Background: The city of Ozyorsk (Southern Urals) was created as a secret city in 1945 and is a closed city until today. It housed workers of the earliest and one of the country's largest nuclear facilities. Workers of the nuclear reactors, radiochemical or reprocessing plants were exposed to high levels of ionising radiation in the early years of operation and possibly further exposed from inhalation of plutonium aerosols.
Methods: The cause-of-death registry of Ozyorsk received paper copies of original death certificates of all deaths of residents of the city. Data were analysed for recent mortality rates (1998-2010) and time trends in age-standardised mortality rates between 1953 and 2010 of main groups of causes of deaths, in particular cancer.
Results: Comparing workers of the three main plant types with the remainder of the Ozyorsk residents, and with national figures, all-cause mortality rates were lowest among workers, with ratios compared to national figures of 0.65 (men) and 0.56 (women), and compared to the other residents of 0.77 (men) and of 0.74 (women). For cancer overall, the differences were smaller in men (ratio between workers and national figures of 0.86) and there were no differences in women (ratio of 1.00), but ratios differed by cancer type. Most cancer deaths were however least common in the workers, including leukaemia. Over the last 60 years, all-cause mortality has gradually increased among men in all three groups but was stable among women, whereas cancer death rates have slightly declined in both sexes.
Conclusions: Healthy worker effect, relatively better living conditions in Ozyorsk and healthier lifestyles may explain the lower mortality rates in Ozyorsk. Overall mortality time trends in Ozyorsk were similar to the entire country. No apparent radiation-related effects were seen in this population-level analysis, but the radiation-related risks can be better addressed in individual-level studies.
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http://dx.doi.org/10.1186/s12940-015-0078-8 | DOI Listing |
The 2024 European Society of Intensive Care Medicine clinical practice guideline provide clinicians with evidence-based recommendations on intravenous fluid in critically ill adults across a range of common conditions. These guidelines aim to improve the practices of fluid therapy by adopting a global perspective that considers both clinical efficacy and resource utilization in diverse healthcare settings. The guidelines address three key questions: (1) albumin versus crystalloids, (2) balanced crystalloids versus isotonic saline, and (3) small-volume hypertonic solutions versus isotonic crystalloids.
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Division of Cardiothoracic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
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Division of Hematology/Oncology, Department of Internal Medicine, Kameda Medical Center, Chiba, Japan.
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Wayne State University School of Medicine, Detroit, MI, USA.
Hospital mergers have increased significantly since 2010, driven by factors such as healthcare policy changes, reimbursement, economies of scale, and quality improvement goals. However, limited evidence exists about how these mergers affect the quality of care and cancer outcomes. We conducted a difference-in-differences analysis to assess the impact of hospital consolidation on cancer outcomes.
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