the United States, detection of squamous carcinoma in situ (CIS) by screening has led to reduced rates for invasive squamous carcinoma and lower mortality. Adenocarcinoma in situ (AIS) rates also have increased, but invasive cervical adenocarcinoma rates have not declined similarly. To make inferences about the effectiveness of screening, the authors assessed mortality trends for squamous and adenocarcinoma in relation to incidence of these tumors, incidence of their precursors and survival. METHODS Using data from the Surveillance, Epidemiology, and End Results program (SEER), the authors tabulated incidence per 105 woman-years for invasive carcinomas (1976,2000) and for CIS and AIS (1976,1995) by age (< 50 years, , 50 years) and race (whites, blacks). Cumulative relative survival rates were tabulated for 1976,1995 and mortality rates were estimated for 1986,2000. RESULTS Among all groups, CIS rates approximately doubled whereas rates for invasive squamous carcinoma declined. Among younger whites, mortality declined from 1.12 to 0.93, and for older whites, mortality decreased from 5.02 to 3.82. Among younger blacks, mortality for squamous carcinoma decreased from 2.69 to 1.96. Among older blacks, the mortality rates declined from 14.88 to 9.15. Although AIS rates have increased dramatically among whites (all ages) and younger blacks, adenocarcinoma incidence and mortality rates have not changed greatly. Survival for patients did not change greatly within these age-race groups. CONCLUSIONS The authors concluded that increases in CIS seemed disproportionately large compared with improvements in mortality rates for squamous carcinoma. Despite increased reporting of AIS, declines in mortality for cervical adenocarcinoma have not been demonstrated conclusively. However, future analyses are required to evaluate these trends more completely. Cancer 2005. Published 2005 by the American Cancer Society. [source] Complications affecting preterm neonates from 1991 to 2006: what have we gained?ACTA PAEDIATRICA, Issue 3 2010F Groenendaal Abstract Aim:, In this study, we determined whether outcome of preterm neonates has improved over a period of 16 years. Study design:, Inborn neonates with a gestational age of 25.0,29.9 weeks were included. Patients with severe congenital malformations were excluded. Mortality and morbidity (chronic lung disease; CLD, intraventricular haemorrhage: IVH grade III or IV, cystic periventricular leukomalacia: cPVL, perforated necrotizing enterocolitis: NEC, severe retinopathy of prematurity needing surgery: ROP and cerebral palsy: CP) were compared in three periods (period 1: 1991,1996 n = 434; period 2: 1997,2001 n = 356; period 3: 2002,2006 n = 422). Results:, Infant mortality decreased from 15.2% to 10.9%. CLD did not differ significantly between periods (14.1,14.8%). Perforated NEC decreased from 2.8% to 1.6%. IVH grade III and IV both remained at 5.7% in period 3, whereas cPVL decreased significantly from 4.5% to 1.6%. Cerebral palsy decreased from 5.8% to 3.5% in period 3. Two neonates in each period were in need of surgery for ROP. Conclusion:, Inborn preterm patients showed an improved survival and a significant reduction in cPVL and CP. Perforated NEC showed a trend to decrease. CLD and IVH grade III and IV remain a matter of concern. [source] Early surfactant in spontaneously breathing with nCPAP in ELBW infants , a single centre four year experienceACTA PAEDIATRICA, Issue 3 2008Angela Kribs Abstract Objective: To evaluate whether the experience with a method to administer surfactant during spontaneous breathing with nasal continuous positive airway pressure (nCPAP) as primary respiratory support in infants with respiratory distress syndrome (RDS) influences the frequency of its use and affects the outcome of patients. Methods: All inborn extremely low birthweight (ELBW) infants treated after introduction of the method were retrospectively studied (n = 196). The entire observational period was divided into four periods (periods 1,4) and compared with a control period (period 0) (n = 51). Primary respiratory support, demographics, prenatal risks and outcomes were compared. Results: There were no changes in demographics or prenatal risks over time. The choice of nCPAP as initial airway management significantly increased from 69% to 91% and for nCPAP with surfactant from 75% to 86%. The rate of nCPAP failure decreased from 46% to 25%. Survival increased significantly between periods 0 and 1 from 76% to 90% and survival without bronchopulmonary dysplasia (BPD) rose from 65% to 80%. No changes in nonpulmonary outcomes were observed. Conclusion: The success of nCPAP increased with increasing use of nCPAP with surfactant. Simultaneously, mortality decreased without deterioration of other outcomes indicating that the use of surfactant in spontaneous breathing with nCPAP could be beneficial. [source] | ||||||||||