Time series of diabetes attributable mortality from 2008 to 2017

Purpose Diabetes is a growing health problem. The aim of this study was to capture time trends in mortality associated with diabetes. Methods The mortality database of the Veneto region (Italy) includes both the underlying causes of death, and all the diseases mentioned in the death certificate. The annual percent change (APC) in age-standardized rates from 2008 to 2017 was computed by the Joinpoint Regression Program. Results Overall 453,972 deaths (56,074 with mention of diabetes) were observed among subjects aged ≥ 40 years. Mortality rates declined for diabetes as the underlying cause of death and from diabetes-related circulatory diseases. The latter declined especially in females − 4.4 (CI 95% − 5.3/− 3.4), while in males the APC was − 2.8 (CI 95% − 4.0/− 1.6). Conclusion We observed a significant reduction in mortality during the period 2008–2017 in diabetes either as underlying cause of death or when all mentions of diabetes in the death certificate were considered.

FACTORS INFLUENCING THE MORTALITY OF THE MALE POPULATION RESIDING IN THE ACTIVITY AREA OF COPER-NICKEL ENTERPRISE

Introduction. The city-forming enterprise are the main work-givers and the source of socio-economic well-being of monotowns. However, its activities may have a negative impact on the health of workers and citizens. The goal is a differentiated assessment of production activities of a copper-nickel enterprise and its socio-economic policy consequences on mortality of population in monotowns. Methods. Using mortality rates for 5-year age groups averaged for the period 2010-2017 was compared male population of Monchegorsk to Norilsk both are Arctic monotowns placed copper-nickel enterprises, and to Russia. To assess the consequences of copper-nickel enterprise production activities Monchegorsk male population was compared to Russia To assess the effect socio-economic development, Norilsk male population was compared to Monchegorsk. Results. In Monchegorsk working age mortality rate was compared to Russia for circulatory diseases 416.3 and 269.8 per 100,000; for MN 143.5 and 102.5. Also higher for post-working age for circulatory diseases 3962.4 and 3305.8; for MN 1283.8 and 1106.4. In Norilsk circulatory mortality were lower in all age groups compared to Monchegorsk and Russia (215.3 per 100,000 in working age and 2377.2 in post-working age); cancer mortality was lower for working age (74.3 per 100,000) and higher for post-working age (1185.3 per 100,000). Conclusions. Carcinogenic copper-nickel enterprise production activity is the cause of increased MN and circulatory mortality of the male population, which indicates the need to improve occupational and environmental conditions The socio-economic activity of city-forming enterprise in Norilsk, aimed at improving the standard of living and quality of medical care, had reduce the circulatory mortality throughout life and cancer mortality in working age. In older ages, the death risk for MN kept high, suggestive of the priority of measures reducing carcinogenic risk, and enhanced medical and social care for older age groups.

Remote monitoring of patients with chronic heart failure using blood pressure telemonitoring and ECG

Introduction. Remote monitoring of patients with chronic heart failure seems to be very promising in connection with a possible decrease in mortality as a result of the use of telemedicine technologies in the treatment of chronic heart failure (CHF). Materials and methods. Remote monitoring of the health of 997 patients with confirmed diagnoses of circulatory diseases complicated by CHF, aged 18 to 74, inclusive, living in rural areas, mainly in remote and hard-to-reach settlements of Uvatsky, Vagaysky, Nizhnetavdinsky, Tobolsky and Yarkovsky, was carried out. districts of the Tyumen region. Results. We studied the results of remote monitoring of blood pressure and ECG in 997 patients with chronic heart failure in rural areas for 24 months using various models of telemedicine support. In the «home» monitoring group (n = 316), patients independently recorded and broadcast blood pressure and ECG data; in the «office» monitoring group (n = 681), the same studies were performed by medical workers. Additionally, the presence or absence of patient complaints about the state of health at the time of the research was recorded. Conclusions. The organization and conduct of remote monitoring of the health status of patients with CHF using teleAP and teleECG in the «home» self-registration mode has an advantage over the implementation of such monitoring in a medical organization, which is reflected in a statistically significant decrease in the need for hospitalizations.

ELECTROMAGNETIC ENVIRONMENT CREATED BY MOBILE COMMUNICATION AS A RISK FACTOR CAUSING HIGHER PREVALENCE OF CIRCULATORY DISEASES

Our research goal was to examine energy and time parameters of electromagnetic environment created by mobile communication terminals in Crimea and to detect a relationship between morbidity with diseases of the circulatory system (DCS) among people living in the republic due to electromagnetic environment. Electromagnetic environment was determined as per energy flux density (EFD) at terminals, average daily electro- magnetic exposure (ADEE) and individual electromagnetic burden (IEB). Correlation analysis of all the obtained data was performed to detect possible correlations with diseases of the circulatory system. Measurements of electromagnetic environment created by terminals in the region during a period from March 2019 to February 2020 (4,204 measurements at points where people used mobile communications intensely) yielded the following results: average EFD value amounted to 1.43 ± 0.04 µWt/cm2; IEB, 117.80 ± 6.55 (µWt/cm 2)·min; ADEE, 60.56 ± 1.15 min. Electromagnetic environment parameters and prevalence of the most common DCS in Crimea were statistically proc- essed and the following authentic correlations were revealed: between overall morbidity with circulatory diseases and en- ergy (EFD (Тau=0.399; p < 0.01)) and integral (IEB (Тau=0.437; p < 0.01)) properties of electromagnetic radiation; be- tween overall morbidity with diseases that involved elevated blood pressure and IEB (Тau=0.377, p=0.01); between primary morbidity with diseases that involved elevated blood pressure and all electromagnetic radiation properties: EFD (Тau=0.304, p=0.04), IEB (Тau=0.342, p=0.02), and ADEE (Тau=0.299, p=0.04); between primary morbidity with cere- brovascular diseases (CVD) and ADEE (Тau=0.411, p < 0.01) as time property of the examined factor. Energy and time parameters of electromagnetic environment created by mobile communication terminals that have been measured in Crimea are authentically correlated with distribution of morbidity with circulatory diseases and exert their influence on a risk of probable growth in morbidity with these nosologies among people living in Crimea.

RISK OF CIRCULATORY DISEASES ON THE EXAMPLE OF HEART RHYTHM DISORDERS IN PATIENTS WITH SEROLOGICAL MARKERS OF EPSTEIN – BARR INFECTION

To reduce a burden of circulatory diseases (CD) is among primary tasks the state has to solve. There are available data on a contribution made by chronic inflammation on occurrence of heart and vascular diseases. Given that, it seems especially interesting to examine impacts exerted by Epstein-Barr virus infection on CD development. The paper focuses on analyzing morbidity with infectious mononucleosis and CD in the Russian Federation over 1995–2018. 103 patients with heart rhythm disorders and 92 blood donors were examined to determine whether they had immunoglobulins to EBV antigens The results were statistically processed involving calculation of Pearson’s linear correlation coefficient, error of cor- relation coefficient, validity coefficient, determination coefficient, and frequencies of EBV markers detection per 100 exam- ined people and their confidence intervals. Differences were considered to be authentic when confidence probability was equal to 95 % and confidence significance was p<0.05. Relative risks of heart rhythm disorders in patients with active EBV- infection were calculated as per results obtained via creating a fourfold table. EBV was established to make a significant contribution into circulatory pathology occurrence and it was confirmed by an overall ascending trend in morbidity with infectious mononucleosis and CD in the Russian Federation in 1995-2018 and an authentic strong direct correlation between these two processes (r=0.94; m=0.02; t=47; p<0.01) with determination be- ing equal to 0.88. Risk of developing heart rhythm disorders was determined by active EBV-infection in case history com- bined with detected M-immunoglobulins to capsid EBV antigen and G-immunoglobulins to early EBV antigen, as well as an increase in concentration of G-immunoglobulins to capsid antigen in blood serum (RR=5.8 and 2.3 accordingly).

ELECTROMAGNETIC ENVIRONMENT CREATED BY MOBILE COMMUNICATION AS A RISK FACTOR CAUSING HIGHER PREVALENCE OF CIRCULATORY DISEASES

Our research goal was to examine energy and time parameters of electromagnetic environment created by mobile communication terminals in Crimea and to detect a relationship between morbidity with diseases of the circulatory system (DCS) among people living in the republic due to electromagnetic environment. Electromagnetic environment was determined as per energy flux density (EFD) at terminals, average daily electro- magnetic exposure (ADEE) and individual electromagnetic burden (IEB). Correlation analysis of all the obtained data was performed to detect possible correlations with diseases of the circulatory system. Measurements of electromagnetic environment created by terminals in the region during a period from March 2019 to February 2020 (4,204 measurements at points where people used mobile communications intensely) yielded the following results: average EFD value amounted to 1.43 ± 0.04 µWt/cm2; IEB, 117.80 ± 6.55 (µWt/cm 2)·min; ADEE, 60.56 ± 1.15 min. Electromagnetic environment parameters and prevalence of the most common DCS in Crimea were statistically proc- essed and the following authentic correlations were revealed: between overall morbidity with circulatory diseases and en- ergy (EFD (Тau=0.399; p < 0.01)) and integral (IEB (Тau=0.437; p < 0.01)) properties of electromagnetic radiation; be- tween overall morbidity with diseases that involved elevated blood pressure and IEB (Тau=0.377, p=0.01); between primary morbidity with diseases that involved elevated blood pressure and all electromagnetic radiation properties: EFD (Тau=0.304, p=0.04), IEB (Тau=0.342, p=0.02), and ADEE (Тau=0.299, p=0.04); between primary morbidity with cere- brovascular diseases (CVD) and ADEE (Тau=0.411, p < 0.01) as time property of the examined factor. Energy and time parameters of electromagnetic environment created by mobile communication terminals that have been measured in Crimea are authentically correlated with distribution of morbidity with circulatory diseases and exert their influence on a risk of probable growth in morbidity with these nosologies among people living in Crimea.

RISK OF CIRCULATORY DISEASES ON THE EXAMPLE OF HEART RHYTHM DISORDERS IN PATIENTS WITH SEROLOGICAL MARKERS OF EPSTEIN – BARR INFECTION

To reduce a burden of circulatory diseases (CD) is among primary tasks the state has to solve. There are available data on a contribution made by chronic inflammation on occurrence of heart and vascular diseases. Given that, it seems especially interesting to examine impacts exerted by Epstein-Barr virus infection on CD development. The paper focuses on analyzing morbidity with infectious mononucleosis and CD in the Russian Federation over 1995–2018. 103 patients with heart rhythm disorders and 92 blood donors were examined to determine whether they had immunoglobulins to EBV antigens.The results were statistically processed involving calculation of Pearson’s linear correlation coefficient, error of cor- relation coefficient, validity coefficient, determination coefficient, and frequencies of EBV markers detection per 100 exam- ined people and their confidence intervals. Differences were considered to be authentic when confidence probability was equal to 95 % and confidence significance was p<0.05. Relative risks of heart rhythm disorders in patients with active EBV- infection were calculated as per results obtained via creating a fourfold table. EBV was established to make a significant contribution into circulatory pathology occurrence and it was confirmed by an overall ascending trend in morbidity with infectious mononucleosis and CD in the Russian Federation in 1995-2018 and an authentic strong direct correlation between these two processes (r=0.94; m=0.02; t=47; p<0.01) with determination be- ing equal to 0.88. Risk of developing heart rhythm disorders was determined by active EBV-infection in case history com- bined with detected M-immunoglobulins to capsid EBV antigen and G-immunoglobulins to early EBV antigen, as well as an increase in concentration of G-immunoglobulins to capsid antigen in blood serum (RR=5.8 and 2.3 accordingly). These detected peculiarities require further more profound study and development of activities aimed at risk minimization.

Prevalence and incidence of physical health conditions in people with intellectual disability – a systematic review

Objective To synthesize evidence on the prevalence and incidence of physical health conditions in people with intellectual disability (ID). Methods We searched Medline, PsycInfo, and Embase for eligible studies and extracted the prevalence, incidence, and risk of physical health conditions in people with ID. Results Of 131 eligible studies, we synthesized results from 77 moderate- to high-quality studies, which was mainly limited to high-income countries. The highest prevalence estimates were observed for epilepsy, ear and eye disorders, cerebral palsy, obesity, osteoporosis, congenital heart defects, and thyroid disorders. Some conditions were more common in people with a genetic syndrome. Compared with the general population, many health conditions occur more frequently among people with ID, including asthma and diabetes, while some conditions such as non-congenital circulatory diseases and solid cancers occur at the same or lower rate. The latter associations may reflect under-detection. Conclusions People with ID have a health profile more complex than previously known. There is a pressing need for targeted, evidence-informed population health initiatives including preventative programs for this population.

Does living at moderate altitudes in Austria affect mortality rates of various causes? An ecological study

ObjectivesThe effects of altitude residence on ageing, longevity and mortality are poorly understood. While adaptations to chronic exposure to altitude may exert beneficial effects on cardiovascular risk factors and some types of cancer, an elevated risk to die from chronic respiratory diseases has been reported. Moreover, high-altitude residence may be correlated with increased depression and suicide rates. The present study tested the hypothesis that living at moderate altitudes (up to 2000 m) is associated with reduced mortality from all causes.Setting and participantsWe used a dataset comprising all deaths (n=467 834) across 10 years of a country (Austria) characterised by varying levels of altitudes up to 2000 m.Main outcome measuresTotal number of deaths, age-standardised mortality rates (ASMRs) per 100 000 population, cause-specific ASMRs.ResultsASMRs for residents living in higher (>1000 m) versus lower (<251 m) altitude regions (with agriculture employment below 3%) were 485.8 versus 597.0 (rate ratio and 95% CI 0.81 (0.72 to 0.92); p<0.001) for men and 284.6 versus 365.5 (0.78; 0.66 to 0.91); p=0.002) for women. Higher levels of agriculture employment did not influence mortality rates. Diseases of the circulatory system and cancers were main contributors to lower mortality rates at higher altitude. Residence at higher altitude did not negatively affect mortality rates from any other diseases. We highlight gender effects and—beside environmental factors—also discuss socioeconomic factors that may be responsible for conflicting results with data from other populations.ConclusionsLiving at moderate altitude (1000–2000 m) elicits beneficial effects on all-cause mortality for both sexes, primarily due to lower ASMRs from circulatory diseases and cancer. The presented analysis on cause-specific ASMRs over a 10-year period among the entire population of an alpine country will contribute to a better understanding on the effects of altitude-related mortality.