Significant changes in mortality trends were identified by Joinpoint regression and annual percentage changes (APCs) were calculated for periods with uniform trends. Cancer mortality in Romania was among the lowest in Europe in 1986, but was higher than most countries by 2009. Despite the declining mortality (APC) in younger Romanians for all cancers combined (men – 1.5% from 1997, women – 1.2% 1997-2004 and – 3.8% 2004-2009), male lung cancer ( – 2.8% from 1997), female breast
( – 3.5% from 1999) and cervical ( – 5.4% from 2004) cancers, mortality has increased in middle-aged and elderly PXD101 patients for most cancers analysed. The exception was declining stomach cancer mortality in most Romanians, except elderly men. For most
cancers analysed, mortality declined in the Baltic countries in young and middle-aged patients, and in western URMC-099 in vitro and northern countries for all ages. Lung cancer mortality in women increased in all countries except Latvia. We urge immediate steps to reverse the alarming increase in cancer mortality among middle-aged and elderly Romanians. European Journal of Cancer Prevention 22: 199-209 (C) 2013 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.”
“Background: Left ventricular systolic dysfunction (LVSD) is frequently observed in patients with advanced chronic kidney disease (CKD) and its presence is associated with a poor prognosis. Renin-angiotensin system (RAS) inhibition and beta-adrenergic blockade are the cornerstones of medical management for LVSD. Current guidelines advocate that CKD patients with advanced LVSD should receive these therapies. The extent to
which these recommendations are followed is unclear. The goal of this study was to evaluate practice patterns for LVSD management across the spectrum of patients with advanced CKD, and to determine the rate of utilization of recommended therapies for LVSD.
Methods: This cross-sectional study encompassed all long-term dialysis patients (n=299) and patients with advanced pre-dialysis CKD who were followed in a multidisciplinary clinic (n=176) at a tertiary care center in Toronto, Canada. Echocardiographic and pharmacotherapy data were Selleck Epacadostat sought for each patient. In patients with moderate-severe LVSD (ejection fraction <40%), we evaluated the extent to which optimal pharmacotherapy, defined as the receipt of a beta-adrenergic receptor blocker and a RAS inhibitor (an angiotensin-converting enzyme inhibitor or an angiotensin II receptor blocker), was applied. We then sought to identify factors to explain the usage of these therapies.
Results: Of the 475 eligible patients, 387 had echocardiographic data available for analysis. Among these individuals, 34 (8.8%) had moderate-severe LVSD, of whom 23 (67.7%) were receiving optimal therapy. Non-receipt of optimal therapy could not be explained by hypotension, hyperkalemia, known drug sensitivities, or pill burden.