An increase in ALS incidence on the Kii Peninsula, 1960-2009: a possible link to change in drinking water source

We investigated changes in the incidence of amyotrophic lateral sclerosis (ALS) in the Koza/Kozagawa/Kushimoto area (K. area) in the Kii Peninsula, Japan in 1960-2009. Probable and definite ALS cases diagnosed using El Escorial criteria were collected during a five-decade period: period I-V, 1960-2009. Forty-three ALS patients matched the selection criteria in the overall K. area, including three patients on Oshima, a small island opposite the mainland K. area. The age- and gender-adjusted incidence of ALS in the overall K. area (standardized for the 2005 Japanese population) decreased from 5.47/100,000 (95% CI 1.86-9.08) in period I to 0.61/100,000 (95% CI-0.28-1.50) in period III, and then increased to 4.39/100,000 (95% CI 1.70-7.07) in period V. On Oshima, the age- and gender-adjusted incidence of ALS was 9.45/100,000 (95% CI-7.39-26.29) in period V. The present research indicates an increase of ALS incidence in the K. area, especially on Oshima. A limitation of this study was the small population.     

Incidence of hip fractures in the population of Belgrade during the period 1990-2000. Projections for 2020

The aim of this survey was estimation of incidence of hip fractures in the population of Belgrade during the period from 1990 to 2000, as well as the estimation of expected numbers and incidence of hip fractures for 2010 and 2020, based on linear trend models. Our investigation included 8139 subjects (29% males and 71% females) with hip fractures aged 50 and more, who hospitalized at all Clinics and Departmets of Orthopedics and Traumatology in Belgrade, during the period 1990-2000. In epidemiological analysis, sex- and age-specific incidence rates and standardized (according to the US standard population) rates were calculated. The average number of hip fractures in male and female populations of Belgrade aged 50 and more were 214 and 525 new cases per year, respectively (total 739). The average incidence rates were 84.9/100,000 for males, 167.3/100,000 for females, and 118.6/100,000 for both sexes. During the period observed, incidence of hip fractures showed statistically significant increase (y=111.88+3.11x, p=0.024), especially among females (y=135.94+5.23x, p=0.007). Age-specific incidence rates of hip fractures strongly related with age, and the highest values were registrated in the age group 80 and more for both sexes (505.2/100,000-for males and (1042.8/100,000 for females). Among Belgrade inhabitants aged 50 and more, the increasing number of hip fractures could be expected up to 2020, 23.7% for males and 128.8% for females.     

Epidemiology of amputations and severe injuries of the hand

In a prospective population-based study, all open hand, wrist, and forearm injuries that were treated during a 10-year period, at hospitals and emergency wards in three Norwegian cities with 225,000 inhabitants, were registered. Injury severity was graded using the abbreviated injury scale (AIS). For moderate injuries (AIS 2) overall incidence (95% CI) was 59 (56-62), incidence among males 92 (86-98), and among females 28 (25-31) per 100,000 person-years. For severe injuries (AIS > or = 3), overall incidence (95% CI) was 7.5 (6.3-8.6), incidence among males 11.1 (9.1-13.1), and among females 4.0 (2.8-5.2) per 100,000 person-years. In a second study, all upper extremity amputation and devascularization injuries were referred during a 9-year period to the only replantation center in a southern Swedish region where 1.6 million inhabitants were analyzed. The incidence rate (95% CI) for upper extremity amputation or devascularization injuries potentially requiring replantation or revascularization was 1.9 (1.7-2.1), incidence among males 3.3 (2.9-3.7), and among females 0.5 (0.4-0.7) per 100,000 person-years.     

Oesophageal and other main cancer patterns in four districts of Transkei, 1981-1984

The mean annual number of cancer cases reported by hospitals in four districts of Transkei during the period 1981 - 1984 was 413. The age-standardised incidence rates (African standard) for cancer (all reported cases) were 51.0 and 52.0/100,000 per annum for males and females respectively. Histopathological examination of 48% of the reported tumours revealed that 71.3% were squamous carcinomas, 16.4% adenocarcinomas and the remainder non-epithelial neoplasms. The most frequently reported cancer was oesophageal cancer (OC), which represented 45.8% of all reported cancer cases. The mean age-standardised incidence rates for OC were 28.4 and 17.8/100,000 for males and females respectively. The male/female ratio was 1.6:1. The incidence of OC in both sexes was higher in the two south-western districts (Butterworth and Kentani) than in the two north-eastern districts (Bizana and Lusikisiki). The highest mean rates (45.0 and 29.3/100,000 for males and females respectively) occurred in Kentani and the lowest rates (19.5 and 15.0/100,000) in Bizana. Comparison of OC rates in the four districts during 1981 - 1984 with previously reported rates for the periods 1955 - 1959 and 1965 - 1969 revealed a consistently high rate in Kentani, a high but decreasing rate in Butterworth, and progressively increasing rates in Bizana and Lusikisiki. The second most common cancer among males was liver cancer, with a mean incidence rate of 4.8/100,000. The highest incidence of liver cancer (7.7/100,000) also occurred in Kentani. The male/female ratio was 2.7:1. The second most common cancer among females was cervical cancer (20.1/100,000), followed by breast cancer (4.0/100,000). Incidences of all other tumours were below 3/100,000.     

Incidence of Bronchopulmonary Carcinoma in Castile-Leon and Cantabria in 2007. Study from the Castile-Leon and Cantabria Respiratory Disease Society (SOCALPAR)

IntroductionThis study sets out to find out the incidence of bronchopulmonary cancer and other epidemiological characteristics in patients living in Cantabria and Castile-Leon (Spain), by comparing current data from the communities with that obtained 10 years ago in a similar study.Patients and methodsProspective, multicentre study using information (age, sex, residence, smoking habits and histology) obtained from all patients diagnosed during 2007.ResultsA total of 1,486 patients were included: 1,295 males (87.1%) and 191 females (12.9%). Of these, 1,145 lived in Castile-Leon: 1,010 males (88.2%) and 135 females (11.8%); while 341 lived in Cantabria: 285 males (83.6%) and 56 females (16.4%). The incidence rates per 100,000 inhabitants adjusted to the world standard population were significantly higher in Cantabria (29.53; [males: 52.9; females: 9.76]) than in Castile-Leon (21.35; [males: 38.31; females: 5.58]). A total of 90.24% were smokers (males: 96.12% and women: 49.17%). The main histology types were: squamous, 32.82%; adenocarcinoma, 28.74%; and small cell carcinomas, 18.33%. In Castile-Leon, from 1997 to 2007, the numbers went from 920 to 1,010 in males and from 95 to 135 in females (a crude increase rate of 10.5% in males and 43% in females), with a decrease in squamous tumours and an increase in adenocarcinomas.ConclusionsThe incidence rates of bronchopulmonary cancer in 2007 were significantly higher in Cantabria than in Castile-Leon. The 2007 rates in this community were higher than in 1997 for both males and females.     

What is the lifetime risk of contact with an A&E Department or an Institute of Forensic Medicine following violent victimisation?

OBJECTIVE: The aim of the study was to estimate the age and gender specific incidence rates of first time contact with an A&E Department and/or an Institute of Forensic Medicine due to violent victimisation in a Danish low-risk urban population and, secondly to estimate the corresponding lifetime risk of violence based upon these incidence rates. METHODS: All first time contacts of victims of violence with the A&E Department at Odense University Hospital and/or the Institute of Forensic Medicine, University of Southern Denmark 1991-2002 were included. Based on estimated age and gender specific annual incidence rates of first time violence and on the survival rates of the background population, the lifetime risk was estimated assuming calendar time stationarity of incidence and survival rates. RESULTS: The overall annual incidence rate of first time violence was 9.2 [95% CI: 9.0-9.4] per 1000 population/year for males and 2.6 [95% CI: 2.5-2.7] per 1000 population/year for females. The estimated lifetime risk was 0.440 [95% CI: 0.438-0.442] for males and 0.180 [95% CI: 0.178-0.181] for females. The highest cumulative risk for both males and females was in the age group 15-24 years, 0.192 [95% CI: 0.188-0.195] for males and 0.048 [95% CI: 0.046-0.051] for females. CONCLUSION: The current study shows, that even in a country with a relatively low risk of violent victimisation a considerable part of the population over a lifetime will need medical assistance after violent victimisation.     

No evidence for a large difference in ALS frequency in populations of African and European origin: a population based study in inner city London

Abstract Previous studies have suggested a lower incidence of ALS in people of African origin. We used a population based register in an urban setting from inner city London postcodes where there is a large population of people of African ancestry to compare the frequency of ALS in people of European and African origin. Population statistics stratified by age, gender and ethnicity were obtained from the 2001 census. Incidence and prevalence were calculated in each ethnic group. Results showed that in a population of 683,194, of which 22% were of African ancestry, 88 individuals with ALS were identified over a seven-year period, including 14 people with African ancestry. The adjusted incidence in people of African ancestry was 1.35 per 100,000 person-years (95% CI 0.72-2.3) and in those of European ancestry 1.97 per 100,000 person-years (95% CI 1.55-2.48). In conclusion, in this small population based study we could not detect a difference in rates of ALS between people of African ancestry and those of European ancestry.     

Ruptured abdominal aortic aneurysm in the Huntingdon district: a 10-year experience.

A study was undertaken to establish the true incidence of ruptured abdominal aortic aneurysms (RAAA) in the Huntingdon districts. RAAAs in the Huntingdon district between 1986 and 1995 were studied retrospectively. Data were collected from hospital records and hospital and community autopsies. There was a total of 139 cases of RAAA; 119 were males and 20 females, giving a M:F ratio of 6:1. The incidence of RAAAs was 17.8/100,000 person years (py) in males and 3.0/100,000 py in females. Mean age at rupture was 75.5 years in men (95% confidence intervals (CI) 74-78 years) and 80.2 in women (95% CI 78.8-83 years). There was an age-specific increase in incidence after the age of 65 years in men and after 80 years in women, although 12.6% of all RAAAs occurred in men under 65 years. In all, 100 patients were confirmed to have died of RAAA during the 10-year period. This represents 79% of all ruptures discovered. Almost three-quarters of patients did not reach the operating theatre. Of the 61 patients operated on, 29 survived (48%). The size of the aneurysm at rupture was recorded in 68 cases (49%). The mean size was 8.14 cm (SD 2.0 cm). In five cases (7.4%), rupture occurred in AAAs smaller than 6 cm. The overall mortality from RAAA in Huntingdon health district is approximately 80% and three-quarters of all deaths occurred without an operation.     

Epidemiology of hip fractures in Belgrade,Serbia Montenegro, 1990–2000

Introduction This study retrospectively determined the incidence rates of hip fractures in Belgrade, Serbia and Montenegro, during the period 1990–2000. Materials and methods All patients with hip fractures treated at all Belgrade hospitals were identified from the Republic of Serbia’s Ministry of Health National Health Care database. Patient demographics, type of hip fracture, and details of the mechanism of injury were collected. The annual incidence rates were calculated with interpolation according to the Belgrade population census of 1991 and 2002. Results There were a total of 8,904 hip fractures with a mean annual incidence of 51.7 per 100,000 adults (62.2 females and 35.5 males). Mean age at the time of fracture was 67 years (72.6 for females and 59.3 for males), with 64.7% of all fractures occurring in women. There was a significant increase in hip fracture incidence rates over the observed period in females (P = 0.006), but not in males (P = 0.962). Trochanteric fractures predominated, accounting for 53% compared with cervical fractures. In patients over 50 years of age there was an exponential increase in the incidence of hip fractures in both sexes; though more so in females. 91% of hip fractures occurred in these older patients with incidence rates of 143.6 per 100,000 (185.9 for female and 92.2 for male patients). The most common mechanism of injury in the older group was low-energy trauma (70.3%) resulting from a fall from standing height onto a flat surface (same level). Standardizing incidence rates in the older age group to the US 1985 white population gave values of 228 per 100,000 females and 96 per 100,000 males. These incidence rates are similar to those reported in Italy, France and Great Britain, but lower than those in Scandinavian countries. Conclusion In view of growing population numbers and an increase in the proportion of patients aged over 60 years, we can expect an increase in the prevalence of osteoporosis and an increase in the incidence of fragility hip fractures in the future, with resource implications.     

Declining incidence of osteoporotic hip fracture in Australia

Summary

Between 1997?C1998 and 2006?C2007 in Australia, the age-standardised incidence rates of hip fractures declined by 20 and 13?%, in females and males, respectively. Although this may be related to the rollout of public health campaigns and strategies addressing osteoporosis, absolute numbers of hip fractures continued to increase.

Background

Previous reports described an increasing trend in osteoporotic hip fracture incidence in Australia in the 1980s with a stabilisation over the 1990s.

Aim

The aim of this study was to describe national trends in the incidence of osteoporotic hip fracture in Australia between 1997?C1998 and 2006?C2007.

Methods

Data on low-trauma hip fractures in persons aged 50?years and over were obtained from the National Hospital Morbidity Database. Cases where the patient was transferred in from another hospital were excluded. Age-standardised incidence rates were calculated and a linear test for trend applied.

Results

Although the absolute number of hip fracture cases has continued to increase, from 14,769 in 1997?C1998 to 16,412 in 2006?C2007, these numbers are lower than previous predictions based on population ageing. Over the 10-year period, the age-standardised incidence rates in females declined by 20?%, from 370 to 295 per 100,000, while the age-standardised incidence rates in males declined by 13?%, from 200 to 174 per 100,000. Both declines were statistically significant. The sex difference in incidence rates narrowed between 1997?C1998 (females 85?% higher) and 2006?C2007 (females 70?% higher).

Conclusions

The age-standardised incidence of osteoporotic hip fracture in Australia is falling. This may be related to the uptake of bisphosphonates as well as the rollout of public health campaigns and strategies addressing osteoporosis.     

Invasive Pneumococcal Disease in Solid Organ Transplant Recipients—10-Year Prospective Population Surveillance

Prospective population-based surveillance to assess the incidence and impact of invasive pneumococcal disease (IPD) in organ transplant patients is lacking. By using a population-based Invasive Bacterial Diseases Network surveillance program, we studied the incidence, clinical significance, serotypes and antimicrobial resistance pattern of IPD in a large cohort of adult transplant patients and the general population. Streptococcus pneumoniae isolates and patient data were collected prospectively from 1995 to 2004. We identified 21 cases of IPD (based on sterile-site isolates) in our organ transplant population over a 10-year period. This translated to an incidence rate of 146 infections per 100,000 persons per year. This compared to an incidence of 11.5 per 100,000 persons per year in the general population (R(R)=12.8; 95% CI 8.1-19.9, p<0.00001). If nonsterile-site isolates (respiratory tract) were included, the incidence rate in transplant patients was 419 of 100 000 persons per year. Serotypes 23F and 22F were most common, and 85.0% had a serotype included in the 23-valent pneumococcal vaccine. The antimicrobial resistance rates were high, especially for penicillin and trimethoprim-sulfamethoxazole (TMP/SMX), but were not significantly different from the general population. Solid organ transplant recipients are at significantly greater risk for IPD than the general population. Preventative strategies are necessary.     

Incidence of hip fracture in Shiraz, Iran

Hip fracture, the most serious complication of osteoporosis, puts the burden of a lot of costs for treatment on any health system. Previous reports on rates of hip fracture in Asian countries differ a lot. The aim of this study was to estimate the incidence rate of hip fracture in Shiraz, Iran. In Shiraz, Iran, all operating-room logs with diagnosis of hip fracture were reviewed for hip fractures caused by a simple fall in patients over 50 years, during March 21, 2000, to March 21, 2003. According to patients medical records, age, sex, type of fracture (intertrochanteric, neck, subtrochanteric) and patients regions according to Shiraz municipality divisions were obtained. The age-adjusted incidence rates of hip fracture standardized to the 1985 US white population (325.74/100,000 for men and 519.05/100,000 for women) and to the 1989 US white population (384.61/100,000 for men and 548.17/100,000 for women) were the highest in Asia. The intertrochanteric fractures were significantly higher among females ( p =0.003). The incidence of intertrochanteric and neck fractures were increased with age. In all age groups, females had higher incidence rates, except for ages over 80 years, in which males had higher incidence rates than females. In wealthier regions of the city, the incidence rates were higher than in other regions. High incidence of hip fracture in our population, especially in males over 80 years, shows that preventive strategies for hip fracture and osteoporosis should be considered in males as well as females. Further studies are needed to find incidence rates in other cities, especially in the very urbanized city of Tehran.     

Increasing incidence of pelvic and acetabular fractures. A nationwide study of 87,308 fractures over a 16-year period in Sweden

Background: Fractures of the pelvis and acetabulum are major injuries, often associated with hospitalization, reduced function and sometimes life-threatening conditions. Current data on nationwide incidence and treatment is sparse. Existing epidemiological studies are either single-centered or investigating only in-patients. The aim of this study was to investigate the epidemiology and treatment of pelvic and acetabular fractures in a nationwide register study including all adult patients in Sweden during 2001-2016.Methods: We used the Swedish National Patient Register to collect data on the entire Swedish population aged ≥18 years from 2001 to 2016. Variables included age, gender, fracture type and treatment.Results: We found a total of 87,308 pelvic and acetabular fractures (71% females) in Sweden during the 16-year study period and the incidence increased from 64 to 80 per 100,000 person-years from 2001 to 2016. The incidence of pelvic fractures increased from 58 to 73 per 100,000 person-years and the majority of the patients (74%) were female. The incidence of acetabular fracture increased from 8.7 to 11 per 100,000 person years and the majority of the patients (58%) were male. Only 2.0% of all patients with a pelvic fracture were treated surgically, as compared to 15% for acetabular fractures. The rate of surgical treatment was higher for males compared to females for both pelvic (4.4 and 1.2% respectively) and acetabular (19 and 10% respectively) fractures.Conclusion: The incidence of pelvic and acetabular fractures increased markedly in Sweden from 2001-2016. Pelvic fractures were more common among females and acetabular among males. The surgical rate was higher for acetabular compared to pelvic fractures. Major gender differences in treatment choices were found with higherproportion of men treated surgically for both fracture types, and in all age groups.     

Incidence of metacarpal fractures in the US population

Background

There are scarce data regarding the epidemiology of metacarpal fractures within the US population. The purpose of this study is to report the epidemiology of metacarpal fractures in the USA using the National Electronic Injury Surveillance System Database (NEISS).

Methods

The NEISS database represents a national probability sample of approximately 100 hospitals in the USA and its territories. The database was queried for metacarpal fractures during the time period 2002–2006. US census data were used to calculate incidence rate (IR) for various demographic criteria.

Results

A total of 4,718 metacarpal fractures were identified, representing approximately 160,790 metacarpal fractures. The calculated IR was 13.6 (95 % CI, 13.6–13.67) per 100,000 person-years. The highest IR occurred in the 10–19 age group (IR 38.8; 95 % CI, 38.6–38.9) followed by those 20–29 years of age (IR 28.4; 95 % CI, 28.3–28.5). Metacarpal fractures were found more commonly in males (IR 23; 95 % CI, 22.9–23.1) than females (IR 4.5; 95 % CI, 4.5–4.5), with an incidence rate ratio of 5.08. The most common mechanisms of injury were contact with a wall or door, and falls. The most common setting was in the home, followed by recreational locations.

Conclusions

The estimated incidence of metacarpal fractures presenting for acute hospital care in the USA is 13.6 per 100,000 person-years. Males in the second and third decades of life sustain this injury most commonly. Metacarpal fractures occur frequently in the home or recreational setting, with contact force as the primary mechanism of injury.     

Traumatic spinal cord injury mortality from 2006 to 2016 in China

Purpose: To report on the national traumatic spinal cord injury (TSCI) mortality of China population, and assess sex-, age-, location-, and cause-specific mortality rates, respectively.Methods: A population-based longitudinal study based on mortality data from the Disease Surveillance Points system of China, 2006–2016. TSCI was defined according to the 10th International Classification of Disease. Negative binomial regression was used to test the significance of the change in overall and subgroup mortality rate.Results: Age-adjusted TSCI mortality rate increased by 64% from 2006 to 2016, ranging from 0.19 to 0.34 per 100,000 population. The crude mortality was 0.31 per 100,000 population in 2016. Males and rural residents had higher TSCI mortality rates than females and urban residents. The age-adjusted TSCI mortality rate increased 53% for males, 107% for females, 75% in an urban area, and 59% in a rural area. In comparison with insignificant change in the age group of 0–44 years, TSCI mortality increased 56% and 147% in age groups of 45–64 years and 65 years. Falls accounted for 45.4% of total mortality.Conclusions: TSCI mortality rates were higher in males and in rural residents than in females and in urban residents during the study time period. TSCI mortality increased quickly as age increased; adults aged 65 years and older had the highest mortality rate. Falls and motor vehicle crashes were the two most common causes of TSCI mortality. More prevention efforts are needed to reduce a number of deaths from TSCI injury considering a substantial increase in TSCI mortality.     

Incidence of clinically diagnosed vertebral fractures: a population-based study in Rochester, Minnesota, 1985-1989.

Vertebral fractures are the classic hallmark of osteoporosis, yet little is known of their epidemiology. The incidence of clinically diagnosed vertebral fractures was therefore directly assessed in the predominantly white (European descent) population of Rochester, Minnesota. Altogether, 341 Rochester residents were radiologically diagnosed for the first time with one or more vertebral fractures in the 5 year study period, 1985-1989. The overall age- and sex-adjusted incidence rate was 117 per 100,000 person-years (95% CI, 105 to 130). The age-adjusted rate in women (145 per 100,000 person-years) was almost twice that in men (73 per 100,000 person-years). Of all fractures, 47 (14%) followed severe trauma, 282 (83%) followed moderate or no trauma, and 12 (3%) were pathologic. Incidence rates for fractures following moderate trauma were higher in women than in men and rose steeply with age in both genders. In contrast, fractures following severe trauma were more frequent in men, and their incidence increased less with age. These Rochester rates are greater than those previously reported from studies in Britain and Sweden but lower than the incidence rates extrapolated from a prevalence study in this population.     

Trends in neck of femur fracture incidence in EU15+ Countries from 1990-2017

BackgroundNeck of femur fractures (NOFF) pose significant socio-economic costs to society with a high degree of morbidity and mortality. Its incidence rate has been collated within the Global Burden of Disease (GBD) database; however, to date, no comparison across countries has been reported.MethodsNOFF age-standardised incidence rates (ASIR) per 100,000 population were extracted from the GBD database for European Union (EU) 15+ countries over the period 1990 to 2017. Joinpoint regression analysis of the data identified trends in ASIR and associated estimated annual percentage changes (EAPC). These were analysed by specified timeframe, country and gender.ResultsOf the 19 EU15+ countries, 11 (58%) had overall increases in NOFF ASIRs in 2017 compared to 1990. The median ASIRs were 240/100,000 and 322/100,000 for males and females, respectively, in 1990. By 2017, this had increased to 259/100,000 and 325/100,000, respectively. Females consistently had relatively higher NOFF ASIRs with a median gender fracture gap of 62/100,000 in 2017. Males had a higher percentage change in increasing ASIRs, with a smaller percentage change in decreasing ASIRs for all included countries. The highest national ASIRs was observed in Australia, followed by Finland and Belgium. Conversely the Mediterranean countries demonstrated the lowest ASIRs, closely followed by the USA.ConclusionDespite significant advances in primary and secondary hip fracture prevention strategies over the 28-year study period, significant increases in NOFF ASIRs among most EU15+ countries were observed, especially with respect to gender.     

A prospective population-based study of suicidal behavior by burns in the province of Ilam, Iran

Objective

The aim of this study was to examine epidemiologic characteristics of suicidal behavior by burns requiring hospitalization in the province of Ilam, Iran.

Methods

A prospective population-based study of all suicidal behaviors by burns requiring hospitalization was conducted in the province of Ilam, Iran, from March 21, 2005 to March 20, 2006. Data were obtained from patients, family members, and/or significant others through interviews during the course of hospitalization.

Results

A total of 51 patients with suicidal behavior by burns requiring hospitalization were identified during the study period, representing an overall incidence rate of 12.5 per 100,000 person-years (P-Y) (95% confidence interval [CI]: 9.1-16.0 per 100,000 P-Y). Women had a higher rate of suicidal behavior by burns than men (18.0 vs. 7.2 per 100,000 P-Y) (P < 0.001). The age-specific rate of suicidal behavior by burns peaked at age group 20-29 years (19.3 per 100,000 P-Y). The rate of suicidal behavior by burns was slightly higher among married persons than single persons, although not statistically significant (13.5 vs. 9.8 per 100,000 P-Y) (P = 0.25). The rate of suicidal behavior by burns among the rural population was significantly higher than the urban population (17.9 vs. 9.3 per 100,000 P-Y) (P = 0.02). The most frequent precipitating factor for suicidal behavior was marital conflicts.

Conclusions

The high rate of suicidal behavior by burns among young, married women in Ilam is an alarming social tragedy. Despite substantial efforts toward improving health and human rights, persistent conditions allow violence against women in Iran and these women continue to turn to the desperate remedy of self-burning. Findings of this study highlight the need for the implementation of a well-organized approach to reduce the incidence of suicide by burns.     

Thyroid Cancer: Is the Incidence Still Increasing?

Background: The objective of this study was to define the epidemiology of thyroid cancer in our regional population and compare results with Surveillance, Epidemiology, and End Results (SEER) Program cancer registry trends.Methods: Thyroid cancer cases diagnosed between 1990 and 2000 were identified in the Florida Cancer Data System (FCDS). Overall, gender-specific, age-specific, and stage-specific incidence rates were calculated. All rates are per 100,000 and age-adjusted to the 2000 U.S. standard population. Estimated Annual Percent Change (EAPC) was calculated with a linear least-squares model.Results: Patients with thyroid cancer (n = 8603) were identified in the FCDS registry. Age-adjusted incidence rates increased from 4.2 per 100,000 to 7 per 100,000 in 2000. The EAPC for this period was 5.5% (P < .001). The SEER incidence rates increased from 7.9 to 10.2 per 100,000, and the EAPC was 3.7% (P < .05). Analysis of gender-specific incidence rates showed increases from 6 and 2.2 per 100,000 in 1990 to 10.1 and 3.8 per 100,000 in 2000 among females and males, respectively, with EAPCs of 5.9% (females) and 4.5% (males) (P < .001). With stratification by age group, the highest incidence rates were 9 per 100,000 in the group aged 65 to 84 years and 8.4 per 100,000 in the group aged 45 to 64 years.Conclusions: Thyroid cancer incidence rates in Florida almost doubled over the 1990–2000 period and are concordant with SEER trends. Etiologic studies addressing temporal changes in reproductive factors, more intensive diagnostic activities, and changes in histological criteria are warranted.     

Decline in the ischaemic heart disease mortality rates of South Africans, 1968-1985

The age-adjusted ischaemic heart disease (IHD) mortality rates (MRs) of white, Asian and coloured South Africans aged 35-74 years were studied for the period 1968-1985. Asians have the highest IHD MR in the RSA, followed by whites, coloureds and then blacks. Asian female have much higher rates than females in the other groups, especially in the older age groups. Asian males have noticeably higher rates in the younger age groups. Coloured females aged 35-44 years have a surprisingly high rate. Declines of 36.5% (from 482 to 306/100,000) for whites between 1970 and 1985, 27.5% (from 583 to 422/100,000) for Asians between 1973 and 1985, and 19.5% (from 287 to 231/100,000) for coloureds between 1976 and 1985 were observed. Rates declined among both males and females as well as in all the age groups studied. Trends in IHD MRs for black South Africans were studied for 1978-1985. The MRs for IHD among blacks are very much lower than those for South African Asians, coloureds and whites. The age-adjusted IHD MR for all South Africans was 162/100,000 in 1978 and had dropped to 121/100,000 in 1985, a 25.3% decline.