scholarly journals Mortality trends for multiple sclerosis in Italy

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
F Gori ◽  
L Kundisova ◽  
D Bezzini ◽  
A Martini ◽  
L Giovannetti ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Initial Period ◽  
Central Italy ◽  
Mortality Data ◽  
Geographical Differences ◽  
Mortality Trends ◽  
North West ◽  
South Italy ◽  
North East ◽  
Socio Economic Impact

Abstract Background Multiple sclerosis (MS) is the immune-mediated inflammatory disease affecting myelinated axons of the central nervous system with enormous socio-economic impact. The aim of this study was to analyze mortality trends for MS in Italy. Methods The mortality data relative to period 1980-2015 were provided by Italian Institute of Statistics, data were aggregated in 5 intervals (1980-1986; 1987-1993; 1994-2000; 2001-2008; 2008-2015). The Age-Standardized mortality Rates (SR) with respective 95% confidence intervals (95%CI) were calculated (using the European standard 2013) in order to evaluate the mortality trends (in confrontation to the initial period) and Standardized Mortality Ratios (SMR), in order to confront mortality in 5 major geographic areas: North-East (NE), North-West (NW), Central Italy (CI), South Italy (SI) and Islands (I). Results During the study period 4959 deaths for males and 7433 for females were observed. The SRs were significantly higher for females (0.71;95%CI:0.70-0.73 vs. 0.56; 95%CI:0.54-0.57). Significantly higher SMR were observed for both sexes in I (M:123.3 vs F:112.7), for females also in NE (106.5) and NW (115.8). Significantly lower SMR for both sexes were observed in SI (M:88.8; F:71.4) and for males in CI (90.9). The observed SRs during the five intervals for males were: 0.65(95%CI 0.60-0.69); 0.52 (95%CI 0.49-0.56); 0.46 (95%CI 0.43-0.49); 0.53 (95%CI 0.49-0.56); 0.59 (95%CI 0.56-0.62); and for females: 0.69 (0.65-0.73); 0.69 (0.65-0.73); 0.61 (0.58-0.65); 0.68 (0.65-0.72); 0.81(0.77-0.84); respectively. An initial decrease of SRs was observed for males until 2001-2007 in confrontation to the initial period (p < 0.05). For females significant increase of SRs was observed in 2008-2015 (p < 0.05). Conclusions An increase of mortality for MS, observed for females, especially after 2000 may reflect the raising prevalence of MS in Italy. Important geographical differences were observed for five main areas. Key messages During the study period an increase of mortality for MS was observed for females. Important differences were observed between five main Italian geographic areas.

scholarly journals Cancer Mortality Trend in Central Italy: Focus on A “Low Rate of Land Use” Area from 1982 to 2011

2019 ◽  
Vol 16 (4) ◽  
pp. 628 ◽  
Author(s):  
Francesca Santilli ◽  
Stefano Martellucci ◽  
Jennifer Di Pasquale ◽  
Cecilia Mei ◽  
Fabrizio Liberati ◽  
...  
Keyword(s):  
Land Use ◽  
Cancer Mortality ◽  
Central Italy ◽  
Mortality Rates ◽  
Mortality Data ◽  
Mortality Trends ◽  
High Prevalence ◽  
Oncological Diseases ◽  
Total Cancer ◽  
Low Rate

The aim of the present study was to estimate total cancer mortality trends from 1982 to 2011 in a “low rate of land use” province of the Latium region (Rieti, central Italy) characterized by a low degree of urbanization, a high prevalence of elderly, and a low number of births. Mortality data of the studied period, provided by the Italian National Institute of Statistics, were used for calculating standardized cancer mortality rates. Trends in mortality were analyzed using Joinpoint regression analysis. Results showed that total standardized cancer mortality rates decreased in the monitored area over the study period. A comparison with other provinces of the same region evidenced that the studied province presented the lowest cancer mortality. The three systems/apparatuses affected by cancer that mainly influenced cancer mortality in the monitored province were the trachea-bronchus-lung, colorectal-anus, and stomach. These findings could be attributed to the implement of preventive initiatives performed in the early 2000s, to healthier environmental scenario, and to lower levels of carcinogenic pollutants in air, water, and soil matrices. Thus, our results indicate that the studied area could be considered a “healthy” benchmark for studies in oncological diseases.

scholarly journals Subnational estimates of maternal mortality in Nigeria: Analysis of female siblings’ survivorship histories. 

2021 ◽  
Author(s):  
Opeyemi Oluwatosin Babajide ◽  
Joshua Odunayo Akinyemi ◽  
Olusola Ayeni
Keyword(s):  
Maternal Mortality ◽  
Rural Areas ◽  
Small Area ◽  
Demographic And Health Surveys ◽  
The South ◽  
Mortality Trends ◽  
North West ◽  
North East ◽  
The North ◽  
South West

Abstract BACKGROUND High Maternal Mortality (MM) in Nigeria is further complicated by the lack of reliable estimates for subnational levels such as states and geopolitical regions. Disaggregating maternal mortality estimates by subnational levels is crucial to ensuring policy decisions and program implementation are adapted to areas with a high burden of mortality. This study involves a novel adaptation of small area estimation techniques to derive plausible estimates of levels and trends in Maternal Mortality rates and ratios for states and geopolitical regions in Nigeria. METHODS. Survivorship history data of 293,769 female siblings were provided by 114,154 women in the Nigeria Demographic and Health Surveys of 2008, 2013 and 2018. MM Rates and Ratios were estimated using the Empirical Bayesian technique for small area demographic estimates. The James-Stein estimator was used to shrink the estimates closer to the population mean values with 95% Confidence Interval (CI). RESULTS Levels of MMRatio were highest in the rural areas, States and regions in Northern Nigeria. MMRatio was consistently lower in the South West (2008=281; 2013=367; 2018=392) and higher among the Northern regions of the country, particularly the North-East (2008=654; 2013=612; 2018=901) for three consecutive surveys. Over the three surveys, mortality trends declined about 18% in the North West and 54.2% in the South East region. However, there was a 4.8% increase in MMRatio for South West between 2008 to 2018. CONCLUSIONS Nigeria has geopolitical and sub-national disparities that pose a burden to the country’s maternal health. Since several states in the Northern geopolitical zone still show high maternal mortality, targeted intervention at state levels should be explored to ensure that mothers who need help get it to ensure the sustainable development goals are met.

scholarly journals Variation of Cancer Incidence between and within GRELL Countries

2021 ◽  
Vol 18 (17) ◽  
pp. 9262
Author(s):  
Paolo Contiero ◽  
Giovanna Tagliabue ◽  
Gemma Gatta ◽  
Jaume Galceran ◽  
Jean-Luc Bulliard ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cancer Incidence ◽  
Social Inequalities ◽  
Central Italy ◽  
Cancer Registries ◽  
Incidence Rates ◽  
North West ◽  
North East ◽  
Latin Language ◽  
The Difference

Variation in cancer incidence between countries and groups of countries has been well studied. However cancer incidence is linked to risk factors that may vary within countries, and may subsist in localized geographic areas. In this study we investigated between- and within-country variation in the incidence of all cancers combined for countries belonging to the Group for Cancer Epidemiology and Registration in Latin Language Countries (GRELL). We hypothesized that investigation at the micro-level (circumscribed regions and local cancer registry areas) would reveal incidence variations not evident at the macro level and allow identification of cancer incidence hotspots for research, public health, and to fight social inequalities. Data for all cancers diagnosed in 2008–2012 were extracted from Cancer Incidence in Five Continents, Vol XI. Incidence variation within a country or region was quantified as r/R, defined as the difference between the highest and lowest incidence rates for cancer registries within a country/region (r), divided by the incidence rate for the entire country/region × 100. We found that the area with the highest male incidence had an ASRw 4.3 times higher than the area with the lowest incidence. The area with the highest female incidence had an ASRw 3.3 times higher than the area with the lowest incidence. Areas with the highest male ASRws were Azores (Portugal), Florianopolis (Brazil), Metropolitan France, north Spain, Belgium, and north-west and north-east Italy. Areas with the highest female ASRws were Florianopolis (Brazil), Belgium, north-west Italy, north-east Italy, central Italy, Switzerland and Metropolitan France. Our analysis has shown that cancer incidence varies markedly across GRELL countries but also within several countries: the presence of several areas with high cancer incidence suggests the presence of area-specific risk factors that deserve further investigation.

A new volcanic province: evidence from glacial erratics in western North Greenland

2000 ◽  
pp. 35-41 ◽  
Author(s):  
Peter R. Dawes ◽  
Bjørn Thomassen ◽  
T.I. Hauge Andersson
Keyword(s):  
Volcanic Rocks ◽  
Iron Formation ◽  
Banded Iron Formation ◽  
Common Component ◽  
Volcanic Province ◽  
North West ◽  
North East ◽  
The North ◽  
Surficial Deposits ◽  
North Greenland

NOTE: This article was published in a former series of GEUS Bulletin. Please use the original series name when citing this article, for example: Dawes, P. R., Thomassen, B., & Andersson, T. H. (2000). A new volcanic province: evidence from glacial erratics in western North Greenland. Geology of Greenland Survey Bulletin, 186, 35-41. https://doi.org/10.34194/ggub.v186.5213 _______________ Mapping and regional geological studies in northern Greenland were carried out during the project Kane Basin 1999 (see Dawes et al. 2000, this volume). During ore geological studies in Washington Land by one of us (B.T.), finds of erratics of banded iron formation (BIF) directed special attention to the till, glaciofluvial and fluvial sediments. This led to the discovery that in certain parts of Daugaard-Jensen Land and Washington Land volcanic rocks form a common component of the surficial deposits, with particularly colourful, red porphyries catching the eye. The presence of BIF is interesting but not altogether unexpected since BIF erratics have been reported from southern Hall Land just to the north-east (Kelly & Bennike 1992) and such rocks crop out in the Precambrian shield of North-West Greenland to the south (Fig. 1; Dawes 1991). On the other hand, the presence of volcanic erratics was unexpected and stimulated the work reported on here.

Stratigraphy, structure and geochemistry of Archaean supracrustal rocks from Oqaatsut and Naajaat Qaqqaat, north-east Disko Bugt, West Greenland

1999 ◽  
pp. 65-78
Author(s):  
Henrik Rasmussen ◽  
Lars Frimodt Pedersen
Keyword(s):  
Tectonic Setting ◽  
Trace Element Geochemistry ◽  
Element Geochemistry ◽  
West Greenland ◽  
North West ◽  
North East ◽  
Metavolcanic Rocks ◽  
Arc Setting ◽  
Area North ◽  
Back Arc

NOTE: This article was published in a former series of GEUS Bulletin. Please use the original series name when citing this article, for example: Rasmussen, H., & Frimodt Pedersen, L. (1999). Stratigraphy, structure and geochemistry of Archaean supracrustal rocks from Oqaatsut and Naajaat Qaqqaat, north-east Disko Bugt, West Greenland. Geology of Greenland Survey Bulletin, 181, 65-78. https://doi.org/10.34194/ggub.v181.5114 _______________ Two Archaean supracrustal sequences in the area north-east of Disko Bugt, c. 1950 and c. 800 m in thickness, are dominated by pelitic and semipelitic mica schists, interlayered with basic metavolcanic rocks. A polymict conglomerate occurs locally at the base of one of the sequences. One of the supracrustal sequences has undergone four phases of deformation; the other three phases. In both sequences an early phase, now represented by isoclinal folds, was followed by north-west-directed thrusting. A penetrative deformation represented by upright to steeply inclined folds is only recognised in one of the sequences. Steep, brittle N–S and NW–SE striking faults transect all rock units including late stage dolerites and lamprophyres. Investigation of major- and trace-element geochemistry based on discrimination diagrams for tectonic setting suggests that both metasediments and metavolcanic rocks were deposited in an environment similar to a modern back-arc setting.

scholarly journals A preliminary assessment of guideline adherence and clinical variation in oral cancer treatment: a MarketScan database study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Antoine Eskander ◽  
Axel Sahovaler ◽  
Jennifer Shin ◽  
Konrado Deutsch ◽  
Matthew Crowson ◽  
...  
Keyword(s):  
Oral Cavity ◽  
Radiation Treatment ◽  
Tube Placement ◽  
Adjuvant Chemoradiotherapy ◽  
Research Database ◽  
Chest Imaging ◽  
Geographical Differences ◽  
Processes Of Care ◽  
North East ◽  
Multidisciplinary Consultation

Abstract Background To assess variations in adherence to guideline-recommended processes of care for oral cavity cancer patients. Methods Retrospective study using a U.S. healthcare research database (MarketScan). Index diagnoses were considered from 2010 to 2012 with follow-up from 2013 to 2014. Diagnostic and procedure codes were utilized to identify oral cavity patients with a defined treatment modality. Compliance with guideline-recommended processes of care, which included pre-treatment imaging, thyroid-function testing (TFTs), multidisciplinary consultation and gastrostomy-tube insertion rates, were assessed. Results A total of 2752 patients were identified. Surgery alone was the most common treatment (60.8%), followed by surgery with adjuvant chemoradiotherapy (20.4%) and surgery with adjuvant radiotherapy (18.8%). Head/neck and chest imaging were obtained in 60% and 62.5% of patients respectively. Significant geographical differences in head and neck imaging were observed between North-central (64%), South (58.4%) and West (56.1%) regions (p = 0.026). Differences in chest imaging were also present between North-east (65%) and West (56.8%; p = 0.007). TFTs were obtained in 54.4% of the patients after radiation treatment, and 18.6% of patients had multidisciplinary consultation during the 6 months before and 3 months after initiation of treatment. During the year after treatment initiation, 21.2% of patients underwent G-tube placement, with significantly higher rates in patients receiving triple modality treatment (58%) when compared to surgery plus radiation (27%) and surgery alone (15%; p < 0.01). Conclusion Adherence to evidence-based practices was low based on the database coding. These data suggest a potential to improve adherence and increase the routine use of practices delineated in national clinical practice guidelines. Clinical relevance This study reflects a suboptimal adherence to guidelines based on the database employed. This study should be considered by healthcare providers and efforts should be maximized to follow the processes of care which have proven to impact on patient's outcomes.

scholarly journals P087 Mortality trends from systemic lupus erythematosus in Cuba: 2001-2014

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Halbert Hernández Negrín
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Health Problem ◽  
Time Trends ◽  
Reference Population ◽  
World Health ◽  
Mortality Data ◽  
Systemic Lupus ◽  
Mortality Trends ◽  
Health Organization

Abstract Background/Aims  There is little research on the mortality of Cuban patients with systemic lupus erythematosus (SLE), with not enough impact to recognize SLE as a health problem in the country. Our aim was to identify time trends and geographic variability in the mortality of Cuban patients with SLE. Methods  Mortality data of decedents over 15 years old were retrieved from the Cuban Ministry of Public Health mortality database, based on International Classification of Disease (ICD), Tenth Revision (ICD-10, code M32). We computed age-standardized mortality rate (ASMR) for each year and province as the estimated number of deaths per million inhabitants and its 95% confidence interval (95% CI) using World Health Organization reference population. The 2001-2014 time trends were analyzed using Jointpoint software. Results  Between 2001 and 2014, 1,054 deaths from SLE were found, mostly women (89.0%), white (54.4%) with a median age of 43 years (interquartile range: 34-53). In 2014 the ASMR caused by SLE per million inhabitants was 14.4 (95% CI: 10.9 to 18.4) in women and 1.3 (95% CI: 0.5 to 3.2) in men. A growing time trend was identified in the ASMR by SLE throughout the period (average annual percentage change [AAPC]: 1.6; 95% CI: 0.6 to 2.6), highest in males (AAPC: 5.6; 95% CI: 1.7 to 9.7) than in females (AAPC: 1.2; 95% CI: 0.3 to 2.0). The highest mortality in women was concentrated in the provinces of Camagüey, Las Tunas and Granma, and in the case of men, in Havana and Ciego de Ávila. Conclusion  The variation in the magnitude of the risk of dying from SLE over time and geographic areas indicates the possible influence of biological, environmental, socioeconomic and health systems factors. The growing trend in SLE mortality in Cuba demands its recognition as an important health problem and immediate actions that help mitigate it. Disclosure  H. Hernández Negrín: None.

scholarly journals DISTRIBUTION AND RACE COMPOSITION OF DOWNY MILDEW (Plasmopara halstedii (Farl.) Berl. and de Toni) IN BULGARIA / EXTENSION Y RAZAS DEL MILDIU (Plasmopara halstedii (Farl.) Berl. y de Toni) EN BULGARIA / ÉTENDUE ET RACES DE LA ROUILLE (Plasmopara halstedii (Farl.) Berl. and de Toni) EN BULGARIE

Helia ◽  
2000 ◽  
Vol 23 (33) ◽  
pp. 25-32
Author(s):  
P.S. Shindrova
Keyword(s):  
Downy Mildew ◽  
Resistance Gene ◽  
The Other ◽  
Plasmopara Halstedii ◽  
North West ◽  
North East ◽  
Race 1 ◽  
Race 2 ◽  
Production Areas ◽  
Number Of Authors

SUMMARY Downy mildew caused by the fungus Plasmopara halstedii is the main disease on sunflower in Bulgaria. In recent years a number of authors have reported the occurrence of new more virulent races of the pathogen. According to other authors these races demonstrate resistance to the fungicides used up to now. This fact is rather alarming and imposes the necessity of annual researches with the aim of following the changes in the downy mildew race variability. In the period 1995-1997 downy mildew isolates were collected from the following locations: Bourgas, Boyanovo, Karnobat, Ognyanovo, Selanovtsi, Kroushari, Lovech, Koubrat, Brashlyan, Sitovo, Tervel, Targovishte, IWS “Dobroudja” and Dobrich. The samples were assessed for virulence on a set of sunflower differential - lines under greenhouse conditions. The obtained results do not reveal a great race variability of downy mildew population in Bulgaria. In the period of study two races of the pathogen were identified: race 1 which infects the differential lines without genes for resistance to the pathogen. It is distributed in all sunflower production areas of the country. The other one is race 2. It is of limited distribution and has been registered in individual fields of north-east and north-west Bulgaria. It attacks the differential lines carrying the resistance gene Pl-1.

scholarly journals Otolaryngology activity in two hospitals in northern and central Italy differently affected by COVID-19 pandemic

2021 ◽  
Vol 104 (2) ◽  
pp. 003685042199848
Author(s):  
Antonio Minni ◽  
Francesco Pilolli ◽  
Massimo Ralli ◽  
Niccolò Mevio ◽  
Luca Roncoroni ◽  
...  
Keyword(s):  
Intensive Care ◽  
Severe Acute Respiratory Syndrome ◽  
Intensive Care Units ◽  
Healthcare System ◽  
Central Italy ◽  
Northern Italy ◽  
Public Hospitals ◽  
Geographical Differences ◽  
Italian Regions

The Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) pandemic had a significant impact on the Italian healthcare system, although geographical differences were present; regions in northern Italy have been the most severely affected while regions in the south of the country were relatively spared. Otolaryngologists were actively involved in the management of the pandemic. In this work, we analyzed and compared the otolaryngology surgical activity performed during the pandemic in two large public hospitals located in different Italian regions. In northern Italy, otolaryngologists were mainly involved in performing surgical tracheotomies in COVID-19 positive patients and contributed to the management of these patients in intensive care units. In central Italy, where the burden of the infection was significantly lower, otolaryngologists focused on diagnosis and treatment of emergency and oncology patients. This analysis confirms the important role of the otolaryngology specialists during the pandemic, but also highlights specific differences between two large hospitals in different Italian regions.

Excavations at Fishbourne, 1963. Third Interim Report

1964 ◽  
Vol 44 (1) ◽  
pp. 1-8
Keyword(s):  
Interim Report ◽  
The West ◽  
Civic Society ◽  
North West ◽  
The Third ◽  
North East ◽  
The North ◽  
The Future ◽  
Set Up

Early in 1963 much of the land occupied by the Roman building at Fishbourne was purchased by Mr. I. D. Margary, M.A., F.S.A., and was given to the Sussex Archaeological Trust. The Fishbourne Committee of the trust was set up to administer the future of the site. The third season's excavation, carried out at the desire of this committee, was again organized by the Chichester Civic Society.1 About fifty volunteers a day were employed from 24th July to 3rd September. Excavation concentrated upon three main areas; the orchard south of the east wing excavated in 1962, the west end of the north wing, and the west wing. In addition, trial trenches were dug at the north-east and north-west extremities of the building and in the area to the north of the north wing. The work of supervision was carried out by Miss F. Pierce, M.A., Mr. B. Morley, Mr. A. B. Norton, B.A., and Mr. J. P. Wild, B.A. Photography was organized by Mr. D. B. Baker and Mrs. F. A. Cunliffe took charge of the pottery and finds.

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