Trends in Long-Term Mortality After Congenital Heart Surgery

Background

Congenital heart surgery has improved the survival of patients with even the most complex defects, but the long-term survival after these procedures has not been fully described.

Increased Mortality of Patients With Childhood-Onset Inflammatory Bowel Diseases,Compared With the General Population

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Risk prediction of hospital mortality for adult patients admitted to Australian and New Zealand intensive care units: Development and validation of the Australian and New Zealand Risk of Death model

Purpose

The purpose of this study is to develop and validate a new mortality prediction model (Australian and New Zealand Risk of Death [ANZROD]) for Australian and New Zealand intensive care units (ICUs) and compare its performance with the existing Acute Physiology and Chronic Health Evaluation (APACHE) III-j.

Materials and Methods

All ICU admissions from 2004 to 2009 were extracted from the Australian and New Zealand Intensive Care Society Adult Patient Database. Hospital mortality was modeled using logistic regression with training (two third) and validation (one third) data sets. Predictor variables included APACHE III score components, source of admission to ICU and hospital, lead time, elective surgery, treatment limitation, ventilation status, and APACHE III diagnoses. Model performance was assessed by standardized mortality ratio, Hosmer-Lemeshow C and H statistics, Brier score, Cox calibration regression, area under the receiver operating characteristic curve, and calibration curves.

Results

There were 456 605 patients available for model development and validation. Observed mortality was 11.3%. Performance measures (standardized mortality ratio, Hosmer-Lemeshow C and H statistics, and receiver operating characteristic curve) for the ANZROD and APACHE III-j model in the validation data set were 1.01, 104.9 and 111.4, and 0.902; 0.84, 1596.6 and 2087.3, and 0.885, respectively.

Conclusions

The ANZROD has better calibration; discrimination compared with the APACHE III-j. Further research is required to validate performance over time and in specific subgroups of ICU population.     

Effects of somatosensory deafferentation on spectral characteristics of the sensorimotor EEG in the adult cat

A quantitative assessment of the sensorimotor EEG before and after transection of the dorsal columns at either a high (C1 to C3) or low (C5 to T1) cervical level was undertaken in unrestrained, adult cats. Electroencephalographic signals recorded unilaterally from postcruciate cortex (A:23) at medial (L:2 to 5) and lateral (L: 10 to 12) sites were subjected to bandpass frequency analysis. The incidence of 12- to 15-Hz sleep spindles and sensorimotor rhythm (SMR) activity was evaluated in comparable pre/postlesion EEG segments. Frequency analyses focused on the distribution of voltage in four bands (4 to 7, 8 to 11, 12 to 15, and 18 to 23 Hz). The findings showed that dorsal column transections markedly altered EEG spectral distributions. Most consistently affected was 8- to 15-Hz activity which increased significantly over sites corresponding to peripheral receptive fields below the level of the lesions. Observed increases in sleep spindles and SMR activity contributed to this finding. In prelesion recordings, voltage in all bands increased progressively over the course of slow-wave sleep to REM onset. Abrupt peaks in 12- to 15-Hz and 18- to 23-Hz activity preceded the REM stage. Dorsal column transections eliminated this sequence of frequency/voltage changes. These findings were interpreted in terms of the release of intrinsic rhythmic discharge patterns over ventrobasal thalamocortical projection pathways.     

Work-related laryngeal cancer: Trends in France from 2001 to 2016

Objectives

As part of the 2014–2019 cancer plan and in order to improve our knowledge of work-related cancers, we analysed the work-related laryngeal cancer risk situations identified in the French national occupational disease surveillance and prevention network (rnv3p) from 2001 to 2016.

Scoping Meta‐Review: Introducing a New Methodology

For researchers, policymakers, and practitioners facing a new field, undertaking a systematic review can typically present a challenge due to the enormous number of relevant papers. A scoping review is a method suggested for addressing this dilemma; however, scoping reviews present their own challenges. This paper introduces the “scoping meta‐review” (SMR) for expanding current methodologies and is based on our experiences in mapping the field of consumer engagement in healthcare. During this process, we developed the novel SMR method. An SMR combines aspects of a scoping review and a meta‐review to establish an evidence‐based map of a field. Similar to a scoping review, an SMR offers a practical and flexible methodology. However, unlike in a traditional scoping review, only systematic reviews are included. Stages of the SMR include: undertaking a preliminary nonsystematic review; building a search strategy; interrogating academic literature databases; classifying and excluding studies based on titles and abstracts; saving the refined database of references; revising the search strategy; selecting and reviewing the full text papers; and thematically analyzing the selected texts and writing the report. The main benefit of an SMR is to map a new field based on high‐level evidence provided by systematic reviews.     

2002-2005年哈尔滨市南岗区居民寿命表与死亡原因分析

目的分析2002～2005年南岗区居民平均寿命和死亡原因,发现亟待解决的健康问题。方法收集人口资料和死亡资料,按蒋庆琅法编制寿命表,应用Exccel软件计算死因构成。结果南岗区2002～2005年人口期望寿命为75.99岁,接近世界先进国家水平。三类与动脉粥样硬化关系密切的疾病—心血管疾病、脑血管疾病、糖尿病合计死亡率达118.47/10万,占总死亡的比率为40.20%,居全死因的首位。结论预防控制心脑血管疾病以及糖尿病将极大地延长居民平均寿命,发现促使发病的地域性、特征性因素并加以阻断,将是流行病学研究的重大课题。     

Hiroshima survivors exposed to very low doses of A-bomb primary radiation showed a high risk for cancers

Objectives  The aim of this study was to compare the risk for cancers of A-bomb survivors in the ongoing life span study (LSS) with unexposed groups consisting of the entire populations of Hiroshima prefecture and neighboring Okayama prefecture. Methods  The subjects consisted of the Hiroshima group reported in LSS report 12 (LSS-H group) and a control group (the entire populations of Hiroshima and Okayama—HPCG and OPCG, respectively). We estimated the expected number of deaths due to all causes and to cancers of various causes among the exposed survivors of the Hiroshima bombing in the LSS report 12 who died in the follow-up interval at ages similar to those of people in Hiroshima and Okayama prefectures who were aged 0–34 years at the time of the bombing in 1945. We compared the standardized mortality ratio (SMR) of the LSS-H group to that of the HPCG and OPCG (SMR-H and SMR-O, respectively). Results  Even at low and very low dose categories, the SMR-H and SMR-O were significantly high for all deaths, all cancers, solid cancers, and liver cancers in male subjects, and for uterus and liver cancers in female subjects, respectively. The results show that, if the dose estimations of the dosimetry system 1986 (DS86) are correct, there are significantly increased risks of cancer among even survivors exposed to the very low dose level. Conclusions  The dose assumptions of DS86 have been criticized for underestimating doses in areas distant from the hypocenter. The contribution of residual radiation, ignored in LSS, and that of neutrons, underestimated by DS86, is suggested to be fairly high. An erratum to this article can be found at