Showing papers by "Christopher J L Murray published in 1992"

Tuberculosis: commentary on a reemergent killer.

Abstract: Tuberculosis remains the leading cause of death in the world from a single infectious disease, although there is little knowledge of the mechanisms of its pathogenesis and protection from it. After a century of decline in the United States, tuberculosis is increasing, and strains resistant to multiple antibiotics have emerged. This excess of cases is attributable to changes in the social structure in cities, the human immunodeficiency virus epidemic, and a failure in certain major cities to improve public treatment programs. The economic costs of not adequately addressing the problem of tuberculosis in this country are estimated from an epidemiological model.

Understanding morbidity change.

Abstract: The authors develop an approach to morbidity definition and measurement review specific methods and present a framework for classifying different types of morbidity indicators. They examine various approaches to the interactions between morbidity and mortality change illustrating these with selected data from India the United States and Ghana. (SUMMARY IN FRE AND SPA) (EXCERPT)

Prevention of graft-versus-host disease by selective depletion of CD6-positive T lymphocytes from donor bone marrow.

Abstract: PURPOSEAcute and chronic graft-versus-host disease (GVHD) continues to be the major causes of morbidity and mortality after allogeneic bone marrow transplantation (BMT). In this study, we have evaluated the clinical effects of selective in vitro T-cell depletion of donor allogeneic bone marrow by using a single monoclonal antibody ([MoAb] anti-T12, CD6) and rabbit complement. This antibody recognizes mature T cells, but not other cellular elements such as natural-killer (NK) cells, B cells, and myeloid precursors.PATIENTS AND METHODSFrom August 1983 to April 1991, 112 consecutive adult patients with hematologic malignancies underwent BMT with bone marrow from HLA-identical sibling donors. Marrow was harvested and depleted of mature T lymphocytes ex vivo by the use of three rounds of incubation with an anti-T12 antibody and rabbit complement. The preparative regimen consisted of cyclophosphamide and fractionated total body irradiation (TBI) in 108 patients. No patients received prophylactic immune suppress...

Adult mortality: levels patterns and causes.

Abstract: Examination of the levels patterns and causes of adult mortality reveals some differences in commonly accepted ideas. For example the findings are that adult mortality is a concern for countries regardless of the stage in the countries demographic transition. Child or infant mortality is necessarily linked to adult mortality. Mens mortality is higher than womens in nearly all developing countries. Both communicable and noncommunicable diseases have declined with decline in total mortality in developing countries. Discussion is focused on the following topics: 1) the measurement of adult mortality; 2) trends in adult mortality in the developing countries by age by preventable cause by years of preventable life lost and other probabilities of death; 3) empirical and historical data on adult mortality in developed and developing countries; and 4) model based cause of death analysis and comparisons with empirical data. Adult mortality levels vary both between countries and within countries. The range of change in the probability of death between 15 and 60 years varies from more than 50% in areas in West Africa to about 5% in Switzerland. There is greater variability in adult mortality in developed countries. Historical changes have also varied widely. Although there have been marked declines in adult mortality in developed countries some countries (central European) still have high risks of adult mortality. Some ethnic groups within countries such as black men in the US have high mortality risks. Adult male mortality is high in Latin America in industrialized nonmarket countries and in Africa regardless of age. There is some evidence from China that suggests that socioeconomic determinants of adult and child mortality are different. The empirical record reveals that cause-specific mortality may show different rankings depending on the choice of measure and the mortality level in the community. A useful analysis aims to assign importance to causes that differentiate between high and low mortality populations. For instance tuberculosis respiratory infections and maternal mortality explain 33% of the differences between high and low female mortality. For men the most important causes are tuberculosis digestive diseases unintentional injuries respiratory infections and senile and other conditions. Limitations of this analysis are indicated.