Declining stroke and myocardial infarction mortality between 1989 and 2010 in a country of the African region.

BACKGROUND AND PURPOSE: In low- and middle-income countries, the total burden of cardiovascular diseases is expected to increase due to demographic and epidemiological transitions. However, data on cause-specific mortality are lacking in sub-Saharan Africa. Seychelles is one of the few countries in the region where all deaths are registered and medically certified. In this study, we examine trends in mortality for stroke and myocardial infarction (MI) between 1989 and 2010. METHODS: Based on vital statistics, we ascertained stroke and MI as the cause of death if appearing in any of the 4 fields for immediate, intermediate, underlying, and contributory causes in death certificates. RESULTS: Mortality rates (per 100 000, age-standardized to World Health Organization standard population) decreased from 1669/710 (men/women) in 1989 to 1991 to 1113/535 in 2008-10 for all causes, from 250/140 to 141/86 for stroke, and from 117/51 to 59/24 for MI, corresponding to proportionate decreases of 33%/25% for all-cause mortality, 44%/39% for stroke, and 50%/53% for MI over 22 years. The absolute number of stroke and MI deaths did not increase over time. In 2008 to 2010, the median age of death was 65/78 years (men/women) for all causes, 68/78 for stroke, and 66/73 for MI. CONCLUSIONS: Between 1989 and 2010, age-standardized stroke and MI mortality decreased markedly and more rapidly than all-cause mortality. The absolute number of cardiovascular disease deaths did not increase over time because the impact of population aging was fully compensated by the decline in cardiovascular disease mortality. Stroke mortality remained high, emphasizing the need to strengthen cardiovascular disease prevention and control.

Irak y el club europeo: ¿cuál de ellos?

El pasado 27 de enero, el Consejo de Asuntos Generales y de Relaciones Exteriores de la Unión tomó una decisión altamente significativa para el desarrollo del papel exterior de la Unión: su primera operación militar. Las páginas de la prensa dedicaban, sí lo hacían, unas pocas líneas a la operación de mantenimiento de la paz que la UE llevará a cabo en Macedonia a partir de la próxima primavera. La una de la prensa estaba ocupada por el hecho de que los Quince estaban más desunidos que nunca, a causa de la actual crisis internacional. De ahí que en la misma reunión tan sólo hubieran sido capaces de producir una declaración relativa a la situación en Irak de “minimísimo común denominador”, cuyo eje central son dos temas indiscutibles: la obligación de Irak de cooperar con los inspectores y el papel del Consejo de Seguridad como responsable del matenimiento de la paz y de la seguridad...

Mycobacterium tuberculosis transmission in a country with low tuberculosis incidence: role of immigration and HIV infection.

Immigrants from high-burden countries and HIV-coinfected individuals are risk groups for tuberculosis (TB) in countries with low TB incidence. Therefore, we studied their role in transmission of Mycobacterium tuberculosis in Switzerland. We included all TB patients from the Swiss HIV Cohort and a sample of patients from the national TB registry. We identified molecular clusters by spoligotyping and mycobacterial interspersed repetitive-unit-variable-number tandem-repeat (MIRU-VNTR) analysis and used weighted logistic regression adjusted for age and sex to identify risk factors for clustering, taking sampling proportions into account. In total, we analyzed 520 TB cases diagnosed between 2000 and 2008; 401 were foreign born, and 113 were HIV coinfected. The Euro-American M. tuberculosis lineage dominated throughout the study period (378 strains; 72.7%), with no evidence for another lineage, such as the Beijing genotype, emerging. We identified 35 molecular clusters with 90 patients, indicating recent transmission; 31 clusters involved foreign-born patients, and 15 involved HIV-infected patients. Birth origin was not associated with clustering (adjusted odds ratio [aOR], 1.58; 95% confidence interval [CI], 0.73 to 3.43; P = 0.25, comparing Swiss-born with foreign-born patients), but clustering was reduced in HIV-infected patients (aOR, 0.49; 95% CI, 0.26 to 0.93; P = 0.030). Cavitary disease, male sex, and younger age were all associated with molecular clustering. In conclusion, most TB patients in Switzerland were foreign born, but transmission of M. tuberculosis was not more common among immigrants and was reduced in HIV-infected patients followed up in the national HIV cohort study. Continued access to health services and clinical follow-up will be essential to control TB in this population.

M. le comte [Maurice] Jaclot de Potier, président du Ice skating club [de Paris] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 57073

Cannes 21-1-20, Miss Ryan [Elisabeth] et Ritchie [Josiah] [contre] Mlle Lenglen [Suzanne] et Albarran [Pierre] [tournoi de lawn-tennis du Carlton-Club de Cannes] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 57735

Cannes 21-1-20, lord Rochsavage [i. e. marquis de Cholmondeley au tournoi de lawn-tennis du Carlton-Club de Cannes] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 57737

B. [Blanche] Amblard, S. [Suzanne] Amblard [joueuses de tennis du Sporting club de Paris, rue de Saussure] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 57566

21/2/20 [i.e. 22/2/20, Juvisy, championnat de Paris de cross country], Guillemot : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 58127

Parc des Princes, 29/2/20, rugby, RCF [Racing Club de France] contre Bayonne : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 58266

Parc des Princes, 29/2/20, rugby, RCF [Racing Club de France] contre Bayonne : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 58264

Cannes 21-1-20, Miss Lenglen [Suzanne] et Albarran [Pierre] [tournoi de lawn-tennis du Carlton-Club de Cannes] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 57731

Cannes 21-1-20, Eddis [tournoi de lawn-tennis du Carlton-Club de Cannes] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 57736

Clamart, 18-1-20, interclubs du comité de Paris, Denis gagnant [du cross-country] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 57696

Miss Lenglen, Cannes 21-1-20 [au tournoi de lawn-tennis du Carlton-Club de Cannes] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 57734

Saint-Cloud, 28/12/19, challenge de la Nézière [i. e. Georges de La Nézière], Guillemot [du Club athlétique de la Société générale] 2e : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 57341