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Sample records for case fatality rates

  1. Case Fatality Rate of Severe Acute Respiratory Syndromes in Beijing

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    Objective To describe the case fatality rate of SARS in Beijing. Methods Data of SARS cases notified from Beijing Center for Disease Control and Prevention (BCDC) and supplemented by other channels were collected. The data were analyzed by rate calculation. Results The case fatality rate of SARS in Beijing was 7.66%, and had an ascending trend while the age of cases was getting older, and a descending trend while the epidemic development. The case fatality rate in Beijing was lower than that in other main epidemic countries or regions. Conclusions The risk of death increases with the increment of age of SARS patients. Beijing is successful in controlling and treating SARS.

  2. Case fatality ratio and mortality rate trends of community-onset Staphylococcus aureus bacteraemia

    DEFF Research Database (Denmark)

    Tom, S; Galbraith, J C; Valiquette, L;

    2014-01-01

    Lethal outcomes can be expressed as a case fatality ratio (CFR) or as a mortality rate per 100 000 population per year (MR). Population surveillance for community-onset methicillin-sensitive (MSSA) and methicillin-resistant (MRSA) Staphylococcus aureus bacteraemia was conducted in Canada, Austral......-onset S. aureus bacteraemia, particularly MSSA, is associated with major disease burden. This study highlights complementary information provided by evaluating both CFR and MR.......Lethal outcomes can be expressed as a case fatality ratio (CFR) or as a mortality rate per 100 000 population per year (MR). Population surveillance for community-onset methicillin-sensitive (MSSA) and methicillin-resistant (MRSA) Staphylococcus aureus bacteraemia was conducted in Canada, Australia...

  3. Age trajectories of stroke case fatality

    DEFF Research Database (Denmark)

    Olsen, Tom Skyhøj; Andersen, Zorana Jovanovic; Andersen, Klaus Kaae

    2011-01-01

    Mortality rates level off at older ages. Age trajectories of stroke case-fatality rates were studied with the aim of investigating prevalence of this phenomenon, specifically in case-fatality rates at older ages.......Mortality rates level off at older ages. Age trajectories of stroke case-fatality rates were studied with the aim of investigating prevalence of this phenomenon, specifically in case-fatality rates at older ages....

  4. [The determinants of the low case fatality rate of the cholera epidemic in the Littoral department of Benin in 2008].

    Science.gov (United States)

    Gbary, Akpa Raphaël; Sossou, Roch Aristide; Dossou, Jean-Paul; Mongbo, Virginie; Massougbodji, Achille

    2011-01-01

    The 2008 cholera outbreak in Benin was characterized by a low case fatality rate (0.39 p.100) in the Littoral department, where 502 cases were recorded between July and December. The aim of this study was to identify the key factors associated with the low case fatality rate within the department. The cross-sectional, descriptive and analytical study conducted as part of this research used 404 patient records, focus group discussions with ten former patients, in-depth interviews with 8 health authorities involved in the response and structured face-to-face interviews with 12 health personnel involved in the treatment of patients. The data were analyzed using qualitative and quantitative content analysis based on EPIINFO 3.3.2 and EXCEL 2007 software. The results from several sources were cross-checked through triangulation. The mean age of patients was 23.72 ± 14.8 years. 39.35% patients were admitted with severe dehydration. Oral rehydration, intravenous rehydration and antibiotic therapy were given to 99.5%, 85% and 97.77% of patients, respectively. Only one hospital death was noted. The low case fatality rate was mainly due to the following factors: the high quality of care provided in a center with qualified personnel and available and free of charge treatment kits, protocols based on massive rehydration and appropriate hygiene measures, and patient compliance with the treatment plan. The response was also characterized by good coordination, wide mass and local health promotion, and selective antibiotic prophylaxis, which contributed significantly to reducing the spread of the infection. PMID:22177702

  5. Fatal cases of influenza a in childhood.

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    Benjamin F Johnson

    Full Text Available BACKGROUND: In the northern hemisphere winter of 2003-04 antigenic variant strains (A/Fujian/411/02 -like of influenza A H3N2 emerged. Circulation of these strains in the UK was accompanied by an unusually high number of laboratory confirmed influenza associated fatalities in children. This study was carried out to better understand risk factors associated with fatal cases of influenza in children. METHODOLOGY/PRINCIPAL FINDINGS: Case histories, autopsy reports and death registration certificates for seventeen fatal cases of laboratory confirmed influenza in children were analyzed. None had a recognized pre-existing risk factor for severe influenza and none had been vaccinated. Three cases had evidence of significant bacterial co-infection. Influenza strains recovered from fatal cases were antigenically similar to those circulating in the community. A comparison of protective antibody titres in age stratified cohort sera taken before and after winter 2003-04 showed that young children had the highest attack rate during this season (21% difference, 95% confidence interval from 0.09 to 0.33, p = 0.0009. Clinical incidences of influenza-like illness (ILI in young age groups were shown to be highest only in the years when novel antigenic drift variants emerged. CONCLUSIONS/SIGNIFICANCE: This work presents a rare insight into fatal influenza H3N2 in healthy children. It confirms that circulating seasonal influenza A H3N2 strains can cause severe disease and death in children in the apparent absence of associated bacterial infection or predisposing risk factors. This adds to the body of evidence demonstrating the burden of severe illness due to seasonal influenza A in childhood.

  6. Comparative study of the in-hospital case-fatality rate of leptospirosis between pediatric and adult patients of different age groups

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    Lopes Antonio Alberto

    2004-01-01

    Full Text Available The main objective was to compare the in-hospital case-fatality rate of leptospirosis between pediatric (19 years patients, taking into account gender, renal function, duration of symptoms and jaundice. Medical records of 1016 patients were reviewed. Comparative analysis was restricted to 840 patients (100 pediatric, 740 adults with recorded information on the variables included in the analysis. Among these patients 81.7% were male and 91.5% were icteric. The case-fatality rate of leptospirosis was 14.4%. The odds of death adjusted for gender, jaundice, duration of symptoms, serum urea and serum creatinine were almost four times higher for the adult than for the pediatric group (odds ratio (OR = 3.94; 95% confidence interval = 1.19-13.03, p = 0.029. Among adults, increased age was also significantly and independently associated with increased risk of death (p < 0.01. Older patients were also more often treated by dialysis. In conclusion, the data suggest that the in-hospital case fatality rate of leptospirosis is higher for adults than for children and adolescents, even after taking into account the effects of several potential risk factors of death. Among adults, older age was also strongly and independently associated with higher risk of death.

  7. The possible roles of solar ultraviolet-B radiation and vitamin D in reducing case-fatality rates from the 1918–1919 influenza pandemic in the United States

    OpenAIRE

    Grant, William B.; Giovannucci, Edward

    2009-01-01

    Deaths during the 1918–1919 influenza pandemic have been linked to both the influenza virus and secondary bacterial lung infections. Case fatality rates and percentage of influenza cases complicated by pneumonia were available from survey data for twelve United States locations in the 1918–1919 pandemic. This study analyzes case fatality rates and cases complicated by pneumonia with respect to estimated summertime and wintertime solar ultraviolet-B (UVB) doses as indicators of population mean...

  8. A season of snakebite envenomation: presentation patterns, timing of care, anti-venom use, and case fatality rates from a hospital of southcentral Nepal.

    Science.gov (United States)

    Pandey, Deb P; Vohra, Rais; Stalcup, Philip; Shrestha, Bhola R

    2016-01-01

    Snakebite envenomation affects thousands of people annually in Nepal. Published hospital-based studies of snakebite treatment in Nepal are scarce. Here we present the results of the first prospective, cross-sectional study of hospitalized envenomed snakebite cases in southcentral Nepal, a region characterized by poor pre-hospital care of snakebites, limited supply and excessive use of antivenom, and a high case/fatality ratio. We seek to identify clinical management problems and suggest potential interventions to improve treatment of snakebites. Out of the 342 patients presented with snakebites to an urban emergency department in the Terai region of Nepal between April and September of 2007, 39 patients were enrolled based on development of ptosis or swelling of bitten body parts. We collected patient demographic information and documented circumstances of snakebite, prehospital care, hospital care, and development of complications. Among 39 envenomated patients admitted to Bharatpur Hospital enrolled in the study 34 (92%) exhibited features of clinically significant neurotoxicity and were treated with antivenom. Antivenom use ranged from 4 to 98 vials of Polyspecific Indian Antivenom per patient. Each of victims (n=34) received antivenom an average of 4.3 (median) ±0.73 (standard error of mean) hours after receiving the snakebite. The overall case fatality rate was 21%. Neurotoxicity developed up to 25.8hr after suspected elapid snakebites. This was not observed for viperid snake bites. No enrolled patients received any of the currently recommended first aid for snake bite. The prevalence of nocturnal elapid snake bites, the practice of inappropriate first aid measures and highly variable administration of antivenom were identified as major challenges to appropriate care in this study. To address these issues we suggest development of a comprehensive checklist for identification of snake species, management of envenomation, and an educational program which

  9. Analysis of spatio-temporal variations in stroke incidence and case-fatality in Hong Kong

    OpenAIRE

    Pui Hing Chau; Jean Woo; Goggins, William B; Moses Wong; Kam Che Chan; Ho, Suzanne C.

    2011-01-01

    Geographical variations in stroke incidence and case-fatality have been documented worldwide. This study examines whether there are spatio-temporal variations in stroke incidence and case-fatality in Hong Kong and attempts to determine to what extent socioeconomic status (SES) and healthcare provision account for these variations. Residence-based hospital discharge data from the Hospital Authority (HA) in Hong Kong were geo-referenced and used to examine incidence rates and case-fatality rate...

  10. Do inter-hospital comparisons of in-hospital, acute myocardial infarction case-fatality rates serve the purpose of fostering quality improvement? An evaluative study

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    Molenberghs Geert

    2010-12-01

    Full Text Available Abstract Background In-hospital case-fatality rates in patients, admitted for acute myocardial infarction (AMI-CFRs, are internationally used as a quality indicator. Attempting to encourage the hospitals to assume responsibility, the Belgian Ministry of Health decided to stimulate initiatives of quality improvement by means of a limited set of indicators, among which AMI-CFR, to be routinely analyzed. In this study we aimed, by determining the existence of inter-hospital differences in AMI-CFR, (1 to evaluate to which extent Belgian discharge records allow the assessment of quality of care in the field of AMI, and (2 to identify starting points for quality improvement. Methods Hospital discharge records from all the Belgian short-term general hospitals in the period 2002-2005. The study population (N = 46,287 included patients aged 18 years and older, hospitalized for AMI. No unique patient identifier being present, we tried to track transferred patients. We assessed data quality through a comparison of MCD with data from two registers for acute coronary events and through transfer and sensitivity analyses. We compared AMI-CFRs across hospitals, using multivariable logistic regression models. In the main model hospitals, Charlson's co-morbidity index, age, gender and shock constituted the covariates. We carried out two types of analyses: a first one wherein transferred-out cases were excluded, to avoid double counting of patients when computing rates, and a second one with exclusion of all transferred cases, to allow the study of patients admitted into, treated in and discharged from the same hospital. Results We identified problems regarding both the CFR's numerator and denominator. Sensitivity analyses revealed differential coding and/or case management practices. In the model with exclusion of transfer-out cases, the main determinants of AMI-CFR were cardiogenic shock (ORadj 23.0; 95% CI [20.9;25.2], and five-year age groups ORadj 1.23; 95

  11. A fatal case of Perthes syndrome

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    Jérôme Jobé

    2013-01-01

    Full Text Available Perthes syndrome, or traumatic asphyxia, is a clinical syndrome associating cervicofacial cyanosis with cutaneous petechial haemorrhages and subconjonctival bleeding resulting from severe sudden compressive chest trauma. Deep inspiration and a Valsalva maneuver just prior to rapid and severe chest compression, are responsible for the development of this syndrome. Current treatment is symptomatic: urgent relief of chest compression and cardiopulmonary resuscitation if needed. Outcome may be satisfactory depending on the duration and severity of compression. Prolonged thoracic compression may sometimes lead to cerebral anoxia, irreversible neurologic damage and death. We report a fatal case of Perthes syndrome resulting from an industrial accident.

  12. Two fatal intoxication cases with imidacloprid: LC/MS analysis

    OpenAIRE

    Proença, Paula; Teixeira, Helena; Castanheira, Fernando; Pinheiro, João; Monsanto, Paula V.; Marques, Estela P.; Vieira, Duarte Nuno

    2005-01-01

    Imidacloprid [1-(6-chloro-3pyridylmethyl)-N-nitroimidazolidin-2-ylideneamine] is a new and potent nitromethylene insecticide with high insecticidal activity at very low application rates. It is the first highly effective insecticide that, like nicotine, acts on the nervous system, causing blockage of postsynaptic nicotinergic acetylcholine receptors. Two fatal cases with this insecticide in two male individuals, of 33 and 66 years old, are presented.

  13. Underreporting of fatal cases to a regional poison control center.

    OpenAIRE

    Blanc, P D; Kearney, T E; Olson, K.R.

    1995-01-01

    We assessed fatal drug overdose and poisoning case surveillance by a regional poison control center, comparing it with medical examiner determinations of death by poisoning over the same 2-year period and from the same catchment area. We studied 358 fatal cases of poisoning or drug overdose reported by a medical examiner and 10 fatal cases of poisoning or drug overdose reported by a poison control center, analyzing demographics and other case-associated factors with with possible successful p...

  14. Fatal falls from bicycles: a case report.

    Science.gov (United States)

    Venara, A; Mauillon, D; Gaudin, A; Rouge-Maillart, C; Jousset, N

    2013-03-10

    Though rare occurrences, fatal falls from bicycles are generally linked to the absence of a protective helmet and/or a collision with another vehicle. The case presented here is exceptional due to its circumstances and the consequences of the accident: a fall with no obstacle at a low speed that brought about multiple traumas and the death of a cyclist wearing a protective helmet. Comparing this against a review of cyclist accidentology literature, this case is unique. The increased use of autopsy in terms of forensic accidentology is to be encouraged so as not to misunderstand the possibility of such lesion-based consequences following a simple fall from a bicycle. PMID:23312586

  15. A fatal intoxication case involving ropinirole.

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    Duband, Sébastien; Bidat, Carolyne; Gaillard, Yvan; Rochet, Max; Camdessanche, Jean-Philippe; Péoc'h, Michel

    2012-10-01

    Ropinirole, a specific non-ergoline dopamine D2-receptor agonist, belongs to the drugs applied in treatment of Parkinson's disease (PD) and restless legs syndrome (RLS) and acts as a D2, D3, and D4 dopamine receptor agonist with highest affinity for D3. Therapeutic ropinirole plasma levels in adults are defined between 0.4 and 6 ng/mL. This case report documents a fatal intoxication involving ropinirole. Information about lethal ropinirole concentrations is hitherto lacking in the literature and the assessed ropinirole levels of this case may present a step towards defining potentially lethal concentrations. A 37-year-old man without medical history was found dead in a converted van used as place of residence and an autopsy was performed. The pathological findings did not reveal an apparent cause of death but the toxicological analysis revealed the presence of ropinirole, paracetamol, and alcohol in the peripheral blood sample. Quantitative analysis revealed that ropinirole was present at a peripheral blood concentration of 64 ng/mL. The ropinirole concentrations determined in vitreous humor, urine and bile were respectively, 11 ng/mL, 2670 ng/mL and 826 ng/mL. Paracetamol was detected at a blood level of intoxication with ropinirole in combination with alcohol. PMID:22920767

  16. Fatal Case of Enterovirus 71 Infection, France, 2007

    OpenAIRE

    Vallet, Sophie; Legrand-Quillien, Marie-Christine; Dailland, Thomas; Podeur, Gaëtan; Gouriou, Stéphanie; Schuffenecker, Isabelle; Payan, Christopher; Marcorelles, Pascale

    2009-01-01

    A fatal case of enterovirus 71 infection with pulmonary edema and rhombencephalitis occurred in Brest, France, in April 2007. The virus was identified as subgenogroup C2. This highly neurotropic enterovirus merits specific surveillance outside the Asia-Pacific region.

  17. Secular trends in incidence and 30-day case fatality of acute pancreatitis in North Jutland Country

    DEFF Research Database (Denmark)

    Floyd, A.K.; Pedersen, L; Nielsen, GL;

    2002-01-01

    Secular Trends in Incidence and 30-Day Case Fatality of Acute Pancreatitis in North Jutland County, Denmark: A Register-based Study from 1981-2000 A. Floyd, L. Pederson, G. Lauge Nielsen, O. Thorlacius-Ussing and H. T. Sorensen ‌   Background: The incidence rate of acute pancreatitis has been...... reported as having increased during recent decades in Western countries. Reported mortality lies around 10% and has improved during the past 20 years. The incidence rate and 30-day case fatality rate of acute pancreatitis in North Jutland County, Denmark were examined for the period 1981 to 2000. Methods......: Data were collected from the Hospital Discharge Registry of North Jutland County for the period 1981-2000. Sex- and age-standardized incidence rates and 30-day case fatality rate of a first attack of acute pancreatitis were calculated. Data on endoscopic procedures were assessed for the period 1992 to...

  18. Fatal High Voltage Accidental Electrocution – Two Case Reports

    OpenAIRE

    Manigandan G; Peranantham S; Shanmugam K

    2014-01-01

    Electric accidents cause serious injuries by direct heat exposure or by igniting clothes. The severity varies between simple harmless shocks to death. Many at times the victims are thrown to ground from the electric poles sustaining fatal non electric injuries. In this article two cases of high voltage electrocution are reported and discussed. In the first case the victim sustained injuries due to arcing of current. In the second case, there were multiple exit wounds in both legs...

  19. Fatal case of acute gastroenteritis with multiple viral coinfections.

    Science.gov (United States)

    Lupo, Julien; Morel-Baccard, Christine; Michard-Lenoir, Anne-Pascale; Germi, Raphaële; Pothier, Pierre; Ambert-Balay, Katia; Morand, Patrice

    2016-01-01

    We report a fatal case of acute gastroenteritis in a child with autism spectrum disorder. Multiple viral coinfections were detected by PCR in the patient's stool and digestive biopsy specimens. As viral detection is not necessarily associated with symptomatic disease, a semi-quantitative approach using cycle treshold values was proposed for the clinical interpretation of PCR. We discuss whether concomitant viral infections could be a risk factor for severe outcome in gastroenteritis cases. Individual risk factors are also addressed. PMID:26655270

  20. A fatal case of pulmonary nocardiosis

    Science.gov (United States)

    Patil, Mahantesh; C, Shivaprasad; Varghese, Jaicob; Rajagopalan, Natarajan

    2012-01-01

    Pulmonary nocardiosis is a serious, most often considered an opportunistic infection affecting the respiratory tract. Even though it is more common in immunocompromised hosts, it is not infrequently seen in immunocompetent patients as well. The aerosol route is the main portal of entry in to the body. Molecular techniques have revolutionised the identification of Nocardia species. However such tests are limited to referral laboratories. The radiographic appearances of Nocardia infection vary from a small nodule to bilateral infiltrates with cavitation. Traditionally sulphonamides have been considered the treatment of choice. However, resistance to sulphonamides is increasingly recognised. Carbapenems and linezolid have been found to be uniformly active against all the pathogenic species of Nocardia that affect human beings. The authors report a case of pulmonary nocardiosis in an immunocompetent patient, in whom the infection relentlessly progressed to florid sepsis despite prompt institution of right antibiotics. Florid sepsis relating to pulmonary nocardiosis is rare. PMID:22665550

  1. Fatal injection of ranitidine: a case report

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    Oliva Antonio

    2008-07-01

    Full Text Available Abstract Introduction Ranitidine hydrochloride (Zantac®, a histamine-2-receptor antagonist, is a widely used medication with an excellent safety record. Anaphylactic reaction to ranitidine is an extremely rare event and a related death has never been described in the literature. Case presentation We present the clinical history, histological and toxicological data of a 51-year-old man with negative anamnesis for allergic events, who died suddenly after the intravenous administration of one phial of Zantac® 50 mg prescribed as a routine post-surgical prophylaxis for stress ulcer. Conclusion Although the incidence of anaphylactic reactions related to ranitidine is low, caution needs to be exercised on administration of this drug. In addition, further study is needed to define strategies for the prevention of adverse drug reactions in hospitalized patients.

  2. Fatal case of ciprofloxacin-induced toxic epidermal necrolysis

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    Adesh D. Mishra

    2014-12-01

    Full Text Available Ciprofloxacin is a very commonly used antibiotic. Mild to moderate gastrointestinal side effects commonly reported whereas serious reactions such as Steven and ndash;Johnson syndrome and toxic epidermal necrolysis (TEN are very rare. We report the fatal case of 25 years female who had TEN after ingestion of tablet ciprofloxacin. This case report highlights the need to be critically aware of this rare, but life-threatening side effect of this commonly prescribed antibiotic. [Int J Basic Clin Pharmacol 2014; 3(6.000: 1090-1092

  3. Air pollution and case fatality of SARS in the People's Republic of China: an ecologic study

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    Yu Shun-Zhang

    2003-11-01

    Full Text Available Abstract Background Severe acute respiratory syndrome (SARS has claimed 349 lives with 5,327 probable cases reported in mainland China since November 2002. SARS case fatality has varied across geographical areas, which might be partially explained by air pollution level. Methods Publicly accessible data on SARS morbidity and mortality were utilized in the data analysis. Air pollution was evaluated by air pollution index (API derived from the concentrations of particulate matter, sulfur dioxide, nitrogen dioxide, carbon monoxide and ground-level ozone. Ecologic analysis was conducted to explore the association and correlation between air pollution and SARS case fatality via model fitting. Partially ecologic studies were performed to assess the effects of long-term and short-term exposures on the risk of dying from SARS. Results Ecologic analysis conducted among 5 regions with 100 or more SARS cases showed that case fatality rate increased with the increment of API (case fatality = - 0.063 + 0.001 * API. Partially ecologic study based on short-term exposure demonstrated that SARS patients from regions with moderate APIs had an 84% increased risk of dying from SARS compared to those from regions with low APIs (RR = 1.84, 95% CI: 1.41–2.40. Similarly, SARS patients from regions with high APIs were twice as likely to die from SARS compared to those from regions with low APIs. (RR = 2.18, 95% CI: 1.31–3.65. Partially ecologic analysis based on long-term exposure to ambient air pollution showed the similar association. Conclusion Our studies demonstrated a positive association between air pollution and SARS case fatality in Chinese population by utilizing publicly accessible data on SARS statistics and air pollution indices. Although ecologic fallacy and uncontrolled confounding effect might have biased the results, the possibility of a detrimental effect of air pollution on the prognosis of SARS patients deserves further investigation.

  4. Fatal Disseminated Tuberculous Peritonitis following Spontaneous Abortion: A Case Report

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    Munire Erman Akar

    2014-01-01

    Full Text Available We describe a rare case of fatal disseminated tuberculous peritonitis in a young woman with rapid progressive clinical course following spontaneous abortion of 20-week gestation. Clinical and laboratory findings were initially unremarkable. She underwent diagnostic laparoscopy which revealed numerous tiny implants on the peritoneum and viscera. Histopathology showed chronic caseating granulomas, and the tissue culture grew Mycobacterium tuberculosis. At fifth day of the antituberculous treatment multiorgan failure occurred in terms of pulmonary, hepatic, and renal insufficiency. She developed refractory metabolic acidosis with coagulopathy and pancytopenia, and she died of acute respiratory distress syndrome and septic shock on her twelfth day of hospitalization.

  5. Fatal parvoviral myocarditis: A case report and review of literature

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    Zhao Richard

    2008-04-01

    Full Text Available Abstract Background Histologically documented cases of parvoviral myocarditis are exceedingly rare. Case presentation Here, we report a 41-year old African American immunocompetent patient who died of parvoviral myocarditis after a 10 day illness characterized by fever, headaches, generalized arthralgias, and a maculopapular rash. Autopsy revealed an infiltrate myocarditis composed primarily of T-lymphocytes and macrophages associated with extensive myocardial fibrosis. The diagnosis of parvovirus was determined by polymerase chain reaction (PCR on both pre-mortem serum and post-mortem myocardial tissue Methods DNA was extracted from tissue and serum and primers were used to amplify DNAsequences of parvovirus B19 using nested polymerase chain reaction (PCR. Conclusion The diagnosis of parvovirus should be considered in cases of fatal myocarditis, and diagnosis can be confirmed at autopsy by molecular techniques.

  6. Fatal hemolytic anemia associated with metformin: A case report

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    Packer Clifford D

    2008-09-01

    Full Text Available Abstract Introduction Metformin is a widely prescribed biguanide antidiabetic drug that has been implicated as a cause of hemolytic anemia in three previous case reports. We report a case of rapidly fatal hemolysis that was temporally associated with the initiation of metformin treatment for diabetes. Clinicians need to be aware of this rare but potentially serious side effect of metformin. Case presentation A 56-year-old Caucasian man with type 2 diabetes mellitus was started on metformin to improve glycemic control. Shortly afterwards, he developed progressive fatigue, exertional dyspnea, cranberry-colored urine and jaundice. Laboratory studies showed severe hemolysis, with a drop in hemoglobin from 14.7 to 6.6 g/dl over 4 days, markedly elevated lactate dehydrogenase, bilirubin and reticulocyte counts, and a low haptoglobin level. A peripheral blood smear showed no schistocytes, and a direct Coombs test was positive for anti-IgG and negative for anti-C3. Despite corticosteroid treatment and transfusion of packed red blood cells, the patient developed increasing dyspnea, hypotension, further decline in hemoglobin to 3.3 g/dl, and fatal cardiorespiratory arrest 12 hours after admission. Conclusion The serologic findings in this case suggest an autoimmune hemolytic anemia, caused either by a drug-induced autoantibody or a warm autoantibody. Based on the temporal association with metformin and the lack of other clear precipitating causes, we propose that metformin-induced hemolysis with a drug-induced autoantibody is a strong possibility. This mechanism differs from a previously described case with a possible antibody to the erythrocyte-drug complex. It has been shown, however, that hemolysis may occur via multiple mechanisms from the same drug. Clinicians should consider the possibility of metformin-associated immune hemolytic anemia in patients with otherwise unexplained hemolysis.

  7. A Fatal Outcome of Rhino-orbito-cerebral Mucormycosis Following Tooth Extraction: A Case Report

    OpenAIRE

    Motaleb, Hesham Y Abdel; Mohamed, Mostafa S.; Mobarak, Fahmy A

    2015-01-01

    Rhino-orbito-cerebral mucormycosis is an uncommon aggressive life-threatening opportunistic fungal infection that affects mainly the immunocompromised population with mortality rate up to 50%. Due to its aggressive nature, early detection and prompt management are of great importance for a good prognosis. Our report describes a fatal outcome of a case of rhino-orbito-cerebral mucormycosis following tooth extraction in an uncontrolled non-insulin-dependent diabetes mellitus patient after 14 da...

  8. Fatal case of cryptogenic organizing pneumonia associated with everolimus.

    Science.gov (United States)

    Nazer, Lama; Alnajjar, Taghreed; Salah, Samer; Khzouz, Jakub; Alfaqeer, Nour; Qandeel, Monther

    2014-01-01

    Noninfectious pneumonitis (NIP) has been reported with everolimus; however, the majority of the reported cases were mild to moderate. We report a fatal case of cryptogenic organizing pneumonia (COP) in a 61-year-old man. About 4 weeks after starting everolimus, the patient was admitted to the hospital with complaints of a 1-week history of progressive dyspnea with exertion and cough. The chest radiograph showed bilateral multifocal dense opacities, and he was started on antibiotics. However, his respiratory status deteriorated, and he was subsequently intubated and transferred to the intensive care unit. Chest computed tomography showed bronchocentric consolidation associated with widespread bilateral fine reticular opacification. Video-assisted thoracoscopic lung biopsy showed noncaseating granulomatous inflammation and features of COP. All cultures were negative for bacterial, viral, and fungal infections. Despite discontinuing everolimus and initiating corticosteroids, the patient died of progressive respiratory failure secondary to COP. PMID:25827702

  9. Risk factors for fatality among confirmed adult dengue inpatients in Singapore: a matched case-control study.

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    Tun-Linn Thein

    Full Text Available OBJECTIVES: To identify demographic, clinical and laboratory risk factors for death due to dengue fever in adult patients in Singapore. METHODS: Multi-center retrospective study of hospitalized adult patients with confirmed dengue fever in Singapore between 1 January 2004 and 31 December 2008. Non-fatal controls were selected by matching age and year of infection with fatal cases. World Health Organization 1997, 2009 criteria were applied to define dengue hemorrhagic fever (DHF, warning signs and severe dengue. Statistical significance was assessed by conditional logistic regression modeling. RESULTS: Significantly more fatal cases than matched controls had pre-existing co-morbid conditions, and presented with abdominal pain/tenderness. Median pulse rates were significantly higher while myalgia was significantly less frequent in cases. . Fatal cases also had higher leucocyte counts, platelet counts, serum sodium, potassium, urea, creatine and bilirubin levels on admission compared to controls. There was no statistical significant difference between the prevalence of DHF and hematocrit level among cases and controls. Multivariate analysis showed myalgia and leucocyte count at presentation were independent predictors of fatality (adjusted odds ratios 0.09 and 2.94 respectively. None of the controls was admitted to intensive care unit (ICU or given blood transfusion, while 71.4% and 28.6% of fatal cases received ICU admission and blood transfusion. CONCLUSIONS: Absence of myalgia and leucocytosis on admission were independently associated with fatality in our matched case-control study. Fatalities were also commonly associated with co-morbidities and clinicians should be alarmed if dengue patients fulfilled severe dengue case definition on admission.

  10. THE RETURN OF THE STRANGLER? CASE REPORT OF A FATAL CASE OF DIPHTHERIA

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    Srikamakhsi Kothandaraman

    2012-11-01

    Full Text Available This article is a case report of a case of diphtheria which presented as diphtheritic tonsillitis in stridor and finallysuccumbed to diphtheritic myocarditis. Here we describe the case presentation, the treatment modalities undertaken,and the fatal course of events followed by an elaborate discussion on diphtheria.

  11. A Fatal Case of "Bullous Erysipelas-like" Pseudomonas Vasculitis.

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    Yang, Sam Shiyao; Chandran, Nisha Suyien; Huang, Jing Xiang; Tan, Kong-Bing; Aw, Derrick Chen-Wee

    2016-01-01

    Erysipelas is a generally benign superficial bacterial skin infection, and its bullous form constitutes a rare and more severe variant. We describe the first and fatal case of "bullous erysipelas-like" septic vasculitis due to Pseudomonas bacteremi. A 69-year-old Chinese man presenting with diarrhea and septic shock initially began to rapidly develop sharply defined erythematous plaques with non-hemorrhagic bullae over his lower limbs. Culture of the aspirate from the bullae was positive for Pseudomonas aeruginosa. This was also consistent with his blood cultures showing Pseudomonas bacteremia. Histology of the skin lesion showed microthrombi and neutrophilic infiltrates in blood vessels with Gram-negative bacilli extruding from the vessel walls, characteristic of septic vasculitis. The bullous erysipelas-like lesions seen in this patient represents a rare manifestation of both septic vasculitis and Pseudomonas infection. PMID:26955132

  12. Bicycle Helmet Laws are Associated with a Lower Fatality Rate from Bicycle-Motor Vehicle Collisions

    Science.gov (United States)

    Meehan, William P.; Lee, Lois K.; Fischer, Christopher M.; Mannix, Rebekah C.

    2013-01-01

    Objective To assess the association between bicycle helmet legislation and bicycle-related deaths sustained by children involved in bicycle-motor vehicle collisions. Study design We conducted a cross sectional study of all bicyclists aged 0-16 years included in the Fatality Analysis Reporting System (FARS) who died between January 1999 and December 2010. We compared fatality rates per age-specific state populations between states with helmet laws and those without helmet laws. We used a clustered Poisson multivariate regression model to adjust for factors previously associated with rates of motor vehicle fatalities: elderly driver licensure laws, legal blood alcohol limit ( 0.08 between states with helmet laws and those without helmet laws. The mean unadjusted rates of fatalities were lower in states with helmet laws (2.0/1,000,000 vs. 2.5/1,000,000; p= 0.03). After adjusting for potential confounding factors, states with mandatory helmet laws continued to be associated with a lower rate of fatalities (adjusted Incidence Rate Ratio 0.84; 95% CI 0.70, 0.98). Conclusions Bicycle helmet safety laws are associated with a lower incidence of fatalities among child bicyclists involved in motor vehicle collisions. PMID:23706604

  13. Fatal cold agglutinin-induced haemolytic anaemia: a case report

    Directory of Open Access Journals (Sweden)

    Reverberi Roberto

    2010-08-01

    Full Text Available Abstract Introduction Cold agglutinin disease usually develops as a result of the production of a specific immunoglobulin M auto-antibody directed against the I/i and H antigens, precursors of the ABH and Lewis blood group substances, on red blood cells. Autoimmune and lymphoproliferative disorders, Mycoplasma pneumoniae and other infections can be associated with the production of cold agglutinins. In its classic presentation with haemolytic anaemia and Raynaud's syndrome, cold agglutinin disease is usually idiopathic. Several factors play a role in determining the ability of a cold agglutinin to induce a haemolytic anaemia such as antibody concentration and temperature range, in particular the highest temperature at which antibodies interact with red blood cells. Case presentation A 48-year-old Caucasian man presented to our hospital with symptoms of extreme asthenia caused by severe anaemia. The transfusion of red blood cells (O Rh-positive, started as prescribed by the emergency guidelines in force without pre-transfusion tests, induced fatal haemolysis because of the presence of high levels of anti-H antibodies in his blood, that reacted with the large amount of H antigen in universal (0 red blood cells. Conclusion Emergency transfusion of universal red blood cells (0 Rh-positive or negative is usually accepted by the international guidelines in force in emergency departments. In this report we describe a rare complication caused by the very high concentration in the recipient of cold agglutinins and the activation of the complement system, responsible for red blood cell lysis and consequent fatal cardiovascular shock. We conclude that emergency transfusion of universal red blood cells (0 Rh-positive or negative may be dangerous and its risk should be assessed against the risk of delaying transfusion until the pre-transfusion tests are completed.

  14. Intradural spinal seeding and fatal progression of a sacrococcygeal chordoma:a case report

    Institute of Scientific and Technical Information of China (English)

    JI Tao; GUO Wei; SHEN Dan-hua; YANG Yi; TANG Shun

    2008-01-01

    @@ Chordoma as a rare malignant tumor arising from remnants of the fetal notochord accounts for 1%-4% of primary bone tumors.It is usually predominant in males.Local recurrences are common (44%-78%)1-3 and distant metastases may occur years after the initial presentation.The reposed rates of metastases range from 10% to 48%,4-6 which are usually accompanied by a sacrococcygeal chordoma.Cases of surgical seeding and intradural spinal seeding also have been reported clinically.7-9 To our knowledge,the present case is the first one concerning cerebrospinal fluid metastases and fatal progression of a sacrococcygeal chordoma.

  15. Reduced case fatality among hospitalized children during a war in Guinea-Bissau

    DEFF Research Database (Denmark)

    Sodemann, Morten; Veirum, Jens Erik; Biai, S;

    2004-01-01

    During a recent armed conflict in Guinea-Bissau, we observed a marked decline in the case fatality among hospitalized children at the only paediatric department in the country.......During a recent armed conflict in Guinea-Bissau, we observed a marked decline in the case fatality among hospitalized children at the only paediatric department in the country....

  16. FATAL RHABDOMYOLYSIS IN DENGUE HEMORRHAGIC FEVER: A CASE REPORT.

    Science.gov (United States)

    Siriyakorn, Nirada; Insiripong, Somchai

    2015-01-01

    Dengue hemorrhagic fever is caused by dengue virus infection. The classical manifestations consist of fever, thrombocytopenia, and hemoconcentration. However, its unusual complications may be fatal, such as prolong shock, massive bleeding, volume overload, and unusual manifestations, for example, severe rhabdomyolysis. Here we report a case of 17-year old Thai man who was referred to our hospital because of 7-day fever with thrombocytopenia, hemoconcentration and right pleural effusion. The serology tests confirmed to be dengue infection. He developed various complications: severe hepatitis, coagulopathy, and heavy proteinuria; encephalopathy that needed a respiratory ventilator. On day 12 of fever, he had myalgia and passed dark urine. Serum creatinine and serum creatinine phosphokinase (CPK) were found abnormally high. He was diagnosed as severe rhabdomyolysis with acute kidney injury, and immediate hemodialysis was performed. He did not respond to treatment and expired within three hours. Although the mechanism of severe rhabdomyolysis in dengue fever is not clearly known, it may theoretically be proposed such as direct muscle cell injury leading to myositis by dengue virus, myotoxic cytokines which are produced in response to viral infection, dehydration or hypophosphatemia. PMID:26506741

  17. An autopsy case of fatal repellent air freshener poisoning.

    Science.gov (United States)

    Hitosugi, Masahito; Tsukada, Chie; Yamauchi, Shinobu; Matsushima, Kazumi; Furukawa, Satoshi; Morita, Satomu; Nagai, Toshiaki

    2015-09-01

    We describe a first fatal case of repellent air freshener ingestion. A 79-year-old Japanese man with Alzheimer-type senile dementia orally ingested repellent air freshener containing three surfactants: polyoxyethylene 9-lauryl ether, polyoxyethylene (40) hydrogenated castor oil, and lauric acid amidopropyl amine oxide (weight ratio of 1.3%). About 1h after the collapse, he was in cardiopulmonary arrest and subsequently died 10h after his arrival. The forensic autopsy performed 5.5h after death revealed the 380ml of stomach contents with a strong mint perfume identical to that of the repellent air freshener and the findings of acute death. Toxicologically, 9.1μg/ml and 558.2μg/ml of polyoxyethylene 9-lauryl ether were detected from the serum and stomach contents taken at autopsy. Generally, ingestion of anionic or non-ionic surfactants have been considered as safe. However, because the patient suffered from cardiac insufficiency with a low dose of repellent air freshener ingestion, medical staff members must evaluate the elderly patient for cardiac and circulatory problems regardless of the ingested dose. Not only medical and nursing staff members, but also families who are obliged to care for elderly persons must be vigilant to prevent accidental ingestion of toxic substances generally used in the household. PMID:25982958

  18. First fatal case of CNS infection caused by Enterovirus A in Brazil

    OpenAIRE

    Oliveira, D B; Machado, G; Almeida, G.M.F.; P. C. P. Ferreira; C.A. Bonjardim; G. de Souza Trindade; Abrahão, J.S.; E.G. Kroon

    2015-01-01

    We describe what is to our knowledge the first fatal case of central nervous system Enterovirus infection in Brazil. Molecular and phylogenetic characterization revealed that Enterovirus A was the aetiologic agent of this case.

  19. Trends in incidence, case-fatality and recurrence of myocardial infarction in the Danish MONICA population 1982-1991

    DEFF Research Database (Denmark)

    Davidsen, M; Brønnum-Hansen, H; Jørgensen, Torben; Madsen, M; Gerdes, Lars Ulrik; Osler, M; Schroll, M

    2001-01-01

    BACKGROUND: Growing awareness of risk factors for myocardial infarction (MI), continuous mass campaigns on lifestyle factors, increasing use of heart rehabilitation and improved treatment should imply decreases in the incidence, case-fatality and recurrence rates of MI. The purpose of the study was...

  20. A fatal case of bupropion (Zyban) hepatotoxicity with autoimmune features: Case report

    OpenAIRE

    Humayun Fawwaz; Shehab Thomas M; Tworek Joseph A; Fontana Robert J

    2007-01-01

    Abstract Background Bupropion is approved for the treatment of mood disorders and as an adjuvant medication for smoking cessation. Bupropion is generally well tolerated and considered safe. Two randomized controlled trials of bupropion therapy for smoking cessation did not report any hepatic adverse events. However, there are three reports of severe but non-fatal bupropion hepatotoxicity published in the literature. Case Presentation We present the case of a 55-year old man who presented with...

  1. A Fatal Case of Klebsiella pneumoniae Mycotic Aneurysm

    OpenAIRE

    Chien-Ming Chao; Kun-Kuang Lee; Chia-Sheng Wang; Ping-Jen Chen; Tsung-Chih Yeh

    2011-01-01

    Mycotic aneurysm is a serious clinical condition with significant morbidity and mortality. Staphylococcus aureus and Salmonella species are the most common causative pathogens. Klebsiella pneumoniae was rarely reported as a possible pathogen causing mycotic aneurysm; therefore, we describe a K. pneumoniae-related fatal bacteremia mycotic aneurysm in a patient in spite of appropriate antimicrobial agents and surgical management.

  2. The global role of natural disaster fatalities in decision-making: statistics, trends and analysis from 116 years of disaster data compared to fatality rates from other causes

    Science.gov (United States)

    Daniell, James; Wenzel, Friedemann; McLennan, Amy; Daniell, Katherine; Kunz-Plapp, Tina; Khazai, Bijan; Schaefer, Andreas; Kunz, Michael; Girard, Trevor

    2016-04-01

    In this study, analysis is undertaken showing disaster fatalities trends from around the world using the CATDAT Natural Disaster and Socioeconomic Indicator databases from 1900-2015. Earthquakes have caused over 2.3 million fatalities since 1900; however absolute numbers of deaths caused by them have remained rather constant over time. However, floods have caused somewhere between 1.7 and 5.4 million fatalities, mostly in the earlier half of the 20th century (depending on the 1931 China floods). Storm and storm surges (ca. 1.3 million fatalities), on the other hand, have shown an opposite trend with increasing fatalities over the century (or a lack of records in the early 1900s). Earthquakes due to their sporadic nature, do not inspire investment pre-disaster. When looking at the investment in flood control vs. earthquakes, there is a marked difference in the total investment, which has resulted in a much larger reduction in fatalities. However, a key consideration for decision-makers in different countries around the world when choosing to implement disaster sensitive design is the risk of a natural disaster death, compared to other types of deaths in their country. The creation of empirical annualised ratios of earthquake, flood and storm fatalities from the year 1900 onwards vs. other methods of fatalities (cancer, diseases, accidents etc.) for each country using the CATDAT damaging natural disasters database is undertaken. On an annualised level, very few countries show earthquakes and other disaster types to be one of the highest probability methods for death. However, in particular years with large events, annual rates can easily exceed the total death count for a particular country. An example of this is Haiti, with the equivalent earthquake death rate in 2010 exceeding the total all-cause death rate in the country. Globally, fatality rates due to disasters are generally at least 1 order of magnitude lower than other causes such as heart disease. However, in

  3. Stroke risk factors, subtypes, and 30-day case fatality in Abuja, Nigeria

    Directory of Open Access Journals (Sweden)

    Nura H Alkali

    2013-01-01

    Full Text Available Background: Stroke is the second leading cause of death and the leading cause of adult disability worldwide. A better understanding of stroke risk factors and outcome may help guide efforts at reducing the community burden of stroke. This study aimed to understand stroke risk factors, imaging subtypes, and 30-day outcomes among adult Nigerians. Materials and Methods: We prospectively recruited all patients presenting with acute stroke at the National Hospital Abuja between January 2010 and June 2012. We assessed clinical and laboratory variables, as well as brain computerized tomography, magnetic resonance imaging, and carotid Doppler ultrasound scans. We also assessed case fatality and functional outcome at 30 days after stroke. Results: Of 272 patients studied, 168 (61.8% were males. Age at presentation (mean ± standard deviation was 56.4 ± 12.7 years in males and 52.9 ± 14.8 years in females ( P = 0.039. Neuroimaging was obtained in 96.7% patients, revealing cerebral infarction (61.8%, intracerebral hemorrhage (ICH (34.8%, and subarachnoid hemorrhage (SAH (3.4%. Carotid plaques or stenosis ≥50% were detected in 53.2% patients with cerebral infarction. Stroke risk factors included hypertension (82.7%, obesity (32.6%, diabetes (23.5%, hyperlipidemia (18.4%, atrial fibrillation (9.2%, and cigarette smoking (7.7%. At 30 days after stroke, case-fatality rate was 18.8%, whereas modified Rankin Scale (mRS scores for cerebral infarction, ICH, and SAH were 3.71, 4.21, and 4.56, respectively. Atrial fibrillation, a previous stroke, and age older than 50 years were all associated with worse mRS scores at 30 days. Conclusion: Although hypertension, obesity, diabetes mellitus, and atrial fibrillation were important stroke risk factors, in many patients, these were detected only after a stroke. While the commonest stroke subtype was cerebral infarction, observed in almost two-third of patients, SAH was associated with the highest case-fatality rate at

  4. Trends and inequalities in short-term acute myocardial infarction case fatality in Scotland, 1988-2004

    OpenAIRE

    Leyland Alastair H; Davies Carolyn A

    2010-01-01

    Abstract Background There have been substantial declines in ischemic heart disease in Scotland, partly due to decreases in acute myocardial infarction (AMI) incidence and case fatality (CF). Despite this, Scotland's IHD mortality rates are among the worst in Europe. We examine trends in socioeconomic inequalities in short-term CF after a first AMI event and their associations with age, sex, and geography. Methods We used linked hospital discharge and death records covering the Scottish popula...

  5. A fatal case of bupropion (Zyban hepatotoxicity with autoimmune features: Case report

    Directory of Open Access Journals (Sweden)

    Humayun Fawwaz

    2007-09-01

    Full Text Available Abstract Background Bupropion is approved for the treatment of mood disorders and as an adjuvant medication for smoking cessation. Bupropion is generally well tolerated and considered safe. Two randomized controlled trials of bupropion therapy for smoking cessation did not report any hepatic adverse events. However, there are three reports of severe but non-fatal bupropion hepatotoxicity published in the literature. Case Presentation We present the case of a 55-year old man who presented with jaundice and severe hepatic injury approximately 6 months after starting bupropion for smoking cessation. Laboratory evaluation demonstrated a mixed picture of hepatocellular injury and cholestasis. Liver biopsy demonstrated findings consistent with severe hepatotoxic injury due to drug induced liver injury. Laboratory testing was also notable for positive autoimmune markers. The patient initially had clinical improvement with steroid therapy but eventually died of infectious complications. Conclusion This report represents the first fatal report of bupropion related hepatotoxicity and the second case of bupropion related liver injury demonstrating autoimmune features. The common use of this medication for multiple indications makes it important for physicians to consider this medication as an etiologic agent in patients with otherwise unexplained hepatocellular jaundice.

  6. A fatal case of acute HHV-6 myocarditis following allogeneic haemopoietic stem cell transplantation.

    Science.gov (United States)

    Brennan, Yvonne; Gottlieb, David J; Baewer, David; Blyth, Emily

    2015-11-01

    Human herpesvirus 6 (HHV-6) is an ubiquitous virus that can reactivate in immunocompromised hosts, resulting in diverse clinical sequelae. We describe a case of fatal acute HHV-6 myocarditis in a patient who underwent allogeneic haemopoietic stem cell transplantation (HSCT). To our knowledge, this is the first reported case of biopsy proven HHV-6 myocarditis post-HSCT. PMID:26465970

  7. An acute gabapentin fatality: a case report with postmortem concentrations.

    Science.gov (United States)

    Cantrell, F Lee; Mena, Othon; Gary, Ray D; McIntyre, Iain M

    2015-07-01

    Gabapentin (GBP) (Neurontin®, Horizant®, Gralise®) is a widely prescribed medication used primarily for the treatment of epilepsy and neuropathic pain. GBP has a favorable adverse effect profile in therapeutic dosing with the most common reported effects being dizziness, fatigue, drowsiness, weight gain, and peripheral edema. Even with intentional GBP self-poisonings, serious effects are rare. A 47-year-old female was found dead at work with her daughter's bottle of GBP 600 mg. There were 26 tablets missing and the decedent's only known medication was hydrocodone/acetaminophen. Following initial detection by an alkaline drug screen (GC-MS), analysis utilizing specific liquid chromatography-mass spectrometry revealed an elevated postmortem GBP peripheral blood concentration of 37 mg/L, central blood 32 mg/L, liver 26 mg/kg, vitreous 32 mg/L, and gastric contents 6 mg. Screening for volatiles, drugs of abuse, alkaline compounds, and acid/neutral compounds was negative with the exception of ibuprofen (<2 mg/L) detected in peripheral blood. This report presents a fatality that appears to be associated with an isolated and acute GBP ingestion. PMID:25904080

  8. Vascular Ehlers-Danlos syndrome: a case with fatal outcome.

    Science.gov (United States)

    Morais, Paulo; Mota, Alberto; Eloy, Catarina; Lopes, José Manuel; Torres, Fátima; Palmeiro, Aida; Tavares, Purificação; Azevedo, Filomena

    2011-01-01

    A 13-year-old boy, born prematurely and hypotonic, from non-consanguineous healthy parents, was referred to our department because of easy bruising. A slightly extensible, thin and translucent skin, associated with dysmorphic facies, acrogeria, multiple ecchymoses, hypermobility of the small joints, dorsal kyphosis, genu valgum, flat feet, elongated upper limbs, and low muscle tone were all evident. A history of learning disability and bilateral inguinal hernia was present. Blood and imaging studies were unremarkable. A skin biopsy disclosed an unremarkable dermis; electron microscopy showed abnormalities in the diameter, contour, and shape of collagen fibrils/fibers. Genetic analysis revealed heterozygosity for a novel mutation in COL3A1 gene (c.3527G>A), confirming the diagnosis of vascular Ehlers-Danlos syndrome (VEDS). The patient died at 15 years of age because of aortic dissection. Vascular Ehlers-Danlos syndrome is a rare, life-threatening, autosomal dominant variant of EDS, resulting from mutations in COL3A1 gene. Affected individuals are prone to serious and potentially fatal complications, especially vascular, intestinal, and uterine ruptures. Delay in diagnosis is common, even when the clinical presentation is typical. Therefore, dermatologists should be familiar with VEDS features because the skin findings may be the first signs. Early diagnosis will improve management of visceral complications and allow early genetic counseling. PMID:21549076

  9. Fatal case of sorafenib-associated idiosyncratic hepatotoxicity in the adjuvant treatment of a patient with renal cell carcinoma

    Directory of Open Access Journals (Sweden)

    Fairfax BP

    2012-12-01

    Full Text Available Abstract Background Sorafenib is an orally available kinase inhibitor with activity at Raf, PDGFβ and VEGF receptors that is licensed for the treatment of advanced renal cell carcinoma (RCC and hepatocellular carcinoma (HCC. Current evidence-based post-nephrectomy management of individuals with localized RCC consists of surveillance-based follow up. The SORCE trial is designed to investigate whether treatment with adjuvant sorafenib can reduce recurrence rates in this cohort. Case presentation Here we report an idiosyncratic reaction to sorafenib resulting in fatal hepatotoxicity and associated renal failure in a 62 year-old man treated with sorafenib within the SORCE trial. Conclusion This is the first reported case of sorafenib exposure associated fatal toxicity in the adjuvant setting and highlights the unpredictable adverse effects of novel adjuvant therapies.

  10. Sporadic fatal insomnia in a young woman: A diagnostic challenge: Case Report

    OpenAIRE

    Cracco Laura; Zou Wen-Quan; Maddox Ryan A; Schonberger Lawrence B; Moody Karen M; Cali Ignazio

    2011-01-01

    Abstract Background Sporadic fatal insomnia (sFI) and fatal familial insomnia (FFI) are rare human prion diseases. Case Presentation We report a case of a 33-year-old female who died of a prion disease for whom the diagnosis of sFI or FFI was not considered clinically. Following death of this patient, an interview with a close family member indicated the patient's illness included a major change in her sleep pattern, corroborating the reported autopsy diagnosis of sFI. Genetic tests identifie...

  11. A fatal case of Lassa fever in London, January 2009.

    Science.gov (United States)

    Kitching, A; Addiman, S; Cathcart, S; Bischop, L; Krahé, D; Nicholas, M; Coakley, J; Lloyd, G; Brooks, T; Morgan, D; Turbitt, D

    2009-02-12

    In January 2009, the eleventh [corrected] case of Lassa fever imported to the United Kingdom was diagnosed in London. Risk assessment of 328 healthcare contacts with potential direct exposure to Lassa virus - through contact with the case or exposure to bodily fluids - was undertaken. No contacts were assessed to be at high risk of infection and no secondary clinical cases identified. PMID:19215723

  12. Fatal Granulomatous Amoebic Encephalitis Caused by Acanthamoeba in a Patient With Kidney Transplant: A Case Report.

    Science.gov (United States)

    Salameh, Ahmad; Bello, Nancy; Becker, Jennifer; Zangeneh, Tirdad

    2015-09-01

    Granulomatous amoebic encephalitis (GAE) due to Acanthamoeba is almost a uniformly fatal infection in immune-compromised hosts despite multidrug combination therapy. We report a case of GAE in a female who received a deceased donor kidney graft. She was treated with a combination of miltefosine, pentamidine, sulfadiazine, fluconazole, flucytosine, and azithromycin. PMID:26280011

  13. Fatal case of sorafenib-associated idiosyncratic hepatotoxicity in the adjuvant treatment of a patient with renal cell carcinoma

    International Nuclear Information System (INIS)

    Sorafenib is an orally available kinase inhibitor with activity at Raf, PDGFβ and VEGF receptors that is licensed for the treatment of advanced renal cell carcinoma (RCC) and hepatocellular carcinoma (HCC). Current evidence-based post-nephrectomy management of individuals with localized RCC consists of surveillance-based follow up. The SORCE trial is designed to investigate whether treatment with adjuvant sorafenib can reduce recurrence rates in this cohort. Here we report an idiosyncratic reaction to sorafenib resulting in fatal hepatotoxicity and associated renal failure in a 62 year-old man treated with sorafenib within the SORCE trial. This is the first reported case of sorafenib exposure associated fatal toxicity in the adjuvant setting and highlights the unpredictable adverse effects of novel adjuvant therapies

  14. A Case of Fatal Gastrointestinal Anthrax in North Eastern Iran

    OpenAIRE

    Seyed Ahmad Hashemi; Amir Azimian; Sara Nojumi; Tahereh Garivani; Saghar Safamanesh; Majid Ghafouri

    2015-01-01

    Background. Bacillus species are aerobic or facultative anaerobic, gram-positive, or gram-variable spore-forming rods. They are ubiquitous in the environmental sources. Bacillus anthracis may usually cause three forms of anthrax: inhalation, gastrointestinal, and cutaneous. The gastrointestinal (GI) anthrax develops after eating contaminated meat. In this paper we report septic intestinal anthrax. Case Presentation. We report an isolation of Bacillus anthracis from blood culture of patient wi...

  15. A Case of Fatal Gastrointestinal Anthrax in North Eastern Iran

    Directory of Open Access Journals (Sweden)

    Seyed Ahmad Hashemi

    2015-01-01

    Full Text Available Background. Bacillus species are aerobic or facultative anaerobic, gram-positive, or gram-variable spore-forming rods. They are ubiquitous in the environmental sources. Bacillus anthracis may usually cause three forms of anthrax: inhalation, gastrointestinal, and cutaneous. The gastrointestinal (GI anthrax develops after eating contaminated meat. In this paper we report septic intestinal anthrax. Case Presentation. We report an isolation of Bacillus anthracis from blood culture of patient with intestinal anthrax. Bacillus anthracis was isolated from a blood culture of a 34-year-old man who had a history of severe abdominal pain, bloody diarrhea, nausea, vomiting, fever, sweating, and lethargy within 4 to 5 days after eating the meat of domestic goat. He had evidence of severe infection and septic shock and did not respond to treatments and subsequently expired 9 hours after hospitalization. Conclusion. Gastrointestinal anthrax is characterized by rapid onset, fever, and septicemia. Rapid diagnosis and prompt initiation of antibiotic therapy can help in survival. Most of previous cases of septicemic anthrax were related to injection drug users but, in our case, septicemia occurred after gastrointestinal anthrax.

  16. A case of fatal gastrointestinal anthrax in north eastern iran.

    Science.gov (United States)

    Hashemi, Seyed Ahmad; Azimian, Amir; Nojumi, Sara; Garivani, Tahereh; Safamanesh, Saghar; Ghafouri, Majid

    2015-01-01

    Background. Bacillus species are aerobic or facultative anaerobic, gram-positive, or gram-variable spore-forming rods. They are ubiquitous in the environmental sources. Bacillus anthracis may usually cause three forms of anthrax: inhalation, gastrointestinal, and cutaneous. The gastrointestinal (GI) anthrax develops after eating contaminated meat. In this paper we report septic intestinal anthrax. Case Presentation. We report an isolation of Bacillus anthracis from blood culture of patient with intestinal anthrax. Bacillus anthracis was isolated from a blood culture of a 34-year-old man who had a history of severe abdominal pain, bloody diarrhea, nausea, vomiting, fever, sweating, and lethargy within 4 to 5 days after eating the meat of domestic goat. He had evidence of severe infection and septic shock and did not respond to treatments and subsequently expired 9 hours after hospitalization. Conclusion. Gastrointestinal anthrax is characterized by rapid onset, fever, and septicemia. Rapid diagnosis and prompt initiation of antibiotic therapy can help in survival. Most of previous cases of septicemic anthrax were related to injection drug users but, in our case, septicemia occurred after gastrointestinal anthrax. PMID:25918652

  17. Air pollution and case fatality of SARS in the People's Republic of China: an ecologic study

    OpenAIRE

    Yu Shun-Zhang; Wang Hua; Zhao Jinkou; Froines John; Zhang Zuo-Feng; Cui Yan; Detels Roger

    2003-01-01

    Abstract Background Severe acute respiratory syndrome (SARS) has claimed 349 lives with 5,327 probable cases reported in mainland China since November 2002. SARS case fatality has varied across geographical areas, which might be partially explained by air pollution level. Methods Publicly accessible data on SARS morbidity and mortality were utilized in the data analysis. Air pollution was evaluated by air pollution index (API) derived from the concentrations of particulate matter, sulfur diox...

  18. A fatal case of pulmonary infection by Mycobacterium colombiense in Para State, Amazon Region, Brazil.

    Science.gov (United States)

    Barretto, Adriana Rodrigues; Felício, João Soares; Sales, Lucia Helena Messias; Yamada, Elizabeth Sumi; Lopes, Maria Luiza; da Costa, Ana Roberta Fusco

    2016-07-01

    Mycobacterium avium complex (MAC) is a heterogeneous group of species found in several environmental sources and that exhibit variable degrees of pathogenicity. Among the MAC members, Mycobacterium colombiense has been related to pulmonary disease and disseminated infection in HIV-infected patients in Colombia. Lymphadenopathy cases have also been reported. We have described a fatal case of M. colombiense pulmonary disease in a Brazilian patient without evidence of HIV infection or other known causes of immunosuppression. PMID:27133309

  19. Circadian hormonal rhythms in two new cases of fatal familial insomnia.

    Science.gov (United States)

    Avoni, P; Cortelli, P; Montagna, P; Tinuper, P; Sforza, E; Contin, M; Parchi, P; Pierangeli, G; Maltoni, P; Pavani, A

    1991-12-01

    We used a chronobiological inferential statistical method to investigate circadian rhythms of hypophyseal hormones, cortisol, melatonin and catecholamines in two females of the same family affected by fatal familial insomnia. Case 1 (confirmed at autopsy) presented an absent or progressive loss of circadian rhythms of all hormones. In case 2 there was a loss of GH circadian rhythm and a less significant rhythm for melatonin, catecholamines and gonadotropins. These results confirm the role of the thalamus in regulating hormonal circadian rhythm. PMID:1805556

  20. Fatal transfusion related acute lung injury following coronary artery by-pass surgery: a case report

    OpenAIRE

    Bawany, Fauzia Ahmad; Sharif, Hasanat

    2008-01-01

    Background Transfusion related acute lung injury (TRALI) is a potentially fatal Acute Lung Injury following transfusion of blood components. Hypotheses implicate donor-derived anti-human leukocyte antigen or granulocyte antibodies reacting with recipients' leukocytes, releasing inflammatory mediators. Lack of agreement on underlying cellular and molecular mechanisms renders improving transfusion safety difficult and expensive. Case Presentation Literature search has not revealed any case of T...

  1. Diferença de letalidade hospitalar do infarto agudo do miocárdio entre homens e mulheres submetidos a angioplastia primária Difference in the case-fatality rate of acute myocardial infarction between men and women submitted to primary angioplasty

    Directory of Open Access Journals (Sweden)

    Luiz Carlos Santana Passos

    1998-10-01

    Full Text Available OBJETIVO: Comparar a letalidade hospitalar (LH de homens e mulheres submetidos a angioplastia transluminal coronária primária (ATCP como estratégia de reperfusão no infarto agudo do miocárdio (IAM. MÉTODOS: Estudo de coorte retrospectivo baseado em informações de prontuários médicos de pacientes hospitalizados devido a IAM em hospital de referência para doença coronária, utilizando preferencialmente a ATCP como técnica de reperfusão miocárdica precoce. Foram incluídos 83 pacientes, 35 (42% mulheres e 48 (58% homens, que preencheram critérios para reperfusão miocárdica precoce. RESULTADOS: A média de idade das mulheres foi superior a dos homens (66±10 vs 58±11 anos; pPURPOSE: To compare the in-hospital case-fatality rate of men and women submitted to percutaneous transluminal coronary angioplasty (PTCA as a strategy of reperfusion in acute myocardial infarction (MI. METHODS: A retrospective cohort study based on information abstracted from medical records of MI patients admitted to a hospital where PTCA is used as the prefered method for early myocardial reperfusion. A total of 83 patients, 35 (42% women and 48 (58% men, who met the criteria for early myocardial reperfusion was included in the analysis. RESULTS: The mean age of women was higher than that of men (66±10 vs 58±11 years; p<0.001. The women also had a higher frequency of diabetes mellitus (37.1% vs 6.4%; p<0.001. Despite these differences in age and in the frequency of diabetes mellitus, the percentage of patients in whom the PTCA was considered successful was similar between men (83.3% and women (82.3%. The case-fatality rate was also similar between men and women; 14.6% and 14.3%, respectively. CONCLUSION: The possibility that the excess risk of death in women with MI may be reduced and even eliminated with the use of PTCA, supports to the need for the development of a clinical trial to assess this question.

  2. Hypereosinophilic Syndrome: A Case of Fatal Löffler Endocarditis

    Directory of Open Access Journals (Sweden)

    Mario Enrique Baltazares-Lipp

    2016-01-01

    Full Text Available Hypereosinophilic syndrome (HES is a rare disorder with unknown global prevalence, barely reported in Hispanic population, and characterized by persistent eosinophilia in association with organ dysfunctions directly attributable to eosinophilic infiltration. Cardiac involvement may be present in 50 to 60% of the patients. This is known as Löffler endocarditis. We present a case of a 36-year-old Hispanic man with signs of heart failure. Laboratory studies showed eosinophilia (23,100/μL. Thoracic computer tomography showed bilateral pleural effusion and a large left ventricular mass. Transthoracic echocardiography showed left ventricle apical obliteration and a restrictive pattern. Pulmonary angiography demonstrated a thrombus in the lingular and middle lobe. Despite treatment, the patient deceased seven days after admission. Autopsy confirmed the diagnosis of Löffler endocarditis.

  3. A Case of Fatal Congenital Human Immunodeficiency Virus Infection

    Directory of Open Access Journals (Sweden)

    Halil Uğur Hatipoğlu

    2016-06-01

    Full Text Available Acquired immune deficiency syndrome is a clinical condition caused by human immunodeficiency virus (HIV which can be transmitted either vertically or horizontally. More than 90% of children living with HIV in developing countries have been infected through mother to child transmission during pregnancy, around the time of birth, or through breastfeeding. In order to reduce the number of infected children, increasing emphasis should be placed on preventing mother to child transmission programs with the use of antiretroviral medications in the pregnant woman during pregnancy and at delivery and, starting immediately after birth for the exposed infant. Here, we present the case of a 60-day-old infant heavily immunocompromised due to an extremely high viral burden of HIV, which was acquired perinatally from an undiagnosed and untreated mother, leading to severe bronchopneumonia, sepsis, septic shock and death.

  4. Subacute fatal aluminum encephalopathy after reconstructive otoneurosurgery: a case report.

    Science.gov (United States)

    Reusche, E; Pilz, P; Oberascher, G; Lindner, B; Egensperger, R; Gloeckner, K; Trinka, E; Iglseder, B

    2001-10-01

    We report a 52-year-old woman who underwent otoneurosurgery to resect acoustic neurinoma. Bone reconstruction was performed with an aluminium (Al)-containing cement. Six weeks later the patient suffered from loss of consciousness, myoclonic jerks, and persistent grand mal seizures, clinical symptoms that resembled those of lethal dialysis encephalopathy of the 1960s and 1970s. She died 6 months later because of septic complications. Light- and electron-microscopic investigation of the central nervous system (CNS) showed pathognomonic Al-containing intracytoplasmic argyrophilic inclusions in choroid plexus epithelia, neurons, and cortical glia. These changes are characteristics of dialysis-associated encephalopathy (DAE), induced nowadays by long-term ingestion of Al-containing drugs (and with benign clinical courses). Atomic absorption spectrometry showed an increase of mean bulk Al concentration of the cortex and subcortex up to 9.3 microg/g (normal range <2 microg/g); laser microprobe showed the increase of Al in subcellular structures. This unique case again shows the extraordinary neurotoxicity of Al, which was, in our patient, initiated by an amount of about 30 mg Al and apparently caused by direct Al access to the brain parenchyma via a cerebrospinal fluid leakage. PMID:11679949

  5. Fatal septicemia by multidrug-resistant Enterococcus faecium in a case of exomphalos minor

    Directory of Open Access Journals (Sweden)

    Mahantesh V Parande

    2012-01-01

    Full Text Available Exomphalos minor is one among uncommon disorders of the umbilical region. Here, we report a fatal case of exomphalos minor with enterococcal septicemia. A male baby, born with exomphalos minor, developed clinical features of septicemia on the fourth postnatal day. Blood samples were collected by venepuncture from two sites for culture. Enterococcus faecium was isolated from both the blood samples. The swabs collected from the site of exomphalos also yielded growth of Enterococcus faecium, confirming the source of infection. The antibiogram with Minimum Inhibitory Concentrations (MIC for various antibiotics was done for isolates from all three sites, which was similar. The isolate was resistant to multiple antibiotics with high level aminoglycoside resistance. The baby was treated with antibiotics and other supportive measures. However, the baby succumbed to the septicemia. As per our knowledge, this is the first reported case of fatal septicemia by multidrug-resistant Enterococcus faecium in a case of exomphalos minor.

  6. Significant decline in case fatality after acute myocardial infarction in Denmark--a population-based study from 1994 to 2001

    DEFF Research Database (Denmark)

    Abildstrom, Steen Z; Rasmussen, Søren; Madsen, Mette

    2002-01-01

    OBJECTIVE: We evaluated trends in in-hospital case fatality after acute myocardial infarction (AMI) in Denmark and analysed changes in the hospitalization rate for AMI. DESIGN: National population-based registries were used to identify patients (> or =30 years) who were admitted for their first A...

  7. Pulmonary and central nervous system pathology in fatal cases of hand foot and mouth disease caused by enterovirus A71 infection.

    Science.gov (United States)

    Wang, Zijun; Nicholls, John M; Liu, Fengfeng; Wang, Joshua; Feng, Zijian; Liu, Dongge; Sun, Yanni; Zhou, Cheng; Li, Yunqian; Li, Hai; Qi, Shunxiang; Huang, Xueyong; Sui, Jilin; Liao, Qiaohong; Peiris, Malik; Yu, Hongjie; Wang, Yu

    2016-04-01

    In the past 17 years, neurological disease associated with enterovirus A71 (EV-A71) has increased dramatically in the Asia-Pacific region with a high fatality rate in young infants, often due to pulmonary oedema, however the mechanism of this oedema remains obscure. We analysed the brainstem, heart and lungs of 15 fatal cases of confirmed EV-A71 infection in order to understand the pathophysiological mechanism of death and pulmonary oedema. In keeping with other case studies, the main cause of death was neurogenic pulmonary oedema. In the brainstem, 11 cases showed inflammation and all cases showed parenchymal inflammation with seven cases showing moderate or severe clasmatodendrosis. No viral antigen was detected in sections of the brainstem in any of the cases. All fatal cases showed evidence of pulmonary oedema; however, there was absence of direct pulmonary viral damage or myocarditis-induced damage and EV-A71 viral antigen staining was negative. Though there was no increase in staining for Na/K-ATPase, 11 of the 15 cases showed a marked reduction in aquaporin-4 staining in the lung, and this reduction may contribute to the development of fatal pulmonary oedema. PMID:27020504

  8. Suicidal hanging: fatalities in Istanbul retrospective analysis of 761 autopsy cases.

    Science.gov (United States)

    Uzün, Ibrahim; Büyük, Yalçin; Gürpinar, Kağan

    2007-10-01

    We retrospectively analyzed the autopsy records of the Institute of Forensic Medicine during the five-year period between 1998 and 2002 to document the characteristics of fatalities resulting from hanging which is the commonest mode of suicide in Istanbul. Upon analysis of death scene investigation and autopsy reports together with the information gathered from the police, the cases of hanging fatalities of suicidal origin were selected. Seven hundred sixty one hanging cases of suicidal origin were detected and evaluated in terms of demographic features, the type of hanging material used for ligature, cause of death, internal findings in neck organs, other traumatic findings suggesting the use of another method for suicide, toxicological findings and microscopic findings in delayed death cases. In 364 of these cases suspension was complete and in 397 incomplete. Five hundred thirty seven of those (70.56%) were male and 224 (29.44%) were female. The preponderance of male cases in our autopsy population was also detected in suicidal hanging cases. There was no case aged lower 10 and the number of the cases in the age group of cases aged over 80 was the lowest (n=3, 0.4%). In 634 of cases, the place of hanging was the subject's own house, most victims selected rope (652 cases) for the ligature with the rest using sheet, belt, cable and necktie. There were traumatic findings showing attempts of suicide other than hanging in 24 cases (tentative marks in 22 cases and non-fatal burning in 2). In 23 of cases, there were bruises of different ages. In these cases females constituted the majority suggesting violence against women that is a social problem in various cultural subgroups of our country. This violence may have played a role in the decision of suicide. Superficial bruises were detected in 56 cases and were attributed to the trauma. Fractures in neck organs were detected in 446 of cases. In fracture-determined cases, fracture in hyoid bone was seen in 177, in

  9. Moxifloxacin induced fatal hepatotoxicity in a 72-year-old man: a case report

    OpenAIRE

    Verma, Rajanshu; Dhamija, Radhika; Batts, Donald H.; Stephen C Ross; Loehrke, Mark E

    2009-01-01

    Moxifloxacin is a newer-generation synthetic fluoroquinolone that is used for treatment of acute bacterial sinusitis, acute exacerbation of chronic bronchitis, community acquired pneumonia, intra-abdominal infections and skin/skin structure infections. We describe a case of fatal hepatotoxicity caused by Moxifloxacin in a 72-year-old man. He presented with jaundice and epigastric tenderness that started one week after being treated for acute exacerbation of his chronic bronchitis with Moxiflo...

  10. Mediating punitiveness: understanding public attitudes towards work-related fatality cases

    OpenAIRE

    Almond, Paul James; Colover, Sarah

    2010-01-01

    This paper concerns an empirical investigation into public attitudes towards work-related fatality cases, where organizational offenders cause the death of workers or members of the public. This issue is particularly relevant following the introduction of the Corporate Manslaughter and Corporate Homicide Act 2007 into UK law. Here, as elsewhere, the use of criminal law against companies reflects governmental concerns over public confidence in the law’s ability to regulate risk. The empirical ...

  11. Creutzfeldt-Jakob-like EEG Changes in a Case of Fatal Lithium Toxicity

    OpenAIRE

    YİĞİT, Aytaç; ÇELİK, Tuncay; Canan Togay IŞIKAY

    2011-01-01

    We present a case of fatal lithium toxicity with EEG changes suggesting Creutzfeldt-Jakob disease. A 52-year-old woman was admitted with declined consciousness, fever, and generalized seizures. She had bipolar affective disorder and was on lithium and chlorpromazine treatment for about three decades. Her family described that she had systemic symptoms of lithium toxicity such as anorexia, nausea, vomiting, diarrhea, and insomnia for one month. Neurological examination disclosed declined consc...

  12. Fatal pneumonitis associated with postoperative intensity-modulated radiotherapy in lung cancer: Case report and review

    OpenAIRE

    Hu, Yan; Li, Jingjing; SU, XIAOYAN

    2012-01-01

    Radiation pneumonitis (RP) is the most significant complication of acute treatment-related toxicities in lung cancer. Intensity-modulated radiotherapy (IMRT) with inverse planning enables us to achieve the desired dose distribution. However, there are many high-risk procedures associated with lung irradiation, including chemotherapy and surgery. We report a case of fatal treatment-related pneumonitis, where the patient had undergone postoperative IMRT for lung cancer. Following completion of ...

  13. Fatal herpetic hepatitis in adult following short corticotherapy: a case report.

    Science.gov (United States)

    Seksik, P; Gozlan, J; Guitton, C; Galula, G; Maury, E; Offenstadt, G

    1999-04-01

    Herpes simplex virus hepatitis (HSV hepatitis) is an uncommon and severe complication of HSV type 1 and HSV type 2 infection. HSV hepatitis affects mostly immunocompromised patients. We report the case of a young man without any previous known immunodeficiency who developed fatal HSV hepatitis in the first 8 days of oral corticotherapy given for ulcerative colitis. A prompt diagnosis was possible because HSV was recovered from peripheral blood leukocytes. PMID:10342519

  14. Systemic Lupus Erythematosus Presenting with a Fatal Intestinal Vasculitis: a Case Report

    OpenAIRE

    Nozari, Neda; Divsalar, Parisa

    2014-01-01

    This case report demonstrates fatal gastrointestinal vasculitis as a rare presentation of systemic lupus erythematosus. A 34-year-old woman presented with abdominal pain and diarrhea. Anti nuclear antibody was positive and high titre of anti-ds DNA antibody was also reported. Treatment with corticosteroid and supportive cares were started; however, her condition worsened. Eventually, she was considered as a candidate for diagnostic laparoscopy. Immediately after laparoscopy, she developed res...

  15. Application of permanents of square matrices for DNA identification in multiple-fatality cases

    OpenAIRE

    Narahara, Maiko; Tamaki, Keiji; Yamada, Ryo

    2013-01-01

    Background DNA profiling is essential for individual identification. In forensic medicine, the likelihood ratio (LR) is commonly used to identify individuals. The LR is calculated by comparing two hypotheses for the sample DNA: that the sample DNA is identical or related to a reference DNA, and that it is randomly sampled from a population. For multiple-fatality cases, however, identification should be considered as an assignment problem, and a particular sample and reference pair should ther...

  16. Tuberculosis Case Fatality and Other Causes of Death among Multidrug-Resistant Tuberculosis Patients in a High HIV Prevalence Setting, 2000-2008, South Africa

    OpenAIRE

    Martie van der Walt; Joey Lancaster; Karen Shean

    2016-01-01

    Introduction South Africa has the highest reported rates of multi-drug resistant TB in Africa, typified by poor treatment outcomes, attributable mainly to high default and death rates. Concomitant HIV has become the strongest predictor of death among MDR-TB patients, while anti-retroviral therapy (ART) has dramatically reduced mortality. TB Case fatality rate (CFR) is an indicator that specifically reports on deaths due to TB. Aim The aim of this paper was to investigate causes of death among...

  17. First Reported Case of Fatal Stinging by the Large Carpenter Bee Xylocopa tranquebarica.

    Science.gov (United States)

    Kularatne, Senanayake A M; Raveendran, Sathasivam; Edirisinghe, Jayanthi; Karunaratne, Inoka; Weerakoon, Kosala

    2016-06-01

    In the order Hymenoptera, bees, hornets, and wasps are well-known stinging insects whose envenoming can be fatal. Their stinging attacks are common in rural and forested areas of Sri Lanka. However, fatal stinging by the large-bodied carpenter bees is unreported. We report the first known case of a fatal sting by the large carpenter bee, Xylocopa tranquebarica, in a forested area in Puttalam (North Western Province) in the dry zone of Sri Lanka. A 59-year-old healthy male manual laborer accompanied by a fellow worker had been fixing a fence on a coconut estate bordering a forested area when a flying insect emerged from a dead tree trunk and stung him on his face. His coworker, who was watching the incident, killed the insect. The victim complained of immediate intense pain in the face and collapsed on the ground just after resuming work after 10 minutes of resting. He was found dead on admission to the hospital 90 minutes later. Autopsy showed normal coronary arteries and heart, but the lungs were slightly congested and contained secretions in the bronchi. Acute anaphylaxis was the most likely cause of death. This case presents the habitat, morphology, attack pattern, and the medical importance of large carpenter bees. PMID:27061039

  18. Fatal Cases of Influenza A(H3N2) in Children: Insights from Whole Genome Sequence Analysis

    OpenAIRE

    Monica Galiano; Johnson, Benjamin F.; Richard Myers; Joanna Ellis; Rod Daniels; Maria Zambon

    2012-01-01

    During the Northern Hemisphere winter of 2003-2004 the emergence of a novel influenza antigenic variant, A/Fujian/411/2002-like(H3N2), was associated with an unusually high number of fatalities in children. Seventeen fatal cases in the UK were laboratory confirmed for Fujian/411-like viruses. To look for phylogenetic patterns and genetic markers that might be associated with increased virulence, sequencing and phylogenetic analysis of the whole genomes of 63 viruses isolated from fatal cases ...

  19. A non-fatal case of invasive zygomycete (Lichtheimia corymbifera) infection in an allogeneic haematopoietic cell transplant recipient

    DEFF Research Database (Denmark)

    Eickhardt, Steffen; Braendstrup, Peter; Clasen-Linde, Erik; Jensen, Karl E; Alhede, Morten; Bjarnsholt, Thomas; Høiby, Niels; Vindeløv, Lars; Moser, Claus

    2013-01-01

    Post-transplant infections in allogeneic haematopoietic cell transplant (allo-HCT) recipients often have severe consequences. This is especially the case when dealing with zygomycete infections where the result is often fatal. A major problem when dealing with zygomycete infections is the need for...... an accurate and fast diagnosis as the phylum is highly resistant towards the conventional antifungals. We herein describe a non-fatal case of Lichtheimia corymbifera infection in an allo-HCT recipient....

  20. Impact of a Partial Smoke-Free Legislation on Myocardial Infarction Incidence, Mortality and Case-Fatality in a Population-Based Registry: The REGICOR Study

    OpenAIRE

    Fernando Agüero; Dégano, Irene R.; Isaac Subirana; Maria Grau; Alberto Zamora; Joan Sala; Rafel Ramos; Ricard Treserras; Jaume Marrugat; Roberto Elosua

    2013-01-01

    BACKGROUND AND OBJECTIVE: Coronary heart disease (CHD) is the leading cause of death, and smoking its strongest modifiable risk factor. Our aim was to determine the impact of the Spanish 2006 partial smoke-free legislation on acute myocardial infarction (AMI) incidence, hospitalization and mortality rates, and 28-day case-fatality in Girona, Spain. METHODS: Using a population-based registry (the REGICOR Study), we compared population incidence, hospitalization, and mortality rates, and 28-day...

  1. Micro computed tomography features of laryngeal fractures in a case of fatal manual strangulation.

    Science.gov (United States)

    Fais, Paolo; Giraudo, Chiara; Viero, Alessia; Miotto, Diego; Bortolotti, Federica; Tagliaro, Franco; Montisci, Massimo; Cecchetto, Giovanni

    2016-01-01

    Cases of subtle fatal neck compression are often complicated by the lack of specificity of the post-mortem signs of asphyxia and by the lack of clear signs of neck compression. Herein we present a forensic case of a 45-year-old schizophrenic patient found on the floor of the bedroom of a psychiatric ward in cardiopulmonary arrest and who died after two days in a vegetative state. The deposition of the roommate of the deceased, who claimed responsibility for the killing of the victim by neck compression, was considered unreliable by the prosecutor. Autopsy, toxicological analyses, and multi-slice computed tomography (MSCT), micro computed tomography (micro-CT) and histology of the larynx complex were performed. Particularly, micro-CT analysis of the thyroid cartilage revealed the bilateral presence of ossified triticeous cartilages and the complete fragmentation of the right superior horn of the thyroid, but it additionally demonstrated a fracture on the contralateral superior horns, which was not clearly diagnosable at MSCT. On the basis of the evidence of intracartilaginous laryngeal hemorrhages and bilateral microfracture at the base of the superior horns of the larynx, the death was classified as a case of asphyxia due to manual strangulation. Micro-CT was confirmed as a useful tool in cases of subtle fatal neck compression, for the detection of minute laryngeal cartilage fractures, especially in complex cases with equivocal findings on MSCT. PMID:26832384

  2. Fatal cases of influenza A(H3N2 in children: insights from whole genome sequence analysis.

    Directory of Open Access Journals (Sweden)

    Monica Galiano

    Full Text Available During the Northern Hemisphere winter of 2003-2004 the emergence of a novel influenza antigenic variant, A/Fujian/411/2002-like(H3N2, was associated with an unusually high number of fatalities in children. Seventeen fatal cases in the UK were laboratory confirmed for Fujian/411-like viruses. To look for phylogenetic patterns and genetic markers that might be associated with increased virulence, sequencing and phylogenetic analysis of the whole genomes of 63 viruses isolated from fatal cases and non fatal "control" cases was undertaken. The analysis revealed the circulation of two main genetic groups, I and II, both of which contained viruses from fatal cases. No associated amino acid substitutions could be linked with an exclusive or higher occurrence in fatal cases. The Fujian/411-like viruses in genetic groups I and II completely displaced other A(H3N2 viruses, but they disappeared after 2004. This study shows that two A(H3N2 virus genotypes circulated exclusively during the winter of 2003-2004 in the UK and caused an unusually high number of deaths in children. Host factors related to immune state and differences in genetic background between patients may also play important roles in determining the outcome of an influenza infection.

  3. Review of Dengue hemorrhagic fever fatal cases seen among adults: a retrospective study.

    Directory of Open Access Journals (Sweden)

    Sing-Sin Sam

    Full Text Available BACKGROUND: Dengue is a mosquito-borne viral disease endemic in many countries in the tropics and sub-tropics. The disease affects mainly children, but in recent years it is becoming more of an adult disease. Malaysia experienced a large dengue outbreak in 2006 to 2007, involving mostly adults, with a high number of deaths. METHODOLOGY/PRINCIPAL FINDINGS: We undertook a retrospective study to examine dengue death cases in our hospital from June 2006 to October 2007 with a view to determine if there have been changes in the presentation of severe to fatal dengue. Nine of ten fatal cases involved adult females with a median age of 32 years. All had secondary dengue infection. The mean duration of illness prior to hospitalization was 4.7 days and deaths occurred at an average of 2.4 days post-admission. Gastrointestinal pain, vomiting, diarrhea, intravascular leakages and bleeding occurred in the majority of cases. DSS complicated with severe bleeding, multi-organ failure and coagulopathy were the primary causes of deaths. Seven patients presented with thrombocytopenia and hypoalbuminemia, five of which had hemoconcentration and increased ALT and AST indicative of liver damage. Co-morbidities particularly diabetes mellitus was common in our cohort. Prominent unusual presentations included acute renal failure, acute respiratory distress syndrome, myocarditis with pericarditis, and hemorrhages over the brain and heart. CONCLUSIONS: In our cohort, dengue fatalities are seen primarily in adult females with secondary dengue infection. The majority of the patients presented with common clinical and laboratory warning signs of severe dengue. Underlying co-morbidities may contribute to the rapid clinical deterioration in severe dengue. The uncommon presentations of dengue are likely a reflection of the changing demographics where adults are now more likely to contract dengue in dengue endemic regions.

  4. Quantification of 25C-NBOMe in a fatal poisoning case

    DEFF Research Database (Denmark)

    Andreasen, Mette Findal; Telving, Rasmus; Rosendal, Ingrid;

    2015-01-01

    described in several scientific papers. However, there are few scientific reports of intoxication with the other NBOMe-derivatives. Recently, drugs of the NBOMe class have entered the Scandinavian drug scene, and in the present work, we describe the first death related to the intake of 25C-NBOMe in Denmark....... Since October 2013, this drug has been controlled in Denmark. To the best of our knowledge, the present work reports the first quantification of 25C-NBOMe in biological specimens obtained from a fatal intoxication case. Aims Quantification of 25C-NBOMe. Methods Ultra-performance liquid chromatography...

  5. Fatal Stevens-Johnson syndrome induced by phenytoin: a case report

    Directory of Open Access Journals (Sweden)

    Ritu J. Budania

    2013-12-01

    Full Text Available Toxic epidermal necrolysis (TEN and Stevens-Johnson syndrome (SJS are rare (one to two per 10,00,00 population per year but life threatening adverse drug reactions. Drugs commonly implicated are anti-epileptics, anti-microbials and non-steroidal anti-inflammatory drugs (NSAIDS. Amongst anti-epileptics, carbamazepine and phenytoin are the major culprits. We report here a fatal case of SJS due to phenytoin. [Int J Basic Clin Pharmacol 2013; 2(6.000: 843-845

  6. A Case of Fatal Acute Lung Injury after Balloon Valvuloplasty of Pulmonary Stenosis: Case Report and Review of Literature

    OpenAIRE

    Ostovan Mohammad Ali; Kamali Maliheh; Zolghadrasli Abdolali

    2015-01-01

    A newly described immediate complication after percutaneous pulmonary valvuloplasty is acute lung injury. Here we report a case of fatal acute lung injury after pulmonary valvuloplasty.The patient was a 26-year-old woman, referred to a general hospital with the diagnosis of livercirrhosis. In her work-ups severe pulmonary stenosis was detected and so a decision was madeto relieve the valve stenosis. Despite the procedural success, the patient developed severe dyspneaand desaturation a few hou...

  7. Risk factors associated with hantavirosis fatality: a regional analysis from a case-control study in Brazil

    Directory of Open Access Journals (Sweden)

    Maria Cristina Antunes Willemann

    2014-01-01

    Full Text Available Introduction: In Brazil, hantavirus cardiopulmonary syndrome (HCPS has a high lethality rate that varies by region. This study aimed to identify the risk factors associated with fatal hantavirosis. Methods: This study was a case-control study that included all laboratory confirmed cases of hantavirosis. The cases were stratified by the different Brazilian regions using data from the Notifiable Diseases Information System. “Cases” were patients who progressed to death, whereas “controls” were patients who were cured. The odds ratio (OR and the adjusted OR were calculated. Results: Overall, 158 cases and 281 controls were included in this study. In the Midwest region, the cases were 60% less likely to present with flank pain, and the time between the beginning of symptoms and death was shorter than the time between the beginning of symptoms and a cure. In the Southeast region, the cases were 60% less likely to present with thrombocytopenia or reside in rural areas compared to those who progressed to a cure. Additionally, the cases sought medical assistance, notification and investigation more quickly than the controls. In the Southern region, the cases that died were 70% less likely to be male compared to the controls. Conclusions: HCPS manifests with nonspecific symptoms, and there are few published studies related to the condition, so determining a patient's therapeutic strategy is difficult. This study presents findings from different Brazilian regions and highlights the need for further investigations to improve comprehension about regional risk factors associated with hantavirosis and to reduce morbimortality.

  8. Sporadic fatal insomnia in a young woman: A diagnostic challenge: Case Report

    Directory of Open Access Journals (Sweden)

    Cracco Laura

    2011-10-01

    Full Text Available Abstract Background Sporadic fatal insomnia (sFI and fatal familial insomnia (FFI are rare human prion diseases. Case Presentation We report a case of a 33-year-old female who died of a prion disease for whom the diagnosis of sFI or FFI was not considered clinically. Following death of this patient, an interview with a close family member indicated the patient's illness included a major change in her sleep pattern, corroborating the reported autopsy diagnosis of sFI. Genetic tests identified no prion protein (PrP gene mutation, but neuropathological examination and molecular study showed protease-resistant PrP (PrPres in several brain regions and severe atrophy of the anterior-ventral and medial-dorsal thalamic nuclei similar to that described in FFI. Conclusions In patients with suspected prion disease, a characteristic change in sleep pattern can be an important clinical clue for identifying sFI or FFI; polysomnography (PSG, genetic analysis, and nuclear imaging may aid in diagnosis.

  9. A Bayesian and Classical Econometric Evaluation of the Effect of Cell Phones on Motor Vehicle Fatality Rates

    OpenAIRE

    Richard Fowles; Peter Loeb; William A. Clarke

    2009-01-01

    This paper examines the potential effect of cell phones on motor vehicle fatality rates normalized for other driving related and socioeconomic factors. The model used is nonlinear so as to address both life-taking and life-saving attributes of cell phones. The models are evaluated using classical methods along with Bayesian Extreme Bounds Analysis (EBA). The use of both classical and Bayesian methods diminishes the model and parameter uncertainties which afflict more conventional modeling met...

  10. Pathologic study of a fatal case of dengue-3 virus infection in Rio de Janeiro, Brazil

    Directory of Open Access Journals (Sweden)

    C.A. Basílio-de-Oliveira

    2005-08-01

    Full Text Available Dengue hemorrhagic fever (DHF is a severe febrile disease, characterized by abnormalities in hemostasis and increased vascular permeability, which in some cases results in hypovolemic shock syndrome and in dengue shock syndrome. The clinical features of DHF include plasma leakage, bleeding tendency and liver involvement. We studied the histopathological features of a fatal case of dengue-3 virus infection. The patient, a 63-year old male, presented with an acute onset of severe headache, myalgia and maculopapular rash. Tissue fragments (liver, spleen, lung, heart, kidney and lymph nodes were collected for light microscopy studies and stained by standard methods. Histopathology revealed severe tissue damage, caused by intense hemorrhage, interstitial edema and inflammation. Some tissue sections were also processed with the immunoperoxidase reaction, which revealed the dengue viral antigen. Dengue-3 virus was isolated and identified with electron microscopy in a C6/36 cell culture inoculated with the patient's serum. Viral particles were detected in the infected cell culture.

  11. Application of abbreviated injury scale and injury severity score in fatal cases with abdominopelvic injuries.

    Science.gov (United States)

    Subedi, Nuwadatta; Yadav, Bishwanath; Jha, Shivendra

    2014-12-01

    In forensic casework, investigation of injury severity is important in evaluating the mortality, occasionally in terms of the adequacy of clinical management. The study was conducted with an objective to study the relationship of severity of the injuries using Abbreviated Injury Scale and Injury Severity Score (ISS) with survival period and place of death among fatal cases with abdominopelvic trauma.The total number of cases studied was 80. The injuries in all the body parts were allotted using the Abbreviated Injury Scale 2005, Update 2008, and the ISS was calculated. The male/female ratio was 4:1, and the mean (SD) age was 30.76 (15.2) years. The cause of trauma was road traffic accidents in 82.5% of the cases. The median duration of survival was 2 hours. The mean (SD) ISS was 38.90 (14.89). Abbreviated Injury Scale scores of 5 and 4 were the most common in the region. With increase in the ISS, the survival period was decreased. There was a highly significant difference between the mean ISS of the victims who died prehospital and that of who died in the emergency department (P < 0.005). The mean ISS of the victims who died in the emergency department and of those who died in the ward, intensive care unit, or after discharge was also significantly different (P < 0.05).Although the cases with more severe injuries died sooner, there should be provision of treatment on the spot without delay. More time taken to start the treatment increases the fatalities. PMID:25354224

  12. Acute lyme infection presenting with amyopathic dermatomyositis and rapidly fatal interstitial pulmonary fibrosis: a case report

    Directory of Open Access Journals (Sweden)

    Nguyen Hanh

    2010-06-01

    Full Text Available Abstract Introduction Dermatomyositis has been described in the setting of lyme infection in only nine previous case reports. Although lyme disease is known to induce typical clinical findings that are observed in various collagen vascular diseases, to our knowledge, we believe that our case is the first presentation of acute lyme disease associated with amyopathic dermatomyositis, which was then followed by severe and fatal interstitial pulmonary fibrosis only two months later. Case presentation We present a case of a 64-year-old African-American man with multiple medical problems who was diagnosed with acute lyme infection after presenting with the pathognomonic rash and confirmatory serology. In spite of appropriate antimicrobial therapy for lyme infection, he developed unexpected amyopathic dermatomyositis and then interstitial lung disease. Conclusions This case illustrates a potential for lyme disease to produce clinical syndromes that may be indistinguishable from primary connective tissue diseases. An atypical and sequential presentation (dermatomyositis and interstitial lung disease of a common disease (lyme infection is discussed. This case illustrates that in patients who are diagnosed with lyme infection who subsequently develop atypical muscular, respiratory or other systemic complaints, the possibility of severe rheumatological and pulmonary complications should be considered.

  13. The Impact of Cell Phones and BAC Laws on Motor Vehicle Fatality Rates

    OpenAIRE

    Peter D. Loeb; William A. Clarke; Richard Anderson

    2007-01-01

    This paper develops a set of models for the determinants of automobile fatalities with particular attention devoted to the effects of increased cell phone usage. Cell phones have been associated with both life-taking and life-saving properties. However, prior statistical evaluations of the effects of cell phones have led to fragile results. We develop in this paper econometric models using time series data, allowing for polynomial structures of the regressors. The models are evaluated with a ...

  14. Trends and inequalities in short-term acute myocardial infarction case fatality in Scotland, 1988-2004

    Directory of Open Access Journals (Sweden)

    Leyland Alastair H

    2010-12-01

    Full Text Available Abstract Background There have been substantial declines in ischemic heart disease in Scotland, partly due to decreases in acute myocardial infarction (AMI incidence and case fatality (CF. Despite this, Scotland's IHD mortality rates are among the worst in Europe. We examine trends in socioeconomic inequalities in short-term CF after a first AMI event and their associations with age, sex, and geography. Methods We used linked hospital discharge and death records covering the Scottish population (5.1 million. Between 1988 and 2004, 178,781 of 372,349 patients with a first AMI died on the day of the event (Day0 CF and 34,198 died within 28 days after surviving the day of their AMI (Day1-27 CF. Results Age-standardized Day0 CF at 30+ years decreased from 51% in 1988-90 to 41% in 2003-04. Day1-27 CF decreased from 29% to 18% over that period. Socioeconomic inequalities in Day0 CF existed for both sexes and persisted over time. The odds of case fatality for men aged 30-59 living in the most deprived areas in 2000-04 were 1.7 (95%CI: 1.3-2.2 times as high as in the least deprived areas and 1.9 (1.1-3.2 times as high for women. There was little evidence of socioeconomic inequality in Day1-27 CF in men or women. After adjustment for socioeconomic deprivation, significant geographic variation still remained for both CF definitions. Conclusions A high proportion of AMI incidents in Scotland result in death on the day of the first event; many of these are sudden cardiac deaths. Short-term CF has improved, perhaps reflecting treatment advances and reductions in first AMI severity. However, persistent socioeconomic and geographic inequalities suggest these improvements are not uniform across all population groups, emphasizing the need for population-wide primary prevention.

  15. Clinical and histopathological features of fatal cases with dengue and chikungunya virus co-infection in Colombia, 2014 to 2015.

    Science.gov (United States)

    Mercado, Marcela; Acosta-Reyes, Jorge; Parra, Edgar; Pardo, Lissethe; Rico, Angélica; Campo, Alfonso; Navarro, Edgar; Viasus, Diego

    2016-06-01

    We report clinical features and histopathological findings in fatal cases with dengue (DENV) and chikungunya (CHIKV) co-infection identified at the Colombian National Institute of Health between September 2014 and October 2015. Seven such cases were documented. Dengue serotype 2 virus was identified in six cases. All patients were adults and comorbidities were present in four. Fever, arthralgia or myalgia was present in all cases. The frequency of rash, haemorrhage, oedema, and gastrointestinal symptoms was variable. Laboratory findings such as thrombocytopenia, renal failure, and leukocyte count were also inconsistent between cases. Post-mortem tissue examination documented focal hepatocellular coagulative necrosis in three cases, incipient acute pericarditis in one and tubulointerstitial nephritis in one. This study provides evidence of mortality in patients with DENV and CHIKV co-infection. Fatal cases were characterised by variable clinical and laboratory features. Evaluation of histopathology of autopsy tissues provided evidence of the pathological consequences of the disease. PMID:27277216

  16. A case of Creutzfeldt-Jakob disease: diagnostic dilemmas of a rapidly fatal disease.

    Science.gov (United States)

    M Baig, Mirza; Phillips, Martin

    2013-10-01

    Creutzfeldt-Jakob disease (CJD) is a rapidly progressive and ultimately fatal disorder of the central nervous system. It occurs worldwide with an incidence of 0.5-1 new case per million population per year. No specific treatment is available and management is limited to supportive care. Autopsy or biopsy provides a definitive diagnosis. Because of the transmissible nature of the disease and hesitancy of patients/family members to give consent for biopsy, numerous challenges in confirming the clinical diagnosis are faced by healthcare professionals. We report a case of 66-year-old male who was hospitalized due to hip fracture following a fall. Acute mental status changes followed the surgical fixation of hip fracture which triggered neurologic work up. This finally revealed suspicion and confirmation of CJD. Patient had progressive cognitive decline with akinetic mutism during further hospital stay and was later discharged home with hospice. Shorter thereafter he died at home. This case demonstrates the importance of keeping an open mind towards possibility of CJD when faced with esoteric neurologic presentations. Also this case provides insight into challenges in quarantine and sterilization of surgical instruments when these patients go through major surgeries. PMID:24470960

  17. Unusual Fatal Effect of Radioiodine (I-131) Therapy : A Case Report

    International Nuclear Information System (INIS)

    The aim of radioiodine therapy following surgery for thyroid carcinoma is to ablate the remnant thyroid tissue in the neck by delivering a minimum dose of 300 gray to the residual thyroid tissue. Side-effects are usually minimal and transient, and use of rhTSH can reduce their incidence. In patients with functioning metastases, successive doses of radio iodine are administered until complete ablation of metastatic disease is achieved. A 54-year-old woman with diffuse pulmonary metastases from thyroid cancer died from a fatal sudden alveolar haemorrhage that occurred 3 weeks after radioiodine therapy. Post mortem biopsy of specimens taken from the sites of pulmonary metastasis revealed massive haemorrhage and apoptosis. It is known that in vitro, beta-irradiation can activate apoptosis pathways. This effect seems to depend on dose of radioiodine and time point. In humans, I-131 therapy can induce apoptosis in hyper-functioning thyroid tissue. This effect is dependent on iodine concentration which is dependent on NIS expression itself. A sudden wave of apoptosis occurring 3 weeks after radioiodine dose could be lethal. On the other hand in order to have favourable treatment response it is essential to have high I-131 uptake by pulmonary metastases. Although fatal effect of radioiodine therapy are rare, this particular case suggests that a high level of I-131 concentration in critical organs detected by post-therapy whole-body scan (WBS) should be an indication for imposing particular care in the management of such patients, and perhaps consideration for prolonged hospitalization and late discharge. (author)

  18. Wind energy development: methods to assess bird and bat fatality rates post-construction

    Science.gov (United States)

    Huso, Manuela; Dalthorp, Daniel; Miller, T J; Bruns, Dawn

    2016-01-01

    Monitoring fatalities at wind energy facilities after they have been constructed can provide valuable information regarding impacts of wind power development on wildlife. The objective of this monitoring is to estimate abundance of a super-population of carcasses that entered the area within a designated period of time. By definition, the population is not closed and carcasses can enter as they are killed through collision with turbines, and leave as they are removed by scavengers or decompose to a point where they are not recognizable. In addition, the population is not inherently mobile, but can only change location through some external force. A focus on number of animal carcasses comprising the super-population, combined with peculiar traits that resist classic assumptions, distinguish fatality estimation at wind-power facilities from more classic abundance estimates that can be addressed through mark-recapture techniques or other well-known abundance estimators. We review the available methods to estimate the super-population of carcasses at wind power facilities. We discuss the role of these estimates in determining appropriate levels of minimization and mitigation of impacts to individual species of concern. We discuss the potential to extrapolate these measurements to reflect the cumulative effect of the industry on individual species. Finally, we suggest avenues of research needed to strengthen our understanding of the effect wind power development has, and might have in the future, on wildlife on this continent and worldwide.

  19. Fatal echinococcosis in three lemurs in the United Kingdom--A case series.

    Science.gov (United States)

    Denk, Daniela; Boufana, Belgees; Masters, Nicholas J; Stidworthy, Mark F

    2016-03-15

    Tapeworms of the genus Echinococcus reside in the small intestine of a number of carnivorous species, predominantly canids. In enzootic areas, hydatidosis caused by taeniid metacestodes can present a significant problem in accidental intermediate hosts, including humans. Whereas the United Kingdom is currently considered free of Echinococcus multilocularis, Echinococcus granulosus sensu stricto (s.s.) and Echinococcus equinus are endemic in the UK and have been reported in a variety of captive mammals. The presentation of echinoccocosis in non-human primates widely parallels disease in humans, and public health concerns are related to the four genera, E. granulosus, E. multilocularis, Echinococcus vogeli and Echinococcus oligarthrus. In contrast, sporadic outbreaks and individual hydatid disease cases in non-human primates have been associated with several Echinococcus and Taenia species. Here we describe three fatal cases of cystic echinococcosis in two captive ring-tailed lemurs (Lemur catta) and one captive red-ruffed lemur (Varecia variegata rubra) and provide molecular tapeworm characterisation. To the best of the authors' knowledge, this includes the first report of Echinococcus ortleppi in a UK born ring-tailed lemur and provides the first in depth case reports of echinococcosis due to E. equinus in UK born ring-tailed and red ruffed lemurs with detailed clinical and pathological findings. The cestode life cycle and implications for zoo collections are discussed. PMID:26872922

  20. Chapare virus, a newly discovered arenavirus isolated from a fatal hemorrhagic fever case in Bolivia.

    Directory of Open Access Journals (Sweden)

    Simon Delgado

    2008-04-01

    Full Text Available A small focus of hemorrhagic fever (HF cases occurred near Cochabamba, Bolivia, in December 2003 and January 2004. Specimens were available from only one fatal case, which had a clinical course that included fever, headache, arthralgia, myalgia, and vomiting with subsequent deterioration and multiple hemorrhagic signs. A non-cytopathic virus was isolated from two of the patient serum samples, and identified as an arenavirus by IFA staining with a rabbit polyvalent antiserum raised against South American arenaviruses known to be associated with HF (Guanarito, Machupo, and Sabiá. RT-PCR analysis and subsequent analysis of the complete virus S and L RNA segment sequences identified the virus as a member of the New World Clade B arenaviruses, which includes all the pathogenic South American arenaviruses. The virus was shown to be most closely related to Sabiá virus, but with 26% and 30% nucleotide difference in the S and L segments, and 26%, 28%, 15% and 22% amino acid differences for the L, Z, N, and GP proteins, respectively, indicating the virus represents a newly discovered arenavirus, for which we propose the name Chapare virus. In conclusion, two different arenaviruses, Machupo and Chapare, can be associated with severe HF cases in Bolivia.

  1. Unexpected Fatal Hypernatremia after Successful Cardiopulmonary Resuscitation with Therapeutic Hypothermia: A Case Report

    OpenAIRE

    Choi, Sang-Sik; Kim, Won Young; Kim, Won; Lim, Kyung-Su

    2012-01-01

    Central diabetes insipidus (DI), characterized by unexpected fatal hypernatremia, is a rare complication after successful cardiopulmonary resuscitation with therapeutic hypothermia, but may be potentially fatal if recognition is delayed. We describe here a patient who experienced cardiac arrest due to a pulmonary embolism, followed by successful resuscitation after induction of therapeutic hypothermia. The patient, however, suddenly developed unexpected hypernatremia with increased urine outp...

  2. Socio-economic position and time trends in invasive management and case fatality after acute myocardial infarction in Denmark

    DEFF Research Database (Denmark)

    Mårtensson, Solvej; Gyrd-Hansen, Dorte; Prescott, Eva;

    2016-01-01

    BACKGROUND: Lower case fatality and increased use of evidence-based invasive management incl. coronary angiography (CAG) have been reported for patients admitted with acute myocardial infarction (AMI) in the last 25 years. This article seeks to investigate whether these advances have benefitted...

  3. First Fatal Oseltamivir-Resistant 2009 Pandemic Influenza A (H1N1) Case in an Adult in Korea

    OpenAIRE

    Hong, Seung-Dok; Park, Seong-Hwan; Kang, Seung-Ji; Kwon, Yong Soo; Kee, Seung-Jung; Park, Kyung-Hwa; Jung, Sook-In; Jang, Hee-Chang

    2011-01-01

    It has been suggested that oseltamivir-resistant influenza viruses harboring the H274/275Y mutation are less virulent than are those that are oseltamivir-sensitive, and fatality attributed to infection with an oseltamivir-resistant virus is very rare. Here we report the first fatal adult case of oseltamivir-resistant 2009 pandemic influenza A (H1N1) in Korea. A 60-year-old Korean male who had hypertension, diabetes mellitus, chronic kidney disease, and dilated cardiomyopathy visited Chonnam N...

  4. Severe malaria - a case of fatal Plasmodium knowlesi infection with post-mortem findings: a case report

    Directory of Open Access Journals (Sweden)

    Adem Patricia

    2010-01-01

    Full Text Available Abstract Background Zoonotic malaria caused by Plasmodium knowlesi is an important, but newly recognized, human pathogen. For the first time, post-mortem findings from a fatal case of knowlesi malaria are reported here. Case presentation A formerly healthy 40 year-old male became symptomatic 10 days after spending time in the jungle of North Borneo. Four days later, he presented to hospital in a state of collapse and died within two hours. He was hyponatraemic and had elevated blood urea, potassium, lactate dehydrogenase and amino transferase values; he was also thrombocytopenic and eosinophilic. Dengue haemorrhagic shock was suspected and a post-mortem examination performed. Investigations for dengue virus were negative. Blood for malaria parasites indicated hyperparasitaemia and single species P. knowlesi infection was confirmed by nested-PCR. Macroscopic pathology of the brain and endocardium showed multiple petechial haemorrhages, the liver and spleen were enlarged and lungs had features consistent with ARDS. Microscopic pathology showed sequestration of pigmented parasitized red blood cells in the vessels of the cerebrum, cerebellum, heart and kidney without evidence of chronic inflammatory reaction in the brain or any other organ examined. Brain sections were negative for intracellular adhesion molecule-1. The spleen and liver had abundant pigment containing macrophages and parasitized red blood cells. The kidney had evidence of acute tubular necrosis and endothelial cells in heart sections were prominent. Conclusions The overall picture in this case was one of systemic malaria infection that fit the WHO classification for severe malaria. Post-mortem findings in this case were unexpectedly similar to those that define fatal falciparum malaria, including cerebral pathology. There were important differences including the absence of coma despite petechial haemorrhages and parasite sequestration in the brain. These results suggest that further

  5. A fatal case of severe serotonin syndrome accompanied by moclobemide and paroxetine overdose

    Directory of Open Access Journals (Sweden)

    Sener Serkan

    2005-01-01

    Full Text Available Aim: To present a fatal case of serotonin syndrome accompanied by moclobemide and paroxetine overdose. Case presentation: A 34-year-old married woman was presented following intentional ingestion of 3.5 g moclobemide and 2.6 g paroxetine. She was drowsy, agitated, and having rigor. In 1 h she developed myoclonus and diffuse muscle rigidity prominent in lower extremities. All laboratory tests were unremarkable except hyperglycemia (160 mg/dl, sinus tachycardia (103/min, and metabolic acidosis (7.051 pH, 52 mmHg pO2, 74.7 mmHg pCO2, 15% HCO3, 77% SaO2. Despite oxygen supplementation, her respiratory acidosis got worse and the SaO2 concentration decreased to 72%. Endotracheal intubation and paralysis were decided to control muscle hyperactivity followed by hyperthermia (max. 42.3°C unresponsive to benzodiazepine. Even aggressive supportive treatment (mechanical ventilation, buffer replacement, cyproheptadine, and dantrolene were applied, the patient could not recover and suffered cardiopulmonary arrest 20 h after presentation. Conclusion: Physicians working in the emergency departments and intensive care units, managing patients presenting with acute ingestion of selective serotonin reuptake inhibitors combined with monoamine oxidase inhibitors, should be aware of recognizing and treating serotonin stndrome. This is because many of these patients may require intensive care monitoring as well as tracheal intubation and ventilatory support.

  6. Four cases of fatal toxoplasmosis in three species of endemic New Zealand birds.

    Science.gov (United States)

    Howe, Laryssa; Hunter, Stuart; Burrows, Elizabeth; Roe, Wendi

    2014-03-01

    Four cases of fatal toxoplasmosis in three endemic New Zealand avian species are reported. Between 2009 and 2012, two kereru (Hemiphaga novaeseelandiae), one North Island brown kiwi (Apteryx mantelli), and one North Island kaka (Nestor meridionalis) were submitted for necropsy examination. On gross postmortem, the kiwi had marked hepatosplenomegaly while the kaka and two kereru had swollen, slightly firm, deep-red lungs. Histologically there was extensive hepatocellular necrosis in the liver of the kiwi while the kaka and kereru showed severe fibrinous bronchointerstitial pneumonia. In the kiwi, protozoal organisms were present within both hepatocytes and Kupffer cells of the liver and within the epithelial cells and macrophages of the interstitium of the lungs in the kaka and two kereru. The diagnosis of toxoplasmosis was confirmed with immunohistochemistry and PCR of paraffin-embedded formalin-fixed tissue of the liver, lungs, or both. Genotyping of up to seven markers revealed that an atypical Type II isolate of Toxoplasma gondii was present in at least three of the cases. This study provides evidence that T. gondii can cause mortality in these endemic species and suggests further research is needed to determine the full extent of morbidity and mortality caused by this parasite in New Zealand's unique avifauna. PMID:24758132

  7. A fatal case of DRESS induced by strontium ranelate associated with HHV-7 reactivation.

    Science.gov (United States)

    Drago, F; Cogorno, L; Broccolo, F; Ciccarese, G; Parodi, A

    2016-03-01

    We report the first case of drug rash with eosinophilia and systemic symptoms (DRESS) following strontium ranelate (SR) treatment associated with systemic human HHV-7 reactivation. DRESS syndrome is a severe adverse drug-induced reaction presenting as a diffuse maculopapular skin rash with fever, hematological abnormalities (leukocytosis, eosinophilia, and/or atypical lymphocytosis), and multiorgan involvement. In our patient, diagnosis of DRESS was confirmed by the presence of six of the seven diagnostic criteria established in 2006 by the Japanese Research Committee on Severe Cutaneous Adverse Drug Reaction: maculopapular skin rash developing at least 3 weeks after starting therapy with a limited number of drugs, prolonged clinical symptoms after discontinuation of the causative drug, lymphadenopathy, fever, leukocyte abnormalities, and liver abnormalities. The diagnostic criteria of human herpesvirus (HHV)-6 reactivation have not been fulfilled in our patient, but a HHV-7 active infection was demonstrated by the presence of HHV-7 DNA and IgM in the patient's serum. In fact, in some DRESS instances, reactivation of HHVs other than HHV-6 may be detected, including HHV-7, Epstein-Barr virus (EBV), and cytomegalovirus (CMV). Our case underlines that not only HHV-6 but also HHV-7 systemic reactivation may be associated with a more severe and even fatal course of this syndrome. PMID:26519419

  8. Impact of a partial smoke-free legislation on myocardial infarction incidence, mortality and case-fatality in a population-based registry: the REGICOR Study.

    Directory of Open Access Journals (Sweden)

    Fernando Agüero

    Full Text Available BACKGROUND AND OBJECTIVE: Coronary heart disease (CHD is the leading cause of death, and smoking its strongest modifiable risk factor. Our aim was to determine the impact of the Spanish 2006 partial smoke-free legislation on acute myocardial infarction (AMI incidence, hospitalization and mortality rates, and 28-day case-fatality in Girona, Spain. METHODS: Using a population-based registry (the REGICOR Study, we compared population incidence, hospitalization, and mortality rates, and 28-day case-fatality in the pre- and post-ban periods (2002-2005 and 2006-2008, respectively by binomial regression analysis adjusted for confounding factors. We also analyzed the ban's impact on the outcomes of interest using the AMI definitions of the American Heart Association (AHA/European Society of Cardiology (ESC and the World Health Organization (WHO-Monitoring trends and determinants in cardiovascular diseases (MONICA. RESULTS: In the post-ban period, AMI incidence and mortality rates significantly decreased (relative risk [RR] = 0.89; 95% confidence interval [CI] = 0.81-0.97 and RR = 0.82; 95% CI = 0.71-0.94, respectively. Incidence and mortality rates decreased in both sexes, especially in women, and in people aged 65-74 years. Former and non-smokers (passive smokers showed diminished incidence rates. Implementation of the ban was not associated with AMI case-fatality. Models tended to be more significant with the WHO-MONICA than with the AHA/ESC definition. CONCLUSIONS: The 2006 Spanish partial smoke-free legislation was associated with a decrease in population AMI incidence and mortality, particularly in women, in people aged 65-74 years, and in passive smokers. These results clarify the association between AMI mortality and the enactment of a partial smoke-free legislation and reinforce the effectiveness of smoking regulations in preventing CHD.

  9. Clinicopathologic, Immunohistochemical, and Ultrastructural Findings of a Fatal Case of Middle East Respiratory Syndrome Coronavirus Infection in the United Arab Emirates, April 2014.

    Science.gov (United States)

    Ng, Dianna L; Al Hosani, Farida; Keating, M Kelly; Gerber, Susan I; Jones, Tara L; Metcalfe, Maureen G; Tong, Suxiang; Tao, Ying; Alami, Negar N; Haynes, Lia M; Mutei, Mowafaq Ali; Abdel-Wareth, Laila; Uyeki, Timothy M; Swerdlow, David L; Barakat, Maha; Zaki, Sherif R

    2016-03-01

    Middle East respiratory syndrome coronavirus (MERS-CoV) infection causes an acute respiratory illness and is associated with a high case fatality rate; however, the pathogenesis of severe and fatal MERS-CoV infection is unknown. We describe the histopathologic, immunohistochemical, and ultrastructural findings from the first autopsy performed on a fatal case of MERS-CoV in the world, which was related to a hospital outbreak in the United Arab Emirates in April 2014. The main histopathologic finding in the lungs was diffuse alveolar damage. Evidence of chronic disease, including severe peripheral vascular disease, patchy cardiac fibrosis, and hepatic steatosis, was noted in the other organs. Double staining immunoassays that used anti-MERS-CoV antibodies paired with immunohistochemistry for cytokeratin and surfactant identified pneumocytes and epithelial syncytial cells as important targets of MERS-CoV antigen; double immunostaining with dipeptidyl peptidase 4 showed colocalization in scattered pneumocytes and syncytial cells. No evidence of extrapulmonary MERS-CoV antigens were detected, including the kidney. These results provide critical insights into the pathogenesis of MERS-CoV in humans. PMID:26857507

  10. Early age of onset in fatal familial insomnia. Two novel cases and review of the literature.

    Science.gov (United States)

    Harder, A; Gregor, A; Wirth, T; Kreuz, F; Schulz-Schaeffer, W J; Windl, O; Plotkin, M; Amthauer, H; Neukirch, K; Kretzschmar, H A; Kuhlmann, T; Braas, R; Hahne, H H; Jendroska, K

    2004-06-01

    Fatal familial insomnia (FFI) is a prion disease exhibiting the PRNP D178N/129M genotype. Features of this autosomal dominant illness are progressive insomnia, dysautonomia, myoclonus, cognitive decline and motor signs associated with thalamic nerve cell loss and gliosis. In contrast to the new variant of Creutzfeldt-Jakob disease (vCJD) the onset of FFI is in middle to late adulthood. We report two male patients who belong to a large German FFI kindred. They were examined clinically, and postmortem neuropathological examination was carried out in collaboration with the German reference centre for prion disease. Additionally, the prion protein gene (PRNP) was analysed. To identify further patients with disease onset under 30 years of age a comprehensive literature review was carried out. Two male patients presented with typical symptoms of FFI at the age of 23 and 24 years. In their kindred, the age of onset has never before been under 44 years of age. Our literature review identified five additional early onset cases who died at age 21 to 25 years. In all 22 reviewed FFI families the median manifestation age was 49.5 years. Although phenotypic variability of FFI is common, age of onset under 30 years has been considered to be a hallmark of vCJD with a mean manifestation at 27 years of age. Our findings underline that in addition to vCJD, FFI must be considered in cases of young-onset prion disease. This has considerable impact on clinical management and genetic counselling. PMID:15311348

  11. Toxicity of tetramethylammonium hydroxide: review of two fatal cases of dermal exposure and development of an animal model.

    Science.gov (United States)

    Lee, Chung-Hsun; Wang, Chao-Ling; Lin, Hsiu-Fen; Chai, Chee-Yin; Hong, Ming-Yuan; Ho, Chi-Kung

    2011-07-01

    To document two cases of patients who were fatally exposed to tetramethylammonium hydroxide (TMAH) on the skin and to establish a rat model to investigate the effects of dermal exposure to TMAH. The charts of two workers who died from occupational accidental exposure to TMAH were reviewed. The 4-hour lethal dose (LD₅₀) of TMAH was determined by applying solutions mimicking the two most common industrially used concentrations (2.38% and 25%) of TMAH to the skin of Sprague-Dawley rats. Exposure of the rat's skin to 2.38% or 25% TMAH generated LD₅₀ values of 85.9 mg/kg and 28.7 mg/kg, respectively. Application of either concentration of TMAH to the skin produced a rapid, significant increase in the rate of respiration. The serum concentrations of tetramethylammonium (TMA) also changed significantly with time of exposure to both concentrations of TMAH. The level of blood urea nitrogen decreased significantly in rats exposed to the 2.38% TMAH, and rats exposed to the 25% solution had a significant decrease in the serum concentration of sodium. Injection of atropine after 5 minutes of exposure did not significantly overcome any of the toxic effects observed with either solution of TMAH. The preliminary results in the rat model indicated that the lethality of TMAH cannot be fully explained by the severity of the patients' chemical burns, and the physiologic effects on respiratory and kidney functions were probably involved. PMID:21310775

  12. Scorpionism in Ecuador: First report of severe and fatal envenoming cases from northern Manabí by Tityus asthenes Pocock.

    Science.gov (United States)

    Borges, Adolfo; Morales, Melva; Loor, Wilmer; Delgado, Miguel

    2015-10-01

    The presence in rural areas of western Ecuador of scorpions in the genus Tityus capable of producing pediatric mortality is hereby evidenced. The medical significance of scorpions in Ecuador has been underestimated partly because of the clinically unimportant stings delivered by Centruroides margaritatus and Teuthraustes atramentarius, which have venom with low toxicity to vertebrates. Five intra-domiciliary cases of scorpion envenoming in victims aged between 1.9 and 16 years old, including one fatality, are reported from rural settings in forest areas of Chone (n = 2) and Flavio Alfaro (n = 3) counties, northern Manabí province, western Ecuador. Three cases were graded as Class II (moderate) and two in Class III (severe) envenoming. Manifestations showed characteristic autonomic nervous system hyper-stimulation and the fatality (a 1.9-year-old boy from Flavio Alfaro) was due to cardio-respiratory failure. Marked leukocytosis in four of the cases (21,800-31,800 cells/mm(3)), with notable neutrophilia (58-82%), suggests induction of a venom-mediated systemic inflammatory response-like syndrome. Specimens responsible for cases in Flavio Alfaro County, including the fatality, were classified as Tityus asthenes Pocock, accountable for severe scorpionism in Colombia. These findings demand implementation of control and therapeutic measures in affected areas in Ecuador, including evaluation of available scorpion antivenoms. PMID:26344916

  13. An Acute Butyr-Fentanyl Fatality: A Case Report with Postmortem Concentrations.

    Science.gov (United States)

    McIntyre, Iain M; Trochta, Amber; Gary, Ray D; Wright, Jennifer; Mena, Othon

    2016-03-01

    In this case report, we present an evaluation of the distribution of postmortem concentrations of butyr-fentanyl in a fatality attributed principally to the drug. A man who had a history of intravenous drug abuse was found unresponsive on the bathroom floor of his home. Drug paraphernalia was located on the bathroom counter. Toxicology testing, which initially screened positive for fentanyl by enzyme-linked immunosorbent assay, subsequently confirmed butyr-fentanyl, which was then quantitated by gas chromatography-mass spectrometry-specific ion monitoring (GC-MS SIM) analysis following liquid-liquid extraction. The butyr-fentanyl peripheral blood concentration was quantitated at 58 ng/mL compared with the central blood concentration of 97 ng/mL. The liver concentration was 320 ng/g, the vitreous was 40 ng/mL, the urine was 670 ng/mL and the gastric contained 170 mg. Acetyl-fentanyl was also detected in all biological specimens tested. Peripheral blood concentration was quantitated at 38 ng/mL compared with the central blood concentration of 32 ng/mL. The liver concentration was 110 ng/g, the vitreous was 38 ng/mL, the urine was 540 ng/mL and the gastric contained <70 mg. The only other drug detected was a relatively low concentration of benzoylecgonine. The cause of death was certified as acute butyr-fentanyl, acetyl-fentanyl and cocaine intoxication, and the manner of death was certified as accident. PMID:26683128

  14. Fatal child abuse: a study of 13 cases of continuous abuse.

    Science.gov (United States)

    Kauppi, Anne Leena Marika; Vanamo, Tuija; Karkola, Kari; Merikanto, Juhani

    2012-07-26

    A parent who continuously physically abuses her/his child doesn't aim to kill the child but commits an accidental filicide in a more violent outburst of anger. Fatal abuse deaths are prevented by recognition of signs of battering in time. Out of 200 examined intra-familial filicides, 23 (12%) were caused by child battering and 13 (7%) by continuous battering. The medical and court records of the victim and the perpetrator were examined. The perpetrator was the biological mother and the victim was male in 69 per cent of the cases. The abused children were either younger than one year or from two-and-a-half to four years old. Risk factors of the victim (being unwanted, premature birth, separation from the parent caused by hospitalization or custodial care, being ill and crying a lot) and the perpetrator (personality disorder, low socioeconomic status, chaotic family conditions, domestic violence, isolation, alcohol abuse) were common. The injuries caused by previous battering were mostly soft tissue injuries in head and limbs and head traumas and the battering lasted for days or even an year. The final assault was more violent and occurred when the parent was more anxious, frustrated or left alone with the child. The perpetrating parent was diagnosed as having a personality disorder (borderline, narcissistic or dependent) and often substance dependence (31%). None of them were psychotic. Authorities and community members should pay attention to the change in child's behavior and inexplicable injuries or absence from daycare. Furthermore if the parent is immature, alcohol dependent, have a personality disorder and is unable to cope with the demands the small child entails in the parent's life, the child may be in danger. PMID:25478105

  15. [Fatal head injury caused by a crossbow arrow with unusually preserved posttraumatic volitional activity - case report].

    Science.gov (United States)

    Řehulka, Hynek; Čechová, Eva; Mottlová, Jitka; Valenta, Martin; Mareška, Zdeněk

    2016-01-01

    The authors deal with a case of suicidal attempt resulting in a fatal head injury. A young man shot himself with a serially produced mechanical sports crossbow. The young man with a critical intracranial injury, a penetration, was nevertheless capable of basic locomotive activity, as well as of coherent communication with another people present at the scene. The critically injured patient was transported from the scene directly to medical centre where he subsequently underwent a neurologic surgery. On the eight day after the incident he died in the hospital as a result of sustained wounds. During the autopsy, a penetrating arrow-shot wound head injury was certified, occurring in the right and left temple area. Signs of a complex decompressive craniectomy were established too. The shooting channel was generally horizontally oriented, extending from the right to the left side, from behind in a 10 up to 15 degrees angle to the frontal plane, penetrating the brain from the right temple lobe and the frontal lobe, thereby pervading also frontal horns of lateral ventricles, and from the left afflicting the frontal lobe on the left side of the brain. In the course of the shooting channel, brain contusion occurred, accompanied by intraventricular haemorrhage. In addition, a heavy cerebral oedema, multiple secondary malacias, Durett haemorrhages and extensive thrombosis of cerebral sinuses were stated. In the course of police investigation, based mainly on the information given by the wounded man right after he had been found at the scene, it was revealed that another person might have been involved. The forensic autopsy, the investigation of the Police and the subsequent criminalist-ballistics expert investigation, supported by a series of experimental substitutive target shots, didnt, however, decidedly prove that any other culprit had been involved. PMID:27108656

  16. Fatal child abuse: a study of 13 cases of continuous abuse

    Directory of Open Access Journals (Sweden)

    Juhani Merikanto

    2012-01-01

    Full Text Available A parent who continuously physically abuses her/his child doesn’t aim to kill the child but commits an accidental filicide in a more violent outburst of anger. Fatal abuse deaths are prevented by recognition of signs of battering in time. Out of 200 examined intra-familial filicides, 23 (12% were caused by child battering and 13 (7% by continuous battering. The medical and court records of the victim and the perpetrator were examined. The perpetrator was the biological mother and the victim was male in 69 per cent of the cases. The abused children were either younger than one year or from two-and-a-half to four years old. Risk factors of the victim (being unwanted, premature birth, separation from the parent caused by hospitalization or custodial care, being ill and crying a lot and the perpetrator (personality disorder, low socioeconomic status, chaotic family conditions, domestic violence, isolation, alcohol abuse were common. The injuries caused by previous battering were mostly soft tissue injuries in head and limbs and head traumas and the battering lasted for days or even an year. The final assault was more violent and occurred when the parent was more anxious, frustrated or left alone with the child. The perpetrating parent was diagnosed as having a personality disorder (borderline, narcissistic or dependent and often substance dependence (31%. None of them were psychotic. Authorities and community members should pay attention to the change in child’s behavior and inexplicable injuries or absence from daycare. Furthermore if the parent is immature, alcohol dependent, have a personality disorder and is unable to cope with the demands the small child entails in the parent’s life, the child may be in danger.

  17. Clinical, histopathological and genetic studies in a case of fatal familial insomnia with review of the literature

    OpenAIRE

    Peng, Bin; Zhang, Shenqi; Dong, Hongjuan; Lu, Zuneng

    2015-01-01

    To explore clinical, histopathological and genetic features of a case with fatal familial insomnia (FFI) and review the related literatures. A middle-aged woman who complained of “insomnia for 9 months and psychosis for 3 months” was suspicious of FFI. The clinical features of the patient were analyzed, and the dead patient was examined by autopsy and the brain tissues were obtained for histopathological studies, and the blood samples from the patient and some of her familial members were col...

  18. Midbrain Hypometabolism in Fatal Familial Insomnia: A Case Report and a Statistical Parametric Mapping Analysis of a Korean Family

    OpenAIRE

    Lee, Mi Ji; Shin, Jisoo; Chung, Eun Joo; Kim, Sang-Jin; Kwon, Soonwook; Kim, Jung-Hyun; Seo, Sang Won; Ki, Chang-Seok; Na, Duk L.

    2014-01-01

    Background and Methods Fatal familial insomnia (FFI) is a rare genetic disease characterized by intractable insomnia, dysautonomia, and dementia. Herein we describe a patient with FFI. In order to study brain glucose hypometabolism in the patient, we used statistical parametric mapping (SPM) analysis of [18F]-fluorodeoxyglucose positron emission tomography (FDG-PET). Case Report The patient was a 34-year-old Korean man. He presented with intractable insomnia, rapidly progressive dementia and ...

  19. A Near-Fatal Infection with Oseltamivir-Resistant Seasonal Influenza A in a Previously Healthy Child: Case Report

    Directory of Open Access Journals (Sweden)

    Jesse Papenburg

    2009-01-01

    Full Text Available A case of near-fatal oseltamivir-resistant seasonal influenza A infection in a previously healthy four-year-old boy is reported. This case highlights three important points for physicians: oseltamivir-resistant influenza A (H1N1 has recently emerged in North America; contrary to previously held beliefs, such strains are capable of causing severe disease in healthy children; and given this change in epidemiology, clinicians caring for children with severe seasonal influenza A infection should consider empiric dual therapy with oseltamivir and amantadine.

  20. Forensic intelligence as a useful tool for reducing traffic fatalities: the Brazilian Federal District case

    Directory of Open Access Journals (Sweden)

    Wilson X. Camargo Filho

    2016-07-01

    Full Text Available Traffic accidents in Brazil kill more than 40,000 people a year and injure another 400,000, with largely permanent health impacts. This paper proposes the use of Forensic Intelligence, a field of Forensic Science that is able to convert forensic data into useful information, as a means to support policy measures and strategies, in order to prevent accidents. The selected study site was a small stretch on a Federal Highway (BR-040, where four fatal crashes occurred at the beginning of 2012. This highway had good mobility conditions and had no problems that could be correlated with these four fatal events, although speeding, alcohol abuse, and/or driver inattention were present in the crashes. We propose some possible interventions here, such as the use of advertising campaigns, strengthening traffic law enforcement, reduction of the speed limit, and the installation of electronic speed control devices in order to avoid future traffic accidents.

  1. An unusual fatal injury due to tyre burst: a case report.

    Science.gov (United States)

    Rautji, Ravi; Rudra, A; Dogra, T D

    2003-12-17

    A 20 year-old male driver of a heavy duty crane, employed in an industry located in an industrial area on the outskirts of Delhi was fatally injured while repositioning an ill-fitted locking rim of a crane tyre (Fig. 1). The inner tube of the crane tyre had accidentally burst, dislodging the loose iron-locking rim, which hit the individual with a great force resulting in multiple injuries. He died on his way to the hospital. PMID:14642727

  2. Mass fatality management following the South Asian tsunami disaster: case studies in Thailand, Indonesia, and Sri Lanka.

    Directory of Open Access Journals (Sweden)

    Oliver W Morgan

    2006-06-01

    Full Text Available BACKGROUND: Following natural disasters, mismanagement of the dead has consequences for the psychological well-being of survivors. However, no technical guidelines currently exist for managing mass fatalities following large natural disasters. Existing methods of mass fatality management are not directly transferable as they are designed for transport accidents and acts of terrorism. Furthermore, no information is currently available about post-disaster management of the dead following previous large natural disasters. METHODS AND FINDINGS: After the tsunami disaster on 26 December 2004, we conducted three descriptive case studies to systematically document how the dead were managed in Thailand, Indonesia, and Sri Lanka. We considered the following parameters: body recovery and storage, identification, disposal of human remains, and health risks from dead bodies. We used participant observations as members of post-tsunami response teams, conducted semi-structured interviews with key informants, and collected information from published and unpublished documents. Refrigeration for preserving human remains was not available soon enough after the disaster, necessitating the use of other methods such as dry ice or temporary burial. No country had sufficient forensic capacity to identify thousands of victims. Rapid decomposition made visual identification almost impossible after 24-48 h. In Thailand, most forensic identification was made using dental and fingerprint data. Few victims were identified from DNA. Lack of national or local mass fatality plans further limited the quality and timeliness of response, a problem which was exacerbated by the absence of practical field guidelines or an international agency providing technical support. CONCLUSIONS: Emergency response should not add to the distress of affected communities by inappropriately disposing of the victims. The rights of survivors to see their dead treated with dignity and respect requires

  3. Fatal poisonings in Oslo: a one-year observational study

    Directory of Open Access Journals (Sweden)

    Heyerdahl Fridtjof

    2010-06-01

    Full Text Available Abstract Background Acute poisonings are common and are treated at different levels of the health care system. Since most fatal poisonings occur outside hospital, these must be included when studying characteristics of such deaths. The pattern of toxic agents differs between fatal and non-fatal poisonings. By including all poisoning episodes, cause-fatality rates can be calculated. Methods Fatal and non-fatal acute poisonings in subjects aged ≥16 years in Oslo (428 198 inhabitants were included consecutively in an observational multi-centre study including the ambulance services, the Oslo Emergency Ward (outpatient clinic, and hospitals, as well as medico-legal autopsies from 1st April 2003 to 31st March 2004. Characteristics of fatal poisonings were examined, and a comparison of toxic agents was made between fatal and non-fatal acute poisoning. Results In Oslo, during the one-year period studied, 103 subjects aged ≥16 years died of acute poisoning. The annual mortality rate was 24 per 100 000. The male-female ratio was 2:1, and the mean age was 44 years (range 19-86 years. In 92 cases (89%, death occurred outside hospital. The main toxic agents were opiates or opioids (65% of cases, followed by ethanol (9%, tricyclic anti-depressants (TCAs (4%, benzodiazepines (4%, and zopiclone (4%. Seventy-one (69% were evaluated as accidental deaths and 32 (31% as suicides. In 70% of all cases, and in 34% of suicides, the deceased was classified as drug or alcohol dependent. When compared with the 2981 non-fatal acute poisonings registered during the study period, the case fatality rate was 3% (95% C.I., 0.03-0.04. Methanol, TCAs, and antihistamines had the highest case fatality rates; 33% (95% C.I., 0.008-0.91, 14% (95% C.I., 0.04-0.33, and 10% (95% C.I., 0.02-0.27, respectively. Conclusions Three per cent of all acute poisonings were fatal, and nine out of ten deaths by acute poisonings occurred outside hospital. Two-thirds were evaluated as accidental

  4. Linezolid-induced near-fatal serotonin syndrome during escitalopram therapy: Case report and review of literature

    Directory of Open Access Journals (Sweden)

    Ranganath R Kulkarni

    2013-01-01

    Full Text Available Linezolid is a synthetic antimicrobial agent of the oxazolidinone class with weak, nonspecific inhibitor of monoamine oxidase enzymes. Concomitant therapy with an adrenergic or serotonergic agent or consuming tyramine (>100 mg/day may induce serotonin syndrome (SS. We present a case report of near-fatal adverse interaction between linezolid and escitalopram inducing SS in a 65-year-old woman with sepsis, under empirical antibiotic treatment. This report also summarizes the current relevant literature as identified via PubMed, EMBASE, and PsycINFO, supplemented with a manual search of cross references.

  5. Thalamic form of Creutzfeldt-Jakob disease or fatal insomnia? Report of a sporadic case with normal prion protein genotype.

    Science.gov (United States)

    Kawasaki, K; Wakabayashi, K; Kawakami, A; Higuchi, M; Kitamoto, T; Tsuji, S; Takahashi, H

    1997-03-01

    We describe a 68-year-old man with a 53-month history of progressive dementia and clinical features of a progressive supranuclear palsy-like syndrome and dysautonomia. In the late stage of his illness, the patient also developed generalized myoclonic seizures. There was no family history of similar disorders. Histological examination revealed neuronal loss and gliosis with spongiosis in the cerebral cortex. In addition, more severe neuronal loss and gliosis without spongiosis were observed in the thalamus, especially in the anterior ventral and mediodorsal nuclei, and the inferior olivary nucleus. There was also obvious loss of Purkinje cells. Immunohistochemically, no protease-resistant prion protein (PrPres)-positive structures were demonstrated. However, Western blotting revealed the presence of PrPres in the cerebral cortex. This patient had a wild type of PrP genotype. We initially considered this to be a case of the thalamic form of Creutzfeldt-Jakob disease (CJD) with a long duration. However, it is noteworthy that essentially similar pathology, albeit with less severe cerebral cortical changes, has also been reported in fatal familial insomnia, a newly identified phenotypically different prion disease with a mutation in the PrP gene. On the basis of clinicopathological features, we eventually felt that this patient was more likely to have been a sporadic case of fatal insomnia (FI) of long duration. The present case appears to draw further attention to the possible relationship between CJD and FI. PMID:9083566

  6. A pulmonary aspergillosis case with fatal course in a patient with SIRS clinic

    Directory of Open Access Journals (Sweden)

    Nedim Çekmen

    2011-01-01

    Full Text Available A 77-year-old male patient with a history of tuberculosis applied to emergency service with complaints of confusion, shortness of breath, tachycardia, hypothermia and hypotension. A bronchoalveolar lavage culture was collected because a fungus ball was seen on repeat chest X-ray and thoracic CT of the patient. Aspergillus fumigatus grew and voricona-zole treatment was started, but the patient was lost from multiple organ failure (MOF. In diagnosis of patients with SIRS clinic, causative factor may be aspergillus located in an old tuberculosis cavity, and this may have a fatal course in an old patient having previous pulmonary and systemic diseases.

  7. Contribution of exposure, risk of crash and fatality to explain age- and sex-related differences in traffic-related cyclist mortality rates.

    Science.gov (United States)

    Martínez-Ruiz, Virginia; Jiménez-Mejías, Eladio; Amezcua-Prieto, Carmen; Olmedo-Requena, Rocío; Luna-del-Castillo, Juan de Dios; Lardelli-Claret, Pablo

    2015-03-01

    This study was designed to quantify the percent contribution of exposure, risk of collision and fatality rate to the association of age and sex with the mortality rates among cyclists in Spain, and to track the changes in these contributions with time. Data were analyzed for 50,042 cyclists involved in road crashes in Spain from 1993 to 2011, and also for a subset of 13,119 non-infractor cyclists involved in collisions with a vehicle whose driver committed an infraction (used as a proxy sample of all cyclists on the road). We used decomposition and quasi-induced exposure methods to obtain the percent contributions of these three components to the mortality rate ratios for each age and sex group compared to males aged 25-34 years. Death rates increased with age, and the main component of this increase was fatality (around 70%). Among younger cyclists, however, the main component of increased death rates was risk of a collision. Males had higher death rates than females in every age group: this rate increased from 6.4 in the 5-14 year old group to 18.8 in the 65-79 year old group. Exposure, the main component of this increase, ranged between 70% and 90% in all age categories, although the fatality component also contributed to this increase. The contributions of exposure, risk of crash and fatality to cyclist death rates were strongly associated with age and sex. Young male cyclists were a high-risk group because all three components tended to increase their mortality rate. PMID:25658669

  8. Giant Asian honeybee or Bambara stings causing myocardial infarction, bowel gangrene and fatal anaphylaxis in Sri Lanka:a case series

    Institute of Scientific and Technical Information of China (English)

    Budagoda BDSS; Kularatne SAM; Kodikara KAS; Kularatne WKS; Mudiyanse RM; Edussuriya DH; Edirisinghe JP; Karunaratne IP; Weerakoon KGAD; Medagedara SC

    2010-01-01

    The sting of Giant Asian honeybee (Apis dorsata) or Bambara in Sinhala and Karunge Kulavi in Tamil is a common environmental hazard in Sri Lanka known to cause immediate allergic reactions, which could be fatal in sensitized individuals. We reported myocardial infarction, bowel gangrene and fatal anaphylaxis in a prospectively proven case series and the association of these uncommon complications with delayed removal of stingers from the patients’ skin.

  9. Fatal Candida septic shock during systemic chemotherapy in lung cancer patient receiving corticosteroid replacement therapy for hypopituitarism. A case report

    International Nuclear Information System (INIS)

    Invasive candidiasis has increased as nosocomial infection recently in cancer patients who receive systemic chemotherapy, and the timely risk assessment for developing such specific infection is crucial. Especially in those concomitantly with hypopituitarism, febrile neutropenia with candidiasis can cause severe stress and lead potentially to sudden fatal outcome when the temporal steroid coverage for the adrenal insufficiency is not fully administered. We report a 72-year-old male case diagnosed as non-small-cell lung cancer, Stage 3A. He had received a steroid replacement therapy for the prior history of hypophysectomy due to pituitary adenoma with hydrocortisone of 3.3 mg/day, equivalent to prednisolone of 0.8 mg/day. This very small dosage of steroid was hardly supposed to weaken his immune system, but rather potentially led to an inappropriate supplementation of his adrenal function, assuming that the serum sodium and chlorine levels decreased. On Day 6 of second cycle of chemotherapy with carboplatin and paclitaxel, he developed sudden febrile neutropenia, septic shock and ileus, leading to death. After his death, the venous blood culture on Day 7 detected Candida albicans. Autopsy findings showed a massive necrotizing enterocolitis with extensive Candida invasion into submucous tissue. In conclusion, this case may suggest that (1) immediate initiation of antifungal therapy soon after the careful risk assessment of Candida infection and (2) adequate administration of both basal steroid replacement therapy and temporal steroid coverage for febrile neutropenia might have improved his fatal outcome. (author)

  10. Analysis of a fatal left ventricular assist device infection: a case report and discussion

    Directory of Open Access Journals (Sweden)

    Gerstein NS

    2015-01-01

    Full Text Available No abstract available. Article truncated at 150 words. Introduction: Left ventricular assist device (VAD therapy is an increasingly utilized treatment as a bridge to heart transplantation or as long-term destination therapy. Recent reports show there is a 22% - 32% incidence of VAD-associated infections with staphylococci and nosocomial gram-negative bacilli being the most common causative organisms (1,2. These organisms are often found in intensive care units, where they have the highest proportion of resistance, thus exposing already critically ill patients to the possibility of resistant organism VAD-associated infections (3. Mortality rates exceed 60% when sepsis develops in a patient with a continuous flow left VAD and infection is the number one cause of death in those awaiting cardiac transplantation (4,5. With continued left VAD use clinicians will likely see multidrug-resistant (MDR or even pandrug-resistant organism VAD-associated infections. Clinicians need to be prepared to manage such an intimidating entity. Case Report: We report a case of a 25 year-old ...

  11. First case of Mediterranean spotted fever-associated rhabdomyolysis leading to fatal acute renal failure and encephalitis

    Directory of Open Access Journals (Sweden)

    Claudia Colomba

    2014-09-01

    Full Text Available Mediterranean spotted fever (MSF is a tick-borne zoonosis caused by Rickettsia conorii. In Italy, about 400 cases are reported every year and nearly half of them occur in Sicily, which is one of the most endemic regions. Although MSF is mostly a self-limited disease characterized by fever, skin rash, and a dark eschar at the site of the tick bite called a ‘tache noire’, serious complications are described, mainly in adult patients. Nevertheless, severe forms of the disease with major morbidity and a higher mortality risk have been described. We report a fatal case of MSF complicated by rhabdomyolysis, acute renal failure, and encephalitis in an elderly woman.

  12. Fatal pulmonary embolism subsequent to the use of Esmarch bandage and tourniquet: A case report and review of literature

    Directory of Open Access Journals (Sweden)

    Sameer Desai

    2013-01-01

    Full Text Available We report a case of fatal pulmonary embolism (PE following exsanguinations of lower limb in orthopedic surgery. A 30-year-old man was posted for fixation of a tibial plateau fracture on the seventh day after injury. Subarchnoid block was performed. Esmarch bandage was used for exsanguination of the limb and tourniquet was inflated. Within three minutes after tourniquet inflation, the patient became unconscious hypotensive, and collapsed. Resuscitation was instituted and spontaneous circulation restored. Right ventricular strain pattern on transthoracic echocardiography, increased levels of D-dimer, and Doppler examination of the lowerlimb confirmed deep venous thrombosis of right femoral vessels and PE. In spite of thrombolytic therapy with streptokinase and heparin, the patient died on the ninth day after the event. Cases of PE secondary to the use of Esmarch bandage and tourniquet are reviewed here to identify the risk groups and management of PE.

  13. Rat bite fever, a fatal case of Streptobacillus moniliformis infection in a 14-month-old boy.

    Science.gov (United States)

    Banerjee, Priya; Ali, Zabiullah; Fowler, David R

    2011-03-01

    Streptobacillus moniliformis is the primary cause of rat bite fever in North America. Children under 12 years of age are primarily infected, presenting with an acute syndrome of fever, rash, and polyarthritis. Common vectors include rats and mice. Transmission is predominantly from a bite or scratch, but contact with or ingestion of food contaminated with feces or saliva has also been reported. We report a fatal case of S. moniliformis infection in a 14-month-old-boy. At home, the child was exposed to filthy living conditions and the family had pet ferrets. Autopsy revealed a red-pink, mostly confluent rash and a circumscribed area suspicious for a possible bite mark. Cerebrospinal fluid cultures were positive for S. moniliformis. This case highlighted key features, such as the morbiliform rash, but lacked lymphadenopathy or joint manifestations. It is important to consider rat or rodent exposure as a source of infection. PMID:21306374

  14. Fatal nosocomial meningitis caused by Mycoplasma hominis in an adult patient: case report and review of the literature.

    Science.gov (United States)

    Reissier, Sophie; Masson, Romain; Guérin, François; Viquesnel, Gérald; Petitjean-Lecherbonnier, Joëlle; Pereyre, Sabine; Cattoir, Vincent; Isnard, Christophe

    2016-07-01

    Meningitis due to Mycoplasma hominis in adults is rarely described, with only three cases having been reported to date. A case of fatal meningitis in a 39-year-old patient after a neurosurgical procedure for a subarachnoid haemorrhage is reported herein. Identification and treatment were significantly delayed because of the rarity of the aetiology and difficulty identifying this organism with the routinely used conventional methods, such as Gram staining and agar growth on standard agar plates. Clinical procedures and the treatment of 'culture-negative' central nervous system infections is a real challenge for clinical microbiologists and clinicians, and M. hominis has to be considered as a potential, although very uncommon, pathogen. PMID:27208637

  15. 75 FR 27375 - Postal Rate Case Management

    Science.gov (United States)

    2010-05-14

    ... From the Federal Register Online via the Government Publishing Office POSTAL REGULATORY COMMISSION Postal Rate Case Management AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is seeking comments relevant to management of an anticipated exigent postal rate case. It...

  16. Influence of ballistic and autopsy parameters on the manner of death in case of long firearms fatalities.

    Science.gov (United States)

    de la Grandmaison, Geoffroy Lorin; Fermanian, Christophe; Aegerter, Philippe; Durigon, Michel

    2008-05-20

    A retrospective study was carried out on 132 fatalities due to gunshot wounds secondary to long firearms. One group of suicide (n=72) and one group of homicide (n=60) were statistically compared regarding age and sex of the victim, number of shots, range of fire, direction of the projectile(s), anatomical distribution of entrance sites, weapon and ammunition types and the nature of eventual associated traumatic lesions. The frequency of suicide was higher when the victim's age increased. Females constituted about 43% of the homicide victims and about 8% of the suicide victims. 51.5% of the homicide victims and about 10% of the suicide victims had sustained more than one gunshot wound. Close range was respectively found in 53.5% of the homicide cases and in all suicide cases. Most of the suicide cases (85% of the cases) showed typical entrance sites. Entrance sites in the limbs and lateral or posterior wall of the chest were only encountered in homicide cases. Associated traumatic lesions were found in about 23% of the homicide cases and in 18% of the suicide cases. In case of suicidal gunshots to the left chest, both upwards and downwards directions, and also both right-to-left and left-to-right directions can occur. From 22 suicide cases showing entrance wound in the mouth, a downwards direction was found in only one. This study underlines the importance but also the limits of the autopsy findings (including direction of the projectile(s) related to the entrance site) for giving an indication of the manner of death (homicide vs. suicide). PMID:18282673

  17. Traffic fatalities and economic growth.

    Science.gov (United States)

    Kopits, Elizabeth; Cropper, Maureen

    2005-01-01

    This paper examines the relationship between traffic fatality risk and per capita income and uses it to forecast traffic fatalities by geographic region. Equations for the road death rate (fatalities/population) and its components--the rate of motorization (vehicles/population) and fatalities per vehicle (F/V)--are estimated using panel data from 1963 to 1999 for 88 countries. The natural logarithm of F/P, V/P, and F/V are expressed as spline (piecewise linear) functions of the logarithm of real per capita GDP (measured in 1985 international prices). Region-specific time trends during the period 1963-1999 are modeled in linear and log-linear form. These models are used to project traffic fatalities and the stock of motor vehicles to 2020. The per capita income at which traffic fatality risk (fatalities/population) begins to decline is 8600 US dollars (1985 international dollars) when separate time trends are used for each geographic region. This turning point is driven by the rate of decline in fatalities/vehicles as income rises since vehicles/population, while increasing with income at a decreasing rate, never declines with economic growth. Projections of future traffic fatalities suggest that the global road death toll will grow by approximately 66% over the next twenty years. This number, however, reflects divergent rates of change in different parts of the world: a decline in fatalities in high-income countries of approximately 28% versus an increase in fatalities of almost 92% in China and 147% in India. The road death rate is projected to rise to approximately 2 per 10,000 persons in developing countries by 2020, while it will fall to less than 1 per 10,000 in high-income countries. PMID:15607288

  18. Road fatalities in The Netherlands.

    OpenAIRE

    2011-01-01

    This fact sheet outlines the development of the number of road fatalities in the Netherlands since 1950. After a rise in the 1950s and 1960s, the number of road deaths in the Netherlands has shown a gradual decline since 1973. As was the case in 2013, the Netherlands counted 570 road fatalities in 2014. Nearly a third of the fatalities are car occupants (187), another near third are cyclists (185). Measured by the population size, relatively many fatalities occur among young people and young ...

  19. Fatal Granulomatous Amebic Encephalitis Due to Balamuthia mandrillaris in New Mexico: A Case Report.

    Science.gov (United States)

    Pindyck, Talia N; Dvorscak, Lauren E; Hart, Blaine L; Palestine, Michael D; Gallant, Joel E; Allen, Sarah E; SantaCruz, Karen S

    2014-09-01

    Balamuthia mandrillaris is a free-living amoeba that can cause granulomatous amebic encephalitis (GAE). We report a case in an individual with a history of alcohol abuse, cocaine use, and ditch water exposure. This is the first reported case of GAE due to B mandrillaris in New Mexico. PMID:25734132

  20. Fatal Granulomatous Amebic Encephalitis Due to Balamuthia mandrillaris in New Mexico: A Case Report

    OpenAIRE

    Pindyck, Talia N.; Dvorscak, Lauren E.; Hart, Blaine L.; Palestine, Michael D.; Gallant, Joel E.; Allen, Sarah E; SantaCruz, Karen S.

    2014-01-01

    Balamuthia mandrillaris is a free-living amoeba that can cause granulomatous amebic encephalitis (GAE). We report a case in an individual with a history of alcohol abuse, cocaine use, and ditch water exposure. This is the first reported case of GAE due to B mandrillaris in New Mexico.

  1. Reflections on involuntary treatment in the prevention of fatal anorexia nervosa: A review of five cases

    DEFF Research Database (Denmark)

    Holm, Janni Schmidt; Brixen, Kim; Andries, Alin;

    2011-01-01

    room treatment was extracted from a population-based registration system. RESULTS: Personality disorders were diagnosed in all five patients and substance abuse in three patients. In all cases, illness duration was more than 10 years and late onset was seen in two cases. None of the deaths were due...

  2. On the Fatal Crash Experience of Older Drivers

    OpenAIRE

    Kent, Richard; Henary, Basem; Matsuoka, Fumio

    2005-01-01

    This study describes the fatal crash experiences of older drivers. Data from two U.S. databases (NASS-CDS and FARS) were used. Several crash, vehicle, and occupant characteristics were compared across age groups, including vehicle type, crash direction (PDOF), severity (ΔV), and injured body region. A sub-set of 97 fatally injured drivers was chosen for a detailed case study. The mean travel speed, ΔV, and airbag deployment rate decreased significantly with age (p

  3. Fatal phenytoin hypersensitivity syndrome

    OpenAIRE

    Mahadeva, U; Al-Mrayat, M; Steer, K; Leen, E

    1999-01-01

    The phenytoin (hydantoin) hypersensitivity syndrome is rare but potentially fatal. Often, as in this case, it presents with non-specific symptoms and signs, requiring a high degree of clinical suspicion for diagnosis.


Keywords: phenytoin; hydantoin; hypersensitivity.

  4. Fatal Spotted Fever Rickettsiosis, Kenya

    OpenAIRE

    Rutherford, Jeremiah S.; Macaluso, Kevin; Smith, Nathaniel; Zaki, Sherif R.; Paddock, Christopher D.; Davis, Jon; Peterso, Norman; Azad, Abdu F.; Rosenberg, Ronald

    2004-01-01

    We report a fatal case of rickettsiosis in a woman from the United States living in Kenya, who had a history of tick exposure. Immunohistochemical staining of skin, kidney, and liver demonstrated spotted fever group rickettsiae. The clinical findings, severity, and fatal outcome are most consistent with Rickettsia conorii infection.

  5. Fatal hepatitis E viral infection in pregnant women in Ghana: a case series

    OpenAIRE

    Bonney Joseph Humphrey; Kwame-Aryee Robert A; Obed Samuel; Tamatey Ama; Barnor Jacob; Armah Naa; Oppong Samuel; Osei-Kwesi Mubarak

    2012-01-01

    Abstract Background Viral infections during pregnancy can pose serious threats to mother and fetus from the time of conception to the time of delivery. These lead to congenital defects, spontaneous abortion and even death. The definitive diagnosis and management of pregnancy-related viral infections may be challenging especially in less resourced countries. Case presentation We present clinical and laboratory responses to the diagnosis and management of three cases of fulminant hepatitis seco...

  6. A nested case-control study of fatal work related injuries among Brazilian steel workers.

    OpenAIRE

    S.M. Barreto; Swerdlow, A J; Smith, P G; Higgins, C D

    1997-01-01

    OBJECTIVES: To estimate the relative risk of death from work related injury in a steelworks, associated with exposure to various occupational hazards, sociodemographic factors, and medical history. MATERIAL AND METHODS: The study was a nested case-control design. It was based on a cohort of men employed in the steel plant of USIMINAS, Brazil between January 1977 and August 1990, who were followed up to November 1992. The cases were defined as all workers in the cohort who died from injury in ...

  7. Avian influenza A virus (H7N7) associated with human conjunctivitis and a fatal case of acute respiratory distress syndrome.

    NARCIS (Netherlands)

    R.A.M. Fouchier (Ron); P.M. Schneeberger (Peter); F.W. Rozendaal (Frans); J.M. Broekman (Jan); S.A. Kemink (Stiena); V.J. Munster (Vincent); G.F. Rimmelzwaan (Guus); M. Schutten (Martin); G.J.J. van Doornum (Gerard); G. Koch (Guus); A. Bosman (Arnold); M.P.G. Koopmans D.V.M. (Marion); A.D.M.E. Osterhaus (Albert); T. Kuiken (Thijs)

    2004-01-01

    textabstractHighly pathogenic avian influenza A viruses of subtypes H5 and H7 are the causative agents of fowl plague in poultry. Influenza A viruses of subtype H5N1 also caused severe respiratory disease in humans in Hong Kong in 1997 and 2003, including at least seven fatal cases, posing a serious

  8. Estimating the Influence of Accident Related Factors on Motorcycle Fatal Accidents using Logistic Regression (Case Study: Denpasar-Bali

    Directory of Open Access Journals (Sweden)

    Wedagama D.M.P.

    2010-01-01

    Full Text Available In Denpasar the capital of Bali Province, motorcycle accident contributes to about 80% of total road accidents. Out of those motorcycle accidents, 32% are fatal accidents. This study investigates the influence of accident related factors on motorcycle fatal accidents in the city of Denpasar during period 2006-2008 using a logistic regression model. The study found that the fatality of collision with pedestrians and right angle accidents were respectively about 0.44 and 0.40 times lower than collision with other vehicles and accidents due to other factors. In contrast, the odds that a motorcycle accident will be fatal due to collision with heavy and light vehicles were 1.67 times more likely than with other motorcycles. Collision with pedestrians, right angle accidents, and heavy and light vehicles were respectively accounted for 31%, 29%, and 63% of motorcycle fatal accidents.

  9. An antique pistol fatality: consideration of the legal and pathological aspects: a case report.

    Science.gov (United States)

    Cook, Deborah S; James, Ryk S

    2002-10-01

    This article presents a case report of a shooting using an antique pistol. The unusual pathological findings are presented, together with a review of the law in this area. It seems that there is currently a loophole in the 1997 Firearms Act by means of which 'enthusiasts' or 'collectors' may legally possess weapons and then subsequently acquire ammunition illegally. PMID:12487522

  10. Primary pleural leiomyosarcoma with rapid progression and fatal outcome: a case report

    Directory of Open Access Journals (Sweden)

    Rais Ghizlane

    2012-04-01

    Full Text Available Abstract Introduction Leiomyosarcomas are neoplasms of smooth muscles that most commonly arise from the uterus, gastrointestinal tract, or soft tissue. Primary pleural leiomyosarcoma is extremely rare. To the best of our knowledge, only nine cases have been published to date. Because of the rarity of pleural leiomyosarcoma and its similarity (clinical and histological to other pleural neoplasms, particularly sarcomatous mesothelioma, diagnosis is often difficult. Case presentation A 58-year-old North African man was admitted with complaints of dyspnea and chest pain to our hospital. Chest computed tomography revealed right pleural effusion and pleural thickening. A transthoracic needle biopsy yielded a diagnosis of leiomyosarcoma, and tumor cells were strongly and uniformly positive for vimentin, a smooth muscle actin at immunohistochemical analysis. A general examination did not show any metastatic lesions in other areas. One month after diagnosis, the tumor grew rapidly, with pulmonary invasion, and therefore he was treated only by palliative care. He died from respiratory failure one month later. Because no organ of origin of the leiomyosarcoma, other than the pleura, was detected, this case was diagnosed as a primary pleural leiomyosarcoma. Conclusions Although leiomyosarcoma originating from the pleura is rare, this entity is increasingly described. The purpose of presenting this case report is to raise awareness among clinicians to consider this clinical entity as a differential diagnosis when a pleural mass is identified.

  11. Venous barium embolization, a rare, potentially fatal complication of barium enema: 2 case reports

    International Nuclear Information System (INIS)

    Venous embolization of barium has been recognized for 4 decades as one of the most dreaded complications of barium enema. Fortunately, the condition is extremely rare. In this report, the radiographic findings in 2 cases of venous embolization (one involving the portal vein and one systematic) are described, and ways to decrease the risk of this complication are discussed. (author)

  12. Fatal haemoptysis in a case of lymphomatoid granulomatosis treated with rituximab.

    Science.gov (United States)

    Jaffre, S; Jardin, F; Dominique, S; Duet, E; Hubscher, Ph; Genevois, A; Corne, F; Bota, S; Nouvet, G; Thiberville, L

    2006-03-01

    Lymphomatoid granulomatosis is a rare angiocentric and angiodestructive disease, which commonly involves the lungs but also the brain, kidneys, liver and skin. This report describes the case of a 33-yr-old female with an aggressive form of lymphoid granulomatosis treated with an anti-CD20 antibody. Dramatic radiological improvement was seen at the fourth week. However, the patient died at home 1 month after the last rituximab administration from a massive haemoptysis. PMID:16507866

  13. Clinical Experiences of Bronchopleural Fistula-related Fatal Hemoptysis after 
the Resection of Lung Cancer: A Report of 7 Cases

    Directory of Open Access Journals (Sweden)

    Zhenming ZHANG

    2012-01-01

    Full Text Available Background and objective Massive hemoptysis was a rare but severe postoperative complication of lung cancer. The aim of the present study is to investigate the mechanisms, risk factors, early symptoms, prevention, and treatment options for fatal hemoptysis. Methods From April 2007 to May 2011, 1,737 patients with lung cancer were surgically treated in the West China Hospital of Sichuan University. Twenty patients died during the perioperative period, seven of whom died of massive hemoptysis. These seven cases were analyzed, and their clinical data, as well as related literatures, were reviewed. Results Massive hemoptysis is the second cause of death after lung cancer surgery. Six patients died directly of massive hemoptysis. One patient underwent secondary surgery because of massive hemoptysis, but eventually died because of lung infection and respiratory failure. Early symptoms of hemorrhage were observed in four cases, and the overall incidence rate of massive hemoptysis was 0.4% (7/1,737. Conclusion Bronchovascular fistula (BVF caused by bronchopleural fistula (BPF is the mechanism for massive hemoptysis. Diabetes is a high risk factor. Early diagnosis and surgical treatment of BPF or BVF can prevent the occurrence of death as a result of massive hemoptysis.

  14. Review of Dengue Hemorrhagic Fever Fatal Cases Seen Among Adults: A Retrospective Study

    OpenAIRE

    Sam, Sing-Sin; Omar, Sharifah Faridah Syed; Teoh, Boon-Teong; Abd-Jamil, Juraina; Abubakar, Sazaly

    2013-01-01

    Background Dengue is a mosquito-borne viral disease endemic in many countries in the tropics and sub-tropics. The disease affects mainly children, but in recent years it is becoming more of an adult disease. Malaysia experienced a large dengue outbreak in 2006 to 2007, involving mostly adults, with a high number of deaths. Methodology/Principal Findings We undertook a retrospective study to examine dengue death cases in our hospital from June 2006 to October 2007 with a view to determine if t...

  15. Review of Dengue Hemorrhagic Fever Fatal Cases Seen Among Adults: A Retrospective Study

    OpenAIRE

    Sing-Sin Sam; Sharifah Faridah Syed Omar; Boon-Teong Teoh; Juraina Abd-Jamil; Sazaly AbuBakar

    2013-01-01

    BACKGROUND: Dengue is a mosquito-borne viral disease endemic in many countries in the tropics and sub-tropics. The disease affects mainly children, but in recent years it is becoming more of an adult disease. Malaysia experienced a large dengue outbreak in 2006 to 2007, involving mostly adults, with a high number of deaths. METHODOLOGY/PRINCIPAL FINDINGS: We undertook a retrospective study to examine dengue death cases in our hospital from June 2006 to October 2007 with a view to determine if...

  16. Type 2 Diabetes and Pyonephrosis: a Potentially Fatal Complication. A Case Report

    Directory of Open Access Journals (Sweden)

    Miguel Ángel Serra Valdés

    2013-09-01

    Full Text Available Bacterial infections of the urinary tract are a common problem in daily medical practice. They are very frequent and severe complications affecting diabetic patients. Motivation to report this case lies in its relevance to teaching, and invites reflection on how clinical practice of this entity is being performed. We report the case of a patient who started suffering from pain in the left lumbar region, radiating toward the front of the abdomen on that side of the body as far as the thigh, two months before hospital presentation. The pain was severe, constant and stabbing; it was relieved by analgesics and sometimes by bending the leg on that side. In addition, the patient experienced fatigue, loss of appetite, nausea, fever (38-39˚C, and burning sensation with frequent urination of small amounts of dark urine. Physical examination led to the diagnostic possibility of obstructive pyonephrosis which was confirmed by computed tomography. Medical treatment was applied and a left radical nephrectomy was performed.

  17. A Case of Fatal Bacterial Meningitis Caused by Enterococcus Faecalis: Postmortem Diagnosis

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    Gülhan Yağmur

    2015-10-01

    Full Text Available Enterococcus species rarely cause bacterial meningitis without predisposing factors such as trauma, brain surgery, etc. In this study, we present a bacterial meningitis case caused by Enterococcus faecalis (E. faecalis in a 13-year-old male who was found dead at home. One hundred and forty two cm tall, 37 kg weight male had admitted to hospital two days after the beginning of complaints such as weakness, headache, swelling of left eye, nausea and vomiting. Body temperature was 37.3 oC, leucocyte count 22100/ mm3, and CRP 71 g/dl at the hospital admission. Antibiotic treatment with amoxicillin/clavulanic acid (625 mg was given to the patient but he was found dead in his house the day after. In autopsy; yellow-green purulant liquid in left frontoparietal zone, fullness of meningeal vessels and oedema was seen in brain. Isolated bacteria in cerebrospinal fluid (CSF was identificated as E. faecalis by mini API 32 Strep®. Postmortem microbiological sampling in autopsy and defining etiologic agents is important for rare meningitis cases in which antemortem identification could not be done before death.

  18. Iatrogenic left common iliac artery and vein perforation during lumbar discectomy: a fatal case.

    Science.gov (United States)

    Busardò, Francesco Paolo; Frati, Paola; Carbone, Iacopo; Pugnetti, Paola; Fineschi, Vittorio

    2015-01-01

    Iatrogenic vascular injury during lumbar disk surgery, although rare, is a serious complication, and when it does occur, can be sudden and life-threatening. The risk of injury to the pelvic vessels intra-operatively can be explained by the close proximity of the retroperitoneal vessels to the vertebral column therefore causing injury to the anterior longitudinal ligament, which can give access to the retroperitoneal space. If signs of circulatory instability are noted during lumbar disk surgery, early diagnosis of vascular injury and urgent transperitoneal surgery or emergency stenting can save the patient's life. Here, is presented the case of a 52-year-old man who underwent an elective lumbar discectomy for a rightward disk herniation in the L4-L5 intervertebral space and died 12h after the operation for a hemorrhagic shock due to a severe intra-abdominal hemorrhage following iatrogenic left common iliac artery and vein perforation during lumbar discectomy. PMID:25467198

  19. The Clinical Course of Late Diagnosed Fatal Cases of A (H1N1 Influenza in Poland 

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    Marta Rorat

    2013-06-01

    Full Text Available Introduction: The most frequent complication of A (H1N1 influenza and the leading cause of death was pneumonia with a primary viral or mixed viral and bacterial etiology. 182 patients had died because of a pandemic influenza in Poland by 31st July 2010.Material and Methods: A retrospective study of 6 fatal cases of pandemic influenza, aged 23-41, including 3 women, hospitalised between November 2009 and February 2011 in different Polish medical centres.Results: We present the clinical course of 6 late diagnosed cases of A (H1N1 influenza. All patients presented typical flu-like symptoms in the beginning. 4/6 patients had severe disease risk factors: pregnancy, arthritis, Wegener granulomatosis and obesity. All patients were seen by doctors, no one had received antiviral therapy, 4/5 were treated with antibiotics before they were hospitalized. One patient had nosocomial infection. Patients were admitted to the hospital on the 3rd to 8th day of the disease. They received oseltamivir treatment on the 4th to 9th day. All patients developed pneumonia complicated by acute respiratory distress syndrome. Death appeared between the 4th and 27th day after the onset of symptoms. Autopsies were performed in 5 cases and revealed haemorrhagic pneumonia in 2 patients.Conclusion: Delayed diagnosis and antiviral treatment initiation has a significant impact on mortality in A (H1N1 influenza. During the influenza epidemic, patients presenting typical symptoms should always be suspected of having influenza. Antiviral treatment has to be initiated immediately, especially ifthere are risk factors of severe disease.

  20. Cases of fatal accidents and violence among children, adolescents and young people: perception of the family and associated factors

    Directory of Open Access Journals (Sweden)

    Christine Baccarat de Godoy Martins

    2014-10-01

    Full Text Available Hundreds of children and young people die from fatal accidents or violence every year and others suffer the consequences of non-lethal lesions. Knowing the associated factors is essential for moving forward in the control of these events. The study analysed the families’ perception and factors associated with deaths due to external causes of children, adolescents and young people. Cross-sectional study from deaths from accidents and violence in the age group of 0 to 24 years in the city ofCuiabá-State of Mato Grosso, followed by a domestic survey with the families. The families could not tell whether the accident/violence was a foreseeable event and do not believe that habits/lifestyle have favoured the occurrence. Intentional deaths showed a greater association with factors: maternity/paternity in adolescence, role overload of the mother, consumption of alcohol/drugs, family conflicts and prior deaths from external cause. Feelings of appreciation (study, housing, work, and whether the victim’s pregnancy has been desired were positive in a higher proportion among cases at which the victims died in an accident. The families had easy access to health care services; however, it was difficult to access the network of social and religious support. Associated factors differ according to the intentionality of the event.

  1. Clinical, histopathological and genetic studies in a case of fatal familial insomnia with review of the literature.

    Science.gov (United States)

    Peng, Bin; Zhang, Shenqi; Dong, Hongjuan; Lu, Zuneng

    2015-01-01

    To explore clinical, histopathological and genetic features of a case with fatal familial insomnia (FFI) and review the related literatures. A middle-aged woman who complained of "insomnia for 9 months and psychosis for 3 months" was suspicious of FFI. The clinical features of the patient were analyzed, and the dead patient was examined by autopsy and the brain tissues were obtained for histopathological studies, and the blood samples from the patient and some of her familial members were collected for the sequencing of prion protein gene (PRNP). The main clinical features included intractable insomnia, psychiatric symptoms and abnormal night sleep behavior, unsteady gait, difficulty swallowing, sudden death, and positive family history. The pathological studies showed neuronal loss and gliosis of multiple brain tissues in the proband, predominated with thalamus; and analysis of PRNP revealed gene D178N mutation, and linkage with 129 methionine (Met) allele in the proband and a relative. FFI patients may manifest as sudden death, and may have prominent psychiatric symptoms; the corresponding gene mutation could occur in the asymptomatic carriers; the data of autopsy and brain tissue pathology is helpful for further understanding of this disease. PMID:26617725

  2. Allopurinol inappropriate use in case of asymptomatic hyperuricemic patient causes fatal Allopurinol hypersensitive syndrome: lesson to all

    Directory of Open Access Journals (Sweden)

    Arvind Kumar

    2015-12-01

    Full Text Available Allopurinol is used to treat hyperuricemia (HU in a patient of gout. It is also used to prevent HU in a patient of hematological malignancies who are about to undergo chemotherapy. Allopurinol is usually well-tolerated but it occasionally induces hypersensitivity reactions that manifest after few months of therapy. Cutaneous reactions are pruritic, erythematous, or maculopapular eruptions. Rarely fatal toxic epidermal necrolysis or Stevens-Johnson syndrome may occur. Transient leukopenia or leukocytosis, eosinophilia and elevated transaminases may also occur. HU is not a disease in itself. Its level is highly variable in the general population. Uric acid level is influenced by many factors such as dietary intake of proteins, hypertension, and obesity. Only very rarely patients of AHU may progress to gout and renal stones. Not much data is available that support HU alone in an asymptomatic patient in later life shows the diseases which are associated with HU. Sometimes only lifestyle changes, diet restrictions, alcohol restrictions, and treatment of underlying acquired cause may correct HU. Here, we are presenting a rare case of allopurinol hypersensitivity syndrome in an AHU patient. Our aim is to raise awareness among physicians so that they avoid using unnecessarily allopurinol in AHU patients and also titrate the dose of allopurinol in patients of renal failure. Risk-benefit ratio must be considered in these patients before starting allopurinol. [Int J Basic Clin Pharmacol 2015; 4(6.000: 1302-1304

  3. Non specific drug distribution in an autopsy case report of fatal caffeine intoxication.

    Science.gov (United States)

    Ishikawa, Takaki; Yuasa, Isao; Endoh, Minoru

    2015-11-01

    Caffeine has long been recognized as an addictive substance that causes autonomic nerve effect, and is known to increase catecholamine secretion from the adrenal glands. In recent years, the risk of ingesting toxic levels of caffeine has increased because of the easy availability of analgesics, CNS (Central Nervous System) stimulant medicine and dietary supplements at shops, health stores and through online purchases. We report the death of a young female resulting from the ingestion for suicide of an online purchased sleepiness-preventing medicine containing caffeine. The autopsy findings included pulmonary edema and congestion plus cutaneous emphysema. The stomach contents included a dark-brown viscous fluid without tablet or food residue. Toxicological examination revealed the presence of caffeine in the right heart blood (154.2 μg/mL) and stomach contents (197.5 μg/mL) (lethal blood level, >80 μg/mL). The highest caffeine content was in the bile (852.3 μg/mL). Biochemical findings showed that catecholamine concentration in the peripheral blood in the iliac vein was elevated. Immunostaining of catecholamine was weak in the adrenal medulla. We recommend highlighting the toxicity risk of ingesting substances with a high caffeine concentration, and we propose that caffeine concentrations should be included in the comprehensive routine forensic toxicological tests for all cases. PMID:26594005

  4. Fatal disseminated mucormycosis in a patient with mantle cell non-hodgkin's lymphoma: an autopsy case

    Directory of Open Access Journals (Sweden)

    Inci Alacacioglu

    2009-06-01

    Full Text Available A patient with mantle cell non-Hodgkin's lymphoma presented herself with fever, nausea, right upper quadrant pain on the 7th day of R-CHOP chemotherapy. After hospitalization with the suspicion of acute cholecystitis, she received antibiotherapy with G-CSF because of emerging neutropenia at the 10th day of chemotherapy. Abdominal computed tomography revealed small infarcts in the spleen and kidneys. The echymotic lesion which developed on her right lateral malleolus, became bullous in the following days and treated as ecthyma gangrenosum. Altough the patient was afebrile with a normal neutrophil count on the third day of antibiotherapy, she developed acute renal failure and deteriorated rapidly. The patient underwent hemodialysis but expired on the 10th day of hospitalization. Post mortem autopsy findings showed ischemic infarction and necrosis of parenchyma due to mycotic thrombosis of arteries and veins of many organs (heart, lung, diaphgram, kidneys, spleen, gut mucosa as well as invasion of vessel walls and parenchyma by mucor. We reviewed mucormycosis in the light of this case.

  5. Malignant histiocytosis X. Report of a rapidly fatal case in an elderly man.

    Science.gov (United States)

    Wood, C; Wood, G S; Deneau, D G; Oseroff, A; Beckstead, J H; Malin, J

    1984-07-15

    A 71-year-old white man developed an increasing number of 1-to-10 mm, erythematous nodules, many with central ulceration, most prominent on the head and trunk. Biopsy of a nodule showed infiltration of the dermis and epidermis by large cells with multilobulated nuclei and numerous mitoses. Electron microscopy showed that most tumor cells contained Langerhans' cell granules. Immunohistochemical studies demonstrated a pattern of antigen expression similar to that of Langerhans' cells including Ia and Leu-6 (T6) antigens. Chest x-ray showed diffuse pulmonary infiltration and similar tumor cells were present in the sputum and urine. He developed increasing dyspnea and jaundice despite chemotherapy, and died 6 months after the onset of the disease. Autopsy showed massive tumor infiltration of the lungs, liver, spleen, and lymph nodes, and focal involvement of the myocardium, skin and bladder. Clinical and cytologic features indicated this case to be a rare example of highly malignant histiocytosis X in an elderly man. PMID:6202393

  6. Fatal liver failure caused by reactivation of lamivudine-resistant hepatitis B virus: A case report

    Institute of Scientific and Technical Information of China (English)

    Yuka Suzuki; Fumio Itoh; Hiroshi Yotsuyanagi; Chiaki Okuse; Yoshihiko Nagase; Hideaki Takahashi; Kyoji Moriya; Michihiro Suzuki; Kazuhiko Koike; Shiro lino

    2007-01-01

    We present a case of fetal liver failure caused by the activation of lamivudine-resistant hepatitis B virus (HBV) nine months after lamivudine treatment. A 57-year old man visited our hospital for the treatment of decompensated chronic hepatitis B. Lamivudine was started in December 2001. Subsequently, serum HBV was negative for HBV DNA with seroconversion from HBeAg to anti-HBe and improvement of liver function. However, HBV DNA and HBeAg were again detected in September 2002. He was complicated by breakthrough hepatitis and admitted to our hospital in November for severely impaired liver function. Vidarabine treatment was started and serum HBV DNA and alanine aminotransferase (ALT) decreased transiently. However, after the start of a-interferon treatment, HBV DNA level increased and liver function deteriorated. He died 1 mo after admission. An analysis of amino acid sequences in the polymerase region revealed that rtM204I/V with rtL80I/V occurred at the time of viral breakthrough. After the start of antiviral treatment, rtL180M was detected in addition to rtM204I/V and rtL80I/V, and became predominant in the terminal stage of the disease. HBV clone with a high replication capacity may be produced by antiviral treatment leading to the worsening of liver function. Antiviral therapy for patients with breakthrough hepatitis in advanced liver disease should be carefully performed.

  7. [Severe myocardial damage caused by leptospirosis. Report of a fatal case in Mexico].

    Science.gov (United States)

    Velasco-Castrejón, Oscar; Rivas-Sánchez, Beatriz; Soriano-Rosas, Juan; Rivera-Reyes, Héctor Hugo

    2009-01-01

    Chagasic cardiomyopathy is a common disease in Latin America, however similar clinical pictures exist that can be confused with this, as they give negative results to the tests that detects T. cruzi, like non Chagasic rural endemic chronic cardiopathy, highly common in Venezuela. Using histopathology techniques, "idiopathic cardiomyopathy" is frequently found as the cause of death when the etiology of this disease is not known. This paper presents the case of a man of 26-years-old who died of dilated cardiomyopathy secondary to leptospirosis. Clinically, in addition to the cardiac failure, jaundice, hyperbilirubinemia, transaminases increase, proteinuria and hematuria were present. Initially it was suspected Chagasic cardiomyopathy but the epidemiologic background and the parasitologic and serologic tests for T. cruzi gave negative results. The dark field microscopy videorecording of blood and urine samples, argentic impregnation and immunohistochemistry tests as well as haemoculture in EMJH medium were positive for L. interrogans serovar Pomona. Postmortem we confirmed the presence of leptospira in different tissues through of histopathology, argentic impregnation, indirect immunofluorescence and immunohistochemistry. PMID:20191987

  8. End-stage renal disease due to delayed diagnosis of renal tuberculosis: a fatal case report

    Directory of Open Access Journals (Sweden)

    Elizabeth De Francesco Daher

    2007-02-01

    Full Text Available Renal TB is difficult to diagnose, because many patients present themselves with lower urinary symptoms which are typical of bacterial cystitis. We report a case of a young woman with renal TB and ESRD. She was admitted with complaints of adynamia, anorexia, fever, weight loss, dysuria and generalized edema for 10 months. At physical examination she was febrile (39ºC, and her abdomen had increased volume and was painful at palpation. Laboratorial tests showed serum urea=220mg/dL, creatinine=6.6mg/dL, hemoglobin=7.9g/dL, hematocrit=24.3%, leukocytes=33,600/mm³ and platelets=664,000/mm³. Urinalysis showed an acid urine (pH=5.0, leukocyturia (2+/4+ and mild proteinuria (1+/4+. She was also oliguric (urinary volume <400mL/day. Abdominal echography showed thick and contracted bladder walls and heterogeneous liquid collection in the left pelvic region. Two laparotomies were performed, in which abscess in pelvic region was found. Anti-peritoneal tuberculosis treatment with rifampin, isoniazid and pyrazinamide was started. During the follow-up, the urine culture was found to be positive for M. tuberculosis. Six months later the patient had complaints of abdominal pain and dysuria. New laboratorial tests showed serum urea=187mg/dL, creatinine=8.0mg/dL, potassium=6.5mEq/L. Hemodialysis was then started. The CT scan showed signs of chronic nephropathy, dilated calyces and thinning of renal cortex in both kidneys and severe dilation of ureter. The patient developed neurologic symptoms, suggesting tuberculous meningoencephalitis, and died despite of support measures adopted. The patient had ESRD due to secondary uropathy to prolonged tuberculosis of urinary tract that was caused by delayed clinical and laboratorial diagnosis, and probably also due to inadequate antituberculous drugs administration.

  9. Acute methoxetamine and amphetamine poisoning with fatal outcome: A case report

    Directory of Open Access Journals (Sweden)

    Marek Wiergowski

    2014-08-01

    Full Text Available Methoxetamine (MXE is a psychoactive substance distributed mostly via the Internet and is not liable to legal regulation in Poland. MXE has a toxicity profile similar to that of ketamine but longer-lasting effects. The paper describes a case of acute poisoning that resulted from recreational use of MXE and amphetamine and ended in death. In mid-July 2012, a 31-year old man was admitted to the clinical toxicology unit in Gdańsk because of poisoning with an unknown psychoactive substance. The patient was transported to the emergency department (ED at 5:15 a.m. in a very poor general condition, in a deep coma, with acute respiratory failure, hyperthermia (> 39°C and generalized seizures. Laboratory tests showed marked leukocytosis, signs of massive rhabdomyolysis, hepatic failure and beginning of acute renal failure. Despite intensive therapy, the patient died 4 weeks after the poisoning in the course of multi-organ dysfunction syndrome. Chemical and toxicological studies of serum and urine samples collected on the poisoning day at 1:40 p.m. confirmed that amphetamine and MXE had been taken earlier that day. Concentration of amphetamine in the serum (0.06 μg/ml was within the non-toxic range, while MXE (0.32 μg/ml was within the toxic range of concentrations. Amphetamine was also detected in the patient's hair, which suggested a possibility of its use within the last dozen weeks or so. The serious clinical course of intoxication and co-existence of amphetamine and MXE in the patient's blood and urine suggest the possibility of adverse interactions between them.

  10. Fatal Intoxication Involving 3-MeO-PCP: A Case Report and Validated Method.

    Science.gov (United States)

    Bakota, Erica; Arndt, Crystal; Romoser, Amelia A; Wilson, Stephen K

    2016-09-01

    We present in this case report a validated method for accurate quantitative analysis of 3-methoxy phencyclidine (3-MeO-PCP) to determine postmortem blood concentrations of this PCP analog. A 29-year-old male with a history of illicit drug use was found unresponsive in his bed with a bag of white powder next to him. Resuscitation efforts were unsuccessful and the individual was pronounced dead 9 minutes after arrival to the hospital. Initial ELISA screening suggested the presence of PCP in the decedent's blood. However, confirmatory testing revealed no detectable PCP. Instead, a large peak corresponding to a m/z 274.218 species with retention time similar to PCP was present on a LC-TOF-MS drug screen, suggesting a possible PCP analog. This mass corresponds specifically to a methoxy-PCP analog, several of which are available for purchase online. Standards for 3-MeO-PCP and 4-MeO-PCP were obtained and injected on the same instrument. Although the 3- and 4-MeO-PCP analogs have identical masses and retention times, they are still distinguishable through their mass spectra. The peak from the decedent's sample matched both the mass spectrum and the retention time of 3-MeO-PCP. A quantitative LC-MS-MS method was subsequently developed and validated for casework. Analysis using this method revealed a concentration of 139 ± 41 µg/L 3-MeO-PCP in the decedent's blood. Diphenhydramine (4.1 ± 0.7 mg/L), marijuana metabolite (presumptive positive, confirmation not performed) and a small amount of amphetamine (<0.10 mg/L) were also found in the decedent's blood. The cause of death was determined to be combined 3-MeO-PCP, diphenhydramine and amphetamine toxicity. The manner of death was certified as an accident. PMID:27339479

  11. Systematic review of the magnitude and case fatality ratio for severe maternal morbidity in sub-Saharan Africa between 1995 and 2010

    Directory of Open Access Journals (Sweden)

    Kakaire Othman

    2011-09-01

    Full Text Available Abstract Background Analysis of severe maternal morbidity (maternal near misses provides information on the quality of care. We assessed the prevalence/incidence of maternal near miss, maternal mortality and case fatality ratio through systematic review of studies on severe maternal morbidity in sub-Saharan Africa. Methods We examined studies that reported prevalence/incidence of severe maternal morbidity (maternal near misses during pregnancy, childbirth and postpartum period between 1996 and 2010. We evaluated the quality of studies (objectives, study design, population studied, setting and context, definition of severe acute obstetric morbidity and data collection instruments. We extracted data, using a pre-defined protocol and criteria, and estimated the prevalence or incidence of maternal near miss. The case-fatality ratios for reported maternal complications were estimated. Results We identified 12 studies: six were cross-sectional, five were prospective and one was a retrospective review of medical records. There was variation in the setting: while some studies were health facility-based (at the national referral hospital, regional hospital or various district hospitals, others were community-based studies. The sample size varied from 557 women to 23,026. Different definitions and terminologies for maternal near miss included acute obstetric complications, severe life threatening obstetric complications and severe obstetric complications. The incidence/prevalence ratio and case-fatality ratio for maternal near misses ranged from 1.1%-10.1% and 3.1%-37.4% respectively. Ruptured uterus, sepsis, obstructed labor and hemorrhage were the commonest morbidities that were analyzed. The incidence/prevalence ratio of hemorrhage ranged from 0.06% to 3.05%, while the case fatality ratio for hemorrhage ranged from 2.8% to 27.3%. The prevalence/incidence ratio for sepsis ranged from 0.03% to 0.7%, while the case fatality ratio ranged from 0.0% to 72

  12. The association between serum potassium at hospital admission and the case-fatality rate of leptospirosis in men Associação entre potássio sérico na admissão hospitalar e letalidade da leptospirose em homens

    Directory of Open Access Journals (Sweden)

    Antonio Alberto LOPES

    2001-08-01

    Full Text Available Severe leptospirosis affects predominantly males and presents a high susceptibility to hypokalemic acute renal failure. As hypokalemia and hyperkalemia induce severe complications, it is important to evaluate if the initial serum potassium is an independent risk factor for death in leptospirosis. The medical records of 1016 patients hospitalized with the diagnosis of leptospirosis were reviewed. The analysis was restricted to 442, according to the following criteria: male, 18 years or older, information about death or hospital discharge and recorded values of serum potassium, serum creatinine and duration of symptoms at admission. Potassium values lower than 3.5 mEq/L (hypoK, 3.5-5 mEq/L (normoK and above 5 mEq/L (hyperK were detected in 180, 245 and 17 patients, respectively. The death rate increased with serum potassium: 11.1% in the hypoK, 14.7% in the normoK and 47.1% in the hyperK group (p = 0.002. In a logistic regression model (normoK as referent, including age, creatinine and duration of symptoms, hypoK was not associated with increased death rate (odds ratio (OR = 0.80; p > 0.1. On the other hand, hyperK showed a significant association with increased risk of death (OR = 3.95, p = 0.021. In conclusion, in this sample of men with leptospirosis initial serum potassium was positively and independently correlated with the risk of in-hospital death.Leptospirose grave afeta predominantemente os homens e apresenta alta susceptibilidade para insuficiência renal aguda com hipocalemia. Como hipocalemia e hipercalemia induzem complicações graves, é importante avaliar se o potássio sérico é um independente fator de risco de morte na leptospirose. Foram revistos os prontuários de 1016 pacientes internados com o diagnóstico de leptospirose. A análise foi restrita a 442, obedecendo os seguintes critérios: sexo masculino, idade igual ou superior a 18 anos, informação sobre morte ou alta hospitalar e registro dos valores do potássio s

  13. Association of clinical signs and symptoms of Ebola viral disease with case fatality: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Harsha Moole

    2015-09-01

    Full Text Available Background: Ebola virus disease (EVD is a public health emergency of international concern. There is limited laboratory and clinical data available on patients with EVD. This is a meta-analysis to assess the utility of clinical signs, symptoms, and laboratory data in predicting mortality in EVD. Aim: To assess the utility of clinical signs, symptoms, and laboratory data in predicting mortality in EVD. Method: Study selection criterion: EVD articles with more than 35 EVD cases that described the clinical features were included. Data collection and extraction: Articles were searched in Medline, PubMed, Ovid journals, and CDC and WHO official websites. Statistical methods: Pooled proportions were calculated using DerSimonian Laird method (random effects model. Results: Initial search identified 634 reference articles, of which 67 were selected and reviewed. Data were extracted from 10 articles (N=5,792 of EVD which met the inclusion criteria. Bleeding events (64.5% vs. 25.1%, abdominal pain (58.3% vs. 37.5%, vomiting (60.8% vs. 31.7%, diarrhea (69.9% vs. 37.8%, cough (31.6% vs. 22.3%, sore throat (47.7% vs. 19.8%, and conjunctivitis (39.3% vs. 20.3% were more often present in pooled proportion of fatal cases as compared to EVD survivors. Conclusions: Clinical features of EVD that may be associated with higher mortality include bleeding events, vomiting, diarrhea, abdominal pain, cough, sore throat, and conjunctivitis. These patients should be identified promptly, and appropriate management should be instituted immediately.

  14. Case-fatality risk of pregnant women with acute viral hepatitis type E: a systematic review and meta-analysis.

    Science.gov (United States)

    Jin, H; Zhao, Y; Zhang, X; Wang, B; Liu, P

    2016-07-01

    It is of great concern that pregnant women with acute viral hepatitis (AVH) type E have serious consequences. This study aimed to estimate the case-fatality risk (CFR) and potential risk factors of pregnant women with AVH type E. We searched the PubMed, EMBASE, and Web of Science databases for studies containing data on CFR in pregnancy with AVH type E. A pooled estimate of CFR was calculated using a random-effects model. Potential sources of heterogeneity were explored using subgroup analysis, sensitivity analysis, and meta-regression. We identified 47 eligible studies with a total African and Asian population of 3968 individuals. The pooled CFRs of maternal and fetal outcomes were 20·8% [95% confidence interval (CI) 16·6-25·3] and 34·2% (95% CI 26·0-43·0), respectively. Compared with these, the pooled CFR was highest (61·2%) in women with fulminant hepatic failure (FHF). Community-based surveys had lower pooled CFR (12·2%, 95% CI 9·2-15·6) and heterogeneity (25·8%, 95% CI 20·1-32·0) than hospital-based surveys. Univariate analysis showed that hospital-based surveying (P = 0·007), and patients in the third trimester of pregnancy or with FHF (P < 0·05), were significantly associated with CFR. Intrauterine fetal mortality (27·0%) was statistically higher than neonatal mortality (3·9%). Control measures for HEV infection would reduce feto-maternal mortality in Asia and Africa. PMID:26939626

  15. Systematic review of the magnitude and case fatality ratio for severe maternal morbidity in sub-Saharan Africa between 1995 and 2010

    OpenAIRE

    Kaye, Dan K; Kakaire, Othman; Osinde, Michael O

    2011-01-01

    Background Analysis of severe maternal morbidity (maternal near misses) provides information on the quality of care. We assessed the prevalence/incidence of maternal near miss, maternal mortality and case fatality ratio through systematic review of studies on severe maternal morbidity in sub-Saharan Africa. Methods We examined studies that reported prevalence/incidence of severe maternal morbidity (maternal near misses) during pregnancy, childbirth and postpartum period between 1996 and 2010....

  16. Systematic review of the magnitude and case fatality ratio for severe maternal morbidity in sub-Saharan Africa between 1995 and 2010

    OpenAIRE

    Kakaire Othman; Kaye Dan K; Osinde Michael O

    2011-01-01

    Abstract Background Analysis of severe maternal morbidity (maternal near misses) provides information on the quality of care. We assessed the prevalence/incidence of maternal near miss, maternal mortality and case fatality ratio through systematic review of studies on severe maternal morbidity in sub-Saharan Africa. Methods We examined studies that reported prevalence/incidence of severe maternal morbidity (maternal near misses) during pregnancy, childbirth and postpartum period between 1996 ...

  17. A Fatal Case of Acute Myeloid Leukaemia-Methotrexate Related or Primary Autoimmune Disease Related: A Rare Case Report.

    Science.gov (United States)

    Agarwal, Saurabh; Kaeley, Nidhi; Gupta, Priyanka; Gupta, Vibha; Bhatia, Rohan

    2016-03-01

    Methotrexate is being used for many years in the treatment of chronic medical disorders e.g. rheumatoid arthritis since 1951. It has been associated with various systemic toxicities and complications including bone marrow suppression and lymphomas. The development of leukaemia in a patient of chronic rheumatoid arthritis is either related with the primary disease or due to the drugs which are used in the treatment like cyclophosphamide. In our present case, a 70-year-old female who was a known case of Rheumatoid Arthritis (RA) and was on methotrexate once a week orally for the past 20 years presented with complaints of loss of appetite, loss of weight and anaemia since 2 months. After thorough examination and investigation, she was diagnosed with acute myeloid leukaemia (AML-M4) with bilateral chest consolidation. PMID:27134915

  18. Detailed examination of the lower cervical spine facet joints in a road traffic crash fatality - a case study

    DEFF Research Database (Denmark)

    Uhrenholt, Lars; Nielsen, Edith; Vesterby, Annie; Gregersen, Markil Ebbe Gregers; Melsen, Flemming

    The lower cervical spine facet joints of a road traffic crash fatality were examined using diagnostic imaging and histological techniques. No injuries to the cervical spine facet joints could be identified with diagnostic imaging including conventional radiology, CT and MRI. Examination of stained...

  19. Death by 'ice': fatal methamphetamine intoxication of a body packer case detected by postmortem computed tomography (PMCT) and validated by autopsy.

    Science.gov (United States)

    Bin Abdul Rashid, Saiful Nizam; Rahim, Amir Saad Abdul; Thali, Michael J; Flach, Patricia M

    2013-03-01

    Fatal acute methamphetamine (MA) poisoning in cases of internal drug trafficking is rarely described in the literature. This case study reports an MA 'body packer' who died from fatal methamphetamine intoxication due to leaking drug packages in the alimentary tract. The deceased was examined by postmortem computed tomography (PMCT), and the results were correlated to subsequent autopsy and toxicological findings. The deceased was arrested by the police when he was found disoriented in the city of Kuala Lumpur. He was transferred to the emergency department on suspicion of drug abuse. The initial drug screening was reactive for amphetamines. Shortly after admission to the hospital, he died despite rigorous resuscitation attempts. The postmortem plain chest and abdominal radiographs revealed multiple suspicious opacities in the gastrointestinal tract attributable to body packages. An unenhanced whole body PMCT revealed twenty-five drug packages, twenty-four in the stomach and one in the transverse colon. At least two were disintegrating, and therefore leaking. The autopsy findings were consistent with the PMCT results. Toxicology confirmed the diagnosis of fatal methamphetamine intoxication. PMID:23404531

  20. Postmortem computed tomography and magnetic resonance imaging facilitates forensic autopsy in a fatal case of poisoning with formic acid, diphenhydramine, and ethanol.

    Science.gov (United States)

    Berger, Florian; Steuer, Andrea E; Rentsch, Katharina; Gascho, Dominic; Stamou, Stamatios; Schärli, Sarah; Thali, Michael J; Krämer, Thomas; Flach, Patricia M

    2016-09-01

    A case of fatal poisoning by ingesting formic acid, diphenhydramine, and ethanol by a 25-year-old woman who committed suicide is presented. Prior to autopsy, postmortem computed tomography and postmortem magnetic resonance tomography were performed and revealed severe damage to the stomach, the left thoracic wall, and parts of the liver. Imaging detected acid-induced fluid-fluid level within the thoracic cavity (fat-equivalent fluid and necrotic pleural effusion). This case report illustrates that postmortem cross-sectional imaging may facilitate dissection of severely damaged or complex regions, and may provide additional information compared to autopsy and toxicological examinations alone. PMID:27427196

  1. Does access to invasive examination and treatment influence socioeconomic differences in case fatality for patients admitted for the first time with non-ST-elevation myocardial infarction or unstable angina?

    DEFF Research Database (Denmark)

    Martensson, Solvej; Gyrd-Hansen, Dorte; Prescott, Eva;

    2016-01-01

    nominal equal access to health care, social inequality in case fatality after NSTEMI and unstable angina exists in Denmark. The patients with the shortest education waited longer for angiography; however, this did not seem to explain inequality in case fatality. This register-based study was approved by...... the Danish Data Protection Agency (Approval number 2010-41-5263). Register-based studies do not need approval by a medical ethics committee in Denmark....

  2. Emotional and cognitive changes during and post a near fatal heart attack and one-year after: A case study

    OpenAIRE

    Andrew M. Lane; Richard Godfrey

    2010-01-01

    This case study reports on changes in emotions before and during an unexpected heart rate in a young, apparently healthy male with a life-long history of exercise in the absence of family history of heart problems. He completed the Brunel Mood Scale (Terry et al. , 2003) to assess emotions before, during, and after the heart attack, and also describing his thoughts during these periods. Results indicate he experienced unpleasant emotions in the build up to the heart attack, feelings he attrib...

  3. Fatal colchicine intoxication

    Directory of Open Access Journals (Sweden)

    Smael Labib

    2014-01-01

    Full Text Available Colchicine is an alkaloid extracted from autumnal Colchicum plant which is used primarily for its anti-inflammatory therapy effect. Acute intoxication with colchicine is uncommon but often severe and results in multiple visceral organ dysfunctions. The intoxication severity and mortality are directly depending on the ingested dose. The treatment is manly symptomatic. However, the development of specific anti-colchicine immunotherapy would offer a new therapeutic perspective. Authors report a case of a young patient that ingested 40 tablets colchicine, which caused a multiple organ failure and with fatal outcome.

  4. A poor metabolizer of both CYP2C19 and CYP2D6 identified by mechanistic pharmacokinetic simulation in a fatal drug poisoning case involving venlafaxine

    DEFF Research Database (Denmark)

    Jornil, J; Nielsen, T S; Rosendal, I;

    2013-01-01

    pharmacokinetic simulations suggested that the low metabolite ratio was the result of combined poor metabolizer (PM) status of cytochrome P450 (CYP) 2C19 and CYP2D6. This hypothesis was confirmed by genetic analysis. Simulations revealed that it was likely that the combined missing CYP2D6 and CYP2C19 activity...... combined with genotyping were considered very useful in this fatal drug poisoning case. Keywords CYP2D6; CYP2C19; Venlafaxine; Poor metabolizer; Drug poisoning; Mechanistic pharmacokinetic simulation --------------------------------------------------------------------------------...

  5. Involvement of the NADPH Oxidase NOX2-Derived Brain Oxidative Stress in an Unusual Fatal Case of Cocaine-Related Neurotoxicity Associated With Excited Delirium Syndrome.

    Science.gov (United States)

    Schiavone, Stefania; Riezzo, Irene; Turillazzi, Emanuela; Trabace, Luigia

    2016-10-01

    Here, we investigated the possible role of the Nicotinamide Adenine Dinucleotide Phosphate oxidase NOX2-derived brain oxidative stress in a fatal case of cocaine-related neurotoxicity, associated to excited delirium syndrome. We detected a strong NOX2 immunoreactivity, mainly in cortical GABAergic neurons and astrocytes, with a minor presence in microglia, glutamatergic and dopaminergic neurons as well as a significant immunostaining for other markers of oxidative stress (8OhDG, HSP70, HSP90, and NF-κB) and apoptotic phenomena. These results support a crucial role of NOX2-derived brain oxidative stress in cocaine-induced brain dysfunctions and neurotoxicity. PMID:27533346

  6. [Fatal outcome during physiotherapy (Vojta's method) in a 3-month old infant. Case report and comments on manual therapy in children].

    Science.gov (United States)

    Jacobi, G; Riepert, T; Kieslich, M; Bohl, J

    2001-01-01

    Detailed clinical and neuropathological report on a fatal incident during the first manual therapy according to Vojta conducted in a 3 months old baby: during forced active rotation and head retraction the baby suffered from a bleeding into the adventitia of both her vertebral arteries at the level of C1 prompting ischemia of the caudal brainstem with subarachnoid haemorrhage around. It has to be suggested that similar cases already have occurred but have not been reported yet. There might be a time lag between the performance of physiotherapy and the beginning of neurologic symptoms. The risks of manual therapy in children will be discussed. PMID:11305197

  7. Cases of fatal accidents and violence among children, adolescents and young people: perception of the family and associated factors

    OpenAIRE

    Christine Baccarat De Godoy Martins; Maria Helena Prado de Mello Jorge

    2014-01-01

    Hundreds of children and young people die from fatal accidents or violence every year and others suffer the consequences of non-lethal lesions. Knowing the associated factors is essential for moving forward in the control of these events. The study analysed the families’ perception and factors associated with deaths due to external causes of children, adolescents and young people. Cross-sectional study from deaths from accidents and violence in the age group of 0 to 24 years in the city ofCui...

  8. Fatal residential fire accidents in the municipality of Copenhagen, 1991-1996

    DEFF Research Database (Denmark)

    Leth, Peter Mygind; Gregersen, Markil Ebbe Gregers; Sabroe, Svend

    1998-01-01

    handicap. METHODS: This was a case-control study of fatal fire accidents in private homes in the municipality of Copenhagen from 1991 to 1996. The fatal fire accidents were identified from a police register, and the two non-fatal fire accidents registered immediately before and after each fatal fire were...... selected as a control group. Information about the circumstances surrounding the fires was derived from the police reports. Multivariate logistic regression analysis was used to estimate the risk associated with each variable after adjusting for confounders. The analysis was performed on the basis of the......BACKGROUND: The death rate for fatal fire accidents in Denmark has doubled since 1951, mostly due to an increase in the number of fire accidents associated with smoking. The most common cause of residential fire deaths in Denmark today is smoking, often combined with alcohol intoxication or...

  9. Fatal crocodile attack.

    Science.gov (United States)

    Chattopadhyay, Saurabh; Shee, Biplab; Sukul, Biswajit

    2013-11-01

    Attacks on human beings by various animals leading to varied types of injuries and even death in some cases are not uncommon. Crocodile attacks on humans have been reported from a number of countries across the globe. Deaths in such attacks are mostly due to mechanical injuries or drowning. Bites by the crocodiles often cause the limbs to be separated from the body. The present case refers to an incident of a fatal attack by a crocodile on a 35 years old female where only the mutilated head of the female was recovered. Multiple lacerated wounds over the face and scalp along with fracture of the cranial bones was detected on autopsy. Two distinct bite marks in the form of punched in holes were noted over the parietal and frontal bones. Injuries on the head with its traumatic amputation from the body were sufficient to cause death. However, the presence of other fatal injuries on the unrecovered body parts could not be ruled out. PMID:24237838

  10. Skull fracture and hemorrhage pattern among fatal and nonfatal head injury assault victims - a critical analysis

    Directory of Open Access Journals (Sweden)

    Chandrabhal Tripathi

    2010-07-01

    Full Text Available BACKGROUND: The global incidence of fatal head injuries as the result of assault is greater than the number of non-fatal cases. The important factors that determine the outcome in terms of survival of such head injury cases include the type of weapon used, type and site of skull fracture, intra cranial hemorrhage and the brain injury. The present study aims to highlight the role of skull fractures as an indirect indicator of force of impact and the intra cranial hemorrhage by a comparative study of assault victims with fatal and nonfatal head injuries. METHODS: 91 head injury cases resulting from assault were studied in the Department of Forensic Medicine, IMS, BHU Varanasi over a period of 2 years from which 18 patients survived and 73 cases had a lethal outcome. Details of the fatal cases were obtained from the police inquest and an autopsy while examination of the surviving patients was done after obtaining an informed consent. The data so obtained were analyzed and presented in the study. RESULTS: Assault with firearms often led to fatality whereas with assault involving blunt weapons the survival rate was higher. Multiple cranial bones were involved in 69.3% cases while comminuted fracture of the skull was common among the fatal cases. Fracture of the base of the skull was noted only in the fatal cases and a combination of subdural and subarachnoid haemorrhage was found in the majority of the fatal cases. CONCLUSIONS: The present study shows skull fractures to be an important indicator of severity of trauma in attacks to the head. Multiple bone fracture, comminuted fracture and base fractures may be considered as high risk factors in attempted homicide cases.

  11. Fatal equine meningoencephalitis in the United Kingdom caused by the panagrolaimid nematode Halicephalobus gingivalis: case report and review of the literature.

    Science.gov (United States)

    Hermosilla, C; Coumbe, K M; Habershon-Butcher, J; Schöniger, S

    2011-11-01

    A fatal case of eosinophilic and granulomatous meningoencephalitis caused by the free-living panagrolaimid nematode Halicephalobus gingivalis is reported in a 10-year-old Welsh gelding in the United Kingdom. Clinical examination first revealed behavioural abnormalities which rapidly progressed to severe ataxia, reduced mentation status and cranial nerve signs. Despite symptomatic treatment no amelioration of neurological signs was achieved and the horse was subjected to euthanasia. A complete post mortem examination revealed eosinophilic and granulomatous meningoencephalitis mainly affecting the cerebellum and brain stem with intralesional adult nematodes, larvae and eggs. There was also eosinophilic meningitis of the cervical spinal cord. The intralesional nematodes were morphologically consistent with the panagrolaimid nematode H. gingivalis. Although infection by this facultative neurotropic parasite is extremely rare, it needs to be considered in the differential diagnosis of central nervous signs in horses and, in particular, other equine helminthic infection of the central nervous system. This fatal case is unusual since lesions were locally very extensive and the nematodes did not colonise haematogenously to other organs as seen often in equine halicephalobosis. As the taxonomy of H. gingivalis has changed and some recent reports in the literature still refer to this species as Micronema deletrix or Halicephalobus deletrix, we here provide a short update of the species and some insights on the order Tylenchida, which contains free-living nematodes with parasitic tendencies. PMID:21496093

  12. A fatal case of acute pulmonary embolism caused by right ventricular masses of acute lymphoblastic lymphoma-leukemia in a 13 year old girl

    Directory of Open Access Journals (Sweden)

    Yu Mi Ko Ko

    2012-07-01

    Full Text Available We report a case of a 13-year-old girl with acute lymphoblastic lymphoma- leukemia, who presented with a cardiac metastasis in the right ventricle, resulting in a pulmonary embolism. At the time of her leukemia diagnosis, a cardiac mass was incidentally found. The differential diagnosis for this unusual cardiac mass included cardiac tumor, metastasis, vegetation, and thrombus. Empirical treatment was initiated, including anticoagulation and antibiotics. She underwent plasmapheresis and was administered oral prednisolone for her leukemia. Five days later, she experienced sudden hemodynamic collapse and required extracorporeal membrane oxygenation insertion and emergency surgery. These interventions proved futile, and the patient died. Pathology revealed that the cardiac mass comprised an aggregation of small, round, necrotic cells consistent with leukemia. This is the first known case of acute lymphoblastic leukemia presenting as a right ventricular mass, with consequent fatal acute pulmonary embolism. A cardiac mass in a child with acute leukemia merits investigation to rule out every possible etiology, including vegetation, thrombus, and even a mass of leukemic cells, which could result in the fatal complication of pulmonary embolism.

  13. Mountaineering fatalities on Aconcagua: 2001-2012.

    Science.gov (United States)

    Westensee, Jeffrey; Rogé, Ignacio; Van Roo, Jon D; Pesce, Carlos; Batzli, Sam; Courtney, D Mark; Lazio, Matthew P

    2013-09-01

    High altitude mountaineering is a dangerous endeavor due to the hypoxic hypobaric environment, extreme weather, and technical skills required. One of the seven summits, Aconcagua (6962 m) is the highest mountain outside of Asia. Its most popular route is nontechnical, attracting >3000 mountaineers annually. Utilizing data from the Servicio Médico Aconcagua (park medical service), we performed a retrospective descriptive analysis with the primary objective of deriving a fatality rate on Aconcagua from 2001 to 2012. The fatality rate on Aconcagua was then compared to other popular mountains. For climbers who died, we report all available demographic data, mechanisms of death, and circumstances surrounding the death. Between 2001 and 2012, 42,731 mountaineers attempted to summit Aconcagua. There were 33 fatalities. The fatality rate was 0.77 per 1000, or 0.077%. The fatality rate on Aconcagua is lower than that on Everest or Denali but higher than that on Rainier. PMID:24028641

  14. Double fatal outcome after ruptured vasa previa in monochorionic twins: case report and review of the literature.

    Science.gov (United States)

    van Steenis, A; Zhao, D P; Steggerda, S J; Kist, W J; Haak, M C; Oepkes, D; Lopriore, Enrico

    2016-08-01

    Vasa previa is a condition in which one or more fetal blood vessels run through the amniotic membranes and cross or run near the external orifice of the uterus. Rupture of membranes can lead to tearing of these vessels and cause acute fetal exsanguination. In monochorionic twin (MC) pregnancies, acute exsanguination in one twin can lead to severe complications in the co-twin due to the presence of inter-twin placental vascular connections. We report a MC pair with severe perinatal asphyxia due to acute exsanguination after prenatally undetected ruptured vasa previa. This resulted in severe hemorrhagic shock in both twins with double fatal outcome. Antenatal detection of vasa previa is of paramount importance to prevent severe morbidity and mortality, especially in MCs. A review of the literature is presented. PMID:26366672

  15. Fatal diphenhydramine poisoning in a dog

    Science.gov (United States)

    Buchweitz, John P.; Raverty, Stephen A.; Johnson, Margaret B.; Lehner, Andreas F.

    2014-01-01

    We report a fatal diphenhydramine poisoning of a 10-year-old, male poodle-cross dog with pre-existing conditions and suspected co-ingestion of ethanol. This case illustrates that diphenhydramine overdose can be fatal in certain circumstances and that analytical toxicology may play an important role in animal death investigations. PMID:25392554

  16. The turning point in the number of traffic fatalities

    DEFF Research Database (Denmark)

    Brüde, Ulf; Elvik, Rune

    2015-01-01

    The number of traffic fatalities reached a peak in many highly motorised countries around 1970. Some previous studies have suggested that the turning point in the number of traffic fatalities was inevitable and did not reflect a change in the underlying trends influencing the number of traffic...... fatalities. Other studies suggest that trends in traffic growth and fatality rate changed from before to after the turning point. This paper proposes two hypotheses about the turning point in the number of traffic fatalities. One hypothesis is that the long-term trends in traffic growth and fatality rate...... were the same before and after the turning point. The other hypothesis is that the long-term trends in traffic growth and fatality rate were different before and after the turning point was reached, in particular that the annual percentage decline in fatality rate became greater after the turning point...

  17. Campylobacter jejuni Fatal Sepsis in a Patient with Non-Hodgkin’s Lymphoma: Case Report and Literature Review of a Difficult Diagnosis

    Science.gov (United States)

    Gallo, Maria Teresa; Di Domenico, Enea Gino; Toma, Luigi; Marchesi, Francesco; Pelagalli, Lorella; Manghisi, Nicola; Ascenzioni, Fiorentina; Prignano, Grazia; Mengarelli, Andrea; Ensoli, Fabrizio

    2016-01-01

    Campylobacter jejuni (C. jejuni) bacteremia is difficult to diagnose in individuals with hematological disorders undergoing chemotherapy. The cause can be attributed to the rarity of this infection, to the variable clinical presentation, and to the partial overlapping symptoms underlying the disease. Here, we report a case of a fatal sepsis caused by C. jejuni in a 76-year-old Caucasian man with non-Hodgkin’s lymphoma. After chemotherapeutic treatment, the patient experienced fever associated with severe neutropenia and thrombocytopenia without hemodynamic instability, abdominal pain, and diarrhea. The slow growth of C. jejuni in the blood culture systems and the difficulty in identifying it with conventional biochemical phenotyping methods contributed to the delay of administering a targeted antimicrobial treatment, leading to a fatal outcome. Early recognition and timely intervention are critical for the successful management of C. jejuni infection. Symptoms may be difficult to recognize in immunocompromised patients undergoing chemotherapy. Thus, it is important to increase physician awareness regarding the clinical manifestations of C. jejuni to improve therapeutic efficacy. Moreover, the use of more aggressive empirical antimicrobial treatments with aminoglycosides and/or carbapenems should be considered in immunosuppressed patients, in comparison to those currently indicated in the guidelines for cancer-related infections supporting the use of cephalosporins as monotherapy. PMID:27077849

  18. Characteristics of single vehicle rollover fatalities in three Australian states

    OpenAIRE

    Frechede, Bertrand; McIntosh, Andrew S.; GRZEBIETA, Raphaël; BAMBACH, Michaël

    2011-01-01

    An analysis of 2000-2007 single vehicle rollover fatalities in three Australian states was carried out using data from the Australian National Coroners Information System. In this paper, successive selection criteria were applied to the initial dataset to analyse: - Occupant fatalities in single passenger car crashes (1743 cases), - Occupant fatalities in single passenger car rollovers (474 cases), overall, rollovers accounted for 35% of all occupant fatalities in a single vehicle transport ...

  19. CD206+ Cell Number Differentiates Influenza A (H1N1pdm09 from Seasonal Influenza A Virus in Fatal Cases

    Directory of Open Access Journals (Sweden)

    Heidi G. Rodriguez-Ramirez

    2014-01-01

    Full Text Available In 2009, a new influenza A (H1N1 virus affected many persons around the world. There is an urgent need for finding biomarkers to distinguish between influenza A (H1N1pdm09 and seasonal influenza virus. We investigated these possible biomarkers in the lung of fatal cases of confirmed influenza A (H1N1pdm09. Cytokines (inflammatory and anti-inflammatory and cellular markers (macrophages and lymphocytes subpopulation markers were analyzed in lung tissue from both influenza A (H1N1pdm09 and seasonal influenza virus. High levels of IL-17, IFN-γ, and TNF-α positive cells were identical in lung tissue from the influenza A (H1N1pdm09 and seasonal cases when compared with healthy lung tissue (P<0.05. Increased IL-4+ cells, and CD4+ and CD14+ cells were also found in high levels in both influenza A (H1N1pdm09 and seasonal influenza virus (P<0.05. Low levels of CD206+ cells (marker of alternatively activated macrophages marker in lung were found in influenza A (H1N1pdm09 when compared with seasonal influenza virus (P<0.05, and the ratio of CD206/CD14+ cells was 2.5-fold higher in seasonal and noninfluenza group compared with influenza A (H1N1pdm09 (P<0.05. In conclusion, CD206+ cells differentiate between influenza A (H1N1pdm09 and seasonal influenza virus in lung tissue of fatal cases.

  20. Ataque por animales acuáticos (tiburón y cocodrilo: A propósito de dos casos fatales en la provincia de Bocas del Toro (Panamá Attack for aquatic animals (shark and alligator: Report of two fatal cases in the Bocas del Toro province (Panama

    Directory of Open Access Journals (Sweden)

    C. Mendieta

    2009-10-01

    Full Text Available Los ataques por animales acuáticos, y especialmente los producidos por tiburón y cocodrilo, son muy poco frecuentes. Se han descrito ataques por tiburón en países como Australia, Sudáfrica, Brasil, Bahamas, México y Puerto Rico, algunos con resultado fatal en los últimos cinco años. En Panamá, los casos descritos de ataques por escualo son escasos, siendo el último descrito con resultado no fatal en julio de 2008 en una playa de la localidad de San Carlos mientras que el último caso fatal se remonta al año 1964. Los ataques por cocodrilo, al igual que en el caso anterior, son poco frecuentes. A nivel mundial la mayor parte de los casos descritos proceden de Australia, Angola, India, Brasil y Florida. En Panamá, el último caso fatal ocurrió en el Lago de Miraflores en mayo de 2007, pero el cadáver no fue encontrado. En este artículo se describen dos casos de depredación animal, por tiburón y cocodrilo, en la provincia de Bocas del Toro (Panamá con el objetivo de reconocer el patrón de las lesiones por mordedura y las áreas anatómicas vulnerables afectadas.Attacks for aquatic animals, especially those due to shark and alligator, are very unusual. Shark attacks have been reported in countries such as Australia, South Africa, Brazil, Bahamas, Mexico and Puerto Rico, some with fatal consequences in the last five years. In Panama, reported cases from shark attack are scarce, being the last one in the city of San Carlos, while the last fatal case was reported in the year 1964. Alligator attacks, as in the previous case, are very scarce. Worldwide, the major part of the described cases are from Australia, Angola, India, Brazil and Florida. In Panama, the last fatal case occurred in the Miraflores lake in May 2007; however, the corpse was never found. In this paper, we described two cases of animal predation, from shark and alligator, occurred in the Bocas del Toro province (Panama with the aim to recognize the pattern of bite

  1. EMOTIONAL AND COGNITIVE CHANGES DURING AND POST A NEAR FATAL HEART ATTACK AND ONE-YEAR AFTER: A CASE STUDY

    Directory of Open Access Journals (Sweden)

    Andrew M. Lane

    2010-09-01

    Full Text Available This case study reports on changes in emotions before and during an unexpected heart rate in a young, apparently healthy male with a life-long history of exercise in the absence of family history of heart problems. He completed the Brunel Mood Scale (Terry et al. , 2003 to assess emotions before, during, and after the heart attack, and also describing his thoughts during these periods. Results indicate he experienced unpleasant emotions in the build up to the heart attack, feelings he attributed at the time to frustration to achieve fitness goals. He maintained an exercise regime prior to having a heart attack, a finding consistent with previous research suggesting that early diagnosis, although vital for survival, is not likely to be identified among seemingly healthy individuals. During the heart attack, he experienced a rapid emotional change characterised by a rapid increase in anger coupled with thoughts of needing to survive. The intensity of emotions and regulation strategies employed before and during the heart attack provide insight this experience, and we suggest future research should investigate emotional change during adverse conditions

  2. Clinical, clinicopathologic, radiographic, and ultrasonographic abnormalities in dogs with fatal acute pancreatitis: 70 cases (1986-1995)

    International Nuclear Information System (INIS)

    To determine clinical, clinicopathologic, radiographic, ultrasonographic, and coagulation abnormalities in dogs in which acute pancreatitis was fatal. Retrospective study. 70 dogs. History, clinical signs, and physical examination findings at the time of initial evaluation at the veterinary teaching hospital; results of pretreatment laboratory tests, abdominal radiography, and ultrasonography; and histologic abnormalities were obtained from medical records. Clinical signs included anorexia, vomiting, Weakness, diarrhea, polyuria and polydipsia, neurologic abnormalities, melena, weight loss, hematemesis, and passage of frank blood in feces. At the time of initial examination at the veterinary teaching hospital, 68 (97%) dogs were dehydrated, 18 (26%) were icteric, 22 (32%) were febrile, 40 (58%) had signs of abdominal pain, and 30 (43%) were classified as overweight or obese. Most dogs had leukocytosis, neutrophilia with a left shift, and thrombocytopenia. Various serum biochemical abnormalities were identified, including hypoglycemia, azotemia, hypercalcemia and other electrolyte abnormalities, hypoalbuminemia, high hepatic and pancreatic enzyme activities, hypercholesterolemia, and lipemia. For 17 of 28 (61%) dogs, results of coagulation function tests were abnormal. Results of abdominal ultrasonography and radiography were consistent with a diagnosis of acute pancreatitis in 23 of 34 (68%) and 10 of 41 (24%) dogs, respectively. For 2 dogs, results of abdominal ultrasonography were not suggestive of acute pancreatitis, but results of abdominal radiography were. Clinical signs and results of clinicopathologic tests are inconsistent. Abdominal ultrasonography may be valuable in the diagnostic evaluation of dogs suspected to have acute pancreatitis

  3. Trends in incidence, case-fatality and recurrence of myocardial infarction in the Danish MONICA population 1982-1991

    DEFF Research Database (Denmark)

    Davidsen, M; Brønnum-Hansen, H; Jørgensen, Torben; Madsen, Mette; Gerdes, L U; Osler, M; Schroll, M

    2001-01-01

    -period-cohort analyses were carried out according to a method described by Clayton and Schifflers. RESULTS: During the 10-year period a significant decrease in the incidence rate of MI was seen for men and women and for the rate of recurrent MI. The decrease in incidence and recurrence could not unambiguously be...

  4. A non-fatal case of hantavirus cardiopulmonary syndrome imported into the UK (ex Panama), July 2014

    OpenAIRE

    Atkinson, Barry; Jameson, Lisa J.; Bovill, Begoña A.; Aarons, Emma J.; Clewlow, Jodie; Lumley, Sarah; Latham, Jennie; Jenkins, Megan H.; MacGowan, Alasdair P; Simpson, Andrew J.; Ahmed, Javeed; Brooks, Timothy J.; Hewson, Roger

    2015-01-01

    Highlights • Detection of hantavirus cardiopulmonary syndrome imported into Europe. • Additional evidence that Choclo hantavirus is currently circulating and causing human disease in Panama. • Novel diagnostic and sequencing assays for identifying cases of Choclo hantavirus infection.

  5. A Fatal Urban Case of Rocky Mountain Spotted Fever Presenting an Eschar in San José, Costa Rica

    OpenAIRE

    Argüello, Ana Patricia; Hun, Laya; Rivera, Patricia; Taylor, Lizeth

    2012-01-01

    This study reports the first urban human case of Rocky Mountain spotted fever caused by Rickettsia rickettsii, in Costa Rica. An 8-year-old female who died at the National Children's Hospital 4 days after her admission, and an important and significant observation was the presence of an “eschar” (tache noire), which is typical in some rickettsial infections but not frequent in Rocky Mountain spotted fever cases.

  6. Retrospective analysis of fatal falls.

    Science.gov (United States)

    Thierauf, Annette; Preuss, Johanna; Lignitz, Eberhard; Madea, Burkhard

    2010-05-20

    Fatal falls are frequent and inhomogeneous events and affect every age. The criminalistic classification can often only be done on the basis of extensive investigations and the autopsy results. We retrospectively surveyed 291 cases of fatal falls on which a post-mortem examination had been carried out in the institutes of Forensic Medicine in Bonn and Greifswald. In large part, these cases are falls from height (n=123) and ground-level falls (n=122). These are compared to fatal falls down a stairs (n=46); the analysis is confined to injuries to the cranium. In ground-level falls the injury pattern in falls under the influence of alcohol differs from that of falls with no alcohol in the case history: all injuries are seen in higher relative frequency in casualties after the consumption of alcohol. In falls from height, the previous consumption of alcohol did not influence the injury pattern; the intracranial traumas are seen in decreasing frequency with increasing heights. The aim of this retrospective analysis is to present injury patterns and influencing factors like fall heights and alcohol for the different kinds of falls on the basis of our collective and to demonstrate similarities and differences between the subgroups. PMID:20176452

  7. Trends and factors associated with dengue mortality and fatality in Brazil

    Directory of Open Access Journals (Sweden)

    Enny Santos Paixão

    2015-08-01

    Full Text Available AbstractINTRODUCTION:Studies that generate information that may reduce the dengue death risk are essential. This study analyzed time trends and risk factors for dengue mortality and fatality in Brazil from 2001 to 2011.METHODS:Time trends for dengue mortality and fatality rates were analyzed using simple linear regression. Associations between the dengue mortality and the case fatality rates and socioeconomic, demographic, and health care indicators at the municipality level were analyzed using negative binomial regression.RESULTS:The dengue hemorrhagic fever case fatality rate increased in Brazil from 2001 to 2011 (β=0.67; p=0.036, in patients aged 0-14 years (β=0.48; p=0.030 and in those aged ≥15 years (β=1.1; p<0.01. Factors associated with the dengue case fatality rate were the average income per capita (MRR=0.99; p=0.038 and the number of basic health units per population (MRR=0.89; p<0.001. Mortality rates increased from 2001 to 2011 (β=0.350; p=0.002.Factors associated with mortality were inequality (RR=1.02; p=0.001 high income per capita (MRR=0.99; p=0.005, and higher proportions of populations living in urban areas (MRR=1.01; p<0.001.CONCLUSIONS:The increases in the dengue mortality and case fatality rates and the associated socioeconomic and health care factors, suggest the need for structural and intersectoral investments to improve living conditions and to sustainably reduce these outcomes.

  8. [A case of fatal pneumonia caused by Legionella pneumophila serogroup 6 developed after drowning in a public bath].

    Science.gov (United States)

    Tokuda, H; Yahagi, N; Kasai, S; Kitamura, S; Otsuka, Y

    1997-02-01

    A 57-year-old male was admitted to our hospital because of high fever, productive cough and dyspnea. Six days prior to admission he had an episode of drowning in a public bath. On admission chest X-ray showed wide-spread pneumonia causing severe respiratory distress for which mechanical ventilatory support was started. Despite chemotherapy including erythromycin and rifampicin his condition continued to deteriorate. Chemistry showed marked elevation of CPK and findings of acute renal failure. He eventually passed away with septic shock. During the course Legionellae remained negative with culture of broncho-alveolar lavage fluid. L. pneumophila serogroup 1 (SG1) antigen in the urine was not detected, and no elevation of serum antibody titer was noted. Culture of the material obtained from the lung abscess at autopsy revealed L. pneumophila SG6 and serum antibody titer against SG6 also was found to be extremely high. With this evidence we concluded that this case of pneumonia was caused by L. pneumophila SG6. We believe this is the first reported case of the SG6 pneumonia in Japan. Another remarkable feature of this case was massive rhabdomyolysis pathologically confirmed after autopsy. Although the pathogenesis of this process has not been clarified, there are several case reports of rhabdomyolysis complicated with Legionnair's disease in the past. Therefore, we should bear in mind and pay careful attention while coping with this disease. PMID:9077075

  9. Recombinant factor VIIa: use in fatal post partum hemorrhage — Indian experience case series and review of literature

    OpenAIRE

    Singi, Shailesh R.; Fernandez, Evita; Sunil T Pandya; Badrinath, H. R.

    2009-01-01

    Postpartum hemorrhage is leading cause of maternal mortality and still remains a challenging condition to treat and hysterectomy may be required to control the bleeding once medical interventions fail. These strategies are not always successful and a direct approach in activating the coagulation system can be more effective and life saving. We describe here the mechanism of action of rFVIIa, review of literature and its use in 10 cases with different causes for PPH with good response.

  10. Recurrent shunt associated ventriculitis caused by methicillin-resistant Staphylococcus aureus: Case with fatal outcome despite linezolid therapy

    Directory of Open Access Journals (Sweden)

    Sadia Khan

    2012-01-01

    Full Text Available Ventriculoperitoneal shunt-associated ventriculitis is a serious though under-reported nosocomial complication of neurocritical settings. The treatment of CNS Methicillin-resistant Staphylococcus aureus (MRSA infections is usually successful with vancomycin or linezolid. Here, we report a case of ventriculitis due to MRSA following a shunt infection, which did not show clinical response to linezolid therapy. With the increasing use of invasive procedures, nosocomial infections have increased exponentially. Exercising extreme care in such CNS procedures becomes very important.

  11. Association of clinical signs and symptoms of Ebola viral disease with case fatality: a systematic review and meta-analysis

    OpenAIRE

    Moole, Harsha; Chitta, Swetha; Victor, Darlyn; Kandula, Manasa; Moole, Vishnu; Ghadiam, Harshavardhan; Akepati, Anusha; Yerasi, Charan; Uppu, Achuta; Dharmapuri, Sowmya; Boddireddy, Raghuveer; Fischer, Jacqueline; Lynch, Teresa

    2015-01-01

    Background: Ebola virus disease (EVD) is a public health emergency of international concern. There is limited laboratory and clinical data available on patients with EVD. This is a meta-analysis to assess the utility of clinical signs, symptoms, and laboratory data in predicting mortality in EVD.Aim: To assess the utility of clinical signs, symptoms, and laboratory data in predicting mortality in EVD.Method: Study selection criterion: EVD articles with more than 35 EVD cases that described th...

  12. Molecular identification of poisonous mushrooms using nuclear ITS region and peptide toxins: a retrospective study on fatal cases in Thailand.

    Science.gov (United States)

    Parnmen, Sittiporn; Sikaphan, Sujitra; Leudang, Siriwan; Boonpratuang, Thitiya; Rangsiruji, Achariya; Naksuwankul, Khwanruan

    2016-02-01

    Cases of mushroom poisoning in Thailand have increased annually. During 2008 to 2014, the cases reported to the National Institute of Health included 57 deaths; at least 15 died after ingestion of amanitas, the most common lethal wild mushrooms inhabited. Hence, the aims of this study were to identify mushroom samples from nine clinically reported cases during the 7-year study period based on nuclear ITS sequence data and diagnose lethal peptide toxins using a reversed phase LC-MS method. Nucleotide similarity was identified using BLAST search of the NCBI database and the Barcode of Life Database (BOLD). Clade characterization was performed by maximum likelihood and Bayesian phylogenetic approaches. Based on BLAST and BOLD reference databases our results yielded high nucleotide similarities of poisonous mushroom samples to A. exitialis and A. fuliginea. Detailed phylogenetic analyses showed that all mushroom samples fall into their current classification. Detection of the peptide toxins revealed the presence of amatoxins and phallotoxins in A. exitialis and A. fuliginea. In addition, toxic α-amanitin was identified in a new provisional species, Amanita sp.1, with the highest toxin quantity. Molecular identification confirmed that the mushrooms ingested by the patients were members of the lethal amanitas in the sections Amanita and Phalloideae. In Thailand, the presence of A. exitialis was reported here for the first time and all three poisonous mushroom species provided new and informative data for clinical studies. PMID:26763394

  13. High Fatality Rate of Epstein-Barr Virus-Associated Lymphoproliferative Disorder Occurring after Bone Marrow Transplantation with Rabbit Antithymocyte Globulin Conditioning Regimens

    OpenAIRE

    Peres, E; Savasan, S.; Klein, J; Abidi, M.; Dansey, R; Abella, E.

    2005-01-01

    Epstein-Barr virus (EBV)-associated lymphoproliferative disorder (EBV-LPD) following bone marrow transplantation can be fatal. The major risk factors for the development of EBV-LPD are ex vivo T-cell depletion or in vivo T-cell depletion with either antithymocyte globulin (ATG) or monoclonal anti-T-cell antibodies. Between March 1999 and January 2001, a total of 23 transplants with ATG of equine source (20 transplants) and ATG of rabbit source (3 transplants) used as part of the preparatory r...

  14. Analysis of fatal outcomes from influenza A(H1N1pdm09 in Mongolia

    Directory of Open Access Journals (Sweden)

    Erdenebaatariin Soyolmaa

    2012-08-01

    Full Text Available Introduction: While influenza A(H1N1pdm09 usually causes mild illness in the majority of people, there have been reports of severe cases and deaths. As there is no documented evidence on fatal outcomes from influenza in Mongolia previously, we aimed to describe the epidemiology of fatal influenza A(H1N1pdm09 cases to provide recommendations to assist the national influenza prevention and control strategy.Methods: We selected influenza A(H1N1pdm09-confirmed deaths in hospitals between 12 October 2009 and 31 January 2010 in Mongolia from the national influenza surveillance system. The mortality rate and case fatality rate (CFR of influenza A(H1N1pdm09-hospitalized deaths were calculated. Using country prevalence of pregnancy and chronic diseases, we calculated the relative risk of death from influenza A(H1N1pdm09.Results: There were 29 deaths with a mortality rate of 1.0 per 100 000 population during the study period, which was highest in children under five and the middle-aged population. Crude CFR was 2.2%. Of all fatal cases, 62% had at least one underlying condition. Most (62% were provided antivirals, although none received these within 48 hours of symptom onset. Prevalence for pregnancy, cardiovascular and chronic liver diseases was five to 50 times higher in fatal cases compared to country prevalence.Discussion: Mortality and crude CFR in our study was higher than in other studies. However, due to the diagnostic policy change during the epidemic, this estimate is likely to have overestimated actual case fatalities. Pregnancy, cardiovascular and chronic liver diseases were suggestive risk factors for death from influenza A(H1N1pdm09. Strengthening hospital-based influenza surveillance is important in predicting severity of an epidemic and responding to influenza epidemics in a timely and appropriate manner.

  15. Fatal motorcycle accidents and alcohol

    DEFF Research Database (Denmark)

    Larsen, C F; Hardt-Madsen, M

    1987-01-01

    A series of fatal motorcycle accidents from a 7-year period (1977-1983) has been analyzed. Of the fatalities 30 were operators of the motorcycle, 11 pillion passengers and 8 counterparts. Of 41 operators 37% were sober at the time of accident, 66% had measurable blood alcohol concentration (BAC......); 59% above 0.08%. In all cases where a pillion passenger was killed, the operator of the motorcycle had a BAC greater than 0.08%. Of the killed counterparts 2 were non-intoxicated, 2 had a BAC greater than 0.08%, and 4 were not tested. The results advocate that the law should restrict alcohol...... consumption by pillion passengers as well as by the motorcycle operator. Suggestions made to extend the data base needed for developing appropriate alcohol countermeasures by collecting sociodemographic data on drivers killed or seriously injured should be supported....

  16. [Atypical case of teenager fatal poisoning by butane as a result of gas for lighters inhalation against his will].

    Science.gov (United States)

    Celiński, Rafał; Skowronek, Rafał; Uttecht-Pudełko, Anna

    2013-01-01

    Inhalatomania with volatile organic compounds is a still present phenomenon among Polish young adolescents. Conscious, voluntary exposition on such substances may result in serious health consequences, including sudden death in the course of acute intoxication. In this paper, atypical case of death of 16-year-old teenager as a result of complications of physically forced inhalation of gas for lighters is presented. According to testimonies of witnesses, the container was placed in the mouth of victim and the gas was introduced directly to his throat. Autopsy revealed small damage of tooth with corresponding bruising of lower lip; brain and lung oedma; single bruisings in the upper respiratory tract and subpleural. Chemical-toxicological analysis of blood, brain and lung samples taken during autopsy revealed in all of them the presence of n-butan--a component of gas for lighters (the greatest in brain and lung tissues). Additionally, in blood the presence of carboxyhemoglobin (COHb) in concentration 7% was confirmed. Based on the results of analyses, acute intoxication with n-butan was estimated as a cause of death; however the key role played the information obtained during the investigation. This case shows, that deaths resulting from gas for lighters inhalation may be a consequence of forced exposition--against victim's will. So medical staff should always check, if on the body of patient there are any signs of physical constraint (the presence of bruisings in the area of viscerocranium and oral cavity, teeth damages, etc.). PMID:24167951

  17. Substance use among Iranian drivers involved in fatal road accidents

    Directory of Open Access Journals (Sweden)

    Shervin eAssari

    2014-08-01

    Full Text Available Background: Although the problem of substance use among drivers is not limited to a special part of the world, most published epidemiological reports on this topic is from industrial world.Aim: To determine drug use among Iranian adults who were imprisoned for vehicle accidents with fatality. Methods: This study enrolled 51 Iranian adults who were imprisoned for vehicle accidents with fatality. This sample came from a national survey of prisoners. Data was collected at entry to prisons during the last 4 months of 2008 in 7 prisons in different parts of the country. Self reported drug use was registered. Commercial substance use screening tests were also done. Results: Drug test was positive for opioids, cannabis and both in 37.3%, 2.0% and 13.7%, respectively. 29.4% tested positive for benzodiazepines. Using test introduced 23.5% of our sample as drug users, who had declined to report any drug use. Conclusion: Opioids are the most used illicit drug in the case of vehicle accidents with fatality, however, 20% of users do not declare their use. This high rate of drug use in vehicle accidents with fatality reflects the importance of drug use control as a part of injury prevention in Iran. There might be a need for drug screening after severe car accidents.

  18. A case-control study of non-fatal traffic accidents on hospital patients in Bangkok metropolis.

    Science.gov (United States)

    Böhning, D; Na Ayutha, R S

    1997-01-01

    Morbidity and mortality from road traffic accidents in Bangkok metropolis is high with a trend strictly increasing in time, thus establishing one of the major public health problems and targets of the Kingdom of Thailand. An unmatched case-control study was undertaken to evaluate various risk patterns connected with the occurrence of traffic accidents. 350 cases were sampled from five major hospitals distributed over the Bangkok Metropolitan area and 350 controls were included from out-patients of Rajawithi hospital. The major interest in this case-control analysis is to estimate relative risk (through odds ratio) and measure statistical significance of association between road traffic accident and the following risk factors: the demographic risk factors are age (age between 15 and 19 years has odds ratio of 8.25 [1.01, 67.72]; age above 40 is baseline), marital status (single has odds ratio of 2.74 [1.26, 5.95]; baseline is not-single), sex (males have an odds ratio of 2.05 [0.51, 8.24], occupation (salespersons have an odds ratio of 4.27 [1.47, 12.46]; baseline are office workers); the driving related exposure factors type of vehicle (motorbikers have an odds ratio of 6.22 [2.82, 13.78]; baseline are other vehicle drivers), driving time per day (odds ratio 1.35 [0.88, 2.09]) and the number of accidents in the last three years (odds ratio of 4.36 [2.51, 7.58]); the behavioral factors one hour before driving such as the consumption of alcohol (odds ratio 3.01 [1.53, 5.94]; baseline in no alcohol) and the consumption of a lot of food (odds ratio of 0.07 [0.03, 0.16]; baseline is not eating a lot before driving). The odds ratios for traffic accident when being under allergic medication and the consumption of tranquilizer were not significant. The results are consistent with current results in traffic accident research and point to target groups for potential prevention programmes in traffic accident prevention. PMID:9499466

  19. Trends and Analyses of General Aviation Fatalities

    OpenAIRE

    Nordyke, Shane

    2005-01-01

    Recent publications have shown that general aviation accident rates in the United States are decreasing, though they remain much higher than other segments of aviation. What is behind this safety improvement? Are all types of accidents decreasing or are certain types of accidents driving the overall decrease? This study provides the preliminary results of an in depth analysis of the causes of fatal general aviation accidents from 1992 through 2002. First a database of all fatal Part 91 accide...

  20. Short-term starvation with a near-fatal asthma attack induced ketoacidosis in a nondiabetic pregnant woman: A case report.

    Science.gov (United States)

    Wei, Kuang-Yu; Chang, Shan-Yueh; Wang, Sheng-Huei; Su, Her-Young; Tsai, Chen-Liang

    2016-06-01

    Life-threatening refractory metabolic acidosis due to starvation ketoacidosis is rarely reported, even among nondiabetic pregnant women, and may be overlooked. Furthermore, stressful situations may increase the acidosis severity.In the present case, a nondiabetic multiparous woman was admitted for a near-fatal asthma attack and vomiting during the third trimester of pregnancy. She was intubated and rapidly developed high anion gap metabolic acidosis. We diagnosed the patient with starvation ketoacidosis based on vomiting with concomitant periods of stress during pregnancy and the absence of other causes of high anion gap metabolic acidosis. She responded poorly to standard treatment, although the ketoacidosis and asthma promptly resolved after an emergency caesarean section. The patient and her baby were safely discharged.Short-term starvation, if it occurs during periods of stress and medication, can result in life-threatening ketoacidosis, even among nondiabetic women during the third trimester of pregnancy. Awareness of this condition may facilitate prompt recognition and proactive treatment for dietary and stress control, and emergent interventions may also improve outcomes. PMID:27368034

  1. Fatal Fusarium solani species complex infections in elasmobranchs: the first case report for black spotted stingray (Taeniura melanopsila) and a literature review.

    Science.gov (United States)

    Fernando, Nimal; Hui, Suk-Wai; Tsang, Chi-Ching; Leung, Shui-Yee; Ngan, Antonio H Y; Leung, Raymond W W; Groff, Joseph M; Lau, Susanna K P; Woo, Patrick C Y

    2015-07-01

    Fusarium species are environmental saprophytic fungi. Among the many Fusarium species, members of the Fusarium solani species complex (FSSC) are the most prevalent and virulent in causing human and animal infections. In this study, we describe the first case of fatal FSSC infection in a black spotted stingray and three concomitant infections in scalloped hammerhead sharks. In the stingray, cutaneous lesions were characterised by ulcers and haemorrhage of the ventral pectoral fin, or 'ray', especially around the head; while cutaneous lesions in the sharks were characterised by ulcers, haemorrhage, as well as white and purulent exudates at the cephalic canals of the cephalofoil and lateral line. Histological sections of the cutaneous lesions revealed slender (1-4 μm in diameter), branching, septate fungal hyphae. Internal transcribed spacer region and 28S nrDNA sequencing of the fungal isolates from the fish showed two isolates were F. keratoplasticum (FSSC 2) and the other two were FSSC 12. Environmental investigation revealed the FSSC strains isolated from water and biofilms in tanks that housed the elasmobranchs were also F. keratoplasticum and FSSC 12. Fusarium is associated with major infections in elasmobranchs and FSSC 12 is an emerging cause of infections in marine animals. DNA sequencing is so far the most reliable method for accurate identification of Fusarium species. PMID:26095191

  2. A validated method for quantifying atractyloside and carboxyatractyloside in blood by HPLC-HRMS/MS, a non-fatal case of intoxication with Atractylis gummifera L.

    Science.gov (United States)

    Carlier, Jérémy; Romeuf, Ludovic; Guitton, Jérôme; Priez-Barallon, Cédric; Bévalot, Fabien; Fanton, Laurent; Gaillard, Yvan

    2014-01-01

    Atractyloside (ATR) and carboxyatractyloside (CATR) are diterpene glycosides that are responsible for the toxicity of several Asteraceae plants around the world. Mediterranean gum thistle (Atractylis gummifera L.) and Zulu impila (Callilepis laureola DC.), in particular, are notoriously poisonous and the cause of many accidental deaths, some suicides and even some murders. There is no current method for measuring the two toxins in biological samples that meet the criteria of specificity required in forensic medicine. We have endeavored to fill this analytical gap. Analysis was carried out using a solid-phase extraction and a high-performance liquid chromatography coupled with high-resolution tandem mass spectrometry detection. The method was validated in the whole blood with quantification limits of 0.17 and 0.15 µg/L for ATR and CATR, respectively. The method was applied to a non-fatal case of intoxication with A. gummifera. To the best of the authors' knowledge, this is the first time that a concentration of ATR and CATR in blood (883.1 and 119.0 µg/L, respectively) and urine (230.4 and 140.3 µg/L, respectively) is reported. ATR and CATR were quantified in A. gummifera roots by the standard method addition (3.7 and 5.4 mg/g, respectively). PMID:24990875

  3. Presentations of patients of poisoning and predictors of poisoning-related fatality: Findings from a hospital-based prospective study

    Directory of Open Access Journals (Sweden)

    Lin Hung-Jung

    2008-01-01

    Full Text Available Abstract Background Poisoning is a significant public health problem worldwide and is one of the most common reasons for visiting emergency departments (EDs, but factors that help to predict overall poisoning-related fatality have rarely been elucidated. Using 1512 subjects from a hospital-based study, we sought to describe the demographic and clinical characteristics of poisoning patients and to identify predictors for poisoning-related fatality. Methods Between January 2001 and December 2002 we prospectively recruited poisoning patients through the EDs of two medical centers in southwest Taiwan. Interviews were conducted with patients within 24 hours after admission to collect relevant information. We made comparisons between survival and fatality cases, and used logistic regressions to identify predictors of fatality. Results A total of 1512 poisoning cases were recorded at the EDs during the study period, corresponding to an average of 4.2 poisonings per 1000 ED visits. These cases involved 828 women and 684 men with a mean age of 38.8 years, although most patients were between 19 and 50 years old (66.8%, and 29.4% were 19 to 30 years. Drugs were the dominant poisoning agents involved (49.9%, followed by pesticides (14.5%. Of the 1512 patients, 63 fatalities (4.2% occurred. Paraquat exposure was associated with an extremely high fatality rate (72.1%. The significant predictors for fatality included age over 61 years, insufficient respiration, shock status, abnormal heart rate, abnormal body temperature, suicidal intent and paraquat exposure. Conclusion In addition to well-recognized risk factors for fatality in clinical settings, such as old age and abnormal vital signs, we found that suicidal intent and ingestion of paraquat were significant predictors of poisoning-related fatality. Identification of these predictors may help risk stratification and the development of preventive interventions.

  4. Characteristics and Risk Factors for Fatality in Patients with Dengue Hemorrhagic Fever, Taiwan, 2014.

    Science.gov (United States)

    Wei, Hsin-Yi; Shu, Pei-Yun; Hung, Min-Nan

    2016-08-01

    An unprecedented dengue outbreak involving more than 15,000 infections, including 136 dengue hemorrhagic fever (DHF) cases and 20 fatalities, occurred in Taiwan in 2014. The median age of the DHF cases was 71 years (range: 4-92 years) and most of them (N = 100, 73.5%) had comorbidities, of which the majority were hypertension (56%) and diabetes mellitus (DM; 27%). Only approximately half of the DHF cases (59/136) were classified as severe dengue, based on the 2009 WHO-revised dengue classification. The fatality rate for this DHF outbreak was 14.7%. DM (odds ratio [OR] = 3.60, 95% confidence interval [CI] = 1.22-10.63) and presentation with severe plasma leakage (OR = 6.42, 95% CI = 1.76-23.63) were independent risk factors for fatality. PMID:27273649

  5. Primary angiitis of the central nervous system presenting with subacute and fatal course of disease: a case report

    Directory of Open Access Journals (Sweden)

    Börnke Christian

    2005-09-01

    Full Text Available Abstract Background Primary angiitis of the central nervous system is an idiopathic disorder characterized by vasculitis within the dural confines. The clinical presentation shows a wide variation and the course and the duration of disease are heterogeneous. This rare but treatable disease provides a diagnostic challenge owing to the lack of pathognomonic tests and the necessity of a histological confirmation. Case presentation A 28-year-old patient presenting with headache and fluctuating signs of encephalopathy was treated on the assumption of viral meningoencephalitis. The course of the disease led to his death 10 days after hospital admission. Postmortem examination revealed primary angiitis of the central nervous system. Conclusion Primary angiitis of the central nervous system should always be taken into consideration when suspected infectious inflammation of the central nervous system does not respond to treatment adequately. In order to confirm the diagnosis with the consequence of a modified therapy angiography and combined leptomeningeal and brain biopsy should be considered immediately.

  6. Rifampicin-isoniazid induced fatal fulminant hepatitis during treatment of latent tuberculosis: A case report and literature review

    Directory of Open Access Journals (Sweden)

    Khan Fahmi

    2010-01-01

    Full Text Available A 42-year-old Indian man received 450 mg rifampicin (RIF and 150 mg isoniazid (INH daily after being diagnosed of a latent tuberculosis infection. Baseline serum aminotransferase and total bilirubin levels were within normal limits. On day 31 of treatment, the patient experienced epigastric discomfort and general malaise and one week later he developed nausea and episodic vomiting. The patient missed his first scheduled clinic appointment and he continued taking RIF-INH despite his symptoms. He visited the tuberculosis clinic on day 47 of treatment where he was found to be jaundiced and his liver enzymes were elevated. RIF-INH was stopped and the patient was admitted to our hospital as a case of RIF-INH induced hepatitis. On the 7th day of hospitalization, the patient developed consciousness disturbance with flapping tremor and high ammonia level. The patient was diagnosed with fulminant hepatic failure and transferred immediately to the medical intensive care unit, where he died 4 days later.

  7. A case-control study of physical activity patterns and risk of non-fatal myocardial infarction

    Directory of Open Access Journals (Sweden)

    Gong Jian

    2013-02-01

    Full Text Available Abstract Background The interactive effects of different types of physical activity on cardiovascular disease (CVD risk have not been fully considered in previous studies. We aimed to identify physical activity patterns that take into account combinations of physical activities and examine the association between derived physical activity patterns and risk of acute myocardial infarction (AMI. Methods We examined the relationship between physical activity patterns, identified by principal component analysis (PCA, and AMI risk in a case-control study of myocardial infarction in Costa Rica (N=4172, 1994-2004. The component scores derived from PCA and total METS were used in natural cubic spline models to assess the association between physical activity and AMI risk. Results Four physical activity patterns were retained from PCA that were characterized as the rest/sleep, agricultural job, light indoor activity, and manual labor job patterns. The light indoor activity and rest/sleep patterns showed an inverse linear relation (P for linearity=0.001 and a U-shaped association (P for non-linearity=0.03 with AMI risk, respectively. There was an inverse association between total activity-related energy expenditure and AMI risk but it reached a plateau at high levels of physical activity (P for non-linearity=0.01. Conclusions These data suggest that a light indoor activity pattern is associated with reduced AMI risk. PCA provides a new approach to investigate the relationship between physical activity and CVD risk.

  8. A nationwide, retrospective analysis of symptoms, comorbidities, medical care and autopsy findings in cases of fatal pulmonary embolism in younger patients

    DEFF Research Database (Denmark)

    Haunsø, S; Theilade, J; Winkel, B G; Holst, A G; Tfelt-Hansen, J; Svendsen, J H; Haunsø, Stig

    2010-01-01

    Our objective was to provide a comprehensive description of fatal pulmonary embolism (PE) in younger persons. Specifically, we recorded information on symptoms, comorbidity, medical contact, if this had been required, and subsequent autopsy findings.......Our objective was to provide a comprehensive description of fatal pulmonary embolism (PE) in younger persons. Specifically, we recorded information on symptoms, comorbidity, medical contact, if this had been required, and subsequent autopsy findings....

  9. Rate of return on common equity: Annual survey of gas rate cases

    International Nuclear Information System (INIS)

    The results of the 1989-1990 gas rate survey are represented. The data is a tabular compilation of basic information from natural gas rate orders issued by state public utility commissions throughout the country. It includes a summary of rates of return on common equity approved in rate-making proceedings. The table covers rate orders issued between August 31, 1989, and September 1, 1990. The table provides other basic rate case information besides return on common equity, such as the dollar amount of rate increases applied for and granted, filing dates of the application and order, test year ending dates, and identifying docket or case numbers

  10. Energy efficiency rating of districts, case Finland

    International Nuclear Information System (INIS)

    There is an increasing political pressure on the city planning to create more energy efficient city plans. Not only do the city plans have to enable and promote energy efficient solutions, but it also needs to be clearly assessed how energy efficient the plans are. City planners often have no or poor know how about energy efficiency and building technologies which makes it difficult for them to answer to this need without new guidelines and tools. An easy to use tool for the assessment of the energy efficiency of detailed city plans was developed. The aim of the tool is for city planners to easily be able to assess the energy efficiency of the proposed detailed city plan and to be able to compare the impacts of changes in the plan. The tool is designed to be used with no in-depth knowledge about energy or building technology. With a wide use of the tool many missed opportunities for improving energy efficiency can be avoided. It will provide better opportunities for sustainable solutions leading to less harmful environmental impact and reduced emissions. - Highlights: • We have created a tool for assessing energy efficiency of detailed city plans. • The energy source is the most important factor for efficiency of districts in Finland. • Five case districts in Finland were analyzed. • In this paper one residential district has in-depth sensitivity analyses done

  11. Predictors of non-invasive therapy and 28-day-case fatality in elderly compared to younger patients with acute myocardial infarction: an observational study from the MONICA/KORA Myocardial Infarction Registry

    OpenAIRE

    Amann, Ute; Kirchberger, Inge; Heier, Margit; Thilo, Christian; Kuch, Bernhard; Peters, Annette; Meisinger, Christa

    2016-01-01

    Background A substantial proportion of patients with acute myocardial infarction (AMI) did not receive invasive therapy, defined as percutaneous coronary intervention and/or coronary artery bypass grafting. Aims of this study were to evaluate predictors of non-invasive therapy in elderly compared to younger AMI patients and to assess the association between invasive therapy and 28-day-case fatality. Methods From the German population-based registry, 3475 persons, consecutively hospitalized wi...

  12. Use of Viremia to Evaluate the Baseline Case Fatality Ratio of Ebola Virus Disease and Inform Treatment Studies: A Retrospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Oumar Faye

    2015-12-01

    Full Text Available The case fatality ratio (CFR of Ebola virus disease (EVD can vary over time and space for reasons that are not fully understood. This makes it difficult to define the baseline CFRs needed to evaluate treatments in the absence of randomized controls. Here, we investigate whether viremia in EVD patients may be used to evaluate baseline EVD CFRs.We analyzed the laboratory and epidemiological records of patients with EVD confirmed by reverse transcription PCR hospitalized in the Conakry area, Guinea, between 1 March 2014 and 28 February 2015. We used viremia and other variables to model the CFR. Data for 699 EVD patients were analyzed. In the week following symptom onset, mean viremia remained stable, and the CFR increased with viremia, V, from 21% (95% CI 16%-27% for low viremia (V < 104.4 copies/ml to 53% (95% CI 44%-61% for intermediate viremia (104.4 ≤ V < 105.2 copies/ml and 81% (95% CI 75%-87% for high viremia (V ≥ 105.2 copies/ml. Compared to adults (15-44 y old [y.o.], the CFR was larger in young children (0-4 y.o. (odds ratio [OR]: 2.44; 95% CI 1.02-5.86 and older adults (≥ 45 y.o. (OR: 2.84; 95% CI 1.81-4.46 but lower in children (5-14 y.o. (OR: 0.46; 95% CI 0.24-0.86. An order of magnitude increase in mean viremia in cases after July 2014 compared to those before coincided with a 14% increase in the CFR. Our findings come from a large hospital-based study in Conakry and may not be generalizable to settings with different case profiles, such as with individuals who never sought care.Viremia in EVD patients was a strong predictor of death that partly explained variations in CFR in the study population. This study provides baseline CFRs by viremia group, which allow appropriate adjustment when estimating efficacy in treatment studies. In randomized controlled trials, stratifying analysis on viremia groups could reduce sample size requirements by 25%. We hypothesize that monitoring the viremia of hospitalized patients may inform the

  13. Evaluation of clinical and laboratory predictors of fatality in patients with Hantavirus infection

    Directory of Open Access Journals (Sweden)

    Uğur Kostakoğlu

    2012-12-01

    Full Text Available Objectives: To determine the clinical and laboratory predictors of fatality among patients with Hantavirus infection.Materials and methods: A retrospective study was conducted on the patients with Hantavirus infection between April 2009and October 2011 at the Black Sea and the Mediterranean regions in Turkey. Demographic, clinical and laboratory findings offatal cases and non-fatal cases at the admission were compared.Results: Twenty-two patients with confirmed Hantavirus infection were evaluated. Five patients died (22.7%. The cause ofdeath was massive bleeding. The rate of hemorrhage was significantly higher in the fatal cases than non-fatal cases (p<0.001.Massive gastrointestinal hemorrhage was seen in four of these patients, cerebral hemorrhage in two and both gastrointestinaland pulmonary hemorrhage in one. Disseminated intravascular coagulation (DIC was present in four of the fatal cases and aremarkable cause of the bleeding (p=0.02. White blood cell count (WBC (p=0.002, creatine phosphokinase (CPK (p=0.011,blood-urea-nitrogen (BUN (p=0.014, C reactive protein (CRP (p=0.005 and D-dimer levels (p=0.001, prothrombin time (PT(p=0.023, activated partial thromboplastin time (aPTT (p=0.001 and international normalized ratio (INR (p=0.021 were significantlyhigher, and platelet counts (p=0.038 significantly lower in the fatal cases. Optimum diagnostic cut-off points for specificlaboratory parameters which may be predictive of fatality were; WBC=16,000 μL-1, PLT=30000 μL-1, PT=19.7 s, aPTT=36s, INR=1.2, D-dimer=9.3 μg/mL, CPK=600 U/L, BUN=47 mg/dL and CRP=13.4 mg/dL.Conclusions: Physicians should be aware of the high fatality risk for patients with Hantavirus infection with hemorrhage, elevatedWBC, CPK, BUN, CRP, PT, aPTT, INR and D-dimer and reduced platelet counts. J Microbiol Infect Dis 2012; 2(4: 155-159Key words: Hantavirus; hemorrhagic fever with renal syndrome; predictors of fatality; predictive factors

  14. Fatalities associated with farm tractor injuries: an epidemiologic study.

    OpenAIRE

    Goodman, R A; Smith, J. D.; Sikes, R K; Rogers, D L; Mickey, J L

    1985-01-01

    Death certificates were used as a source of information to characterize fatalities associated with farm tractor injuries in Georgia for the period 1971-81. In this period, 202 tractor-associated fatalities occurred among residents of Georgia; 198 of these persons were males. The annual tractor-associated fatality rate for males based on the population of male farm residents was 23.6 per 100,000; rates of fatal injury increased with age for this population. Persons whose primary occupation was...

  15. Fatal Injuries in Sports

    OpenAIRE

    Leonid S. Khodasevich; Aleksei L. Khodasevich; Sergei G. Kuzin

    2013-01-01

    The literary review, related to fatal injuries in sports, contains epidemiology, their mechanisms, causes of death in sports. Injuries in different sports have their own features, concerned with sports equipment, performed exercises, sports facilities equipment and protective equipment, used by the athletes.

  16. No to fatalism

    International Nuclear Information System (INIS)

    By saying 'No to fatalism', M. Pecqueur is forming the wish that the recent awarness of the energy situation, far from bringing about resignation, speeds up the implementation of the indispensable measures on which the economic and political stability of the world depends in the decade ahead

  17. Prenatal diagnosis of medium-chain acyl-CoA dehydrogenase (MCAD) deficiency in a family with a previous fatal case of sudden unexpected death in childhood

    DEFF Research Database (Denmark)

    Gregersen, N; Winter, V; Jensen, P K;

    1995-01-01

    Medium-chain acyl-CoA dehydrogenase (MCAD) deficiency is a potentially fatal inherited disease with a carrier frequency of approximately 1:100 in most Caucasian populations. The disease is implicated in sudden unexpected death in childhood. A prevalent disease-causing point mutation (A985G...

  18. Phylogenetic characterisation of the G(L) sequences of equine arteritis virus isolated from semen of asymptomatic stallions and fatal cases of equine viral arteritis in Denmark

    DEFF Research Database (Denmark)

    Larsen, Lars Erik; Storgaard, Torben; Holm, Elisabeth

    2001-01-01

    three different outbreaks of EVA. From these fatalities, the complete open reading frame 5, encoding the EAV GL protein, was amplified by reverse transcription-polymerase chain reaction and subjected to nucleotide sequence analysis. Furthermore, DNA sequences were obtained from virus isolated from semen...

  19. Children and bicycles: what is really happening? Studies of fatal and non-fatal bicycle injury.

    OpenAIRE

    Acton, C. H.; Thomas, S; Nixon, J. W.; Clark, R; Pitt, W R; Battistutta, D.

    1995-01-01

    OBJECTIVES: The objectives of the study were to ascertain the causes of accidents, injuries, and deaths in children who ride bicycles. Fatality and injury rates were also studied in order to compare with other studies. METHODS: Two studies of children were undertaken in children aged less than 15 years. In the first (retrospective fatality study), children who died as a result of a bicycle incident during the period 1981-92 were reviewed. In the second (prospective injury study) data were obt...

  20. Laffer Taxation Rate: Estimations For Romania’S Case

    OpenAIRE

    Elena Pădurean; Andreea Stoian; Emilia Câmpeanu

    2011-01-01

    The relationship between taxation rate and tax revenues for the public budget has generated an important debate aiming that level of taxation rate that maximizes tax revenues collected for the public budget. Laffer curve involves the existence of a strong correlation between taxation rate and tax revenues. The aim of this paper is to estimate a Laffer taxation rate for Romania’s case using annual data over the period 1990-2008. The main findings highlight that a taxation rate higher than 28% ...

  1. Fatal case of hydrocarbon aspiration and use of lipoid cells as corroborative finding for rapid autopsy diagnosis in cases of delayed death.

    Science.gov (United States)

    Jaybhaye, Prasad L; Shilawant, Santosh S

    2014-01-01

    Accidental aspiration of diesel can cause consolidation, atelectasis, and abscess formation. Aspiration of diesel usually results into pneumonitis, which resolves completely within 5-7 days of treatment. Diesel aspiration resulting in bilateral pneumonia and death is rare and is scarcely documented in literature. Finding of lipoid cells in lung autopsy specimen is one of the important features of hydrocarbon aspiration. Unfortunately this important finding is not mentioned in most of the toxicology textbooks. Hence, we are reporting this case. PMID:25948973

  2. Fatal falciparum malaria in Canadian travellers

    OpenAIRE

    Humar, A.; Sharma, S.; Zoutman, D; Kain, K. C.

    1997-01-01

    The authors report 2 cases of severe falciparum malaria in Canadians that had fatal outcomes. In the first case a man presented to a local hospital shortly after returning from Africa, but a diagnosis of malaria was not considered. He was transferred to a secondary and then to a tertiary care facility, where he subsequently died. Intravenous quinidine therapy, the treatment of choice, was unavailable at all 3 hospitals. In the second case, a woman taking chloroquine prophylaxis while visiting...

  3. Fatal Monocytic Ehrlichiosis in Woman, Mexico, 2013.

    Science.gov (United States)

    Sosa-Gutierrez, Carolina G; Solorzano-Santos, Fortino; Walker, David H; Torres, Javier; Serrano, Carlos A; Gordillo-Perez, Guadalupe

    2016-05-01

    Human monocytic ehrlichiosis is a febrile illness caused by Ehrlichia chaffeensis, an intracellular bacterium transmitted by ticks. In Mexico, a case of E. chaffeensis infection in an immunocompetent 31-year-old woman without recognized tick bite was fatal. This diagnosis should be considered for patients with fever, leukopenia, thrombocytopenia, and elevated liver enzyme levels. PMID:27088220

  4. Fatal lawn mower related projectile injury

    DEFF Research Database (Denmark)

    Colville-Ebeling, Bonnie; Lynnerup, Niels; Banner, Jytte

    2014-01-01

    operator or a bystander is impacted by an object mobilized from the grass by the rotating mower blades. This type of injury often leaves only modest external trauma, which increases the risk of overlooking an entry wound. In this paper we present a case of a fatal lawn mower related projectile injury which...

  5. Fatal Monocytic Ehrlichiosis in Woman, Mexico, 2013

    Science.gov (United States)

    Sosa-Gutierrez, Carolina G.; Solorzano-Santos, Fortino; Walker, David H.; Torres, Javier; Serrano, Carlos A.

    2016-01-01

    Human monocytic ehrlichiosis is a febrile illness caused by Ehrlichia chaffeensis, an intracellular bacterium transmitted by ticks. In Mexico, a case of E. chaffeensis infection in an immunocompetent 31-year-old woman without recognized tick bite was fatal. This diagnosis should be considered for patients with fever, leukopenia, thrombocytopenia, and elevated liver enzyme levels. PMID:27088220

  6. Fatal cerebral oedema in adult diabetic ketoacidosis.

    NARCIS (Netherlands)

    Haringhuizen, A.; Tjan, D.H.; Grool, A.; Vugt, R. van; Zante, A.R. van

    2010-01-01

    In this report, a case of adult onset fatal cerebral oedema as a rare complication of diabetic ketoacidosis (DKA) is described and confirmed at post-mortem pathological examination. The pathogenesis of cerebral oedema due to DKA is still unknown. Potential mechanisms include the administration of so

  7. Bordetella bronchiseptica and fatal pneumonia of dogs and cats

    Science.gov (United States)

    Bordetella bronchiseptica frequently causes nonfatal tracheobronchitis, but its role in fatal pneumonia is less well-studied. The objectives of this study were to identify the frequency of Bordetella bronchiseptica infection in fatal cases of bronchopneumonia in dogs and cats and to compare the diag...

  8. The Characteristics of Road Traffic Fatalities in Kazakhstan's Semey Region, 2006-2010: A Descriptive Retrospective Study.

    Directory of Open Access Journals (Sweden)

    Ayan Myssayev

    2014-06-01

    Full Text Available Kazakhstan, a developing middle-income country, has the highest road traffic collision (RTC mortality in the European Region. The aims of this study were to determine main characteristics of road traffic fatalities in Semey region, Kazakhstan and to compare findings with National data and middle-income European countries.This descriptive surveillance study assesses RTC mortality rates and epidemiology in the Semey Region of East Kazakhstan Oblast. Data of all 318 road traffic fatalities form the Semey Regional Center for Forensic Medicine were analyzed for the 5-year period of January 1, 2006 through December 31, 2010.Over the study period, the average road traffic mortality in the Semey Region was 12.1 per 100,000 population with downward trend by 35.1% (p=0.002. The victims mean age was 37.1 (SD=17 years. Males predominated at 74.5%. Vehicle fatality was the most common mode of fatality at 61.3%. The majority of collisions, 53.1%, occurred on highways. Most victims, 67.3%, have died at the scene of collision; in 67.3% of fatalities, autopsies identified multiple injuries as cause of death. The high number of fatal collisions took place in "no snow" season (P<0.001, with an overall 5-years downward dynamic.High proportion of males, pedestrians and car occupants among road traffic fatalities; high proportion of death on scene in case of highway collisions are specifics for Semey region, Kazakhstan. These findings can be used to formulate preventive strategies to reduce fatalities and to improve the medical care system for road traffic fatalities.

  9. Long-term trends in flood fatalities in the United State

    Science.gov (United States)

    Sharif, Hatim; Chaturvedi, Smita

    2015-04-01

    This presentation reviews flood-related fatalities in the United States between 1959 and 2013. Information on flood fatality victims and the flood-causing events was obtained from the National Climatic Data Center. The data collected included the date, time, location, and weather conditions and the gender and age of the flood victims. Long term trends in the numbers of fatalities and fatality rates were analyzed. For most of the states fatalities were largely caused by single catastrophic events. The analysis indicates that the standardized annual flood fatality rates are decreasing significantly for all states. Vehicle related fatalities represent more than 50% of flood fatalities for most of the states and can be as high as 77%. A combination of improved hydrometeorological forecasting, educational programs aimed at enhancing public awareness of flood risk and the seriousness of flood warnings, and timely and appropriate action by local emergency and safety authorities will help further reduce flood fatalities in Texas.

  10. Active Surveillance of Child Abuse Fatalities.

    Science.gov (United States)

    Schloesser, Patricia; And Others

    1992-01-01

    Birth and death certificates were correlated with information in the state Child Abuse and Neglect Registry on 104 abuse-related fatalities. Significant findings included young age of parents at first pregnancy; high rate of single parenthood; and lower educational achievement among mothers. A model for data collection is discussed. (Author/BRM)

  11. Fatal rhabdomyolysis after acute sodium monensin (Rumensin®) toxicity: case report Rabdomiólise fatal aguda pós-intoxicação por monensina sódica (Rumensin®): relato de caso

    OpenAIRE

    João Aris Kouyoumdjian; Maria da Penha Ananias Morita; Adriana Komatsu Sato; Amalia Fernanda Pissolatti

    2001-01-01

    Myoglobinuria or rhabdomyolysis occurs when myoglobin escapes into the blood and then into the urine after acute muscle necrosis. It can be a serious medical condition leading to renal failure and death. There are many causes including exertion, crush syndromes, ischaemia, metabolic disorders, exogenous toxins and drugs, heat stroke and hereditary disorders such as malignant hyperthermia. We report the case of a 17 year-old boy who developed myoglobinuria, renal failure and death 11 days afte...

  12. Road traffic fatalities among pedestrians, bicyclists and mo-tor vehicle occupants in Sirjan, Kerman, Iran

    Institute of Scientific and Technical Information of China (English)

    Ghorbanali Mohammadi

    2009-01-01

    Objective: To analyze the crash and injury data in forensic medicine for years of 2004-2007. Methods: A sample of over 567 accident cases (9 pedestrians, 116 bicyclists, and 442 motor vehicle occupants) was considered from the Department of Foren-sic Medicine, Shahid Bahonar University of Kerman, in-volving drivers of all ages and covering a four-year period.Results: The male fatality rates were significantly higher than female ones. The groups at 15-30 years old and at 30-55 years old had the first and second highest numbers of deaths (40% and 34%, respectively). There were sub-stantial differences in distribution of injuries in motor ve-hicle occupants and pedestrians and bicyclists. Among motor vehicle occupants, there were more head injuries, such as skull fracture, brain contusion, subdural haemorrhage, and epidural haemorrhage. Nearly 77% of fatalities occurred during 08:00-22:00 in Sirjan. Internal bleeding was also higher in motor vehicle occupants. Pedestrians and bicyclists also had head injuries frequently.Conclusions: In spite of reduction of road traffic fatali-ties in Sirjan in 2007, it is still one of the cities with high road traffic fatality in the world. These results underline the im-portance of preventive strategies in transportation, sug-gesting that different methods are necessary to reduce fa-talities of various traffic participants.

  13. Fatal pulmonary thromboembolism in gastrectomy intraoperative procedures by gastric adenocarcinoma: case report Tromboembolismo pulmonar fatal no intra-operatório de gastrectomia por adenocarcinoma gástrico: relato de caso

    Directory of Open Access Journals (Sweden)

    Cláudio Bresciani

    1999-08-01

    Full Text Available The case of a patient with gastric adenocarcinoma with indication for gastrectomy is reported. The surgery took place without complications. A palliative, subtotal gastrectomy was performed after para-aortic lymph nodes compromised by neoplasm were found, which was confirmed by pathological exam of frozen sections carried out during the intervention. At the end of the gastroenteroanastomosis procedure, the patient began to show intense bradycardia: 38 beats per minute (bpm, arterial hypotension, changes in the electrocardiogram's waveform (upper unlevelling of segment ST, and cardiac arrest. Resuscitation maneuvers were performed with temporary success. Subsequently, the patient had another circulatory breakdown and again was recovered. Finally, the third cardiac arrest proved to be irreversible, and the intra-operative death occurred. Necropsy showed massive pulmonary embolism. The medical literature has recommended heparinization of patients, in an attempt to avoid pulmonary thromboembolism following major surgical interventions. However, in the present case, heparinization would have been insufficient to prevent death. This case indicates that it is necessary to develop preoperative propedeutics for diagnosing the presence of venous thrombi with potential to migrate, causing pulmonary thromboembolism (PTE. If such thrombi could be detected, preventative measures, such as filter installation in the Cava vein could be undertaken.Relata-se um caso de paciente com adenocarcinoma gástrico com indicação de gastrectomia. O ato operatório transcorreu sem anormalidades. Foi realizada gastrectomia subtotal paliativa, pois encontrou-se linfonodos para-aórticos comprometidos pela neoplasia, confirmado por exame anátomo-patológico de congelação realizado no decorrer da intervenção. Ao fim da confecção da gastroêntero-anastomose o paciente passou a apresentar bradicardia intensa: 38 batimentos por minuto (bpm, hipotensão arterial, altera

  14. Worst-Case Portfolio Optimization under Stochastic Interest Rate Risk

    Directory of Open Access Journals (Sweden)

    Tina Engler

    2014-12-01

    Full Text Available We investigate a portfolio optimization problem under the threat of a market crash, where the interest rate of the bond is modeled as a Vasicek process, which is correlated with the stock price process. We adopt a non-probabilistic worst-case approach for the height and time of the market crash. On a given time horizon [0; T], we then maximize the investor’s expected utility of terminal wealth in the worst-case crash scenario. Our main result is an explicit characterization of the worst-case optimal portfolio strategy for the class of HARA (hyperbolic absolute risk aversion utility functions.

  15. Fatal rhabdomyolysis after acute sodium monensin (Rumensin® toxicity: case report Rabdomiólise fatal aguda pós-intoxicação por monensina sódica (Rumensin®: relato de caso

    Directory of Open Access Journals (Sweden)

    João Aris Kouyoumdjian

    2001-09-01

    Full Text Available Myoglobinuria or rhabdomyolysis occurs when myoglobin escapes into the blood and then into the urine after acute muscle necrosis. It can be a serious medical condition leading to renal failure and death. There are many causes including exertion, crush syndromes, ischaemia, metabolic disorders, exogenous toxins and drugs, heat stroke and hereditary disorders such as malignant hyperthermia. We report the case of a 17 year-old boy who developed myoglobinuria, renal failure and death 11 days after ingesting sodium monensin, possibly with the intention of developing muscles. Sodium monensin, the active principle of Rumensin®, is a dietary additive used as a growth promoter for confined cattle. There are no previous reports of human intoxication. Accidental or experimental sodium monensin intoxication in animals produces similar findings to those seen in this case.Mioglobinúria ou rabdomiólise refere-se a necrose muscular aguda com liberação de mioglobina na circulação e na urina podendo causar, na sua forma mais grave, insuficiência renal e óbito. A etiologia é ampla, incluindo exercício intenso, síndrome do esmagamento, isquemia, toxinas exógenas, anormalidades metabólicas, medicações, altas temperaturas, além de algumas condições herdadas como hipertermia maligna. Neste relato descreve-se o caso de um paciente jovem, do sexo masculino, que desenvolveu mioglobinúria, insuficiência renal e óbito, 11 dias após ingestão de monensina sódica, princípio ativo de Rumensin®, usado como aditivo alimentar para gado confinado; a ingestão possivelmente foi feita para desenvolvimento muscular. Não há relato na literatura de intoxicação humana e o quadro clínico nos animais com intoxicação experimental ou acidental pelo Rumensin® se assemelha àquele observado no presente caso.

  16. 2009 Pandemic Influenza A Virus Subtype H1N1 in Morocco, 2009–2010: Epidemiology, Transmissibility, and Factors Associated With Fatal Cases

    OpenAIRE

    Barakat, Amal; Ihazmad, Hassan; El Falaki, Fatima; Tempia, Stefano; Cherkaoui, Imad; El Aouad, Rajae

    2012-01-01

    Background. Following the emergence of 2009 pandemic influenza A virus subtype H1N1 (A[H1N1]pdm09) in the United States and Mexico in April 2009, A(H1N1)pdm09 spread rapidly all over the world. There is a dearth of information about the epidemiology of A(H1N1)pdm09 in Africa, including Morocco. We describe the epidemiologic characteristics of the A(H1N1)pdm09 epidemic in Morocco during 2009–2010, including transmissibility and risk factors associated with fatal disease.

  17. Muertes por homicidio, consecuencia fatal de la violencia: el caso de Mexico, 1979-1992 Mortality by homicide, the fatal consequences of violence: the case of Mexico, 1979-1992

    Directory of Open Access Journals (Sweden)

    María Victoria López

    1996-02-01

    Full Text Available Se analizaron las muertes registradas como homicidio en México de 1979-1992. El estudio se basó en fuente secundaria, siendo las variables analizadas: año, edad, sexo y causa externa de traumatismos y envenenamientos según CIE IX Rev.(E960-E969. Se utilizó un modelo de regresión Poisson para las causas más frecuentes, obteniendo riesgos relativos según edad y sexo. El grupo de referencia fue el de 10-14 años y el sexo femenino. Se registraron 198,485 muertes por Homicidio, con un promedio anual de 14,177 y diario de 39. La principal causa fue ataque con arma de fuego y explosivos(56%. El riesgo relativo más alto fue para el grupo de 35-39 años, con RR 15,4 IC(95% 14,9-16,0, en comparación al de referencia. El sexo masculino presentó un riesgo relativo 10,1 veces mayor que el femenino, ajustado por edad IC10.0-10.3. Los resultados llaman la atención sobre la necesidad de profundizar y analizar el problema de los homicidios bajo una perspectiva multidisciplinaria.A study of homicide in the population of Mexico, was undertaken for the purpose of discovering the mortality panorama by this cause during 1979-1992. Homicide mortality trends were analized, as well as the main causes by age and sex. Rate by cause and sex were also analized using a Poisson Regression model. The variables were: age, sex, year, external cause of intentional injuries ICD 9th. E960-E969. Results: The total number of deaths due to homicide was 198,485. Each day 35 persons die in Mexico as a result of homicide. Men were more affected than women with a RR of 10.1 and CI (95%14.9-16.0, adjusted for age. The main cause 56% was homicide by firearms and explosives.The high relative risk was for those aged from 35 to 39 with an RR of 15.4 CI 14.9-16.0. To the cause assault by other and unspecified means, the elderly population has a RR of 21.2 IC 19.7-22.9. Further research in the area and prevention should make use of a multidisciplinary approach in considering the

  18. Female Survival Advantage Relates to Male Inferiority Rather Than Female Superiority: A Hypothesis Based on the Impact of Age and Stroke Severity on 1-Week to 1-Year Case Fatality in 40,155 Men and Women

    DEFF Research Database (Denmark)

    Olsen, T.S.; Andersen, Klaus Kaae

    2010-01-01

    until death or censoring. Case fatality (stratified by 1 week, 1 month, 3 months, and 1 year) in men and women was correlated with age and stroke severity. Adjustment for cardiovascular risk factors was performed by means of multivariate regression analysis. Results: A total of 20,854 (51.9%) men and 19......,301 (48.1%) women were registered. Women were significantly older than men at the time of stroke (74.5 vs 69.7 years, respectively; P <0.001) and had signficantly more severe strokes, as expressed by the mean SSS score (39.6 vs 43.3; P <0.001). Stratification of 1-week to 1-year case fatality according to...... patients with severe as well as mild strokes, but not in those younger than age 50 years. Conclusions: Our findings dispute the effects of female sex hormones as the underlying cause of female survival superiority over men. Instead, we propose the hypothesis that the progressive deficiency of male sex...

  19. Fatal Acute Diclofenac-Induced Rhabdomyolysis in A Pediatric Patient

    Directory of Open Access Journals (Sweden)

    Ahmet Güzel

    2011-03-01

    Full Text Available Diclofenac, a widely used nonsteroidal anti-inflammatory drug, has been reported to cause fatal drug-induced rhabdomyolysis very rarely . We report a case of a 13-month-old girl who developed fatal rhabdomyolysis after administration of intramuscular diclofenac for relief of pain caused by a scalding burn injury. Rhabdomyolysis due to diclofenac has not been reported in children. Here, we present the first case report to demonstrate rhabdomylysis secondary to diclofenac administration.

  20. Fatal Acute Diclofenac-Induced Rhabdomyolysis in A Pediatric Patient

    OpenAIRE

    GÜZEL, Ahmet; Biner, Betül Orhaner; Aylanç, Hakan

    2011-01-01

    Diclofenac, a widely used nonsteroidal anti-inflammatory drug, has been reported to cause fatal drug-induced rhabdomyolysis very rarely . We report a case of a 13-month-old girl who developed fatal rhabdomyolysis after administration of intramuscular diclofenac for relief of pain caused by a scalding burn injury. Rhabdomyolysis due to diclofenac has not been reported in children. Here, we present the first case report to demonstrate rhabdomylysis secondary to diclofenac administration.

  1. Fatal child abuse in Japan: does a trend exist toward tougher sentencing?

    OpenAIRE

    Satoshi Fujiwara; Akiyoshi Nishimura; Shigeru Nishimura; Ayako Nasu; Saori Nambu

    2011-01-01

    Abstract: Background: It has been pointed out in Japan that criminal punishment in domestic homicide cases, especially in fatal child abuse cases, tends to be more lenient than in public homicide cases that occur outside the home. In recent news accounts of fatal child abuse cases, however, the media has reported that court-imposed sentences have tended to be stricter every year. Methods: Using the online databases of three major Japanese newspapers, we collected articles about fatal child ab...

  2. Day case surgery: geographical variation, trends and readmission rates.

    OpenAIRE

    Henderson, J.; Goldacre, M J; Griffith, M.; Simmons, H M

    1989-01-01

    Data from the Oxford Record Linkage Study were analysed to determine the amount of work undertaken in day case surgery for 12 surgical conditions in five districts in the Oxford Region during the years 1976 to 1985. Record linkage was used to study readmission rates, comparing day surgery with inpatient care. The use of day surgery gradually increased in some conditions (eg, termination of pregnancy, female sterilisation) but did not increase from a fairly low base for others (eg, inguinal he...

  3. Investigation of a fatal airplane crash: autopsy, computed tomography, and injury pattern analysis used to determine who was steering the plane at time of accident. A case report

    DEFF Research Database (Denmark)

    Høyer, Christian Bjerre; Nielsen, Trine Skov; Nagel, Lise Loft;

    2012-01-01

    A fatal accident is reported in which a small single-engine light airplane crashed. The airplane carried two persons in the front seats, both of whom possessed valid pilot certificates. Both victims were subject to autopsy, including post-mortem computed tomography scanning (PMCT) prior to the...... autopsy. The autopsies showed massive destruction to the bodies of the two victims but did not identify any signs of acute or chronic medical conditions that could explain loss of control of the airplane. PMCT, histological examination, and forensic chemical analysis also failed to identify an explanation...... for the crash. A detailed review of an airplane identical to the crashed airplane was performed in collaboration with the Danish Accident Investigation Board and the Danish National Police, National Centre of Forensic Services. The injuries were described using the abbreviated injury scale, the injury...

  4. 1例家族性致死性失眠症病人的护理%Nursing care of 1 case with familial fatal insomnia

    Institute of Scientific and Technical Information of China (English)

    付玉娟; 乔雨晨; 刘媛

    2011-01-01

    @@ 家族性致死性失眠症(familial fatal insomnia,FFI)是一种罕见的常染色体显性遗传性疾病,是遗传性朊蛋白病(Prion)的一种类型,是世界上第3大遗传性朊蛋白病,与当前在全世界蔓延的疯牛病同属于传播性海绵状脑病(TSE).FFI是一种极其罕见的神经科疾病,发病率在世界范围内为每年百万分之一.

  5. Assessment of blood-brain barrier penetration of miltefosine used to treat a fatal case of granulomatous amebic encephalitis possibly caused by an unusual Balamuthia mandrillaris strain.

    Science.gov (United States)

    Roy, Sharon L; Atkins, Jane T; Gennuso, Rosemaria; Kofos, Danny; Sriram, Rama R; Dorlo, Thomas P C; Hayes, Teresa; Qvarnstrom, Yvonne; Kucerova, Zuzana; Guglielmo, B Joseph; Visvesvara, Govinda S

    2015-12-01

    Balamuthia mandrillaris, a free-living ameba, causes rare but frequently fatal granulomatous amebic encephalitis (GAE). Few patients have survived after receiving experimental drug combinations, with or without brain lesion excisions. Some GAE survivors have been treated with a multi-drug regimen including miltefosine, an investigational anti-leishmanial agent with in vitro amebacidal activity. Miltefosine dosing for GAE has been based on leishmaniasis dosing because no data exist in humans concerning its pharmacologic distribution in the central nervous system. We describe results of limited cerebrospinal fluid (CSF) and serum drug level testing performed during clinical management of a child with fatal GAE who was treated with a multiple drug regimen including miltefosine. Brain biopsy specimens, CSF, and sera were tested for B. mandrillaris using multiple techniques, including culture, real-time polymerase chain reaction, immunohistochemical techniques, and serology. CSF and serum miltefosine levels were determined using a liquid chromatography method coupled to tandem mass spectrometry. The CSF miltefosine concentration on hospital admission day 12 was 0.4 μg/mL. The serum miltefosine concentration on day 37, about 80 h post-miltefosine treatment, was 15.3 μg/mL. These are the first results confirming some blood-brain barrier penetration by miltefosine in a human, although with low-level CSF accumulation. Further evaluation of brain parenchyma penetration is required to determine optimal miltefosine dosing for Balamuthia GAE, balanced with the drug's toxicity profile. Additionally, the Balamuthia isolate was evaluated by real-time polymerase chain reaction (PCR), demonstrating genetic variability in 18S ribosomal RNA (18S rRNA) sequences and possibly signaling the first identification of multiple Balamuthia strains with varying pathogenicities. PMID:26329128

  6. Rotenone Analysis by Liquid Chromatography-Tandem Mass Spectrometry with Information-Dependent Acquisition in a Fatal Case of Rotenone Poisoning with a Commercial Organic Insecticide Being Sold in Korea.

    Science.gov (United States)

    Rhee, Jongsook; Yum, Hyesun; Moon, Sungmin; In, Sanwhan; Lee, Sangki; Seo, Joongseok

    2016-07-01

    Rotenone is a neurotoxin derived from Derris roots or yam bean of genus Derris or Lonchocarpus It is known to cause Parkinson-like symptoms and is a potent electron transport inhibitor. Rotenone was detected in postmortem specimens in a fatal case of rotenone poisoning with an organic pesticide by liquid chromatography-tandem mass spectrometry with an information-dependent acquisition and MS-MS library search. The forensic specimens were prepared by solid-phase extraction with a Bond Elut(®) Certify cartridge. The mobile phase comprised 5 mM ammonium formate in 10% methanol and 5 mM ammonium formate in 90% methanol. The assay was linear over the range from 0.01 to 1.0 mg/L (r(2) = 0.995). The limit of detection and quantitation in the blood were 0.001 mg/L (signal-to-noise, S/N = 3) and 0.003 mg/L (S/N = 10), respectively. The intraday accuracy and precision for rotenone that were determined by five replicates at 0.02, 0.10 and 1.0 mg/L in blood were <15.0% of bias and <9.0% of CV, respectively. The interday accuracy and precision for rotenone that were determined by seven replicates at 0.02, 0.10 and 1.0 mg/L in blood were <18.0% of bias and <17.0% of CV, respectively. Relative recovery with 0.02, 0.1 and 1.0 mg/L in blood was 104.2, 103.3 and 81.6% (n = 6), respectively. The described method was applied for the determination of rotenone in a fatal case of intoxication of a 33-year-old man who was found dead on a bed in a temporary house. In this case study, the concentrations of rotenone in heart blood (HB), peripheral blood (PB), gastric contents and vitreous humor were 0.77 mg/L, 0.02 mg/L, 126.4 mg/kg and 0.003 mg/L, respectively. The rotenone concentration ratio of the HB/PB was 38.8 and that of gastric contents/PB was 6412.3, suggesting a massive ingestion of rotenone with postmortem redistribution. This study is the report of rotenone detection in a fatal case with the ingestion of the organic insecticide containing rotenone. PMID:27197984

  7. Fatal Necrotizing Fasciitis following Episiotomy

    Directory of Open Access Journals (Sweden)

    Faris Almarzouqi

    2015-01-01

    Full Text Available Introduction. Necrotizing fasciitis is an uncommon condition in general practice but one that provokes serious morbidity. It is characterized by widespread fascial necrosis with relative sparing of skin and underlying muscle. Herein, we report a fatal case of necrotizing fasciitis in a young healthy woman after episiotomy. Case Report. A 17-year-old primigravida underwent a vaginal delivery with mediolateral episiotomy. Necrotizing fasciitis was diagnosed on the 5th postpartum day, when the patient was referred to our tertiary care medical center. Surgical debridement was initiated together with antibiotics and followed by hyperbaric oxygen therapy. The patient died due to septic shock after 16 hours from the referral. Conclusion. Delay of diagnosis and consequently the surgical debridement were most likely the reasons for maternal death. In puerperal period, a physician must consider necrotizing fasciitis as a possible diagnosis in any local sings of infection especially when accompanied by fever and/or tenderness. Early diagnosis is the key for low mortality and morbidity.

  8. Risk and protection factors in fatal accidents.

    Science.gov (United States)

    Dupont, Emmanuelle; Martensen, Heike; Papadimitriou, Eleonora; Yannis, George

    2010-03-01

    This paper aims at addressing the interest and appropriateness of performing accident severity analyses that are limited to fatal accident data. Two methodological issues are specifically discussed, namely the accident-size factors (the number of vehicles in the accident and their level of occupancy) and the comparability of the baseline risk. It is argued that - although these two issues are generally at play in accident severity analyses - their effects on, e.g., the estimation of survival probability, are exacerbated if the analysis is limited to fatal accident data. As a solution, it is recommended to control for these effects by (1) including accident-size indicators in the model, (2) focusing on different sub-groups of road-users while specifying the type of opponent in the model, so as to ensure that comparable baseline risks are worked with. These recommendations are applied in order to investigate risk and protection factors of car occupants involved in fatal accidents using data from a recently set up European Fatal Accident Investigation database (Reed and Morris, 2009). The results confirm that the estimated survival probability is affected by accident-size factors and by type of opponent. The car occupants' survival chances are negatively associated with their own age and that of their vehicle. The survival chances are also lower when seatbelt is not used. Front damage, as compared to other damaged car areas, appears to be associated with increased survival probability, but mostly in the case in which the accident opponent was another car. The interest of further investigating accident-size factors and opponent effects in fatal accidents is discussed. PMID:20159090

  9. Non-Fatal Suicidal Behaviors in Adolescents

    OpenAIRE

    Jena, S.; Sidhartha, T.

    2004-01-01

    In the USA, suicide ranked as the third leading cause of death for adolescents in 1999. Non-fatal suicidal behaviours are suicidal thought, specific suicidal plan and suicide attempt. Prospective studies have emphasized the high subsequent suicide rates in clinically presenting suicide attempters. This study was planned to critically review the existing international literature on this area, and compare, if possible, with the Indian data. Both electronic and manual search for published and un...

  10. Work-related fatal motor vehicle traffic crashes: Matching of 2010 data from the Census of Fatal Occupational Injuries and the Fatality Analysis Reporting System.

    Science.gov (United States)

    Byler, Christen; Kesy, Laura; Richardson, Scott; Pratt, Stephanie G; Rodríguez-Acosta, Rosa L

    2016-07-01

    Motor vehicle traffic crashes (MVTCs) remain the leading cause of work-related fatal injuries in the United States, with crashes on public roadways accounting for 25% of all work-related deaths in 2012. In the United States, the Bureau of Labor Statistics (BLS) Census of Fatal Occupational Injuries (CFOI) provides accurate counts of fatal work injuries based on confirmation of work relationship from multiple sources, while the National Highway Traffic Safety Administration (NHTSA) Fatality Analysis Reporting System (FARS) provides detailed data on fatal MVTCs based on police reports. Characterization of fatal work-related MVTCs is currently limited by data sources that lack either data on potential risk factors (CFOI) or work-relatedness confirmation and employment characteristics (FARS). BLS and the National Institute for Occupational Safety and Health (NIOSH) collaborated to analyze a merged data file created by BLS using CFOI and FARS data. A matching algorithm was created to link 2010 data from CFOI and FARS using date of incident and other case characteristics, allowing for flexibility in variables to address coding discrepancies. Using the matching algorithm, 953 of the 1044 CFOI "Highway" cases (91%) for 2010 were successfully linked to FARS. Further analysis revealed systematic differences between cases identified as work-related by both systems and by CFOI alone. Among cases identified as work-related by CFOI alone, the fatally-injured worker was considerably more likely to have been employed outside the transportation and warehousing industry or transportation-related occupations, and to have been the occupant of a vehicle other than a heavy truck. This study is the first step of a collaboration between BLS, NHTSA, and NIOSH to improve the completeness and quality of data on fatal work-related MVTCs. It has demonstrated the feasibility and value of matching data on fatal work-related traffic crashes from CFOI and FARS. The results will lead to

  11. Fatal poisoning in drug addicts in the Nordic countries

    DEFF Research Database (Denmark)

    Steentoft, Anni; Teige, Brita; Ceder, Gunnel;

    2001-01-01

    . For all countries the distribution of deaths according to geographical regions showed a decreasing number of drug deaths in the metropolitan area and an increasing number in other cities. Heroin/ morphine dominated as the cause of death and was responsible for about 90% of the cases in Norway. In...... Sweden and Denmark, however, heroin/morphine caused only about 70% of the fatal poisonings. About 30% of the fatal poisonings in Denmark and Sweden were caused by other group I drugs, in Denmark mainly methadone and in Sweden mainly propoxyphene. Apart from two cases in Sweden methadone deaths were not...... seen in the other Nordic countries. In Finland heroin/morphine deaths have increased from about 10% in 1991 to about 40% in 1997. Forty-four percent of the fatal poisonings in Finland were caused by other group I drugs, mainly codeine and propoxyphene. The two fatal poisonings in Iceland were caused by...

  12. Two Fatal Intoxications with Cyanohydrins.

    Science.gov (United States)

    Zheng, Shuiqing; Yuan, Xiaoliang; Wang, Wei; Liang, Chen; Cao, Fangqi; Zhang, Runsheng

    2016-06-01

    Cyanohydrins, also be called cyanoalcohols, are important industrial precursors to carboxylic acids and some amino acids. Acetone cyanohydrin (ACH) and formaldehyde cyanohydrin (glycolonitrile, FCH), which are the typical examples of cyanohydrins, are classified as extremely hazardous substances. As the cyanohydrins can readily decompose, and it is hard to find cyanohydrins in gastric contents and heart blood, the determination study in biological samples can be divided into two parts: the first is the determination of HCN by using a Prussian blue reaction and the HS-GC-MSD after derivatization by chloramine-T. The second is the determination of acetone or formaldehyde. In this part, headspace gas chromatography with flame ionization detector (HS-GC-FID) and solid phase microextraction (SPME)-gas chromatography with mass spectrometric detectors (GC-MSD) had been used. In this report, we reported two fatal intoxication cases of ACH and FCH; one person was killed by his wife by poisoning his food and the other was suicide by poison. Two real cases of ACH and FCH in human blood and gastric contents have been analyzed by using the above-mentioned method. The Prussian blue reaction was positive in the two cases. The peaks of acetone with retention times of 0.998 min appear in specimens of the deceased are consistent with the retention times of pure acetone. The peaks of formaldehyde with a retention time of 1.658 min appear in heart blood of the deceased, and the retention time of formaldehyde of the liquid is 1.674 min, which are consistent with the retention times of pure formaldehyde (1.673 min). PMID:27026650

  13. An empirical model for global earthquake fatality estimation

    Science.gov (United States)

    Jaiswal, Kishor; Wald, David

    2010-01-01

    We analyzed mortality rates of earthquakes worldwide and developed a country/region-specific empirical model for earthquake fatality estimation within the U. S. Geological Survey's Prompt Assessment of Global Earthquakes for Response (PAGER) system. The earthquake fatality rate is defined as total killed divided by total population exposed at specific shaking intensity level. The total fatalities for a given earthquake are estimated by multiplying the number of people exposed at each shaking intensity level by the fatality rates for that level and then summing them at all relevant shaking intensities. The fatality rate is expressed in terms of a two-parameter lognormal cumulative distribution function of shaking intensity. The parameters are obtained for each country or a region by minimizing the residual error in hindcasting the total shaking-related deaths from earthquakes recorded between 1973 and 2007. A new global regionalization scheme is used to combine the fatality data across different countries with similar vulnerability traits. [DOI: 10.1193/1.3480331

  14. Fatal Intoxication with Acetyl Fentanyl.

    Science.gov (United States)

    Cunningham, Susan M; Haikal, Nabila A; Kraner, James C

    2016-01-01

    Among the new psychoactive substances encountered in forensic investigations is the opioid, acetyl fentanyl. The death of a 28-year-old man from recreational use of this compound is reported. The decedent was found in the bathroom of his residence with a tourniquet secured around his arm and a syringe nearby. Postmortem examination findings included marked pulmonary and cerebral edema and needle track marks. Toxicological analysis revealed acetyl fentanyl in subclavian blood, liver, vitreous fluid, and urine at concentrations of 235 ng/mL, 2400 ng/g, 131 ng/mL, and 234 ng/mL, respectively. Acetyl fentanyl was also detected in the accompanying syringe. Death was attributed to recreational acetyl fentanyl abuse, likely through intravenous administration. The blood acetyl fentanyl concentration is considerably higher than typically found in fatal fentanyl intoxications. Analysis of this case underscores the need for consideration of a wide range of compounds with potential opioid-agonist activity when investigating apparent recreational drug-related deaths. PMID:26389815

  15. Fatal and Non-Fatal Work Related Injuries Among Workers of Iranian Aluminum and Copper Industries Between 2003 and 2011

    OpenAIRE

    Elaheh Kabir-Mokamelkhah; Mashallah Aghilinejad; Amir Bahrami-Ahmadi; Mohammad Kazem Nouri; Seyed Ali Mousavi; Mohammad Hassan Nassiri Kashani

    2016-01-01

    One-third of globally, injuries to the adults in the world were related to workers and work situations. The aim of the present study was determining of work-related injuries rate among workers at two main metal industries (aluminum and Cooper industries) and independent predictors of fatal work-related injuries among them. Present cross-sectional study was assessed fatal and not fatal work-related injuries among 11172 workers into two groups of Iranian metal industries between April 2003 a...

  16. Comparison of risk factors for cervical spine, head, serious, and fatal injury in rollover crashes.

    Science.gov (United States)

    Funk, James R; Cormier, Joseph M; Manoogian, Sarah J

    2012-03-01

    Previous epidemiological studies of rollover crashes have focused primarily on serious and fatal injuries in general, while rollover crash testing has focused almost exclusively on cervical spine injury. The purpose of this study was to examine and compare the risk factors for cervical spine, head, serious, and fatal injury in real world rollover crashes. Rollover crashes from 1995-2008 in the National Automotive Sampling System-Crashworthiness Data System (NASS-CDS) were investigated. A large data set of 6015 raw cases (2.5 million weighted) was generated. Nonparametric univariate analyses, univariate logistic regression, and multivariate logistic regression were conducted. Complete or partial ejection, a lack of seatbelt use, a greater number of roof inversions, and older occupant age significantly increased the risk of all types of injuries studied (phead, and cervical spine injury (pinjury in general. Higher BMI was associated with an increased risk of fatal, serious, and cervical spine injury (phead injury. Greater roof crush was associated with a higher rate of fatal and cervical spine injury (poccupant height, and occupant gender had inconsistent and generally non-significant effects on injury. This study demonstrates both common and unique risk factors for different types of injuries in rollover crashes. PMID:22269486

  17. Occupational Injuries, Illnesses and Fatalities

    Science.gov (United States)

    ... that was created by Act of Congress and publishes data related to safety, injuries, and fatalities that are both work-related and non-work related. National Highway Traffic Safety Administration (NHTSA) - a government organization that is part of ...

  18. Allegheny County Fatal Accidental Overdoses

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — Fatal accidental overdose incidents in Allegheny County, denoting age, gender, race, drugs present, zip code of incident and zip code of residence. Zip code of...

  19. Fatal and non-fatal injuries due to intentional explosions in Nepal, 2008-2011: analysis of surveillance data

    OpenAIRE

    Bilukha, Oleg O; Becknell, Kristin; Laurenge, Hugues; Danee, Luhar; Subedi, Krishna P

    2013-01-01

    Background Nepal is one of the post-conflict countries affected by violence from explosive devices. We undertook this study to assess the magnitude of injuries due to intentional explosions in Nepal during 2008-2011 and to describe time trends and epidemiologic patterns for these events. Methods We analyzed surveillance data on fatal and non-fatal injuries due to intentional explosions in Nepal that occurred between 1 January 2008 and 31 December 2011. The case definition included casualties ...

  20. Empirical evidence against the exchange rate anomaly: the Australian case

    Directory of Open Access Journals (Sweden)

    Luis A. Gil-Alana

    2006-06-01

    Full Text Available Though there is widespread agreement that the logarithmic spot and forward rates are both integrated of order one (I(1 variables, so that their corresponding returns are I(0 stationary, it has been recently claimed that they may be long memory. In this article, we examine this hypothesis by means of fractional integration techniques. The results based on parametric and semiparametric tests show that though fractional degrees of integration are plausible alternatives, the confidence intervals include the unit root case in both series. In addition, the hypothesis of unbiasedness of the forward rate as a forecaster for the future spot rate cannot be rejected for the Australian daily exchange rate market.Embora haja um acordo difundido de que o ponto logarítmico e as taxas para frente são ambas integradas de variáveis da ordem um (I(1, de modo que seus retornos correspondentes sejam I(0 estacionário, tem-se reivindicado recentemente que elas podem ser memória longa. Neste artigo, examinamos esta hipótese por meio do uso de técnicas fracionárias de integração. Os resultados baseados em testes paramétricos e semiparametricos mostram que embora os graus fracionários de integração sejam alternativas plausíveis, os intervalos de confiança incluem o caso da raiz unitária em ambas as séries. Além disso, a hipótese de não viés da taxa para frente como um preditor para a taxa a vista futura não pode ser rejeitada para o caso australiano.

  1. Evaluation of clinical and laboratory predictors of fatality in patients with Hantavirus infection

    OpenAIRE

    Kostakoglu, Uğur; Yılmaz, Gürdal; Volkan, Serkan; Sökel, Sevinc Kant; Kaya, Selcuk; Köksal, Iftihar

    2012-01-01

    Objectives: To determine the clinical and laboratory predictors of fatality among patients with Hantavirus infection. Material and methods: A retrospective study was conducted on the patients with Hantavirus infection between April 2009 and October 2011 at the Black Sea and the Mediterranean regions in Turkey. Demographic, clinical and laboratory findings of fatal cases and non-fatal cases at the admission were compared. Results: Twenty-two patients with confirmed Hantavirus infection...

  2. Clinical diagnosis versus autopsy findings in polytrauma fatalities

    Directory of Open Access Journals (Sweden)

    Fakler Johannes K

    2010-10-01

    Full Text Available Abstract Objectives The aim of the study was to determine if differences in clinical diagnosis versus autopsy findings concerning the cause of death in polytrauma fatalities would be detected in 19 cases of fatal polytrauma from a Level 1 trauma centre. Methods Clinical diagnoses determining the cause of death in 19 cases of fatal polytrauma (2007 - 2008 from a Level 1 trauma centre were correlated with autopsy findings. Results In 13 cases (68%, the clinical cause of death and the cause of death as determined by autopsy were congruent. Marginal differences occurred in three (16% patients while obvious differences in interpreting the cause of death were found in another three (16% cases. Five fatalities (three with obvious differences and two with marginal differences were remarked as early death (1-4 h after trauma and one fatality with marginal differences as late death (>1 week after trauma. Obvious and marginal discrepancies mostly occurred in the early phase of treatment, especially when severely injured patients were admitted to the emergency room undergoing continued cardiopulmonary resuscitation, i. e. limiting diagnostic procedures, and thus the clinical cause of death was essentially determined by basic emergency diagnostics. Conclusions Autopsy as golden standard to define the cause of death in fatal polytrauma varies from the clinical point of view, depending on the patient's pre-existing condition, mechanism of polytrauma, necessity of traumatic cardiopulmonary resuscitation, survival time, and thus the possibility to perform emergency diagnostics. An autopsy should be performed at least in cases of early fatal polytrauma to help establishing the definite cause of death. Moreover, autopsy data should be included in trauma registries as a quality assessment tool.

  3. Recent trends in cyclist fatalities in Australia.

    Science.gov (United States)

    Boufous, Soufiane; Olivier, Jake

    2016-08-01

    The study examines trends in bicycling fatalities reported to the Australian police between 1991 and 2013. Trends were estimated using Poisson regression modelling. Overall, cycling fatalities decreased by 1.9% annually between 1991 and 2013. However, while deaths following multivehicle crashes decreased at a rate of 2.9% per annum (95% CI -4.0% to -1.8%), deaths from single vehicle crashes increased by 5.8% per annum (95% CI 4.1% to 7.5%). Over the study period, the average age of cyclists who died in single vehicle crashes (45.3 years, 95% CI 41.5 to 49.1) was significantly higher than cyclists who died in multivehicle crashes (36.2 years, 95% CI 34.7 to 37.7). The average age of deceased cyclists increased significantly for both types of crashes. The observed increase in single vehicle crashes need to be closely monitored in Australia and internationally. In-depth studies are needed to investigate the circumstances of fatal single bicycle crashes in order to develop appropriate countermeasures. PMID:26180104

  4. Fatal injury in tree felling and related activities, Victoria, Australia 1992-2007.

    Science.gov (United States)

    Brodie, Lisa Ruth; Ibrahim, Joseph Elias

    2010-02-01

    This study aims to examine fatalities resulting from tree felling and related activities in Victoria, Australia, involving work and do-it-yourself (DIY) activities, 1992-2007. Case identification was undertaken using coronial databases. A manual review of coroners' findings of closed cases was performed. Data collected and examined comprised demographics, occupation, incident location, activity, equipment used, injury mechanism and cause of death. Sixty-two cases were identified during the 16-year period; over 50% comprised DIY deaths (n=33). All but one victim was male. The median age for paid workers was less than for DIY (43 years vs 59 years). One-third of work activities were performed by persons outside professional tree-felling industries. While commercial forestry and logging industries experience a high fatality rate in Australia, non-professionals are also vulnerable to tree-felling injury. Study findings identified in excess of 70% of fatal incidents involved persons not employed within a relevant industry. Prevention efforts must focus on safety beyond workplaces and certain industries alone to reduce these deaths. PMID:20179037

  5. Fatal lymphoproliferation and acute monocytic leukemia-like disease following infectious mononucleosis in the elderly

    OpenAIRE

    Hehlmann, R.; Walther, B; ZÖLLNER, N.; Wolf, Hans J.; Deinhardt, F; Schmid, M.

    1981-01-01

    Three elderly patients are reported, in whom serologically confirmed recent infectious mononucleosis is followed by fatal lymphoproliferation (case 1), by acute monocytic leukemia (case 2), and by acute probably monocytic leukemia (case 3).

  6. Choice of Time of Operation for Severe Acute Pancreatitis (Attached 78 Cases)%重症急性胰腺炎的手术时机(附78例分析)

    Institute of Scientific and Technical Information of China (English)

    耿静明

    2002-01-01

    Objective To study the choice of time of operation for SAP. Methods Analysing retrospectively 78 cases ofclinical manifestation of SAP in different stages and summing - up the treatment and prognosis. Result The unoperativetreatment account for 71.8 % (56 cases ), fatal rate 14.3 %. The operative treatments are 22 cases with fatal rate 27.3 % (earlyoperation 7 cases, transfer operation 9 cases time choice operation 6 cases). Conclusion The fatal rates of operative andunoperative treatment are high. To improve the prognosis of SAP, we should pay close attention to time choice of operation andindividual treatment.

  7. FATAL QUARTET OR QUINTET?

    Directory of Open Access Journals (Sweden)

    Y. V. Sviryaev

    2014-07-01

    Full Text Available Correction of potential risk factors is essential for effective therapy for cardiovascular diseases. This clinical case demonstrates negative impact of non-corrected risk factors — obstructive sleep apnea — in occurrence and further progression of cardiovascular disease.

  8. Acute respiratory failure and active bleeding are the important fatality predictive factors for severe dengue viral infection.

    Directory of Open Access Journals (Sweden)

    Kamolwish Laoprasopwattana

    Full Text Available To determine the outcome of severe dengue viral infection (DVI and the main dengue fatality risk factors.The medical records of patients aged <15 years admitted to Songklanagarind Hospital in southern Thailand during 1989-2011 were reviewed. Patients who had dengue hemorrhagic fever (DHF grades III-IV, organ failure (cardiovascular, respiratory, liver, renal or hematologic, impaired consciousness, or aspartate aminotransferase more than 1,000 units/L, were classified as having severe DVI. To determine the fatality risk factors of severe DVI, the classification trees were constructed based on manual recursive partitioning.Of the 238 children with severe DVI, 30 (12.6% died. Compared to the non-fatal DVI cases, the fatal cases had higher rates of DHF grade IV (96.7% vs 24.5%, repeated shock (93.3% vs 27.9%, acute respiratory failure (ARF (100% vs 6.7%, acute liver failure (ALF (96.6% vs 6.3%, acute kidney injury (AKI (79.3% vs 4.5%, and active bleeding requiring blood transfusion (93.3% vs 5.4%, all p<0.01. The combined risk factors of ARF and active bleeding considered together predicted fatal outcome with sensitivity, specificity, and negative and positive predictive values of 0.93 (0.78-0.99, 0.97 (0.93-0.99, 0.99 (0.97-1.00, and 0.82 (0.65-0.93, respectively. The likelihood ratios for a fatal outcome in the patients who had and did not have this risk combination were 32.4 (14.6-71.7 and 0.07 (0.02-0.26, respectively.Severe DVI patients who have ARF and active bleeding are at a high risk of death, while patients without these things together should survive.

  9. Megacólon tóxico fatal por cytomegalovirus em paciente com retocolite ulcerativa idiopática: relato de caso e revisão de literatura Fatal toxic megacolon due to cytomegalovirosis in a patient with ulcerative colitis: case report and review

    Directory of Open Access Journals (Sweden)

    Sérgio Ossamu IOSHII

    2002-04-01

    Full Text Available Racional - O megacólon tóxico é complicação grave e pouco freqüente na retocolite ulcerativa idiopática. Ocorre, geralmente, em pacientes cuja doença ativa é resistente ao tratamento clínico e, em algumas situações, o fator desencadeante é desconhecido. A infecção pelo cytomelogalovirus em seres humanos em geral é evento subclínico; entretanto, em pacientes imunocomprometidos a primoinfecção ou mesmo a reativação de infecção latente pode ter amplas repercussões clínicas, uma das quais o desencadeamento de megacólon tóxico. Objetivo - Descrever um caso de megacólon tóxico fatal por cytomegalovirose em paciente com retocolite ulcerativa idiopática. Paciente - Masculino, 38 anos, com clínica de diarréia e perda ponderal cuja investigação mostrou tratar-se de retocolite ulcerativa idiopática e para a qual foi instituída terapêutica imunossupressora vigorosa. Resultados - Evoluiu com quadro clínico de megacólon tóxico, sendo submetido a colectomia total. Complicações clínicas culminaram no óbito pós-operatório e o estudo anatomopatológico do cólon revelou doença ativa, associada a ulcerações confluentes na base das quais foram observadas células com alterações características da cytomegalovirose. Conclusão - A cytomegalovirose deve ser considerada como um dos agentes causadores de megacólon tóxico em retocolite ulcerativa.Background - The toxic megacolon is a rare and severe complication of ulcerative colitis. In general it complicates patients with active colitis that are resistant to clinical treatment and, in some cases, the developing factor is unknown. Cytomegalovirus infection in humans in general is a subclinical condition. However, in patients with immunodeficiency the primary infection or the reactivation of latent infection could have enormous clinical effects. One of these effects is the toxic megacolon. Aim - To report a case of fatal toxic megacólon due to cytomegalovirosis in a

  10. Ornithine transcarbamylase deficiency of a male newborn with fatal outcome.

    Science.gov (United States)

    Hartung, Benno; Temme, Oliver; Neuen-Jacob, Eva; Ritz-Timme, Stefanie; Hinderhofer, Katrin; Daldrup, Thomas

    2016-05-01

    Ornithine transcarbamylase deficiency (OTCD) is the most common malfunction of ureagenesis. The case of a male newborn who died at the age of 2 days for clinically unclear reasons is presented. The post-mortem routine and esoteric testing methods that finally led to the diagnosis of a fatal case of OTCD are outlined here. PMID:26753873

  11. Bovine viral diarrhea virus in postweaned calves in a feedlot after vaccination and from fatal respiratory cases: isolation and differentiation of MLV BVDV and field strains

    Science.gov (United States)

    Viral infections are important etiologies in BRD cases. Calves at stocker/feedlot entry usually receive modified live viral (MLV) vaccines containing bovine herpesvirus-1 (BoHV-1), parainfluenza-3 virus (PI3V), bovine viral diarrhea viruses (BVDV), and bovine respiratory syncytial virus (BRSV). In...

  12. Pediatric epidemiological aspects of scorpionism and report on fatal cases from Tityus stigmurus stings (Scorpiones: Buthidae in State of Pernambuco, Brazil

    Directory of Open Access Journals (Sweden)

    Cleide Maria Ribeiro de Albuquerque

    2013-08-01

    Full Text Available Introduction Envenomation by scorpion stings is a major public health problem in numerous tropical countries because of its frequent incidence and potential severity. Approximately 1,900 species of scorpions are known in the world, and at least 130 of these have been described in Brazil. Methods This work reports on 3 child deaths caused by Tityus stigmurus stings and characterizes epidemiological and clinical surveys on pediatric cases of scorpionism recorded in the Centro de Assistência Toxicológica de Pernambuco (Ceatox-PE. Results Scorpion stings accounted for more than 60% of all cases recorded for venomous animals. The children were from 37 cities of the Pernambuco state and accounted for 28.8% of the victims treated for scorpion stings, with the highest incidence in the metropolitan area of Recife. Stings occurred throughout the year and slightly increased during the rainy season. Independent of the elapsed time for a prognosis, most cases showed mild symptoms. Three moderate cases that resulted in death featured cardiogenic shock and/or pulmonary edema or severe neurological symptoms. For the first time, death attributed to T. stigmurus was confirmed by the presence of the scorpion. Conclusions These results suggest that scorpionism in Pernambuco is a public health problem that needs to be monitored carefully throughout the year by the government.

  13. Fatal outbreak of botulism in Greenland

    DEFF Research Database (Denmark)

    Hammer, Tóra Hedinsdottir; Jespersen, Sanne; Kanstrup, Jakob;

    2015-01-01

    Botulism commonly occurs when the anaerobic, gram-positive bacterium Clostridium botulinum, under suitable conditions, produces botulinum neurotoxins. Named A-F, these toxins are the immediate causative agent of the clinical symptoms of symmetrical, descending neurological deficits, including...... recovery was complete. Microbiological assays, including toxin neutralization bioassay, demonstrated the presence of neurotoxin E in two survivors. The third survivor was shown by PCR to have the BoNT type E gene in faeces. This is the first report of cases of fatal botulism in Greenland. It underscores...

  14. Fatal measles pneumonitis during Hodgkin's lymphoma.

    Science.gov (United States)

    Wyplosz, Benjamin; Lafarge, Marion; Escaut, Lélia; Stern, Jean-Baptiste

    2013-01-01

    The treatment of measles pneumonitis in immunocompromised adults is not established. We describe a patient with Hodgkin's lymphoma who developed acute pneumonia during a measles infection. On day 13, intravenous ribavirin and immunoglobulins were administrated. On day 18, the patient developed acute respiratory failure. An examination of transbronchial pulmonary biopsies showed Warthin-Finkeldey giant cells that are pathognomonic of measles pneumonitis. The patient died despite aggressive supportive care. Our case and a review of literature show that measles pneumonitis is routinely fatal in patients with cancer. We suggest that antiviral drugs should be considered as soon as the diagnosis has been established. PMID:24105383

  15. Early Indicators of Fatal Leptospirosis during the 2010 Epidemic in Puerto Rico

    Science.gov (United States)

    Sharp, Tyler M.; Rivera García, Brenda; Pérez-Padilla, Janice; Galloway, Renee L.; Guerra, Marta; Ryff, Kyle R.; Haberling, Dana; Ramakrishnan, Sharada; Shadomy, Sean; Blau, Dianna; Tomashek, Kay M.; Bower, William A.

    2016-01-01

    Background Leptospirosis is a potentially fatal bacterial zoonosis that is endemic throughout the tropics and may be misdiagnosed as dengue. Delayed hospital admission of leptospirosis patients is associated with increased mortality. Methodology/Principal Findings During a concurrent dengue/leptospirosis epidemic in Puerto Rico in 2010, suspected dengue patients that tested dengue-negative were tested for leptospirosis. Fatal and non-fatal hospitalized leptospirosis patients were matched 1:1–3 by age. Records from all medical visits were evaluated for factors associated with fatal outcome. Among 175 leptospirosis patients identified (4.7 per 100,000 residents), 26 (15%) were fatal. Most patients were older males and had illness onset during the rainy season. Fatal case patients first sought medical care earlier than non-fatal control patients (2.5 vs. 5 days post-illness onset [DPO], p < 0.01), but less frequently first sought care at a hospital (52.4% vs. 92.2%, p < 0.01). Although fatal cases were more often diagnosed with leptospirosis at first medical visit (43.9% vs. 9.6%, p = 0.01), they were admitted to the hospital no earlier than non-fatal controls (4.5 vs. 6 DPO, p = 0.31). Cases less often developed fever (p = 0.03), but more often developed jaundice, edema, leg pain, hemoptysis, and had a seizure (p ≤ 0.03). Multivariable analysis of laboratory values from first medical visit associated with fatal outcome included increased white blood cell (WBC) count with increased creatinine (p = 0.001), and decreased bicarbonate with either increased WBC count, increased creatinine, or decreased platelet count (p < 0.001). Conclusions/Significance Patients with fatal leptospirosis sought care earlier, but were not admitted for care any earlier than non-fatal patients. Combinations of routine laboratory values predictive of fatal outcome should be considered in admission decision-making for patients with suspected leptospirosis. PMID:26914210

  16. Fatal Work-Related Injuries: Southeastern United States, 2008-2011.

    Science.gov (United States)

    Brinker, Kimberly; Jacobs, Teri; Shire, Jeffrey; Bunn, Terry; Chalmers, Juanita; Dang, Gregory; Flammia, Dwight; Higgins, Sheila; Lackovic, Michelle; Lavender, Antionette; Lewis, Jocelyn S; Li, Yinmei; Harduar Morano, Laurel; Porter, Austin; Rauscher, Kimberly; Slavova, Svetla; Watkins, Sharon; Zhang, Lei; Funk, Renée

    2016-04-01

    In 2008, the work-related injury fatality rate was 3.8 per 100,000 workers in the United States but was 5.2 per 100,000 workers for the southeast region. Work-related fatalities in the southeast were examined for the period 2008 to 2011. Median work-related injury fatality rates are reported for the southeast region, each of the 12 states, and the United States. The percentages of employees in high fatality industries and work-related fatalities by cause were calculated. Finally, the Occupational Safety and Health Administration's database was searched for fatality reports. States with the highest rates (per 100,000 workers) included Arkansas (7.2), Louisiana (6.8), and West Virginia (6.6). Arkansas, Louisiana, Mississippi, and West Virginia each had more than 20% of their employees in high fatality industries. Forty percent of work-related injury fatalities were from transportation incidents in the southeast and the United States. Future analyses should include work-related injury fatality rates by industry and compare rates with other U.S. regions. PMID:26467194

  17. Alcohol Control Policies and Motor Vehicle Fatalities

    OpenAIRE

    Chaloupka, Frank J.; Henry Saffer; Michael Grossman

    1991-01-01

    The purpose of this study is to estimate the effects of drunk driving deterrents and other alcohol related policies on drunk driving. The data set employed is an annual time-series of state cross-sections for the 48 contiguous states of the U.S. from 1982 through 1988. Total and alterative alcohol involved motor vehicle fatality rates, for the general population and for 18 to 20 year olds, are used as measures of drunk driving. The results indicate that the moat effective policies are increas...

  18. Factors affecting rate of stroke-related death in elderly male military population A 23-year cohort study of 1 268 cases in Xi'an, China

    Institute of Scientific and Technical Information of China (English)

    Yanhua Li; Yu Sun; Xiaoyong Sai; Yao He; Qiang Wu; Yongping Yan; Ke Men; Liangshou Li

    2011-01-01

    The study is the first long-term cohort study examining stroke and its subtypes among a population of Chinese elderly male retired military veterans. We reported on a 23-year cohort study examining stroke in 1 268 elderly male patients living in Xi'an, China since 1987. The stroke-related mortality rate in this cohort was 361.50/1 × 106 per year. Cerebral hemorrhage was the dominant cause of death, with 28 cases of fatal cerebral infarction and 49 cases of fatal cerebral hemorrhage among 77 stroke-related deaths. Independent risk factors for stroke mortality included age, blood pressure, smoking, body mass index, family history of hypertension, past medical history of stroke, hypertension and hyperlipidemia. Among them, ischemic stroke mortality correlated with age, smoking, family history of hypertension and past medical history of stroke, while hemorrhagic stroke was related to blood pressure, body mass index and past medical history of hypertension. Our results indicated that maintaining appropriate levels of blood pressure and body mass, smoking cessation and prevention of hyperlipidemia can reduce the risk of stroke-related death in elderly males who are retired from military service.

  19. Use of Viremia to Evaluate the Baseline Case Fatality Ratio of Ebola Virus Disease and Inform Treatment Studies: A Retrospective Cohort Study

    OpenAIRE

    Faye, Oumar; Andronico, Alessio; Faye, Ousmane; Salje, Henrik; Boëlle, Pierre-Yves; Magassouba, N’Faly; Bah, Elhadj Ibrahima; Koivogui, Lamine; Diallo, Boubacar; Diallo, Alpha Amadou; Keita, Sakoba; Konde, Mandy Kader; Fowler, Robert; Fall, Gamou; Cauchemez, Simon

    2015-01-01

    Editors' Summary Background During the current outbreak of Ebola virus disease (EVD) in West Africa, which started in December 2013, there have been more than 28,000 confirmed, probable, and suspected cases of EVD and more than 11,000 deaths from the disease. Ebola virus is transmitted to people from wild animals and spreads in human populations through direct contact with the bodily fluids (including blood, saliva, and urine) or organs of infected people or through contact with bedding and o...

  20. Nominal effective exchange rate neutrality: the case of Macedonia

    OpenAIRE

    Josheski, Dushko; Lazarov, Darko

    2012-01-01

    urrently, the exchange rate regime in the Republic of Macedonia is what is refered to as a "managed float." The exchange rate of the denar is established on the basis of supply and demand of foreign exchange markets. The denar exchange rate against the euro serves as a fundamental of the Republic of Macedonia monetary policy. Money supply and interest rates are dictated by the exchange rate target. This paper uses Structural Vector Autoregression method to find empirical evidence ...

  1. Fatal diving accidents in western Norway 1983-2007.

    Science.gov (United States)

    Ramnefjell, M P; Morild, I; Mørk, S J; Lilleng, P K

    2012-11-30

    Despite efforts to reduce their number, fatal diving accidents still occur. The circumstances and post-mortem findings in 40 fatal diving accidents in western Norway from 1983 through 2007 were investigated. Diving experience, medical history and toxicology reports were retrieved. The material consisted of recreational divers, professional saturation divers and professional divers without experience with saturation. In 33 cases the diving equipment was examined as part of the forensic investigation. In 27 cases defects in the diving equipment were found. For six divers such defects were responsible for the fatal accidents. Eighteen divers died on the surface or less than 10 m below surface. Five divers reached below 100 msw, and two of them died at this depth. The fatalities were not season-dependent. However, wave-height and strength of currents were influential factors in some cases. Twelve divers were diving alone. Twenty divers had one buddy, 9 of these divers were alone at the time of death. The cause of death was drowning in 31 out of 40 divers; one of them had a high blood-ethanol concentration, in two other divers ethanol was found in the urine, indicating previous ethanol consumption. Nine divers died from sudden decompression, pulmonary barotraumas, underwater trauma and natural causes. The study shows that most of the fatal diving accidents could be avoided if adequate diving safety procedures had been followed. PMID:22981212

  2. Results from the Hawaii domestic violence fatality review, 2000-2009

    Science.gov (United States)

    Pobutsky, Ann; Brown, Melissa; Nakao, Lisa; Reyes-Salvail, Florentina

    2014-01-01

    Abstract: Background: Patterns of domestic violence fatalities and agency responses in Hawaii have not been explicated. Methods: Retrospective reviews of events leading up to domestic violence related fatalities in Hawaii were assessed from 45 adjudicated cases that resulted in 62 fatalities for the ten year period from 2000-2009. Results: Almost one-half of the fatalities were homicide/suicide combinations. Females were disproportionately more likely to be fatal victims of domestic violence relative to their proportion in the population. Those aged 21-40 years and those over 80 years were more likely to be fatal victims of domestic violence, relative to their proportion in the population. Filipinas and ‘Other” ethnic groups are disproportionately more likely to be fatal victims of domestic violence while Native Hawaiians and Japanese are less likely to be fatal victims, relative to their proportions in the population. In more than two-thirds of the cases, the victim had made some attempt to leave the relationship prior to the fatality. Conclusions: In the majority of cases there was agency involvement in some form: either the victim alone or the perpetrator alone, or both. However, less than one-third (31.1%) of the cases over the past ten years had documentation of prior violence from medical reports, so this may be an area to further document and address domestic violence. PMID:24292165

  3. Results from the Hawaii domestic violence fatality review, 2000-2009

    Directory of Open Access Journals (Sweden)

    Ann Pobutsky

    2014-07-01

    Full Text Available Abstract: Background: Patterns of domestic violence fatalities and agency responses in Hawaii have not been explicated. Methods: Retrospective reviews of events leading up to domestic violence related fatalities in Hawaii were assessed from 45 adjudicated cases that resulted in 62 fatalities for the ten year period from 2000-2009. Results: Almost one-half of the fatalities were homicide/suicide combinations. Females were disproportionately more likely to be fatal victims of domestic violence relative to their proportion in the population. Those aged 21-40 years and those over 80 years were more likely to be fatal victims of domestic violence, relative to their proportion in the population. Filipinas and „Other” ethnic groups are disproportionately more likely to be fatal victims of domestic violence while Native Hawaiians and Japanese are less likely to be fatal victims, relative to their proportions in the population. In more than two-thirds of the cases, the victim had made some attempt to leave the relationship prior to the fatality. Conclusions: In the majority of cases there was agency involvement in some form: either the victim alone or the perpetrator alone, or both. However, less than one-third (31.1% of the cases over the past ten years had documentation of prior violence from medical reports, so this may be an area to further document and address domestic violence.

  4. Fatal and near-fatal anaphylaxis: factors that can worsen or contribute to fatal outcomes.

    Science.gov (United States)

    Greenberger, Paul A

    2015-05-01

    Anaphylaxis implies a risk of death even in patients whose prior episodes have been considered mild and managed easily. Anaphylaxis occurs in all age groups, from infants to the elderly, but most deaths occur in adults. Factors or circumstances associated with near-fatal or fatal anaphylaxis are reviewed from the following 10 perspectives: accidents and mishaps, adulterated products, age, allergens, atopy, comorbidities, Munchausen syndrome or contrived anaphylaxis, patient factors, route of administration, and treatment-related issues. There are no absolute contraindications to self-injectable epinephrine, and epinephrine can be administered for anaphylaxis to elderly patients or to those patients receiving beta-adrenergic blockers. PMID:25841558

  5. FATAL ACCIDENT REPORTING SYSTEM (FARS)

    Science.gov (United States)

    The Fatal Accident Reporting System (FARS) database consist of three relational tables, containing data on automobile accidents on public U.S. roads that resulted in the death of one or more people within 30 days of the accident. Truck and trailer accidents are also included.

  6. Evaluating the Role of Perceived Stress on the Likelihood of Having a Non - Fatal Acute Coronary Syndrome: A Case-Control Study

    OpenAIRE

    Katsarou, Alexia; Triposkiadis, Filippos; Skoularigis, John; Griva, Emmanuela; Neroutsos, George; Karayannis, Georgios; Papageorgiou, Charalabos; Panagiotakos, Demosthenes

    2014-01-01

    Objectives: The aim of the current study was to evaluate the independent role of perceived stress, measured by the PSS-14, on the likelihood of having acute coronary syndrome (ACS). Conclusion: This is a case-control study with individual matching by age and sex. During 2010-2012, 250 consecutive patients (60±11 years, 78% men) with a first ACS and 250 population-based, control subjects (60±8.6 years, 77.6% men), were enrolled. Perceived stress levels were evaluated with the PSS-14 scale, dep...

  7. Vascular type Ehlers-Danlos Syndrome with fatal spontaneous rupture of a right common iliac artery dissection: case report and review of literature

    OpenAIRE

    Abayazeed, Aly; Hayman, Emily; Moghadamfalahi, Mana; Cain, Darren

    2014-01-01

    Vascular Ehlers-Danlos Syndrome (previously Ehlers-Danlos IV) is a rare autosomal dominant collagen vascular disorder caused by a 2q31 COL3A1 gene mutation encoding pro-alpha1 chain of type III collagen (in contrast to classic Ehlers-Danlos, caused by a COL5A1 mutation). The vascular type accounts for less than 4% of all Ehlers-Danlos cases and usually has a poor prognosis due to life threatening vascular ruptures and difficult, frequently unsuccessful surgical and vascular interventions. In ...

  8. Appalachian versus non-Appalachian US traffic fatalities, 2008-2010

    Science.gov (United States)

    Zhu, Motao; Zhao, Songzhu; Gurka, Kelly K.; Kandati, Sahiti; Coben, Jeffrey H.

    2013-01-01

    Purpose Though myriad health disparities exist in Appalachia, limited research has examined traffic fatalities in the region. This study compared traffic-fatality rates in Appalachia and the non-Appalachian US. Methods Fatality Analysis Reporting System and Census data from 2008-2010 were used to calculate traffic-fatality rates. Poisson models were used to estimate unadjusted (RR) and adjusted rate ratios (aRR), controlling for age, sex, and county-specific population density levels. Results: The Appalachian traffic-fatality rate was 45% (95% CI: 1.42, 1.47) higher than the non-Appalachian rate. Though only 29% of fatalities occur in rural counties in non-Appalachia versus 48% in Appalachia, rates in rural counties were similar (RR=0.97; 95% CI: 0.95, 1.00). However, the rate for urban, Appalachian counties was 42% (95% CI: 1.38, 1.45) higher than among urban, non-Appalachian counties. Appalachian rates were higher for passenger-vehicle drivers, motorcyclists, and all-terrain-vehicle riders, regardless of rurality, as well as for passenger-vehicle passengers overall and for urban counties. Conversely, Appalachia experienced lower rates among pedestrians and bicyclists, regardless of rurality. Conclusions Disparities in traffic fatality rates exist in Appalachia. Though elevated rates are partially explained by the proportion of residents living in rural settings, overall rates in urban Appalachia were consistently higher than in urban non-Appalachia. PMID:23619016

  9. Provincial Variations in Divorce Rates: A Canadian Case.

    Science.gov (United States)

    Makabe, Tomoko

    1980-01-01

    Examines differentials in divorce rates in Canada. Provinces with higher population turnover are characterized by lower degrees of social integration and lower social costs attached to divorce, reflected in higher divorce rates. The hypothesis that divorce rates are higher where more economic opportunities are available for women is explored.…

  10. Assessment of averted fatal cancer cases due to limitation of radiocaesium intake with milk for population of Belarus after the Chernobyl accident

    International Nuclear Information System (INIS)

    After the Chernobyl accident different protective measures for radiation protection of Belorussian population were carried out. As a result, annual reduction of exposure and prevention of significant doses for people of Belarus are registered. Exposure doses for overwhelming majority of population during all phases of accidental period are conditioned, mainly by the levels of internal doses. For inhabitants of clean and low contaminated territories total doses are formed only by means of internal exposure from consumed foodstuffs, contaminated by radionuclides. For 1.3 million of inhabitants of contaminated territories (with density of radiocaesium contamination more than 37 kBq/sq.m internal doses are higher than external doses in most cases. Only for inhabitants of individual settlements with densities of radiocaesium contamination of territories more than 185 kBq/sq.m, external exposure doses play an important role in total dose formation. (author)

  11. Human immunodeficiency virus infection presenting as a fatal case of Guillain-Barré syndrome on a background of diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Enwere O.O

    2015-06-01

    Full Text Available Background: Guillain-Barré syndrome (GBS, a post-infective acute polyneuropathy, which occurs rarely among Africans, has been associated with HIV infection and less commonly with diabetes mellitus. Aim: The article documents a case of GBS occurring on the setting of HIV infection on a background of diabetes mellitus. Findings: A 47 years old man presented with features of inability to walk, “pins and needles” sensation in the lower limbs, progressive lower limb weakness of 3 days duration and later on admission involving the upper limbs and, finally respiratory distress leading to his death on the 3rd day of hospital admission. He had an antecedent history of a diarrheal illness 3 weeks prior to his admission, and was treated at a private hospital without any complication. He was observed to have concomitant HIV infection and diabetes mellitus. He was not previously known to have any of these diseases and initially diagnosed as having acute diabetic neuropathy. Conclusion: GBS can occur in the setting of HIV infection on a background of DM and may be associated with a poor prognosis. There is a need to have a high index of suspicion in making a diagnosis of GBS in diabetic patients when it occurs concomitantly with HIV infection.

  12. Differences in the epidemiology and virology of mild, severe and fatal human infections with avian influenza A (H7N9) virus.

    Science.gov (United States)

    Sha, Jianping; Chen, Xiaowen; Ren, Yajin; Chen, Haijun; Wu, Zuqun; Ying, Dong; Zhang, Zhiruo; Liu, Shelan

    2016-05-01

    A novel avian influenza A (H7N9) virus caused 5-10 % mild and 30.5 % fatal human infections as of December 10, 2015. In order to investigate the reason for the higher rate of fatal outcome of this infection, this study compared the molecular epidemiology and virology of avian influenza A (H7N9) viruses from mild (N = 14), severe (N = 50) and fatal (N = 35) cases, as well as from non-human hosts (N = 73). The epidemiological results showed that the average age of the people in the mild, severe and fatal groups was 27.6, 52 and 62 years old, respectively (p < 0.001). Males accounted for 42.9 % (6/14), 58.0 % (29/50), and 74.3 % (26/35) of cases in the mild, severe and fatal group respectively (p = 0.094). Median days from onset to start of antiviral treatment were 2, 5 and 7 days in the mild, severe and fatal group, respectively (p = 0.002). The median time from onset to discharge/death was 12, 40 and 19 days in the mild, severe and fatal group, respectively (p < 0.001). Analysis of whole genome sequences showed that PB2 (E627K), NA (R294K) and PA (V100A) mutations were markedly associated with an increased fatality rate, while HA (N276D) and PB2 (N559T) mutations were clearly related to mild cases. There were no differences in the genotypes, adaptation to mammalian hosts, and genetic identity between the three types of infection. In conclusion, advanced age and delayed confirmation of diagnosis and antiviral intervention were risk factors for death. Furthermore, PB2 (E627K), NA (R294K) and PA (V100A) mutations might contribute to a fatal outcome in human H7N9 infection. PMID:26887968

  13. Estimating Side Underride Fatalities Using Field Data

    OpenAIRE

    Padmanaban, Jeya

    2013-01-01

    There is evidence that underride events are undercounted by the Fatality Analysis Reporting System (FARS), a census of fatal crashes on public roads in the United States. This study’s principal objective was to develop accurate fatality estimates for side underride crashes involving “combination trucks” and light vehicles. Police reports from 29 states were used to estimate the incidence of fatal crashes in which light vehicles underrode the sides of large combination trucks. A protocol was d...

  14. 2007 Wholesale Power Rate Case Final Proposal : Wholesale Power Rate Development Study.

    Energy Technology Data Exchange (ETDEWEB)

    United States. Bonneville Power Administration.

    2006-07-01

    The Wholesale Power Rate Development Study (WPRDS) serves two primary purposes. It synthesizes information supplied by the other final studies that comprise the BPA rate proposal and shows the actual calculations for BPA's power rates. In addition, the WPRDS is the primary source for certain information used in establishing the power rates. Information developed in the WPRDS includes rate design (including seasonal and diurnal shapes for energy rates, demand, and load variance rates), the risk mitigation tools (Cost Recovery Adjustment Clause (CRAC), along with the [N]ational Marine Fisheries Service [F]ederal Columbia River Power System [B]iological Opinion (NFB) Adjustment, the Emergency NFB Surcharge, and Dividend Distribution Clause (DDC)), development of the Slice rate, and all discounts and other adjustments that are included in the rate schedules and the General Rate Schedule Provisions. The WPRDS also includes the description of the methodology for the Cost of Service Analysis (COSA), and the various rate design steps necessary to establish BPA's power rates. The WPRDS also shows the calculations for inter-business line revenues and expenses, the revenue forecast and, finally, includes a description of all of the rate schedules. The actual rate schedules are shown in ''Administrator's Final Record of Decision (ROD), Appendix A: 2007 Wholesale Power Rate Schedules and General Rate Schedule Provisions, WP-07-A-02''. The WPRDS also includes the Partial Resolution of Issues, shown in Attachment 1 of the ROD. The Partial Resolution of Issues affected many of the features described in this study. These are noted where appropriate.

  15. Road Accidents and Road Fatalities in Denmark from 1968 to 2004

    DEFF Research Database (Denmark)

    Orozova-Bekkevold, Ivanka; Hels, Tove; Bernhoft, Inger Marie

    2008-01-01

    actions targeted to improve road safety have indeed led to a significant reduction in injury accidents and fatalities. Further research and more detailed data, especially on traffic volume and individual exposure are necessary in order to investigate properly a causal relation between the number of......The purpose of this article is to describe the road accidents and road fatalities in Denmark in the period 1968-2004. Only accidents registered by the police were used. Crude and gender & age specific fatality rates (counts per 1,000,000 inhabitants) were estimated for all road users and for...... bicyclists. The accident and fatality rates have decreased by around 70% from 1968 to 2004, while the motorisation rate has increased by approximately 90%. The sharpest decrease in the fatality rate was observed among the youngest (below 18 years old) and the older (above 64) road users. Gender related...

  16. Road Accidents and Road Fatalities in Denmark from 1968 to 2004

    DEFF Research Database (Denmark)

    Orozova-Bekkevold, Ivanka; Hels, Tove; Bernhoft, Inger Marie

    actions targeted to improve road safety have indeed led to a significant reduction in injury accidents and fatalities. Further research and more detailed data, especially on traffic volume and individual exposure are necessary in order to investigate properly a causal relation between the number of......The purpose of this article is to describe the road accidents and road fatalities in Denmark in the period 1968-2004. Only accidents registered by the police were used. Crude and gender & age specific fatality rates (counts per 1,000,000 inhabitants) were estimated for all road users and for...... bicyclists. The accident and fatality rates have decreased by around 70% from 1968 to 2004, while the motorisation rate has increased by approximately 90%. The sharpest decrease in the fatality rate was observed among the youngest (below 18 years old) and the older (above 64) road users. Gender related...

  17. Insights for Analyzing Earnings Growth Rates: A Case Study.

    Science.gov (United States)

    Hannah, Richard L.

    1994-01-01

    A study at one public university investigated the annualized rate of salary/wage increase of employees from the time of hiring until July 1992. It examined promotion patterns, equity adjustments, employee degree acquisition, and certification of clerical workers. The study underscored the wide variation in earnings growth rates due in large part…

  18. Aspectos patológicos de 155 casos fatais de cães atropelados por veículos automotivos Pathological aspects of 155 fatal cases of dogs victimized by motor vehicles accidents

    Directory of Open Access Journals (Sweden)

    Rafael Almeida Fighera

    2008-08-01

    Full Text Available O atropelamento por veículos automotivos contribui significativamente para as estatísticas de morte em cães. Entretanto, há poucos estudos sobre os aspectos patológicos reportados na literatura. Este artigo descreve 155 casos fatais de atropelamento por veículos automotivos em cães. Dos 155 cães atropelados, em 138 (89,0% havia lesões que explicavam a morte ou a razão para a eutanásia desses cães. Essas lesões incluíram traumatismo espinhal-medular (43 [27,7%], ruptura de órgãos parenquimatosos (40 [25,8%], traumatismo cranioencefálico (28 [18,1%], ruptura de órgãos ocos (16 [10,3%], fratura de costelas com laceração de órgãos parenquimatosos (15 [9,7%] e ruptura de diafragma com deslocamento de vísceras abdominais para a cavidade torácica (10 [6,4%].Motor vehicle-related trauma significantly contributes to death statistics of dogs. There are however few documented reports on the pathological aspects of such cases. This paper describes 155 fatal cases of dogs victimized by motor vehicle accidents. In 138 (89.0% of the 155 dogs hit by motor vehicles there were lesions that could explain the death or reason for these dogs being euthanatized. These lesions included vertebrospinal trauma (43 [27.7%], rupture of parenchymal organs (40 [25.8%], cranioencephalic trauma (28 [18.1%], rupture of hollow organs (16 [10.3%], rib fracture with subsequent laceration of parenchymal organs (15 [9.7%], and diaphragmatic rupture with displacement of abdominal viscera into the thoracic cavity (10 [6.4%].

  19. Incorporating a Time Horizon in Rate-of-Return Estimations: Discounted Cash Flow Model in Electric Transmission Rate Cases

    International Nuclear Information System (INIS)

    Electric transmission and other rate cases use a form of the discounted cash flow model with a single long-term growth rate to estimate rates of return on equity. It cannot incorporate information about the appropriate time horizon for which analysts' estimates of earnings growth have predictive powers. Only a non-constant growth model can explicitly recognize the importance of the time horizon in an ROE calculation. (author)

  20. Fatal cerebro-renal oxalosis after appendectomy.

    Science.gov (United States)

    Pfeiffer, H; Weiss, F U; Karger, B; Aghdassi, A; Lerch, M M; Brinkmann, B

    2004-04-01

    A case of a 24-year-old male with fatal cerebro-renal oxalosis assumed to be due to infusions of the sugar surrogate xylitol after appendectomy is reported. The diagnosis was established only after intensive histological investigations following the autopsy. The clinical picture was characterized by an acute seizure, coma and renal failure 2 days after the first xylitol infusion. Death occurred due to cerebral dysregulation as a very rare complication after parenteral administration of xylitol. Subendothelial double refractive calcium oxalate crystals were found in the walls of cerebral blood vessels, in particular in the stem ganglion regions and in the cortical renal tubules. The most common type of primary oxalosis was excluded by sequencing analysis. The young age, the minor surgical intervention and the otherwise unremarkable history are special features of this case. Since the genetic background of xylitol intolerance is still unclear, it is suggested that it should be banned as a sugar surrogate in clinical practice. PMID:14634832

  1. Exchange Rate Instability and Trade. The Case of Pakistan

    OpenAIRE

    M. Ali Kemal

    2005-01-01

    The variations in exchange rate play a vital role in the determination of trade balance. Volatile exchange rate shatters the investor’s and trader’s confidence, and slows down the process of trade, which results in slower growth. In this paper, other market instabilities—such as GDP growth instability in imports equation and agriculture and manufacturing instability in exports equation—have been used with exchange rate instability, and GARCH variance is used to measure it. It is found that th...

  2. Brazilian road traffic fatalities: a spatial and environmental analysis.

    Directory of Open Access Journals (Sweden)

    Luciano de Andrade

    Full Text Available BACKGROUND: Road traffic injuries (RTI are a major public health epidemic killing thousands of people daily. Low and middle-income countries, such as Brazil, have the highest annual rates of road traffic fatalities. In order to improve road safety, this study mapped road traffic fatalities on a Brazilian highway to determine the main environmental factors affecting road traffic fatalities. METHODS AND FINDINGS: Four techniques were utilized to identify and analyze RTI hotspots. We used spatial analysis by points by applying kernel density estimator, and wavelet analysis to identify the main hot regions. Additionally, built environment analysis, and principal component analysis were conducted to verify patterns contributing to crash occurrence in the hotspots. Between 2007 and 2009, 379 crashes were notified, with 466 fatalities on BR277. Higher incidence of crashes occurred on sections of highway with double lanes (ratio 2∶1. The hotspot analysis demonstrated that both the eastern and western regions had higher incidences of crashes when compared to the central region. Through the built environment analysis, we have identified five different patterns, demonstrating that specific environmental characteristics are associated with different types of fatal crashes. Patterns 2 and 4 are constituted mainly by predominantly urban characteristics and have frequent fatal pedestrian crashes. Patterns 1, 3 and 5 display mainly rural characteristics and have higher prevalence of vehicular collisions. In the built environment analysis, the variables length of road in urban area, limited lighting, double lanes roadways, and less auxiliary lanes were associated with a higher incidence of fatal crashes. CONCLUSIONS: By combining different techniques of analyses, we have identified numerous hotspots and environmental characteristics, which governmental or regulatory agencies could make use to plan strategies to reduce RTI and support life-saving policies.

  3. Fatal splenic rupture in Ehlers-Danlos syndrome.

    OpenAIRE

    Harris, S. C.; Slater, D N; Austin, C. A.

    1985-01-01

    A fatal case of Ehlers-Danlos syndrome (Type IV) is described. Autopsy revealed splenic rupture that had resulted from spontaneous haemorrhage into the splenic parenchyma. This is a previously unrecorded complication of Ehlers-Danlos syndrome and should be considered in the differential diagnosis of chest and abdominal pain in patients with this condition.

  4. Stock Returns and Interest Rates: The Case of Greece

    OpenAIRE

    Harissis, H.F.

    1999-01-01

    This paper examines the influence of interest rate changes on stocks’ returns for seven portfolios, which have been constructed from various industries of the Greek Economy. For that purpose we use the two–factors model. The present paper, using the Augmented Market Model, aims at analysing stock returns of those Greek Economy industries that are listed at the Athens Stock Exchange with reference to the interest rate changes.

  5. Government Spending and Real Exchange Rate Case of Albania

    Directory of Open Access Journals (Sweden)

    Edmira Cakrani

    2013-04-01

    Full Text Available Various studies have found that governmentspending can lead to overestimation orunderestimation of the real exchange rate, depending on the composition of theseexpenditures. The purpose of this paper is toassess the impact of government spendingon real exchange rate in Albania. In this paper is used a log liner model with quarterlydata. Other explanatory variables in this model are: foreign direct investment, remittances,real GDP per capita, openness. Variables are tested for unit root and cointegration. Theresults indicate that government spendingis associated with overvaluation of realexchange rate in Albania.JEL Classification: E62; F31Various studies have found that governmentspending can lead to overestimation orunderestimation of the real exchange rate, depending on the composition of theseexpenditures. The purpose of this paper is toassess the impact of government spendingon real exchange rate in Albania. In this paper is used a log liner model with quarterlydata. Other explanatory variables in this model are: foreign direct investment, remittances,real GDP per capita, openness. Variables are tested for unit root and cointegration. Theresults indicate that government spendingis associated with overvaluation of realexchange rate in Albania.JEL Classification: E62; F31

  6. Cilia-associated bacteria in fatal Bordetella bronchiseptica pneumonia of dogs and cats

    Science.gov (United States)

    Bordetella bronchiseptica frequently causes nonfatal tracheobronchitis, but its role in fatal pneumonia is less well-studied. The objectives of this study were to identify the frequency of Bordetella bronchiseptica infection in fatal cases of bronchopneumonia in dogs and cats and to compare the diag...

  7. Learning from Tragedy: A Survey of Child and Adolescent Restraint Fatalities

    Science.gov (United States)

    Nunno, Michael A.; Holden, Martha J.; Tollar, Amanda

    2006-01-01

    Objective: This descriptive study examines 45 child and adolescent fatalities related to restraints in residential (institutional) placements in the United States from 1993 to 2003. Method: The study team used common Internet search engines as its primary case discovery strategy to determine the frequency and the nature of the fatalities, as well…

  8. Pharyngitis – fatal infectious disease or medical error?

    Directory of Open Access Journals (Sweden)

    Marta Rorat

    2015-08-01

    Full Text Available Reporting on adverse events is essential to create a culture of safety, which focuses on protecting doctors and patients from medical errors. We present a fatal case of Streptococcus C pharyngitis in a 56-year-old man. The clinical course and the results of additional diagnostics and autopsy showed that sepsis followed by multiple organ failure was the ultimate cause of death. The clinical course appeared fatal due to a chain of adverse events, including errors made by the physicians caring for the patient for 10 days.

  9. A report of fatal cervical throtrast deposition

    International Nuclear Information System (INIS)

    A case of fatal Thorotrastoma seen by a 67-year-old male was reported. The patient received a right carotid angiography in 1943 for the investigation of a gunshot wound during the war. Extravasation of Thorotrast was notified by the physician and a small induration remained. In 1976, the induration increased in size occupying the whole of the right lateral cervical area. This was accompanied with bouts of clonic seizure, loss of consciousness and lower cranial nerve palsies. In June, 1980, A sudden increase of the mass, high fever with general malaise, and permanent lower cranial nerve palsies led the patient seek administration to the University Hospital. His general condition kept detereorating with two attacks of severe hemoptysis and the patient deceased. Necropsy revealed a large Thorotrast granuloma, containing amorphous mass of residual Thorotrast, extending from the cranial base down to the mediastinum. Two perforations, which led to the fatal hemoptysis, were identified at the hypopharynx and tracheocarina. Both the right brachiocephalic artery and innominate vein were occluded and the right carotid artery was constricted to a narrow cleft. A bibliographical review of Thorotrast granuloma was also included. (author)

  10. Evaluation of meteorological and epidemiological characteristics of fatal pulmonary embolism

    Science.gov (United States)

    Törő, Klára; Pongrácz, Rita; Bartholy, Judit; Váradi-T, Aletta; Marcsa, Boglárka; Szilágyi, Brigitta; Lovas, Attila; Dunay, György; Sótonyi, Péter

    2016-03-01

    The objective of the present study was to identify risk factors among epidemiological factors and meteorological conditions in connection with fatal pulmonary embolism. Information was collected from forensic autopsy records in sudden unexpected death cases where pulmonary embolism was the exact cause of death between 2001 and 2010 in Budapest. Meteorological parameters were detected during the investigated period. Gender, age, manner of death, cause of death, place of death, post-mortem pathomorphological changes and daily meteorological conditions (i.e. daily mean temperature and atmospheric pressure) were examined. We detected that the number of registered pulmonary embolism (No 467, 211 male) follows power law in time regardless of the manner of death. We first described that the number of registered fatal pulmonary embolism up to the nth day can be expressed as Y( n) = α ṡ n β where Y denotes the number of fatal pulmonary embolisms up to the nth day and α > 0 and β > 1 are model parameters. We found that there is a definite link between the cold temperature and the increasing incidence of fatal pulmonary embolism. Cold temperature and the change of air pressure appear to be predisposing factors for fatal pulmonary embolism. Meteorological parameters should have provided additional information about the predisposing factors of thromboembolism.

  11. EXCHANGE RATE AND ECONOMIC GROWTH. THE CASE OF ROMANIA

    Directory of Open Access Journals (Sweden)

    Nicolae Ghiba

    2010-12-01

    Full Text Available Considering the difficulties created by the economic crisis, many exporters have criticized the National Bank of Romania (NBR’s policy regarding the exchange rate evolution. They argue that depreciation is a necessary condition for recovery and not financial stability. On the contrary, Romania cannot afford a shock in the exchange rate level. The risk associated with such a measure is too high for an emerging country and it annihilates any export competitive advantages. Therefore, depreciation may delay the imperative of Romanian economic recovery. A solid economic recovery should have as starting point a financial system sound and stable. Excessive exchange rate depreciation jeopardizes the financial soundness of banks and the borrower’s ability to repay their loans. Therefore, it creates inflationary flare-ups, particularly dangerous for the economy of any state.

  12. Estimating national road crash fatalities using aggregate data.

    Science.gov (United States)

    Ahmed, Anwaar; Khan, Beenish Akbar; Khurshid, Muhammad Bilal; Khan, Muhammad Babar; Waheed, Abdul

    2016-09-01

    Injuries and fatalities from road traffic crashes have emerged a major public health challenge in Pakistan. Reliable estimates of road crash fatalities (RCF) of a country, is a vital element needed for identification and control of key risk factors, road-safety improvement efforts and prioritizing national health. Reliability of current annual RCF estimates for Pakistan becomes highly questionable due to serious underreporting. This study aimed to predict annual RCF for Pakistan using data from World Health Organization and International Road Federation sources. An ordinary least square (OLS) regression model that relates fatality rate with different explanatory variables was developed. RCF were predicted for Pakistan for year 2012 and 2013, and results were compared with national police reported estimates. Study results indicated that there is serious underreporting of RCF in Pakistan and immediate measures are needed to improve the existing road crash recording and reporting system at the national and subnational levels. PMID:25571957

  13. The economic value of fatal and non-fatal occupational risks in Mexico City using actuarial- and perceived-risk estimates.

    Science.gov (United States)

    Hammitt, James K; Ibarrarán, María Eugenia

    2006-12-01

    Compensating wage differentials are used to estimate marginal rates of substitution between income and both fatal and non-fatal occupational-injury risks in the Mexico City metropolitan area. Data are obtained by in-person survey of almost 600 workers and include workers' perceived risks of fatal and non-fatal occupational injury supplemented by actuarial-risk estimates from government statistics. Results using both actuarial- and perceived-risk estimates are reasonably consistent. Estimates of the value per statistical life are between 235,000 US dollars and 325,000 US dollars and estimates of the value per statistical non-fatal injury are between 3500 US dollars and 11,000 US dollars (2002 US dollars). These values are much smaller than corresponding estimates for higher-income countries but are compatible with the small number of prior estimates for lower-income countries. PMID:16929475

  14. Análise de acidentes fatais na mineração: o caso da mineração no Peru Analyzes of fatal accidents in the mining industry: the case of Peruvian mining

    Directory of Open Access Journals (Sweden)

    Renan Collantes Candia

    2009-12-01

    Full Text Available A mineração é uma das atividades industriais que oferecem maior risco; embora nos últimos anos tenham-se percebido reduções na taxa de lesões e acidentes, o seu número e grau de severidade ainda são elevados. As causas fundamentais para as altas taxas de acidentes podem ser atribuídas às condições inseguras e os atos inseguros; nesse cenário, a identificação de problemas de segurança visando à proposta de soluções efetivas para gerenciar riscos faz-se necessária. Por outro lado, a dependência de países em desenvolvimento por indústrias primárias como a mineração é evidente. Na economia peruana, aproximadamente, 16 % do PIB e mais de 50 % das exportações referem-se a esta indústria, destacando sua posição competitiva na mineração mundial. Esse artigo analisa os acidentes fatais na mineração peruana, desde o ano 2000 até maio de 2008. A fonte de informação primária foi o registro de acidentes, disponibilizado pelo Ministério de Energia e Minas do Peru; identificando-se vários tipos de acidentes com destaque para aqueles provocados por queda de rochas em minas subterrâneas. A maioria das vitimas são trabalhadores de empresas terceirizadas prestadoras de serviços especializados. Os resultados mostram que a mineração subterrânea tem maiores riscos do que a de superfície.Mining is one of the indústrial activities that offers greater risks; although in recent years, reduction in the rate of injuries and accidents has been observed, the numbers and degree of severity are high. The basic causes for the high rates can be attributed to unsafe conditions and unsafe acts; in this instance, the identification of security problems aiming to propose effective solutions becomes necessary for risk management. On the other hand, the dependence of developing countries on primary industries such as mining is evident. In the Peruvian economy, approximately 16% of the GIP and more than 50% of the exportations are

  15. Correct Interpretation of Creep Rates: A Case Study of Cu

    Czech Academy of Sciences Publication Activity Database

    Blum, W.; Dvořák, Jiří; Král, Petr; Eisenlohr, P.; Sklenička, V.

    2015-01-01

    Roč. 31, č. 11 (2015), s. 1065-1068. ISSN 1005-0302 R&D Projects: GA MŠk(CZ) ED1.1.00/02.0068 Institutional support: RVO:68081723 Keywords : Cu * Creep * Minimum creep rate * Activation energy * Stress exponent Subject RIV: JJ - Other Materials Impact factor: 1.909, year: 2014

  16. Trends in cardiovascular mortality and hospitalisations, and potential contribution of inhospital case-fatality rates to changes in national mortality in the Czech Republic 1994-2009

    Czech Academy of Sciences Publication Activity Database

    Davídkovová, Hana; Kyselý, J.; Kříž, B.; Vojtíšek, P.; Bobák, M.

    2013-01-01

    Roč. 99, č. 6 (2013), s. 409-416. ISSN 1355-6037 Institutional support: RVO:67985530 Keywords : acute myocardial infarction * coronary heart disease * economic perspectives * longitudinal trends Subject RIV: DG - Athmosphere Sciences, Meteorology Impact factor: 6.023, year: 2013

  17. Trends in cardiovascular mortality and hospitalisations, and potential contribution of inhospital case-fatality rates to changes in national mortality in the Czech Republic 1994-2009

    Czech Academy of Sciences Publication Activity Database

    Davídkovová, Hana; Kyselý, Jan; Kříž, B.; Vojtíšek, P.; Bobák, M.

    2013-01-01

    Roč. 99, č. 6 (2013), s. 409-416. ISSN 1355-6037 R&D Projects: GA ČR(CZ) GAP209/11/1985 Institutional support: RVO:68378289 Keywords : acute myocardial infarction * coronary heart disease * economic perspectives * longitudinal trends Subject RIV: DG - Athmosphere Sciences, Meteorology Impact factor: 6.023, year: 2013 http://heart.bmj.com/content/early/2013/02/05/heartjnl-2012-303123.abstract

  18. Exchange Rate Exposure and Exchange Rate Risk Management: The case of Japanese exporting firms

    OpenAIRE

    Ito, Takatoshi; KOIBUCHI Satoshi; SATO Kiyotaka; SHIMIZU Junko

    2013-01-01

    In this paper, we estimate Japanese firms' exchange rate exposure and investigate the impact of exchange rate risk management on them. By using the results of the questionnaire survey sent to all Tokyo Stock Exchange listed firms in 2009, we conduct empirical analysis to investigate whether each risk management tool—financial and operational hedging, the choice of invoice currency, and the price revision strategy (pass-through)—specifically affects their foreign exchange exposure. As a result...

  19. Injury fatalities among young children.

    OpenAIRE

    Fingerhut, L A; Kleinman, J. C.; Malloy, M H; Feldman, J J

    1988-01-01

    Injuries and violence are the primary causes of death among young children in the United States. In particular, in 1982-84 motor vehicle injuries, fires, drowning, and homicide were the leading external causes of death at ages 1-4 years and 5-9 years, accounting for nearly 80 percent of all deaths from external causes. The purpose of this article is to analyze race and sex differentials in injury fatalities among young children. Race and sex differentials in injury mortality were measured in ...

  20. A deadly prion disease: fatal familial insomnia.

    Science.gov (United States)

    Sundstrom, Dianne G; Dreher, H Michael

    2003-12-01

    Fatal familial insomnia (FFI) is an inherited disease caused by a mutation in the protein prion gene. Symptoms of FFI closely resemble those of familial Creutzfeldt-Jakob disease, making genetic testing and histological examination of brain tissue the only means to determine a definitive diagnosis. The disease is rare--approximately 60 cases have been detected worldwide since 1986. Incubation time of the disease may be as long as 30 years; death generally occurs within 1 year of the onset of symptoms. There is no known procedure or treatment for delaying the onset of symptoms or modifying the disease course. Nurses who confront patients with FFI will be challenged to provide care to a patient and family who are facing certain death. PMID:14713095

  1. The Case for an M2 Growth Rate of 10%

    OpenAIRE

    William Carlson; Conway Lackman

    2013-01-01

    The recovery from the 2008-2009 recession has been much slower than the average recovery since the 1924 recession. As analysts who believe that the St. Louis model created by Leonall Andersen and Jerry Jordan still has relevance we believe that the slow rate of M2 growth since 2Q2009 is a major reason why GDP growth has been so slow. At the 9th Annual Missouri Economics Conference on March 27, 2009 we presented a paper, “Interwar Hoarding, Liquidity Traps, and the 2008 Solvency Trap” in whic...

  2. Fatal adenovirus 32 infection in a bone marrow transplant recipient.

    OpenAIRE

    Charles, A K; Caul, E. O.; Porter, H J; Oakhill, A

    1995-01-01

    A case of disseminated adenovirus type 32 infection causing severe hepatitis, gastrointestinal ulceration and also with respiratory involvement is reported in a bone marrow transplant recipient. Typical viral inclusions were seen in the postmortem histological sections and adenovirus infection was confirmed using in situ hybridisation and isolation of adenovirus type 32 from separate organs at necropsy. This is the first case in which adenovirus 32 was the cause of fatal disseminated disease ...

  3. Fatal group a streptococcal meningitis in an adult

    Directory of Open Access Journals (Sweden)

    Mani R

    2007-01-01

    Full Text Available Despite the recent resurgence in reports of invasive Group A Streptococcal (GAS infections worldwide, it remains a rare cause of pyogenic meningitis both in children and adults. We report a case of fatal GAS meningitis in a healthy adult emphasizing the need for clinicians to be aware of its fulminant course, prompting early diagnosis and treatment. There is also a need to consider postexposure chemoprophylaxis in close contacts of such cases.

  4. Driving through the Great Recession: Why does motor vehicle fatality decrease when the economy slows down?

    Science.gov (United States)

    He, Monica M

    2016-04-01

    The relationship between short-term macroeconomic growth and temporary mortality increases remains strongest for motor vehicle (MV) crashes. In this paper, I investigate the mechanisms that explain falling MV fatality rates during the recent Great Recession. Using U.S. state-level panel data from 2003 to 2013, I first estimate the relationship between unemployment and MV fatality rate and then decompose it into risk and exposure factors for different types of MV crashes. Results reveal a significant 2.9 percent decrease in MV fatality rate for each percentage point increase in unemployment rate. This relationship is almost entirely explained by changes in the risk of driving rather than exposure to the amount of driving and is particularly robust for crashes involving large commercial trucks, multiple vehicles, and speeding cars. These findings provide evidence suggesting traffic patterns directly related to economic activity lead to higher risk of MV fatality rates when the economy improves. PMID:26967529

  5. Fatalities from black powder percussion handguns.

    Science.gov (United States)

    Karger, B; Teige, K

    1998-12-21

    Three suicides and one homicide from black powder muzzle loading handguns are reported and the muzzle velocities of two weapons are recorded. The fatal head shots caused wide wound tracts traversing the brains and intracerebral haemorrhages remote from the tract were present in every case. The skulls showed considerable fractures which were pronounced in the cases of contact shots but were also present when the range of fire was 5 m. These extensive injuries from soft lead spheres with muzzle velocities of only approximately 200 m/s are attributed to the expansion of the spheres. The regularly occurring deformation resulted in 13-16 mm calibre missiles in the cases of .44 spheres. The special features of black powder such as incomplete and slow combustion resulted in intense soot deposits in the vicinity of the entrance wound and in long ranges the gunshot residues travelled. In contact shots, large pocket-like underminings even in deeper tissue layers, abundant soot along the trajectory and skin burns were observed. PMID:9924783

  6. Fatal cocaine intoxication in a body packer

    Directory of Open Access Journals (Sweden)

    Brajković Gordana

    2016-01-01

    Full Text Available Introduction. ‘Body packer’ syndrome with severe intoxication or sudden death may happen in persons who smuggle drugs in their body cavities. In case of lethal outcome when carrying cocaine, it is important, but sometimes difficult to determine whether death was due to intoxication or due to other causes. Therefore, it is necessary not only to quantify cocaine and its metabolites in biological material, but also based on their distribution in body fluids and tissues to conclude whether it is acute intoxication. We described a well-documented case of fatal poisoning in a body packer and post mortem distribution of the drug in biological samples. Case report. A 26-year-old man was brought to hospital with no vital signs. Resuscitation measures started at once, but with no success. Autopsy revealed 66 packets of cocaine in his digestive tract, one of which was ruptured. Hyperemia of the most of all internal organs and pulmonary and brain edema were found. High concentrations of cocaine, its metabolites benzoylecgonine and ecgonine methyl ester, as well as cocaine adulteration levamisole were proven in the post mortem blood and tissues by liquid chromatography-mass spectrometry (LC-MC method with selective-ion monitoring. Conclusion. The ratio of cocaine and its metabolites concentrations in the brain and blood obtained by LC-MS method can be used for forensic confirmation of acute intoxication with cocaine.

  7. Evaluation of clinical and laboratory predictors of fatality in patients with Hantavirus infection

    OpenAIRE

    Uğur Kostakoğlu; Gürdal Yılmaz; Serkan Volkan; Sevinç Kant Sökel1; Selçuk Kaya; İftihar Köksal

    2012-01-01

    Objectives: To determine the clinical and laboratory predictors of fatality among patients with Hantavirus infection.Materials and methods: A retrospective study was conducted on the patients with Hantavirus infection between April 2009and October 2011 at the Black Sea and the Mediterranean regions in Turkey. Demographic, clinical and laboratory findings offatal cases and non-fatal cases at the admission were compared.Results: Twenty-two patients with confirmed Hantavirus infection were evalu...

  8. Near fatal pulmonary embolism in a 16-year-old

    International Nuclear Information System (INIS)

    Acute pulmonary thrombo-embolism (PE) may present with a variety of clinical problems; patients with this condition may range from being asymptomatic to acutely unwell, with sudden death being at the extreme end of the spectrum. This case report of a young man with PE demonstrates the scintigraphic features of massive, near-fatal embolism. On transfer to the Nuclear Medicine Department, the patient's blood pressure was unrecordable, the heart rate was 150/min, there was deep cyanosis despite 100 per cent oxygen and the pupils were fixed and dilated. A limited perfusion scan was obtained using 76 MBq of 99mTc-MAA (Technescan MAA, Mallinckrodt), with an estimated 260 000 MAA particles being injected directly into a peripheral vein. Anterior and posterior images showed perfusion only to a small portion of the left upper lobe. The patient recovered quickly following embolectomy resulting in removal of a large amount of thrombus from both pulmonary arteries. It has been thus demonstrated that the perfusion scan is a rapid and safe method of confirming suspected massive PE prior to surgery. 4 refs., 2 figs

  9. Gasoline Prices and Motor Vehicle Fatalities

    Science.gov (United States)

    Grabowski, David C.; Morrisey, Michael A.

    2004-01-01

    Fatal motor vehicle crashes per capita remained relatively stable over the 1990s, in spite of new traffic safety laws and vehicle innovations. One explanation for this stability is that the price of gasoline declined, which resulted in more vehicle miles traveled and potentially more fatalities. By using 1983-2000 monthly gasoline price and…

  10. Comparison of road traffic fatalities and injuries in Iran with other countries

    Institute of Scientific and Technical Information of China (English)

    Mohammad R Rasouli; Mohsen Nouri; Mohammad-Reza Zarei; Soheil Saadat; Vafa Rahimi-Movaghar

    2008-01-01

    Objective: To compare fatalities and injuries in road traffic crashes (RTC) in Iran with other countries. Methods: Data were obtained from national health sources of Iran. These data included population number, registered motor-vehicles number, number of RTCs and consequent fatalities and injuries from 1997 to 2006. Results: RTC fatality and injury rates increased from 1997 to 2005, but decreased in 2006. The overall men/women ratio in the RTC fatalities was 4.2:1. High RTC fatality rate of 39 per 100 000 population in Iran was almost the same as some other developing countries. In Iran, RTC fatalities in recent years were almost twice as much as the highest rate among the European countries. Conclusions: This investigation shows that in spite of reduction of RTC fatality in Iran in 2006, it is still one of the highest in the world. Moreover, this paper describes the state of RTC-related parameters in a developing country in comparIson with the developed countries.

  11. Fatal Asthma with Rhabdomyolysis Induced by Hair Dye

    OpenAIRE

    Fukushima, Chizu; Shimoda, Terufumi; Matsuse, Hiroto; Matsuo, Nobuko; Takao, Atsuko; Obase, Yasushi; Kohno, Shigeru; Asai, Sadahiro

    1998-01-01

    Hair dyes have been reported to cause exacerbation of asthma in hairdressers through occupational exposure. We report a 54-year-old housewife who developed a fatal asthma attack following the use of a hair dye at home. She was admitted semiconscious with multiple organ failure. Laboratory findings were indicative of rhabdomyolysis. Skin prick and interdermal tests with hair dyes were performed. Hair dyes can be nonspecific stimuli that cause an asthma attack. But in our case, we cannot deny t...

  12. Fatal fulminant hepatic failure in a 'solvent abuser'.

    OpenAIRE

    McIntyre, A S; Long, R G

    1992-01-01

    The case of a 17 year old abuser of butane aerosols who developed fulminant hepatic failure after taking a proprietary engine or carburetor cleaner is described. Fatalities as a result of liver failure due to volatile hydrocarbons or solvents have not previously been reported. The likely toxins included isopropyl alcohol, methyl amyl alcohol, butylated hydroxytoluene as well as petroleum products, and evidence for their toxicity is reviewed. The possibility of increased susceptibility to hepa...

  13. Fatal pneumoni med Panton-Valentine-leukocidinproducerende Staphylococcus aureus

    DEFF Research Database (Denmark)

    Rabøl, Peter Hedelund; Dessau, Ram Benny; Warnecke, Mads;

    2010-01-01

    We describe a case of fatal pneumonia in a previously healthy 14-year-old boy. The patient was severely affected at the time of admission with high fever, tachypnea, tachycardia and peripheral cyanosis. The condition worsened despite treatment with antibiotics as well as respiratory and pressure ...... support. Acidosis and critical leucopenia supervened and the patient died just short of 24 hours after admission. Subsequent bacterial cultivation showed Panton-Valentine Leucocidin-producing Staphylococcus aureus....

  14. Fatal Neurological Respiratory Insufficiency Is Common Among Viral Encephalitides

    OpenAIRE

    Wang, Hong; Siddharthan, Venkatraman; Kesler, Kyle K.; Jeffery O Hall; Motter, Neil E.; Julander, Justin G.; John D Morrey

    2013-01-01

    Background.  Neurological respiratory insufficiency strongly correlates with mortality among rodents infected with West Nile virus (WNV), which suggests that this is a primary mechanism of death in rodents and possibly fatal West Nile neurological disease in human patients. Methods.  To explore the possibility that neurological respiratory insufficiency is a broad mechanism of death in cases of viral encephalitis, plethysmography was evaluated in mice infected with 3 flaviviruses and 2 alphav...

  15. Fatal Dysrhythmia Following Potassium Replacement for Hypokalemic Periodic Paralysis

    OpenAIRE

    Ahmed, Imdad; Chilimuri, Sridhar S.

    2010-01-01

    We present a case of fatal rebound hyperkalemia in a patient with thyrotoxic periodic paralysis (TPP) treated with potassium supplementation. Although TPP is a rare hyperthyroidism-related endocrine disorder seen predominantly in men of Asian origin, the diagnosis should be considered in patients of non-Asian origins presenting with hypokalemia, muscle weakness or acute paralysis. The condition may present as a life threatening emergency and unfamiliarity with the disease could result in a fa...

  16. Hospital presenting self-harm and risk of fatal and non-fatal repetition: systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Robert Carroll

    Full Text Available BACKGROUND: Non-fatal self-harm is one of the most frequent reasons for emergency hospital admission and the strongest risk factor for subsequent suicide. Repeat self-harm and suicide are key clinical outcomes of the hospital management of self-harm. We have undertaken a comprehensive review of the international literature on the incidence of fatal and non-fatal repeat self-harm and investigated factors influencing variation in these estimates as well as changes in the incidence of repeat self-harm and suicide over the last 30 years. METHODS AND FINDINGS: Medline, EMBASE, PsycINFO, Google Scholar, article reference lists and personal paper collections of the authors were searched for studies describing rates of fatal and non-fatal self-harm amongst people who presented to health care services for deliberate self-harm. Heterogeneity in pooled estimates of repeat self-harm incidence was investigated using stratified meta-analysis and meta-regression. The search identified 177 relevant papers. The risk of suicide in the 12 months after an index attempt was 1.6% (CI 1.2-2.4 and 3.9% (CI 3.2-4.8 after 5 years. The estimated 1 year rate of non-fatal repeat self-harm was 16.3% (CI 15.1-17.7. This proportion was considerably lower in Asian countries (10.0%, CI 7.3-13.6% and varies between studies identifying repeat episodes using hospital admission data (13.7%, CI 12.3-15.3 and studies using patient report (21.9%, CI 14.3-32.2. There was no evidence that the incidence of repeat self-harm was lower in more recent (post 2000 studies compared to those from the 1980s and 1990s. CONCLUSIONS: One in 25 patients presenting to hospital for self-harm will kill themselves in the next 5 years. The incidence of repeat self-harm and suicide in this population has not changed in over 10 years. Different methods of identifying repeat episodes of self-harm produce varying estimates of incidence and this heterogeneity should be considered when evaluating interventions

  17. Civil liability, criminal law, and other policies and alcohol-related motor vehicle fatalities in the United States: 1984-1995.

    Science.gov (United States)

    Whetten-Goldstein, K; Sloan, F A; Stout, E; Liang, L

    2000-11-01

    This study examines the associations between alcohol policies and motor vehicle fatality rates from 1984 to 1995 in the United States. State policies and state characteristics variables were merged with motor vehicle fatality rates over an 11 year period and analyzed using minimum logit chi-square method and fixed effects to create a quasi time-series analysis. Laws allowing individuals to sue bars for the drunken behavior of their patrons were the policies most strongly associated with lower minor and adult fatality rates. The mandatory first offense fine was associated with lower minor fatality rates but not adult fatality rates, while minor and adult rates fell after administrative per se license suspension and anti-consumption laws for all vehicle occupants. Many other public policies evaluated were not associated with lower fatality rates. PMID:10994599

  18. The distribution of fatal risk in Ontario industries

    International Nuclear Information System (INIS)

    The purpose of this study was to estimate non-radiological risks of occupational fatalities in Ontario industries. The distribution of high-risk occupations was found to vary widely between the different industries for a number of reasons including the fact that insufficient data in some instances resulted in less than desirable reliability. However, in spite of various data limitations, a number of occupations had above average fatal risk rates in several industries, including Material Handlers and Related, N.E.C. (SOC-9319), Welders and Flame Cutters (SOC-8335), Truck Drivers (SOC-9175) and Mechanics and Repairmen, except Electrical (SOC-8589). The majority of occupations had rates below or close to the industry average; however, between 15% and 30% of the occupations in any given industry had fatal risk rates above the industry average. When the number of workers involved in different occupations was considered, between 18% and 40% of workers were in occupations with above average risk. Recommendations for future work are also provided

  19. Óbito durante tratamento da leishmaniose tegumentar americana com stibogluconato de sódio bp 88® (shandong xinhua Fatal case during treatment of american tegumentary leishmaniasis with sodium stibogluconate bp 88® (shandong xinhua

    Directory of Open Access Journals (Sweden)

    Jackson M.L. Costa

    2003-04-01

    Full Text Available Os autores relatam a ocorrência de óbito em paciente portador da forma cutânea da LTA no município de Caxias-MA. Trata-se de paciente do sexo masculino, 22 anos, gari, portador de lesão ulcerada no membro inferior (perna esquerda, diagnosticado, após encontro do parasita (Leishmania na lesão, tratado com stibogluconato de sódio BP88® (Shandong Xinhua na dose de 10mg/Sb+5/kg/dia/20 dias. Após a 3ª dose apresentou dores articulares, naúseas, mal estar geral. Com a continuação da medicação houve agravamento do quadro com dor epigástrica e no hipocôndrio direito irradiando-se para o hemitórax homolateral. Após a 7ª dose apresentou dispnéia associado à dor torácica de leve intensidade. Na 9ª dose houve piora do quadro, mesmo assim continuou a usar o medicamento até a 11ª dose quando seu estado agravou-se. Foi internado, necessitando de tratamento intensivo. Nos exames realizados apresentou: 4,4 milhões de eritócitos, 10,6% de hemoglobina, 35% de hematócrito, 26.400 de leucócitos, basófilos e mielócitos (0, 59% de segmentados, 30% de linfócitos, 2% de monócitos, plaquetas (normais, glicose 42mg%, uréia 73mg%, creatinina (2,4mg%, eletrocardiograma (bloqueio de ramo direito. Veio a falecer tendo como causa do óbito, insuficiência cárdio respiratória. O relato atual mostra a necessidade de esclarecimento das equipes de saúde quanto ao uso dos Sb+5 e também lembrar o Ministério da Saúde quando da aquisição de novos produtos, preocupar-se com a qualidade e procedência do mesmo.The authors report the occurrence of a fatal case in patient with cutaneous leishmaniasis in the municipality of Caxias, MA. Male patient, 22 years old, road sweeper, presented with an ulcer in left leg, diagnosed as cutaneous leishmaniasis and treated with sodium stibogluconate BP88®(Sb+5 (Shandong Xinhua at a dose of 10mg/Sb+5/kg/day/20 days. After dose three he presented arthralgia, myalgia, nausea and weakness. During the therapy

  20. Physical Activity in Individuals with Severe Mental Illness: Client versus Case Manager Ratings

    Science.gov (United States)

    Bezyak, Jill L.; Chan, Fong; Lee, Eun-Jeong; Catalano, Denise; Chiu, Chung-Yi

    2012-01-01

    The "Physical Activity Scale for Individuals With Physical Disabilities" was examined as a physical activity measure for people with severe mental illness. Case manager ratings were more closely related to body mass index than clients' ratings, challenging the accuracy of self-report physical activity measures for individuals with severe mental…

  1. Variability in case-mix adjusted in-hospital cardiac arrest rates

    Science.gov (United States)

    Merchant, Raina M.; Yang, Lin; Becker, Lance B.; Berg, Robert A.; Nadkarni, Vinay; Nichol, Graham; Carr, Brendan G.; Mitra, Nandita; Bradley, Steven M.; Abella, Benjamin S.; Groeneveld, Peter W.

    2011-01-01

    Background It is unknown how in-hospital cardiac arrest (IHCA) rates vary across hospitals and predictors of variability. Objectives Measure variability in IHCA across hospitals and determine if hospital-level factors predict differences in case-mix adjusted event rates. Research design Get with the Guidelines Resuscitation (GWTG-R) (n=433 hospitals) was used to identify IHCA events between 2003-2007. The American Hospital Association survey, Medicare, and US Census were used to obtain detailed information about GWTG-R hospitals. Subjects adult patients with IHCA Measures Case-mix adjusted predicted IHCA rates were calculated for each hospital and variability across hospitals was compared. A regression model was used to predict case-mix adjusted event rates using hospital measures of volume, nurse-to-bed ratio, percent ICU beds, palliative care services, urban designation, volume of black patients, income, trauma designation, academic designation, cardiac surgery capability and a patient risk score. Results We evaluated 103,117 adult IHCAs at 433 US hospitals. The case mix adjusted IHCA event rate was highly variable across hospitals, median 1/1000 bed days (interquartile range: 0.7-1.3 events/1000 bed-days). In a multivariable regression model, case-mix adjusted IHCA event rates were highest in urban hospitals (rate ratio [RR] 1.1, 95% confidence interval [CI] 1.0-1.3, p=0.03) and hospitals with higher proportions of black patients (RR 1.2, 95% CI 1.0-1.3, p=0.01) and lower in larger hospitals (RR 0.54, 95% CI 0.45-0.66, p<.0001). Conclusion Case-mix adjusted IHCA event rates varied considerably across hospitals. Several hospital factors associated with higher IHCA event rates were consistent with factors often linked with lower hospital quality of care. PMID:22249921

  2. Fatal poisoning among patients with drug addiction

    DEFF Research Database (Denmark)

    Simonsen, K. W.; Christoffersen, D. J.; Banner, J.;

    2015-01-01

    Introduction: Fatal poisonings among drug addicts in Denmark in 2012 were examined. Cause of death, abuse pattern and geographic differences are discussed and data are compared with previous studies. Methods: All fatal poisonings examined at the three institutes of forensic medicine in Denmark in...... on Funen and in South Jutland. Cocaine was most frequently detected in East Denmark, while amphetamine was more frequent in West Denmark. ConclusionS: The number of fatal poisonings among drug addicts has stabilised around 200. The increase in methadone deaths continued and, as in 2007, methadone was...... compared with 2007, indicating that a considerable number of drug addicts also have psychiatric illness....

  3. Fatal accidents among Danes with multiple sclerosis

    DEFF Research Database (Denmark)

    Brønnum-Hansen, Henrik; Hansen, Thomas; Koch-Henriksen, Nils;

    2006-01-01

    -1996. The end of follow-up was 1 January 1999. We calculated standardized mortality ratios (SMRs) for various types of fatal accidents. A total of 76 persons (48 men and 28 women) died from accidents, whereas the expected number of fatalities from such causes was 55.7 (31.4 men and 24.3 women). Thus, the...... particularly high for deaths from burns (SMR = 8.90) and suffocation (SMR = 5.57). We conclude that persons with MS are more prone to fatal accidents than the general population. The excess risk is due not to traffic accidents but to burns and suffocation....

  4. Rate of recurrence and malignant transformation in 88 cases with inverted papilloma between 1998-2008

    DEFF Research Database (Denmark)

    Nygren, Alexander; Kiss, Katalin; von Buchwald, Christian;

    2016-01-01

    continued need for long-term follow-up. The rate of malignant transformation in inverted papilloma cases has not changed in Denmark. Objectives Inverted papillomas are benign tumours located in the nasal cavity and paranasal sinuses. They are known for their tendency to recur after surgery and show invasive...... establish whether the recurrence rate and the rate of malignant transformation of IP have changed with the application of these new techniques. Method A retrospective study between 1998-2008 including 88 cases with inverted papilloma. Results In total, 25.3% had recurrence. Combined surgical approach with...

  5. Trends in Pneumonia Mortality Rates and Hospitalizations by Organism, United States, 2002-2011(1).

    Science.gov (United States)

    Wuerth, Brandon A; Bonnewell, John P; Wiemken, Timothy L; Arnold, Forest W

    2016-09-01

    Because the epidemiology of pneumonia is changing, we performed an updated, population-based analysis of hospitalization and case-fatality rates for pneumonia patients in the United States. From 2002 to 2011, hospitalization rates decreased significantly for pneumonia caused by pneumococcus and Haemophilus influenzae but increased significantly for Pseudomonas spp., Staphylococcus aureus, and influenza virus. PMID:27532154

  6. Roller coaster related fatalities, United States, 1994–2004

    Science.gov (United States)

    Pelletier, A; Gilchrist, J

    2005-01-01

    Objective: To determine the number of fatalities related to roller coasters and examine factors common to multiple incidents. Methods: A case was defined as the death of a person, which was associated with a roller coaster in the United States between 15 May 1994 and 14 May 2004. Cases were identified from four data sources: (1) Consumer Product Safety Commission, (2) Lexis-Nexis, (3) Medline, and (4) Saferparks. Results: Forty people, ranging in age from 7 to 77 years, were killed in 39 separate incidents. Twenty nine (73%) deaths occurred among roller coaster patrons. Eleven fatalities resulted from external causes related to injuries from falls or collisions. Eighteen people died from medical conditions that might have been caused or exacerbated by riding a roller coaster; 15 were the result of intracranial hemorrhages or cardiac problems. Eleven (28%) deaths involved employees; all were caused by injuries. Conclusions: Approximately four deaths annually in the United States are associated with roller coasters. Prevention of roller coaster fatalities is dependent on establishing an effective surveillance system for amusement ride injuries, engineering rides to better protect both patrons and employees, improving training and supervision of employees regarding safety precautions, and posting cautionary notices near roller coasters for people with specified medical conditions. Further research is needed on roller coaster related deaths resulting from intracranial hemorrhages and cardiac problems. PMID:16203841

  7. Severe and fatal obstetric injury claims in relation to labor unit volume

    DEFF Research Database (Denmark)

    Milland, Maria; Mikkelsen, Kim L; Christoffersen, Jens K; Hedegaard, Morten

    2015-01-01

    OBJECTIVE: To assess possible association between the incidence of approved claims for severe and fatal obstetric injuries and delivery volume in Denmark. DESIGN AND SETTING: A nationwide panel study of labor units. POPULATION: Claimants seeking financial compensation due to injuries occurring in...... quintiles as annual volume per labor unit: (10-1377), (1378-2016), (2017-2801), (2802-3861), (3862-6659). MAIN OUTCOME MEASURES: Five primary measures of outcome were used. Incidence rate ratios of (A) Submitted claims, (B) Approved claims, (C) Approved severe injury claims (120% degree of disability), (D......) Approved fatal injury claims, and (C+D) Combined. RESULTS: 1 151 734 deliveries in 51 labor units and 1872 submitted claims were included. The incidence rate ratios of approved claims overall, of approved fatal injury claims, and of approved severe and fatal injuries combined increased significantly with...

  8. Acute fatal metabolic complications in alkaptonuria.

    Science.gov (United States)

    Davison, A S; Milan, A M; Gallagher, J A; Ranganath, L R

    2016-03-01

    Alkaptonuria (AKU) is a rare inherited metabolic disorder of tyrosine metabolism that results from a defect in an enzyme called homogentisate 1,2-dioxygenase. The result of this is that homogentisic acid (HGA) accumulates in the body. HGA is central to the pathophysiology of this disease and the consequences observed; these include spondyloarthropathy, rupture of ligaments/muscle/tendons, valvular heart disease including aortic stenosis and renal stones. While AKU is considered to be a chronic progressive disorder, it is clear from published case reports that fatal acute metabolic complications can also occur. These include oxidative haemolysis and methaemoglobinaemia. The exact mechanisms underlying the latter are not clear, but it is proposed that disordered metabolism within the red blood cell is responsible for favouring a pro-oxidant environment that leads to the life threatening complications observed. Herein the role of red blood cell in maintaining the redox state of the body is reviewed in the context of AKU. In addition previously reported therapeutic strategies are discussed, specifically with respect to why reported treatments had little therapeutic effect. The potential use of nitisinone for the management of patients suffering from the acute metabolic decompensation in AKU is proposed as an alternative strategy. PMID:26596578

  9. Causes of Fatal Accidents Involving Cranes in the Australian Construction Industry

    OpenAIRE

    Ehsan Gharaie; Helen Lingard; Tracy Cooke

    2015-01-01

    In ten years from 2004 to 2013, 359 workers died in the Australian construction industry because of work related causes. This paper investigates crane-related fatalities in order to find the upstream causation of such accidents. The National Coroners’ Information System (NCIS) database was searched to identify fatal accidents in the construction industry involving the use of a crane.  The narrative description of the cases provided in the coroners’ findings and associated documents were conte...

  10. Fatal Dysrhythmia Following Potassium Replacement for Hypokalemic Periodic Paralysis

    Directory of Open Access Journals (Sweden)

    Ahmed, Imdad

    2010-02-01

    Full Text Available We present a case of fatal rebound hyperkalemia in a patient with thyrotoxic periodic paralysis (TPP treated with potassium supplementation. Although TPP is a rare hyperthyroidism-related endocrine disorder seen predominantly in men of Asian origin, the diagnosis should be considered in patients of non-Asian origins presenting with hypokalemia, muscle weakness or acute paralysis. The condition may present as a life threatening emergency and unfamiliarity with the disease could result in a fatal outcome. Immediate therapy with potassium chloride supplementation may foster a rapid recovery of muscle strength and prevent cardiac arrhythmias secondary to hypokalemia, but with a risk of rebound hyperkalemia. [West J Emerg Med. 2010; 11(1:57-59.

  11. Fatal venous air embolism in a cat undergoing dental extractions.

    Science.gov (United States)

    Gunew, M; Marshall, R; Lui, M; Astley, C

    2008-11-01

    A five-year-old domestic shorthair cat underwent general anaesthesia and tooth extractions. Immediately after use of a high-speed, air-driven, water-cooled dental drill, the cat suffered cardiac arrest and attempted resuscitation was unsuccessful. Post-mortem radiographs showed air in the vena cava, right atrium, right auricle and right ventricle, hepatic and renal veins. These findings were confirmed at post-mortem examination. The cause of death was massive air embolism. There are reports of fatal venous air embolism in the human literature from the use of high-speed, air-driven, water-cooled dental drills. In this case, we believe that the air jet from the cooling system provided an enormous pressure gradient allowing air entry through an alveolar bone fracture or the inflamed gingival tissues. This is the first report of fatal venous air embolism associated with the use of a high-speed dental drill in the veterinary literature. PMID:19006491

  12. Alcohol Advertising and Motor Vehicle Fatalities

    OpenAIRE

    Henry Saffer

    1994-01-01

    The purpose of this paper is to empirically estimate the effect of alcohol advertising on motor vehicle fatalities. The concept of an industry level advertising response function is developed and other empirical issues in estimating the effects of advertising are reviewed. The data set consists of quarterly observations, from 1986 to 1989, for 75 advertising markets in the United States and includes 1200 observations. Since motor vehicle fatalities and alcohol advertising are jointly determin...

  13. Latent risk and trend models for the evolution of annual fatality numbers in 30 European countries.

    Science.gov (United States)

    Dupont, Emmanuelle; Commandeur, Jacques J F; Lassarre, Sylvain; Bijleveld, Frits; Martensen, Heike; Antoniou, Constantinos; Papadimitriou, Eleonora; Yannis, George; Hermans, Elke; Pérez, Katherine; Santamariña-Rubio, Elena; Usami, Davide Shingo; Giustiniani, Gabriele

    2014-10-01

    In this paper a unified methodology is presented for the modelling of the evolution of road safety in 30 European countries. For each country, annual data of the best available exposure indicator and of the number of fatalities were simultaneously analysed with the bivariate latent risk time series model. This model is based on the assumption that the amount of exposure and the number of fatalities are intrinsically related. It captures the dynamic evolution in the fatalities as the product of the dynamic evolution in two latent trends: the trend in the fatality risk and the trend in the exposure to that risk. Before applying the latent risk model to the different countries it was first investigated and tested whether the exposure indicator at hand and the fatalities in each country were in fact related at all. If they were, the latent risk model was applied to that country; if not, a univariate local linear trend model was applied to the fatalities series only, unless the latent risk time series model was found to yield better forecasts than the univariate local linear trend model. In either case, the temporal structure of the unobserved components of the optimal model was established, and structural breaks in the trends related to external events were identified and captured by adding intervention variables to the appropriate components of the model. As a final step, for each country the optimally modelled developments were projected into the future, thus yielding forecasts for the number of fatalities up to and including 2020. PMID:25000194

  14. 76 FR 73008 - Technical Report on Fatality Risk, Mass, and Footprint of Model Year 2000-2007 Passenger Cars and...

    Science.gov (United States)

    2011-11-28

    ... Model Year 2000-2007 Passenger Cars and LTVs AGENCY: National Highway Traffic Safety Administration... is: Relationships Between Fatality Risk, Mass, and Footprint in Model Year 2000-2007 Passenger Cars... pedestrians. The analyses comprised MY 2000-2007 cars and LTVs in CY 2002-2008 crashes. Fatality rates...

  15. Seven fatalities associated with ethylphenidate.

    Science.gov (United States)

    Maskell, P D; Smith, P R; Cole, R; Hikin, L; Morley, S R

    2016-08-01

    Ethylphenidate is a stimulant novel psychoactive substance that is an analogue of the prescription drug methylphenidate (Ritalin(®)). Methylphenidate is used commonly for the treatment of attention deficit hyperactivity disorder. Due to its stimulant effects ethylphenidate is being abused. There is a single case report of a death associated with ethylphenidate in Germany, and a case series of 19 deaths in the East of Scotland, but otherwise, the contribution of ethylphenidate to death is poorly documented. We report the analytical results of 7 cases (between February 2013 and January 2015) in which ethylphenidate was detected and quantitated with a validated liquid chromatography tandem mass spectrometry method (LC-MS/MS). The individuals (all male) ranged in age from 23 to 49 years (median 25 years). The concentration of ethylphenidate in the cases ranged from 0.026mg/L to 2.18mg/L in unpreserved post-mortem femoral blood. Only one case had ethylphenidate present as a sole drug. All other cases had at least 2 other drug classes present (benzodiazepines, heroin, methadone antipsychotics, other new psychoactive compounds). Ethylphenidate toxicity was the sole contribution to the cause of death in one case. Hanging was the cause of death in 2 cases, with the other 4 cases being reported as having occurred due to mixed drug toxicity. These data will further help with the interpretation of post-mortem ethylphenidate levels. PMID:26829338

  16. Do Case Rates Affect Physicians' Clinical Practice in Radiation Oncology?: An Observational Study

    Science.gov (United States)

    Loy, Bryan A.; Shkedy, Clive I.; Powell, Adam C.; Happe, Laura E.; Royalty, Julie A.; Miao, Michael T.; Smith, Gary L.; Long, James W.; Gupta, Amit K.

    2016-01-01

    Case rate payments combined with utilization monitoring may have the potential to improve the quality of care by reducing over and under-treatment. Thus, a national managed care organization introduced case rate payments at one multi-site radiation oncology provider while maintaining only fee-for-service payments at others. This study examined whether the introduction of the payment method had an effect on radiation fractions administered when compared to clinical guidelines. The number of fractions of radiation therapy delivered to patients with bone metastases, breast, lung, prostate, and skin cancer was assessed for concordance with clinical guidelines. The proportion of guideline-based care ascertained from the payer's claims database was compared before (2011) and after (2013) the payment method introduction using relative risks (RR). After the introduction of case rates, there were no significant changes in guideline-based care in breast, lung, and skin cancer; however, patients with bone metastases and prostate cancer were significantly more likely to have received guideline-based care (RR = 2.0 and 1.1, respectively, p<0.05). For the aggregate of all cancers, the under-treatment rate significantly declined (p = 0.008) from 4% to 0% after the introduction of case rate payments, while the over-treatment rate remained steady at 9%, with no significant change (p = 0.20). These findings suggest that the introduction of case rate payments did not adversely affect the rate of guideline-based care at the provider examined. Additional research is needed to isolate the effect of the payment model and assess implications in other populations. PMID:26870963

  17. Do Case Rates Affect Physicians' Clinical Practice in Radiation Oncology?: An Observational Study.

    Directory of Open Access Journals (Sweden)

    Bryan A Loy

    Full Text Available Case rate payments combined with utilization monitoring may have the potential to improve the quality of care by reducing over and under-treatment. Thus, a national managed care organization introduced case rate payments at one multi-site radiation oncology provider while maintaining only fee-for-service payments at others. This study examined whether the introduction of the payment method had an effect on radiation fractions administered when compared to clinical guidelines. The number of fractions of radiation therapy delivered to patients with bone metastases, breast, lung, prostate, and skin cancer was assessed for concordance with clinical guidelines. The proportion of guideline-based care ascertained from the payer's claims database was compared before (2011 and after (2013 the payment method introduction using relative risks (RR. After the introduction of case rates, there were no significant changes in guideline-based care in breast, lung, and skin cancer; however, patients with bone metastases and prostate cancer were significantly more likely to have received guideline-based care (RR = 2.0 and 1.1, respectively, p<0.05. For the aggregate of all cancers, the under-treatment rate significantly declined (p = 0.008 from 4% to 0% after the introduction of case rate payments, while the over-treatment rate remained steady at 9%, with no significant change (p = 0.20. These findings suggest that the introduction of case rate payments did not adversely affect the rate of guideline-based care at the provider examined. Additional research is needed to isolate the effect of the payment model and assess implications in other populations.

  18. Value of CT in the Discrimination of Fatal from Non-Fatal Stercoral Colitis

    International Nuclear Information System (INIS)

    Clinical presentation and physical signs may be unreliable in the diagnosis of stercoral colitis (SC). This study evaluates the value of computed tomography (CT) in distinguishing fatal from non-fatal SC. Ten patients diagnosed as SC were obtained from inter-specialist conferences. Additional 13 patients with suspected SC were identified via the Radiology Information System (RIS). These patients were divided into two groups; fatal and non-fatal SCs. Their CT images are reviewed by two board-certified radiologists blinded to the clinical data and radiographic reports. SC occurred in older patients and displayed no gender predisposition. There was significant correlation between fatal SC and CT findings of dense mucosa (p 0.017), perfusion defects (p = 0.026), ascites (p = 0.023), or abnormal gas (p = 0.033). The sensitivity, specificity, and accuracy of dense mucosa were 71%, 86%, and 81%, respectively. These figures were 75%, 79%, and 77% for perfusion defects; 75%, 80%, and 78% for ascites; and 50%, 93%, and 78% for abnormal gas, respectively. Each CT sign of mucosal sloughing and pericolonic abscess displayed high specificity of 100% and 93% for diagnosing fatal SC, respectively. However, this did not reach statistical significance in diagnosing fatal SC. CT appears to be valuable in discriminating fatal from non-fatal SC.

  19. Value of CT in the Discrimination of Fatal from Non-Fatal Stercoral Colitis

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Cheng Hsien; Huang, Chen Chin; Wang, Li Jen; Wong, Yon Cheng; Wang, Chao Jan; Lo, Wang Chak; Lin, Being Chuan; Wan, Yung Liang; Haueh, Chuen [Chang Gung Memorial Hospital, Chang Gung University, Taoyuan (China)

    2012-06-15

    Clinical presentation and physical signs may be unreliable in the diagnosis of stercoral colitis (SC). This study evaluates the value of computed tomography (CT) in distinguishing fatal from non-fatal SC. Ten patients diagnosed as SC were obtained from inter-specialist conferences. Additional 13 patients with suspected SC were identified via the Radiology Information System (RIS). These patients were divided into two groups; fatal and non-fatal SCs. Their CT images are reviewed by two board-certified radiologists blinded to the clinical data and radiographic reports. SC occurred in older patients and displayed no gender predisposition. There was significant correlation between fatal SC and CT findings of dense mucosa (p 0.017), perfusion defects (p = 0.026), ascites (p = 0.023), or abnormal gas (p = 0.033). The sensitivity, specificity, and accuracy of dense mucosa were 71%, 86%, and 81%, respectively. These figures were 75%, 79%, and 77% for perfusion defects; 75%, 80%, and 78% for ascites; and 50%, 93%, and 78% for abnormal gas, respectively. Each CT sign of mucosal sloughing and pericolonic abscess displayed high specificity of 100% and 93% for diagnosing fatal SC, respectively. However, this did not reach statistical significance in diagnosing fatal SC. CT appears to be valuable in discriminating fatal from non-fatal SC.

  20. Heart Rate Variability based Classification of Normal and Hypertension Cases by Linear-nonlinear Method

    OpenAIRE

    M. G. Poddar; Vinod Kumar; Yash Paul Sharma

    2014-01-01

    The aim of this study is to analyse and compare the heart rate variability (HRV) of normal and hypertension cases using time domain, frequency domain, and nonlinear methods. For short term HRV analysis, a five-minute electrocardiogram (ECG) of 57 normal and 56 hypertension subjects were recorded with prior verification of their clinical status by a cardiologist. Most time domain features of hypertension cases have clearly reduced values over normal subjects, frequency domain features, like po...

  1. Occupational safety data and casualty rates for the uranium fuel cycle

    International Nuclear Information System (INIS)

    Occupational casualty (injuries, illnesses, fatalities, and lost workdays) and production data are presented and used to calculate occupational casualty incidence rates for technologies that make up the uranium fuel cycle, including: mining, milling, conversion, and enrichment of uranium; fabrication of reactor fuel; transportation of uranium and fuel elements; generation of electric power; and transmission of electric power. Each technology is treated in a separate chapter. All data sources are referenced. All steps used to calculate normalized occupational casualty incidence rates from the data are presented. Rates given include fatalities, serious cases, and lost workdays per 100 man-years worked, per 1012 Btu of energy output, and per other appropriate units of output

  2. Explicit Solution of Worst-Case Secrecy Rate for MISO Wiretap Channels With Spherical Uncertainty

    Science.gov (United States)

    Li, Jiangyuan; Petropulu, Athina P.

    2012-07-01

    A multiple-input single-output (MISO) wiretap channel model is considered, that includes a multi-antenna transmitter, a single-antenna legitimate receiver and a single-antenna eavesdropper. For the scenario in which spherical uncertainty for both the legitimate and the eavesdropper channels is included, the problem of finding the optimal input covariance that maximizes the worst-case secrecy rate subject to a power constraint, is considered, and an explicit expression for the maximum worst-case secrecy rate is provided.

  3. Explicit Solution of Worst-Case Secrecy Rate for MISO Wiretap Channels with Spherical Uncertainty

    CERN Document Server

    Li, Jiangyuan

    2011-01-01

    A multiple-input single-output (MISO) wiretap channel model is considered, that includes a multi-antenna transmitter, a single-antenna legitimate receiver and a single-antenna eavesdropper. For the scenario in which spherical uncertainty for both the legitimate and the eavesdropper channels is included, the problem of finding the optimal input covariance that maximizes the worst-case secrecy rate subject to a power constraint, is considered, and an explicit expression for the maximum worst-case secrecy rate is provided.

  4. On Trade Impact of Exchange Rate Volatility and Institutional Quality: The Case of Central European Countries.

    OpenAIRE

    Ferto, Imre; Fogarasi, Jozsef

    2011-01-01

    This paper explores the effect of exchange rate volatility and of the institutional quality on international trade flows of transition economies in Central European Countries by applying a gravity model of balance panel between 1999 and 2008. The results show that nominal exchange rate volatility has had a significant negative effect on trade by applying Psuedo- Maximum-Likelihood (PML) estimator method over this period. The institutional quality need to be improved in case of size of governm...

  5. Count rate determination for quality control of combined lung ventilation and perfusion scintigraphy. Case report

    International Nuclear Information System (INIS)

    We present the case of a 43-year-old male patient who suffered from a massive pulmonary embolism, induced by a peritoneovenous shunt of the Denver type. Calculation of the count rates of the ventilation and perfusion scintigraphy respectively showed a too low ventilation/perfusion ratio. After reinjection of additional 99mTc-MAA the second perfusion study showed further mismatch areals. Count rate ratio determination is essential as a clinical quality control. (orig.)

  6. Pancreatite necro-hemorrágica fatal associada ao uso de valproato de sódio: relato de caso Necro-hemorrhagic pancreatitis related to sodium valproate: case report

    OpenAIRE

    Renato P. Munhoz; Mara Lucia S.F. dos Santos; Otto Jesus Hernández-Fustes

    2001-01-01

    Das complicações idiossincrásicas do uso do VPA, a pancreatite é a mais rara, porém não menos importante pelo curso potencialmente fatal. Relatamos caso de paciente de 5 anos de idade, com diagnóstico de epilepsia desde os 3 anos de idade, em uso de CBZ e PB que, após estado de mal epiléptico três meses atrás, iniciou tratamento com dose de 40 mg/kg/dia de VPA, associado a CBZ 20 mg/kg/dia e PB 3 mg/kg/dia em retirada. Reinternando por vômitos, dor abdominal, febrícula, abdome tenso, doloroso...

  7. Fatal parasitosis in blackbucks (Antilope cervicapra: a possible factor risk in hunting units

    Directory of Open Access Journals (Sweden)

    Ned de la Cruz-Hernández

    2015-11-01

    Full Text Available In February 2012, a reproductive group of 60 adult blackbucks (Antilope cervicapra from Veracruz, Mexico was relocated to hunting units in eastern and northeastern Mexico. Seven individuals died due to hemorrhagic parasitic, abomasitis and enteritis caused by Haemonchus spp., Setaria spp., and Trichostrongylids. Deaths were associated with hepatic necrosis, bilateral congestive distention of heart and fibrinonecrotic bronchopneumonia. Also Anaplasma marginale was identified. The blackbucks’ population displayed a general mortality rate of 11.67%, where 25% of total male and 9.62% of total female died. The mortality was controlled by segregation of all remaining blackbucks and the treatment for internal and external parasites (biting flies and ticks. After the treatment, no fatality cases related to parasitosis were recorded. The results presented here exhibit the high relevance of parasitosis as possible factor risk in the survival of tis specie.

  8. A case mix simulation decision support system model for negotiating hospital rates.

    Science.gov (United States)

    Hatcher, M E; Connelly, C

    1988-12-01

    The institution of prospective payment systems by many health care insurers has drawn increased attention to case-based financial planning in hospitals. When hospital revenues are directly linked to patient diagnoses rather than to the types and quantities of services supplied to patients, managers must be aware of the financial implications of different case mixes and must be prepared to influence insurers' price structures. A case-based financial planning model is presented here for the purpose of assisting managerial decision making in the strategic areas of case mix planning and pricing. The computerized model characterizes hospitals as product manufacturers, the product being discharged patients. Diagnosis serves to differentiate the "products"; however, diagnoses are grouped by payor and similar treatment cost experiences to create a limited set of managerially meaningful case types. Diagnostic and treatment costs are also aggregated to facilitate the modeling of the hospital production process. The computerized model projects the number of patients of each case-type and total patient volume, based on estimated patient volume growth rates. The model also projects prices and contribution margins for each case-type, as well as total contribution to hospital overhead. Testing the model with a hypothetical example of a hospital strategic planning problem demonstrates the model's potential as a decision-making aid in case mix planning and case-type pricing. It also reveals several model shortcomings that require further developmental effort. PMID:3148679

  9. ORAL MELANOMA: A FATAL ENTITY

    Directory of Open Access Journals (Sweden)

    Amit

    2014-08-01

    Full Text Available : Oral melanomas are uncommon and similar to their cutaneous counterparts, are neoplasm that developed from melanocytic cells lying in the basal layer of the mucosa, its incidence is about 1.2 cases per 10 million inhabitants per year with a variation between 0.2% to 8% of all the melanomas and 0.5% of all the malignant neoplasias of the oral cavity.1 Oral conditions with increased melanin pigmentation are common; however, melanocytic hyperplasias are rare. The relative incidence amongst mucosal neoplasms of the head and neck had been reviewed by Hormia and Vuori2, about 7253 cases of malignancies of upper respiratory and gastrointestinal tracts between 1953-1964, five cases of oral melanoma were found with an incidence of 0.07%

  10. Body piercing with fatal consequences.

    Science.gov (United States)

    Ranga, N; Jeffery, A J

    2011-01-01

    Body modifications such as piercings, tattoos and surgery have increased in popularity in recent times and have become more socially acceptable. The common complications of piercing different parts of the human anatomy are well-documented, including sepsis, allergic reactions and, more rarely, endocarditis and ischaemia. Deaths related to piercing complications are primarily septic in origin. In this case, a man in his 50s died due to complications of his multiple umbilical piercings. The cause of death was unusually linked to body modification; the umbilical piercings had ultimately led to a mesenteric infarction. Cases such as these are forensically important due to potential manslaughter charges that could be brought against a piercing establishment. More importantly, this case highlights another extreme complication of body modification. Fashion statements are always changing and impact upon many lives. It is important to highlight to people the potentially life-threatening complications of common piercing practices. PMID:22715261

  11. Severe human influenza infections in Thailand: oseltamivir treatment and risk factors for fatal outcome.

    Directory of Open Access Journals (Sweden)

    Wanna Hanshaoworakul

    Full Text Available BACKGROUND: Influenza is often not recognized as an important cause of severe or fatal disease in tropical and subtropical countries in Southeast Asia. The extent to which Oseltamivir treatment may protect against a fatal outcome in severe influenza infections is not known. Thailand's National Avian Influenza Surveillance (NAIS system affords a unique opportunity to describe the epidemiology of laboratory-confirmed severe and fatal human influenza infections. METHODOLOGY/PRINCIPAL FINDINGS: During January 2004 through December 2006, 11,641 notifications to the NAIS were investigated in 73 of 76 Thai provinces. Clinical and demographic data and respiratory swab specimens were collected and tested by PCR for influenza. Using the NAIS database, we identified all patients with laboratory confirmed human influenza (A/H3N2, A/H1N1 and Type B infection. A retrospective medical record review was conducted on all fatal cases with laboratory confirmed influenza and from a sample of hospitalized cases in 28 provinces. The association of underlying risk factors, Oseltamivir treatment and risk of a fatal outcome were examined. Human influenza infections were identified in 2,075 (18% cases. Twenty-two (1% deaths occurred including seven deaths in children less than ten years of age. Thirty-five percent of hospitalized human influenza infections had chest X-ray confirmed pneumonia. Current or former smoking; advanced age, hypertension and underlying cardiovascular, pulmonary or endocrine disease were associated with a fatal outcome from human influenza infection. Treatment with Oseltamivir was statistically associated with survival with a crude OR of .11 (95% CI: 0.04-0.30 and .13 (95% CI: 0.04-0.40 after controlling for age. CONCLUSIONS: Severe and fatal human influenza infections were commonly identified in the NAIS designed to identify avian A/H5N1 cases. Treatment with Oseltamivir is associated with survival in hospitalized human influenza pneumonia

  12. A fatal pseudo-tumour: disseminated basidiobolomycosis

    Directory of Open Access Journals (Sweden)

    Bemelman Willem A

    2006-09-01

    with amphotericin B (Itraconazol contra-indicated because of renal insufficiency. A few days later the patient died of a septic shock. After autopsy Basidiobolus ranarum was cultured from liver, gallbladder and colon. Conclusion Our patient died of gastrointestinal basidiobolomycosis with an obstructing colon tumour and a large hepatic mass. This was a rare presentation of basidiobolomycosis and the second fatal case described worldwide.

  13. Near-fatal asthma in the elderly.

    Science.gov (United States)

    Arjona, Nydia

    2015-01-01

    Asthma affects the elderly as often as other age groups; however, it more often becomes fatal in the elderly. Unfortunately, asthma is often unmanaged or underdiagnosed in the older population. It is important for health care providers to recognize risk factors in the elderly and properly treat them before asthma becomes fatal. This article describes near-fatal asthma and identifies risk factors specifically for the elderly. Symptoms of asthma are reviewed as well as assessments and diagnostic tests to identify asthma severity and complications. Proper management needs to be urgently initiated to prevent worsening respiratory distress; this includes fast-acting drug treatments appropriate for elderly patients. Decompensated acute respiratory failure, secondary to severe asthma, requires the skills of an experienced anesthesiologist because these patients may rapidly deteriorate during induction and intubation. Ventilator management must include strategies to prevent worsening hyperinflation of the lungs. Elderly asthma patients have a higher mortality risk related to ventilator complications and other comorbidities. PMID:25470264

  14. Fatal incidents involving pickup trucks in Alabama.

    Science.gov (United States)

    Hamar, G B; King, W; Bolton, A; Fine, P R

    1991-03-01

    Death or injury resulting from crashes involving light trucks (ie, pickup trucks) is a significant problem. Data show that fatal crashes and occupant fatalities involving light trucks have steadily increased since 1983. This project describes vehicle crashes involving passengers riding in the beds of pickup trucks. Actual crashes were identified through the Fatal Accident Reporting System (FARS) of the National Highway Traffic Safety Administration. The 40 incidents studied involved 204 pickup truck passengers. Of these, 45 were killed, 107 sustained visible injuries or were carried from the scene, 6 had bruises and abrasions, and 2 had no visible injury but were briefly unconscious or had a documented complaint of pain. The risk of death among pickup truck passengers who were fully ejected from the vehicle was nearly six times that of passengers not fully ejected. Correspondingly, the risk of ejection from the truck was 26.7 times greater among occupants riding in the bed than occupants riding in the cab. PMID:2000522

  15. Body piercing with fatal consequences

    OpenAIRE

    Ranga, N; Jeffery, A J

    2011-01-01

    Body modifications such as piercings, tattoos and surgery have increased in popularity in recent times and have become more socially acceptable. The common complications of piercing different parts of the human anatomy are well-documented, including sepsis, allergic reactions and, more rarely, endocarditis and ischaemia. Deaths related to piercing complications are primarily septic in origin. In this case, a man in his 50s died due to complications of his multiple umbilical piercings. The cau...

  16. Determining an Appropriate Weight attribute in Fraud Call Rate Data Using Case Based Reasoning

    Directory of Open Access Journals (Sweden)

    Musa Bala Shuaibu

    2014-03-01

    Full Text Available Fraud cases are significantly causing huge revenue losses in telecommunication companies around the world. Although previous cases are very important data in dealing with fraud patterns, there are variations in the dataset of different fraud case scenarios which in turns need specific detection system without necessarily involving the domain expert directly. This paper investigates the appropriate weight values for attributes using fraud Call Rate Data that is based on Artificial Intelligence technique (Case Based Reasoning with a meaningful confidence in telecommunication data. The experimental result on the fraud data reports that the weight for all attribute used in this study needs to be set at 0.9 in order to get the best performance of 98.33%.

  17. Postpartum Clostridium sordellii infection associated with fatal toxic shock syndrome

    DEFF Research Database (Denmark)

    Rørbye, C; Petersen, Ina Sleimann; Nilas, Lisbeth

    2000-01-01

    . In 5-10% of all women, Clostridium species are also found to be normal inhabitants in the microbial flora of the female genital tract. In case of a non-sexually transmitted genital tract infection, Clostridium species are isolated in 4-20%, and clostridium welchii seems to be the most common isolate....... Clostridium sordellii is rarely encountered in clinical specimens (1% of Clostridium species), but it has been described as a human pathogen with fatal potential. Two toxins, a lethal and a hemorrhagic (that antigenically and pathophysiologically appear similar to Clostridium difficile toxins B and A...

  18. Huge Interatrial Septal Aneurysm: A Coincidental but Rather Fatal Finding

    Science.gov (United States)

    Tzimas, Petros; Papadopoulos, Georgios

    2011-01-01

    We report the case of a patient with a huge interatrial septal aneurysm as an intraoperative coincidental finding that led to a fatal outcome. The patient was admitted to our hospital in order to undergo elective coronary artery bypass grafting because he suffered from severe coronary artery disease. We intraoperatively diagnosed by transesophageal echocardiography a huge interatrial septal aneurysm mimicking a right atrial tumor. The aneurysm was initially resected and then coronary artery bypass grafting was successfully performed but the patient never achieved a successful separation from cardiopulmonary bypass probably because of massive embolic events. PMID:21317987

  19. [Fatal explosion injuries from blasting a cigarette machine].

    Science.gov (United States)

    Madea, Burkhard; Ridwan, Hani; Längin, Volker; Doberentz, Elke

    2016-01-01

    In the last few years, a growing number of cases have been reported in Germany in which vending machines have been blasted by criminals to get at the money. Thus, it was only a question of time for the first fatalities to occur as a consequence of such careless explosions. We report on the death of a 16-year-old boy who died after triggering an explosion by spraying a deodorant into the coin slot of a cigarette machine. Death was caused by severe craniocerebral trauma due to tertiary blast-related injuries when the front plate of the machine hit the victim's cerebral and facial skull. PMID:27120900

  20. Bats and wind energy in Canada : causes, consequences and variation of fatalities

    Energy Technology Data Exchange (ETDEWEB)

    Barclay, R.; Baerwald, E. [Calgary Univ., AB (Canada). Dept. of Biology

    2008-07-01

    This presentation discussed various aspects of bat mortalities that occur at wind turbines. The majority of bat fatalities related to wind turbines take place in the Fall among Hoary, Silver-haired, and Eastern red bat species. The fatality rate varies geographically. Migratory routes explain the geographic variations of bats. Tall wind turbines kill more bats than birds. Activity and fatality rates vary geographically. Small-scale geographic patterns were discussed along with bat mortality rates at different wind farm facilities. Higher turbines are known to disrupt bat activities. During a 1-year period in Alberta only 189 bird mortalities were recorded compared to 1775 bat mortalities. Across North America, 3940 bats died in collisions with wind turbines compared to only 1241 birds. It was concluded that monitoring studies conducted from the ground do not fully indicate the risks of wind turbines to bats. tabs., figs.

  1. Estimating cost ratio distribution between fatal and non-fatal road accidents in Malaysia

    Science.gov (United States)

    Hamdan, Nurhidayah; Daud, Noorizam

    2014-07-01

    Road traffic crashes are a global major problem, and should be treated as a shared responsibility. In Malaysia, road accident tragedies kill 6,917 people and injure or disable 17,522 people in year 2012, and government spent about RM9.3 billion in 2009 which cost the nation approximately 1 to 2 percent loss of gross domestic product (GDP) reported annually. The current cost ratio for fatal and non-fatal accident used by Ministry of Works Malaysia simply based on arbitrary value of 6:4 or equivalent 1.5:1 depends on the fact that there are six factors involved in the calculation accident cost for fatal accident while four factors for non-fatal accident. The simple indication used by the authority to calculate the cost ratio is doubted since there is lack of mathematical and conceptual evidence to explain how this ratio is determined. The main aim of this study is to determine the new accident cost ratio for fatal and non-fatal accident in Malaysia based on quantitative statistical approach. The cost ratio distributions will be estimated based on Weibull distribution. Due to the unavailability of official accident cost data, insurance claim data both for fatal and non-fatal accident have been used as proxy information for the actual accident cost. There are two types of parameter estimates used in this study, which are maximum likelihood (MLE) and robust estimation. The findings of this study reveal that accident cost ratio for fatal and non-fatal claim when using MLE is 1.33, while, for robust estimates, the cost ratio is slightly higher which is 1.51. This study will help the authority to determine a more accurate cost ratio between fatal and non-fatal accident as compared to the official ratio set by the government, since cost ratio is an important element to be used as a weightage in modeling road accident related data. Therefore, this study provides some guidance tips to revise the insurance claim set by the Malaysia road authority, hence the appropriate method

  2. Fatal dengue hemorrhagic fever in adults: emphasizing the evolutionary pre-fatal clinical and laboratory manifestations.

    Directory of Open Access Journals (Sweden)

    Ing-Kit Lee

    Full Text Available BACKGROUND: A better description of the clinical and laboratory manifestations of fatal patients with dengue hemorrhagic fever (DHF is important in alerting clinicians of severe dengue and improving management. METHODS AND FINDINGS: Of 309 adults with DHF, 10 fatal patients and 299 survivors (controls were retrospectively analyzed. Regarding causes of fatality, massive gastrointestinal (GI bleeding was found in 4 patients, dengue shock syndrome (DSS alone in 2; DSS/subarachnoid hemorrhage, Klebsiella pneumoniae meningitis/bacteremia, ventilator associated pneumonia, and massive GI bleeding/Enterococcus faecalis bacteremia each in one. Fatal patients were found to have significantly higher frequencies of early altered consciousness (≤24 h after hospitalization, hypothermia, GI bleeding/massive GI bleeding, DSS, concurrent bacteremia with/without shock, pulmonary edema, renal/hepatic failure, and subarachnoid hemorrhage. Among those experienced early altered consciousness, massive GI bleeding alone/with uremia/with E. faecalis bacteremia, and K. pneumoniae meningitis/bacteremia were each found in one patient. Significantly higher proportion of bandemia from initial (arrival laboratory data in fatal patients as compared to controls, and higher proportion of pre-fatal leukocytosis and lower pre-fatal platelet count as compared to initial laboratory data of fatal patients were found. Massive GI bleeding (33.3% and bacteremia (25% were the major causes of pre-fatal leukocytosis in the deceased patients; 33.3% of the patients with pre-fatal profound thrombocytopenia (<20,000/µL, and 50% of the patients with pre-fatal prothrombin time (PT prolongation experienced massive GI bleeding. CONCLUSIONS: Our report highlights causes of fatality other than DSS in patients with severe dengue, and suggested hypothermia, leukocytosis and bandemia may be warning signs of severe dengue. Clinicians should be alert to the potential development of massive GI bleeding

  3. The Impact of Treasury Bill Rate and Interest Rate On The Stock Market Returns: Case Of Ghana Stock Exchange

    OpenAIRE

    Augustine  Addo; Fidelis Sunzuoye

    2013-01-01

    Several studies have suggested that macroeconomic variables affect Stock market returns using Treasury bill rate as a measure of interest rate. The study examines the joint impact of  interest rates and Treasury bill rate on  stock market returns on Ghana Stock Exchange over the period between January 1995 and December 2011. Using Johansen’s Multivariate Cointegration Model and Vector Error  Correction Model the study establish that there is cointegration between Interest rate, Treasury bill ...

  4. Dengue virus identification by transmission electron microscopy and molecular methods in fatal dengue hemorrhagic fever.

    Science.gov (United States)

    Limonta, D; Falcón, V; Torres, G; Capó, V; Menéndez, I; Rosario, D; Castellanos, Y; Alvarez, M; Rodríguez-Roche, R; de la Rosa, M C; Pavón, A; López, L; González, K; Guillén, G; Diaz, J; Guzmán, M G

    2012-12-01

    Dengue virus is the most significant virus transmitted by arthropods worldwide and may cause a potentially fatal systemic disease named dengue hemorrhagic fever. In this work, dengue virus serotype 4 was detected in the tissues of one fatal dengue hemorrhagic fever case using electron immunomicroscopy and molecular methods. This is the first report of dengue virus polypeptides findings by electron immunomicroscopy in human samples. In addition, not-previously-documented virus-like particles visualized in spleen, hepatic, brain, and pulmonary tissues from a dengue case are discussed. PMID:22527878

  5. Fatal Myocarditis Associated With HHV-6 Following Immunosuppression in Two Children.

    Science.gov (United States)

    Stefanski, Heather E; Thibert, Kathryn A; Pritchett, Joshua; Prusty, Bhupesh K; Wagner, John E; Lund, Troy C

    2016-01-01

    Fatal myocarditis is a rare complication in immunosuppressed children. Recent reports have linked human herpesvirus 6 (HHV-6) infection, typically a benign infection in childhood, with myocarditis. HHV-6 can reactivate during periods of immunosuppression. Here, we report 2 cases in which children were immunosuppressed, one for treatment of Evans syndrome and the other post hematopoietic stem cell transplantation, who developed rapid and fatal HHV-6-associated myocarditis. These cases suggest that HHV-6 infection should be considered as an etiology of myocarditis in immunosuppressed patients regardless of correlating blood levels. Early treatment of HHV-6 in patients with myocarditis could improve morbidity and mortality. PMID:26681781

  6. Meeste suurim meistriteos - femme fatale / Marianne Kõrver

    Index Scriptorium Estoniae

    Kõrver, Marianne, 1980-

    2006-01-01

    15.-21. maini on kinos Sõprus Manifesti filminädal, mis pühendatud prantsuse mängufilmidele, kus keskne karakter on femme fatale - saatuslik naine, meeste hukutaja. Ajalooline lühiülevaade selle naisetüübi kujutamisest religioonist kinokunstini

  7. Fatal familial insomnia: a seventh family.

    Science.gov (United States)

    Silburn, P; Cervenáková, L; Varghese, P; Tannenberg, A; Brown, P; Boyle, R

    1996-11-01

    A 60-year-old woman with a typical history of fatal familial insomnia (FFI) had FFI proven by histologic examination and molecular testing. Her son, who died at the age of 20 in 1978, had a rapidly progressive dementing illness without reported insomnia. He carried the characteristic mutation for FFI and is the youngest patient reported with this condition. PMID:8909452

  8. A Fatal Complication of Dermatomyositis: Spontaneous Pneumomediastinum

    Directory of Open Access Journals (Sweden)

    Ezgi Demirdöğen Çetinoğlu

    2016-04-01

    Full Text Available Interstitial lung disease (ILD is a negative prognostic factor associated with increased morbidity and mortality in patients with dermatomyositis (DM. Spontaneous pneumomediastinum is a rare complication of DM and it can be fatal. We present a 48-year-old woman with DM and ILD complicated by pneumomediastinum without pneumothorax and subcutaneous emphysema.

  9. The Seascale childhood leukaemia cases - the mutation rates implied by paternal preconceptional radiation doses

    International Nuclear Information System (INIS)

    Recent studies have demonstrated that paternal preconceptional radiation exposure is an insufficient explanation of the excess of leukaemia cases among children born in the West Cumbrian village of Seascale. Less than 10% of the children whose fathers were employed at the Sellafield nuclear installation and received a dose of radiation prior to their conception were born in Seascale; but the statistical association between paternal preconceptional radiation dose and leukaemia is apparent only in these Seascale-born children. This paper explores the speculative proposition that the Seascale leukaemia cases are caused by a strong interaction between paternal preconceptional irradiation and exposure after conception to a specific co-factor which is confined to Seascale. This hypothesis is demonstrated to be biologically implausible, the implied rate of transmitted radiation-induced leukaemogenic mutations being far beyond the established rates for hereditary effects. (Author)

  10. Trends of Occupational Fatalities Involving Machines, United States, 1992–2010

    Science.gov (United States)

    Marsh, Suzanne M.; Fosbroke, David E.

    2016-01-01

    Background This paper describes trends of occupational machine-related fatalities from 1992–2010. We examine temporal patterns by worker demographics, machine types (e.g., stationary, mobile), and industries. Methods We analyzed fatalities from Census of Fatal Occupational Injuries data provided by the Bureau of Labor Statistics to the National Institute for Occupational Safety and Health. We used injury source to identify machine-related incidents and Poisson regression to assess trends over the 19-year period. Results There was an average annual decrease of 2.8% in overall machine-related fatality rates from 1992 through 2010. Mobile machine-related fatality rates decreased an average of 2.6% annually and stationary machine-related rates decreased an average of 3.5% annually. Groups that continued to be at high risk included older workers; self-employed; and workers in agriculture/forestry/fishing, construction, and mining. Conclusion Addressing dangers posed by tractors, excavators, and other mobile machines needs to continue. High-risk worker groups should receive targeted information on machine safety. PMID:26358658

  11. Heart rate variability analysis in postural orthostatic tachycardia syndrome: a case report

    Directory of Open Access Journals (Sweden)

    Raffaele Calabrò

    2006-09-01

    Full Text Available The authors present a case of 36 year old male patient with idiopathic postural orthostatic tachycardia syndrome (POTS diagnosed during head-up tilt testing. Power spectral analysis of heart rate variability (HRV during the tilt test revealed that the ratio of low and high frequency powers (LF/HF increased with the onset of orthostatic intolerance. This analysis confirmed in our patient a strong activation in sympathetic tone.

  12. Heart Rate Variability based Classification of Normal and Hypertension Cases by Linear-nonlinear Method

    Directory of Open Access Journals (Sweden)

    M. G. Poddar

    2014-11-01

    Full Text Available The aim of this study is to analyse and compare the heart rate variability (HRV of normal and hypertension cases using time domain, frequency domain, and nonlinear methods. For short term HRV analysis, a five-minute electrocardiogram (ECG of 57 normal and 56 hypertension subjects were recorded with prior verification of their clinical status by a cardiologist. Most time domain features of hypertension cases have clearly reduced values over normal subjects, frequency domain features, like power in different spectral bands, also have the distinguishable decreased values, whereas sympathovagal balance has clear edge over hypertension cases than normal cases. Nonlinear parameters of Poincare plot, approximate entropy and sample entropy, have higher values in normal cases when compared with hypertension cases. Support vector machine-based binary system classifies these two classes with 100 per cent accuracy and 100 per cent sensitivity when all time domain, frequency domain, and nonlinear features were used. It may work as a better predictor for in patients with hypertension.Science Journal, Vol. 64, No. 6, November 2014, pp.542-548, DOI:http://dx.doi.org/10.14429/dsj.64.7867

  13. The Impact of Treasury Bill Rate and Interest Rate On The Stock Market Returns: Case Of Ghana Stock Exchange

    Directory of Open Access Journals (Sweden)

    Augustine  Addo

    2013-10-01

    Full Text Available Several studies have suggested that macroeconomic variables affect Stock market returns using Treasury bill rate as a measure of interest rate. The study examines the joint impact of  interest rates and Treasury bill rate on  stock market returns on Ghana Stock Exchange over the period between January 1995 and December 2011. Using Johansen’s Multivariate Cointegration Model and Vector Error  Correction Model the study establish that there is cointegration between Interest rate, Treasury bill rate and stock market returns indicating long run relationship. On the basis of the Multiple Regression Analysis (OLS carried out by Eviews 7 program, the results show that Treasury bill rate and interest rate both have a negative relationship with stock market returns but  are not  significant. These results lend support to the idea that interest rate and Treasury bill rate has both  negative  relationship  but  weak predictive  power on stock market returns independently. The study conclude that interest rate and Treasury bill rate jointly impact on stock market returns in the long run. Understanding the effects of both  Treasury bill rate and interest rate dynamics on stock market returns will help investors, fund  and portfolio managers and firms make better investment decisions.

  14. Fatal Outcome in Atrial Migration of the Tempofilter

    International Nuclear Information System (INIS)

    Purpose: To report the risk of fatal atrial migration with the Tempofilter. Methods: Among temporary filters, the high safety profile Tempofilter has been marketed as offering protection for up to 6 weeks. We implanted about 60 Tempofilters to prevent pulmonary embolism. The main indications were temporary thromboembolic risk, recurrent pulmonary embolism, and contraindication to or failure of anticoagulant therapy. Follow-up was performed regularly by plain abdominal film and Doppler ultrasound. Filters were removed about 4 weeks after placement. Results: We encountered three cases (5%) of atrial migration and one case of 5-cm cephalad displacement of the filter. Of the three patients with atrial migration, two died within 3 days of implantation, one from a massive pulmonary embolism and the other with cardiac tamponade. One patient did not show any serious complications. Conclusions: The Tempofilter may actively migrate cranially and become dangerous in the case of migration within the heart

  15. Evaluation of poly-drug use in methadone-related fatalities using segmental hair analysis.

    Science.gov (United States)

    Nielsen, Marie Katrine Klose; Johansen, Sys Stybe; Linnet, Kristian

    2015-03-01

    In Denmark, fatal poisoning among drug addicts is often related to methadone. The primary mechanism contributing to fatal methadone overdose is respiratory depression. Concurrent use of other central nervous system (CNS) depressants is suggested to heighten the potential for fatal methadone toxicity. Reduced tolerance due to a short-time abstinence period is also proposed to determine a risk for fatal overdose. The primary aims of this study were to investigate if concurrent use of CNS depressants or reduced tolerance were significant risk factors in methadone-related fatalities using segmental hair analysis. The study included 99 methadone-related fatalities collected in Denmark from 2008 to 2011, where both blood and hair were available. The cases were divided into three subgroups based on the cause of death; methadone poisoning (N=64), poly-drug poisoning (N=28) or methadone poisoning combined with fatal diseases (N=7). No significant differences between methadone concentrations in the subgroups were obtained in both blood and hair. The methadone blood concentrations were highly variable (0.015-5.3, median: 0.52mg/kg) and mainly within the concentration range detected in living methadone users. In hair, methadone was detected in 97 fatalities with concentrations ranging from 0.061 to 211ng/mg (median: 11ng/mg). In the remaining two cases, methadone was detected in blood but absent in hair specimens, suggesting that these two subjects were methadone-naive users. Extensive poly-drug use was observed in all three subgroups, both recently and within the last months prior to death. Especially, concurrent use of multiple benzodiazepines was prevalent among the deceased followed by the abuse of morphine, codeine, amphetamine, cannabis, cocaine and ethanol. By including quantitative segmental hair analysis, additional information on poly-drug use was obtained. Especially, 6-acetylmorphine was detected more frequently in hair specimens, indicating that regular abuse of

  16. Lifeline electric rates and alternative approaches to the problems of low-income ratepayers. Ten case studies of implemented programs

    Energy Technology Data Exchange (ETDEWEB)

    1980-07-01

    Program summaries, issue developments, governmental processes, and impacts are discussed for 10 case studies dealing with lifeline electric rates and alternative approaches to the problems of low-income ratepayers, namely; the Boston Edison rate freeze; the California lifeline; Florida Power and Light conservation rate; the Iowa-Illinois Gas and Electric small-use rate; the Maine demonstration lifeline program; the Massachusetts Electric Company A-65 rate; the Michigan optional senior citizen rate; the Narragansett Electric Company A-65 SSI rate; the Northern States Power Company conservation rate break; and the Potomac Electric Power Company rate freeze. (MCW)

  17. Legionnaires’ disease case-finding algorithm, attack rates, and risk factors during a residential outbreak among older adults: an environmental and cohort study

    Science.gov (United States)

    2013-01-01

    Background During a Legionnaires’ disease (LD) outbreak, combined epidemiological and environmental investigations were conducted to identify prevention recommendations for facilities where elderly residents live independently but have an increased risk of legionellosis. Methods Survey responses (n = 143) were used to calculate attack rates and describe transmission routes by estimating relative risk (RR) and 95% confidence intervals (95% CI). Potable water collected from five apartments of LD patients and three randomly-selected apartments of residents without LD (n = 103 samples) was cultured for Legionella. Results Eight confirmed LD cases occurred among 171 residents (attack rate = 4.7%); two visitors also developed LD. One case was fatal. The average age of patients was 70 years (range: 62–77). LD risk was lower among residents who reported tub bathing instead of showering (RR = 0.13, 95% CI: 0.02–1.09, P = 0.03). Two respiratory cultures were characterized as L. pneumophila serogroup 1, monoclonal antibody type Knoxville (1,2,3), sequence type 222. An indistinguishable strain was detected in 31 (74%) of 42 potable water samples. Conclusions Managers of elderly-housing facilities and local public health officials should consider developing a Legionella prevention plan. When Legionella colonization of potable water is detected in these facilities, remediation is indicated to protect residents at higher risk. If LD occurs among residents, exposure reduction, heightened awareness, and clinical surveillance activities should be coordinated among stakeholders. For prompt diagnosis and effective treatment, clinicians should recognize the increased risk and atypical presentation of LD in older adults. PMID:23806063

  18. 78 FR 38096 - Fatality Analysis Reporting System Information Collection

    Science.gov (United States)

    2013-06-25

    ... National Highway Traffic Safety Administration Fatality Analysis Reporting System Information Collection... Reporting System (FARS) is a major system that acquires national fatality information directly from existing...: Request for public comment on proposed collection of information. SUMMARY: Before a Federal agency...

  19. Determinants of the Final Size and Case Rate of Nosocomial Outbreaks.

    Directory of Open Access Journals (Sweden)

    Amy Hurford

    Full Text Available Different nosocomial pathogen species have varying infectivity and durations of infectiousness, while the transmission route determines the contact rate between pathogens and susceptible patients. To determine if the pathogen species and transmission route affects the size and spread of outbreaks, we perform a meta-analysis that examines data from 933 outbreaks of hospital-acquired infection representing 14 pathogen species and 8 transmission routes. We find that the mean number of cases in an outbreak is best predicted by the pathogen species and the mean number of cases per day is best predicted by the species-transmission route combination. Our fitted model predicts the largest mean number of cases for Salmonella outbreaks (22.3 and the smallest mean number of cases for Streptococci outbreaks (8.5. The largest mean number of cases per day occurs during Salmonella outbreaks spread via the environment (0.33 and the smallest occurs for Legionella outbreaks spread by multiple transmission routes (0.005. When combined with information on the frequency of outbreaks these findings could inform the design of infection control policies in hospitals.

  20. Integration of informal medical practitioners in DOTS implementation to improve case detection rate

    International Nuclear Information System (INIS)

    To integrate informal registered medical practitioners (IRMP) in Directly Observed Therapy Short Course (DOTS) implementation to improve case detection rate. This interventional study was conducted in the settlement area of Malir district whereas New Karachi was taken as control, between February to November 2005. All registered health care providers within 5 kilometer around Tuberculosis (T8) DOTS center Malir were included. New sputum positive and sputum direct smear negative cases of pulmonary Tuberculosis above 15 years residing in the catechumen's area were included as target population. Informal registered medical practitioners were trained for the referral of suspected cases to the TB DOTs center where three sputum samples were taken, and X-ray chest was done to confirm if sputum direct smear (D/S) was negative. Demographic data regarding age, gender, address, case number, onset of symptoms, treatment given, response, compliance to treatment was all collected. Out of 64 health care providers there were a drop out of 6 leaving 58 informal registered medical practitioners (36 homeopathic/ 22 Hakims) who referred 54 cases, of these 16 cases were actual suspects. Two out of these 16 (12.5%) were Tuberculosis positive. One was Sputum D/S positive and the other sputum direct smear negative with X-ray chest positive. Comparison of data (Malir and New Karachi diagnostic center) showed that by incorporating homeopathic and Hakims an increase in the proportion of case identification (0.477) was significantly higher in Malir (intervention area) vs New Karachi (non-intervention area) (0.316). Integration of informal registered medical practitioners was found to be effective in DOTS implementation hence they can be incorporated in other national programmes to improve public health (JPMA 60:33; 2010). (author)

  1. Why The Rate Of Financing In Islamic Banks Is High? An Analysis Based On Malaysian Case

    Directory of Open Access Journals (Sweden)

    Irfan Syauqi Beik

    2008-01-01

    Full Text Available Islamic banking has grown rapidly and has become fi nancial-nerve centre in today’s world economy, particularly in the last three decades. It has attracted various entrepreneurs and enterprises to get its fi nancing. However, Islamic banks tend to have a higher rate of fi nancing compared to the conventional ones. This less competitiveness encourage the demand for Islamic products may fall leaving the Islamic banks. Good debtors opted for conventional loans since the interest rates paid were relatively lower and the rest (the bad debtors successfully made their way to Islamic banks. Therefore, the nonperforming financing of Islamic banks is high. This paper attempts to analyze factors that determine high rate of fi nancing in Islamic banks, by taking the case of Malaysian Islamic banks. In this paper, the top three of Islamic banks and conventional banks are selected for comparison. It finds that high default premium and overheads per capital contribute signifi cantly to the high fi nancing rate. Hence, the Islamic banks should diversify their assets and implement universal banking concept.Keywords: Islamic bank, rate of fi nancing, NPF (Non-Performing Financing, universal banking system

  2. Sustainability assessment, rating systems and historical buildings Case study: Rehabilitated construction in a university site

    Directory of Open Access Journals (Sweden)

    Sadrykia Somayeh

    2016-01-01

    Full Text Available This paper explores the relationship between the indicators and different factors that “rating systems for green projects” concentrates on, and principles and factors considered in the rehabilitation of historical buildings. In recent years, different methods and systems concerned and improved for assessing environmental sustainability. LEED (Leadership in Energy and Environmental Design and BREEAM (Building Research Establishment (BRE Environmental Assessment Method are two most commonly used rating systems, established in U.S and UK. These systems comprise some categories and different factors to achieve environmentally responsible design. Firstly, this study focuses on the list of rating systems indicators and criteria. Secondly this paper investigates a historical rehabilitated building in the site of Tabriz Art University, as a case study and has tried to compile its green design elements. Finally, this work intends to compare mentioned elements with indicators and factors of building rating systems. Findings of the study revealed that “Materials and Resources”, “indoor environmental quality” and also “Sustainable Sites” ,the most significant indicator of rating systems, had major and important role in the rehabilitation of the building. Beyond this materials’ life cycle was considerable in construction.

  3. Fatal case of hemolytic-uremic syndrome in an adult due to a rare serogroup O91 Entero hemorrhagic Escherichia coli associated with a Clostridium difficile infection. More than meets the eye

    Directory of Open Access Journals (Sweden)

    Thomas Guillard

    2015-08-01

    Full Text Available Hemolytic-uremic syndrome due to enterohemorrhagic Escherichia coli, belonging to serogroup O91 has rarely been described. We report here a case of post-diarrheal HUS due to EHEC O91 in an elderly patient for whom diagnosis was delayed given a previously diagnosed C. difficile infection. This case highlights the usefulness of Shiga-toxin detection.

  4. Fatal mediastinal biopsy: How interventional radiology saves the day

    Directory of Open Access Journals (Sweden)

    Y Yaacob

    2012-01-01

    Full Text Available This was a case of a 35-year-old man with mediastinal mass requiring computed tomography (CT-guided biopsy for tissue diagnosis. A posterior approach with an 18-gauge biopsy needle was used to obtain tissue sample. Post biopsy, patient condition deteriorated and multiphase CT study detected active bleeding in arterial phase at the biopsy site with massive hemothorax. Subsequent angiography showed arterial bleeder arising from the apical branch of the right pulmonary artery. Selective endovascular embolization with NBCA (n-Butyl cyanoacrylate was successful. Patient survived the complication. The case highlighted a rare complication in a common radiology procedure and the value of the interventional radiology unit in avoiding a fatal outcome.

  5. Possible fatal acetaminophen intoxication with atypical clinical presentation.

    Science.gov (United States)

    De-Giorgio, Fabio; Lodise, Maria; Chiarotti, Marcello; d'Aloja, Ernesto; Carbone, Arnaldo; Valerio, Luca

    2013-09-01

    Acetaminophen or paracetamol, a commonly used over-the-counter analgesic, is known to elicit severe adverse reactions when taken in overdose, chronically at therapeutic dosage or, sporadically, following single assumptions of a therapeutic dose. Damage patterns including liver damage and, rarely, acute tubular necrosis or a fixed drug exanthema. We present a case of fatal acetaminophen toxicity with postmortem blood concentration 78 μg/mL and unusual clinical features, including a visually striking and massive epidermolysis and rhabdomyolysis, disseminated intravascular coagulation and myocardial ischemia. This case is compared with the most similar previous reports in terms of organ damage, clinical presentation, and cause of death. We conclude that a number of severe patterns of adverse effects to acetaminophen are emerging that were previously greatly underestimated, thus questioning the adequacy of the clinical spectrum traditionally associated with acetaminophen intoxication and leading to the need to review this spectrum and the associated diagnostic criteria. PMID:23822653

  6. Fatal anaphylactoid reaction following ioversol administration.

    Science.gov (United States)

    Jansman, Frank Ga; Kieft, Hans; Harting, Johannes W

    2007-12-01

    We report a fatal intravenous ioversol administration in a 60-year old male patient. Although the introduction of new low-osmolar non-ionogenic contrast media with a more favourable efficacy-toxicity balance has diminished the side-effects significantly, everyone involved in radiodiagnostic procedures should be aware of the potential life-threatening effects. Especially patients with risk factors for side-effects should be monitored carefully. PMID:17557212

  7. Immunolocalization and Distribution of Rubella Antigen in Fatal Congenital Rubella Syndrome

    Science.gov (United States)

    Lazar, Mihaela; Perelygina, Ludmila; Martines, Roosecelis; Greer, Patricia; Paddock, Christopher D.; Peltecu, Gheorghe; Lupulescu, Emilia; Icenogle, Joseph; Zaki, Sherif R.

    2015-01-01

    Background An estimated 100,000 cases of congenital rubella syndrome (CRS) occur worldwide each year. The reported mortality rate for infants with CRS is up to 33%. The cellular mechanisms responsible for the multiple congenital defects in CRS are presently unknown. Here we identify cell types positive for rubella virus (RV) in CRS infants. Methods Cells and organs involved in RV replication were identified in paraffin-embedded autopsy tissues from three fatal case-patients by histopathologic examination and immunohistochemical (IHC) staining using a rabbit polyclonal RV antibody. Normal rabbit antisera and RV antisera preabsorbed with highly purified RV served as negative controls. Results RV antigen was found in interstitial fibroblasts in the heart, adventitial fibroblasts of large blood vessels, alveolar macrophages, progenitor cells of the outer granular layer of the brain, and in capillary endothelium and basal plate in the placenta. The antibody specificity was verified by IHC staining of multiple tissue sections from other infectious disease cases. RV infection of each cell type is consistent with abnormalities which have been identified in patients with CRS, in the heart, large blood vessels, and brain. Antigen distribution was consistent with inflammatory response to vascular injury and systemic spread of RV. Conclusions The identification of RV positive cell types in CRS is important to better understand the pathology and pathogenesis of CRS. PMID:26870820

  8. Neuropatía hemorrágica tóxica aguda y fallo multiorgánico tras intoxicación por anticoagulantes, disolventes, AINES y antihistamínicos: A propósito de un caso fatal Acute toxic haemorrhagic neuropathy and multiorganic failure following poisoning by anticoagulants, solvents, nsaids and antihistaminic drugs: Report of a fatal case

    Directory of Open Access Journals (Sweden)

    A. Garfia

    2002-01-01

    Full Text Available Se presenta un caso de intoxicación mortal por ingestión del raticida Brodifacum, un anticoagulante superwarfarínico, junto con otros fármacos, entre los que se incluían antiinflamatorios no esteroideos y un disolvente orgánico de uso doméstico. El sujeto falleció en la UCI, con un cuadro de insuficiencia respiratoria aguda, seguida de fallo hepático y renal. En la autopsia se pusieron de manifiesto lesiones hemorrágicas circunferenciales que afectaban a diversos tejidos, entre los que se encontraban la grasa mesentérica, el epicardio, y la grasa perirrenal. El estudio microscópico demostró la existencia de una típica lesión hemorrágica aguda, circunferencial, en los nervios vegetativos epicárdicos y del área del esplácnico. La explicación de porqué los nervios periféricos vegetativos se constituyen en diana de los efectos tóxicos se atribuye a la acción combinada de los disolventes y de los anticoagulantes, sobre el sistema nervioso periférico. Se sabe que los disolventes orgánicos producen una lesión neuronal aguda, consistente en tumefacción axonal y del soma neuronal, que conlleva a la alteración del sistema de transporte a lo largo del axón. Creemos que -desde el punto de vista fisiopatológico- la vasodilatación reactiva de los vasa nervorum, producida a consecuencia de la lesión neuronal aguda inducida por los disolventes, unida al estado de hipocoagulabilidad sanguínea -dependiente de la ingestión de Brodifacum (superwarfarina y potenciada por los antiinflamatorios no esteroideos- constituyen los mecanismos íntimos que podrían explicar esta peculiar Neuropatía Hemorrágica Aguda Tóxica de los nervios periféricos del Sistema Nervioso Neurovegetativo. Desconocemos si los nervios periféricos mixtos se encontraban afectados por esta lesión, al carecer de muestras para un estudio definitivo.In this paper we describe a case of mortal poisoning by ingestion of the rodenticide Brodifacoum, a superwarfarin

  9. Low dose-rate intra-operative brachytherapy for soft tissue sarcomas: 85 cases report

    International Nuclear Information System (INIS)

    MATERIAL AND METHODS: Between May 1986 and January 1994, 85 patients with soft tissue sarcomas underwent intra-operative interstitial implants in conjunction with conservative tumor resections. Brachytherapy was part of the initial treatment in 62 cases, and was realized in 23 cases for recurrent tumor. 70/85 (82%) tumors were located in the limbs, 56/85 (66%) were T2 or T3. 38/85 (45%) were involving or close to neuro-vascular structures. The implant dose was 40 - 65 Gy when brachytherapy was the only treatment 31/85 p), mostly for recurrent sarcomas, and 12 - 25 Gy (mean 20 Gy) when combined with external irradiation ((54(85)) p). RESULTS: Median follow-up is 40 months. - 4 years actuarial survival rate is 70.8% for the whole series, 74.5% for previously untreated patients, 61.8 % for patients treated for recurrent tumors. - 4 years actuarial local control rate is respectively 86.4%, 95; 7% and 68.1%. Of the 8 patients with local relapse, 1 is alive without evolutive disease, 7 have developed pulmonary metastasis. Acute side-effects occurred in 18/85 patients (21 %) requiring surgical repair in 8 cases. Late side-effects were mostly fibrosis (30 p), lymphoedemas (8 p), neuropathies (5 p). As a result, functional impairment was observed in 13/85 (15 %) patients. No amputation was required for side-effects. CONCLUSION: This series emphasizes brachytherapy combined with external irradiation is a safe and efficient treatment technique in the treatment of soft tissue sarcomas. The local control rate appears satisfactory and the side-effects tolerable, with limited functional impairment

  10. Proper price signals: The case for reflecting externalities in utility rates

    International Nuclear Information System (INIS)

    As a general proposition, proper pricing of utility energy products is honored more in the breach than the observance. As a result, and also as a general proposition, energy is underpriced. More of it is consumed and hence more scarce resources are devoted to its production than is wise. Increasingly, external cost are being recognized and accounted for in utilities resource planning. Relatively uncharted is the issue of external costs being reflected in rates to consumers. This paper makes the case for having externalities reflected in utility rates, not by complete internalization which while ideal may be unrealistic and therefore unachievable but by a method that simulates the outcome sought when all social costs are internalized and correct price signals transmitted

  11. Alteration in the erythrocyte sedimentation rate in dengue patients: analysis of 1,398 cases

    OpenAIRE

    Luiz José de Souza; Aldo Franklin Ferreira Reis; Fernanda Carlos Rodrigues de Almeida; Lara Assed de Souza; Marina Abukater; Maurício Assed Estefan Gomes; Olívia Araujo Abicair; Pedro Assed Gonçalves

    2008-01-01

    A study of the erythrocyte sedimentation rate during the first hour (ESR) in dengue patients would help determine how this parameter is affected by this disease, as well as whether it can be used for diagnosis. One thousand, three hundred and ninety-eight cases of dengue attended at the Dengue Treatment Center, Campos dos Goytacazes Rio de Janeiro, Brazil, were included. The ESR values were classified as normal or elevated and compared by gender and clinical form of the disease. Among the 1,3...

  12. Error-rate prediction for programmable circuits: methodology, tools and studied cases

    Science.gov (United States)

    Velazco, Raoul

    2013-05-01

    This work presents an approach to predict the error rates due to Single Event Upsets (SEU) occurring in programmable circuits as a consequence of the impact or energetic particles present in the environment the circuits operate. For a chosen application, the error-rate is predicted by combining the results obtained from radiation ground testing and the results of fault injection campaigns performed off-beam during which huge numbers of SEUs are injected during the execution of the studied application. The goal of this strategy is to obtain accurate results about different applications' error rates, without using particle accelerator facilities, thus significantly reducing the cost of the sensitivity evaluation. As a case study, this methodology was applied a complex processor, the Power PC 7448 executing a program issued from a real space application and a crypto-processor application implemented in an SRAM-based FPGA and accepted to be embedded in the payload of a scientific satellite of NASA. The accuracy of predicted error rates was confirmed by comparing, for the same circuit and application, predictions with measures issued from radiation ground testing performed at the cyclotron Cyclone cyclotron of HIF (Heavy Ion Facility) of Louvain-la-Neuve (Belgium).

  13. Fatal Fulminant Hepatic Failure from Adenovirus in Allogeneic Bone Marrow Transplant Patients

    OpenAIRE

    Jatin M Vyas; Marasco, Wayne A.

    2012-01-01

    We report two cases of fatal hepatic failure in patients who received matched unrelated bone marrow transplantation. Both patients presented with high fevers, abnormal liver functions tests, and hypodense lesions in the liver by CT scan. Histologic examination of postmortem liver samples demonstrated extensive necrosis, and immunohistochemistry was positive for adenovirus.

  14. Septic arthritis and subsequent fatal septic shock caused by Vibrio vulnificus infection

    DEFF Research Database (Denmark)

    Emamifar, Amir; Asmussen Andreasen, Rikke; Andersen, Nanna Skaarup;

    2015-01-01

    Vibrio vulnificus is a rare but potential fatal bacterium that can cause severe infections. Wound infections, primary sepsis and gastroenteritis are the most common clinical features. Septic arthritis caused by V. vulnificus is an atypical presentation that has been reported in only two case...

  15. Fatal necrotizing fasciitis due to necrotic toxin-producing Escherichia coli strain

    Directory of Open Access Journals (Sweden)

    C. Gallois

    2015-11-01

    Full Text Available We report a fatal case of necrotizing soft tissues infection caused by an Escherichia coli strain belonging to phylogenetic group C and harbouring numerous virulence factors reported to be part of a pathogenicity island (PAI such as PAI IIJ96 and conserved virulence plasmidic region.

  16. Fatal Fulminant Hepatic Failure from Adenovirus in Allogeneic Bone Marrow Transplant Patients

    Directory of Open Access Journals (Sweden)

    Jatin M. Vyas

    2012-01-01

    Full Text Available We report two cases of fatal hepatic failure in patients who received matched unrelated bone marrow transplantation. Both patients presented with high fevers, abnormal liver functions tests, and hypodense lesions in the liver by CT scan. Histologic examination of postmortem liver samples demonstrated extensive necrosis, and immunohistochemistry was positive for adenovirus.

  17. Near fatal intra-operative anaphylaxis to chlorhexidine—is it time to change practice?

    OpenAIRE

    R. A. Khan; Kazi, T; O'Donohoe, B

    2011-01-01

    The authors report a case of a near fatal anaphylactic reaction to chlorhexidine. Increasingly adverse reactions are being reported with the use of chlorhexidine. Serious reactions are related to use on mucous membranes and acceptable alternatives are readily available. Therefore, the fundamental question that must be asked is: is it time to withdraw chlorhexidine preparations used for mucous membranes?

  18. [Fatal poisoning in the Department of Toxicology in Poznarn in 2008-2012--preliminary analysis].

    Science.gov (United States)

    Łukasik-Głebocka, Magdalena; Adamek, Robert

    2013-01-01

    This paper presents the results of a preliminary analysis of deaths from acute poisoning, which occurred in the Department of Toxicology in Poznań in 2008-2012. During this period, recorded 31 cases of fatal poisoning, representing 0.38% of all treated cases. In subsequent years the percentage of poisoning deaths ranged from 0.25 to 0.49%. Throughout the period leading cause of fatal poisoning were drugs (38.71%) and non-consumptive alcohols (methanol or ethylene glycol) (38.71%). In subsequent years, however, a decrease in the percentage of drug poisoning (from 75 to 0%) and an increase in the percentage of nonconsumptive alcohol poisoning (from 0% to 100%) were observed. In fatal cases were diagnosed among others olanzapine, carbamazepine, pseudoephedrine, tramadol, benzodiazepines, clozapine, morphine and benzodiazepines, insulin, verapamil, carbon monoxide and smoke fire, cyanide, Amanita phalloides, ethanol and a mixture of drugs with ethanol poisoning. The most common fatal poisoning occurred in people addicted (45.16%), mainly in alcohol dependence syndrome (35.48%). Suicidal poisoning was the cause of 32.26% of the deaths, while accidental of 19.35%. In nine cases, the procedure of diagnosis of death from irreversible cessation of brain stem function was performed in order to qualify donors of organs for transplantation or to terminate the therapy. One of the dead was liver and kidneys, and two were kidneys donors. PMID:24466679

  19. Fatal septicemia linked to transmission of MRSA clonal complex 398 in hospital and nursing home, Denmark

    DEFF Research Database (Denmark)

    Nielsen, Rikke Thoft; Kemp, Michael; Holm, Anette;

    2016-01-01

    We describe 2 fatal cases of methicillin-resistant Staphylococcus aureus (MRSA) clonal complex 398 septicemia in persons who had no contact with livestock. Whole-genome sequencing of the isolated MRSA strains strongly suggest that both were of animal origin and that the patients had been infected...

  20. Factors Associated with Fatality during the Intensive Phase of Anti-Tuberculosis Treatment

    Science.gov (United States)

    Casals, M.; Caminero, J. A.; García-García, J. M.; Jiménez-Fuentes, M. A.; Medina, J. F.; Millet, J. P.; Ruiz-Manzano, J.; Caylá, J.

    2016-01-01

    Objective To determine the case-fatality rate (CFR) at the end of the intensive phase of tuberculosis (TB) treatment, and factors associated with fatality. Methods TB patients diagnosed between 2006 and 2013 were followed-up during treatment. We computed the CFR at the end of the intensive phase of TB treatment, and the incidence of death per 100 person-days (pd) of follow-up. We performed survival analysis using the Kaplan-Meier method and Cox regression, and calculate hazard ratios (HR) and 95% confidence intervals (CI). Results A total of 5,182 patients were included, of whom 180 (3.5%) died; 87 of these deaths (48.3%) occurred during the intensive phase of treatment, with a CFR of 1.7%. The incidence of death was 0.028/100 pd. The following factors were associated with death during the intensive phase: being >50 years (HR = 36.9;CI:4.8–283.4); being retired (HR = 2.4;CI:1.1–5.1); having visited the emergency department (HR = 3.1;CI:1.2–7.7); HIV infection (HR = 3.4;CI:1.6–7.2); initial standard treatment with 3 drugs (HR = 2.0;CI:1.2–3.3) or non-standard treatments (HR = 2.68;CI:1.36–5.25); comprehension difficulties (HR = 2.8;CI:1.3–6.1); and smear-positive sputum (HR = 2.3-CI:1.0–4.8). Conclusion There is a non-negligible CFR during the intensive phase of TB, whose reduction should be prioritised. The CFR could be a useful indicator for evaluating TB programs. PMID:27487189

  1. The Analysis of Relationship between the Rate of Stock Return and Interest Rate with Nonlinear Methods: The Case of Turkey

    OpenAIRE

    Yusuf Ekrem Akbas

    2013-01-01

    In this study, it was analyzed the structure of stationary of Istanbul Stock Exchange return rate and interest rate series and whether it’s are linear in the period of 1986:01-2012:07. It was used linearity and unit root tests developed by Caner and Hansen (2002). As a result of these tests, it was concluded that the series are non-linear and both of series have two regimes. Besides, it was concluded that both of two regimes have unit root in the series of interest rate and first regime has s...

  2. Fatal Pulmonary Hemorrhage Through Fiberoptic Broncoscopy in a Well Controlled Diabetic Female With Mucormycosis

    Directory of Open Access Journals (Sweden)

    P. Di Carlo

    2008-01-01

    Full Text Available A rare case of invasive pulmonary mucormycosis complicated by fatal massive haemoptysis through bronchoscopy in a patient with a well controlled diabetes is reported. Histological features of infection are reported and the characteristic aspects of the staining are discussed. Fiberoptic bronchoscopy revealed bilateral obstruction of the segmental bronchi and fatal massive bleeding occurring because of biopsy sampling. Caution is warranted in the use of bronchoscopy sampling in patients with radiological features of cavitated lesions of fungal origins. Better preventive and early therapeutic antifungal treatments are needed to avoid this serious complication.

  3. Fatalism Revisited: Further Psychometric Testing Across Two Studies.

    Science.gov (United States)

    Heiney, Sue P; Gullatte, Mary; Hayne, Pearman D; Powe, Barbara; Habing, Brian

    2016-08-01

    Cancer fatalism may impact outcomes, particularly for African American (AA) women with breast cancer (BrCa). We examined the psychometrics of the modified Powe Fatalism Inventory in sample of AA women with BrCa from two studies. Only the predetermination and God's will items satisfy the conditions to be classified as a strong subscale. Our analysis identified that five items had strong psychometric properties for measuring fatalism for AA women with BrCa. However, these items do not include all the defining attributes of fatalism. A strong measure of fatalism strengthens our understanding of how this concept influences AA patient outcomes. PMID:26661622

  4. Epidemiological characteristics of fatal pedestrian accidents in Fars Province of Iran: a community-based survey

    Institute of Scientific and Technical Information of China (English)

    Payam Peymani; Ali Foroutan; Seyed Mehdi Ahmadi; Fariborz Ghaffarpasand; Hassan Joulaei; Kamran B Lankarani; Seyed Taghi Heydari; Amin Hoseinzadeh; Yaser Sarikhani; Arya Hedjazi; Mohammad Zarenezhad; Ghasem Moafian; Mohammad Reza Aghabeigi; Najmeh Maharlouei

    2012-01-01

    Objective: To determine the epidemiological characteristics of fatal pedestrian accidents in Fars Province of Iran.Methods: This cross-sectional study was conducted in Fars Province of Iran during a 29-month period from March 2009 to July 2011.The data were from the Fars Forensic Medicine Registry.In 4 923 recorded road traffic accident fatalities,971 deaths were due to pedestrian accidents.The demographic and accident-related information were analyzed by SPSS version 11.5.P value less than 0.05 was considered significant.Results: The mean age of decedents was (47.2±26.2)years,ranging from 6 months to 103 years old.Males accounted for 69.8% of all deaths.Fatal accidents were most common in September; 56.1% of the fatal injuries occurred on intracity roads and 33.1% on extracity roads.Fatal head injuries were present in 60.54% of cases.Evaluation of the injury site and the cause of death found that they were significantly associated with age,interval between injury and death.Besides,the type of roads played an important role in mortality.Conclusion: Although the clinical management of trauma patients has been improved in our country in the recent decade,decreasing the burden of injuries needs coordination among trauma system organizations.

  5. Fatal injuries while under the influence of psychoactive drugs: a cross-sectional exploratory study in England

    Directory of Open Access Journals (Sweden)

    Dryden Ruth

    2006-06-01

    Full Text Available Abstract Background Studies of drug-related mortality rarely describe fatal injuries due to psychoactive drug intoxication (FIUI. The main aim of this study was to determine the nature, extent and pattern of FIUI. Methods This observational study covered the period January 1999 to December 2001. Data were provided by members of a study panel of coroners in England using a standard protocol. Sources of data for this study included autopsy protocols, death certificates, hospital records, police reports, toxicology reports and inquest transcripts. Inclusion criteria for this were (i the mention of one or more psychoactive substances as contributing to fatality; and (ii the presence of a Controlled Drug at post mortem. Results A total of 3,803 drug-related deaths of persons aged 16–64 years were reported by the study panel during the three-year period. The study panel accounted for 86% of drug-related deaths in England in this period. There were 147 FIUI cases (119 males, 28 females, giving a proportionate mortality ratio of approximately 4%. The majority of FIUI cases (84% were aged 16–44 years, with a median age at death of 33 years (Quartile deviation = 7. Fifty-six percent of FIUI occurred in urban areas of England. The population of the study jurisdictions aged 16–64 years contributed 49,545,766 person-years (py to the study, giving an annual crude rate of 3/1,000,000 person-years (py. Rates for male and females were 4.9 and 1.1/1,000,000 py respectively, giving a male/female rate ratio of 4.5 (95%CI = 2.9–6.8. The rates of intentional and unintentional FIUI were 2 and 1/1,000,000 py respectively. The leading mechanism for intentional FIUI was suffocation while the predominant mechanisms in unintentional FIUI were road traffic accidents and falls. There is a significant difference in the pattern of drug-specific risk between FIUI and fatal poisoning. Risks of intentional FIUI are elevated among Black and Minority Ethnic groups

  6. Road traffic crashes, injury and fatality trends in Sri Lanka: 1938–2013

    OpenAIRE

    2015-01-01

    Abstract Objective To analyse trends in road traffic crashes, injuries and fatalities over 75 years in Sri Lanka. Methods Data on road traffic crashes, injuries and fatalities between 1938 and 2013 were obtained from the Police Statistics Unit. Rates per 100 000 population were calculated and trends were analysed using joinpoint regression analysis. Findings Road traffic crashes and injuries rose substantially between 1938 and 2013: annual crashes increased from 61.2 to 183.6 per 100 000 peop...

  7. Parental mental illness and fatal birth defects in a national birth cohort

    DEFF Research Database (Denmark)

    Webb, Roger; Pickles, A.R.; King-Hele, Sarah;

    2007-01-01

    maternal conditions. There was no elevation in risk of fatal birth defect if the father was admitted with schizophrenia or any other psychiatric diagnosis. CONCLUSIONS: There are many possible explanations for a higher risk of fatal birth defect with maternal schizophrenia and affective disorder. These......BACKGROUND: Few large studies describe links between maternal mental illness and risk of major birth defect in offspring. Evidence is sparser still for how effects vary between maternal diagnoses and no previous study has assessed risk with paternal illnesses.MethodA population-based birth cohort...... estimated using Poisson regression. RESULTS: Risk of fatal birth defect was elevated in relation to history of any maternal admission and also with affective disorders specifically, although the strongest effect found was with maternal schizophrenia. The rate was more than doubled in this group compared to...

  8. Alteration in the erythrocyte sedimentation rate in dengue patients: analysis of 1,398 cases

    Directory of Open Access Journals (Sweden)

    Luiz José de Souza

    2008-12-01

    Full Text Available A study of the erythrocyte sedimentation rate during the first hour (ESR in dengue patients would help determine how this parameter is affected by this disease, as well as whether it can be used for diagnosis. One thousand, three hundred and ninety-eight cases of dengue attended at the Dengue Treatment Center, Campos dos Goytacazes Rio de Janeiro, Brazil, were included. The ESR values were classified as normal or elevated and compared by gender and clinical form of the disease. Among the 1,398 cases ESR was normal in 81.25% (n = 1,136, while in 18.75% (n=262 it was elevated. In 83.92% (n=514 of the male dengue patients ESR was normal, while in 16.08% (n=98 it was elevated. Among female dengue patients, 79.17% (n=622 had normal ESR, and in 20.83% (n=164 ESR was elevated (p=0.05. Among patients with classic dengue, 77.28% (n=961 had normal ESR, while in 22.72% (n=282, it was elevated. Also in 85.81% (n=133 of patients with hemorrhagic dengue, ESR was normal, while in 14.19% (n=22 ESR was elevated (p=0.026. We concluded that ESR was within normal ranges in most dengue cases, independent of gender or clinical presentation. Given the high frequency of normality and the ease of determination of this parameter, ESR data can help in the differential diagnosis of dengue.

  9. High rate of drug resistance among tuberculous meningitis cases in Shaanxi province, China.

    Science.gov (United States)

    Wang, Ting; Feng, Guo-Dong; Pang, Yu; Liu, Jia-Yun; Zhou, Yang; Yang, Yi-Ning; Dai, Wen; Zhang, Lin; Li, Qiao; Gao, Yu; Chen, Ping; Zhan, Li-Ping; Marais, Ben J; Zhao, Yan-Lin; Zhao, Gang

    2016-01-01

    The clinical and mycobacterial features of tuberculous meningitis (TBM) cases in China are not well described; especially in western provinces with poor tuberculosis control. We prospectively enrolled patients in whom TBM was considered in Shaanxi Province, northwestern China, over a 2-year period (September 2010 to December 2012). Cerebrospinal fluid specimens were cultured for Mycobacterium tuberculosis; with phenotypic and genotypic drug susceptibility testing (DST), as well as genotyping of all positive cultures. Among 350 patients included in the study, 27 (7.7%) had culture-confirmed TBM; 84 (24.0%) had probable and 239 (68.3%) had possible TBM. DST was performed on 25/27 (92.3%) culture positive specimens; 12/25 (48.0%) had "any resistance" detected and 3 (12.0%) were multi-drug resistant (MDR). Demographic and clinical features of drug resistant and drug susceptible TBM cases were similar. Beijing was the most common genotype (20/25; 80.0%) with 9/20 (45%) of the Beijing strains exhibiting drug resistance; including all 3 MDR strains. All (4/4) isoniazid resistant strains had mutations in the katG gene; 75% (3/4) of strains with phenotypic rifampicin resistance had mutations in the rpoB gene detected by Xpert MTB/RIF®. High rates of drug resistance were found among culture-confirmed TBM cases; most were Beijing strains. PMID:27143630

  10. Ethanol in Fatal Road Traffic Accidents: The Prevalence of Ethanol in Fatal Road Traffic Accidents in The Bahamas: The Need for a Controlled Study

    Directory of Open Access Journals (Sweden)

    Carey, James

    2005-01-01

    Full Text Available There are no documented studies of the role of ethanol in fatal road traffic accidents in The Bahamas. This paper provides a retrospective analysis of the involvement of ethanol in road traffic fatalities for 2000-2002 in The Bahamas. In the three-year period covered by this study, 185 traffic fatalities were recorded, post-mortem blood samples from 139 decedents were analyzed for blood alcohol concentration (BAC. The involvement of ethanol in many of these fatalities was not conclusive because BAC at the time of the accident cannot be confidently extrapolated from post mortem BAC data. In an effort to understand the involvement of ethanol in road traffic accidents we propose that BAC of all participants in road traffic accidents involving injuries should be recorded. This proposal is based on, and supported by, the analyses of the available data. Analysis of the data highlights its deficiencies and that of the data collection system. The case for a systematic study is presented.

  11. Developing a New Model for Conversion Rate Optimization: A Case Study

    Directory of Open Access Journals (Sweden)

    Pim Soonsawad

    2013-04-01

    Full Text Available This paper will discuss conversion rate optimization in online retail environments. The paper reviews previousliterature on the topic and then examines how one company has created its own model and used the model tosuccessfully to enhance Internet businesses’ conversion rate optimization. The paper will then synthesize all ofthe factors seen in the literature and the case study model into a new model.A variety of academic papers on the factors affecting the decision-making process of online customers from2004 through 2012 were examined and an in-depth face-to-face interview was conducted with the founder ofClixo at a 2012 United States “online marketing” forum, with a follow-up interviews conducted via email. Thepaper discusses the effectiveness of the new model.This paper identifies the variables that influence online customer behavior and discusses the importance each ofthe seven elements; catalyst, persuasion, usability, interactivity, trust, aesthetics, and marketing mix. Theinterrelationship of the elements at each stage of the customer decision-making process is reviewed.The paper illustrates how e-Retailers can apply the elements of the framework in delivering a website experiencelikely to maximize the number of purchases from online visitors, and to reinforce post-purchase confidence.The paper identifies two additional key elements in conversion rate optimization and develops a new model thatincorporates the two new elements. This new hierarchical model presents the elements stage-by-stage to helponline retailers to convert visitors into customers.

  12. INTERNAL RATING – AN ACTIVE INSTRUMENT IN THE MANAGEMENT OF BANKING RISKS. CASE STUDY BCR

    Directory of Open Access Journals (Sweden)

    PhD Gabriela Cornelia Piciu

    2013-06-01

    Full Text Available This paper aims to clarify some aspects regarding the banking activity in general, of crediting, in particular, because it involves a risk by the very elements of anticipation underlying the decision of the banking specialists. For the bank it is very important to know this risk, to make an evaluation as close as possible to reality, and to reject or accept it in full awareness. The contribution of the internal rating in terms of efficiency and stability of a bank is shown via a case study – the Romanian Commercial Bank. The internal rating used by BCR is an active instrument for making credit decisions it provides valuable indicators to the banking analysts that can be used to develop de risk management policies and the prudential measures for the balanced risk dispersion. Given the fact that the credit rating contributes to the objective, professional analysis, the system must be continuously improved and developed by categories of clients and types of risk, so that the included criteria and the resulting conclusions are relevant.

  13. Lung function and risk of fatal and non-fatal stroke. The Copenhagen City Heart Study

    DEFF Research Database (Denmark)

    Truelsen, T; Prescott, E; Lange, P;

    2001-01-01

    the Copenhagen City Heart Study in 1976-1978. The subjects were followed from day of entry until 31 December 1993. During that period 808 first-ever strokes occurred of which 153 were fatal within 28 days. Risk of incident and fatal stroke was estimated by means of Cox hazard regression. The analyses...... included adjustment for potential confounders: sex, age, smoking, inhalation, body mass index, systolic blood pressure, triglycerides, physical activity in leisure time, education, diabetes mellitus, and antihypertensive treatment. RESULTS: We found an inverse association between FEV1 and risk of first...

  14. Reported fatal and non-fatal incidents involving tourists in Thailand, July 1997-June 1999.

    Science.gov (United States)

    Leggat, Peter A; Leggat, Frances W

    2003-05-01

    Objectives. To examine fatal and non-fatal incidents involving tourists in Thailand. Methods. Press records from a major English language newspaper for the period from July 1997 to June 1999 were examined for reports of fatal and non-fatal incidents involving tourists. Results. From July 1997 to June 1999, up to 233 deaths were reported and up to a further 216 were reported injured in incidents involving tourists. One hundred and one deaths and 45 injured were reported following one major domestic jet aircraft crash in southern Thailand, however, it was not stated what proportion of casualties were tourists. Approximately 90 people perished in a single hotel fire in southeast Thailand. Most of the victims were local travellers attending meetings of two Thai companies. Sixteen deaths and 86 injured resulted from five road accidents. The majority of deaths and injuries involved foreigners. Twelve deaths and at least 33 injured resulted from three ferry and tour boat accidents. Most victims were reported to be foreigners. Three deaths and 35 injured resulted from a single cable car accident in northern Thailand. Most of these were Thai tourists, however, four of the injured were foreigners. Eight deaths and six injured resulted from 11 muggings and other violent incidents. All were foreigners. Six deaths were reportedly connected to a scam at the airport in Bangkok involving unlicensed airport taxis. Three deaths and four injured were due to other reported incidents. Conclusions. Newspaper reports of fatal and non-fatal incidents involving tourists in Thailand were probably uncommon, particularly given the volume of tourists entering the Kingdom, although better reporting mechanisms are needed. With the exception of the unusual major incidents, most reported fatal and non-fatal incidents involving tourists were due to road trauma and other transportation accidents, muggings, and occasional water sports and other accidents, which could occur at any major tourist

  15. A comment on "Novel scavenger removal trials increase wind turbine-caused avian fatality estimates"

    Science.gov (United States)

    Huso, Manuela M.P.; Erickson, Wallace P.

    2013-01-01

    In a recent paper, Smallwood et al. (2010) conducted a study to compare their “novel” approach to conducting carcass removal trials with what they term the “conventional” approach and to evaluate the effects of the different methods on estimated avian fatality at a wind power facility in California. A quick glance at Table 3 that succinctly summarizes their results and provides estimated fatality rates and 80% confidence intervals calculated using the 2 methods reveals a surprising result. The confidence intervals of all of their estimates and most of the conventional estimates extend below 0. These results imply that wind turbines may have the capacity to create live birds. But a more likely interpretation is that a serious error occurred in the calculation of either the average fatality rate or its standard error or both. Further evaluation of their methods reveals that the scientific basis for concluding that “many estimates of scavenger removal rates prior to [their] study were likely biased low due to scavenger swamping” and “previously reported estimates of avian fatality rates … should be adjusted upwards” was not evident in their analysis and results. Their comparison to conventional approaches was not applicable, their statistical models were questionable, and the conclusions they drew were unsupported.

  16. Fatal poisoning among patients with drug addiction

    DEFF Research Database (Denmark)

    Simonsen, Kirsten Wiese; Christoffersen, Dorte J; Banner, Jytte;

    2015-01-01

    2012 were included in the study. RESULTS: A total of 188 fatal intoxications were recorded. The median age increased from 37.5 in 2007 to 41.5 in 2012. The majority were men (77%). Methadone (59%) was the main intoxicant. The decrease in the frequency of heroin/morphine deaths since 1997 (71......%) continued, declining to 44% in 2002, 33% in 2007 and finally to 27% in 2012. Few deaths from central stimulants (amphetamine and cocaine) occurred. Multiple drug use was common and consisted mainly of opioids, cocaine, amphetamine, cannabis, benzodiazepines and alcohol. Heroin/morphine use was most frequent...

  17. Fatal radiation pneumonia following subclinical busulfan injury

    Energy Technology Data Exchange (ETDEWEB)

    Soble, A.R.; Perry, H.

    1977-01-01

    A patient with polycythemia vera received a moderate dose (480 mg) of busulfan intermittently over a 6 year period and later developed Hodgkin's disease. Following split-course upper mantle, chest irradiation, he developed rapidly progressive, fatal pneumonia and bone marrow hypoplasia. It is postulated that the hyperacute organ failures (lung and bone marrow) resulted from augmentation of subclinical busulfan-induced damage of these organs by additive radiation effect. It is recommended that in patients who have had antineoplastic chemotherapy, major radiotherapy to the cervicothoracic region be accompanied by careful monitoring of respiratory and hematopoietic function, both before and during radiotherapy.

  18. Delayed onset of fatal basilar thrombotic embolus after whiplash injury

    DEFF Research Database (Denmark)

    Viktrup, L; Knudsen, G M; Hansen, S H

    1995-01-01

    collision. CASE DESCRIPTION: After whiplash trauma in a car accident, a 50-year-old taxi driver suffered from headache and episodic visual disturbances. Two months after the accident he suddenly lost consciousness and was admitted to the hospital. A CT scan performed at that time was indicative of basilar...... injury caused a lesion of the right vertebral artery, leading to repeated transient ischemic attacks and finally to a fatal basilar thrombotic embolus. We suggest that in patients with disturbances of the vertebrobasilar circulation, attention should be paid to occurrence of neck trauma in the preceding...... 3 months. Further, anticoagulant therapy should particularly be considered in patients who after suffering neck injuries develop signs of transient ischemic attacks with origin from the posterior cerebral circulation....

  19. Fatalities temporally associated with the ingestion of ibogaine.

    Science.gov (United States)

    Alper, Kenneth R; Stajić, Marina; Gill, James R

    2012-03-01

    Ibogaine is a naturally occurring psychoactive plant alkaloid that is used globally in medical and nonmedical settings for opioid detoxification and other substance use indications. All available autopsy, toxicological, and investigative reports were systematically reviewed for the consecutive series of all known fatalities outside of West Central Africa temporally related to the use of ibogaine from 1990 through 2008. Nineteen individuals (15 men, four women between 24 and 54 years old) are known to have died within 1.5-76 h of taking ibogaine. The clinical and postmortem evidence did not suggest a characteristic syndrome of neurotoxicity. Advanced preexisting medical comorbidities, which were mainly cardiovascular, and/or one or more commonly abused substances explained or contributed to the death in 12 of the 14 cases for which adequate postmortem data were available. Other apparent risk factors include seizures associated with withdrawal from alcohol and benzodiazepines and the uninformed use of ethnopharmacological forms of ibogaine. PMID:22268458

  20. Fatal Injury Caused by a Ram (Ovis Aries) Attack.

    Science.gov (United States)

    Škavić, Petar; Šprem, Nikica; Kostelić, Antun

    2015-09-01

    Animal-inflicted injuries to humans are a major public health problem around the world resulting in great morbidity, money loss, and mortality. They are related to wild and domestic animals alike. Animals can cause injuries by various mechanisms--biting, stinging, crushing, goring, stomping, butting, kicking, pecking, etc. We present a case of a ram's attack with fatal consequences. A 4-year-old, 120 kg jezersko-solčava breed ram with prior history of aggressive behavior inflicted multiple injuries to his 83-year-old owner, who died in the hospital a few hours later due to severe blunt force injuries sustained in the attack. The autopsy revealed the cause of death to be multiple injuries of the thorax and the head. Sheep, even though they are not considered aggressive or large farm animals such as cattle and horses, can inflict serious injuries with devastating results. PMID:26258770

  1. Fatal rhino-orbito-cerebral mucormycosis in a healthy individual

    Directory of Open Access Journals (Sweden)

    Rama Krishna Angali

    2014-01-01

    Full Text Available Rhino-orbital-cerebral zygomycosis is a potentially lethal, opportunistic, fungal infection with protean manifestations, rapid progression, unpredictable course and high mortality. It is associated with angioinvasion and infarction, usually observed in diabetic ketoacidosis, immuno-compromised states and rarely reported in an apparently normal host. We present a case of an18-year-old patient with a chronic, painful, non healing ulcer with necrotic margins over the right side of the face which extended to both orbits involving eyes within a period of 1.5 month. Later he developed severe headache, decreased vision, inability to speak, seizures and status epilepticus with fatal outcome. Awareness of its occurrence in normal patients with prompt diagnosis and appropriate management may improve the outcome and decrease mortality.

  2. Postpartum Clostridium sordellii infection associated with fatal toxic shock syndrome

    DEFF Research Database (Denmark)

    Rørbye, C; Petersen, Ina Sleimann; Nilas, Lisbeth

    2000-01-01

    . Clostridium sordellii is rarely encountered in clinical specimens (1% of Clostridium species), but it has been described as a human pathogen with fatal potential. Two toxins, a lethal and a hemorrhagic (that antigenically and pathophysiologically appear similar to Clostridium difficile toxins B and A......Clostridium bacteria are anaerobic Gram positive spore-form-ing bacilli, known to cause distinct clinical syndromes such as botulism, tetanus, pseudomembranous colitis and myonecrosis. The natural habitats of Clostridium species are soil, water and the gastrointestinal tract of animals and humans....... In 5-10% of all women, Clostridium species are also found to be normal inhabitants in the microbial flora of the female genital tract. In case of a non-sexually transmitted genital tract infection, Clostridium species are isolated in 4-20%, and clostridium welchii seems to be the most common isolate...

  3. Fatal Child Abuse in Japan: Does a trend exist toward tougher sentencing?

    Directory of Open Access Journals (Sweden)

    Satoshi Fujiwara

    2011-07-01

    Full Text Available BACKGROUND: It has been pointed out in Japan that criminal punishment in domestic homicide cases, especially in fatal child abuse cases, tends to be more lenient than in public homicide cases that occur outside the home. In recent news accounts of fatal child abuse cases, however, the media has reported that court-imposed sentences have tended to be stricter every year.METHODS: Using the online databases of three major Japanese newspapers, we collected articles about fatal child abuse cases that had been published from January 2008 to December 2009. We analyzed these articles to determine, whether a tendency towards tougher penalties, as was put forward by the media, actually exists at present time in the criminal system in Japan. RESULTS: We found 24 cases, out of which 20 involved only one offender and 4 involved two offenders. These 28 offenders comprised nine biological fathers, 11 biological mothers, and eight other male relatives of the child victims. We found that the sentences handed down by the court clearly tended to be more lenient for female offenders. A new system of criminal jurisprudence, the so-called saiban-in system wherein citizens serve as “lay judges” in criminal trials involving serious crimes, was implemented in Japan at the start of 2009. Each, district court has gradually adopted this new system after a preparation period of approximately five years starting in 2004. CONCLUSIONS: Many figures in the Japanese media predicted that the gap between social expectations and court sentences for sanction against domestic homicide cases would be filled with the present transitional period of the Japanese criminal system. However, the present study found no significant difference in the laws regarding sentencing in fatal child abuse cases before and after the preparation period of the saiban-in system.

  4. Spontaneous liver rupture in hypereosinophilic syndrome: A rare but fatal complication

    OpenAIRE

    Cheung, Yue-Sun; Wong, Shun; Lam, Philip Koon-Ngai; Lee, Kit-Fai; Wong, John; Lai, Paul Bo-San

    2009-01-01

    We report a rare case of spontaneous liver rupture in a patient with hypereosinophilic syndrome (HES), of which the diagnosis was delayed, resulting in a fatal outcome. The diagnostic criteria and treatment of HES with hepatic involvement were reviewed. The possible cause of spontaneous liver rupture in HES and its management were also discussed. To our knowledge, this is the first case report of spontaneous liver rupture in HES. We emphasized the need of a high index of suspicion in diagnosi...

  5. A comprehensive analysis of small-passerine fatalities from collision with turbines at wind energy facilities.

    Science.gov (United States)

    Erickson, Wallace P; Wolfe, Melissa M; Bay, Kimberly J; Johnson, Douglas H; Gehring, Joelle L

    2014-01-01

    Small passerines, sometimes referred to as perching birds or songbirds, are the most abundant bird group in the United States (US) and Canada, and the most common among bird fatalities caused by collision with turbines at wind energy facilities. We used data compiled from 116 studies conducted in the US and Canada to estimate the annual rate of small-bird fatalities. It was necessary for us to calculate estimates of small-bird fatality rates from reported all-bird rates for 30% of studies. The remaining 70% of studies provided data on small-bird fatalities. We then adjusted estimates to account for detection bias and loss of carcasses from scavenging. These studies represented about 15% of current operating capacity (megawatts [MW]) for all wind energy facilities in the US and Canada and provided information on 4,975 bird fatalities, of which we estimated 62.5% were small passerines comprising 156 species. For all wind energy facilities currently in operation, we estimated that about 134,000 to 230,000 small-passerine fatalities from collision with wind turbines occur annually, or 2.10 to 3.35 small birds/MW of installed capacity. When adjusted for species composition, this indicates that about 368,000 fatalities for all bird species are caused annually by collisions with wind turbines. Other human-related sources of bird deaths, (e.g., communication towers, buildings [including windows]), and domestic cats) have been estimated to kill millions to billions of birds each year. Compared to continent-wide population estimates, the cumulative mortality rate per year by species was highest for black-throated blue warbler and tree swallow; 0.043% of the entire population of each species was estimated to annually suffer mortality from collisions with turbines. For the eighteen species with the next highest values, this estimate ranged from 0.008% to 0.038%, much lower than rates attributed to collisions with communication towers (1.2% to 9.0% for top twenty species). PMID

  6. A comprehensive analysis of small-passerine fatalities from collisions with turbines at wind energy facilities

    Science.gov (United States)

    Erickson, Wallace P.; Wolfe, Melissa M.; Bay, Kimberly J.; Johnson, Douglas H.; Gehring, Joelle L.

    2014-01-01

    Small passerines, sometimes referred to as perching birds or songbirds, are the most abundant bird group in the United States (US) and Canada, and the most common among bird fatalities caused by collision with turbines at wind energy facilities. We used data compiled from 39 studies conducted in the US and Canada to estimate the annual rate of small-bird fatalities. It was necessary for us to calculate estimates of small-bird fatality rates from reported all-bird rates for 30% of studies. The remaining 70% of studies provided data on small-bird fatalities. We then adjusted estimates to account for detection bias and loss of carcasses from scavenging. These studies represented about 15% of current operating capacity (megawatts [MW]) for all wind energy facilities in the US and Canada and provided information on 4,975 bird fatalities, of which we estimated 62.5% were small passerines comprising 156 species. For all wind energy facilities currently in operation, we estimated that about 134,000 to 230,000 small-passerine fatalities from collision with wind turbines occur annually, or 2.10 to 3.35 small birds/MW of installed capacity. When adjusted for species composition, this indicates that about 368,000 fatalities for all bird species are caused annually by collisions with wind turbines. Other human-related sources of bird deaths, (e.g., communication towers, buildings [including windows]), and domestic cats) have been estimated to kill millions to billions of birds each year. Compared to continent-wide population estimates, the cumulative mortality rate per year by species was highest for black-throated blue warbler and tree swallow; 0.043% of the entire population of each species was estimated to annually suffer mortality from collisions with turbines. For the eighteen species with the next highest values, this estimate ranged from 0.008% to 0.038%, much lower than rates attributed to collisions with communication towers (1.2% to 9.0% for top twenty species).

  7. A comprehensive analysis of small-passerine fatalities from collision with turbines at wind energy facilities.

    Directory of Open Access Journals (Sweden)

    Wallace P Erickson

    Full Text Available Small passerines, sometimes referred to as perching birds or songbirds, are the most abundant bird group in the United States (US and Canada, and the most common among bird fatalities caused by collision with turbines at wind energy facilities. We used data compiled from 116 studies conducted in the US and Canada to estimate the annual rate of small-bird fatalities. It was necessary for us to calculate estimates of small-bird fatality rates from reported all-bird rates for 30% of studies. The remaining 70% of studies provided data on small-bird fatalities. We then adjusted estimates to account for detection bias and loss of carcasses from scavenging. These studies represented about 15% of current operating capacity (megawatts [MW] for all wind energy facilities in the US and Canada and provided information on 4,975 bird fatalities, of which we estimated 62.5% were small passerines comprising 156 species. For all wind energy facilities currently in operation, we estimated that about 134,000 to 230,000 small-passerine fatalities from collision with wind turbines occur annually, or 2.10 to 3.35 small birds/MW of installed capacity. When adjusted for species composition, this indicates that about 368,000 fatalities for all bird species are caused annually by collisions with wind turbines. Other human-related sources of bird deaths, (e.g., communication towers, buildings [including windows], and domestic cats have been estimated to kill millions to billions of birds each year. Compared to continent-wide population estimates, the cumulative mortality rate per year by species was highest for black-throated blue warbler and tree swallow; 0.043% of the entire population of each species was estimated to annually suffer mortality from collisions with turbines. For the eighteen species with the next highest values, this estimate ranged from 0.008% to 0.038%, much lower than rates attributed to collisions with communication towers (1.2% to 9.0% for top

  8. Differential ranking of causes of fatal versus non-fatal injuries among US children

    OpenAIRE

    Ballesteros, M.; Schieber, R; Gilchrist, J.; Holmgreen, P; Annest, J

    2003-01-01

    Method: A descriptive study was conducted using nationally representative data on injury related deaths (National Vital Statistics System) and on non-fatal injury related emergency department visits (IEDV; National Electronic Injury Surveillance System-All Injury Program). Data were accessed using a publicly available web based system.

  9. Risk Factors for Fatal Recurrence of Liver Transplant Recipients with Hepatocellular Carcinoma in the First Year

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective: To investigate the clinicopathological risk factors for fatal recurrence of hepatocellular carcinoma (HCC) in orthotopic liver transplant recipients in the first year. Methods: From April 2002 to October 2005, 303 recipients who received orthotopic liver transplantation for HCC were reviewed. Of These patients, those who demonstrated diffuse intra-hepatic or multiple systemic recurrent lesions and died within 1 y after surgery were investigated (fatal recurrence group, 48 cases). The remaining patients were designated as the control group, and the two groups were compared for clinicopathologic risk factors by logistic regression analysis. Results: Among the 303 patients reviewed, 48 patients were enrolled in the fatal recurrence group (15.84%). Multivariate analysis between the fatal recurrence group and control group showed that the presence of vascular invasion, tumor size greater than 6.5 cm, and pre-operative serum alpha-fetoprotein (AFP) level greater than 1000 μg/L were the risk factors in the fatal recurrence group. 85.71% of the patients who had all the three risk factors, 37.84% of those who had two risk factors, 13.64% of those who had one risk factors, and 6.71% of those who had none risk factors died because of recurrence within 1 y after transplantation. Conclusion: Three distinct risk factors attributed to fatal recurrence of liver transplant recipients for HCC are vascular invasion, tumor size ≥6.5 cm, and pre-operative serum AFP level ≥1000 μg/L. The high risk HCC patients with two or more risk factors should not to be the candidates for liver transplantation.

  10. Risk factors affecting fatal bus accident severity: Their impact on different types of bus drivers.

    Science.gov (United States)

    Feng, Shumin; Li, Zhenning; Ci, Yusheng; Zhang, Guohui

    2016-01-01

    While the bus is generally considered to be a relatively safe means of transportation, the property losses and casualties caused by bus accidents, especially fatal ones, are far from negligible. The reasons for a driver to incur fatalities are different in each case, and it is essential to discover the underlying risk factors of bus fatality severity for different types of drivers in order to improve bus safety. The current study investigates the underlying risk factors of fatal bus accident severity to different types of drivers in the U.S. by estimating an ordered logistic model. Data for the analysis are retrieved from the Buses Involved in Fatal Accidents (BIFA) database from the USA for the years 2006-2010. Accidents are divided into three levels by counting their equivalent fatalities, and the drivers are classified into three clusters by the K-means cluster analysis. The analysis shows that some risk factors have the same impact on different types of drivers, they are: (a) season; (b) day of week; (c) time period; (d) number of vehicles involved; (e) land use; (f) manner of collision; (g) speed limit; (h) snow or ice surface condition; (i) school bus; (j) bus type and seating capacity; (k) driver's age; (l) driver's gender; (m) risky behaviors; and (n) restraint system. Results also show that some risk factors only have impact on the "young and elder drivers with history of traffic violations", they are: (a) section type; (b) number of lanes per direction; (c) roadway profile; (d) wet road surface; and (e) cyclist-bus accident. Notably, history of traffic violations has different impact on different types of bus drivers. PMID:26513334

  11. Fatal case of a 27-year-old male after taking iboga in withdrawal treatment: GC-MS/MS determination of ibogaine and ibogamine in iboga roots and postmortem biological material.

    Science.gov (United States)

    Mazoyer, Cédric; Carlier, Jérémy; Boucher, Alexandra; Péoc'h, Michel; Lemeur, Catherine; Gaillard, Yvan

    2013-11-01

    We report the case of a man who died twelve hours after ingesting powdered iboga root, commonly taken for its stimulant and hallucinogenic properties. Ibogaine and ibogamine were quantified in the powder ingested and the victim's body fluids by GC-MS/MS after liquid-liquid extraction (Toxi-tubes A(®)). The concentrations of ibogaine measured in the blood samples taken at the scene and in the peripheral blood, urine, and gastric fluid samples taken during the autopsy were 0.65, 1.27, 1.7, and 53.5 μg/mL, while the iboga content in the powder was 7.2%. Moreover, systematic toxicological analyses of biological samples showed the presence of diazepam and methadone in therapeutic concentrations. Death was attributed to the ingestion of a substantial quantity of iboga in the context of simultaneous methadone and diazepam consumption. PMID:23919354

  12. Epidemiology of non-fatal cerebrovascular stroke and transient ischemic attacks in Al Quseir, Egypt

    Directory of Open Access Journals (Sweden)

    El-Tallawy HN

    2013-11-01

    Full Text Available Hamdy N El-Tallawy,1 Wafaa MA Farghaly,1 Ghaydaa A Shehata,1 Nabil M Abdel-Hakeem,2 Tarek A Rageh,1 Reda Badry,1 Mahmoud R Kandil1 1Department of Neurology and Psychiatry, Faculty of Medicine, Assiut University Hospital, 2Department of Neurology, Faculty of Medicine, Al-Azhar University, Assiut branch, Assuit, Egypt Background and purpose: Stroke is a medical emergency that can cause permanent neurological damage, complications, and disability. We aim to determine the epidemiology of non-fatal cerebrovascular stroke (CVS and transient ischemic attacks (TIAs in Al Quseir City, Red Sea, Egypt. Methods: The total population (n=33,285 was screened through a door to door study by three specialists of neurology and 15 female social workers (for demographic data collection. All suspected stroke patients were subjected to a full clinical examination, computerized tomography (CT and/or magnetic resonance imaging (MRI of their brain, blood sugar, lipogram, serum uric acid, complete blood cells, blood urea, and serum creatinine, as well as evaluated by Barthel Index and Scandinavian Stroke Scale. Carotid doppler, echocardiography, and thyroid functions were done for selected cases. Results: CVS was recorded among 130 patients out of 19,848 subjects aged 20 years and more, yielding a total prevalence of 6.55/1,000 population. From June 1, 2010 to May 31, 2011, 36 patients were recorded to have stroke within 1-year, yielding an incidence rate of 1.81/1,000. Prevalence and incidence rates were higher among males than females, and both indices increased steadily with advancing age to reach the highest prevalence (37.02/1,000 and incidence rate (9.5/1,000 among aged persons 60 years and more. Conclusion: The prevalence of non-fatal stroke in Al Quseir city (6.55/1,000 was at the lower range of that recorded in developing countries (5–10/1,000 and slightly higher than that recorded in industrialized countries (5/1,000 population. Ischemic stroke is the most

  13. 49 CFR 1109.4 - Mandatory mediation in rate cases to be considered under the stand-alone cost methodology.

    Science.gov (United States)

    2010-10-01

    ... complaint under 49 CFR Part 1111. (b) Within 10 business days after the shipper files its formal complaint... cases, set forth at 49 CFR 1111.8(a). ... 49 Transportation 8 2010-10-01 2010-10-01 false Mandatory mediation in rate cases to be...

  14. [Anesthesia unrelated triggering of a fatal malignant hyperthermia crisis].

    Science.gov (United States)

    Olthoff, D; Vonderlind, C

    1997-12-01

    For incidents of malignant hyperthermia (MH) outside the hospital, a high number of unrecorded cases must be reckoned with because of an insufficient knowledge of emergency services and poor identification and documentation that make it impossible to classify acute situations under the diagnosis of malignant hyperthermia crisis. As a result, there are no statistical data in this field, and only case reports with a broad spectrum of suspected trigger mechanisms have been published. The case described in this report is a proved example of a non-anesthesia-related triggering of MH in a 21-year-old man who had had an anesthetic-induced MH manifestation in childhood, which was confirmed with an in vitro contracture test. After visiting a restaurant, he became unconscious and convulsive after consuming a high level of alcohol (2.9/1000). The first cardiocirculatory arrest occurred directly before hospitalization. After admission, the patient showed a full-blown MH episode whose subsequent fatality was unavoidable in spite of adapted and optimal therapy. Suspected trigger mechanisms seem to be multifactoral (excessive alcohol consumption, over-heating, mental stress) as a forensic investigation did not point to any particular signs of typical trigger substances. The case demonstrates again that an MH attack might be triggered under certain non-anaesthesia-related situations. For patients with an MH disposition, additional information on their behavior outside the hospital is required. PMID:9451492

  15. Assessment of Mass Fatality Preparedness and Response Content in Dental Hygiene Education.

    Science.gov (United States)

    Bruhn, Ann M; Newcomb, Tara L; Sheth-Chandra, Manasi

    2016-05-01

    When mass fatality incidents (MFIs) occur, they can quickly overwhelm local, state, and government agencies, resources, and personnel. It is important to have a rapid and effective response with skilled, multidisciplinary victim identification teams since specific skill sets are necessary to participate in mass fatality preparedness and response. The aims of this study were to determine the extent of formal education related to mass fatality preparedness and response training in U.S. dental hygiene programs and to assess program directors' perceptions of the need for such training. A 23-item cross-sectional survey was emailed to 319 U.S. dental hygiene programs in 2015. Survey questions addressed if the program offered mass fatality preparedness and response training to its students and how much training was given, as well as collecting respondents' demographics and opinions regarding education and training. An overall response rate of 36% was obtained, with 111 program chairs completing the survey. The results showed that only a small percentage of responding programs incorporated coursework related to mass fatality and preparedness in their curricula. Of the responding programs, 84% had no formal instruction on the role of a dental hygienist in MFIs; however, 53 of 69 program directors agreed or strongly agreed that the role of dental hygienists in MFIs should be covered in dental hygiene curricula. The top three barriers to incorporating such training reported by respondents were time requirements, lack of faculty expertise, and lack of equipment. Future research is needed to establish standardized competencies for mass fatality preparedness and response in dental hygiene education. PMID:27139212

  16. Relating traffic fatalities to GDP in Europe on the long term.

    Science.gov (United States)

    Antoniou, Constantinos; Yannis, George; Papadimitriou, Eleonora; Lassarre, Sylvain

    2016-07-01

    Modeling road safety development can provide important insight into policies for the reduction of traffic fatalities. In order to achieve this goal, both the quantifiable impact of specific parameters, as well as the underlying trends that cannot always be measured or observed, need to be considered. One of the key relationships in road safety links fatalities with risk and exposure, where exposure reflects the amount of travel, which in turn translates to how much travelers are exposed to risk. In general two economic variables: GDP and unemployment rate are selected to analyse the statistical relationships with some indicators of road accident fatality risk. The objective of this research is to provide an overview of relevant literature on the topic and outline some recent developments in macro-panel data analysis that have resulted in ongoing research that has the potential to improve our ability to forecast traffic fatality trends, especially under turbulent financial situations. For this analysis, time series of the number of fatalities and GDP in 30 European countries for a period of 38 years (1975-2012) are used. This process relies on estimating long-term models (as captured by long term time-series models, which model each country separately). Based on these developments, utilizing state-of-the-art modelling and analysis techniques such as the Common Correlated Effects Mean Group estimator (Pesaran), the long-term elasticity mean value equals 0.63, and is significantly different from zero for 10 countries only. When we take away the countries, where the number of fatalities is stationary, the average elasticity takes a higher value of nearly 1. This shows the strong sensitivity of the estimate of the average elasticity over a panel of European countries and underlines the necessity to be aware of the underlying nature of the time series, to get a suitable regression model. PMID:27042989

  17. Pulmonary embolism incidence and fatality trends in chinese hospitals from 1997 to 2008: a multicenter registration study.

    Directory of Open Access Journals (Sweden)

    Yuanhua Yang

    Full Text Available BACKGROUND: There has not been sufficient evidence to support the Asians being less susceptible to pulmonary embolism (PE than other ethnicities, because the prevalence of PE/deep venous thrombosis (DVT in different racial and ethnic groups has not been carefully studied until recently except in Caucasians. To test the hypothesis that the Chinese population has a lower risk for PE, this study comprehensively assessed the hospital-based incidence and case fatality rates for PE during the 1997-2008 in China. METHODS: A registration study of patients with suspected PE syndromes admitted to 60 level-3 hospitals involved in the National Cooperative Project for the Prevention and Treatment of Venous Thromboembolism (NCPPT was conducted from January 1997 to December 2008. The only exclusion criterion was an age of less than 18 years. Helical computed tomography scan, ventilation-perfusion lung scintigraphy or pulmonary angiography was carried out before or after hospitalization. All images were reviewed and evaluated independently by two specialists. RESULTS: A total of 18,206 patients were confirmed with PE from 16,972,182 hospital admissions. The annual incidence was 0.1% (95% CI: 0.1% to 0.2%. The overall incidence of PE in male patients (0.2%, 95% CI: 0.1% to 0.3% was higher than that in female patients (0.1% and 95% CI: 0.0% to 0.1%. An increasing incidence gradient for PE was noticed from Southern to Northern China. In addition, the case fatality rate was apparently decreasing: 25.1% (95% CI: 16.2% to 36.9% in 1997 to 8.7% (95% CI: 3.5% to 15.8% in 2008. CONCLUSIONS: Our findings suggest the relatively stable PE incidence and decreasing fatality trends in Chinese hospitals may be partially attributable to the implementation of the NCCPT and suggest the government should reevaluate the severity of PE so that health resources for the prevention, diagnosis and treatment of PE could be used to their fullest.

  18. The usability of green building rating systems in hot arid climates: A case study in Siwa, Egypt

    OpenAIRE

    Attia, Shady; Dabaieh, Marwa

    2013-01-01

    In the last ten years there has been a proliferation of regional building rating systems across the Middle East (ME). Most those emerging rating systems and labels emulate the British and American rating systems BREEAM and LEED that emerged in industrial countries context with an impact reduction paradigm. Thus they are neglecting the local historic, climatic, economic, technological, cultural and social context of the ME. This paper presents a case study of a recently constructed eco-lodge,...

  19. Suicide attempt with a mix of synthetic cannabinoids and synthetic cathinones: Case report of non-fatal intoxication with AB-CHMINACA, AB-FUBINACA, alpha-PHP, alpha-PVP and 4-CMC.

    Science.gov (United States)

    Klavž, Janez; Gorenjak, Maksimiljan; Marinšek, Martin

    2016-08-01

    We report on a case of intoxication with a mix of new psychoactive substances. A 38-year-old male was brought to the emergency department (ED) following the ingestion of an unknown drug in a suicide attempt. During the transport, he became progressively more somnolent and unresponsive to painful stimuli. Urine and stomach content were collected on admission to be screened for drugs of abuse and medicinal drugs. After admission, the patient's next of kin presented five small grip seal plastic bags containing different powders/crystals, and they were sent for analysis along with urine and stomach content to the toxicology laboratory. An easy and rapid sample preparation technique was applied for the extraction of urine and stomach content. Samples were extracted with liquid-liquid extraction (LLE) technique and analysed using gas chromatography-mass spectrometry (GC-MS). A small amount of powder material from the bags was diluted in methanol and injected directly into the GC-MS instrument. Obtained spectra (EI) were evaluated against SWGDRUG library. Five different designer drugs were identified in the powder material, including synthetic cannabinoids (AB-CHMINACA, AB-FUBINACA) and synthetic cathinones (alpha-PHP, alpha-PVP and 4-CMC). With the exception of 4-CMC, all of these substances were also detected in the stomach content along with the prescription drugs. This is the first time that a positive identification of these five drugs has been made by a clinical laboratory in Slovenia. PMID:26890319

  20. Monetary and exchange rate regimes changes: The cases of Poland, Czech Republic, Slovakia and Republic of Serbia

    Directory of Open Access Journals (Sweden)

    Josifidis Kosta

    2009-01-01

    Full Text Available The paper explores (former transition economies, Poland, Czech Republic, Slovakia and the Republic of Serbia, concerning abandonment of the exchange rate targeting and fixed exchange rate regimes and movement toward explicit/implicit inflation targeting and flexible exchange rate regimes. The paper identifies different subperiods concerning crucial monetary and exchange rate regimes, and tracks the changes of specific monetary transmission channels i.e. exchange rate channel, interest rate channel, indirect and direct influences to the exchange rate, with variance decomposition of VAR/VEC model. The empirical results indicate that Polish monetary strategy toward higher monetary and exchange rate flexibility has been performed smoothly, gradually and planned, compared to the Slovak and, especially, Czech case. The comparison of three former transition economies with the Serbian case indicate strong and persistent exchange rate pass-through, low interest rate pass-through, significant indirect and direct influence to the exchange rate as potential obstacles for successful inflation targeting in the Republic of Serbia.

  1. Inherent hazards, poor reporting and limited learning in the solid biomass energy sector: A case study of a wheel loader igniting wood dust, leading to fatal explosion at wood pellet manufacturer

    International Nuclear Information System (INIS)

    Large loaders are commonly used when handling solid biomass fuels. A preventable accident took place in 2010, where the malfunction of a front-end wheel loader led to a dust explosion which killed the driver and destroyed the building. The case offers an opportunity to examine the hazards of solid biomass, the accident investigation and any learning that subsequently took place. The paper argues that learning opportunities were missed repeatedly. Significant root causes were not identified; principles of inherent safety in design were ignored; the hazardous area classification was based on flawed reasoning; the ATEX assessment was inadequate as it dealt only with electrical installations, ignoring work operations; and powered industrial trucks had not been recognized as a source of ignition. Perhaps most importantly, guidelines for hazardous area classification for combustible dust are insufficiently developed and give ample room for potentially erroneous subjective individual judgment. It is a contributing factor that combustible dust, although with great hazard potential, is not classified as a dangerous substance. Accidents therefore fall outside the scope of systems designed to disseminate lessons learned and prevent future accidents. More attention to safety is needed for the renewable energy and environmentally friendly biomass pellet industry also to become sustainable from a worker safety perspective. - Highlights: • Wheel loader ignited wood dust, leading to flash fire and explosion. • ATEX assessment inadequate, dealing only with electrical installations. • Guidelines for ATEX zones for combustible dusts are insufficiently developed. • Facility exploded 2002, 2010, root causes not identified, no evidence of learning. • Future repeat explosion likely had facility not been closed down

  2. Two fatal tiger attacks in zoos.

    Science.gov (United States)

    Tantius, Britta; Wittschieber, Daniel; Schmidt, Sven; Rothschild, Markus A; Banaschak, Sibylle

    2016-01-01

    Two captive tiger attacks are presented that took place in Cologne and Münster zoos. Both attacks occurred when the handlers, intent on cleaning the enclosures, entered whilst the tigers accidently retained access to the location, and thus defended their territory against the perceived intruders. Both victims suffered fatal neck injuries from the bites. At Münster, colleagues managed to lure the tiger away from its victim to enable treatment, whilst the Cologne zoo tiger had to be shot in order to allow access to be gained. Whilst it was judged that human error led to the deaths of the experienced zookeepers, the investigation in Münster was closed as no third party was found to be at fault, whereas the Cologne zoo director was initially charged with being negligent. These charges were subsequently dismissed as safety regulations were found to be up to date. PMID:26115644

  3. Fatal accident caused by isoflurane abuse.

    Science.gov (United States)

    Pavlic, M; Haidekker, A; Grubwieser, P; Rabl, W

    2002-12-01

    A fatal accident after isoflurane abuse is presented in this report. A hospital employee was found dead in the operating area with a plastic bag over his head. In his locker an almost empty bottle of isoflurane was found. Autopsy revealed signs of asphyxiation and toxicological examination revealed nordazepam and isoflurane in non-toxic concentrations in the blood. Quantification of the anaesthetic was also carried out in urine, gastric contents, liver, kidney and brain samples, and in addition, oxazepam, prothipendyl and metabolites of midazolam and prothipendyl were found in the urine. Although the drug problems of the deceased were known before, no efforts had been made to restrict access to these drugs. PMID:12596784

  4. Fatal exit the automotive black box debate

    CERN Document Server

    Kowalick, Tom

    2005-01-01

    "Fatal Exit: The Automotive Black Box Debate cuts through thirty years of political wrangling and institutional biases to provide an argument for the Motor Vehicle Event Data Recorder (MVEDR). This automotive equivalent of an airplane's flight recorder or black box is intended to solve the mysteries of car crashes and improve the safety of our roads. The reader is taken inside the automotive industry and the government highway safety establishment to foster an understanding of the politics and the positions on all sides of this safety debate. The author takes an unbiased approach, chronologically presenting each argument and uncovering the agendas and mandates of each of the stakeholders." "This publication is essential reading for all consumers who need to have their voices heard on this critical issue, as well as for attorneys, public safety advocates, public policy administrators, engineers, automotive professionals, journalists, and insurance executives."--Jacket.

  5. Cyclic vomiting syndrome masking a fatal metabolic disease.

    LENUS (Irish Health Repository)

    Fitzgerald, Marianne

    2013-05-01

    Disorders of fatty acid oxidation are rare but can be fatal. Hypoglycaemia with acidosis is a cardinal feature. Cases may present during early childhood or can be delayed into adolescence or beyond. We present a case of multiple acyl-coenzyme A dehydrogenase deficiency (MADD), an extremely rare disorder of fatty acid oxidation. Our 20-year-old patient presented with cardiovascular collapse, raised anion gap metabolic acidosis and non-ketotic hypoglycaemia. She subsequently developed multi-organ failure and sadly died. She had a previous diagnosis of cyclic vomiting syndrome (CVS) for more than 10 years, warranting frequent hospital admissions. The association between CVS and MADD has been made before though the exact relationship is unclear. All patients with persistent severe CVS should have metabolic investigations to exclude disorders of fatty acid oxidation. In case of non-ketotic hypoglycaemia with acidosis, the patient should be urgently referred to a specialist in metabolic diseases. All practitioners should be aware of these rare disorders as a cause of unexplained acidosis.

  6. Time-dependent first flight leakage rates for the general case of a two-region spherical medium

    International Nuclear Information System (INIS)

    Closed form analytical expressions for the time-dependent first-flight leakage rates for the general case of a two-region spherical medium have been obtained using elementary functions. Two cases were considered both for δ-distribution intime and isotropic source emission. The first case has a spatially uniform distributed source in the outer shell region. This result complements previous time-dependent solutions. The second case has a spatially uniform distributed source in the inner central region. This result has applications to spherical deuterium-tritium inertial confinement fusion targets. (Author)

  7. Ultrastructural pathology of Creutzfeldt-Jakob disease and fatal familial insomnia.

    Science.gov (United States)

    Liberski, P P; Giraud, P; Kopp, N

    2000-01-01

    In this study we examined well fixed brain biopsies of 9 sporadic CJD, 9 iatrogenic CJD cases, 2 hereditary CJD (Gly200Lys and Val203Iso), a case of vCJD and a case of fatal familial insomnia (FFI) from a new French family collected over the years at the Service de Neuropathologie, Hopital Neurologique, Lyon, France. Tubulovesicular structures (TVS) were found in every case including FFI and nvCJD. Thus, TVS, as we suggested previously are important pathologic structure which significance should be more extensively studied. PMID:11693721

  8. Fitting the Stocking Rate with Pastoral Resources to Manage and Preserve Mediterranean Forestlands: A Case Study

    Directory of Open Access Journals (Sweden)

    Elisa Bianchetto

    2015-06-01

    Full Text Available Pasture practices have affected Mediterranean forest ecosystems for millennia, and they are still quite widespread in mountainous areas. Nevertheless, in the last decades, the stability of forest ecosystems has been jeopardized due to the abandonment of traditional agro-pastoral practices, so that the gradual reduction of open areas due to progressive succession processes has caused a high increase of grazing pressure by livestock and wild ungulates feeding on forest areas. This paper aims at showing a methodological approach for evaluating the effect of applying measures in order to improve the grazing value of grasslands and ecotonal patches and lower the grazing impact on native woodlands. A protected area in Sicily (Italy is considered as a representative case study. The analysis of remotely sensed imagery and several field surveys enabled to identify and map six different land use units subject to grazing, i.e., (1 forests; (2 grasslands (pastures dominated by palatable herbs and grasses; (3 overgrazed grasslands (dominated by poisonous and/or thorny herbs and forbs, not palatable; (4 encroached pastures; (5 roadside firebreaks (dominated by palatable herbs with no shrubs; and (6 wooded/ encroached roadside firebreaks. Several data were collected through sample plots selected within each land use unit, in order to assess their pastoral value. These data have been used to define current and optimal animal stock rates aiming at addressing pasture management planning towards a sustainable use of forestland and shrubland.

  9. IgA-dominant post-infectious glomerulonephritis presenting as a fatal pulmonary-renal syndrome

    Directory of Open Access Journals (Sweden)

    Saad M

    2015-08-01

    Full Text Available Marc Saad,1 Magda Daoud,1 Patricia Nasr,1 Rafeel Syed,2 Suzanne El-Sayegh2 1Department of Medicine, 2Department of Nephrology, Staten Island University Hospital, Staten Island, NY, USA Abstract: Over the last decades, post-infectious glomerulonephritis underwent major changes in its epidemiology, pathophysiology, and outcomes. We are reporting a case of IgA-dominant post-infectious glomerulonephritis (IgA-PIGN presenting as a fatal pulmonary-renal syndrome. An 86-year-old Filipino man presented with worsening dyspnea, hemoptysis, and decreased urine output over 2 weeks. Past medical history is significant for hypertension, chronic kidney disease stage III, and pneumonia 3 weeks prior treated with intravenous cefazolin for methicillin-sensitive Staphylococcus aureus bacteremia. Physical examination was remarkable for heart rate of 109/min and respiratory rate of 25/min saturating 99% on 3 liters via nasal cannula. There were bibasilar rales in the lungs and bilateral ankle edema. A chest radiograph showed bibasilar opacifications. Blood work was significant for hemoglobin of 8.3 g/dL and creatinine of 9.2 mg/dL (baseline of 1.67. TTE showed EF 55%. Urinalysis revealed large blood and red blood cell casts. Kidney ultrasound showed bilateral echogenicity compatible with renal disease. Pulse methylprednisolone therapy and hemodialysis were initiated with patient's condition precluding kidney biopsy. Serology workup for rapidly progressive glomerulonephritis was negative. On day 7, the patient required mechanical ventilation; bronchoscopy showed alveolar hemorrhage and plasmapheresis was initiated. Renal biopsy revealed IgA-PIGN with endocapillary and focal extracapillary proliferative and exudative features. IgA-PIGN occurs in diabetic elderly (mean age of 60 years, 0–16 weeks after an infection mainly by Staphylococcus. However, this nondiabetic patient had normal complement IgA-PIGN with fatal pulmonary-renal syndrome. Understanding the

  10. Xeroderma pigmentosum (case report

    Directory of Open Access Journals (Sweden)

    Dubey Arvind

    1990-01-01

    Full Text Available Xeroderma pigmentosum is a rare, hereditary and fatal disease of the skin. Ocular involvement is known to occur in 80% of cases. A case with typical cutaneous and ocular lesions is reported.

  11. Injury typology of fatal motorcycle collisions with roadside barriers in Australia and New Zealand.

    Science.gov (United States)

    Bambach, M R; Grzebieta, R H; McIntosh, A S

    2012-11-01

    Motorcyclists contribute significantly to road trauma around the world through the high incidence of serious injuries and fatalities. The role of roadside safety barriers in such trauma is an area of growing concern amongst motorcyclists, road authorities and road safety researchers and advocates. This paper presents a case series analysis of motorcyclists that were fatally injured following a collision with a roadside barrier during the period 2001-2006 in Australia and New Zealand. Injury profiles and severities are detailed, and associations with crash characteristics are investigated. It is shown that the thorax region had the highest incidence of injury and the highest incidence of maximum injury in fatal motorcycle-barrier crashes, followed by the head region. This is in contrast to fatal motorcycle crashes in all single- and multi-vehicle crash modes, where head injury predominates. The injury profiles of motorcyclists that slid into barriers and those that collided with barriers in the upright posture were similar. However, those that slid in were more likely to receive thorax and pelvis injuries. PMID:23036403

  12. News reports of bullying-related fatal and nonfatal injuries in the Americas.

    Science.gov (United States)

    Srabstein, Jorge Carlos

    2013-05-01

    Bullying is a multifaceted and injurious form of maltreatment, prevalent across social settings and around the globe. Victims and perpetrators of bullying are at significant risk of suffering from an array of morbidity and dying young due to accidental injuries, suicide, and homicide. This study reviews news reports of nonfatal and fatal injuries linked to bullying throughout the Western Hemisphere during 12 months. News reports, obtained through a Google search, of episodes of fatal and nonfatal injuries related to school bullying and violence from July 2011 through June 2012 that affected children and adolescents (ages 5 to 19 years) throughout the Americas were analyzed. News reports were found of 82 cases of bullying-related fatal and nonfatal injuries, occurring in one year, across 24 countries and dependent territories in the Western Hemisphere, which have a combined total youth population of 225.5 million children and adolescents ages 5 to 19 years. Ninety-seven percent of the victims were between 10 and 19 years old; 60% of them were below age 15, with a male/female ratio of 2:1. News reports of fatal and nonfatal injurious events related to bullying and affecting children and adolescents in the Americas in one year represent the tip of the public health iceberg composing the unknown magnitude of injuries associated with this type of maltreatment. Data on the magnitude of mortality linked to bullying, which would be of the essence in developing public health policies for its prevention, have not been documented. PMID:23764670

  13. Pre-symptomatic diagnosis in fatal familial insomnia: serial neurophysiological and 18FDG-PET studies.

    Science.gov (United States)

    Cortelli, Pietro; Perani, Daniela; Montagna, Pasquale; Gallassi, Roberto; Tinuper, Paolo; Provini, Federica; Federica, Provini; Avoni, Patrizia; Ferrillo, Franco; Anchisi, Davide; Moresco, Rosa Maria; Fazio, Ferruccio; Parchi, Piero; Baruzzi, Agostino; Lugaresi, Elio; Gambetti, Pierluigi

    2006-03-01

    Knowing how and when the degenerative process starts is important in neurodegenerative diseases. We have addressed this issue in fatal familial insomnia (FFI) measuring the cerebral metabolic rate of glucose (CMRglc) with 2-[18F]fluoro-2-deoxy-D-glucose PET in parallel with detailed clinical, neuropsychological examinations and polysomnography with EEG spectral analyses. Nine asymptomatic carriers of the D178N mutation, 10 non-carriers belonging to the same family, and 19 age-matched controls were studied over several years. The CMRglc as well as clinical and electrophysiological examinations were normal in all cases at the beginning of the study. Four of the mutation carriers developed typical FFI during the study but CMRglc and the clinical and electrophysiological examinations remained normal 63, 56, 32 and 21 months, respectively before disease onset. The carrier whose tests were normal 32 months before disease onset was re-examined 13 months before the onset. At that time, selective hypometabolism was detected in the thalamus while spectral-EEG analysis disclosed an impaired thalamic sleep spindle formation. Following clinical disease onset, CRMglc was reduced in the thalamus in all 3 patients examined. Our data indicate that the neurodegenerative process associated with FFI begins in the thalamus between 13 and 21 months before the clinical presentation of the disease. PMID:16399807

  14. A test case of the deformation rate analysis (DRA) stress measurement method

    Energy Technology Data Exchange (ETDEWEB)

    Dight, P.; Hsieh, A. [Australian Centre for Geomechanics, Univ. of WA, Crawley (Australia); Johansson, E. [Saanio and Riekkola Oy, Helsinki (Finland); Hudson, J.A. [Rock Engineering Consultants (United Kingdom); Kemppainen, K.

    2012-01-15

    As part of Posiva's site and ONKALO investigations, the in situ rock stress has been measured by a variety of techniques, including hydraulic fracturing, overcoring, and convergence measurements. All these techniques involve direct measurements in a drillhole or at the rock surface. An alternative method is to test drillhole core in a way that enables estimation of the magnitudes and orientations of the in situ rock stress. The Kaiser Effect (KE) and Deformation Rate Analysis (DRA) are two ways to do this. In the work reported here, a 'blind' DRA test was conducted on core obtained from the POSE (Posiva's Olkiluoto Spalling Experiment) niche in the ONKALO. The term 'blind' means that the two first authors of this report, who conducted the tests at the Australian Centre for Geomechanics, did not know the depths below surface at which the cores had been obtained. The results of this DRA Test Case are presented, together with an explanation of the DRA procedure. Also, additional information that would help in such DRA testing and associated analysis is explained. One of the problems in comparing the DRA results with the known Olkiluoto stress field is that the latter is highly variable across the site, as experienced by the previous in situ stress measurements and as predicted by numerical analysis. The variability is mainly caused by the presence of the large brittle deformation zones which perturb the local stress state. However, this variability reduces with depth and the stress field becomes more stable at the {approx} 350 m at which the drillhole cores were obtained. Another compounding difficulty is that the stress quantity, being a second order tensor, requires six independent components for its specification. In other words, comparison of the DRA results and the known stress field requires comparison of six different quantities. In terms of the major principal stress orientation, the DRA results predict an orientation completely

  15. Exercise Testing Induces Fatal Thromboembolism: from Mechanical Mitral Valve

    OpenAIRE

    Yavuzgil, Oguz; Ozerkan, Filiz; Gurgun, Cemil; Zoghi, Mehdi; Can, Levent.; AKIN, Mustafa

    2002-01-01

    Thromboembolism is still one of the most important complications of prosthetic heart valves. Embolism to a major coronary branch is rare, but acute proximal occlusions can be fatal, even when the coronary arteries are otherwise normal and intervention is rapid. We report a fatal complication of an exercise test in a patient who had a St. Jude bileaflet mitral valve.

  16. Estimating wind-turbine-caused bird and bat fatality when zero carcasses are observed

    Science.gov (United States)

    Huso, Manuela M.P.; Dalthorp, Daniel; Dail, David; Madsen, Lisa

    2015-01-01

    Many wind-power facilities in the United States have established effective monitoring programs to determine turbine-caused fatality rates of birds and bats, but estimating the number of fatalities of rare species poses special difficulties. The loss of even small numbers of individuals may adversely affect fragile populations, but typically, few (if any) carcasses are observed during monitoring. If monitoring design results in only a small proportion of carcasses detected, then finding zero carcasses may give little assurance that the number of actual fatalities is small. Fatality monitoring at wind-power facilities commonly involves conducting experiments to estimate the probability (g) an individual will be observed, accounting for the possibilities that it falls in an unsearched area, is scavenged prior to detection, or remains undetected even when present. When g  ~0.45. Further, we develop extensions for temporal replication that can inform prior distributions of M and methods for combining information across several areas or time periods. We apply the method to data collected at a wind-power facility where scheduled searches yielded X = 0 raptor carcasses

  17. Estimating wind-turbine-caused bird and bat fatality when zero carcasses are observed.

    Science.gov (United States)

    Huso, Manuela M P; Dalthorp, Dan; Dail, David; Madsen, Lisa

    2015-07-01

    Many wind-power facilities in the United States have established effective monitoring programs to determine turbine-caused fatality rates of birds and bats, but estimating the number of fatalities of rare species poses special difficulties. The loss of even small numbers of individuals may adversely affect fragile populations, but typically, few (if any) carcasses are observed during monitoring. If monitoring design results in only a small proportion of carcasses detected, then finding zero carcasses may give little assurance that the number of actual fatalities is small. Fatality monitoring at wind-power facilities commonly involves conducting experiments to estimate the probability (g) an individual will be observed, accounting for the possibilities that it falls in an unsearched area, is scavenged prior to detection, or remains undetected even when present. When g -0.45. Further, we develop extensions for temporal replication that can inform prior distributions of M and methods for combining information across several areas or time periods. We apply the method to data collected at a wind-power facility where scheduled searches yielded X = 0 raptor carcasses. PMID:26485950

  18. Potentially fatal haemobilia due to inappropriate use of an expanding biliary stent

    Institute of Scientific and Technical Information of China (English)

    Rakesh Rai; John Rose; Derek Manas

    2003-01-01

    AIM: To highlight the fatal complication caused by expanding biliary stents and the importance of avoiding use of expanding stent in potentially curable diseases.METHODS: Arteriobiliary fistula is an uncommon cause of haemobilia. We describe a case of right hepatic artery pseudoaneurysm causing arteriobiliary fistula and presenting as severe malena and cholangitis, in a patient with a mesh metal biliary stent. The patient had lymphoma causing bile duct obstruction.RESULTS: Gastroduodenoscopy failed to establish the exact source of bleeding and hepatic artery angiography and selective embolisation of the pseudo aneurysm successfully controlled the bleeding.CONCLUSION: Bleeding from the pseudo aneurysm of the hepatic artery can be fatal. Mesh metal stents in biliary tree can cause this complication as demonstrated in this case.So mesh metal stent insertion should be avoided in potentially benign or in curable conditions. Difficulty in diagnosis and management is discussed along with the review of the literature.

  19. Case study regarding local revenue collection rate in Romania between 2008-2013

    OpenAIRE

    Paul Vasile Zai

    2015-01-01

    This article is trying to present local revenues collection rate in Romania between 2008-2013. It is treating local revenues collection rate from Romania at national, regional, county and local level. The highest local revenues collection rate was 85, 38% in 2013 and the lowest collection rate was 80, 23% in 2009. The average of the collection rate in urban area was 81, 69% and 81, 68%. NV Region has the best collection rate and S Region the lowest. From all 3228 local authorities Mintiu Gher...

  20. Case study regarding local revenue collection rate in Romania between 2008-2013

    OpenAIRE

    Zai Paul Vasile

    2015-01-01

    This article is trying to present local revenues collection rate in Romania between 2008-2013. It is treating local revenues collection rate from Romania at national, regional, county and local level. The highest local revenues collection rate was 85,38% in 2013 and the lowest collection rate was 80,23% in 2009. The average of the collection rate in urban area was 81,69% and 81,68%. NV Region has the best collection rate and S Region the lowest. From all 3228 local authorities Mintiu Gherlii...