Health Benefits of Residence at Moderate Altitude Do Not Reduce COVID-19 Mortality.

Moderate altitude (1000−2000 m above sea level) residence is emerging as a protective factor from the mortality of various causes, including of cardiovascular diseases. Conversely, mortality from certain respiratory diseases is higher at these altitudes than in lowlands. These divergent outcomes could indicate either beneficial or detrimental effects of altitude on the mortality of COVID-19 that primarily infects the respiratory tract but results in multi-organ damage. Previous epidemiological data indeed suggest divergent outcomes of moderate to high altitude residence in various countries. Confounding factors, such as variations in the access to clinical facilities or selection biases of investigated populations, may contribute to the equivocation of these observations. We interrogated a dataset of the complete population of an Alpine country in the center of Europe with relatively similar testing and clinical support conditions across altitude-levels of residence (up to around 2000 m) to assess altitude-dependent mortality from COVID-19 throughout 2020. While a reduced all-cause mortality was confirmed for people living higher than 1000 m, no differences in the mortality from COVID-19 between the lowest and the highest altitude regions were observed for the overall population and the population older than 60 years as well. Conversely, COVID-19 mortality seems to have been reduced in the very old (>85 years) women at moderate altitudes.

How Long Does It Take to Regain Normocalcaemia in the Event of Postsurgical Hypoparathyroidism? A Detailed Time Course Analysis.

Background: Postsurgical hypoparathyroidism (PH) is the most common side effect of bilateral thyroid resections. Data regarding the time course of recovery from PH are currently unavailable. Therefore, a detailed analysis of the time course of PH recovery and conditions associated with rapid recovery was conducted. Methods: This is a retrospective analysis of prospectively documented data. Patients with biochemical signs of PH or need for calcium supplementation were followed-up for 12 months. Logistic regression analyses were used to identify covariates of early as opposed to late recovery from PH. Results: There were 1097 thyroid resections performed from 06/2015 to 07/2016 with n = 143 PH. Median recovery time was 8 weeks and six patients (1.1% of total thyroid resections) required calcium supplementation > 12 months. Recovery of PH within 4 and 12 weeks was characterized by high PTH levels on the first postoperative day (4 weeks: OR 1.13, 95% CI 1.06−1.20; 12 weeks: OR 1.08, 95%CI 1.01−1.16). Visualization of all PTGs emerged as an independent predictor of recovery within 12 months (OR 2.32, 95% CI 1.01−4.93) and 24 weeks (OR 2.69, 95% CI 1.08−6.69). Conclusion: In the setting of specialized high-volume endocrine surgery, permanent PH is rare. However, every second patient will require more than 2 months of continued medical surveillance. Early recovery was associated with only moderately decreased postsurgical PTH-levels. Successful late recovery appeared to be associated with the number of parathyroid glands visualized during surgery.

Suicide among 915,303 Austrian cancer patients: who is at risk?

OBJECTIVES: The aim of this study was to determine whether time since first diagnosis, site, and stage of cancer impacted suicide risk within a nationwide cohort of Austrian cancer patients. METHODS: Data for this population-based study were derived from the Austrian National Cancer Registry and Austrian Statistics on Causes of Death. The study of population comprised 915,303 patients diagnosed with cancer between 1983 and 2000 and 14,532,682 person-years of follow-up. Standardized suicide mortality ratios (SMRs) were calculated by sex, time since first diagnosis, site, and stage of cancer. RESULTS: A total of 2877 suicides were registered among all cancer patients over the observation period. Indicating excess suicide risk relative to the general Austrian population, the SMR for the patient cohort was 1.23 (95% CI: 1.19-1.28), and was higher for men (1.41; 95% CI: 1.35-1.47) than women (1.24; 95% CI: 1.15-1.34). This excess risk varied with time since first cancer diagnosis. SMRs peaked in year one after diagnosis (3.17; 95% CI: 2.96-3.40). An excess suicide risk was observed for patients with late locally advanced (SMR=1.59; 95% CI: 1.47-1.71) or metastasized cancer (SMR=4.07; 95% CI: 3.58-4.61), and cancers of the lung (SMR 3.86; 95% CI: 3.36-4.42) and central nervous system (SMR 2.81; 95% CI: 1.92-3.97). LIMITATIONS: No data were available on psychiatric comorbidities, genetic variables, family characteristics, social factors, and community characteristics. CONCLUSIONS: Our study shows that cancer patients have an excess risk for suicide, relative to the general population, which varies with time since first diagnosis, disease severity, and anatomical site. The diagnostic process needs to be sensitive and responsive to their mental health needs. Psychological care should be an integral component of cancer treatment programs.

Heatwaves in Vienna: effects on mortality.

BACKGROUND: The hot summer of 2003 brought about increased mortality in southern and western Europe, highlighting the health impact of heatwaves. No Austrian mortality data have yet been reported for this summer period. METHODS: Daily mortality data for Vienna between 1998 and 2004 were obtained from Statistics Austria and meteorological data from the Austrian Central Institute for Meteorology and Geodynamics. Heatwaves were defined using the Kysely criterion. Daily mortality for May to September was predicted by a generalized additive model considering over-dispersion with Poisson deviates and a log link. Seasonal trend was accounted for by a natural spline, weekdays were modeled by dummy variables and heatwave days were included as dichotomous predictor. RESULTS: The average seasonal temperature for May to September in Vienna has increased by more than 1.7 degrees C during the last 35 years. In 2003 there was an excess of heatwave days, 44 overall, that resulted in an increased number of deaths, approximately 180, most of which were not due to 'harvesting'. Heatwave days between 1998 and 2004 were associated with a significantly increased relative mortality risk of 1.13 [95% confidence interval 1.09-1.17]. This increase was stronger in females than in males. Although excess mortality was seen in all age groups, it reached significance only in the elderly population over 65 years. DISCUSSION: An impact of heatwaves on mortality was apparent in Vienna, although not as pronounced as in France and south-western Europe. In 2003 at least 130 heatwave-related deaths in Vienna could have been avoided by prompt medical assistance and proper advice about how to cope with excessive thermal conditions. Preventive programs are warranted during heatwaves, especially to target elderly people, because the likelihood of heatwaves as a consequence of global warming is increasing.

Prevalence of overweight and obesity in Austrian male and female farmers.

OBJECTIVES: Risk factors for chronic and degenerative diseases, especially overweight and obesity are rarely examined among farmers. Objective of the study was to determine subjective health and health-related lifestyle among Austrian farmers. METHODS: The study was performed in 1999/2000 as a nationwide survey by mail among all Austrian farmers, men and women, all insured by the Health Insurance Agency of Farmers. RESULTS: 15.2% of the farmers were obese. 42.9% were overweight. The prevalence of overweight and obesity was high amongst 15-19 year olds, and reached a second peak among the age groups 50-59 and 60-69 years old. Geographically, the highest concentration of overweight and obese farmers was found in the eastern, flat regions of Austria and the lowest concentration in the western, mountainous areas of Austria. CONCLUSIONS: Prevalence of overweight and obesity is very high among Austrian farmers, especially when compared to the general population. The results of this study emphasize the need for further work, with respect to the development of prevention strategies to reduce the prevalence of overweight and obesity among Austrian farmers.