Articles: mortality.
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We assessed the impact of smoking cessation on subsequent death rates among a cohort of 51,343 men and 66,751 women in California enrolled in late 1959 in the original American Cancer Society (ACS) Cancer Prevention Study (CPS I) and followed for 38 years. We compared the age-adjusted death rate, expressed as deaths per 1,000 person-years, among all subjects who smoked cigarettes in 1959 but who had largely quit as of 1997 with the death rate among never smokers over a 38-year period. The all causes death rate for males decreased from 20.67 during 1960-1969 to 18.68 during 1960-1997 for smokers and decreased from 10.51 to 9.46 for never smokers. ⋯ The lung cancer death rate for females increased greatly from 0.208 to 0.806 for smokers and increased from 0.094 to 0.116 for never smokers. These results indicate there has been no important decline in either the absolute or relative death rates from all causes and lung cancer for cigarette smokers as a whole compared with never smokers in this large cohort, in spite of a substantial degree of smoking cessation. While cessation clearly reduces the mortality risk among long-term former smokers, the population impact of cessation appears to be less than currently believed.
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To reappraise the problem of incarcerated and strangulated inguinal hernias in children in Zaria, Nigeria. ⋯ The policy of early repair of inguinal hernias in children especially below two years and particularly in neonates should be continuously emphasised to avoid morbidity.
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Global and regional estimates show that non-communicable diseases in old age are rising in importance relative to other causes of ill health as populations age, and as progress continues against communicable diseases among infants and children. However, these estimates, which cover population groups at all income levels, do not accurately reflect conditions that prevail among the poor. We estimated the burden of disease among the 20% of the global population living in countries with the lowest per capita incomes, compared with the 20% of the world's people living in the richest countries. ⋯ Our estimates are crude, but despite their limitations, they give a more accurate picture of changes in attributable mortality among the world's poor than do the global averages in current use.
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A national survey of health-care providers in Bangladesh identified 298 women who died from pregnancy-related tetanus. Immunising all girls with tetanus toxoid and providing safe menstrual regulation services would prevent such deaths.