scholarly journals Panorama of Gynecologic Cancer in Brazil

2020 ◽  
pp. 1617-1630
Author(s):  
Eduardo Paulino ◽  
Andreia Cristina de Melo ◽  
Agnaldo Lopes Silva-Filho ◽  
Luiza de Freitas Maciel ◽  
Luiz Claudio Santos Thuler ◽  
...  
Keyword(s):  
Advanced Disease ◽  
Gynecologic Cancer ◽  
Locally Advanced ◽  
Mortality Rates ◽  
Incidence Rates ◽  
Morbidity And Mortality ◽  
Mortality Data ◽  
Gynecologic Cancers ◽  
International Data

PURPOSE Little is known, or has been published previously, regarding consolidated data on the epidemiology of gynecologic cancers (GC) in Brazil. This article describes the incidence, morbidity, and mortality of women in Brazil affected with GC between the years of 2000 and 2017. METHODS Incidence, morbidity, and mortality data from patients with a diagnosis of one out of the five most common GC, cervical (CC), uterine (UC), ovarian (OC), vulvar (VvC), and vaginal (VgC), were obtained from three governmental sources of data. RESULTS From 2000 to 2015 CC, OC, and VgC incidence rates (IRs) decreased, whereas the IRs for UC and VvC remained relatively stable. Data from 382,932 women with GC were analyzed. Most patients presented with locally advanced or advanced disease at diagnosis: 60.1% of patients with CC, 31.2% of patients with UC, 67.2% of patients with OC, 45.2% of patients with VvC, and 67.0% of patients with VgC. Time from diagnosis to first treatment was ≥ 60 days in 58.0% of patients with CC, 58.5% of patients with UC, 27.0% of patients with OC, 55.3% of patients with VvC, and 52.7% of patients with VgC. Regarding mortality rates (MRs), with the exception of CC, UC, and VvC, which showed a slight decrease, MRs remained stable between 2000 and 2017. CONCLUSION A comparison with international data indicates that Brazilian patients are diagnosed with more advanced disease and face a longer delay between diagnosis and first treatment. Despite advances in screening and treatment, GC mortality has not decreased satisfactorily in this country.

Diarrhoea morbidity and mortality in older children, adolescents, and adults

2010 ◽  
Vol 138 (9) ◽  
pp. 1215-1226 ◽  
Author(s):  
C. L. FISCHER WALKER ◽  
R. E. BLACK
Keyword(s):  
Eastern Mediterranean ◽  
Age Groups ◽  
Eastern Mediterranean Region ◽  
Mortality Rates ◽  
Incidence Rates ◽  
Morbidity And Mortality ◽  
Mortality Data ◽  
Older Children ◽  
Incidence And Mortality ◽  
Adolescents And Adults

SUMMARYDiarrhoea is a leading cause of morbidity and mortality yet diarrhoea specific incidence and mortality rates for older children, adolescents, and adults have not been systematically calculated for many countries. We conducted a systematic literature review to generate regional incidence rates by age and to summarize diarrhoea specific mortality rates for regions of the world with inadequate vital registration data. Diarrhoea morbidity rates range from 29·9 episodes/100 person-years for adults in the South East Asian region to 88·4 episodes/100 person-years in older children in the Eastern Mediterranean region and have remained unchanged in the last 30 years. Diarrhoea mortality rates decline as the child ages and remain relatively constant during adulthood. These data are critical for improving estimates worldwide and further highlight the need for improved diarrhoea specific morbidity and mortality data in these age groups.

scholarly journals Outcomes of Revascularized Acute Mesenteric Ischemia in the American College of Surgeons National Surgical Quality Improvement Program Database

2011 ◽  
Vol 77 (7) ◽  
pp. 832-838 ◽  
Author(s):  
William B. Newton ◽  
Matthew J. Sagransky ◽  
Jeanette S. Andrews ◽  
Kimberly J. Hansen ◽  
Matthew A. Corriere ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Mesenteric Ischemia ◽  
Mortality Rates ◽  
Quality Improvement Program ◽  
Morbidity And Mortality ◽  
Definitive Treatment ◽  
Mortality Data ◽  
Improvement Program ◽  
Surgical Quality ◽  
American College Of Surgeons

This report examines outcomes of revascularization for acute arterial mesenteric ischemia (AAMI) using the American College of Surgeons National Surgical Quality Improvement Program database. Patients with International Classification of Diseases, 9th Revision and Current Procedural Terminology codes indicating AAMI with concomitant mesenteric revascularization were identified. Demographic, risk factor, procedural, morbidity, and mortality data were examined. Associations with morbidity and mortality were analyzed by logistic regression. One hundred forty-two cases of AAMI were identified. Seventy-one cases were thrombotic and 71 were embolic according to revascularization codes. Mean age was 66 years, 84 per cent of patients were white, and 54 per cent were female. Unadjusted major morbidity and mortality rates were 69 and 30 per cent, respectively. Patients with thrombotic AAMI were more likely to have a lower body mass index, greater than 10 per cent weight loss in the past 6 months, and a history of smoking. Patients with embolic AAMI were more likely to present emergently with sepsis. Unadjusted morbidity and mortality rates were 78 and 38 per cent for embolic and 61 and 23 per cent for thrombotic AAMI, respectively. Multi-variable predictors of morbidity included bowel resection at the time of revascularization, transfer admission, and involvement of a surgical resident. Multivariable predictors of mortality included impaired functional status, increased age, and postoperative sepsis. Cause of AAMI was not a significant predictor of morbidity or mortality. In a large sample of AAMI cases, AAMI remained a highly lethal and morbid condition. Predictors of morbidity and mortality included indicators of advanced presentation, treatment delay, and patient-related factors specific to AAMI, including debility and advanced age. Efforts directed at prevention and increasing the speed of diagnosis and definitive treatment appear to be necessary to improve outcomes.

scholarly journals Autogenous vaccination reduces antimicrobial usage and mortality rates in a herd facing severe exudative epidermitis outbreaks in weaned pigs

2018 ◽  
Vol 182 (26) ◽  
pp. 744-744 ◽  
Author(s):  
Ioannis Arsenakis ◽  
Filip Boyen ◽  
Freddy Haesebrouck ◽  
Dominiek G D Maes
Keyword(s):  
Mortality Rates ◽  
Morbidity And Mortality ◽  
Mortality Data ◽  
Type B ◽  
Weaned Pigs ◽  
Exfoliative Toxin ◽  
Antimicrobial Usage ◽  
Daily Dose

This study was conducted in a commercial 1000-sow herd facing recurrent exudative epidermitis (EE) outbreaks during the nursery period and assessed the efficacy of autogenous vaccination in controlling such outbreaks. The vaccine was produced using three Staphylococcus hyicus isolates recovered from affected pigs shortly before the onset of the study. All of those isolates were positive for the exhB gene, which encodes the exfoliative toxin type B (ExhB). From four consecutive farrowing batches of sows, two batches were vaccinated (V) against S hyicus at five and two weeks before farrowing, and two sow batches remained non-vaccinated (NV). Vaccination efficacy was primarily determined by the levels of metaphylactic antimicrobial usage, and the morbidity and mortality data for the pigs of the V and NV sows. The total amount of antimicrobials used metaphylactically against EE in pigs among the V and NV farrowing batches was 39,600 and 88,550 mg, respectively. The used daily dose pig to animal daily dose pig ratio for the V and NV batches were 1.31 and 1.79, respectively (a ratio of 0.8 to 1.2 is indicative of correct dosing). The morbidity and mortality rates were V=6.50 and NV=14.36 (P=0.008), and V=2.59 and NV=5.02 (P=0.000), respectively. To conclude, autogenous vaccination of the sows with a vaccine based on exhB-positive S hyicus isolates reduced metaphylactic treatment with antimicrobials as well as the morbidity and mortality rates in weaned pigs compared with pigs from NV sow batches.

scholarly journals Expanding Our Impact in Cervical Cancer Treatment: Novel Immunotherapies, Radiation Innovations, and Consideration of Rare Histologies

2021 ◽  
pp. 252-263
Author(s):  
Leslie M. Randall ◽  
Amanda J. Walker ◽  
Angela Y. Jia ◽  
Devin T. Miller ◽  
Dmitriy Zamarin
Keyword(s):  
Cervical Cancer ◽  
Cancer Treatment ◽  
Radiation Treatment ◽  
Sexual Transmission ◽  
Gynecologic Cancer ◽  
Locally Advanced ◽  
The United States ◽  
Mortality Rates ◽  
Therapeutic Window ◽  
Incidence And Mortality

Cervical cancer is a socially and scientifically distinguishable disease. Its pathogenesis, sexual transmission of high-risk HPV to a metaplastic portion of the uterine cervix, makes cervical cancer preventable by safe and effective HPV vaccines commercially available since 2006. Despite this, cervical cancer remains the deadliest gynecologic cancer in the world. Regrettably, global incidence and mortality rates disproportionately affect populations where women are marginalized, where HIV infection is endemic, and where access to preventive vaccination and screening for preinvasive disease are limited. In the United States, cervical cancer incidence has gradually declined over the last 25 years, but mortality rates remain both constant and disparately higher among communities of color because of the adverse roles that racism and poverty play in outcome. Until these conditions improve and widespread prevention is possible, treatment innovations are warranted. The last standard-of-care treatment changes occurred in 1999 for locally advanced disease and in 2014 for metastatic and recurrent disease. The viral and immunologic nature of HPV-induced cervical cancer creates opportunities for both radiation and immunotherapy to improve outcomes. With the advent of T cell–directed therapy, immune checkpoint inhibition, and techniques to increase the therapeutic window of radiation treatment, an overdue wave of innovation is currently emerging in cervical cancer treatment. The purpose of this review is to describe the contemporary developmental therapeutic landscape for cervical cancer that applies to most tumors and to discuss notable rare histologic subtypes that will not be adequately addressed with these treatment innovations.

scholarly journals Varicella in non-immune persons: incidence, hospitalization and mortality rates

2002 ◽  
Vol 129 (3) ◽  
pp. 599-606 ◽  
Author(s):  
P. Y. BOËLLE ◽  
T. HANSLIK
Keyword(s):  
Case Fatality ◽  
Mortality Rates ◽  
Morbidity And Mortality ◽  
Mortality Data ◽  
Surveillance Systems ◽  
Age Group ◽  
Death Rates ◽  
Hospitalization Rates ◽  
Incidence Prevalence

This study was conducted to estimate the varicella morbidity and mortality rates per age group among the non-immune population in France. Morbidity and mortality data for the years 1990–9 were derived from nationwide databases and surveillance systems. An incidence/prevalence model was designed to quantify the non-immune population per age group. The incidence of varicella in the non-immune population peaks during childhood and again in the 25–35 years age group. For children aged 1–4 years, adults aged 25–34 years and those older than 65 years, the hospitalization rates are respectively 235, 1438 and 8154 per 100 000 cases, and the death rates are respectively 7, 104 and 5345 per million cases. Case fatality or case hospitalization rates were not evenly distributed among adults and increased dramatically with age.

scholarly journals Trends in morbidity and mortality from COPD in Brazil, 2000 to 2016

2019 ◽  
Vol 45 (6) ◽  
Author(s):  
Liana Gonçalves-Macedo ◽  
Eliana Mattos Lacerda ◽  
Brivaldo Markman-Filho ◽  
Fernando Luiz Cavalcanti Lundgren ◽  
Carlos Feitosa Luna
Keyword(s):  
Predictive Models ◽  
Temporal Trends ◽  
Length Of Hospital Stay ◽  
Mortality Rates ◽  
Population Based ◽  
Error Rates ◽  
Morbidity And Mortality ◽  
Mortality Data ◽  
Hospital Morbidity ◽  
Copd Mortality

ABSTRACT Objective: To examine the trends in overall COPD mortality, as well as trends in in-hospital morbidity and mortality due to COPD, in Brazil, and to validate predictive models. Methods: This was a population-based study with a time-series analysis of cause-specific morbidity and mortality data for individuals ≥ 40 years of age, obtained from national health information systems for the 2000-2016 period. Morbidity and mortality rates, stratified by gender and age group, were calculated for the same period. We used regression analyses to examine the temporal trends and double exponential smoothing in our analysis of the predictive models for 2017. Results: Over the study period, COPD mortality rates trended downward in Brazil. For both genders, there was a downward trend in the southern, southeastern, and central-western regions. In-hospital morbidity rates declined in all regions, more so in the south and southeast. There were significant changes in the number of hospitalizations, length of hospital stay, and hospital expenses. The predictive models for 2017 showed error rates below 9% and were therefore validated. Conclusions: In Brazil, COPD age-adjusted mortality rates have declined in regions with higher socioeconomic indices, where there has been an even sharper decrease in all in-hospital morbidity and mortality variables. In addition to factors such as better treatment adherence and reduced smoking rates, socioeconomic factors appear to be involved in controlling COPD morbidity and mortality. The predictive models estimated here might also facilitate decision making and the planning of health policies aimed at treating COPD.

scholarly journals Change in practice in gynecologic oncology during the COVID-19 pandemic: a social media survey

2020 ◽  
Vol 30 (8) ◽  
pp. 1101-1107 ◽  
Author(s):  
Fabio Martinelli ◽  
Annalisa Garbi
Keyword(s):  
Cervical Cancer ◽  
Social Media ◽  
Response Rate ◽  
Early Stage ◽  
Gynecologic Oncology ◽  
Gynecologic Cancer ◽  
Locally Advanced ◽  
Low Grade ◽  
Gynecologic Cancers ◽  
Cancer Management

ObjectiveCOVID-19 has affected gynecologic cancer management. The goal of this survey was to evaluate changes that occurred in gynecologic oncology practice during the COVID-19 pandemic.MethodsA anonymous survey consisting of 33 questions (https://sites.google.com/view/gyncacovidfmartinelli) regarding interaction between gynecologic cancers and COVID-19 was distributed online via social media from April 9 to April 30, 2020. Basic descriptive statistics were applied. Analytics of survey-diffusion and generated-interest (visualizations, engagement rates, response rate) were analyzed.ResultsThe survey received 20 836 visualizations, generating an average engagement rates by reach of 4.7%. The response rate was 30%. A total of 86% of respondents completed the survey, for a total of 187 physicians surveyed across 49 countries. The majority (143/187; 76%) were gynecologic oncologists, and most were ≤50 years old (146/187; 78%). A total of 49.7% (93/187) were facing the early phase of the COVID-19 pandemic, while 26.7% (50/187) and 23.5% (44/187) were in the peak and plateau phases, respectively. For 97.3% (182/187) of respondents COVID-19 affected or changed their respective clinical practice. Between 16% (27/165) (before surgery) and 25% (26/102) (before medical treatment) did not perform any tests to rule out COVID-19 infection among patients. The majority of respondents did not alter indications of treatment if patients were COVID-19-negative, while treatments were generally postponed in COVID-19-positive patients. Treatments were considered priority for: early stage high-risk uterine cancers (85/187; 45%), newly diagnosed epithelial ovarian cancer (76/187; 41%), and locally advanced cervical cancer (76/187; 41%). Treatment of early stage low-grade endometrioid endometrial cancer was deferred according to 49% (91/187) of respondents, with hormonal treatment as the option of therapy (31%; 56/178). A total of 77% (136/177) of respondents reported no changes in (surgical) treatment for early stage cervical cancer in COVID-19-negative patients, while treatment was postponed by 54% (96/177) of respondent, if the patient tested COVID-19-positive. Neoadjuvant chemotherapy for advanced ovarian cancers was considered by over one-third of respondents as well as hypofractionation of radiation treatment for locally advanced cervical cancers.ConclusionCOVID-19 affected the treatment of gynecologic cancers patients, both in terms of prioritization and identification of strategies to reduce hospital access and length of stay. Social media is a reliable tool to perform fast-tracking, worldwide surveys.

Incidence and Mortality Data from Cutaneous Melanoma in Trentino: Registry-Based Study

2008 ◽  
Vol 12 (2) ◽  
pp. 59-63 ◽  
Author(s):  
Sebastiana Boi ◽  
Mario Cristofolini ◽  
Rocco Micciolo ◽  
Enzo Polla ◽  
Silvano Piffer ◽  
...  
Keyword(s):  
Cutaneous Melanoma ◽  
Mortality Rates ◽  
Incidence Rates ◽  
Significant Trend ◽  
Mortality Data ◽  
Period Effect ◽  
Health Campaigns ◽  
Skin Melanoma ◽  
Incidence And Mortality ◽  
Regional Mortality

Background: The province of Trento has been the target of health campaigns for early diagnosis of cutaneous melanoma for 30 years. Objective: To evaluate incidence and mortality data of skin melanoma in the province from January 1992 to December 2001. Methods: The study is based on the provincial skin cancer registry and the regional mortality registry. Standardized incidence and mortality rates were computed, and time trends were evaluated. Incidence rates were modeled using Poisson regression. Results: Five hundred fifty-four melanomas were diagnosed (226 in males and 328 in females). No period effect was revealed. Incidence rates in females were about 1.24 times those in males. No significant trend in mortality rates was observed. Conclusion: We examined incidence and mortality data of cutaneous melanoma during a 10-year period and failed to find any significant trend. It seems we have reached a plateau after many years of continuous, intensive health campaigns.

Correlation of higher preoperative American Society of Anesthesiology grade and increased morbidity and mortality rates in patients undergoing spine surgery

2011 ◽  
Vol 14 (4) ◽  
pp. 470-474 ◽  
Author(s):  
Kai-Ming G. Fu ◽  
Justin S. Smith ◽  
David W. Polly ◽  
Christopher P. Ames ◽  
Sigurd H. Berven ◽  
...  
Keyword(s):  
Disease Process ◽  
Mortality Rates ◽  
Research Society ◽  
Morbidity And Mortality ◽  
Mortality Data ◽  
Complication Rates ◽  
Physical Status ◽  
Scoliosis Research Society ◽  
Physical Status Classification ◽  
American Society

Object Patients with varied medical comorbidities often present with spinal pathology for which operative intervention is potentially indicated, but few studies have examined risk stratification in determining morbidity and mortality rates associated with the operative treatment of spinal disorders. This study provides an analysis of morbidity and mortality data associated with 22,857 cases reported in the multicenter, multisurgeon Scoliosis Research Society Morbidity and Mortality database stratified by American Society of Anesthesiologists (ASA) physical status classification, a commonly used system to describe preoperative physical status and to predict operative morbidity. Methods The Scoliosis Research Society Morbidity and Mortality database was queried for the year 2007, the year in which ASA data were collected. Inclusion criterion was a reported ASA grade. Cases were categorized by operation type and disease process. Details on the surgical approach and type of instrumentation were recorded. Major perioperative complications and deaths were evaluated. Two large subgroups—patients with adult degenerative lumbar disease and patients with major deformity—were also analyzed separately. Statistical analyses were performed with the chi-square test. Results The population studied comprised 22,857 patients. Spinal disease included degenerative disease (9409 cases), scoliosis (6782 cases), spondylolisthesis (2144 cases), trauma (1314 cases), kyphosis (831 cases), and other (2377 cases). The overall complication rate was 8.4%. Complication rates for ASA Grades 1 through 5 were 5.4%, 9.0%, 14.4%, 20.3%, and 50.0%, respectively (p = 0.001). In patients undergoing surgery for degenerative lumbar diseases and major adult deformity, similarly increasing rates of morbidity were found in higher-grade patients. The mortality rate was also higher in higher-grade patients. The incidence of major complications, including wound infections, hematomas, respiratory problems, and thromboembolic events, was also greater in patients with higher ASA grades. Conclusions Patients with higher ASA grades undergoing spinal surgery had significantly higher rates of morbidity than those with lower ASA grades. Given the common application of the ASA system to surgical patients, this grade may prove helpful for surgical decision making and preoperative counseling with regard to risks of morbidity and mortality.

scholarly journals Research of the epidemiology on cancer of the trachea, bronchi, lungs as important components in the development of effective directions for increasing the effectiveness of pharmaceutical support for cancer patients

2021 ◽  
pp. 72-80
Author(s):  
Yurii Pulnyi ◽  
Hanna Panfilova ◽  
Ellona Shelkova ◽  
Oleksandr Kabachnyi ◽  
Vitaly Chernukha
Keyword(s):  
Cancer Patients ◽  
Mortality Rates ◽  
Epidemiological Studies ◽  
Incidence Rates ◽  
Morbidity And Mortality ◽  
Positive Trend ◽  
Female Patients ◽  
Incidence And Mortality ◽  
Male Cohort ◽  
Epidemiological Profile

The aim: to conduct epidemiological studies on cancer of the trachea, bronchi, lungs as important components in the development of effective directions for increasing the effectiveness of pharmaceutical support for cancer patients in Ukraine. Materials and methods. The study used data from special literature, which presents the results of research on cancer in different countries of the world and data from the National Cancer Registry from 2014-2019 by indicators of morbidity and mortality of the population of Ukraine from cancer of the trachea, bronchi and lungs, including by gender. General theoretical (historical, analytical-comparative, systemic, graphic, logical, hypothetical-deductive) and applied (mathematical-statistical, epidemiological) research methods were used. Results. It was found that during 2014-2018 in terms of morbidity and mortality of the population from cancer of the trachea, bronchi and lungs in Ukraine, there was a positive dynamics of decline. So, in terms of incidence rates, which are standardized by WHO in 2018, the data decreased compared to 2014 by 8.4 %, and according to the “Ukrainian standard” – by 7.0 %. Mortality rates, which were standardized by WHO, decreased in 2018 compared to 2014 by 12.1 %, and those presented according to the “Ukrainian standard” – by 11.1 %. It was proved that the average data on morbidity and mortality of male patients were 6.2 and 7.4 times higher than in the same data for female patients. The different nature of changes in morbidity and mortality rates of patients in accordance with their gender in the dynamics of years has been established. So, for the female cohort of patients, the incidence and mortality rate from cancer of the trachea, bronchi and lungs during 2014-2018 had a complex zigzag character of changes, and in 2019, compared with the data of 2014, they increased by 22.54 % and 23.6 %, respectively. In the male cohort of patients, we observed a positive trend towards a decrease in mortality during 2014-2019. So, in 2019, these indicators reached their minimum and were equal to 57.0 and 44.0 cases per 100 thousand population. According to the data of 2019, the incidence and mortality of men from cancer of the trachea, bronchi and lungs relative to the data of 2014 decreased by 21.4 % and 25.0 %, respectively. It looks encouraging that there was relatively little fluctuation during 2014-2019 epidemiological indicators, both in general for the entire population of patients and female patients. Conclusions. The established characteristics and trends in the formation of the onco-epidemiological profile of the country's population for trachea, bronchus and lung cancer in dynamics over the years necessitate further research, taking into account changes in the main demographic indicators development of society

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