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PubMed1979

Report to the Veterans' Administration Department of Medicine and Surgery on service-connected traumatic limb amputations and subsequent mortality from cardiovascular disease and other causes of death.

Men drafted into the Army, hospitalized during 1944 to 1945 for service-connected trauma to the extremities, and consequently separated for disability were followed for mortality from January 1946 to April 1977. Three groups were established consisting of those whose injury resulted in (a) limb amputation, (b) disfiguration without loss of body part, (c) loss of part of hand or part of foot. Group (a) had a mortality, standardized for age and calendar time, 1.4 times that of Group (b), matched on age and length of service at admission, and 1.3 times that of Group (c), similar on age and length of service to Group (a). The excess mortality of limb amputees was statistically significant (P less than .05) for ischemic heart disease, other diseases of the cardiovascular system, suicide by poisoning, alcholic cirrhosis, and cute pancreatitis. Possibly (P less than .1) there was also an increased risk of diabetes and cancer of the buccal cavity and pharynx.

Adult↗
PubMed1986

[Retrospective cohort study of the cancer incidence in pesticide-exposed male pest control workers].

A cohort of 1,214 pest control workers employed during 1945-1980 for at least 5 yr was investigated with regard to cancer mortality. Standardized Mortality Ratio (SMR) was significantly elevated for all malignant neoplasms (SMR = 133; 65 observed vs. 48.5 expected). Significantly elevated SMRs were also found for the following tumor sites: esophagus, SMR = 430 (4 observed vs. 0.9 expected); stomach, SMR = 180 (14 observed vs. 7.8 expected) and melanoma, SMR = 588 (2 observed vs. 0.3 expected). Mortality from stomach cancer showed a rising trend by number of years licensed (less than 10 years, SMR = 118; 10-19 years, SMR = 160; greater than 19 years, SMR = 260). The findings help clarify the role of occupational pesticide exposure as a risk factor for cancer.

Adenocarcinoma↗
PubMed1994

Clostridium septicum abscess in hepatic metastases: successful medical management.

Clostridium septicum bacteremia is frequently associated with hematologic and colonic malignancies and neutropenia. It frequently produces 'metastatic' gangrene with excessive mortality. Standard therapy usually includes surgical debridement and antibiotics. We present a patient with metastatic breast cancer treated with high-dose chemotherapy and bone marrow transplantation. She was treated successfully with antibiotics alone despite developing Cl. septicum bacteremia and gas in hepatic metastases. The pathophysiology of this infection is reviewed.

Adult↗
PubMed1993

[Mortality from pleural mesothelioma in the province of Barcelona].

BACKGROUND: Pleural mesothelioma is a tumor of low incidence whose relation with the exposure to asbestos has been widely demonstrated. This exposure is generally occupational, but may also be domestic and there is the possibility of environmental exposure. METHODS: By death certifications all the cases of death by pleural mesothelioma residing in the province of Barcelona from 1983-1990 have been identified. The rates of direct or indirect mortality (standardized by age and sex) (cause of standard mortality) for all the municipalities of the province with some case of mesothelioma over the period studied were calculated. The geographic localization of the companies using asbestos in the province of Barcelona has been obtained, being classified into 6 groups according to the productive subsector to which they belong. RESULTS: The rate of mortality per 100,000 inhabitants from 1983-1990 was 0.83 for males and 0.47 for females. The calculation of the cause of standard mortality for the municipalities of the province has shown an statistically significant increase in the risk of pleural mesothelioma for El Prat de Llobregat (ratio of standard mortality: 355.1) and Cerdanyola (ratio of standard mortality 313.9) where the companies producing fibrocement are located. CONCLUSIONS: Part of the cases of pleural mesothelioma in the province of Barcelona may not be due to direct occupational exposure; thus there may be important domestic and/or environmental exposure.

Adolescent↗
PubMed1997

[Relationship between heart rate and general mortality and that caused by cardiovascular diseases].

The sample of 1309 men and 1337 women, aged 35-64, randomly selected for the first Warsaw Pol-Monica screening performed in 1984, was followed up in 1992. All deaths were registered according to the cause of death based on death certificate diagnosis. The proportional hazard Cox model was used for univariate heart rate (HR) analysis and for multivariate analysis after adjustment for covariates (HR divided into 4 subgroups). Out of screened subjects 263 persons died (139 due to cardiovascular disease CVD). Mean baseline HR of persons who died was 76.8 (+/- 11.5) versus 73.9 (+/- 10.2) for subjects who survived (p = 0.0001). In the univariate analysis the heart rate was significantly positively related both to all cause mortality (relative risk RR = 1.29, p = 0.0001) as well as to cardiovascular mortality (RR = 1.31, p = 0.0025). In the multivariate analysis HR was significantly positively related to all cause mortality (standardized RR = 1.24, p = 0.0012), but almost significantly related to cardiovascular mortality (SRR = 1.20, p = 0.052).

Adult↗
PubMed1999

Mortality of patients with clinically localized prostate cancer treated with observation for 10 years or longer: a population based registry study.

PURPOSE: We studied the outcome in patients with early and probably organ confined prostate cancer who were considered candidates for curative therapy and treated expectantly. MATERIALS AND METHODS: The study included 2,570 patients with newly diagnosed prostate cancer reported to the Danish Cancer Registry from 1943 to 1986 and surviving for 10 years or longer. Mortality and causes of death were analyzed and stratified by stage, age and time of diagnosis. Excess mortality was calculated from life expectancy tables for the general population. RESULTS: An overall excess mortality (standard mortality ratio 1.58, 95% confidence interval [95% CI] 1.51 to 1.65) was found. Young age and advanced clinical stage at diagnosis entailed a higher risk of death from prostate cancer. Overall 42.7 and 19.1% of the patients who died had prostate cancer as the direct or contributing cause of death, respectively. Of the annual deaths 13% were attributable to prostate cancer. In 1,326 patients 55 to 64 and 65 to 74 years old with clinically localized prostate cancer at diagnosis the excess mortality was still significant (standard mortality ratio 1.72, 95% CI 1.54 to 1.93 and 1.50, 95% CI 1.39 to 1.62, respectively). Prostate cancer was the primary or contributing cause of death in 42.9% of the younger group and 21.5% of the older group. In these patients 15% of the annual deaths were related to prostate cancer. CONCLUSIONS: Patients with clinically localized prostate cancer for 10 years or longer, who were likely candidates for curative therapy when diagnosed, had significant excess mortality when treated expectantly.

Adult↗
PubMed2026

The presence or absence of standard modifiable cardiovascular risk factors in patients with myocardial infarction impacts long-term but not 30-day mortality: a UK Biobank prospective cohort study.

AIMS: Prior studies reported higher early mortality after acute myocardial infarction (MI) in patients without standard modifiable cardiovascular risk factors (SMuRFs), warranting further validation. We aimed to evaluate whether SMuRF-absence is associated with increased 30-day cardiovascular mortality following MI. METHODS AND RESULTS: We conducted a population-based cohort study using UK Biobank data (n = 487 177). Incident MI cases occurring between 2006 and 2022 were identified through linkage to hospital and death registries. Standard modifiable cardiovascular risk factors (diabetes, hypertension, hypercholesterolaemia, current smoker) were defined at baseline and continuously assessed until MI onset. Thirty-day mortality following MI was estimated using Cox proportional hazards models, adjusted for sociodemographic, clinical, and cardiogenomic variables, were used to estimate 30-day mortality risks. Logistic regression model was used to estimate mortality risk at 10 years post-MI. Among 15 463 patients experiencing an MI (1034 without SMuRFs), SMuRF-absence was not significantly associated with 30-day mortality (HR: 0.82, 95% CI: 0.65-1.04, P = 0.103). Propensity score-matched analyses supported these findings (HR: 0.95, 95% CI: 0.69-1.29, P = 0.729). Further analyses stratified by distinct time intervals (2006-2022) revealed no significant modification of this association by advancements in acute MI management. Interaction analyses indicated no significant effect modification by sex, age, socioeconomic status, or period of MI occurrence. However, extended analysis to 10 years revealed that SMuRF absence was significantly associated with lower long-term mortality (OR: 0.61, 95% CI: 0.49-0.75, P < 0.01). CONCLUSION: In this population-based cohort, SMuRF status significantly impacted long-term but not short-term mortality following MI, indicating early survival is predominantly driven by acute-phase factors rather than baseline cardiovascular risk profiles.

Humans↗