Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 103
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wprim-766777


Air pollution is a growing global health concern estimated to contribute to as many as 4.2 million premature deaths worldwide per year. So it poses the greatest environmental risk to human health. A strong and rapidly expanding body of evidence links ambient air pollution to respiratory and cardiovascular conditions that eventually may also affect cognition in the elderly. Among various ambient air pollutants, particulate matter (PM) has been implicated as a chronic source of neuroinflammation and reactive oxygen species that produce neuropathology resulting in neurodevelopmental disorders and neurodegenerative disease. The current review will briefly discuss the clinical features and underlying mechanism of PM induced cognitive dysfunction, more specifically, dementia.

Idoso , Poluição do Ar , Doença de Alzheimer , Cognição , Demência , Poeira , Saúde Global , Humanos , Mortalidade Prematura , Doenças Neurodegenerativas , Transtornos do Neurodesenvolvimento , Neuropatologia , Material Particulado , Espécies Reativas de Oxigênio
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-719539


BACKGROUND: Decreased physical performance, such as weakened handgrip strength and cognitive decline, is associated with disability and premature death in old age. We investigated the association between handgrip strength and cognitive impairment in Korean elderly adults with normal cognitive function. METHODS: This prospective study used the database from the Korean Longitudinal Study of Ageing. The participants included 2,378 adults aged 65 years or older with normal cognitive function (Korean Mini-Mental Status Evaluation [K-MMSE] score ≥21). Using a mixed-effects model, we examined the associations at baseline and over an 8-year follow-up period between handgrip strength and K-MMSE score. We investigated handgrip strength as a predictor of change in cognitive function. RESULTS: This study included 1,138 women (mean maximum handgrip strength 19.2 kg, mean K-MMSE score 25.1) and 1,240 men (mean maximum handgrip strength 30.7 kg, mean MMSE score 26.2). The baseline handgrip strength was positively associated with the baseline K-MMSE score (β=0.18, P < 0.001). Using a mixed-effects model, we found that higher handgrip strength at baseline can predict MMSE scores positively over time (β=0.14, P < 0.001) and the change of handgrip strength over time was a predictor of high MMSE scores over the study period (β=0.01, P < 0.01). CONCLUSION: We observed significant associations between baseline handgrip strength and baseline and change of cognition, as well as the longitudinal influence of handgrip strength on the change of cognitive function in elderly Korean adults with normal cognitive function.

Adulto , Idoso , Envelhecimento , Transtornos Cognitivos , Cognição , Feminino , Seguimentos , Força da Mão , Humanos , Estudos Longitudinais , Masculino , Mortalidade Prematura , Estudos Prospectivos
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-719496


BACKGROUND: Several studies have been conducted regarding people with disabilities, however no studies have estimated the disease burden due to premature death. As such, we aimed to compare the years of life lost (YLLs) due to premature death between a population with disabilities and the total population of Korea. METHODS: To calculate the YLLs in people with disabilities, we combined disability registration data from the 2002–2011 Ministry of Health and Welfare of Korea and the causes of mortality data by Statistics Korea for 3,158,231 people. RESULTS: YLLs of people with disabilities were 517,337, which accounted for 23.4% of YLLs of the total population. YLLs per 100,000 people with disabilities were approximately 3.8 times higher than those in the total Korean population. Ischemic stroke was associated with the highest YLLs per 100,000 people, followed by ischemic heart disease, hemorrhagic, and other non-ischemic stroke, diabetes mellitus, and self-harm. Among individuals with physical disabilities, ischemic heart disease was associated with the highest YLLs. For intellectual disability, epilepsy contributed to the most YLLs. For individuals with mental disability, self-harm was the largest contributor to YLLs. CONCLUSION: The burden of disease was higher in the population with disabilities than that in the general population. Cardiovascular diseases and cancer had a higher burden of disease than did other diseases in the population with disabilities; thus, overall, non-communicable diseases have a higher burden of disease than communicable diseases or injuries in the population with disabilities than in the general population.

Doenças Cardiovasculares , Doenças Transmissíveis , Diabetes Mellitus , Pessoas com Deficiência , Epilepsia , Humanos , Deficiência Intelectual , Coreia (Geográfico) , Mortalidade , Mortalidade Prematura , Isquemia Miocárdica , Acidente Vascular Cerebral
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wprim-787480


BACKGROUND: Diabetes is a chronic disease that cause premature death worldwide. The rate of testing for diabetes among mentally ill patients is 1.5 times that of the general population, and intervention in diabetes care is needed for patient with severe mental illness and diabetes.METHODS: This study was conducted using cross-sectional surveys distributed to patient with severe mental illness (n=54) among those who visited and were hospitalized at the National Mental Health Center.RESULTS: According to the assessment of the knowledge level of diabetes in patient with severe mental illness accompanied by type 2 diabetes, the correct answer rate was lower than that in the general population. Education and income affected the level of diabetes knowledge, and as diabetes knowledge level increased, blood sugar level were observed to decrease. The linear regression model showed that self-efficacy and education level were found to be predictors of diabetes knowledge, and diabetes knowledge level were predictors of fasting blood sugar levels.CONCLUSION: The results of this study showed that the higher education level and self-efficacy of the patient with severe mental illness and diabetes increased the diabetes knowledge and affecting glycemic control.

Glicemia , Doença Crônica , Comorbidade , Estudos Transversais , Diabetes Mellitus , Educação , Jejum , Humanos , Modelos Lineares , Transtornos Mentais , Saúde Mental , Pessoas Mentalmente Doentes , Mortalidade Prematura
Rev. cuba. salud pública ; 44(4)oct.-dic. 2018. graf
Artigo em Espanhol | LILACS (Américas), CUMED | ID: biblio-1042995


Introducción: La forma de culminar la vida es una expresión de la manera en que se vivió. Las mujeres y los hombres no atraviesan su paso por el mundo igualmente y tampoco comparten las mismas características biológicas que son diferentes para cada sexo. Objetivos: identificar la tendencia del riesgo de morir entre los sexos en las principales causas de muerte entre 2005 y 2016 e identificar la tendencia del riesgo de morir prematuramente entre los sexos en las principales causas de muerte entre 2009 y 2016 en Cuba. Métodos: Se elaboraron series cronológicas de las principales causas de muerte conformadas con las razones hombres-mujeres y se analizó la tendencia mediante rectas de regresión o promedios móviles. Los posibles motivos se identificaron mediante entrevistas en profundidad a expertos de género y salud. Resultados: Se encontraron tres grupos de causas de muerte. En el primero clasificaron: tumores malignos, enfermedades del corazón, enfermedad cerebrovascular, influenza y neumonía, accidentes, enfermedades crónicas de las vías respiratorias y las de las arterias, arteriolas y vasos capilares. El segundo estuvo conformado por la cirrosis hepática y otras enfermedades del hígado y las lesiones autoinfligidas. En el último grupo constó la diabetes mellitus. La tendencia se mantuvo sin notable variación a lo largo del tiempo en casi todas las series analizadas. Las explicaciones referidas que trataron explicar las diferencias encontradas en las agrupaciones de causas de muerte transitaron desde las que atribuyeron la acción de factores biológicos hasta las relacionadas con las consecuencias de la identidad de género. Discusión: Los hombres presentaron una situación más desventajosa debido a que el riesgo de morir y el riesgo de morir prematuramente fue superior al de las mujeres en la mayoría de las causas de muerte estudiadas que estuvieron más afectadas, principalmente por la diabetes mellitus. Conclusiones: La tendencia de la mortalidad de la razón hombre-mujer de las principales causas de muerte y de la mortalidad prematura evidenció diferencias entre los sexos, fue el masculino el más afectado a lo largo del tiempo(AU)

Introduction: The way life ends it is an expression of the way it was lived. Women and men do not live life equally and they neither share the same biological characteristics, which are different for each sex. Objectives: To identify the trends related to the risk of dying among both sexes and the main causes of death from 2005 to 2016, and the risk of dying prematurely from 2009 to 2016. Methods: Time series with the main causes of death among men and women were made and it was analyzed the trend by means of straight regression or moving averages. The possible reasons were identified through in-depth interviews to experts in gender and health. Results: There were found three groups of causes of death. In the first, there were: malignant tumors, heart diseases, cerebrovascular diseases, influenza and pneumonia, accidents; respiratory, arteries, arterioles and capillary vessels chronic diseases. The second group was formed by liver cirrhosis and other diseases of the liver and self-inflicted injuries. The third group consisted in diabetes mellitus. The trend continued without an outstanding variation over time in almost all of the analyzed series. Various reasons were found that could affect the group of causes of death that went from the biological to those dealing with the consequences of gender identity. Discussion: Men are those who submitted a disadvantage since the risk of dying and the risk of dying prematurely was superior to the women in the majority of the studied causes, mainly because of diabetes mellitus. Conclusions: Mortality trends among men and women and the main causes of death and of premature mortality evidenced differences between the sexes being males the most affected in long term(AU)

Humanos , Masculino , Feminino , Gênero e Saúde/história , Causas Múltiplas de Morte , Mortalidade Prematura/tendências , Cuba
Mexico City; Organização Mundial da Saúde; Sept. 2018. 16 p.
Monografia em Inglês | LILACS (Américas) | ID: biblio-1021947


Household air pollution is one of the principal causes of disease and premature death in low and middle-income countries (LMIC) and is an avoidable health risk. In the Americas, the World Health Organization (WHO) estimated that approximately 82,000 deaths in these countries were attributale to cooking, heating, and lighting with polluting fuels and technologies in 2016. Accelerating the transition to clean energy for all is an urgent and necessary public health intervention in the region of the Americas, to reduce the health risks that primarily affect socially and economically vulnerable populations, to achieve a continent healthier, more equitable and with sustainable development, contributing to the worldwide efforts to achieve the Sustainable Development Goals (SDGs) by 2030. To achieve this result, the health sector should be involved in the design of policy interventions to reduce exposure to indoor air pollution and its effects on health, as well associal inequities. In line with the WHO Indoor Air Quality Guidelines launched in November 2014, the PAHO Strategic Plan 2014-2019 has set itself the objective of helping Member States to reduce the percentage of population by 5% that depends on solid fuels for cooking in countries with a percentage of users equal to or greater than 10% of the population (priority countries). To measure progress, one indicator is the number of countries that are implementing large-scale programs to reduce solid fuel use (SFU) in the home, and a outcome indicator measures progress in the use of energy and clean technology for cooking at home. Evaluating the progress of the countries in the indicator of the Strategic Plan, some of its member states have successfully reduced solid fuel use (SFU) in the households by 5% and have implemented large-scale programs to transition to clean fuels. Nevertheless, in other countries in the region, progress has been almost non-existent. Following the first workshop carried out in Tegucigalpa (Honduras) in 2015, where new indoor air pollution guidelines were launched by the WHO, the workshop "Toward the elimination of solid fuels and kerosene in urban homes in the Americas" was organized and carried out in Mexico City (Mexico) from September 11 to 13, 2018.

Humanos , Querosene/toxicidade , Poluição Pontual/políticas , Poluição Ambiental/estatística & dados numéricos , /economia , Fatores Socioeconômicos , América , Mortalidade Prematura
Yonsei Medical Journal ; : 1123-1130, 2018.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-718027


PURPOSE: Exposure to indoor radon is associated with lung cancer. This study aimed to estimate the number of lung cancer deaths attributable to indoor radon exposure, its burden of disease, and the effects of radon mitigation in Korea in 2010. MATERIALS AND METHODS: Lung cancer deaths due to indoor radon exposure were estimated using exposure-response relations reported in previous studies. Years of life lost (YLLs) were calculated to quantify disease burden in relation to premature deaths. Mitigation effects were examined under scenarios in which all homes with indoor radon concentrations above a specified level were remediated below the level. RESULTS: The estimated number of lung cancer deaths attributable to indoor radon exposure ranged from 1946 to 3863, accounting for 12.5–24.7% of 15623 total lung cancer deaths in 2010. YLLs due to premature deaths were estimated at 43140–101855 years (90–212 years per 100000 population). If all homes with radon levels above 148 Bq/m3 are effectively remediated, 502–732 lung cancer deaths and 10972–18479 YLLs could be prevented. CONCLUSION: These findings suggest that indoor radon exposure contributes considerably to lung cancer, and that reducing indoor radon concentration would be helpful for decreasing the disease burden from lung cancer deaths.

Coreia (Geográfico) , Neoplasias Pulmonares , Pulmão , Mortalidade Prematura , Radônio
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-716806


BACKGROUND: Ambient fine particulate matter (PM2.5) is the major environmental health risk factor in Korea. Exposure to PM2.5 has been a growing public concern nationwide. With the rapid aging of the Korean population, the health effects attributable to long-term exposure to PM2.5 were expected to increase further in the future. We aimed to estimate premature deaths attributable to long-term exposure to ambient PM(2.5) in Korea. METHODS: A modelled estimation of long-term exposure to PM2.5 was used to calculate the nationwide exposure level. Hazard ratios of long-term exposure to PM2.5 were obtained from a large prospective cohort study in North America. Modified cause of death (CoD) data, which applied the garbage code reclassification algorithm, were used to calculate premature deaths attributable to long-term exposure to PM2.5. RESULTS: From 1990 to 2013, the average population-weighted PM2.5 concentration in Korea was 30.2 μg/m3. The estimated number of premature deaths was 17,203 (95% confidence interval [CI], 11,056–22,772). The most common CoD was ischemic stroke (5,382; 3,101–7,403), followed by cancer of trachea, bronchus, and lung (4,958; 2,857–6,820), hemorrhagic stroke (3,452; 1,989–4,748), and ischemic heart disease (3,432; 1,383–5,358). CONCLUSION: Premature deaths due to long-term exposure to PM2.5 accounted for 6.4% of all deaths in Korea. However, individual efforts alone cannot prevent the effects of air pollution. This disease burden study can serve as a basis for the establishment of government policies and budgets and can be used to assess the effectiveness of environmental health policies.

Envelhecimento , Poluição do Ar , Brônquios , Orçamentos , Causas de Morte , Estudos de Coortes , Saúde Ambiental , Resíduos de Alimentos , Coreia (Geográfico) , Pulmão , Mortalidade , Mortalidade Prematura , Isquemia Miocárdica , América do Norte , Material Particulado , Estudos Prospectivos , República da Coreia , Fatores de Risco , Acidente Vascular Cerebral , Traqueia
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-715771


BACKGROUND: We aimed to evaluate the spatial and temporal trends of the health burden attributable to particulate matter less than 2.5 µm in diameter (PM2.5) in the metropolitan cities and provinces of the Korea. METHODS: We used modeled PM2.5 concentration data for the basic administrative levels, comprising the cities and the provinces of Korea, the corresponding annual population census data for each level, and the age and cause specific mortality data. We applied cause-specific integrated exposure-response functions to calculate the premature mortality attributable to ambient PM2.5 for four disease end points (ischemic heart disease [IHD], chronic obstructive pulmonary disease [COPD], lung cancer [LC], and cerebrovascular disease [stroke]) for the year 2015. Moreover, the temporal trends of the health burden from 2006 to 2015 were assessed. RESULTS: The annual average PM2.5 concentration for Korea was 24.4 μg/m3, and 11,924 premature deaths were attributable to PM2.5 exposure in 2015. By simulating the reduction in the annual mean values of PM2.5 to 10 µg/m3, about 8,539 premature deaths were preventable. There was spatial variation in mortality burden attributable to PM2.5 across the sub-national regions of Korea. In particular, the high burden was concentrated at Seoul and Gyeonggi province due to the high population density. However, decreasing trends were noted for most of the metropolitan cities and provinces of Korea since 2006. CONCLUSION: Our findings show that further actions to improve air quality in Korea would substantially improve the health burden due to particulate matter.

Censos , Transtornos Cerebrovasculares , Cardiopatias , Coreia (Geográfico) , Neoplasias Pulmonares , Mortalidade , Mortalidade Prematura , Material Particulado , Densidade Demográfica , Doença Pulmonar Obstrutiva Crônica , Seul
Journal of Korean Diabetes ; : 200-207, 2018.
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wprim-726693


In Korea, by 2060, the proportion of the elderly population will be 40.1%, and at least one in three persons will have diabetes. Elderly patients with diabetes mellitus have higher rates of premature death, functional disability, and coexisting illnesses such as atherosclerotic cardiovascular disease than those without diabetes. In addition, the risk of geriatric syndrome, such as depression, cognitive dysfunction, urinary incontinence, falls, pain, and polypharmacy, is much higher in those with diabetes. The functional status of each elderly person varies greatly, such that comprehensive geriatric assessments for medical, psychological, functional, and social domains are needed. The goals and methods of diabetes management should be individualized according to the results of these assessments. In the treatment of vulnerable elderly patients with diabetes, hypoglycemia or overtreatment should be avoided.

Acidentes por Quedas , Idoso , Doenças Cardiovasculares , Depressão , Diabetes Mellitus , Diabetes Mellitus Tipo 2 , Avaliação Geriátrica , Humanos , Hipoglicemia , Coreia (Geográfico) , Sobremedicalização , Mortalidade Prematura , Polimedicação , Incontinência Urinária
Rev. panam. salud pública ; 42: e23, 2018. tab, graf
Artigo em Espanhol | LILACS (Américas) | ID: biblio-961719


RESUMEN Las enfermedades no transmisibles (ENT) representan uno de los mayores desafíos para el desarrollo en el siglo XXI, debido al devastador impacto social, económico y de la salud pública que provocan. El propósito de este artículo es describir la evolución y los factores de riesgo de las ENT en Cuba, principalmente en el período 1990-2015, reseñar las acciones emprendidas por el Ministerio de Salud Pública y destacar los desafíos más importantes para su prevención y control. La información contenida proviene de los datos colectados y publicados por la Dirección de Registros Médicos y Estadísticas de Salud, investigaciones sobre los factores de riesgo, otros estudios fundamentados y la documentación de acciones integrales. La mortalidad en Cuba está determinada por cuatro grandes problemas de salud: enfermedades cardiovasculares, tumores malignos, enfermedades crónicas de las vías respiratorias inferiores y diabetes mellitus, que en conjunto causan el 68,0% de los fallecimientos. La tendencia del cáncer es al ascenso y la enfermedad renal crónica emerge como un grave problema de salud. Cuba cuenta con una línea de base conocida sobre los factores de riesgo, de ellos la hipertensión y el consumo de tabaco son los principales relacionados con la mortalidad por ENT. En consonancia con la importancia de estas enfermedades se aprecian hitos e intervenciones de impacto positivo, así como brechas y desafíos en el marco del Plan de Acción Mundial de la Organización Mundial de la Salud para el enfrentamiento a las ENT.

ABSTRACT Non-communicable diseases (NCDs) represent one of the greatest challenges for development of the 21st century due to their devastating social, economic and public health impact. The objective of this article are to describe the evolution and risk factors for NCDs in Cuba, mainly in the period 1990-2015, to outline actions undertaken by the Ministry of Public Health of Cuba, and to highlight the most important challenges with a focus on their prevention and control. The information is based on data collected and published by the Directorate of Medical Records and Health Statistics, research on risk factors, other studies and documentation of comprehensive actions. Mortality in Cuba is determined by four major health problems: cardiovascular diseases, malignant tumors, chronic diseases of the lower respiratory tract and diabetes mellitus, which together cause 68.0% of deaths. Cancer presents a growing trend, and chronic kidney disease emerges as a serious health problem. Cuba has a known baseline on risk factors, and hypertension and tobacco consumption are the main factors related to NCDs mortality. In line with the importance of these diseases, there are milestones and interventions with a positive impact, as well as gaps and challenges within the framework of the World Health Organization's Global Action Plan for the Prevention and Control of NCDs.

RESUMO As doenças não transmissíveis (DNT) representam um dos maiores desafios do século 21 para o desenvolvimento devido ao desvastador impacto social, econômico e de saúde pública que elas causam. O objetivo deste artigo é descrever a evolução e os fatores de risco das doenças não transmissíveis em Cuba, principalmente no período de 1990-2015, para delinear as ações realizadas pelo Ministério da Saúde Pública de Cuba e destacar os desafios mais importantes para sua prevenção e controle. A informação vem dos dados coletados e publicados pela Diretoria de Registros Médicos e Estatísticas de Saúde, pesquisa sobre fatores de risco, outros estudos fundamentados e documentação de ações abrangentes. A mortalidade em Cuba é determinada por quatro principais problemas de saúde: doenças cardiovasculares, tumores malignos, doenças crônicas do trato respiratório inferior e diabetes mellitus, que em conjunto causam 68,0% das mortes. O câncer tem uma tendência crescente, e a doença renal crônica surge como um grave problema de saúde. Cuba tem uma linha de base conhecida sobre os fatores de risco, dos quais a hipertensão e o consumo de tabaco são os principais relacionados à mortalidade por DNT. Em consonância com a importância dessas doenças, há marcos e intervenções com impacto positivo, bem como lacunas e desafios no âmbito do Plano de Ação Mundial da Organização Mundial da Saúde para enfrentar as doenças não transmissíveis.

Humanos , Fatores de Risco , Mortalidade Prematura , Determinantes Sociais da Saúde , Doença Granulomatosa Crônica , Cuba
Cad. Saúde Pública (Online) ; 34(6): e00093417, 2018. tab, graf
Artigo em Inglês | LILACS (Américas) | ID: biblio-952406


Abstract: The objective of this study was to analyze the level and trend of avoidable deaths and non-avoidable deaths and their contribution to the change in life expectancy in Latin America by studying the situations in Argentina, Chile, Colombia and Mexico between the years 2000 and 2011, stratified by sex and 5-year age groups. The information source used in this study was the mortality vital statistics, and the population data were obtained from censuses or estimates. The proposal by Nolte & McKee (2012) was used to calculate the standardized mortality rates and the influence from avoidable and non-avoidable causes in the change in life expectancy between 0 and 74 years. In Argentina, Chile and Colombia, all the rates declined between the years 2000 and 2011, whereas in Mexico, the avoidable deaths and non-avoidable deaths rates increased slightly for men and decreased for women. In all the countries, the non-avoidable death rates were higher than the avoidable death rates, and the rates were higher for men. The largest contributions to changes in life expectancy were explained by the non-avoidable deaths for men in all countries and for women in Argentina; in contrast, in Chile, Colombia and Mexico, the gains in years of life expectancy for women were mainly a result of avoidable causes. The results suggest there have been reductions in mortality from these causes that have resulted in gains in years of life expectancy in the region. Despite these achievements, differences between countries, sex and age groups are still present, without any noticeable progress in the reduction of these inequalities until now.

Resumen: El objetivo de este estudio fue analizar el nivel y tendencia de las muertes evitables e no evitables, así como su contribución en el cambio de la esperanza de vida en Latinoamérica, mediante el estudio de situaciones en Argentina, Chile, Colombia y México entre los años 2000 y 2011, estratificado por sexo y grupos quinquenales de edad. La fuente de información usada en este estudio fueron las estadísticas vitales sobre mortalidad, y los datos sobre la población se obtuvieron mediante censos o estimaciones. La propuesta de Nolte & McKee (2012) se usó para calcular las tasas de mortalidad estandarizadas y la influencia de las causas evitables e no evitables en el cambio de la esperanza de vida entre 0 y 74 años. En Argentina, Chile y Colombia, todas las tasas disminuyeron entre los años 2000 y 2011, mientras que en México, las tasas de muertes evitables e no evitables aumentaron ligeramente para los hombres y decrecieron para las mujeres. En todos los países, las tasas de muertes no evitables eran superiores a las de muertes evitables, y las tasas eran más altas para los hombres. Las aportaciones mayores a los cambios en la esperanza de vida fueron explicadas por las muertes no evitables de hombres en todos los países y para las mujeres en Argentina; por el contrario, en Chile, Colombia y México, los avances en los años de esperanza de vida, en el caso de las mujeres, fueron principalmente como resultado de causas evitables. Los resultados sugieren que hubo descensos en la mortalidad por estas causas que resultaron en un incremento en los años de la esperanza de vida en la región. A pesar de estos logros, las diferencias entre países, sexo y grupos de edad están todavía presentes, sin ningún progreso notable en la reducción de estas inequidades.

Resumo: O estudo teve como objetivo analisar os níveis e a evolução das mortes evitáveis e não-evitáveis e sua contribuição às mudanças na expectativa de vida na América Latina, com foco nas realidades da Argentina, Chile, Colômbia e México entre 2000 e 2011 e estratificação por gênero e faixa etária. Como fontes de informação, o estudo usou os dados vitais sobre mortalidade e dados populacionais obtidos de censos ou através de estimativas. Foi utilizado o modelo proposto por Nolte & McKee (2012) para calcular as taxas de mortalidade padronizada e a influência das causas evitáveis e não-evitáveis na mudança na expectativa de vida entre 0 e 74 anos. Na Argentina, Chile e Colômbia, todas as taxas diminuíram entre 2000 e 2011, enquanto no México as mortes evitáveis e não-evitáveis aumentaram ligeiramente nos homens e diminuíram nas mulheres. Em todos os países, os índices de mortes não-evitáveis foram mais altos do que os de mortes evitáveis, e foram mais altos nos homens. As maiores contribuições às mudanças na expectativa de vida foram explicadas pelas mortes não-evitáveis de homens em todos os países e de mulheres na Argentina; enquanto isso, no Chile, Colômbia e México, os ganhos em anos de expectativa de vida para mulheres resultaram principalmente de causas evitáveis. Os resultados sugerem que houve redução na mortalidade por essas causas, graças aos ganhos nos anos de expectativa de vida na região. Apesar desses avanços, as diferenças entre países, sexos e grupos etários ainda existem, sem qualquer progresso perceptível até o momento na redução dessas desigualdades.

Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Adulto Jovem , Expectativa de Vida/tendências , Causas de Morte/tendências , Argentina , Fatores de Tempo , Chile , Fatores Sexuais , Estudos Transversais , Fatores Etários , Distribuição por Sexo , Colômbia , Distribuição por Idade , Mortalidade Prematura/tendências , México
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-788002


PURPOSE: Annually 27,855 patients in Korea develop treatment-induced mucositis nearly doubling the cost of cancer care. It is an emergency medical condition causing unplanned treatment breaks in 4,998 patients. The subsequent reduction in optimal dose-intensity causes premature deaths due to lower 5-year survival. An additional 216 patients die from mucositis-mediated sepsis and infection. Thus complete elimination of mucositis will immediately reduce the cost of care while simultaneously eliminating 5,214 mucositis-associated deaths. High potency polymerized cross-linked sucralfate (HPPCLS) cleared by the US Food and Drug Administration has been associated with the elimination of mucositis.METHODS: Observational, self-reporting, practice-based mucositis registry. Inclusion criteria: any patient with chemoradiation-induced mucositis. Exclusion criteria: previous adverse reaction to sucralfate products. Primary outcome: rapid reversal or complete prevention. Conduct of study: 28 radiation oncologists from 21 different institutions prescribed HPPCLS to 55 patients undergoing chemoradiation for squamous cell carcinoma of head and neck and esophagus to eliminate mucositis-associated treatment breaks.RESULTS: All patients with World Health Organization grade 1 (n=6), grade 2 (n=23), grade 3 (n=16) oral mucositis, and grade 2 esophageal mucositis (n=2) experienced complete reversal of mucositis. Within 2–3 days both mucosa and swallowing normalized. Anticipated grade 3/4 mucositis was prevented in 8 out of 8 elderly patients aged 78–93 avoiding gastrostomy tube placement. Statistical analysis of outcomes: Outcomes qualified as a positive Glasziou treatment effect that was statistically significant (P<0.05).CONCLUSION: HPPCLS eliminated mucositis by rapid reversal or complete prevention, thereby eliminating unplanned treatment breaks. It may likely reduce mucositis-associated increased cost of care and premature deaths.

Idoso , Carcinoma de Células Escamosas , Deglutição , Tratamento Farmacológico , Emergências , Esôfago , Gastrostomia , Neoplasias de Cabeça e Pescoço , Cabeça , Humanos , Coreia (Geográfico) , Mortalidade Prematura , Mucosite , Membrana Mucosa , Pescoço , Polímeros , Sepse , Estomatite , Sucralfato , United States Food and Drug Administration , Organização Mundial da Saúde
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-27725


BACKGROUND/OBJECTIVES: This study aimed to investigate the association of dietary patterns with overweight risk and all-cause mortality in pediatric cancer patients. SUBJECTS/METHODS: Prospective cohort study was undertaken; 83 cancer patients admitted to the pediatric cancer ward at a university hospital in Seoul were included and followed for obesity and death over 24 months. Food consumption data were collected from patients using validated meal order sheets for breakfast, lunch, and dinner at the pediatric cancer ward over 3 days. Using principal component analysis, three dietary patterns were derived from 29 food groups. RESULTS: Eighteen deaths occurred among the patient cohort during the follow-up period. The “spicy & fried meat and fish” dietary pattern was positively associated with overweight risk at both baseline [odds ratio (OR) = 4.396, 95% confidence interval (CI) = 1.111-17.385, P for trend = 0.023] and after 6 months (OR = 4.088, 95% CI = 1.122-14.896, P for trend = 0.025) as well as all-cause mortality (hazard ratios = 5.124, 95% CI = 1.080-24.320, P for trend = 0.042), when comparing the highest and lowest tertiles after adjusting for covariates. The “fish, egg, meat, and fruits & vegetables” dietary pattern was associated with lower overweight risk after 24 months (OR = 0.157, 95% CI = 0.046-0.982, P for trend = 0.084). CONCLUSION: The results imply that dietary patterns might be associated with weight gain and premature death among pediatric cancer patients.

Desjejum , Criança , Estudos de Coortes , Dieta , Seguimentos , Frutas , Humanos , Almoço , Refeições , Carne , Mortalidade , Mortalidade Prematura , Obesidade , Sobrepeso , Óvulo , Análise de Componente Principal , Estudos Prospectivos , Seul , Ganho de Peso
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-208889


In terms of years of life lost to premature mortality, cancer imposes the highest burden in Korea. In order to reduce the burden of cancer, the Korean government has implemented cancer control programs aiming to reduce cancer incidence, to increase survival rates, and to decrease cancer mortality. However, these programs may paradoxically increase the cost burden. For examples, a cancer screening program for early detection could bring about over-diagnosis and over-treatment, and supplying medical services in a paternalistic manner could lead to defensive medicine or futile care. As a practical measure to reduce the cost burden of cancer, appropriate cancer care should be established. Ensuring appropriateness requires patient-doctor communication to ensure that utility values are shared and that autonomous decisions are made regarding medical services. Thus, strategies for reducing the cost burden of cancer through ensuring appropriate patient-centered care include introducing value-based medicine, conducting cost-utility studies, and developing patient decision aids.

Efeitos Psicossociais da Doença , Técnicas de Apoio para a Decisão , Medicina Defensiva , Detecção Precoce de Câncer , Humanos , Incidência , Coreia (Geográfico) , Mortalidade , Mortalidade Prematura , Assistência Centrada no Paciente , Determinação do Valor Econômico de Organizações de Saúde , Qualidade da Assistência à Saúde , Taxa de Sobrevida , Carga Tumoral
Asian Nursing Research ; : 304-310, 2017.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-172229


PURPOSE: This study explored the lived experiences of Thai women in relation to alcohol addiction in treatment. METHODS: Twelve women aged 20 to 65 years, were participated. The participants were recruited from two special hospitals and one outpatient clinic in a general hospital. Descriptive phenomenology was applied to analyze the transcripts of the individual interviews. RESULT: The explored phenomenon of Thai women experiencing alcohol addiction included four essential aspects, (1) feeling inferior and worthless (2) feeling physically and emotionally hurt, (3) fearing physical deterioration and premature death, and (4) feeling superior and powerful. Through these different aspects of Thai women's lived experiences, the following essence was synthesized. The essence of the lived experience of alcohol addiction among the studied Thai women was ambivalence between feeling inferior and worthless and feeling superior and powerful when acting as a man. Drinking alcohol lessened life's difficulties and fears; for example, of violence, bodily demolition, premature death and marginalization from family and society. CONCLUSION: Thai women who experience alcohol addiction are treated with gender-related double standards when trying to undo gender traditional roles. Their marginalization from family and society deepens making them even more vulnerable to the positive side effects of alcohol drinking.

Consumo de Bebidas Alcoólicas , Alcoolismo , Instituições de Assistência Ambulatorial , Grupo com Ancestrais do Continente Asiático , Ingestão de Líquidos , Feminino , Identidade de Gênero , Hospitais Gerais , Hospitais Especializados , Humanos , Mortalidade Prematura , Violência