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Increased life expectancy in people with untreated phenylketonuria.
The records of 17 people with intellectual disability and untreated phenylketonuria (12 females and five males), who were resident in the Stoke Park Group of Hospitals, Bristol, England, 25 years ago, were re-examined for life expectancy. Six subjects had died (five females and one male). The oldest deceased female was 69 years of age. The average age at death was 55.8 years. Eleven subjects were still alive (seven females and four males). The oldest living male was 79 years of age. The average age of the survivors was 55.7 years.
Life expectancy and dementia in Canada: the Canadian study of health and aging.
Using the 1991 Canadian life table and estimates of the prevalence of dementia from the Canadian Study of Health and Aging, we have partitioned the expectation of life at age 65 into years spent in the community and in institutions, with and without different forms of dementia. The total expectation of life for women was 26% greater than that for men, but women's expectations of life with dementia and of life in institutions were more than twice the corresponding expectations for men. The difference between sexes was greater for Alzheimer's disease than for vascular and other types of dementia.
Excess mortality from breast cancer 20 years after diagnosis when life expectancy is normal.
In a population-based study, causes of death were traced of 418 deceased breast cancer patients diagnosed in 1960-1979 who survived at least 10 years after diagnosis. The pattern of causes of death in these patients was compared with the general female population using standardized mortality ratios (SMRs). Of 418 patients surviving at least 10 years, 196 (47%) died from breast cancer and 50 (12%) died from another cancer. The SMR for breast cancer was 15.8 (95% CI: 13.1-18.8) 10-14 years after diagnosis; it was still 4.7 (95% CI: 2.6-7.8) after 20 years. Overall mortality was higher than expected 10-14 years after diagnosis (SMR: 1.3; 95% CI: 1.1-1.5), but lower after more than 20 years (SMR: 0.6; 95% CI: 0.4-0.7). Despite a normal (or even improved) life expectancy for breast cancer patients 20 years after diagnosis the risk of dying from this disease remained elevated.
BLOOD PRESSURE AND LIFE EXPECTANCY.
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[Life expectancy in athletes].
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[Localized prostatic cancer. Survival and loss of life expectancy].
Computerized linkage between the Danish Cancer Registry and the Central Personal Registry was established. A total of 1459 men aged 55-74 years with newly diagnosed clinically localized prostate cancer in the period 1983-1987 were identified. Routine treatment in this period was observation and endocrine therapy in case of progression. Survival analysis demonstrated a significant excess mortality and a substantial loss of life expectancy.
[[Age-specific mortality and life expectancy]].
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The evaluation of educational and economic effects on life expectation by linear regression analysis.
Socioeconomic effects are supposed to have a fairly long time delay in regard to health development. Taking into consideration time lags, correlation and regression analysis are executed to explain the difference in health levels which exist among countries. The infant mortality rate, life expectation at birth, adult literacy rate, proportions of school enrollment and GNP per capita are taken as variables and their characteristics are discussed. In addition, countries are divided into three groups, i.e. low income, middle income, and industrialized countries, to show that the educational and economic effects on health development vary according to the economic level of the countries.
Air pollution mortality: harvesting and loss of life expectancy.
This article concerns the interpretation of epidemiological studies of air pollution mortality and the choice of indicators for quantifying the impact, for communication with policymakers. It is shown that the total mortality impact (measured by cohort studies) can only be quantified in terms of loss of life expectancy (LLE), not number of premature deaths. Time-series (TS) studies of mortality observe only acute impacts, that is, deaths due to short-term exposure ("acute mortality"); they allow the estimation of a number of deaths without providing any information on the LLE per death. However, even if the average loss per death is as long as 6 mo, acute mortality is only a very small percentage of the total mortality attributable to air pollution. Estimates of the population-average LLE due to air pollution are provided, for acute mortality, total adult mortality, and infant mortality.
Follow-up 15 years after a geronto-psychiatric prevalence study. Conditions concerning death, cause of death, and life expectancy in relation to psychiatric diagnosis.
In relation to a follow-up 15 years after a geronto-psychiatric prevalence investigation of the population aged 65+ in a rural population, analysis has been made of the type of death certificate, residence at time of death, place of death, cause of death and life-expectancy in relation to psychiatric diagnoses prevalent in 1961.
[Life expectancy and size of the liver in the presence of liver metastases: study of the diagnostic significance of palpatory findings (author's transl)].
A retrospective analysis of survival time of 348 patients with liver metastases indicates that both the extent of liver enlargement and also its increased firmness and changes at its surface are easily obtainable findings of prognostic value. In the presence of liver metastases there is a significant correlation between median life expectancy and size of the liver.
Life expectancy of ventriculosubgaleal shunt revisions.
The subgaleal shunt has been and is currently used for the temporary bypass of the normal cerebrospinal fluid (CSF) pathways. We retrospectively reviewed all subgaleal shunts placed at the Children's Hospital, Birmingham, Ala., USA, from 1993 to the present and examined the life expectancy of revisions of this temporary method of CSF diversion. The average length of survival of primary, secondary and tertiary subgaleal shunts in this population was 37.4, 32.4 and 19.6 days, respectively. This current review demonstrates that the majority of patients in whom a subgaleal shunt is utilized may continue to obtain therapeutic diversion of their CSF for greater than 2.5 months with intermittent subgaleal shunt revisions. In the majority of cases, this length of time is sufficient to manage and resolve issues that would make ventriculoperitoneal shunting undesirable.
Inequalities in health. Analytic approaches based on life expectancy and suitable for small area comparisons.
STUDY OBJECTIVE: Simple measures of inequalities in health are proposed to facilitate the work of health policy makers and to build on the understanding of health differences between populations. In addition, it is aimed to make these measures applicable for comparisons of small populations and subgroups. METHODS: Inequalities in health or health deficiencies were quantified as the difference between the life expectancy of the subgroup of interest and that of the national population. Health deficiencies were divided into disease specific components by partial application of cause eliminated life table methods. To manage small numbers and to depict time trends, locally weighted regression smoothing was applied. Confidence intervals were constructed through Monte Carlo simulations. APPLICATIONS AND COMPARISONS: The proposed approaches were applied to the health situation in Cape Breton County, Nova Scotia, Canada, and disclosed the significance of different diseases and distinct patterns between communities. The proposed measures were also compared with the traditionally used standardised mortality rates and ratios. Here, the proposed measures appeared beneficial in that they are easier to comprehend and that they provide time trends and more robust estimates. CONCLUSIONS: The above advantages make the proposed approaches beneficial to health policy makers and epidemiologists. The approaches may also be incorporated in economic evaluations as well as in more sophisticated public health models.
[Life expectancy in Copenhagen 1933-47].
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[Life expectancy in prehistoric and present time].
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[The kidney and life expectancy].
Basic renal functions are physiologically determined as precisely regulated relation between more and less physical events with low energy consumption and energy dependent cellular transport mechanisms. All well in ageing as under various conditions of renal diseases adaptive processes become biologically effective, so that stabilisation of homöostasis is possible up to a loss of 95% of normal function. Life expectancy has to be defined under the new conditions of renal replacement therapy effective beyond this biologically defined border line.
Decision analysis in children with blunt splenic trauma: the effects of observation, splenorrhaphy, or splenectomy on quality-adjusted life expectancy.
The management of blunt splenic trauma in children has remained controversial, with different physicians advocating observation, splenorrhaphy, and splenectomy. Proponents for each position have debated the relative importance of rebleeding (delayed splenic rupture), posttransfusion hepatitis with its sequelae, and overwhelming postsplenectomy sepsis. In an attempt to guide the clinician, a decision analysis was performed. Variables evaluated included the incidence of transfusion, postsplenectomy sepsis, posttransfusion hepatitis, chronic active hepatitis, cirrhosis, and rebleeding. The quality-adjusted life expectancies (QALEs) when the average incidence of the variables were used in the decision analysis were 62.69 years for observation, 62.32 years for splenorrhaphy, and 61.14 years for splenectomy. Sensitivity analysis showed that there was very little difference between observation and splenorrhaphy when the transfusion rate and hepatitis rate were varied. But these treatment options produced longer QALEs than splenectomy. Therefore, in appropriately selected patients, observation is a safe and effective therapeutic option. If an operation is necessary, every effort should be made to preserve the spleen. Splenectomy may still be required in those cases of complete devascularization, persistent hemorrhage, or other associated significant injuries.