Tobacco‐related Mortality in Greece: The Effect of Malignant Neoplasms, Circulatory and Respiratory Diseases, 1994–2016

2020 ◽  
pp. 251-275
Author(s):  
Konstantinos N. Zafeiris
Keyword(s):  
Respiratory Diseases ◽  
Malignant Neoplasms ◽  
Related Mortality

scholarly journals Prospective associations between the nutritional quality of foods consumed (graded by the FSAm-NPS underlying the Nutri-Score) and mortality in Europe

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Mélanie Deschasaux ◽  
Inge Huybrechts ◽  
Neil Murphy ◽  
Chantal Julia ◽  
Serge Hercberg ◽  
...  
Keyword(s):  
Cardiovascular Diseases ◽  
Mortality Risk ◽  
Nutritional Quality ◽  
Respiratory Diseases ◽  
Food Products ◽  
Food Choices ◽  
Competing Events ◽  
Quality Of Food ◽  
Related Mortality

AbstractIn 2017, 11 million deaths related to non-communicable diseases (NCDs) were attributable to dietary risk factors (GBD, 2019). Helping consumers make healthier food choices hence appears as one key strategy to prevent NCDs-related mortality. To this end, political authorities are considering implementing a simple label to reflect the nutritional quality of food products. The five-colour Nutri-Score label, derived from the Nutrient Profiling System of the British Food Standards Agency (FSAm-NPS), has been chosen by several countries in Europe (France, Belgium, Spain). Yet, its implementation is still voluntary per EU labelling regulation. Scientific evidence is therefore needed regarding the relevance of the FSAm-NPS at the European level. Following on our results showing an increased risk of cancer related to the consumption of foods with a high FSAm-NPS score in the EPIC cohort, our objective is now to focus on NCDs-related mortality. Our prospective analyses included 501,594 adults from the EPIC cohort (1992–2015, median follow-up: 17.2 years). Mortality events occurring < 2 years after recruitment were excluded, leaving 50,743 death events (main causes: cancer, n = 21,971; cerebro/cardiovascular diseases, n = 12,407; respiratory diseases, n = 2,796). Usual food intakes were assessed with standardized country-specific diet assessment methods. The FSAm-NPS was calculated for each food/beverage using their 100-g content in energy, sugar, saturated fatty acid, sodium, fibres, proteins, and fruits/vegetables/legumes/nuts. The individual FSAm-NPS Dietary Index (DI) is obtained as an energy-weighted mean of the FSAm-NPS scores of all food items usually consumed by a participant. Cox proportional hazards models adjusted for confounding factors, including personal history of cancer, cardiovascular diseases and diabetes were computed. Fine and Gray models were also tested to take into account competing events for cause-specific mortality analyses. A higher FSAm-NPS DI score, reflecting a lower nutritional quality of the diet, was associated with a higher mortality risk overall (HRQ5vs.Q1 = 1.06 [95%CI: 1.02–1.09], P-trend < 0.001) and by cancer (HRQ5vs.Q1 = 1.06 [1.01–1.11], P-trend = 0.003) and respiratory diseases (HRQ5vs.Q1 = 1.33 [1.16–1.52], P-trend < 0.001), with similar results in competing events analyses. Associations with cerebro-/cardiovascular diseases mortality were weaker (HRQ5vs.Q1 = 1.05 [0.98,1.11], P-trend = 0.04) and no longer statistically significant in competing events analyses. In this large multinational European cohort, the consumption of food products with a higher FSAm-NPS score (lower nutritional quality of the foods consumed) was associated with a higher mortality risk, supporting the relevance of the FSAm-NPS to grade the nutritional quality of food products for public health applications (e.g, Nutri-Score) aiming to guide the consumers towards healthier food choices.

scholarly journals Yellow nail syndrome

2021 ◽  
Vol 97 (5) ◽  
pp. 76-80
Author(s):  
A. V. Motorina ◽  
T. G. Ruksha
Keyword(s):  
Respiratory Diseases ◽  
Clinical Manifestations ◽  
Lymphatic Vessels ◽  
Malignant Neoplasms ◽  
Bile Pigments ◽  
Internal Organs ◽  
Yellow Nail Syndrome ◽  
Slowing Down ◽  
Yellow Color ◽  
Close Relationship

Yellow nail syndrome is an extremely rare syndrome, mainly in people over 50 years of age, occurring both systemically and in isolation and requiring the most careful collection of anamnesis, since this condition has a close relationship with respiratory diseases, malignant neoplasms of internal organs and rheumatoid arthritis. Moreover, this rare disease is not sufficiently studied to fully understand its pathogenesis and effective treatment. Patients pay attention to the yellow color of the nails, associated with the deposition of melanin, bile pigments and hemosiderin in the submarginal space, slowing down the growth and thickening of the nail. It should be noted that the change in the nail plates can be observed long before the other clinical manifestations of this syndrome are detected, and probably this can in some cases serve as a harbinger of incipient changes in the lung tissue, neoplasms and changes in the lymphatic vessels. In this regard, it is extremely important to clearly differentiate this condition and refer patients to related specialists for verification of the diagnosis and further treatment.

Late morbidity and mortality among survivors of neuroblastoma treated with contemporary therapy: A report from the Childhood Cancer Survivor Study.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 10044-10044
Author(s):  
Danielle Novetsky Friedman ◽  
Pamela J. Goodman ◽  
Wendy M. Leisenring ◽  
Lisa Diller ◽  
Susan Lerner Cohn ◽  
...  
Keyword(s):  
High Risk ◽  
Risk Group ◽  
Risk Groups ◽  
Morbidity And Mortality ◽  
Malignant Neoplasms ◽  
Intermediate Risk ◽  
High Risk Disease ◽  
Late Morbidity ◽  
All Cause Mortality ◽  
Related Mortality

10044 Background: Survival rates for neuroblastoma vary widely based on risk group. Therapies have evolved over the past four decades to de-intensify treatment for individuals with low/intermediate risk disease and intensify therapy for those with high risk disease. Risk stratification is predicted to result in differential outcomes in late morbidity and mortality; the magnitude of these differences has not been well studied. Methods: We evaluated late mortality, subsequent malignant neoplasms (SMN) and chronic health conditions (CHC) graded according to CTCAE v4.03 among 491 5-year CCSS survivors of neuroblastoma diagnosed 1987-1999 at ≥1 year of age. Using age, stage at diagnosis, and treatment, survivors were classified into risk groups (low [n=182]; intermediate [n=70]; high [n=239]). Standardized mortality ratios (SMR) and standardized incidence ratios (SIR) of SMN were calculated using rates from NCHS and SEER, respectively. Cox regression models estimated hazard ratios (HR) and 95% confidence intervals (CI) for CHC compared to 1,029 CCSS siblings. Results: Among survivors (48% male; median age 22 years, range 7-42; median follow-up 19 years, range 5-29), 80.4% with low risk disease were treated with surgery alone, while 77.8% with high risk disease received surgery, radiation, chemotherapy ± transplant. The 15-year cumulative incidence of all-cause mortality was 9.2% (CI: 7.1-11.4), with a recurrence-related mortality of 7.3% (CI: 5.3-9.3) and SMN-related mortality of 0.3% (CI: 0-0.7). All-cause mortality was significantly higher in all risk groups: (low, SMR=5.8 [CI: 2.6-13.0]; intermediate, SMR=5.7 [CI: 1.4-23.5]; high, SMR=38.6 [CI: 27.9-53.5]). The risk of SMN was elevated among high risk survivors (SIR=25.1, CI: 16.7-37.6), but did not differ from the US population for survivors of low or intermediate risk disease. Table describes the HR of CHCs (grades 1-5 and 3-5) in survivors, by risk group, as compared with siblings, as well as categories of CHCs for which survivors were at increased risk. Conclusions: Long-term survivors of neuroblastoma have a high risk of late morbidity and mortality; risk is particularly pronounced among survivors of high risk disease. Vigilant lifelong medical surveillance will be required for this relatively young population as they age.[Table: see text]

scholarly journals British rubber and cable industry cohort: 49-year mortality follow-up

2018 ◽  
Vol 75 (12) ◽  
pp. 848-855 ◽  
Author(s):  
Damien Martin McElvenny ◽  
William Mueller ◽  
Peter Ritchie ◽  
John W Cherrie ◽  
Mira Hidajat ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Respiratory Diseases ◽  
Manufacturing Industry ◽  
Sufficient Evidence ◽  
International Agency ◽  
Malignant Neoplasms ◽  
Cancer Risks ◽  
Cable Industry ◽  
Circulatory Diseases

BackgroundThe International Agency for Research on Cancer (IARC) has determined there is sufficient evidence that working in the rubber manufacturing industry increases the risk of cancers of the stomach, lung, bladder and leukaemia and lymphoma.ObjectivesTo examine mortality patterns of a prospective cohort of men from the rubber and cable manufacturing industries in Great Britain.MethodsSMRs were calculated for males aged 35+ years at start of follow-up in 1967–2015 using the population of England and Wales as the external comparator. Tests for homogeneity and trends in SMRs were also completed.ResultsFor all causes, all malignant neoplasms, non-malignant respiratory diseases and circulatory diseases, SMRs were significantly elevated, and also particularly for cancers of the stomach (SMR=1.26,95% CI 1.18 to 1.36), lung (1.25,95% CI 1.21 to 1.29) and bladder (1.16,95% CI 1.05 to 1.28). However, the observed deaths for leukaemia, non-Hodgkin’s lymphoma (NHL) and multiple myeloma were as expected. Bladder cancer risks were elevated only in workers exposed to antioxidants containing 1-naphthylamine and 2-naphthylamine.ConclusionsThis study provides evidence of excess risks in the rubber industry for some non-cancer diseases and supports IARC’s conclusions in relation to risks for cancers of the bladder, lung and stomach, but not for leukaemia, NHL or multiple myeloma.

scholarly journals Mortality Among Male Cigar and Cigarette Smokers in the U.S.

2020 ◽  
Author(s):  
Brad Rodu ◽  
Nantaporn Plurphanswat
Keyword(s):  
Respiratory Diseases ◽  
Proportional Hazards ◽  
Heart Diseases ◽  
Cox Proportional Hazards ◽  
Malignant Neoplasms ◽  
Cox Proportional Hazards Models ◽  
Hazard Ratios ◽  
Low Prevalence ◽  
Cigar Smoking

Abstract Background. Cigars and cigarettes are both smoked, but much less is known about the former’s long-term health effects, due to its low prevalence and infrequent collection of cigar information in national surveys. Purpose. We conducted a follow-up mortality study of cigar-smoking men age 40-79 years in National Health Interview Surveys (NHIS). We utilized Methods. We used pooled NHIS files linked to the National Death Index to obtain follow-up from year of interview to year of death or December 31, 2015. We developed categories of cigarette and cigar smoking that accommodate dual and former use of both products. We used Cox proportional hazards models, adjusted for age, race/ethnicity, marital status, education, income, health status, body mass index, and region to estimate hazard ratios (HRs, 95% confidence intervals, CI) for mortality from all causes, heart diseases, malignant neoplasms, cerebrovascular disease, chronic lower respiratory diseases and two mutually exclusive categories: smoking-related and other diseases.Results. There were 14,628 deaths from all causes, including 3,420 never tobacco users, 3,266 exclusive smokers, and 176 exclusive cigar users. The latter had significantly increased mortality only from chronic lower respiratory diseases (HR = 2.60, CI = 1.04 – 6.50), which was based on 6 deaths. We found no statistically significant evidence among exclusive cigar smokers of increased mortality from any other cause.Conclusions. This study provides evidence that male cigar smokers had elevated mortality risks. However, after accounting for cigarette smoking, we found significantly increased mortality only for chronic lower respiratory diseases.

scholarly journals National Survey of Morbidity and Risk Factors (EMENO): Protocol for a Health Examination Survey Representative of the Adult Greek Population (Preprint)

2018 ◽  
Author(s):  
Giota Touloumi ◽  
Anna Karakatsani ◽  
Argiro Karakosta ◽  
Eleni Sofianopoulou ◽  
Panagiotis Koustenis ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Physical Examination ◽  
National Survey ◽  
Health Surveys ◽  
Respiratory Diseases ◽  
Preventive Measures ◽  
Malignant Neoplasms ◽  
Health Examination ◽  
Health Examination Survey

BACKGROUND Main causes of death in Greece are cardiovascular diseases (CVDs), malignant neoplasms, respiratory diseases, and road traffic crashes. To assess the population health status, monitor health systems, and adjust policies, national population-based health surveys are recommended. The previous health surveys that were conducted in Greece were restricted to specific regions or high-risk groups. OBJECTIVE This paper presents the design and methods of the Greek Health Examination Survey EMENO (National Survey of Morbidity and Risk Factors). The primary objectives are to describe morbidity (focusing on CVD, respiratory diseases, and diabetes), related risk factors, as well as health care and preventive measures utility patterns in a random sample of adults living in Greece. METHODS The sample was selected by applying multistage stratified random sampling on 2011 Census. Trained interviewers and physicians made home visits. Standardized questionnaires were administered; physical examination, anthropometric and blood pressure measurements, and spirometry were performed. Blood samples were collected for lipid profile, glucose, glycated hemoglobin, and transaminases measurements. The survey was conducted from May 2013 until June 2016. RESULTS In total, 6006 individuals were recruited (response rate 72%). Of these, 4827 participated in at least one physical examination, 4446 had blood tests, and 3622 spirometry, whereas 3580 provided consent for using stored samples for future research (3528 including DNA studies). Statistical analysis has started, and first results are expected to be submitted for publication by the end of 2018. CONCLUSIONS EMENO comprises a unique health data resource and a bio-resource in a Mediterranean population. Its results will provide valid estimates of morbidity and risk factors’ prevalence (overall and in specific subdomains) and health care and preventive measures usage in Greece, necessary for an evidence-based strategy planning of health policies and preventive activities. INTERNATIONAL REGISTERED REPOR DERR1-10.2196/10997

scholarly journals Trends in Late Mortality and Life Expectancy after Autologous Blood or Marrow Transplantation (BMT) Performed over Three Decades - a BMT Survivor Study (BMTSS) Report

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 484-484
Author(s):  
Mukta Arora ◽  
Chen Dai ◽  
Wendy Landier ◽  
Lindsey Hageman ◽  
Jessica Wu ◽  
...  
Keyword(s):  
Life Expectancy ◽  
Pulmonary Disease ◽  
Research Funding ◽  
Malignant Neoplasms ◽  
Years Of Life Lost ◽  
Late Mortality ◽  
The Impact ◽  
Related Mortality ◽  
Privately Held

Abstract Background: Advances in therapeutic and supportive care strategies have led to increasing use of autologous BMT to ensure durable disease-free survival in patients with hematologic malignancies. However, autologous BMT recipients carry a high burden of morbidity. The cumulative effect of autologous BMT and the long-term morbidity on life expectancy remains unknown. Further, the impact of changes in transplant practice (older age at BMT, increasing proportion of patients undergoing autologous BMT for plasma cell dyscrasias [PCD], increasing use of peripheral blood stem cells [PBSCs] and decreasing use of total body irradiation [TBI]) on late mortality and life expectancy remains unknown. We determined trends in life expectancy and cause-specific late mortality after autologous BMT performed over a 33y period (1981-2014) using the resources offered by BMTSS - a multi-institutional collaborative designed to examine late morbidity and mortality after BMT. Methods: This retrospective cohort included 4,702 individuals who lived ≥2y after autologous BMT performed between 1981 and 2014 at three transplant centers. We examined trends in life expectancy and late mortality over four eras: 1981-1999; 2000-2005; 2006-2010; 2011-2014. Endpoints included all-cause, recurrence-related mortality (RRM) and non-recurrence-related mortality (NRM) and projected reduction in life expectancy. Information on vital status and cause of death was obtained from National Death Index (NDI) Plus program and Accurinct databases. End of follow-up was 04/19/2021. Results: Median age at BMT was 53y (range, 0-78); 58.7% were male, 67.8% non-Hispanic white. Median follow up after BMT was 9y (range, 2-36). PCD was the most common indication for autologous BMT (42.3%). PBSCs were used for 91.6% of the transplants and TBI was used for conditioning in 23.1% of the patients. Across the four eras, the median age at BMT increased (40y→58y), as did the proportion of patients receiving autologous BMT for PCD (13.7%→60.0%) and the proportion of patients receiving PBSCs as the stem cell source (66.6%→99.5%). There was a dramatic decline in the proportion of patients conditioned with TBI (56.4%→5.2%), and those transplanted for acute myeloid leukemia/ myelodysplastic syndrome (AML/MDS) (15.4%→0.2%). Conditional on surviving ≥2y after autologous BMT, patients experienced a 25.8% reduction in life expectancy, representing 7.0y of life lost. In an analysis adjusted for all relevant demographic and clinical predictors and restricted to 5y of follow-up, the years of life lost declined across the four eras from 5y to 1.6y (Fig 1) The adjusted hazard of all-cause mortality also declined over the four eras (reference: 1981-1999; hazard ratio [HR]2000-2005=0.77; 95%CI=0.7-0.9; HR 2006-2010=0.62; 95%CI=0.5-0.7; HR 2011-2014=0.5; 95%CI=0.4-0.6; P trend &lt;0.0001) (Fig 2). Mediation analysis revealed that the reduction in late mortality was evident among those transplanted for Hodgkin lymphoma (HL) or PCD, and among those who did not receive TBI . The 30y cumulative incidence of NRM (29.2%) was higher than that RRM (23.8%) (Fig 3). The adjusted hazard of RRM declined over the four eras (reference: 1981-1999; HR 2011-2014=0.55; 95%CI=0.4-0.7, P trend: &lt;0.0001). Cause-specific late mortality declined for mortality related to infection (P trend &lt;0.0001), subsequent malignant neoplasms (P trend=0.01), cardiovascular disease (P trend=0.001), and renal disease (P trend=0.0002), but not for pulmonary disease (P trend=0.3). Conclusions and Relevance: Late mortality among autologous BMT recipients has declined over a 30y period, likely due to changes in transplant practice (reduction in use of TBI) and improvement in disease-specific therapeutic strategies (newer therapeutic options for PCD and reduction in dose/volume of radiation for HL). Continued efforts need to focus on mitigation strategies for disease recurrence, subsequent neoplasms, infections, and cardiovascular, renal and pulmonary disease in this population. Figure 1 Figure 1. Disclosures Arora: Kadmom: Research Funding; Pharmacyclics: Research Funding; Syndax: Research Funding. Forman: Allogene: Consultancy; Lixte Biotechnology: Consultancy, Current holder of individual stocks in a privately-held company; Mustang Bio: Consultancy, Current holder of individual stocks in a privately-held company. Weisdorf: Incyte: Research Funding; Fate Therapeutics: Research Funding.

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