scholarly journals GEOGRAPHIC DISPARITIES IN LIFE EXPECTANCY AND MORTALITY IN THE U.S.

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S427-S427
Author(s):  
Julia Kravchenko ◽  
H Kim Lyerly
Keyword(s):  
Heart Failure ◽  
Life Expectancy ◽  
Industrialized Countries ◽  
Future Studies ◽  
Factors Analysis ◽  
Low Weight ◽  
The Us ◽  
Quality Of Medical Care ◽  
The Difference

Abstract Although the US has one of the highest per-capita health expenditures in the world, it noticeably lags behind a number of other industrialized countries in terms of life expectancy (LE). These disparities remain unexplained by individual demographic, socioeconomic, and healthcare factors. Analysis of death certificates for 1999-2016 revealed that diseases contributed most to LE variability are myocardial infarction (explained 12.9% of the difference in mortality), heart failure (10.6%), stroke (8.2%), lung cancer (7.5%) and COPD (7.2%). Analysis of histories of diseased patients in Medicare records showed that septicemia (15.7%), low weight (13.8%), renal disease (13.3%), disorders of electrolyte and fluid balance (9.0%) and heart failure (7.3%) contributed most to the disparities. Diseases that substantially contribute to disparities in LE in the US include both common and less-often-discussed diseases. Future studies of variations in treatment patterns, access-to and quality-of medical care for these diseases could provide important insight in observed patterns.

Problems of Iatrogenic Crimes Qualification

2021 ◽  
Author(s):  
K.V. Pitulko ◽  
Keyword(s):  
Causes Of Death ◽  
Statistical Data ◽  
Criminal Responsibility ◽  
Patient Treatment ◽  
Criminal Prosecution ◽  
Medical Assistance ◽  
Judicial Practice ◽  
Quality Of Medical Care ◽  
The Difference

The article reveals the features of the distinction between criminal and non-criminal circumstances, leading to a patient treatment unfavorable outcome. The aim of the research undertaken is to identify the nature and degree of social danger of professional negligence in the diagnosis and treatment of diseases. The article analyzes statistical data characterizing the dynamics of bringing doctors and other medical workers to criminal responsibility for committing crimes that caused harm to the life and health of patients. The organic connection of iatrogenic crimes with defects in the quality of medical care and improper performance of professional duties by medical workers is argued. The author reveals the difference between the causes of death and deterioration in the health of persons seeking medical assistance, and analyzes the practice of termination of medical workers criminal prosecution on rehabilitating grounds. On the basis of materials of modern judicial practice, it is proved that there is no need to separate the category «iatrogenic crimes» in the criminal law. A differentiated approach to qualification of adverse treatment outcomes seems promising. The author proposes detailing the legal liability of medical workers and medical organizations, depending on the criminal or non-criminal nature of the circumstances of causing harm to the life and health of the patient.

Abstract 279: The Impact of Heart Failure on Depression and Quality of Life is Greater in Men than Women

2012 ◽  
Vol 5 (suppl_1) ◽  
Author(s):  
Rory Hachamovitch ◽  
Brian Griffin ◽  
Alan Klein ◽  
Benjamin Nutter ◽  
Irene Katzan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Demographic Data ◽  
Cardiovascular Assessment ◽  
Related Quality ◽  
Health Related ◽  
The Difference ◽  
The Impact ◽  
The Relationship

Background. Patients (pts) diagnosed with congestive heart failure (HF) have been reported to have more frequent depression and worsened health related quality of life (HRQOL). Although depression is more common in women than men in this condition, the impact of HF on depression and HRQOL in men versus women is unclear. We sought to examine the relationship between pt sex, HF diagnosis, and pt-perceived depression and HRQOL. Methods. Depression (PHQ-9) and HRQOL (EQ5D) data were collected using tablet computers from pts presenting for routine outpatient cardiovascular assessment at our institution between November, 2010 and December, 2011. Demographic, clinical, and historical data was collected as per routine. We examined the association of pt sex and clinical diagnosis of HF with instrument results after adjusting for potential confounding information using mutliple linear regression. Results. Of 3046 pts (age 61±15), 39% were female and 8.7% were diagnosed with HF. Overall, PHQ-9 was greater, and minor or major depression (PHQ-9≥10) was more frequent, in women than men (4.6±4.6 vs. 3.3±4.4; 14.0% vs. 8.9%, both p<0.05) and in HF pts than pts without HF (5.9±5.6 vs. 3.6±4.3, 22.0% versus 9.6%; both p<0.05). Similarly, HRQOL was worse in women than men (EQ-5D 0.80±0.18 vs. 0.87±0.16; p<0.01) and in HF pts than no HF (EQ-5D 0.76±0.18 vs. 0.85±0.17; p<0.01). However, the difference in PHQ-9 between pts with versus without HF was greater in men (6.23±6.06 vs. 3.02±4.06, p<0.01) than women (5.43±4.85 vs. 4.55±4.58, p=0.09). After adjusting for cardiovascular diagnoses, comorbidities, clinical and demographic data, multivariable modeling of PHQ-9 revealed a significant interaction between pt sex and HF diagnosis (p=0.001; see Figure) such that women had greater PHQ-9 scores compared to men without HF, but in the setting of HF, mens' PHQ-9 scores were greater. Modeling of EQ-5D also revealed that after risk-adjustment an interaction between HF diagnosis and sex was present with a similar pattern of findings. Conclusion. Although depression is more frequent and severe in women compared to men, and in pts with versus without HF, HF appears to impact depression severity more in men compared to women.

A VARIED PATTERN OF CHANGE OF THE SEX DIFFERENTIAL IN SURVIVAL IN THE G7 COUNTRIES

2005 ◽  
Vol 38 (3) ◽  
pp. 391-401 ◽  
Author(s):  
FRANK TROVATO ◽  
NILS B. HEYEN
Keyword(s):  
Sex Differences ◽  
Life Expectancy ◽  
Point Of View ◽  
Industrialized Countries ◽  
Circulatory Disease ◽  
G7 Countries ◽  
Death Rates ◽  
The United Kingdom ◽  
Life Expectancy At Birth ◽  
The Difference

Over the course of the 20th century the sex differential in life expectancy at birth in the industrialized countries has widened considerably in favour of women. Starting in the early 1970s, the beginning of a reversal in the long-term pattern of this differential has been noted in some high-income countries. This study documents a sustained pattern of narrowing of this measure into the later part of the 1990s for six of the populations that comprise the G7 countries: Canada, France, Germany, Italy, England and Wales (as representative of the United Kingdom) and USA. For Japan, a persistence of widening sex differences in survival is noted. The sex differences in life expectancy are decomposed over roughly three decades (early 1970s to late 1990s) from the point of view of four major cause-of-death categories: circulatory diseases, cancers, accidents/violence/suicide, and ‘other’ (residual) causes. In the six countries where the sex gap has narrowed, this has resulted primarily from reduced sex differences in circulatory disease mortality, and secondarily from reduced differences in male and female death rates due to accidents, violence and suicide combined. In some of the countries sex differentials in cancer mortality have been converging lately, and this has also contributed to a narrowing of the difference in life expectancy. In Japan, males have been less successful in reducing their survival disadvantage in relation to Japanese women with regard to circulatory disease and cancer; and in the case of accidents/violence/suicide, male death rates increased during the 1990s. These trends explain the divergent pattern of the sex difference in life expectation in Japan as compared with the other G7 nations.

scholarly journals State-of-the-art Structural Interventions in Heart Failure

2019 ◽  
Vol 5 (3) ◽  
pp. 147-154 ◽  
Author(s):  
Jeffrey Park ◽  
Hussam S Suradi
Keyword(s):  
Heart Failure ◽  
Acute Decompensated Heart Failure ◽  
Structural Heart Disease ◽  
Decompensated Heart Failure ◽  
Structural Interventions ◽  
The Past ◽  
Effective Interventions ◽  
The Us ◽  
Multiple Trials

Heart failure (HF) is a leading cause of hospitalisation and healthcare costs worldwide. Acute decompensated heart failure accounts for more than 1 million hospitalisations in the US. Despite advances in the quality of acute and chronic HF disease management, gaps in knowledge about effective interventions to support the transition of care for patients with HF remain. Despite multiple trials of promising therapies, standard care consists of decongestion with IV diuretics and haemodynamic support with vasodilators and inotropes and this has remained largely unchanged during the past 45 years. Newer advances in medical innovations and structural heart disease interventions have now given promise to improved survival, outcomes and quality of life for patients with advanced HF of multiple aetiologies. In this article, we focus on structural interventions in the treatment of patients with HF.

Unobtrusive and comprehensive health screening using an intelligent toilet system

2015 ◽  
Vol 60 (1) ◽  
Author(s):  
Thomas Schlebusch ◽  
Wolfgang Fichtner ◽  
Michael Mertig ◽  
Steffen Leonhardt
Keyword(s):  
Heart Failure ◽  
Home Monitoring ◽  
Chronically Ill ◽  
Levels Of Care ◽  
Comprehensive Health ◽  
Treatment Of Diabetes ◽  
Quality Of Medical Care ◽  
Chronically Ill Patients ◽  
High Degree

AbstractHome monitoring is a promising technology to deal with the increasing amount of chronically ill patients while ensuring quality of medical care. Most systems available today depend on a high degree of interaction between the user and the device. Especially for people relying on advanced levels of care, this scheme is impracticable. In this paper, we are presenting an “intelligent toilet” performing an extensive health check while being as simple to use as a conventional toilet. The main focus of the system is to support the treatment of diabetes and chronic heart failure, but additional applications are possible.

scholarly journals Toll-Like Receptor 9 Promotes Survival in SERCA2a KO Heart Failure Mice

2017 ◽  
Vol 2017 ◽  
pp. 1-11 ◽  
Author(s):  
Yangchen Dhondup ◽  
Ivar Sjaastad ◽  
Øystein Sandanger ◽  
Jan Magnus Aronsen ◽  
Muhammad Shakil Ahmed ◽  
...  
Keyword(s):  
Heart Failure ◽  
Life Expectancy ◽  
Toll Like Receptor ◽  
Gene Expressions ◽  
Lung Weight ◽  
Future Studies ◽  
Cardiac Functions ◽  
Gene Excision ◽  
Left Atrium Size

Aim. Inflammation is important in heart failure (HF). The role of the immune receptor toll-like receptor 9 (TLR9) in HF is not understood and not investigated in diastolic HF. We investigated the role of TLR9 in a murine diastolic HF model caused by cardiomyocyte SERCA2a excision.Methods and Results. We crossed SERCA2a KO and TLR9 KO mice to generate four mouse lines. Tamoxifen-induced cardiomyocyte SERCA2a gene excision was carried out in mice, causing diastolic HF. After 7.6 weeks, cardiac functions and dimensions were analyzed by echocardiography and heart tissues were processed. HF mice depleted of TLR9 demonstrated reduced survival compared to SERC2a KO mice, with a median life expectancy of 58 days compared to 63 days. Both HF groups displayed increased left atrium size, lung weight, fetal gene expressions, monocyte/macrophage infiltration, and fibrosis. However, there were no significant differences between the groups.Conclusion. In mice with SERCA2a KO-induced diastolic HF, the absence of TLR9 reduced median life expectancy. The cause remains elusive, as all investigated HF parameters were unaltered. Still, these findings support a salutary role of TLR9 in some subsets of HF conditions and underline the importance for future studies on the mechanisms of TLR9 in diastolic HF.

scholarly journals Effects of covid-19 pandemic on life expectancy and premature mortality in 2020: time series analysis in 37 countries

BMJ ◽  
2021 ◽  
pp. e066768
Author(s):  
Nazrul Islam ◽  
Dmitri A Jdanov ◽  
Vladimir M Shkolnikov ◽  
Kamlesh Khunti ◽  
Ichiro Kawachi ◽  
...  
Keyword(s):  
Time Series ◽  
New Zealand ◽  
Life Expectancy ◽  
Confidence Interval ◽  
Time Series Analysis ◽  
South Korea ◽  
Mortality Data ◽  
Years Of Life Lost ◽  
The Us ◽  
The Difference

Abstract Objective To estimate the changes in life expectancy and years of life lost in 2020 associated with the covid-19 pandemic. Design Time series analysis. Setting 37 upper-middle and high income countries or regions with reliable and complete mortality data. Participants Annual all cause mortality data from the Human Mortality Database for 2005-20, harmonised and disaggregated by age and sex. Main outcome measures Reduction in life expectancy was estimated as the difference between observed and expected life expectancy in 2020 using the Lee-Carter model. Excess years of life lost were estimated as the difference between the observed and expected years of life lost in 2020 using the World Health Organization standard life table. Results Reduction in life expectancy in men and women was observed in all the countries studied except New Zealand, Taiwan, and Norway, where there was a gain in life expectancy in 2020. No evidence was found of a change in life expectancy in Denmark, Iceland, and South Korea. The highest reduction in life expectancy was observed in Russia (men: −2.33, 95% confidence interval −2.50 to −2.17; women: −2.14, −2.25 to −2.03), the United States (men: −2.27, −2.39 to −2.15; women: −1.61, −1.70 to −1.51), Bulgaria (men: −1.96, −2.11 to −1.81; women: −1.37, −1.74 to −1.01), Lithuania (men: −1.83, −2.07 to −1.59; women: −1.21, −1.36 to −1.05), Chile (men: −1.64, −1.97 to −1.32; women: −0.88, −1.28 to −0.50), and Spain (men: −1.35, −1.53 to −1.18; women: −1.13, −1.37 to −0.90). Years of life lost in 2020 were higher than expected in all countries except Taiwan, New Zealand, Norway, Iceland, Denmark, and South Korea. In the remaining 31 countries, more than 222 million years of life were lost in 2020, which is 28.1 million (95% confidence interval 26.8m to 29.5m) years of life lost more than expected (17.3 million (16.8m to 17.8m) in men and 10.8 million (10.4m to 11.3m) in women). The highest excess years of life lost per 100 000 population were observed in Bulgaria (men: 7260, 95% confidence interval 6820 to 7710; women: 3730, 2740 to 4730), Russia (men: 7020, 6550 to 7480; women: 4760, 4530 to 4990), Lithuania (men: 5430, 4750 to 6070; women: 2640, 2310 to 2980), the US (men: 4350, 4170 to 4530; women: 2430, 2320 to 2550), Poland (men: 3830, 3540 to 4120; women: 1830, 1630 to 2040), and Hungary (men: 2770, 2490 to 3040; women: 1920, 1590 to 2240). The excess years of life lost were relatively low in people younger than 65 years, except in Russia, Bulgaria, Lithuania, and the US where the excess years of life lost was >2000 per 100 000. Conclusion More than 28 million excess years of life were lost in 2020 in 31 countries, with a higher rate in men than women. Excess years of life lost associated with the covid-19 pandemic in 2020 were more than five times higher than those associated with the seasonal influenza epidemic in 2015.

scholarly journals Setting priorities fairly in response to Covid-19: identifying overlapping consensus and reasonable disagreement

2020 ◽  
Vol 7 (1) ◽  
Author(s):  
David Wasserman ◽  
Govind Persad ◽  
Joseph Millum
Keyword(s):  
Quality Of Life ◽  
Life Expectancy ◽  
Priority Setting ◽  
Clinical Ethics ◽  
Overlapping Consensus ◽  
Reasonable Disagreement ◽  
The Face ◽  
The Difference ◽  
Role Based

Abstract Proposals for allocating scarce lifesaving resources in the face of the Covid-19 pandemic have aligned in some ways and conflicted in others. This paper attempts a kind of priority setting in addressing these conflicts. In the first part, we identify points on which we do not believe that reasonable people should differ—even if they do. These are (i) the inadequacy of traditional clinical ethics to address priority-setting in a pandemic; (ii) the relevance of saving lives; (iii) the flaws of first-come, first-served allocation; (iv) the relevance of post-episode survival; (v) the difference between age and other factors that affect life-expectancy; and (vi) the need to avoid quality-of-life judgments. In the second part, we lay out some positions on which reasonable people can and do differ. These include (i) conflicts between maximizing benefits and priority to the worst off; (ii) role-based priority; and (iii) whether patients’ existing lifesaving resources should be subject to redistribution.

scholarly journals Modern approaches to the organization of care for patients with heart failure

Kardiologiia ◽  
2020 ◽  
Vol 60 (8) ◽  
pp. 106-114
Author(s):  
M. G. Glezer ◽  
T. K. Chernyavskaya
Keyword(s):  
Heart Failure ◽  
Russian Federation ◽  
Treatment Quality ◽  
Saint Petersburg ◽  
Organization Of Care ◽  
Patients With Heart Failure ◽  
Specialized Care ◽  
Quality Of Medical Care ◽  
The Russian Federation

Chronic heart failure (CHF) is a wide-spread disease (from 7 to 10% in the Russian Federation) and tends to grow. Frequent, repeated hospitalizations of CHF patients are due to insufficient compliance of patients with the treatment and the absence of continuity in management of patients between the hospital and out-patient clinic. Developing a structure of specialized care could provide improvement of treatment quality, a decrease in the number of hospitalizations, and better prognosis. International experience shows that creation of specialized clinics for heart failure improves quality of medical care in CHF and decreases the frequency of re-hospitalizations and mortality. In the Russian Federation, such clinics were created in Nizhniy Novgorod, Ufa, Saint Petersburg, and several other cities. The article presents an expert consensus on the structure, functions, and equipment of departments and offices for patients with heart failure.

scholarly journals Means And Problems Of Forming A Healthy Lifestyle Among The Population

2021 ◽  
Vol 03 (05) ◽  
pp. 73-77
Author(s):  
Guloyim Sattarovna Avezova ◽  
◽  
Zarnigor Beshimova ◽  
Gulshod Sattarovna Avezova ◽  
◽  
...  
Keyword(s):  
Life Expectancy ◽  
Medical Care ◽  
Healthy Lifestyle ◽  
World Health ◽  
The World ◽  
Hereditary Factors ◽  
Quality Of Medical Care ◽  
Health Organization ◽  
State Of The Environment

The health of the population, its preservation and strengthening, an increase in life expectancy and a reduction in mortality have always been and remain the focus of state social policy. However, it is known that human health depends not only on the quality of medical care, but also on many other factors, such as genetic predisposition to certain diseases, the state of the environment and lifestyle. According to experts from the World Health Organization, the combined contribution of medical care and hereditary factors to health is no more than 30%, while 50% is a healthy lifestyle.

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