ABSTRACT
BACKGROUND: Ofuji's papuloerythroderma is a rare disorder, characterized by a generalized pruriginous eruption, sparing the folds. It predominates in the elderly. The pathology is still unknown but associations with lymphoma have been described. Various therapeutic approaches have been tried, most often including local and general corticosteroids and PUVA. OBSERVATION: Two patients aged 71 and 84 years presented red pruriginous macular rash sparing the abdominal folds. Eosinophilia and lymphopenia were observed. Cutaneous biopsies showed dermal lymphocytic and plasmocytic infiltrates with, in one case, eosinophil and neutrophil exocytosis. Clinical, biological and morphological investigations showed no association with other diseases such as cancer or lymphoma. Azathioprine permitted clinical and biological remission in both patients but had to be interrupted because of minor side effects (infection, gastroenterologic disorders) and corticosteroids were introduced in one case. DISCUSSION: We suggest that histological aspects, such as exocytosis, may represent a link between Ofuji's papuloerythroderma and lymphoma. Azathioprine led to clinical and biological improvement in our 2 patients. Because of its adverse effects, it could be proposed as second-line therapy in patients presenting resistance or intolerance to usual treatments.
Subject(s)
Azathioprine/therapeutic use , Immunosuppressive Agents/therapeutic use , Skin Diseases , Skin Diseases/drug therapy , Adrenal Cortex Hormones/therapeutic use , Age Factors , Aged , Aged, 80 and over , Biopsy , Diagnosis, Differential , Eosinophilia/complications , Follow-Up Studies , Humans , Hypereosinophilic Syndrome/diagnosis , Skin/pathology , Skin Diseases/diagnosis , Skin Diseases/pathology , Syndrome , Time FactorsABSTRACT
This article analyses delays in the registration of death and discusses their effect on mortality statistics. It is shown that the longest delays arise when deaths are the subject of a coroner's inquest, in particular deaths in road traffic accidents. These delays mean that it may be many months before an acceptable proportion of deaths occurring in a year have been registered, so affecting how early a reliable extract of annual data can be taken. It also shows that the difference in the number of deaths occurring and the number registered in a year is strongly influenced by the weekdays on which holidays fall at the New Year.
Subject(s)
Death Certificates , Registries/standards , Cause of Death , Coroners and Medical Examiners , England/epidemiology , Holidays , Humans , Mortality , Reproducibility of Results , Time Factors , Wales/epidemiologyABSTRACT
This article describes the implementation of a computerised system for coding the cause of death from death registrations in England and Wales since the beginning of 1993, and the impact this has had on national cause of death statistics. Overall the automated system has been effective and reliable at deriving ICD-9 codes for the underlying cause of death and other conditions mentioned on the certificate. Automation increases the consistency and international comparability of cause of death coding. However, it has led to discontinuities in time trends between 1992 and 1993, which are explored here. The largest effect was related to expected changes in the application of ICD-9 selection rule 3. However there were other effects which were not expected. The automated system does not deal adequately with external causes of death, which are certified after coroner's inquest, and ONS has reverted to coding these clerically. Lessons for the implementation of ICD-10 for mortality have been learnt.
Subject(s)
Cause of Death , Electronic Data Processing , Mortality/trends , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Death Certificates , England/epidemiology , Humans , Infant , Infant, Newborn , Information Systems , Middle Aged , Wales/epidemiologyABSTRACT
Trends in diabetes-related mortality in England and Wales between 1975-6 and 1985-6, and regional and ethnic differences in diabetes-related mortality in 1985-6, have been examined. Data from death certificates mentioning diabetes in 1975-6 were compared with those for 1985-6 for different age groups. Data for 1985-6 were also analysed for different regions of England and Wales, and for country of birth. Between 1975-6 and 1985-6, the age-standardized rate of mentioning diabetes rose by 2.7% (95% confidence interval 1.4%, 4.1%) in men of all ages, and fell by 11.7% (10.6, 12.8) in women of all ages. By contrast, the rate of mentioning diabetes in those below 45 years fell by 30.7% (23.0, 37.7) in men and by 26.7% (16.5, 35.6) in women. Deaths in which the underlying cause was ischaemic heart disease (IHD), and where diabetes was also mentioned on the death certificate, rose by 14.4% (11.5, 16.8) in men and did not change significantly in women of all ages, but fell by 18.4% (-35.1, +2.6) in men, and 23.5% (-49.1, +15.2) in women below age 45. This was less favourable than the trend in the general population, where IHD mortality fell by 9.7% in men and 8.3% in women of all ages, and by 31.1% (28.6, 33.5) in men and 40.5% (35.0, 45.5) in women under 45 years.(ABSTRACT TRUNCATED AT 250 WORDS)
Subject(s)
Diabetes Mellitus/mortality , Age Factors , Demography , England/epidemiology , Female , Humans , Male , Middle Aged , Sex Characteristics , Time Factors , Wales/epidemiologySubject(s)
Pulmonary Embolism/mortality , Adult , Age Factors , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Sex Factors , United KingdomABSTRACT
Abstract Sierra Leone is in a position typical of many African countries regarding accurate information on her basic demographic characteristics. Such vital registration as exists is confined to a small area and there has been only one census of any reliability, that of 1963. Estimates of fertility levels from the age distribution obtained from that enumeration have been made by Dow, the method having been used previously by Van de Walle for Nigeria.
