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Maternal deaths from ectopic pregnancy in the South Atlantic region, 1960 through 1976.

The authors have calculated the maternal mortality rates from ectopic pregnancy in the Southeastern United States. Between 1960 and 1975 81 per cent of 207 ectopic deaths occurred in nonwhite women. A more detailed study of 24 deaths from ectopic pregnancy in North Carolina shows that from 1961 to 1976 4.2 per cent of all direct obstetric deaths and 15.9 per cent of deaths from hemorrhage were due to reptured ectopic gestation. The most striking observation was the dramatic reduction in deaths from ectopic pregnancy among nonwhite women. Maternal mortality rates for ectopic pregnancy should properly be based on the conception rate, consisting of live births plus abortions rather than live births alone. Missed diagnosis of ectopic pregnancy as a factor in maternal mortality rate requires more intensive educational efforts directed toward primary-care physicians.

Black or African American↗

Legalized abortion: effect on national trends of maternal and abortion-related mortality (1940 through 1976).

Both non-abortion-related maternal and abortion-related mortality declined prior to the Supreme Court decisions of 1973. In order to determine the effect of legalized abortion on maternal mortality, we have analyzed the secular trends in national abortion mortality ratios for 1940 through 1976, compared the trends to those maternal mortality ratios, and hypothesized reasons for differences between these trends. Between 1940 and 1950 and after 1965, deaths from abortion declined more rapidly than deaths from other causes associated with childbirth. However, between 1951 and 1965, maternal mortality related to pregnancy of childbirth declined more rapidly than abortion-related mortality. Five possible explanations exist for the more rapid decline in abortion deaths since 1965--selected underreporting, changes in coding practices, improved safety of illegal abortion, introduction of more effective contraception, and increased availability of legal abortion. We consider the last two explanations as the most likely reasons for the accelerated decline in abortion-related deaths.

Abortion, Legal↗

Premature mortality attributable to smoking and hazardous drinking in Canada.

All causes of death related to the two risk factors, smoking and hazardous drinking, have been reviewed followed by a selection of those causes of death for which the causal role of the risk factor appears to be quasi-certain. For each cause, existing epidemiologic data were reviewed and used to determine the fraction of premature mortality which could be attributed to each factor (called the attributable fraction). This fraction was then multiplied by the corresponding Canadian premature mortality measured in terms of deaths between ages one and 70 and potential years of life lost (PYLL) between ages one and 70, which gives a higher weight to younger deaths. Of the 73,440 deaths between ages one and 70 in Canada in 1974, 12% (or 8718 deaths) were found to be attributable to current smoking and 6% (4716) to hazardous drinking. In terms of PYLL between ages one and 70, hazardous drinking ranks ahead of current smoking with 10% (or 132,044 PYLL) of the total PYLL, whereas current smoking represents 8% (105,085 PYLL) of the total . Regardless of whether premature mortality is expressed in terms of deaths or PYLL, about 18% of Canadian premature mortality is attributable to current smoking and/or drinking (with the range of possible values being 14-22%).

Accidents↗

Log-linear models in the analysis of disease prevalence data from survival/sacrifice experiments.

This paper considers the problem of analyzing disease prevalence data from survival experiments in which there may also be some serial sacrifice. The assumptions needed for "standard" analyses are reviewed in the context of a general model recently proposed by the authors. This model is then reparametrized in log-linear form, and a generalized EM algorithm is utilized to obtain maximum likelihood estimates of the parameters for a broad class of unsaturated models. Tests based on the relative likelihood are proposed to investigate the effects of treatment, time, and the presence of other diseases on the prevalences and lethalities of specific diseases of interest. An example is given, using data from a large experiment to investigate the effects of low-level radiation on laboratory mice. Finally, some possible directions for future research are indicated.

Animals↗

[Epidemiology of burn injuries in the GDR (author's transl)].

Burn injuries in GDR have a slight decreasing tendency concerning both morbidity and mortality. The distribution of injuries to the districts of GDR can be explained by the distribution of population, not by distribution of industry. The overwhelming share of injuries consists of children with small scalds. Therapeutical results are comparable with results from international literature. Owing to the fact that in last years no further decisive improvement could be achieved, more attention must be devoted to the problem of primary prevention especially to target groups, resulting from anamnestic and clinical data analysis.

Adolescent↗

Examining survival data.

This brief review presents a nonmathematical description of the methods used to describe the outcome of patient groups when the time to an event such as death or disease recurrence is of interest. Calculation of the product-limit, actuarial and relative survival curves is described and the underlying principles are explained. Two statistical tests frequently used in comparing survival curves (the generalized Wilcoxon and the log-rank or Mantel test) are described and an example of their use is given.

Epidemiologic Methods↗