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Sample records for death reporting system

  1. National Violent Death Reporting System (NVDRS)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Violent Death Reporting System (NVDRS) provides states and communities with a clearer understanding of violent deaths to guide local decisions about...

  2. Surveillance for Violent Deaths - National Violent Death Reporting System, 17 States, 2013.

    Science.gov (United States)

    Lyons, Bridget H; Fowler, Katherine A; Jack, Shane P D; Betz, Carter J; Blair, Janet M

    2016-08-19

    In 2013, more than 57,000 persons died in the United States as a result of violence-related injuries. This report summarizes data from CDC's National Violent Death Reporting System (NVDRS) regarding violent deaths from 17 U.S. states for 2013. Results are reported by sex, age group, race/ethnicity, marital status, location of injury, method of injury, circumstances of injury, and other selected characteristics. 2013. NVDRS collects data from participating states regarding violent deaths obtained from death certificates, coroner/medical examiner reports, law enforcement reports, and secondary sources (e.g., child fatality review team data, supplemental homicide reports, hospital data, and crime laboratory data). This report includes data from 17 states that collected statewide data for 2013 (Alaska, Colorado, Georgia, Kentucky, Maryland, Massachusetts, North Carolina, New Jersey, New Mexico, Ohio, Oklahoma, Oregon, Rhode Island, South Carolina, Utah, Virginia, and Wisconsin). NVDRS collates documents for each death and links deaths that are related (e.g., multiple homicides, a homicide followed by a suicide, or multiple suicides) from a single incident. For 2013, a total of 18,765 fatal incidents involving 19,251 deaths were captured by NVDRS in the 17 states included in this report. The majority (66.2%) of deaths were suicides, followed by homicides (23.2%), deaths of undetermined intent (8.8%), deaths involving legal intervention (1.2%) (i.e., deaths caused by law enforcement and other persons with legal authority to use deadly force, excluding legal executions), and unintentional firearm deaths (Revision [ICD-10] and does not denote the lawfulness or legality of the circumstances surrounding a death caused by law enforcement.) Suicides occurred at higher rates among males, non-Hispanic whites, American Indian/Alaska Natives, persons aged 45-64 years, and males aged ≥75 years. Suicides were preceded primarily by a mental health, intimate partner, or physical

  3. Homicides by Police: Comparing Counts From the National Violent Death Reporting System, Vital Statistics, and Supplementary Homicide Reports.

    Science.gov (United States)

    Barber, Catherine; Azrael, Deborah; Cohen, Amy; Miller, Matthew; Thymes, Deonza; Wang, David Enze; Hemenway, David

    2016-05-01

    To evaluate the National Violent Death Reporting System (NVDRS) as a surveillance system for homicides by law enforcement officers. We assessed sensitivity and positive predictive value of the NVDRS "type of death" variable against our study count of homicides by police, which we derived from NVDRS coded and narrative data for states participating in NVDRS 2005 to 2012. We compared state counts of police homicides from NVDRS, Vital Statistics, and Federal Bureau of Investigation Supplementary Homicide Reports. We identified 1552 police homicides in the 16 states. Positive predictive value and sensitivity of the NVDRS "type of death" variable for police homicides were high (98% and 90%, respectively). Counts from Vital Statistics and Supplementary Homicide Reports were 58% and 48%, respectively, of our study total; gaps varied widely by state. The annual rate of police homicide (0.24/100,000) varied 5-fold by state and 8-fold by race/ethnicity. NVDRS provides more complete data on police homicides than do existing systems. Expanding NVDRS to all 50 states and making 2 improvements we identify will be an efficient way to provide the nation with more accurate, detailed data on homicides by law enforcement.

  4. Child Maltreatment Fatalities in Children under 5: Findings from the National Violence Death Reporting System

    Science.gov (United States)

    Klevens, Joanne; Leeb, Rebecca T.

    2010-01-01

    Objective: To describe the distribution of child maltreatment fatalities of children under 5 by age, sex, race/ethnicity, type of maltreatment, and relationship to alleged perpetrator using data from the National Violent Death Reporting System (NVDRS). Study design: Two independent coders reviewed information from death certificates, medical…

  5. Occupational Homicides of Law Enforcement Officers, 2003-2013: Data From the National Violent Death Reporting System.

    Science.gov (United States)

    Blair, Janet M; Fowler, Katherine A; Betz, Carter J; Baumgardner, Jason L

    2016-11-01

    Law enforcement officers (LEOs) in the U.S. are at an increased risk for homicide. The purpose of this study is to describe the characteristics of homicides of LEOs in 17 U.S. states participating in the National Violent Death Reporting System. This active surveillance system uses data from death certificates, coroner/medical examiner reports, and law enforcement reports. This study used quantitative and qualitative methods to analyze National Violent Death Reporting System data for 2003-2013. Deaths of LEOs feloniously killed in the line of duty were selected for analysis. LEO homicides and the circumstances preceding or occurring during the incident were characterized. Analyses were conducted October 2015-June 2016. A total of 128 officer homicides from 121 incidents were identified. Most (93.7%) LEO victims were male, 60.9% were aged 30-49 years (average age, 40.9 years). Approximately 21.9% of LEOs were killed during an ambush, and 19.5% were killed during traffic stops or pursuits. Of the 14.1% of LEOs killed responding to domestic disturbances, most disturbances were intimate partner violence related. More than half (57.0%) of homicides were precipitated by another crime, and of these, 71.2% involved crimes in progress. Most suspects were male. Ninety-one percent of homicides of LEOs were committed with a firearm. This information is critical to help describe encounter situations faced by LEOs. The results of this study can be used to help educate and train LEOs on hazards, inform prevention efforts designed to promote LEO safety, and prevent homicide among this population. Published by Elsevier Inc.

  6. Mortality and cause-of-death reporting and analysis systems in seven pacific island countries

    Directory of Open Access Journals (Sweden)

    Carter Karen L

    2012-06-01

    Full Text Available Abstract Background Mortality statistics are essential for population health assessment. Despite limitations in data availability, Pacific Island Countries are considered to be in epidemiological transition, with non-communicable diseases increasingly contributing to premature adult mortality. To address rapidly changing health profiles, countries would require mortality statistics from routine death registration given their relatively small population sizes. Methods This paper uses a standard analytical framework to examine death registration systems in Fiji, Kiribati, Nauru, Palau, Solomon Islands, Tonga and Vanuatu. Results In all countries, legislation on death registration exists but does not necessarily reflect current practices. Health departments carry the bulk of responsibility for civil registration functions. Medical cause-of-death certificates are completed for at least hospital deaths in all countries. Overall, significantly more information is available than perceived or used. Use is primarily limited by poor understanding, lack of coordination, limited analytical skills, and insufficient technical resources. Conclusion Across the region, both registration and statistics systems need strengthening to improve the availability, completeness, and quality of data. Close interaction between health staff and local communities provides a good foundation for further improvements in death reporting. System strengthening activities must include a focus on clear assignment of responsibility, provision of appropriate authority to perform assigned tasks, and fostering ownership of processes and data to ensure sustained improvements. These human elements need to be embedded in a culture of data sharing and use. Lessons from this multi-country exercise would be applicable in other regions afflicted with similar issues of availability and quality of vital statistics.

  7. Discordance in investigator-reported and adjudicated sudden death in TIOSPIR

    Directory of Open Access Journals (Sweden)

    Robert A. Wise

    2017-03-01

    Full Text Available Accurate and consistent determination of cause of death is challenging in chronic obstructive pulmonary disease (COPD patients. TIOSPIR (N=17 135 compared the safety and efficacy of tiotropium Respimat 5/2.5 µg with HandiHaler 18 µg in COPD patients. All-cause mortality was a primary end-point. A mortality adjudication committee (MAC assessed all deaths. We aimed to investigate causes of discordance in investigator-reported and MAC-adjudicated causes of death and their impact on results, especially cardiac and sudden death. The MAC provided independent, blinded assessment of investigator-reported deaths (n=1302 and assigned underlying cause of death. Discordance between causes of death was assessed descriptively (shift tables. There was agreement between investigator-reported and MAC-adjudicated deaths in 69.4% of cases at the system organ class level. Differences were mainly observed for cardiac deaths (16.4% investigator, 5.1% MAC and deaths assigned to general disorders including sudden death (17.4% investigator, 24.6% MAC. Reasons for discrepancies included investigator attribution to the immediate (e.g. myocardial infarction (MI over the underlying cause of death (e.g. COPD and insufficient information for a definitive cause. Cause-specific mortality varies in COPD, depending on the method of assignment. Sudden death, witnessed and unwitnessed, is common in COPD and often attributed to MI without supporting evidence.

  8. Reporting Fatal Neglect in Child Death Review.

    Science.gov (United States)

    Scott, Debbie

    2018-01-01

    Child death reviews are conducted with the aim of preventing child deaths however, definitions, inclusion criteria for the review of child deaths and reporting practices vary across Child Death Review Teams (CDRTs). This article aims to identify a common context and understanding of fatal neglect reporting by reviewing definitional issues of fatal neglect and comparing reporting practice across a number of CDRTs. Providing a consistent context for identifying and reporting neglect-related deaths may improve the understanding of the impact of fatal neglect and the risk factors associated with it and therefore, improve the potential of CDRT review to inform prevention programs, policies, and procedures.

  9. 22 CFR 72.6 - Report of presumptive death.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Report of presumptive death. 72.6 Section 72.6... DEATHS AND ESTATES Reporting Deaths of United States Nationals § 72.6 Report of presumptive death. (a) Local finding. When there is a local finding of presumptive death by a competent local authority, a...

  10. 22 CFR 72.5 - Final report of death.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Final report of death. 72.5 Section 72.5... DEATHS AND ESTATES Reporting Deaths of United States Nationals § 72.5 Final report of death. (a) Preparation. Except in the case of the death of an active duty member of the United States Armed Forces, when...

  11. Improving hospital death certification in Viet Nam: results of a pilot study implementing an adapted WHO hospital death report form in two national hospitals.

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    Walton, Merrilyn; Harrison, Reema; Chevalier, Anna; Esguerra, Esmond; Van Duong, Dang; Chinh, Nguyen Duc; Giang, Huong

    2016-01-01

    Viet Nam does not have a system for the national collection of death data that meets international requirements for mortality reporting. It is identified as a 'no-report' country by the WHO. Verbal autopsy reports are used in the community but exclude deaths in hospitals. This project was undertaken in Bach Mai National General Hospital and Viet Duc Surgical and Trauma Hospital in Viet Nam from 1 March 2013 to 31 March 2015. In phase 1, a modified hospital death report form, consistent with the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, was developed. Small group training in use of the report form was delivered to 427 doctors. In phase two, death data were collected, collated and analysed. In phase three, a random sample (7%) of all report forms was checked for accuracy and completeness against medical records. During the 23 months of the study, 3956 deaths were recorded. Across both hospitals, 222 distinct causes of deaths were recorded. Traumatic cerebral oedema was the immediate cause of death (15% of cases, 575/3956 patients), followed by septic shock (13%, 528/3956), brain compression (11%, 416/3956), intracerebral haemorrhage (8%, 336/3956) and pneumonia (5%, 186/3956); 67% (2639/3956) of patients were discharged home to die and 33% (1314/3956) of deaths were due to a road traffic accident, or injury at home or at work. This study confirms the viability of implementing a death report form system compliant with international standards in hospitals in Viet Nam and provides the foundation for introducing a national death report form scheme. These data are critical to comprehensive knowledge of causes of death in Viet Nam. Death data about patients discharged home to die is presented for the first time, with implications for countries where this is a cultural preference.

  12. Mining for Murder-Suicide: An Approach to Identifying Cases of Murder-Suicide in the National Violent Death Reporting System Restricted Access Database.

    Science.gov (United States)

    McNally, Matthew R; Patton, Christina L; Fremouw, William J

    2016-01-01

    The National Violent Death Reporting System (NVDRS) is a United States Centers for Disease Control and Prevention (CDC) database of violent deaths from 2003 to the present. The NVDRS collects information from 32 states on several types of violent deaths, including suicides, homicides, homicides followed by suicides, and deaths resulting from child maltreatment or intimate partner violence, as well as legal intervention and accidental firearm deaths. Despite the availability of data from police narratives, medical examiner reports, and other sources, reliably finding the cases of murder-suicide in the NVDRS has proven problematic due to the lack of a unique code for murder-suicide incidents and outdated descriptions of case-finding procedures from previous researchers. By providing a description of the methods used to access to the NVDRS and coding procedures used to decipher these data, the authors seek to assist future researchers in correctly identifying cases of murder-suicide deaths while avoiding false positives. © 2015 American Academy of Forensic Sciences.

  13. Cause-specific mortality among children and young adults with epilepsy: Results from the U.S. National Child Death Review Case Reporting System.

    Science.gov (United States)

    Tian, Niu; Shaw, Esther C; Zack, Matthew; Kobau, Rosemarie; Dykstra, Heather; Covington, Theresa M

    2015-04-01

    We investigated causes of death in children and young adults with epilepsy by using data from the U.S. National Child Death Review Case Reporting System (NCDR-CRS), a passive surveillance system composed of comprehensive information related to deaths reviewed by local child death review teams. Information on a total of 48,697 deaths in children and young adults 28days to 24years of age, including 551 deaths with epilepsy and 48,146 deaths without epilepsy, was collected from 2004 through 2012 in 32 states. In a proportionate mortality analysis by official manner of death, decedents with epilepsy had a significantly higher percentage of natural deaths but significantly lower percentages of deaths due to accidents, homicide, and undetermined causes compared with persons without epilepsy. With respect to underlying causes of death, decedents with epilepsy had significantly higher percentages of deaths due to drowning and most medical conditions including pneumonia and congenital anomalies but lower percentages of deaths due to asphyxia, weapon use, and unknown causes compared with decedents without epilepsy. The increased percentages of deaths due to pneumonia and drowning in children and young adults with epilepsy suggest preventive interventions including immunization and better instruction and monitoring before or during swimming. State-specific and national population-based mortality studies of children and young adults with epilepsy are recommended. Published by Elsevier Inc.

  14. Cause-specific mortality among children and young adults with epilepsy: Results from the U.S. National Child Death Review Case Reporting System

    Science.gov (United States)

    Tian, Niu; Shaw, Esther C.; Zack, Matthew; Kobau, Rosemarie; Dykstra, Heather; Covington, Theresa M.

    2015-01-01

    We investigated causes of death in children and young adults with epilepsy by using data from the U.S. National Child Death Review Case Reporting System (NCDR-CRS), a passive surveillance system composed of comprehensive information related to deaths reviewed by local child death review teams. Information on a total of 48,697 deaths in children and young adults 28 days to 24 years of age, including 551 deaths with epilepsy and 48,146 deaths without epilepsy, was collected from 2004 through 2012 in 32 states. In a proportionate mortality analysis by official manner of death, decedents with epilepsy had a significantly higher percentage of natural deaths but significantly lower percentages of deaths due to accidents, homicide, and undetermined causes compared with persons without epilepsy. With respect to underlying causes of death, decedents with epilepsy had significantly higher percentages of deaths due to drowning and most medical conditions including pneumonia and congenital anomalies but lower percentages of deaths due to asphyxia, weapon use, and unknown causes compared with decedents without epilepsy. The increased percentages of deaths due to pneumonia and drowning in children and young adults with epilepsy suggest preventive interventions including immunization and better instruction and monitoring before or during swimming. State-specific and national population-based mortality studies of children and young adults with epilepsy are recommended. PMID:25794682

  15. Fire deaths in aircraft without the crashworthy fuel system.

    Science.gov (United States)

    Springate, C S; McMeekin, R R; Ruehle, C J

    1989-10-01

    Cases reported to the Armed Forces Institute of Pathology were examined for occupants of helicopters without the crashworthy fuel system (CWFS) who survived crashes but died as a result of postcrash fires. There were 16 fire deaths in the 9 such accidents which occurred between January 1976 and April 1984. All of these victims would have survived if there had been no postcrash fire. Partial body destruction by fire probably prevented inclusion of many other cases. The dramatic reduction in fire deaths and injuries due to installation of the CWFS in Army helicopters is discussed. The author concludes that fire deaths and injuries in aircraft accidents could almost be eliminated by fitting current and future aircraft with the CWFS.

  16. Doctor as criminal: reporting of patient deaths to the police and criminal prosecution of healthcare providers in Japan

    Science.gov (United States)

    2010-01-01

    Background In Japan, medical error leading to patient death is often handled through the criminal rather than civil justice system. However, the number of cases handled through the criminal system and how this has changed in recent years has not previously been described. Our aim was to determine the trend in reports of patient death to the police and the trend in the resulting prosecution of healthcare providers for medical error leading to patient death from 1998 to 2008. Methods We collected data regarding the number of police reports of patient death made by physicians, next-of-kin, and other sources between 1998 and 2008. We also collected data regarding the number of resulting criminal prosecutions of healthcare providers between 1998 and 2008. Reporting and prosecution trends were analyzed using annual linear regression models. Results Reports: The number physician reports of patient deaths to the police increased significantly during the study period (slope 18.68, R2 = 0.78, P deaths to the police by physicians increased significantly from 1998 to 2008 while those made by next-of-kin and others did not. The resulting criminal prosecutions of healthcare providers increased significantly during the same time period. The reasons for these increases are unclear and should be the focus of future research. PMID:20187954

  17. Recommendations for saving mothers' lives in Japan: Report from the Maternal Death Exploratory Committee (2010-2014).

    Science.gov (United States)

    Hasegawa, Junichi; Ikeda, Tomoaki; Sekizawa, Akihiko; Tanaka, Hiroaki; Nakamura, Masamitsu; Katsuragi, Shinji; Osato, Kazuhiro; Tanaka, Kayo; Murakoshi, Takeshi; Nakata, Masahiko; Ishiwata, Isamu

    2016-12-01

    To make recommendations for saving mothers' lives, issues related to maternal deaths including diseases, causes, treatments, and hospital and regional systems are analyzed by the Maternal Death Exploratory Committee in Japan. In this report, we present ten clinical important recommendations based on the analysis of maternal deaths between 2010 and 2014 in Japan. © 2016 Japan Society of Obstetrics and Gynecology.

  18. [Study on smoking-attributed mortality by using all causes of death surveillance system in Tianjin].

    Science.gov (United States)

    Jiang, Guohong; Zhang, Hui; Li, Wei; Wang, Dezheng; Xu, Zhongliang; Song, Guide; Zhang, Ying; Shen, Chengfeng; Zheng, Wenlong; Xue, Xiaodan; Shen, Wenda

    2016-03-01

    To understand the smoking-attributed mortality by inclusion of smoking information into all causes of death surveillance. Since 2010, the information about smoking status, smoking history and the number of cigarettes smoked daily had been added in death surveillance system. The measures of training, supervision, check, sampling survey and telephone verifying were taken to increase death reporting rate and reduce data missing rate and underreporting rate. Multivariate logistic regression analysis was conducted to identify risk factors for smoking-attributed mortality. During the study period (2010-2014), the annual death reporting rates ranged from 6.5‰ to 7.0‰. The reporting rates of smoking status, smoking history and the number of cigarettes smoked daily were 95.53%, 98.63% and 98.58%, respectively. Compared with the nonsmokers, the RR of males was 1.38 (1.33-1.43) for all causes of death and 3.07 (2.91-3.24) for lung cancer due to smoking, the RR of females was 1.46 (1.39-1.54) for all causes of death and 4.07 (3.81-4.35) for lung cancer due to smoking, respectively. The study of smoking attributed mortality can be developed with less investment by using the stable and effective all causes of death surveillance system in Tianjin.

  19. Characteristics of Elderly and Other Vulnerable Adult Victims of Homicide by a Caregiver: National Violent Death Reporting System--17 U.S. States, 2003-2007

    Science.gov (United States)

    Karch, Debra; Nunn, Kelly Cole

    2011-01-01

    Homicides of dependent elderly and nonelderly adults by their caregivers violate trust and have long-term consequences for families. A better understanding of the characteristics of homicide by caregivers may provide insights that can inform prevention efforts. Data collected in the National Violent Death Reporting System (NVDRS) between 2003 and…

  20. Distinct mortality profile in systemic sclerosis: a death certificate study in Rio de Janeiro, Brazil (2006-2015) using a multiple causes of death analysis.

    Science.gov (United States)

    de Rezende, Rodrigo Poubel Vieira; Gismondi, Ronaldo Altenburg; Maleh, Haim Cesar; de Miranda Coelho, Elisa Mendes; Vieira, Carol Sartori; Rosa, Maria Luiza Garcia; Mocarzel, Luis Otavio

    2017-12-16

    The objective of this study was to assess the mortality profile related to SSc in the state of Rio de Janeiro, Brazil. We retrospectively examined all registered deaths in the region (2006-2015 period) in which the diagnosis of SSc was mentioned on any line of the death certificates (underlying cause of death [UCD], n = 223; non-UCD, n = 151). Besides the analysis of gender, age, and the causes of death, we also compared the mortality from UCDs between individuals whose death causes included SSc (cases) and those whose death causes did not include SSc (deceased controls). For the latter comparison, we used the mortality odds ratio to approximate the cause-specific standardized mortality ratio. We identified 1495 death causes among the 374 SSc cases. The mean age at death of the SSc cases (85% women) was significantly lower than that of the controls (n = 1,294,117) (58.7 vs. 65.5 years, respectively). The main death causes were circulatory system diseases, infections, and respiratory diseases (36%, 34%, and 21% of SSc cases, respectively). Compared to the deceased controls, there were proportionally more deaths among the SSc cases from pulmonary arterial hypertension, lung fibrosis, septicemia, gastrointestinal hemorrhage, other systemic connective tissue diseases, and heart failure (for death age causes in this predominantly non-Caucasian sample of SSc patients. Of interest, the percentage of infection-related deaths in our report was about three times higher than that in SSc studies with predominantly Caucasian populations.

  1. Maritime illness and death reporting and public health response, United States, 2010-2014.

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    Stamatakis, Caroline E; Rice, Marion E; Washburn, Faith M; Krohn, Kristopher J; Bannerman, Millicent; Regan, Joanna J

    2017-09-01

    Deaths and certain illnesses onboard ships arriving at US ports are required to be reported to the US Centers for Disease Control and Prevention (CDC), and notifications of certain illnesses are requested. We performed a descriptive analysis of required maritime illness and death reports of presumptive diagnoses and requested notifications to CDC's Division of Global Migration and Quarantine, which manages CDC's Quarantine Stations, from January 2010 to December 2014. CDC Quarantine Stations received 2891 individual maritime case reports: 76.8% (2221/2891) illness reports, and 23.2% (670/2891) death reports. The most frequent individual illness reported was varicella (35.9%, 797/2221) and the most frequently reported causes of death were cardiovascular- or pulmonary-related conditions (79.6%, 533/670). There were 7695 cases of influenza-like illness received within aggregate notifications. CDC coordinated 63 contact investigations with partners to identify 972 contacts; 88.0% (855/972) were notified. There was documentation of 6.5% (19/293) receiving post-exposure prophylaxis. Three pertussis contacts were identified as secondary cases; and one tuberculosis contact was diagnosed with active tuberculosis. These data provide a picture of US maritime illness and death reporting and response. Varicella reports are the most frequent individual disease reports received. Contact investigations identified few cases of disease transmission. Copyright © 2017. Published by Elsevier Ltd.

  2. 'Natural' and 'Unnatural' medical deaths and coronial law: A UK and international review of the medical literature on natural and unnatural death and how it applies to medical death certification and reporting deaths to coroners: Natural/Unnatural death: A Scientific Review.

    Science.gov (United States)

    Harris, Andrew

    2017-07-01

    In the United Kingdom, when people die, either a doctor writes an acceptable natural cause of death medical certificate, or a coroner (fiscal in Scotland) investigates the case, usually with an autopsy. An inquest may or may not follow. The concept of 'natural or unnatural cause' death is not internationally standardized. This article reviews scientific evidence as to what is a natural death or unnatural death and how that relates to the international classification of deaths. Whilst there is some consensus on the definition, its application in considering whether to report to the coroner is more difficult. Depictions of deaths in terminal care, medical emergencies and post-operative care highlight these difficulties. It secondly reviews to what extent natural and unnatural are criteria for notification of deaths in England and Wales and internationally. It concludes with consideration of how medical concepts of unnatural death relate in England and Wales to coroners' legal concepts of what is unnatural. Deaths that appear natural to clinicians and pathologists may be legally unnatural and vice versa. It is argued that the natural/unnatural dichotomy is not a good criterion for reporting deaths under medical care to coroners, but the notification of a medical cause of death, using the International Classification of Disease Codes and the medical professional view as to whether it is scientifically natural, is of great value to the coroner in deciding whether it is legally unnatural.

  3. Survival and causes of death in systemic sclerosis patients: a single center registry report from Iran.

    Science.gov (United States)

    Poormoghim, Hadi; Andalib, Elham; Jalali, Arash; Ghaderi, Afshin; Ghorbannia, Ali; Mojtabavi, Nazanin

    2016-07-01

    The aims of the study were to determine prognostic factors for survival and causes of death in a cohort of patients with systemic sclerosis (SSc). This was a cohort study of SSc patients in single rheumatologic center from January 1998 to August 2012. They fulfilled the American College of Rheumatology classification criteria for SSc or had calcinosis Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, telangiectasia or sine sclerosis. Causes of death were classified as SSc related and non-SSc related. Kaplan-Meier and Cox proportional hazard regression models were used in univariate and multivariate analysis to analyse survival in subgroups and determine prognostic factors of survival. The study includes 220 patients (192 female, 28 male). Out of thirty-two (14.5 %) who died, seventeen (53.1 %) deaths were SSc related and in nine (28.1 %) non-SSc-related causes, and in six (18.8 %) of patients causes of death were not defined. Overall survival rate was 92.6 % (95 % CI 87.5-95.7 %) after 5 years and 82.3 % (95 % CI 73.4-88.4 %) after 10 years. Pulmonary involvement was a major SSc-related cause of death, occurred in seven (41.1 %) patients. Cardiovascular events were leading cause of in overall death (11) 34.3 % and 6 in non-SSc-related death. Independent risk factors for mortality were age >50 at diagnosis (HR 5.10) advance pulmonary fibrosis (HR 11.5), tendon friction rub at entry (HR 6.39), arthritis (HR 3.56). In this first Middle Eastern series of SSc registry, pulmonary and cardiac involvements were the leading cause of SSc-related death.

  4. Seeking order amidst chaos: a systematic review of classification systems for causes of stillbirth and neonatal death, 2009-2014.

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    Leisher, Susannah Hopkins; Teoh, Zheyi; Reinebrant, Hanna; Allanson, Emma; Blencowe, Hannah; Erwich, Jan Jaap; Frøen, J Frederik; Gardosi, Jason; Gordijn, Sanne; Gülmezoglu, A Metin; Heazell, Alexander E P; Korteweg, Fleurisca; Lawn, Joy; McClure, Elizabeth M; Pattinson, Robert; Smith, Gordon C S; Tunçalp, Ӧzge; Wojcieszek, Aleena M; Flenady, Vicki

    2016-10-05

    Each year, about 5.3 million babies die in the perinatal period. Understanding of causes of death is critical for prevention, yet there is no globally acceptable classification system. Instead, many disparate systems have been developed and used. We aimed to identify all systems used or created between 2009 and 2014, with their key features, including extent of alignment with the International Classification of Diseases (ICD) and variation in features by region, to inform the World Health Organization's development of a new global approach to classifying perinatal deaths. A systematic literature review (CINAHL, EMBASE, Medline, Global Health, and PubMed) identified published and unpublished studies and national reports describing new classification systems or modifications of existing systems for causes of perinatal death, or that used or tested such systems, between 2009 and 2014. Studies reporting ICD use only were excluded. Data were independently double-extracted (except from non-English publications). Subgroup analyses explored variation by extent and region. Eighty-one systems were identified as new, modifications of existing systems, or having been used between 2009 and 2014, with an average of ten systems created/modified each year. Systems had widely varying characteristics: (i) comprehensiveness (40 systems classified both stillbirths and neonatal deaths); (ii) extent of use (systems were created in 28 countries and used in 40; 17 were created for national use; 27 were widely used); (iii) accessibility (three systems available in e-format); (iv) underlying cause of death (64 systems required a single cause of death); (v) reliability (10 systems tested for reliability, with overall Kappa scores ranging from .35-.93); and (vi) ICD alignment (17 systems used ICD codes). Regional databases were not searched, so system numbers may be underestimated. Some non-differential misclassification of systems was possible. The plethora of systems in use, and continuing

  5. Deaths: Leading Causes for 2011.

    Science.gov (United States)

    Heron, Melonie

    2015-07-27

    This report presents final 2011 data on the 10 leading causes of death in the United States by age, sex, race, and Hispanic origin. Leading causes of infant, neonatal, and postneonatal death are also presented. This report supplements ‘‘Deaths: Final Data for 2011,’’ the National Center for Health Statistics’ annual report of final mortality statistics. Data in this report are based on information from all death certificates filed in the 50 states and the District of Columbia in 2011. Causes of death classified by the International Classification of Diseases, 10th Revision (ICD–10) are ranked according to the number of deaths assigned to rankable causes. Cause-of-death statistics are based on the underlying cause of death. In 2011, the 10 leading causes of death were, in rank order: Diseases of heart; Malignant neoplasms; Chronic lower respiratory diseases; Cerebrovascular diseases; Accidents (unintentional injuries); Alzheimer’s disease; Diabetes mellitus; Influenza and pneumonia; Nephritis, nephrotic syndrome and nephrosis; and Intentional self-harm (suicide). They accounted for 74% of all deaths occurring in the United States. Differences in the rankings are evident by age, sex, race, and Hispanic origin. Leading causes of infant death for 2011 were, in rank order: Congenital malformations, deformations and chromosomal abnormalities; Disorders related to short gestation and low birth weight, not elsewhere classified; Sudden infant death syndrome; Newborn affected by maternal complications of pregnancy; Accidents (unintentional injuries); Newborn affected by complications of placenta, cord and membranes; Bacterial sepsis of newborn; Respiratory distress of newborn; Diseases of the circulatory system; and Neonatal hemorrhage. Important variations in the leading causes of infant death are noted for the neonatal and postneonatal periods. All material appearing in this report is in the public domain and may be reproduced or copied without permission

  6. Deaths: Leading Causes for 2015.

    Science.gov (United States)

    Heron, Melonie

    2017-11-01

    Objectives-This report presents final 2015 data on the 10 leading causes of death in the United States by age, sex, race, and Hispanic origin. Leading causes of infant, neonatal, and postneonatal death are also presented. This report supplements "Deaths: Final Data for 2015," the National Center for Health Statistics' annual report of final mortality statistics. Methods-Data in this report are based on information from all death certificates filed in the 50 states and the District of Columbia in 2015. Causes of death classified by the International Classification of Diseases, Tenth Revision (ICD-10) are ranked according to the number of deaths assigned to rankable causes. Cause-of-death statistics are based on the underlying cause of death. Results-In 2015, the 10 leading causes of death were, in rank order: Diseases of heart; Malignant neoplasms; Chronic lower respiratory diseases; Accidents (unintentional injuries); Cerebrovascular diseases; Alzheimer's disease; Diabetes mellitus; Influenza and pneumonia; Nephritis, nephrotic syndrome and nephrosis; and Intentional self-harm (suicide). They accounted for 74% of all deaths occurring in the United States. Differences in the rankings are evident by age, sex, race, and Hispanic origin. Leading causes of infant death for 2015 were, in rank order: Congenital malformations, deformations and chromosomal abnormalities; Disorders related to short gestation and low birth weight, not elsewhere classified; Sudden infant death syndrome; Newborn affected by maternal complications of pregnancy; Accidents (unintentional injuries); Newborn affected by complications of placenta, cord and membranes; Bacterial sepsis of newborn; Respiratory distress of newborn; Diseases of the circulatory system; and Neonatal hemorrhage. Important variations in the leading causes of infant death are noted for the neonatal and postneonatal periods. All material appearing in this report is in the public domain and may be reproduced or copied without

  7. Deaths: Leading Causes for 2013.

    Science.gov (United States)

    Heron, Melonie

    2016-02-16

    This report presents final 2013 data on the 10 leading causes of death in the United States by age, sex, race, and Hispanic origin. Leading causes of infant, neonatal, and postneonatal death are also presented. This report supplements "Deaths: Final Data for 2013," the National Center for Health Statistics’ annual report of final mortality statistics. Data in this report are based on information from all death certificates filed in the 50 states and the District of Columbia in 2013. Causes of death classified by the International Classification of Diseases, Tenth Revision (ICD–10) are ranked according to the number of deaths assigned to rankable causes. Cause-of-death statistics are based on the underlying cause of death. In 2013, the 10 leading causes of death were, in rank order: Diseases of heart; Malignant neoplasms; Chronic lower respiratory diseases; Accidents (unintentional injuries); Cerebrovascular diseases; Alzheimer’s disease; Diabetes mellitus; Influenza and pneumonia; Nephritis, nephrotic syndrome and nephrosis; and Intentional self-harm (suicide). They accounted for 74% of all deaths occurring in the United States. Differences in the rankings are evident by age, sex, race, and Hispanic origin. Leading causes of infant death for 2013 were, in rank order: Congenital malformations, deformations and chromosomal abnormalities; Disorders related to short gestation and low birth weight, not elsewhere classified; Newborn affected by maternal complications of pregnancy; Sudden infant death syndrome; Accidents (unintentional injuries); Newborn affected by complications of placenta, cord and membranes; Bacterial sepsis of newborn; Respiratory distress of newborn; Diseases of the circulatory system; and Neonatal hemorrhage. Important variations in the leading causes of infant death are noted for the neonatal and postneonatal periods. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as

  8. Methodological review: measured and reported congruence between preferred and actual place of death.

    Science.gov (United States)

    Bell, C L; Somogyi-Zalud, E; Masaki, K H

    2009-09-01

    Congruence between preferred and actual place of death is an important palliative care outcome reported in the literature. We examined methods of measuring and reporting congruence to highlight variations impairing cross-study comparisons. Medline, PsychInfo, CINAHL, and Web of Science were systematically searched for clinical research studies examining patient preference and congruence as an outcome. Data were extracted into a matrix, including purpose, reported congruence, and method for eliciting preference. Studies were graded for quality. Using tables of preferred versus actual places of death, an overall congruence (total met preferences out of total preferences) and a kappa statistic of agreement were determined for each study. Twelve studies were identified. Percentage of congruence was reported using four different definitions. Ten studies provided a table or partial table of preferred versus actual deaths for each place. Three studies provided kappa statistics. No study achieved better than moderate agreement when analysed using kappa statistics. A study which elicited ideal preference reported the lowest agreement, while longitudinal studies reporting final preferred place of death yielded the highest agreement (moderate agreement). Two other studies of select populations also yielded moderate agreement. There is marked variation in methods of eliciting and reporting congruence, even among studies focused on congruence as an outcome. Cross-study comparison would be enhanced by the use of similar questions to elicit preference, tables of preferred versus actual places of death, and kappa statistics of agreement.

  9. Cause of Sudden Cardiac Deaths on Autopsy Findings; a Four-Year Report

    Directory of Open Access Journals (Sweden)

    Dinesh Rao

    2014-03-01

    Full Text Available Introduction: Incidence of sudden cardiac death (SCD has been steadily increasing all over the world. While knowing the cause of SCD is one of the favorites of the physicians involved with these cases, it is very difficult and challenging task for the forensic physician. The present report is a prospective study regarding cause of SCDs on autopsy examination in four-year period, Bangalore, India. Methods: The present prospective study is based on autopsy observations, carried out for four-year period from 2008 to 2011, and analyzed for cause of SCDs. The cases were chosen as per the definition of sudden death and autopsied. The material was divided into natural and unnatural groups. Finally, on histopathology, gross examination, hospital details, circumstantial, and police reports the cause of death was inferred. Results: A total of 2449 autopsy was conducted of which 204 cases were due to SCD. The highest SCDs were reported in 50-60 years age group (62.24%; n-127, followed closely by the age group 60-69 (28.43%; n-58. Male to female ratio was around 10:1. The maximum number of deaths (n=78 was within few hours (6 hours after the onset of signs and symptoms. In 24 (11.8% cases major narrowing was noted in both the main coronaries, in 87 (42.6% cases in the left anterior descending coronary artery (LAD, and in 18 (51.5% cases in the right coronary artery (RCA. The major cardiac pathology resulting in sudden death was coronary artery disease (n-116; 56.86% and myocardial infarction (n-104; 50.9%. most of the SCDs occurred in the place of residence (n-80; 39.2% followed closely by death in hospital (n-49; 24.01%. Conclusion: Coronary occlusion was the major contributory cause of sudden death with cardiac origin and the highest number of deaths were reported in the age 50-59 years with male to female ratio of 10:1. 

  10. Analysis of preventability of stroke-related maternal death from the nationwide registration system of maternal deaths in Japan.

    Science.gov (United States)

    Katsuragi, Shinji; Tanaka, Hiroaki; Hasegawa, Junichi; Nakamura, Masamitsu; Kanayama, Naohiro; Nakata, Masahiko; Murakoshi, Takeshi; Yoshimatsu, Jun; Osato, Kazuhiro; Tanaka, Kayo; Sekizawa, Akihiko; Ishiwata, Isamu; Ikeda, Tomoaki

    2018-08-01

    The number of stroke-related maternal deaths is increasing in Japan. We investigated methods to reduce maternal death from stroke. We analyzed stroke-related maternal deaths in Japan reported to the Committee of the Ministry of Health, Labor, and Welfare from 2010 to 2014 inclusive. A total of 35 cases were identified. The median maternal age was 35 years (range 22-45) and the incidence of stoke in women ≥40 was seven-fold higher than in death from stroke.

  11. 20 CFR 10.414 - What reports of dependents are needed in death cases?

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false What reports of dependents are needed in death cases? 10.414 Section 10.414 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS...' COMPENSATION ACT, AS AMENDED Compensation and Related Benefits Compensation for Death § 10.414 What reports of...

  12. Deaths: Leading Causes for 2012.

    Science.gov (United States)

    Heron, Melonie

    2015-08-31

    This report presents final 2012 data on the 10 leading causes of death in the United States by age, sex, race, and Hispanic origin. Leading causes of infant, neonatal, and postneonatal death are also presented. This report supplements "Deaths: Final Data for 2012," the National Center for Health Statistics' annual report of final mortality statistics. Data in this report are based on information from all death certificates filed in the 50 states and the District of Columbia in 2012. Causes of death classified by the International Classification of Diseases, Tenth Revision (ICD-10) are ranked according to the number of deaths assigned to rankable causes. Cause-of-death statistics are based on the underlying cause of death. In 2012, the 10 leading causes of death were, in rank order: Diseases of heart; Malignant neoplasms; Chronic lower respiratory diseases; Cerebrovascular diseases; Accidents (unintentional injuries); Alzheimer's disease; Diabetes mellitus; Influenza and pneumonia; Nephritis, nephrotic syndrome and nephrosis; and Intentional self-harm (suicide). These causes accounted for 74% of all deaths occurring in the United States. Differences in the rankings are evident by age, sex, race, and Hispanic origin. Leading causes of infant death for 2012 were, in rank order: Congenital malformations, deformations and chromosomal abnormalities; Disorders related to short gestation and low birth weight, not elsewhere classified; Sudden infant death syndrome; Newborn affected by maternal complications of pregnancy; Accidents (unintentional injuries); Newborn affected by complications of placenta, cord and membranes; Bacterial sepsis of newborn; Respiratory distress of newborn; Diseases of the circulatory system; and Neonatal hemorrhage. Important variations in the leading causes of infant death are noted for the neonatal and postneonatal periods.

  13. Deaths: leading causes for 2010.

    Science.gov (United States)

    Heron, Melonie

    2013-12-20

    This report presents final 2010 data on the 10 leading causes of death in the United States by age, sex, race, and Hispanic origin. Leading causes of infant, neonatal, and postneonatal death are also presented. This report supplements the Division of Vital Statistics' annual report of final mortality statistics. Data in this report are based on information from all death certificates filed in the 50 states and the District of Columbia in 2010. Causes of death classified by the International Classification of Diseases, Tenth Revision (ICD-10) are ranked according to the number of deaths assigned to rankable causes. Cause-of-death statistics are based on the underlying cause of death. In 2010, the 10 leading causes of death were, in rank order: Diseases of heart; Malignant neoplasms; Chronic lower respiratory diseases; Cerebrovascular diseases; Accidents (unintentional injuries); Alzheimer's disease; Diabetes mellitus; Nephritis, nephrotic syndrome and nephrosis; Influenza and pneumonia; and Intentional self-harm (suicide). These 10 causes accounted for 75% of all deaths occurring in the United States. Differences in the rankings are evident by age, sex, race, and Hispanic origin. Leading causes of infant death for 2010 were, in rank order: Congenital malformations, deformations and chromosomal abnormalities; Disorders related to short gestation and low birth weight, not elsewhere classified; Sudden infant death syndrome; Newborn affected by maternal complications of pregnancy; Accidents (unintentional injuries); Newborn affected by complications of placenta, cord and membranes; Bacterial sepsis of newborn; Respiratory distress of newborn; Diseases of the circulatory system; and Necrotizing enterocolitis of newborn. Important variations in the leading causes of infant death are noted for the neonatal and post-neonatal periods. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source

  14. Causes of Death Among 379 Patients With Hemophilia: A Developing Country's Report.

    Science.gov (United States)

    Mansouritorghabeh, Hassan; Rahimi, Hossein; Mohades, Seyed Tahereh; Behboudi, Maryam

    2018-05-01

    There are steps to achieve an optimum life for patients with hemophilia in developing countries, and awareness of the pattern of death in patients with hemophilia is a prerequisite for any health-care program. Owing to the lack of any data on the pattern of death in patients with hemophilia from developing countries, the current study was done to address common causes of death, and the spectrum of causes of death among individuals with hemophilia A and B. To address the pattern of death in northeast of Iran, we retrospectively collected demographic data regarding deceased patients with hemophilia A and B. Overall, among 379 people with hemophilia A and B, there were 46 deaths. Thirty-two deaths happened in the severe forms of the diseases. The obtained results show the patterns of death in the patients studied are not as parallel as some reports from the developed countries. Traumatic and spontaneous bleeding events were the main causes of death. The trend of death shows a decrease in the current decade post better therapeutic facilities. Evaluation of causes of death in hemophilia can be a useful indicator for managing the efficacy of health care in the current patients.

  15. Reliability of maternal recall and reporting of child births and deaths in rural Egypt.

    Science.gov (United States)

    Rao, Malla R; Levine, Richard J; Wasif, Nader K; Clemens, John D

    2003-04-01

    Demographic indicators such as fertility rates and infant mortality rates are often measured in census surveys by interviewing mothers to obtain their pregnancy histories and child deaths. The validity of such surveys depends upon accurate recall of histories, truthful reporting of events and understanding of the questions posed. To measure the reliability of maternal reporting, two census surveys conducted in a rural Egyptian population were compared. Women between 15 and 55 years of age residing in 20 villages were asked their histories of live births, stillbirths and child deaths. An identical set of questions was posed 2 years later. Twice-monthly home visits were conducted in the intervening 2-year interval to identify accurately any new births, stillbirths and deaths occurring in the population. The maternal reports from the first census were combined with the prospectively identified births, stillbirths and deaths and compared with the maternal reports from the second census. For 1502 women, the discrepancies in the total number of births, stillbirths and child deaths reported between the two surveys were 0.6%, 4% and 0.6% respectively. However, when the consistency of responses was analysed, the proportion of women with discordant responses was 10%, 6% and 7% for the same measures. These results suggest that, despite the large number of births and deaths that women may experience in developing countries, maternal interviews provide reliable responses that can be used to estimate mortality and fertility rates in settings where vital records are incomplete or unreliable.

  16. Sudden unexpected death caused by stroke

    DEFF Research Database (Denmark)

    Ågesen, Frederik Nybye; Risgaard, Bjarke; Zachariasardóttir, Sára

    2017-01-01

    Background Stroke is the fifth leading cause of death in young individuals globally. Data on the burden of sudden death by stroke are sparse in the young. Aims The aim of this study was to report mortality rates, cause of death, stroke subtype, and symptoms in children and young adults who suffered....... There was a male predominance (56%) and the median age was 33 years. The incidence of sudden death by stroke in individuals aged 1-49 years was 0.19 deaths per 100,000 person-years. Stroke was hemorrhagic in 94% of cases, whereof subarachnoid hemorrhage was the cause of death in 63% of cases. Seventeen (33%) cases...... contacted the healthcare system because of neurological symptoms, whereof one was suspected of having a stroke (6%). Conclusions Sudden death by stroke in children and young adults occurs primarily due to hemorrhagic stroke. We report a high frequency of neurological symptoms prior to sudden death by stroke...

  17. A cause of Sudden Cardiac Deaths on Autopsy Findings; a Four-Year Report.

    Science.gov (United States)

    Rao, Dinesh; Sood, Divya; Pathak, P; Dongre, Sudhir D

    2014-01-01

    Incidence of sudden cardiac death (SCD) has been steadily increasing all over the world. While knowing the cause of SCD is one of the favorites of the physicians involved with these cases, it is very difficult and challenging task for the forensic physician. The present report is a prospective study regarding cause of SCDs on autopsy examination in four-year period, Bangalore, India. The present prospective study is based on autopsy observations, carried out for four-year period from 2008 to 2011, and analyzed for cause of SCDs. The cases were chosen as per the definition of sudden death and autopsied. The material was divided into natural and unnatural groups. Finally, on histopathology, gross examination, hospital details, circumstantial, and police reports the cause of death was inferred. A total of 2449 autopsy was conducted of which 204 cases were due to SCD. The highest SCDs were reported in 50-60 years age group (62.24%; n-127), followed closely by the age group 60-69 (28.43%; n-58). Male to female ratio was around 10:1. The maximum number of deaths (n=78) was within few hours (6 hours) after the onset of signs and symptoms. In 24 (11.8%) cases major narrowing was noted in both the main coronaries, in 87 (42.6%) cases in the left anterior descending coronary artery (LAD), and in 18 (51.5%) cases in the right coronary artery (RCA). The major cardiac pathology resulting in sudden death was coronary artery disease (n-116; 56.86%) and myocardial infarction (n-104; 50.9%). most of the SCDs occurred in the place of residence (n-80; 39.2%) followed closely by death in hospital (n-49; 24.01%). Coronary occlusion was the major contributory cause of sudden death with cardiac origin and the highest number of deaths were reported in the age 50-59 years with male to female ratio of 10:1.

  18. Sudden unexplained death in childhood. An audit of the quality of Autopsy reporting

    LENUS (Irish Health Repository)

    Treacy, A

    2013-03-01

    Cases of sudden unexplained death in childhood (SUDC) in Ireland in children aged >1year and <5 years were examined in order to assess the quality of autopsy reporting. All SUDC cases are notified to and documented by the National Sudden Infant Death Register (NSIDR) in Ireland along with all cases of sudden infant death syndrome (SIDS) referring to sudden infant deaths less than one year of age. The database of the NSIDR in Ireland was interrogated and cases of SIDS and SUDC were compared over a fifteen-year period (1995-2009). SIDS cases whose autopsies were conducted in the same hospital in the same year as the index SUDC case were used for comparison. The autopsy report for each case was examined and modified Rushton(MR) scores 1\\r\

  19. How accurately is euthanasia reported on death certificates in a country with legal euthanasia: a population-based study.

    Science.gov (United States)

    Cohen, Joachim; Dierickx, Sigrid; Penders, Yolanda W H; Deliens, Luc; Chambaere, Kenneth

    2018-04-21

    Death certificates are the main source of information on the incidence of the direct and underlying causes of death, but may be unsuitable for monitoring the practice of medical assistance in dying, e.g. euthanasia, due to possible underreporting. This study examines the accuracy of certification of euthanasia. Mortality follow-back survey using a random sample of death certificates (N = 6871). For all cases identified as euthanasia we checked whether euthanasia was reported as a cause of death on the death certificate. We used multivariable logistic regression analysis to evaluate whether reporting varied according to patient and decision-making characteristics. Through the death certificates, 0.7% of all deaths were identified as euthanasia, compared with 4.6% through the mortality follow-back survey. Only 16.2% of the cases identified from the survey were reported on the death certificate. Euthanasia was more likely to be reported on the death certificate where death was from cancer (14% covered), neurological diseases (22%) and stroke (28%) than from cardiovascular disease (7%). Even when the recommended drugs were used or the physician self-labelled the end-of-life decision as euthanasia, euthanasia was only reported on the death certificate in 24% of cases. Death certificates substantially underestimate the frequency of euthanasia as a cause of death in Belgium. Mortality follow-back studies are essential complementary instruments to examine and monitor the practice of euthanasia more accurately. Death certificate forms may need to be modified and clear guidelines provided to physicians about recording euthanasia to ensure more accurate certification.

  20. NETs: The missing link between cell death and systemic autoimmune diseases?

    Directory of Open Access Journals (Sweden)

    Felipe eAndrade

    2013-01-01

    Full Text Available For almost 20 years, apoptosis and secondary necrosis have been considered the major source of autoantigens and endogenous adjuvants in the pathogenic model of systemic autoimmune diseases. This focus is justified in part because initial evidence in systemic lupus erythematosus (SLE guided investigators toward the study of apoptosis, but also because other forms of cell death were unknown. To date, it is known that many other forms of cell death occur, and that they vary in their capacity to stimulate as well as inhibit the immune system. Among these, NETosis (an antimicrobial form of death in neutrophils in which nuclear material is extruded from the cell forming extracellular traps, is gaining major interest as a process that may trigger some of the immune features found in SLE, granulomatosis with polyangiitis (formerly Wegener’s granulomatosis and Felty’s syndrome. Although there have been volumes of very compelling studies published on the role of cell death in autoimmunity, no unifying theory has been adopted nor have any successful therapeutics been developed based on this important pathway. The recent inclusion of NETosis into the pathogenic model of autoimmune diseases certainly adds novel insights into this paradigm, but also reveals a previously unappreciated level of complexity and raises many new questions. This review discusses the role of cell death in systemic autoimmune diseases with a focus on apoptosis and NETosis, highlights the current short comings in our understanding of the vast complexity of cell death, and considers the potential shift in the cell death paradigm in autoimmunity. Understanding this complexity is critical in order to develop tools to clearly define the death pathways that are active in systemic autoimmune diseases, identify drivers of disease propagation, and develop novel therapeutics.

  1. A multicenter study of outcome in systemic lupus erythematosus. II. Causes of death.

    Science.gov (United States)

    Rosner, S; Ginzler, E M; Diamond, H S; Weiner, M; Schlesinger, M; Fries, J F; Wasner, C; Medsger, T A; Ziegler, G; Klippel, J H; Hadler, N M; Albert, D A; Hess, E V; Spencer-Green, G; Grayzel, A; Worth, D; Hahn, B H; Barnett, E V

    1982-06-01

    Causes of death were examined for 1,103 systemic lupus erythematosus patients who were followed from 1965 to 1978 at 9 centers that participated in the Lupus Survival Study Group. A total of 222 patients (20%) died. Lupus-related organ system involvement (mainly active nephritis) and infection were the most frequent primary causes of death. Causes of death were similar throughout the followup period. Hemodialysis had little impact on the length of survival for patients with nephritis. Active central nervous system disease and myocardial infarction were infrequent causes of death. There were no deaths from malignancy.

  2. Trends in Deaths Involving Heroin and Synthetic Opioids Excluding Methadone, and Law Enforcement Drug Product Reports, by Census Region - United States, 2006-2015.

    Science.gov (United States)

    O'Donnell, Julie K; Gladden, R Matthew; Seth, Puja

    2017-09-01

    Opioid overdose deaths quadrupled from 8,050 in 1999 to 33,091 in 2015 and accounted for 63% of drug overdose deaths in the United States in 2015. During 2010-2015, heroin overdose deaths quadrupled from 3,036 to 12,989 (1). Sharp increases in the supply of heroin and illicitly manufactured fentanyl (IMF) are likely contributing to increased deaths (2-6). CDC examined trends in unintentional and undetermined deaths involving heroin or synthetic opioids excluding methadone (i.e., synthetic opioids)* by the four U.S. Census regions during 2006-2015. Drug exhibits (i.e., drug products) obtained by law enforcement and reported to the Drug Enforcement Administration's (DEA's) National Forensic Laboratory Information System (NFLIS) that tested positive for heroin or fentanyl (i.e., drug reports) also were examined. All U.S. Census regions experienced substantial increases in deaths involving heroin from 2006 to 2015. Since 2010, the South and West experienced increases in heroin drug reports, whereas the Northeast and Midwest experienced steady increases during 2006-2015. † In the Northeast, Midwest, and South, deaths involving synthetic opioids and fentanyl drug reports increased considerably after 2013. These broad changes in the U.S. illicit drug market highlight the urgent need to track illicit drugs and enhance public health interventions targeting persons using or at high risk for using heroin or IMF.

  3. System care improves trauma outcome: patient care errors dominate reduced preventable death rate.

    Science.gov (United States)

    Thoburn, E; Norris, P; Flores, R; Goode, S; Rodriguez, E; Adams, V; Campbell, S; Albrink, M; Rosemurgy, A

    1993-01-01

    A review of 452 trauma deaths in Hillsborough County, Florida, in 1984 documented that 23% of non-CNS trauma deaths were preventable and occurred because of inadequate resuscitation or delay in proper surgical care. In late 1988 Hillsborough County organized a County Trauma Agency (HCTA) to coordinate trauma care among prehospital providers and state-designated trauma centers. The purpose of this study was to review county trauma deaths after the inception of the HCTA to determine the frequency of preventable deaths. 504 trauma deaths occurring between October 1989 and April 1991 were reviewed. Through committee review, 10 deaths were deemed preventable; 2 occurred outside the trauma system. Of the 10 deaths, 5 preventable deaths occurred late in severely injured patients. The preventable death rate has decreased to 7.0% with system care. The causes of preventable deaths have changed from delayed or inadequate intervention to postoperative care errors.

  4. How many deaths will it take? A death from asthma associated with work-related environmental tobacco smoke.

    Science.gov (United States)

    Stanbury, Martha; Chester, Debra; Hanna, Elizabeth A; Rosenman, Kenneth D

    2008-02-01

    Despite epidemiologic, experimental and observational data on the association of environmental tobacco smoke (ETS) and adverse health effects, bar and restaurant workers remain exposed to ETS in the majority of states and countries. Three public health surveillance systems were used to identify and conduct a follow-up investigation of a reported acute asthma death of a young waitress in a bar. The waitress collapsed at the bar where she worked and was declared dead shortly thereafter. Evaluation of the circumstances of her death and her medical history concluded that her death was from acute asthma due to environmental tobacco smoke at work. This is the first reported acute asthma death associated with work-related ETS. Recent studies of asthma among bar and restaurant workers before and after smoking bans support this association. This death dramatizes the need to enact legal protections for workers in the hospitality industry from secondhand smoke.

  5. 16 CFR 1115.6 - Reporting of unreasonable risk of serious injury or death.

    Science.gov (United States)

    2010-01-01

    ... term includes not only the concept of “grievous bodily injury,” defined at § 1115.12(d), but also any... injury or death. 1115.6 Section 1115.6 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER... Reporting of unreasonable risk of serious injury or death. (a) General provision. Every manufacturer...

  6. Sudden cardiac death with triple pathologies: A case report

    Directory of Open Access Journals (Sweden)

    R. Razuin

    2017-06-01

    Full Text Available Sudden cardiac death in young adults may be associated with rare cardiomyopathies such as left ventricular noncompaction (LVNC and arrhythmogenic right ventricular (ARVC cardiomyopathies. LVNC is characterised by hypertrabeculations and deep recesses of the left ventricle. ARVC presents with thin myocardium as a result of extensive fibro-fatty infiltrations. In both conditions, death may be due to arrhythmia, thromboembolic events or heart failure. We report a case of a 21-year old athletic young man who collapsed at the futsal court right after the game. He was resuscitated but expired at the hospital after a brief admission. A week earlier, he had a similar episode of syncope and revived through cardio-pulmonary resuscitation at the site. Post mortem examination showed extensive acute myocardial infarction (AMI involving the papillary muscles and the left ventricular wall. Features of LVNC were also observed. On top of that, the right ventricle showed patchy thin myocardium as the wall was largely comprised of fat. Histology examination confirmed the presence of AMI and massive fibro-fatty infiltrations of the right ventricle. This unfortunate young man had co-existing cardiomyopathies which is rare indeed. As he succumbed to AMI, this mechanism of death is also uncommonly associated with neither LVNC nor ARVC. In conclusion, young and physically active individuals may not be spared of sudden cardiac death. Mild and non-specific symptoms should not be taken lightly as it may be the subtle signs of cardiomyopathies.

  7. Breast milk donation after neonatal death in Australia: a report.

    Science.gov (United States)

    Carroll, Katherine E; Lenne, Brydan S; McEgan, Kerri; Opie, Gillian; Amir, Lisa H; Bredemeyer, Sandra; Hartmann, Ben; Jones, Rachel; Koorts, Pieter; McConachy, Helen; Mumford, Patricia; Polverino, Jan

    2014-01-01

    Lactation and breast milk can hold great value and meaning for grieving mothers who have experienced a recent death of an infant. Donation to a human milk bank (HMB) as an alternative to discarding breast milk is one means of respecting the value of breast milk. There is little research, national policy discussion, or organizational representation in Australia on the subject of breast milk donation after infant death. On 29 November 2013 the Mercy Hospital for Women in Melbourne, Australia hosted Australia's first National Stakeholder Meeting (NSM) on the topic of milk donation after neonatal death. The NSM drew together representatives from Australian HMBs, neonatal intensive care units (NICUs) currently using donor human milk, and Australia's chief NICU parent support organization. The NSM was video-recorded and transcribed, and analyzed thematically by researchers. This article reports the seven dominant themes discussed by stakeholders during the NSM: the spectrum of women's lactation and donation experiences after infant death; the roles of the HMB and NICU in meeting the needs of the bereaved donor; how bereaved mothers' lactation autonomy may interface with a HMB's donation guidelines; how milk donation may be discussed with bereaved mothers; the variation between four categories of milk donation after neonatal death; the impact of limited resources and few HMBs on providing donation programs for bereaved mothers in Australia. This article provides evidence from researchers and practitioners that can assist HMB staff in refining their bank's policy on milk donation after infant death, and provides national policy makers with key considerations to support lactation, human milk banking, and bereavement services nation-wide.

  8. Drug Poisoning Deaths according to Ethnicity in Utah

    OpenAIRE

    Merrill, Ray M.; Hedin, Riley J.; Fondario, Anna; Sloan, Arielle A.; Hanson, Carl L.

    2013-01-01

    This study characterizes drug-related deaths according to ethnicity in Utah during 2005–2010, based on data from the Utah Violent Death Reporting System (UTVDRS). Hispanics made up 12.1% (12.5% male and 11.7% female) of deaths. The most frequently identified drugs among decedents were opiates, then illicit drugs, benzodiazepines, over-the-counter medication, and antidepressants. Death rates for each drug were significantly greater in non-Hispanics than Hispanics. Most decedents used a combina...

  9. Deaths in 122 U.S. cities - 1962-2016. 122 Cities Mortality Reporting System

    Data.gov (United States)

    U.S. Department of Health & Human Services — This file contains the complete set of data reported to 122 Cities Mortality Reposting System. The system was retired as of 10/6/2016. While the system was running...

  10. Electronic Certification of Death in Slovenia - System Considerations and Development Opportunities.

    Science.gov (United States)

    Stanimirovic, Dalibor

    2016-01-01

    Accurate and consistent death certification facilitates morbidity and mortality surveillance, and consequently supports evidence-informed health policies. The paper initially explores the current death certification practice in Slovenia, and identifies related deficiencies and system inconsistencies. Finally, the paper outlines a conceptualization of ICT-based model of death certification including renovation of business processes and organizational changes. The research is based on focus group methodology. Structured discussions were conducted with 29 experts from cross-sectional areas related to death certification. Research results imply that effective ICT-based transformation of the existing death certification model should involve a redefinition of functions and relationships between the main actors, as well as a reconfiguration of the technological, organizational, and regulatory elements in the field. The paper provides an insight into the complexities of the death certification and may provide the groundwork for ICT-based transformation of the death certification model in Slovenia.

  11. Analysis of preventability of hypertensive disorder in pregnancy-related maternal death using the nationwide registration system of maternal deaths in Japan.

    Science.gov (United States)

    Katsuragi, Shinji; Tanaka, Hiroaki; Hasegawa, Junichi; Nakamura, Masamitsu; Kanayama, Naohiro; Nakata, Masahiko; Murakoshi, Takeshi; Yoshimatsu, Jun; Osato, Kazuhiro; Tanaka, Kayo; Sekizawa, Akihiko; Ishiwata, Isamu; Ikeda, Tomoaki

    2018-04-26

    Hypertensive disorder of pregnancy (HDP) is a major cause of maternal death. The goal of this study was to investigate factors associated with maternal death due to HDP. HDP-related maternal deaths in Japan reported to the Committee of the Ministry of Health, Labor and Welfare from 2010 to 2015 were examined. Out of 47 cases of HDP, 30 were identified as the major cause of maternal death. The median maternal age was 34 years (range 24-45) and the mortality in women aged ≥40 years was seven times higher that than in women aged deaths in Japan. Mothers aged ≥40 years are most at risk for HDP-related maternal death. Major concerns for preventabilities were late hospitalization, maternal transportation, and termination of pregnancy for term or near-term HDP. Regular vital checks and prompt lowering of BP were lacked during labor in most cases. HELLP syndrome should be managed at a general hospital with sufficient medical resources.

  12. [Injecting drug abuse: survival after intensive care admission and forensic toxicology reports at death].

    Science.gov (United States)

    Sigvaldason, Kristinn; Ingvarsson, Thoroddur; Thordardottir, Svava; Kristinsson, Jakob; Karason, Sigurbergur

    2014-10-01

    Injecting drug abuse is a worldwide problem with serious consequences for the individual and for society. The purpose of this study was to gather information on the most serious complications of injecting drug use from two perspectives, intensive care admissions and forensic toxicology reports. Firstly, intensive care admissions related to injecting drug abuse during a five year period were reviewed for demographics, complications and 5 year survival. Secondly, information from forensic toxicology reports regarding deaths amongst known injecting drug abusers were gathered for the same period. A total of 57 patients with a history of active injecting drug use were admitted to intensive care or approximately 1% of admissions, most often for overdose (52%) or life threatening infections (39%). Median age was 26, males were 66%. The most common substances used were prescription drugs. Hospital mortality was 16% and five year survival 65%. Average time from hospital discharge to death was 916±858 days. During the study period 38 deaths of individuals with a history of injecting drugs were identified by forensic toxicology reports or 4.1/10(5) population/year (age 15-59). Cause of death was most often overdose (53%), usually from prescription opiates but multiple drug use was common. The life expectancy of injecting drug abusers after intensive care admission is substantially decreased, with 35% death rate within five years. A widespread use of prescription drugs is of concern. Injecting drug abuse seems to be a similar health problem in magnitude in Iceland as in other Scandinavian countries.

  13. Report to the nation finds continuing declines in cancer death rates

    Science.gov (United States)

    Death rates from all cancers combined for men, women, and children continued to decline in the United States between 2004 and 2008, according to the Annual Report to the Nation on the Status of Cancer, 1975-2008. The overall rate of new cancer diagnoses,

  14. Redefining Death

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    The results of 20 years of research on brain death will be released to the public, the Chinese Ministry of Health reported in early April. A special ministry team has drafted the criteria for brain death in Criteria for the Diagnosis of Brain Death in Adults (Revised Edition) and Technical Specifications for the Diagnosis

  15. Using poison center exposure calls to predict methadone poisoning deaths.

    Directory of Open Access Journals (Sweden)

    Nabarun Dasgupta

    Full Text Available PURPOSE: There are more drug overdose deaths in the Untied States than motor vehicle fatalities. Yet the US vital statistics reporting system is of limited value because the data are delayed by four years. Poison centers report data within an hour of the event, but previous studies suggested a small proportion of poisoning deaths are reported to poison centers (PC. In an era of improved electronic surveillance capabilities, exposure calls to PCs may be an alternate indicator of trends in overdose mortality. METHODS: We used PC call counts for methadone that were reported to the Researched Abuse, Diversion and Addiction-Related Surveillance (RADARS® System in 2006 and 2007. US death certificate data were used to identify deaths due to methadone. Linear regression was used to quantify the relationship of deaths and poison center calls. RESULTS: Compared to decedents, poison center callers tended to be younger, more often female, at home and less likely to require medical attention. A strong association was found with PC calls and methadone mortality (b=0.88, se=0.42, t=9.5, df=1, p<0.0001, R(2 =0.77. These findings were robust to large changes in a sensitivity analysis assessing the impact of underreporting of methadone overdose deaths. CONCLUSIONS: Our results suggest that calls to poison centers for methadone are correlated with poisoning mortality as identified on death certificates. Calls received by poison centers may be used for timely surveillance of mortality due to methadone. In the midst of the prescription opioid overdose epidemic, electronic surveillance tools that report in real-time are powerful public health tools.

  16. Addressing maternal deaths due to violence: the Illinois experience.

    Science.gov (United States)

    Koch, Abigail R; Geller, Stacie E

    2017-11-01

    Homicide, suicide, and substance abuse accounted for nearly one fourth of all pregnancy-associated deaths in Illinois from 2002 through 2013. Maternal mortality review in Illinois has been primarily focused on obstetric and medical causes and little is known about the circumstances surrounding deaths due to homicide, suicide, and substance abuse, if they are pregnancy related, and if the deaths are potentially preventable. To address this issue, we implemented a process to form a second statewide maternal mortality review committee for deaths due to violence in late 2014. We convened a stakeholder group to accomplish 3 tasks: (1) identify appropriate committee members; (2) identify potential types and sources of information that would be required for a meaningful review of violent maternal deaths; and (3) revise the Maternal Mortality Review Form. Because homicide, suicide, and substance abuse are closely linked to the social determinants of health, the review committee needed to have a broad membership with expertise in areas not required for obstetric maternal mortality review, including social service and community organizations. Identifying additional sources of information is critical; the state Violent Death Reporting System, case management data, and police and autopsy reports provide contextual information that cannot be found in medical records. The stakeholder group revised the Maternal Mortality Review Form to collect information relevant to violent maternal deaths, including screening history and psychosocial history. The form guides the maternal mortality review committee for deaths due to violence to identify potentially preventable factors relating to the woman, her family, systems of care, the community, the legal system, and the institutional environment. The committee has identified potential opportunities to decrease preventable death requiring cooperation with social service agencies and the criminal justice system in addition to the physical

  17. Canadian Guidelines for Controlled Pediatric Donation After Circulatory Determination of Death-Summary Report.

    Science.gov (United States)

    Weiss, Matthew J; Hornby, Laura; Rochwerg, Bram; van Manen, Michael; Dhanani, Sonny; Sivarajan, V Ben; Appleby, Amber; Bennett, Mary; Buchman, Daniel; Farrell, Catherine; Goldberg, Aviva; Greenberg, Rebecca; Singh, Ram; Nakagawa, Thomas A; Witteman, William; Barter, Jill; Beck, Allon; Coughlin, Kevin; Conradi, Alf; Cupido, Cynthia; Dawson, Rosanne; Dipchand, Anne; Freed, Darren; Hornby, Karen; Langlois, Valerie; Mack, Cheryl; Mahoney, Meagan; Manhas, Deepak; Tomlinson, Christopher; Zavalkoff, Samara; Shemie, Sam D

    2017-11-01

    determination of death, 7) cardiac and innovative pediatric donation after circulatory determination of death, and 8) implementation. For brevity, 48 Good Practice Statement and truncated justification are included in this summary report. The remaining recommendations, detailed methodology, full Grading of Recommendations Assessment, Development, and Evaluation tables, and expanded justifications are available in the full text report. This process showed that rigorous, transparent clinical practice guideline development is possible in the domain of pediatric deceased donation. Application of these recommendations will increase access to pediatric donation after circulatory determination of death across Canada and may serve as a model for future clinical practice guideline development in deceased donation.

  18. Using multiple cause-of-death data to investigate associations and causality between conditions listed on the death certificate.

    Science.gov (United States)

    Redelings, Matthew D; Wise, Matthew; Sorvillo, Frank

    2007-07-01

    Death rarely results from only one cause, and it can be caused by a variety of factors. Multiple cause-of-death data files can list as many as 20 contributing causes of death in addition to the reported underlying cause of death. Analysis of multiple cause-of-death data can provide information on associations between causes of death, revealing common combinations of events or conditions which lead to death. Additionally, physicians report the causal train of events through which they believe that different conditions or events may have led to each other and ultimately caused death. In this paper, the authors discuss methods used in studying associations between reported causes of death and in investigating commonly reported causal pathways between events or conditions listed on the death certificate.

  19. News media reports of patient deaths following 'medical tourism' for cosmetic surgery and bariatric surgery.

    Science.gov (United States)

    Turner, Leigh

    2012-04-01

    Contemporary scholarship examining clinical outcomes in medical travel for cosmetic surgery identifies cases in which patients traveled abroad for medical procedures and subsequently returned home with infections and other surgical complications. Though there are peer-reviewed articles identifying patient deaths in cases where patients traveled abroad for commercial kidney transplantation or stem cell injections, no scholarly publications document deaths of patients who traveled abroad for cosmetic surgery or bariatric surgery. Drawing upon news media reports extending from 1993 to 2011, this article identifies and describes twenty-six reported cases of deaths of individuals who traveled abroad for cosmetic surgery or bariatric surgery. Over half of the reported deaths occurred in two countries. Analysis of these news reports cannot be used to make causal claims about why the patients died. In addition, cases identified in news media accounts do not provide a basis for establishing the relative risk of traveling abroad for care instead of seeking elective cosmetic surgery at domestic health care facilities. Acknowledging these limitations, the case reports suggest the possibility that contemporary peer-reviewed scholarship is underreporting patient mortality in medical travel. The paper makes a strong case for promoting normative analyses and empirical studies of medical travel. In particular, the paper argues that empirically informed ethical analysis of 'medical tourism' will benefit from rigorous studies tracking global flows of medical travelers and the clinical outcomes they experience. The paper contains practical recommendations intended to promote debate concerning how to promote patient safety and quality of care in medical travel. © 2012 Blackwell Publishing Ltd.

  20. THE PROGRAMED CELL DEATH REGULATORS OF ISOLATED MODEL SYSTEMS

    Directory of Open Access Journals (Sweden)

    D. V. Vatlitsov

    2016-06-01

    Full Text Available The technology evolution creates the prerequisites for the emergence of new informational concept and approaches to the formation of a fundamentally new principles of biological objects understanding. The aim was to study the activators of the programmed cell death in an isolated system model. Cell culture aging parameters were performed on flow cytometer. It had formed the theory that the changes in the concentrations of metal ions and increase their extracellular concentration had formed a negative gradient into the cells.regulation of cell death. It was shown that the metals ions concentrations.

  1. Cell death in the pathogenesis of systemic lupus erythematosus and lupus nephritis.

    Science.gov (United States)

    Mistry, Pragnesh; Kaplan, Mariana J

    2017-12-01

    Nephritis is one of the most severe complications of systemic lupus erythematosus (SLE). One key characteristic of lupus nephritis (LN) is the deposition of immune complexes containing nucleic acids and/or proteins binding to nucleic acids and autoantibodies recognizing these molecules. A variety of cell death processes are implicated in the generation and externalization of modified nuclear autoantigens and in the development of LN. Among these processes, apoptosis, primary and secondary necrosis, NETosis, necroptosis, pyroptosis, and autophagy have been proposed to play roles in tissue damage and immune dysregulation. Cell death occurs in healthy individuals during conditions of homeostasis yet autoimmunity does not develop, at least in part, because of rapid clearance of dying cells. In SLE, accelerated cell death combined with a clearance deficiency may lead to the accumulation and externalization of nuclear autoantigens and to autoantibody production. In addition, specific types of cell death may modify autoantigens and alter their immunogenicity. These modified molecules may then become novel targets of the immune system and promote autoimmune responses in predisposed hosts. In this review, we examine various cell death pathways and discuss how enhanced cell death, impaired clearance, and post-translational modifications of proteins could contribute to the development of lupus nephritis. Published by Elsevier Inc.

  2. Lack of recording of systemic lupus erythematosus in the death certificates of lupus patients.

    Science.gov (United States)

    Calvo-Alén, J; Alarcón, G S; Campbell, R; Fernández, M; Reveille, J D; Cooper, G S

    2005-09-01

    To determine to what extent the diagnosis of systemic lupus erythematosus (SLE) in deceased lupus patients is under-reported in death certificates, and the patient characteristics associated with such an occurrence. The death certificates of 76 of the 81 deceased SLE patients from two US lupus cohorts (LUMINA for Lupus in Minorities: Nature vs Nurture and CLU for Carolina Lupus Study), including 570 and 265 patients, respectively, were obtained from the Offices of Vital Statistics of the states where the patients died (Alabama, Georgia, North Carolina, South Carolina, Tennessee and Texas). Both cohorts included patients with SLE as per the American College of Rheumatology criteria, aged > or =16 yr, and disease duration at enrolment of < or =5 yr. The median duration of follow-up in each cohort at the time of these analyses ranged from 38.1 to 53.0 months. Standard univariable analyses were performed comparing patients with SLE recorded anywhere in the death certificate and those without it. A multivariable logistic regression model was performed to identify the variables independently associated with not recording SLE in death certificates. In 30 (40%) death certificates, SLE was not recorded anywhere in the death certificate. In univariable analyses, older age was associated with lack of recording of SLE in death certificates [mean age (standard deviation) 50.9 (15.6) years and 39.1 (18.6) yr among those for whom SLE was omitted and included on the death certificates, respectively, P = 0.005]. Patients without health insurance, those dying of a cardiovascular event and those of Caucasian ethnicity were also more likely to be in the non-recorded group. In the multivariable analysis, variables independently associated with not recording SLE as cause of death were older age [odds ratio = (95% confidence interval) 1.043 (1.005-1.083 per yr increase); P = 0.023] and lack of health insurance [4.649 (1.152-18.768); P = 0.031]. A high proportion of SLE diagnoses are not

  3. [Analysis of death causes among infants in Guangzhou from 2010 to 2013].

    Science.gov (United States)

    Shen, Jichuan; Wang, Ming; Dong, Hang; Zhou, Qin

    2014-06-01

    To analyze the main death causes among infants in Guangzhou in 2010-2013 and to provide an objective and scientific basis for risk communication of public health emergencies in the future. Descriptive epidemiological method was used to analyze the death causes among infants reported in Guangzhou from the National Death Registration Reporting Information System. The death causes among infants were classified by the 10th international classification of diseases (ICD-10). The constitution and rank order of death causes among infants were analyzed according to the underlying causes of deaths. A total of 4 880 cases of infant deaths were reported in Guangzhou from 2010 to 2013 and infant deaths in floating population were 1.8 (3 135/1 745) times of registered population. The deaths of male infants were 1.73 (3 094/1 786) times of female infants. The neonatal group accounted for 52.32% (2 553/4 880) of total infant deaths and early neonatal group accounted for 64.86% (1 656/2 553) of total neonatal deaths. The top five causes of infant deaths followed by perinatal diseases, congenital malformations, respiratory diseases (mainly pneumonia), accidental deaths and communicable diseases. The mortality ratios were respectively 44.12% (2 153 cases) , 24.73% (1 207 cases), 6.86% (335 cases), 3.48% (170 cases), 3.01% (147 cases) , and no vaccine-related death case was reported. The primary cause of infant deaths in Guangzhou 2010-2013 was perinatal diseases.

  4. Self-Administered Ethanol Enema Causing Accidental Death

    Directory of Open Access Journals (Sweden)

    Thomas Peterson

    2014-01-01

    Full Text Available Excessive ethanol consumption is a leading preventable cause of death in the United States. Much of the harm from ethanol comes from those who engage in excessive or hazardous drinking. Rectal absorption of ethanol bypasses the first pass metabolic effect, allowing for a higher concentration of blood ethanol to occur for a given volume of solution and, consequently, greater potential for central nervous system depression. However, accidental death is extremely rare with rectal administration. This case report describes an individual with klismaphilia whose death resulted from acute ethanol intoxication by rectal absorption of a wine enema.

  5. Drug-induced cellular death dynamics monitored by a highly sensitive organic electrochemical system.

    Science.gov (United States)

    Romeo, Agostino; Tarabella, Giuseppe; D'Angelo, Pasquale; Caffarra, Cristina; Cretella, Daniele; Alfieri, Roberta; Petronini, Pier Giorgio; Iannotta, Salvatore

    2015-06-15

    We propose and demonstrate a sensitive diagnostic device based on an Organic Electrochemical Transistor (OECT) for direct in-vitro monitoring cell death. The system efficiently monitors cell death dynamics, being able to detect signals related to specific death mechanisms, namely necrosis or early/late apoptosis, demonstrating a reproducible correlation between the OECT electrical response and the trends of standard cell death assays. The innovative design of the Twell-OECT system has been modeled to better correlate electrical signals with cell death dynamics. To qualify the device, we used a human lung adenocarcinoma cell line (A549) that was cultivated on the micro-porous membrane of a Transwell (Twell) support, and exposed to the anticancer drug doxorubicin. Time-dependent and dose-dependent dynamics of A549 cells exposed to doxorubicin are evaluated by monitoring cell death upon exposure to a range of doses and times that fully covers the protocols used in cancer treatment. The demonstrated ability to directly monitor cell stress and death dynamics upon drug exposure using simple electronic devices and, possibly, achieving selectivity to different cell dynamics is of great interest for several application fields, including toxicology, pharmacology, and therapeutics. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. Death analysis of residents in an area of twenty kilometers around Qinshan nuclear power station

    International Nuclear Information System (INIS)

    Ma Mingqiang; Lu Zhunrong; Zheng Wen; Sun Peizhi

    2001-01-01

    Objective: To set up a data bank for residents health condition 20 kilometers within around Qinshan nuclear power station. Methods: Combining with retrospective investigation, the relevant data were acquired from medical certification for resident's death reported by all local disease surveillance. Results: The mortality rate of these residents from 1988 to 1999 was 6.92%. The first course of mortality was diseases of respiratory system, the second of circulatory system, and the third was malignant tumor. The first 5 death causes among all male and female persons were diseases of respiratory system and circulatory system, malignant tumor, injuries and poisoning, diseases of digestive system. The mortality rate for malignant tumor was 121.33/100000 (the standard death rate is : 100.13/100000), and liver cancer was the first death cause, while lung and stomach cancers, the second and the third, respectively. The main death causes in juvenile and youth was leukemia, but liver cancer and lung cancer were the main courses of death in the middle-aged, and in old people, lung and liver cancers. Conclusion: The chronic non-infectious diseases in respiratory system, circulatory system etc, are the major death causes in the residents, the mortality rate for malignant tumor in them is lower than that reported by provincial disease surveillance station

  7. A Case Report of Successful Kidney Donation After Brain Death Following Nicotine Intoxication.

    Science.gov (United States)

    Räsänen, M; Helanterä, I; Kalliomäki, J; Savikko, J; Parry, M; Lempinen, M

    Nicotine intoxication is a rare cause of death and can lead to brain death after respiratory arrest and hypoxic-ischemic encephalopathy. To our knowledge, no previous reports regarding organ donation after nicotine intoxication have been described. We present a successful case of kidney donation after brain death caused by subcutaneous nicotine overdose from liquid nicotine from an e-cigarette cartridge in an attempted suicide. Both kidneys were transplanted successfully with immediate graft function, and both recipients were discharged at postoperative day 9 with normal plasma creatinine levels. Graft function has remained excellent in follow-up. This case suggests that kidneys from a donor with fatal nicotine intoxication may be successfully used for kidney transplantation in the absence of other contraindications for donation. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Bodies recovered from wells, sewerage systems and pits: what is the cause of death?

    Science.gov (United States)

    Esiyok, Burcu; Balci, Yasemin; Ozbay, Mehmet

    2006-08-01

    The aim of this study was to determine the problems encountered during investigations into causes of death in corpses found in wells, sewer systems and pits, and to seek solutions to the problems. In fact, wells, sewer systems and pits have some common characteristics which may cause the problems. They contain water, have a hypoxic/anoxic environment and prevent corpses from being recognised. Based on the data obtained from the 1st Specialization Board of the Council of Forensic Medicine, affiliated with the Ministry of Justice, we retrospectively reviewed 69 corpses found in wells, sewer systems and pits between 1 January 1992 and 31 December 2002. Data on age, sex, crime scene and causes of death were obtained and evaluated using the SPSS 11.0 package programme. Of 69 cases, 69.1% were male and 33.4% were aged 0 to 10 years. Fifty-eight per cent and 13.1% of the cases were found in wells and sewer systems respectively. Forty-three (62.3%) cases were found in a place with water. However, 34.9% of them had not drowned. The most frequent cause of death was drowning (40.6%). The cause of death was unknown in 18.8% of the cases. 15.9% of the corpses were exhumed to determine the cause of death. Twenty-six cases (37.7%) had signs of putrefaction and the cause of death was not determined in 9 cases. Diatom was investigated in 42.0% of the cases (29 cases), but 17 cases did not have diatom. It is a complicated process to determine the causes of death in bodies recovered from wells, pits, water supplies and sewer systems, etc. Thorough forensic investigations are required because death may result from a wide variety of factors, and lesions on the corpses may undergo some changes quickly or can be covered in wells, pits and water supplies. A complete crime scene investigation, a thorough autopsy and histopathological, toxicological and biochemical examinations would prevent potential problems in determining the causes of death in bodies recovered from wells, sewer systems

  9. Communication about HIV and death: Maternal reports of primary school-aged children's questions after maternal HIV disclosure in rural South Africa.

    Science.gov (United States)

    Rochat, Tamsen J; Mitchell, Joanie; Lubbe, Anina M; Stein, Alan; Tomlinson, Mark; Bland, Ruth M

    2017-01-01

    Children's understanding of HIV and death in epidemic regions is under-researched. We investigated children's death-related questions post maternal HIV-disclosure. Secondary aims examined characteristics associated with death-related questions and consequences for children's mental health. HIV-infected mothers (N = 281) were supported to disclose their HIV status to their children (6-10 years) in an uncontrolled pre-post intervention evaluation. Children's questions post-disclosure were collected by maternal report, 1-2 weeks post-disclosure. 61/281 children asked 88 death-related questions, which were analysed qualitatively. Logistic regression analyses examined characteristics associated with death-related questions. Using the parent-report Child Behaviour Checklist (CBCL), linear regression analysis examined differences in total CBCL problems by group, controlling for baseline. Children's questions were grouped into three themes: 'threats'; 'implications' and 'clarifications'. Children were most concerned about the threat of death, mother's survival, and prior family deaths. In multivariate analysis variables significantly associated with asking death-related questions included an absence of regular remittance to the mother (AOR 0.25 [CI 0.10, 0.59] p = 0.002), mother reporting the child's initial reaction to disclosure being "frightened" (AOR 6.57 [CI 2.75, 15.70] p=financial support to the family may facilitate or inhibit discussions about death post-disclosure. Communication about death did not have immediate negative consequences on child behaviour according to maternal report. In sub-Saharan Africa, given exposure to death at young ages, meeting children's informational needs could increase their resilience. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  10. Mortality and causes of death of 344 Danish patients with systemic sclerosis (scleroderma)

    DEFF Research Database (Denmark)

    Jacobsen, Søren; Halberg, P; Ullman, S

    1998-01-01

    To determine survival, mortality and causes of death in Danish patients with systemic sclerosis (scleroderma), and to analyse how these parameters are influenced by demographic variables and the extent of skin involvement.......To determine survival, mortality and causes of death in Danish patients with systemic sclerosis (scleroderma), and to analyse how these parameters are influenced by demographic variables and the extent of skin involvement....

  11. Shifting paradigm of maternal and perinatal death review system in Bangladesh: A real time approach to address sustainable developmental goal 3 by 2030 [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Animesh Biswas

    2017-07-01

    Full Text Available Recently, Bangladesh has made remarkable progress in reducing maternal and neonatal morality, even though the millennium developmental goal to reduce maternal and neonatal mortality was not achieved. Sustainable Developmental Goal (SDG 3 has already been set for a new target to reduce maternal and neonatal deaths by 2030. The country takes this timely initiative to introduce a maternal and perinatal death review system. This review will discuss the shifting paradigm of the maternal and perinatal death review system in Bangladesh and its challenges in reaching the SDG on time. This review uses existing literature on the maternal and perinatal death review system in Bangladesh, and other systems in similar settings, as well as reports, case studies, news, government letters and meeting minutes. Bangladesh introduced the maternal and perinatal death review system in 2010. Prior to this there was no such comprehensive death review system practiced in Bangladesh. The system was established within the government health system and has brought about positive effects and outcomes. Therefore, the Ministry of Health and Family Welfare of Bangladesh gradually scaled up the maternal and perinatal death review system nationwide in 2016 within the government health system. The present death review system highlighted real-time data use, using the district health information software(DHIS-2. Health mangers are able to take remedial action plans and implement strategies based on findings in DHIS-2. Therefore, effective utilization of data can play a pivotal role in the reduction of maternal and perinatal deaths in Bangladesh. Overall, the maternal and perinatal death review system provides a great opportunity to achieve the SDG 3 on time. However, the system needs continuous monitoring at different levels to ensure its quality and validity of information, as well as effective utilization of findings for planning and implementation under a measureable

  12. Occupation recorded on certificates of death compared with self-report: the Atherosclerosis Risk in Communities (ARIC Study

    Directory of Open Access Journals (Sweden)

    Wolf Susanne H

    2007-08-01

    Full Text Available Abstract Background Death certificates are a potential source of sociodemographic data for decedents in epidemiologic research. However, because this information is provided by the next-of-kin or other proxies, there are concerns about validity. Our objective was to assess the agreement of job titles and occupational categories derived from death certificates with that self-reported in mid and later life. Methods Occupation was abstracted from 431 death certificates from North Carolina Atherosclerosis Risk in Communities Study participants who died between 1987 and 2001. Occupations were coded according to 1980 Bureau of Census job titles and then grouped into six 1980 census occupational categories. This information was compared with the self-reported occupation at midlife as reported at the baseline examination (1987–89. We calculated percent agreement using standard methods. Chance-adjusted agreement was assessed by kappa coefficients, with 95% confidence intervals. Results Agreement between death certificate and self-reported job titles was poor (32%, while 67% of occupational categories matched the two sources. Kappa coefficients ranged from 0.53 for technical/sales/administrative jobs to 0.68 for homemakers. Agreement was lower, albeit nonsignificant, for women (kappa = 0.54, 95% Confidence Interval, CI = 0.44–0.63 than men (kappa = 0.62, 95% CI = 0.54–0.69 and for African-Americans (kappa = 0.47, 95% CI = 0.34–0.61 than whites (kappa = 0.63, 95% CI = 0.57–0.69 but varied only slightly by educational attainment. Conclusion While agreement between self- and death certificate reported job titles was poor, agreement between occupational categories was good. This suggests that while death certificates may not be a suitable source of occupational data where classification into specific job titles is essential, in the absence of other data, it is a reasonable source for constructing measures such as occupational SES that are based on

  13. A Guide for Using the Transient Ground-Water Flow Model of the Death Valley Regional Ground-Water Flow System, Nevada and California

    Energy Technology Data Exchange (ETDEWEB)

    Joan B. Blainey; Claudia C. Faunt, and Mary C. Hill

    2006-05-16

    This report is a guide for executing numerical simulations with the transient ground-water flow model of the Death Valley regional ground-water flow system, Nevada and California using the U.S. Geological Survey modular finite-difference ground-water flow model, MODFLOW-2000. Model inputs, including observations of hydraulic head, discharge, and boundary flows, are summarized. Modification of the DVRFS transient ground-water model is discussed for two common uses of the Death Valley regional ground-water flow system model: predictive pumping scenarios that extend beyond the end of the model simulation period (1998), and model simulations with only steady-state conditions.

  14. Brief Report: Association Between Pregnancy Outcomes and Death From Cardiovascular Causes in Parous Women With Systemic Lupus Erythematosus: A Study Using Swedish Population Registries.

    Science.gov (United States)

    Soh, May Ching; Nelson-Piercy, Catherine; Dib, Fadia; Westgren, Magnus; McCowan, Lesley; Pasupathy, Dharmintra

    2015-09-01

    To determine if maternal placental syndromes (MPS) are associated with an increased risk of death from cardiovascular causes in women with systemic lupus erythematosus (SLE). Between 1973 and 2011, women with SLE and a history of pregnancy were identified using linked Swedish population registries. The outcome was death from primarily cardiovascular causes, defined as death from acute coronary syndrome or coronary artery disease, stroke, or peripheral vascular disease. The exposure was MPS, defined as any hypertensive disorders in pregnancy, stillbirth, placental abruption, or delivery of a small-for-gestational-age infant. The association of preterm delivery (delivery at death from cardiovascular causes was also explored. Risk of death from cardiovascular causes was determined using logistic regression, adjusting for the year of first delivery, duration of SLE, number of inpatient admissions, and cardiovascular risk factors. A total of 3,977 women with SLE had 7,410 pregnancies during the study interval. Death from primarily cardiovascular causes occurred in 44 of the 325 women who died (13.5%). The median age at death from cardiovascular causes was 54 years (interquartile range 48-58 years), and these women were more likely to have had hypertension and renal disease. MPS was associated with an increased risk of death from primarily cardiovascular causes (adjusted odds ratio [OR] 2.19 [95% confidence interval (95% CI) 1.14-4.22]), specifically, a history of placental abruption (adjusted OR 5.78 [95% CI 1.61-20.72]). Delivery at death from primarily cardiovascular causes (adjusted OR 2.49 [95% CI 1.06-5.85]). MPS in pregnancy is associated with a higher risk of death from primarily cardiovascular causes in women with SLE. © 2015, American College of Rheumatology.

  15. 38 CFR 3.211 - Death.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Death. 3.211 Section 3..., Compensation, and Dependency and Indemnity Compensation Evidence Requirements § 3.211 Death. Death should be... community where death occurred. (2) A copy of a coroner's report of death or a verdict of a coroner's jury...

  16. Non-Cell Autonomous Influence of the Astrocyte System xc − on Hypoglycaemic Neuronal Cell Death

    Directory of Open Access Journals (Sweden)

    Nicole A Jackman

    2012-01-01

    Full Text Available Despite longstanding evidence that hypoglycaemic neuronal injury is mediated by glutamate excitotoxicity, the cellular and molecular mechanisms involved remain incompletely defined. Here, we demonstrate that the excitotoxic neuronal death that follows GD (glucose deprivation is initiated by glutamate extruded from astrocytes via system xc −– – an amino acid transporter that imports L-cystine and exports L-glutamate. Specifically, we find that depriving mixed cortical cell cultures of glucose for up to 8 h injures neurons, but not astrocytes. Neuronal death is prevented by ionotropic glutamate receptor antagonism and is partially sensitive to tetanus toxin. Removal of amino acids during the deprivation period prevents – whereas addition of L-cystine restores – GD-induced neuronal death, implicating the cystine/glutamate antiporter, system xc−–. Indeed, drugs known to inhibit system xc −– ameliorate GD-induced neuronal death. Further, a dramatic reduction in neuronal death is observed in chimaeric cultures consisting of neurons derived from WT (wild-type mice plated on top of astrocytes derived from sut mice, which harbour a naturally occurring null mutation in the gene (Slc7a11 that encodes the substrate-specific light chain of system xc −– (xCT. Finally, enhancement of astrocytic system xc −– expression and function via IL-1β (interleukin-1β exposure potentiates hypoglycaemic neuronal death, the process of which is prevented by removal of L-cystine and/or addition of system xc −– inhibitors. Thus, under the conditions of GD, our studies demonstrate that astrocytes, via system xc −–, have a direct, non-cell autonomous effect on cortical neuron survival.

  17. Causes of death and associated conditions (Codac): a utilitarian approach to the classification of perinatal deaths.

    Science.gov (United States)

    Frøen, J Frederik; Pinar, Halit; Flenady, Vicki; Bahrin, Safiah; Charles, Adrian; Chauke, Lawrence; Day, Katie; Duke, Charles W; Facchinetti, Fabio; Fretts, Ruth C; Gardener, Glenn; Gilshenan, Kristen; Gordijn, Sanne J; Gordon, Adrienne; Guyon, Grace; Harrison, Catherine; Koshy, Rachel; Pattinson, Robert C; Petersson, Karin; Russell, Laurie; Saastad, Eli; Smith, Gordon C S; Torabi, Rozbeh

    2009-06-10

    A carefully classified dataset of perinatal mortality will retain the most significant information on the causes of death. Such information is needed for health care policy development, surveillance and international comparisons, clinical services and research. For comparability purposes, we propose a classification system that could serve all these needs, and be applicable in both developing and developed countries. It is developed to adhere to basic concepts of underlying cause in the International Classification of Diseases (ICD), although gaps in ICD prevent classification of perinatal deaths solely on existing ICD codes.We tested the Causes of Death and Associated Conditions (Codac) classification for perinatal deaths in seven populations, including two developing country settings. We identified areas of potential improvements in the ability to retain existing information, ease of use and inter-rater agreement. After revisions to address these issues we propose Version II of Codac with detailed coding instructions.The ten main categories of Codac consist of three key contributors to global perinatal mortality (intrapartum events, infections and congenital anomalies), two crucial aspects of perinatal mortality (unknown causes of death and termination of pregnancy), a clear distinction of conditions relevant only to the neonatal period and the remaining conditions are arranged in the four anatomical compartments (fetal, cord, placental and maternal).For more detail there are 94 subcategories, further specified in 577 categories in the full version. Codac is designed to accommodate both the main cause of death as well as two associated conditions. We suggest reporting not only the main cause of death, but also the associated relevant conditions so that scenarios of combined conditions and events are captured.The appropriately applied Codac system promises to better manage information on causes of perinatal deaths, the conditions associated with them, and the most

  18. Review of autopsy reports of deaths relating to fire in South Australia 2000-2015.

    Science.gov (United States)

    Sully, Claire J; Walker, G Stewart; Langlois, Neil E I

    2018-06-01

    It has been noted there are gaps and inconsistencies in data pertaining to fire related deaths in Australia, which poses difficulties for analysis of national statistics. A search of post-mortem examination reports at Forensic Science SA from 2000 to 2015 revealed 275 cases regarded as fire related in which the body had been involved in a fire. The autopsy reports were evaluated to determine parameters including the location of the fire event, age and sex of victim, as well as the presence of soot in the airways and cherry-red coloration to the blood and/or organs, in addtion to toxicological levels of carboxyhemoglobin and alcohol. Fire events were clasified as structural, transportation or open air in type. Males were more commonly victims than females, especially in transportation fires, where males aged below 50 years were most at risk of death. Carboxyhemoglobin levels tended to be lower in victims of transportation fires. This study has confirmed that presence of soot in the respiratory tract and cherry-red coloration of a body retrieved from a fire are both linked to an increased level of blood carboxyhemoglobin. These findings significantly contribute to the documentation of fire deaths in Australia.

  19. Online news media reporting of football-related fatalities in Australia: A matter of life and death.

    Science.gov (United States)

    Fortington, Lauren V; Bekker, Sheree; Finch, Caroline F

    2018-03-01

    While deaths in sports settings are rare, they do occur. To develop an understanding of the sports and people most at risk, and to identify opportunities for prevention, routine and systematic data detailing the occurrence of these fatalities is required. There is currently no routine reporting of data of this nature in Australia. As there is often strong community interest in these incidents, the media offers an opportunity for surveillance. However before this can occur, understanding of the terminology used by the media is required. The aim of this study was to identify the terminology most frequently used in online Australian news media coverage of football-related deaths. Retrospective review of online news media. Three databases were searched for online news media reports of people who died while participating in football (all football codes) in Australia. A descriptive analysis of terminology was undertaken to identify the common language applied. Thirty-four football-related fatalities in Australia were identified between 2010-2016, via 149 separate articles. The most frequent terms identified in the media items were: Family; Club; Rugby; Football; Player; League; Died; Game; Death; Life; Loved; Hospital; Match; Young; Community; Playing; Friends; Sport; Heart; AFL [Australian Football League]. This study identified terminology used in reporting football-related fatalities in Australia, identifying common reference to terms relating to 'death' as metaphors and the frequent celebration of 'life.' The findings suggest that a reliance on researcher-generated terminology will be insufficient to reflect media discourse in prospective monitoring of sports deaths for surveillance. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  20. Near-death experiences and spiritual well-being.

    Science.gov (United States)

    Khanna, Surbhi; Greyson, Bruce

    2014-12-01

    People who have near-death experiences often report a subsequently increased sense of spirituality and a connection with their inner self and the world around them. In this study, we examined spiritual well-being, using Paloutzian and Ellison's Spiritual Well-Being Scale, among 224 persons who had come close to death. Participants who reported having near-death experiences reported greater spiritual well-being than those who did not, and depth of spiritual well-being was positively correlated with depth of near-death experience. We discussed the implications of these findings in light of other reported aftereffects of near-death experiences and of spiritual well-being among other populations.

  1. Current asthma deaths among adults in Japan

    Directory of Open Access Journals (Sweden)

    Tsugio Nakazawa

    2004-01-01

    Full Text Available Recent asthma deaths were examined from yearly reports of the Ministry of Health, Labor and Welfare of Japan and from reports published by the Japan Asthma Death Investigation Committee on 811 deaths over the period 1992–2000. The rate and number of recent asthma deaths in Japan have been decreasing rapidly. Most asthma deaths were of patients aged 70–90 years and there has been a marked trend for increased asthma deaths in the elderly. As for the circumstances surrounding the deaths, sudden death, unstable sudden aggravation and intermittent aggravation were mainly noted. Respiratory infections, fatigue and stress were the major courses of fatal attacks contributing to deaths due to asthma. Many of the patients who died from asthma had been diagnosed as having as moderate to severe asthma and many had non-atopic asthma. There are some reports that suggest that the recent decrease in asthma deaths in Japan is correlated with the use of inhaled cortico- steroids.

  2. TABLE III. Deaths in 122 U.S. cities

    Data.gov (United States)

    U.S. Department of Health & Human Services — TABLE III. Deaths in 122 U.S. cities - 2014. 122 Cities Mortality Reporting System — Each week, the vital statistics offices of 122 cities across the United States...

  3. Confounding factors in diagnosing brain death: a case report

    Directory of Open Access Journals (Sweden)

    Login Ivan S

    2002-06-01

    Full Text Available Abstract Background Brain death is strictly defined medically and legally. This diagnosis depends on three cardinal neurological features: coma, absent brainstem reflexes, and apnea. The diagnosis can only be made, however, in the absence of intoxication, hypothermia, or certain medical illnesses. Case presentation A patient with severe hypoxic-ischemic brain injury met the three cardinal neurological features of brain death but concurrent profound hypothyroidism precluded the diagnosis. Our clinical and ethical decisions were further challenged by another facet of this complex case. Although her brain damage indicated a hopeless prognosis, we could not discontinue care based on futility because the only known surrogate was mentally retarded and unable to participate in medical planning. Conclusion The presence of certain medical conditions prohibits a diagnosis of brain death, which is a medicolegal diagnosis of death, not a prediction or forecast of future outcome. While prognostication is important in deciding to withdraw care, it is not a component in diagnosing brain death.

  4. TABLE III. Deaths in 122 U.S. cities

    Data.gov (United States)

    U.S. Department of Health & Human Services — TABLE III. Deaths in 122 U.S. cities – 2016. 122 Cities Mortality Reporting System — Each week, the vital statistics offices of 122 cities across the United States...

  5. TABLE III. Deaths in 122 U.S. cities

    Data.gov (United States)

    U.S. Department of Health & Human Services — TABLE III. Deaths in 122 U.S. cities - 2015122 Cities Mortality Reporting System ��� Each week, the vital statistics offices of 122 cities across the United States...

  6. Causes of death and associated conditions (Codac – a utilitarian approach to the classification of perinatal deaths

    Directory of Open Access Journals (Sweden)

    Harrison Catherine

    2009-06-01

    Full Text Available Abstract A carefully classified dataset of perinatal mortality will retain the most significant information on the causes of death. Such information is needed for health care policy development, surveillance and international comparisons, clinical services and research. For comparability purposes, we propose a classification system that could serve all these needs, and be applicable in both developing and developed countries. It is developed to adhere to basic concepts of underlying cause in the International Classification of Diseases (ICD, although gaps in ICD prevent classification of perinatal deaths solely on existing ICD codes. We tested the Causes of Death and Associated Conditions (Codac classification for perinatal deaths in seven populations, including two developing country settings. We identified areas of potential improvements in the ability to retain existing information, ease of use and inter-rater agreement. After revisions to address these issues we propose Version II of Codac with detailed coding instructions. The ten main categories of Codac consist of three key contributors to global perinatal mortality (intrapartum events, infections and congenital anomalies, two crucial aspects of perinatal mortality (unknown causes of death and termination of pregnancy, a clear distinction of conditions relevant only to the neonatal period and the remaining conditions are arranged in the four anatomical compartments (fetal, cord, placental and maternal. For more detail there are 94 subcategories, further specified in 577 categories in the full version. Codac is designed to accommodate both the main cause of death as well as two associated conditions. We suggest reporting not only the main cause of death, but also the associated relevant conditions so that scenarios of combined conditions and events are captured. The appropriately applied Codac system promises to better manage information on causes of perinatal deaths, the conditions

  7. Causes of death and associated conditions (Codac) – a utilitarian approach to the classification of perinatal deaths

    Science.gov (United States)

    Frøen, J Frederik; Pinar, Halit; Flenady, Vicki; Bahrin, Safiah; Charles, Adrian; Chauke, Lawrence; Day, Katie; Duke, Charles W; Facchinetti, Fabio; Fretts, Ruth C; Gardener, Glenn; Gilshenan, Kristen; Gordijn, Sanne J; Gordon, Adrienne; Guyon, Grace; Harrison, Catherine; Koshy, Rachel; Pattinson, Robert C; Petersson, Karin; Russell, Laurie; Saastad, Eli; Smith, Gordon CS; Torabi, Rozbeh

    2009-01-01

    A carefully classified dataset of perinatal mortality will retain the most significant information on the causes of death. Such information is needed for health care policy development, surveillance and international comparisons, clinical services and research. For comparability purposes, we propose a classification system that could serve all these needs, and be applicable in both developing and developed countries. It is developed to adhere to basic concepts of underlying cause in the International Classification of Diseases (ICD), although gaps in ICD prevent classification of perinatal deaths solely on existing ICD codes. We tested the Causes of Death and Associated Conditions (Codac) classification for perinatal deaths in seven populations, including two developing country settings. We identified areas of potential improvements in the ability to retain existing information, ease of use and inter-rater agreement. After revisions to address these issues we propose Version II of Codac with detailed coding instructions. The ten main categories of Codac consist of three key contributors to global perinatal mortality (intrapartum events, infections and congenital anomalies), two crucial aspects of perinatal mortality (unknown causes of death and termination of pregnancy), a clear distinction of conditions relevant only to the neonatal period and the remaining conditions are arranged in the four anatomical compartments (fetal, cord, placental and maternal). For more detail there are 94 subcategories, further specified in 577 categories in the full version. Codac is designed to accommodate both the main cause of death as well as two associated conditions. We suggest reporting not only the main cause of death, but also the associated relevant conditions so that scenarios of combined conditions and events are captured. The appropriately applied Codac system promises to better manage information on causes of perinatal deaths, the conditions associated with them, and the

  8. Correlates of death anxiety in Pakistan.

    Science.gov (United States)

    Suhail, Kausar; Akram, Saima

    2002-01-01

    To ascertain the effect of gender, age, and religiosity on death anxiety, 132 participants were interviewed using Templer Death Anxiety Scale and Collett-Lester Fear of Death Scale (CLS). Women, older participants, and less religious participants were found to be more scared of their impending death. Gender effect was more pronounced, however, on the CLS. Women and less religious people reported to experience greater anxiety than their respective counterparts about different dimensions of death, for example, the shortness of life, total isolation of death, fear of not being, and disintegration of body after dying. The findings of the current work indicate that the general predictors of death anxiety, gender, age, and religiosity reported in Western, predominantly Christian samples also hold in an Eastern, Muslim sample.

  9. Brain death in neonates: a case report

    Directory of Open Access Journals (Sweden)

    Georgios Mitsiakos

    2014-06-01

    Full Text Available Brain death (BD is the permanent and complete loss of cerebral and brainstem function. It is relatively uncommon in newborns with its percentage among deaths being 1-6.3%. BD leads to debate for medical, ethical and philosophical issues. It is a challenging condition in neonatal intensive care units (NICUs since difficulties for BD diagnosis in neonates and ever more so in preterm neonates do arise. Revised guidelines for BD diagnosis definition include history with known etiology, clinical examination, apnea testing and neurological evaluation often assisted by ancillary tests. We present the case of a near term female baby that was born with brain death due to hypoxic ischemic encephalopathy. We conclude that BD in newborns is a challenge to NICUs and there is a need for establishing and implementing new guidelines and checklists on national basis. Proceedings of the 10th International Workshop on Neonatology · Cagliari (Italy · October 22nd-25th, 2014 · The last ten years, the next ten years in Neonatology Guest Editors: Vassilios Fanos, Michele Mussap, Gavino Faa, Apostolos Papageorgiou

  10. Time and place of death from automobile crashes: Research endpoint implications.

    Science.gov (United States)

    Champion, Howard R; Lombardo, Louis V; Wade, Charles E; Kalin, Ellen J; Lawnick, Mary M; Holcomb, John B

    2016-09-01

    Vehicle crashes are a leading cause of US injury and death. Early death, however, has almost entirely been studied in-hospital. The US Department of Transportation Fatality Analysis Reporting System (FARS) database captures both prehospital and in-hospital mortality. FARS location (prehospital, in-hospital) and time of death were reviewed (1978-2013), and a 2003-2005 subgroup of 55,537 early deaths (i.e., between 5 minutes and 4 hours after injury) was analyzed to quantify risk of death over time. There has been an overall decrease in 1978-2013 US vehicle-related deaths (from 3.3 deaths per 100 million vehicle miles traveled to 1.1 and from 22.6 per 100,000 population to 10.4). Snapshots of the death data reveal an overall downward trend of total in-hospital and prehospital deaths. The proportion of hospital deaths decreased by 58%, whereas the proportion of deaths in the prehospital period increased to 56%. Subgroup analysis revealed a rate of mortality risk of 0.4% per minute for the first 30 minutes, 1% per minute for the next 60 minutes, and 0.2% per minute and plateauing thereafter. Analysis of census FARS data of motor vehicle crash-related deaths showed an overall 35% decrease in mortality over a period of 36 years. The disproportionate reduction in in-hospital deaths is perhaps a testament to the effectiveness of trauma centers. However, there is a demonstrable need to focus on prehospital deaths with resuscitative and adjuvant therapy research and trauma system design. Quantifying risk of death over time should help focus emergency medical services, trauma system, and resuscitation goals. Epidemiologic study, level III.

  11. Brain Death,Concept and Criteria

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    The concept of brain death originated in France. In 1959, the French scholars P. Mollaret and M. Goulon proposed the concept of "coma de- passe" or "brain death" for the first time and reported 23 cases with such symptoms. The first guidelines (the Harvard criteria) for diagnosing brain death was established in 1968, defining brain death

  12. Cancer Deaths due to Lack of Universal Access to Radiotherapy in the Brazilian Public Health System.

    Science.gov (United States)

    Mendez, L C; Moraes, F Y; Fernandes, G Dos S; Weltman, E

    2018-01-01

    Radiotherapy plays a fundamental role in the treatment of cancer. Currently, the Brazilian public health system cannot match the national radiotherapy demand and many patients requiring radiotherapy are never exposed to this treatment. This study estimated the number of preventable deaths in the public health system if access to radiotherapy was universal. Incidence rates for the year 2016 provided by Instituto Nacional de Cancer were used in this analysis. The number of untreated patients requiring radiotherapy was obtained through the difference between the total number of patients requiring radiotherapy and the total amount of delivered radiotherapy treatments in the public health system. The number of deaths for the three most common cancers in each gender due to radiotherapy shortage was calculated. Initially, the total number of patients per cancer type was divided in stages using Brazilian epidemiological data. Subsequently, previously published tree arm diagrams were used to define the rate of patients requiring radiotherapy in each specific clinical setting. Finally, the clinical benefit of radiotherapy in overall survival was extracted from studies with level 1 evidence. Over 596 000 cancer cases were expected in Brazil in 2016. The public health system covers more than 75% of the Brazilian population and an estimated 111 432 patients who required radiotherapy in 2016 did not receive this treatment. Breast, colorectal and cervix cancers are the most frequent malignant tumours in women and prostate, lung and colorectal in men. The number of deaths due to a radiotherapy shortage in the year 2016 for these types of cancer were: (i) breast: 1011 deaths in 10 years; (ii) cervix: 2006 deaths in 2 years; (iii) lung: 1206 deaths in 2 years; (iv) prostate, intermediate risk: 562 deaths in 13 years; high risk: 298 deaths in 10 years; (v) colorectal: 0 deaths, as radiotherapy has no proven benefit in overall survival. Thousands of cancer patients requiring

  13. Saving Mothers' Lives: Reviewing maternal deaths to make motherhood safer: 2006-2008. The Eighth Report of the Confidential Enquiries into Maternal Deaths in the United Kingdom.

    LENUS (Irish Health Repository)

    Cantwell, Roch

    2011-03-01

    In the triennium 2006-2008, 261 women in the UK died directly or indirectly related to pregnancy. The overall maternal mortality rate was 11.39 per 100,000 maternities. Direct deaths decreased from 6.24 per 100,000 maternities in 2003-2005 to 4.67 per 100,000 maternities in 2006–2008 (p = 0.02). This decline is predominantly due to the reduction in deaths from thromboembolism and, to a lesser extent, haemorrhage. For the first time there has been a reduction in the inequalities gap, with a significant decrease in maternal mortality rates among those living in the most deprived areas and those in the lowest socio-economic group. Despite a decline in the overall UK maternal mortality rate, there has been an increase in deaths related to genital tract sepsis, particularly from community acquired Group A streptococcal disease. The mortality rate related to sepsis increased from 0.85 deaths per 100,000 maternities in 2003-2005 to 1.13 deaths in 2006-2008, and sepsis is now the most common cause of Direct maternal death. Cardiac disease is the most common cause of Indirect death; the Indirect maternal mortality rate has not changed significantly since 2003-2005. This Confidential Enquiry identified substandard care in 70% of Direct deaths and 55% of Indirect deaths. Many of the identified avoidable factors remain the same as those identified in previous Enquiries. Recommendations for improving care have been developed and are highlighted in this report. Implementing the Top ten recommendations should be prioritised in order to ensure the overall UK maternal mortality rate continues to decline.

  14. Pediatric Death Due to Myocarditis After Exposure to Cannabis

    Directory of Open Access Journals (Sweden)

    Thomas M. Nappe

    2017-03-01

    Full Text Available Since marijuana legalization, pediatric exposures to cannabis have increased. 1 To date, pediatric deaths from cannabis exposure have not been reported. The authors report an 11-month-old male who, following cannabis exposure, presented with central nervous system depression after seizure, and progressed to cardiac arrest and died. Myocarditis was diagnosed post-mortem and cannabis exposure was confirmed. Given the temporal relationship of these two rare occurrences – cannabis exposure and sudden death secondary to myocarditis in an 11-month-old – as well as histological consistency with drug-induced myocarditis without confirmed alternate causes, and prior reported cases of cannabis-associated myocarditis, a possible relationship exists between cannabis exposure in this child and myocarditis leading to death. In areas where marijuana is commercially available or decriminalized, the authors urge clinicians to preventively counsel parents and to include cannabis exposure in the differential diagnosis of patients presenting with myocarditis.

  15. Can deaths in police cells be prevented? Experience from Norway and death rates in other countries.

    Science.gov (United States)

    Aasebø, Willy; Orskaug, Gunnar; Erikssen, Jan

    2016-01-01

    To describe the changes in death rates and causes of deaths in Norwegian police cells during the last 2 decades. To review reports on death rates in police cells that have been published in medical journals and elsewhere, and discuss the difficulties of comparing death rates between countries. Data on deaths in Norwegian police cells were collected retrospectively in 2002 and 2012 for two time periods: 1993-2001 (period 1) and 2003-2012 (period 2). Several databases were searched to find reports on deaths in police cells from as many countries as possible. The death rates in Norwegian police cells reduced significantly from 0.83 deaths per year per million inhabitants (DYM) in period 1 to 0.22 DYM in period 2 (p police cells reduced by about 75% over a period of approximately 10 years. This is probably mainly due to individuals with severe alcohol intoxication no longer being placed in police cells. However, there remain large methodology difficulties in comparing deaths rates between countries. Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  16. Life expectancy and death by diseases of the circulatory system in patients with bipolar disorder or schizophrenia in the Nordic countries

    DEFF Research Database (Denmark)

    Laursen, Thomas Munk; Wahlbeck, Kristian; Hällgren, Jonas

    2013-01-01

    Excess mortality from diseases and medical conditions (natural death) in persons with psychiatric disorders has been extensively reported. Even in the Nordic countries with well-developed welfare systems, register based studies find evidence of an excess mortality. In recent years, cardiac...... mortality and death by diseases of the circulatory system has seen a decline in all the Nordic countries, but a recent paper indicates that women and men in Denmark, Finland, and Sweden, who had been hospitalised for a psychotic disorder, had a two to three-fold increased risk of dying from a cardiovascular...... disease. The aim of this study was to compare the mortality by diseases of the circulatory system among patients with bipolar disorder or schizophrenia in the three Nordic countries Denmark, Sweden, and Finland. Furthermore, the aim was to examine and compare life expectancy among these patients. Cause...

  17. Scientific worker and licensed professional deaths in Alaska, 1990-2002

    OpenAIRE

    Conway, George A.; Moran, Katherine A.; Mode, Nicolle A.

    2004-01-01

    Objectives. Between 1990-2002, 797 Alaskans died while working. After a scientific survey team member drowned, we examined the hazards of traumatic death to scientific and professional workers in Alaska. Study design. Surveillance and analysis methods for acute traumatic occupational injuries: The Alaska Occupational Injury Surveillance System (AOISS) uses direct investigation, jurisdictional agency reports, and death certificates to gather data for active surveillance on occupational injury ...

  18. Deaths associated with Hurricane Sandy - October-November 2012.

    Science.gov (United States)

    2013-05-24

    On October 29, 2012, Hurricane Sandy hit the northeastern U.S. coastline. Sandy's tropical storm winds stretched over 900 miles (1,440 km), causing storm surges and destruction over a larger area than that affected by hurricanes with more intensity but narrower paths. Based on storm surge predictions, mandatory evacuations were ordered on October 28, including for New York City's Evacuation Zone A, the coastal zone at risk for flooding from any hurricane. By October 31, the region had 6-12 inches (15-30 cm) of precipitation, 7-8 million customers without power, approximately 20,000 persons in shelters, and news reports of numerous fatalities (Robert Neurath, CDC, personal communication, 2013). To characterize deaths related to Sandy, CDC analyzed data on 117 hurricane-related deaths captured by American Red Cross (Red Cross) mortality tracking during October 28-November 30, 2012. This report describes the results of that analysis, which found drowning was the most common cause of death related to Sandy, and 45% of drowning deaths occurred in flooded homes in Evacuation Zone A. Drowning is a leading cause of hurricane death but is preventable with advance warning systems and evacuation plans. Emergency plans should ensure that persons receive and comprehend evacuation messages and have the necessary resources to comply with them.

  19. Cause of death and potentially avoidable deaths in Australian adults with intellectual disability using retrospective linked data.

    Science.gov (United States)

    Trollor, Julian; Srasuebkul, Preeyaporn; Xu, Han; Howlett, Sophie

    2017-02-07

    To investigate mortality and its causes in adults over the age of 20 years with intellectual disability (ID). Retrospective population-based standardised mortality of the ID and Comparison cohorts. The ID cohort comprised 42 204 individuals who registered for disability services with ID as a primary or secondary diagnosis from 2005 to 2011 in New South Wales (NSW). The Comparison cohort was obtained from published deaths in NSW from the Australian Bureau of Statistics (ABS) from 2005 to 2011. We measured and compared Age Standardised Mortality Rate (ASMR), Comparative Mortality Figure (CMF), years of productive life lost (YPLL) and proportion of deaths with potentially avoidable causes in an ID cohort with an NSW general population cohort. There were 19 362 adults in the ID cohort which experienced 732 (4%) deaths at a median age of 54 years. Age Standardised Mortality Rates increased with age for both cohorts. Overall comparative mortality figure was 1.3, but was substantially higher for the 20-44 (4.0) and 45-64 (2.3) age groups. YPLL was 137/1000 people in the ID cohort and 49 in the comparison cohort. Cause of death in ID cohort was dominated by respiratory, circulatory, neoplasm and nervous system. After recoding deaths previously attributed to the aetiology of the disability, 38% of deaths in the ID cohort and 17% in the comparison cohort were potentially avoidable. Adults with ID experience premature mortality and over-representation of potentially avoidable deaths. A national system of reporting of deaths in adults with ID is required. Inclusion in health policy and services development and in health promotion programmes is urgently required to address premature deaths and health inequalities for adults with ID. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  20. A theoretical model of naturally occurring cell death in the nervous system

    OpenAIRE

    Galli, Resta; Resta, Giovanni

    1991-01-01

    Throughout the animal kingdom, the formation of the nervous system involves the elimination of many cells, soon after their generation. This phenomenon, known as naturally occurring cell death, has precise time schedules, is observed in the vast majority of nervous structures and causes the 1oss of 15 - 85% of the neurones generated initially. Elimination of erroneous projections, as well as proper size matching between connecting structures can be achieved through cell death. However if elim...

  1. Analysis of maternal death autopsies from the nationwide registration system of maternal deaths in Japan.

    Science.gov (United States)

    Hasegawa, Junichi; Wakasa, Tomoko; Matsumoto, Hiroshi; Takeuchi, Makoto; Kanayama, Naohiro; Tanaka, Hiroaki; Katsuragi, Shinji; Nakata, Masahiko; Murakoshi, Takeshi; Osato, Kazuhiro; Nakamura, Masamitsu; Sekizawa, Akihiko; Ishiwata, Isamu; Ikeda, Tomoaki

    2018-02-01

    To clarify the necessity for and problems related to autopsy for determining the cause of maternal death in Japan. Women who died during pregnancy or within a year after delivery were analyzed by the Maternal Death Exploratory Committee between 2012 and 2015 in Japan. Maternal deaths were analyzed to verify the requirement of autopsy in cases in which autopsy was performed and the need for autopsy in cases in which it was not performed. Among the 49 cases performed autopsy, the final diagnosis was compatible with the clinical course in 24 cases, while the autopsy diagnosis was incompatible with the clinical course in 13 cases. In two cases, the final diagnosis was based on the clinical course, but an autopsy could exclude other possible causes. In three cases, no exact cause of maternal death was identified after autopsy. On the other hand, in cases without an autopsy, the final diagnosis was made using ante-mortem operating findings and surgical specimens in twenty-one cases. Though, thirty-one cases were estimated diagnosis based on post-mortem imaging or ante-mortem examinations, the exact original cause of death was not determined in 25 cases, and the cause of death could not be identified in eight cases without autopsy. Because in most cases the autopsy provides an exact cause of death, the necessity of autopsies should be more widely accepted in Japan.

  2. Sudden death involving inhalation of 1,1-difluoroethane (HFC-152a) with spray cleaner: three case reports.

    Science.gov (United States)

    Sakai, Kentaro; Maruyama-Maebashi, Kyoko; Takatsu, Akihiro; Fukui, Kenji; Nagai, Tomonori; Aoyagi, Miwako; Ochiai, Eriko; Iwadate, Kimiharu

    2011-03-20

    Spray cleaner is a cleaning product containing compressed 1,1-difluoroethane (HFC-152a) to blow dust off electric devices and other sensitive equipment; however, it is also inhaled to induce euphoria. This report describes three cases of death involving HFC-152a inhalation with spray cleaner under different circumstances. In case 1, death was during inhalation for euphoria with which led to having frostbite. In case 2, death may have been associated with suicidal intention. Case 3 was also considered an accidental autoerotic death. In all three cases, HFC-152a was detected at 99.2-136.2mg/l in blood samples, 94.5-191.9 mg/l in urine samples and 3.6-18.4 mg in the gastric contents according to gas chromatography with flame ionization detection. To prevent death associated with HFC-152a inhalation from spray cleaner, the danger of the sudden death should be announced to people, given the ready availability of commercial products containing HFC-152a. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  3. A single-item self-report medication adherence question predicts hospitalisation and death in patients with heart failure.

    Science.gov (United States)

    Wu, Jia-Rong; DeWalt, Darren A; Baker, David W; Schillinger, Dean; Ruo, Bernice; Bibbins-Domingo, Kristen; Macabasco-O'Connell, Aurelia; Holmes, George M; Broucksou, Kimberly A; Erman, Brian; Hawk, Victoria; Cene, Crystal W; Jones, Christine DeLong; Pignone, Michael

    2014-09-01

    To determine whether a single-item self-report medication adherence question predicts hospitalisation and death in patients with heart failure. Poor medication adherence is associated with increased morbidity and mortality. Having a simple means of identifying suboptimal medication adherence could help identify at-risk patients for interventions. We performed a prospective cohort study in 592 participants with heart failure within a four-site randomised trial. Self-report medication adherence was assessed at baseline using a single-item question: 'Over the past seven days, how many times did you miss a dose of any of your heart medication?' Participants who reported no missing doses were defined as fully adherent, and those missing more than one dose were considered less than fully adherent. The primary outcome was combined all-cause hospitalisation or death over one year and the secondary endpoint was heart failure hospitalisation. Outcomes were assessed with blinded chart reviews, and heart failure outcomes were determined by a blinded adjudication committee. We used negative binomial regression to examine the relationship between medication adherence and outcomes. Fifty-two percent of participants were 52% male, mean age was 61 years, and 31% were of New York Heart Association class III/IV at enrolment; 72% of participants reported full adherence to their heart medicine at baseline. Participants with full medication adherence had a lower rate of all-cause hospitalisation and death (0·71 events/year) compared with those with any nonadherence (0·86 events/year): adjusted-for-site incidence rate ratio was 0·83, fully adjusted incidence rate ratio 0·68. Incidence rate ratios were similar for heart failure hospitalisations. A single medication adherence question at baseline predicts hospitalisation and death over one year in heart failure patients. Medication adherence is associated with all-cause and heart failure-related hospitalisation and death in heart

  4. Late quaternary faulting along the Death Valley-Furnace Creek fault system, California and Nevada

    International Nuclear Information System (INIS)

    Brogan, G.E.; Kellogg, K.S.; Terhune, C.L.; Slemmons, D.B.

    1991-01-01

    The Death Valley-Furnace Creek fault system, in California and Nevada, has a variety of impressive late Quaternary neotectonic features that record a long history of recurrent earthquake-induced faulting. Although no neotectonic features of unequivocal historical age are known, paleoseismic features from multiple late Quaternary events of surface faulting are well developed throughout the length of the system. Comparison of scarp heights to amount of horizontal offset of stream channels and the relationships of both scarps and channels to the ages of different geomorphic surfaces demonstrate that Quaternary faulting along the northwest-trending Furnace Creek fault zone is predominantly right lateral, whereas that along the north-trending Death Valley fault zone is predominantly normal. These observations are compatible with tectonic models of Death Valley as a northwest- trending pull-apart basin

  5. Lung cancer death rates fall, helping drive decrease in overall cancer death rates

    Science.gov (United States)

    The Annual Report to the Nation on the Status of Cancer, covering the period 1975–2010, showed death rates for lung cancer, which accounts for more than one in four cancer deaths, dropping at a faster pace than in previous years.

  6. Death receptor Fas (CD95) signaling in the central nervous system: tuning neuroplasticity?

    Science.gov (United States)

    Reich, Arno; Spering, Christopher; Schulz, Jörg B

    2008-09-01

    For over a decade, neuroscientific research has focused on processes of apoptosis and its contribution to the pathophysiology of neurological diseases. In the central nervous system, the degree of intrinsic mitochondrial-mediated apoptotic signaling expresses a cell's individual metabolic stress, whereas activation of the extrinsic death receptor-induced cascade is regarded as a sign of imbalanced cellular networks. Under physiological conditions, most neurons possess death receptors without being sensitive to receptor-mediated apoptosis. This paradox raises two questions: what is the evolutionary advantage of expressing potentially harmful proteins? How is their signaling controlled? This review summarizes the functional relevance of FasL-Fas signaling--a quintessential death ligand/receptor system--in different neurological disease models ranging from traumatic, inflammatory and ischemic to neurodegenerative processes. Furthermore, it outlines alternative non-apoptotic Fas signaling, shedding new light on its neuroplastic capacity. Finally, receptor-proximal regulatory proteins are introduced and identified as potential protagonists of disease-modifying neurological therapies.

  7. One health and cyanobacteria in freshwater systems: animal illnesses and deaths are sentinel events for human health risks.

    Science.gov (United States)

    Hilborn, Elizabeth D; Beasley, Val R

    2015-04-20

    Harmful cyanobacterial blooms have adversely impacted human and animal health for thousands of years. Recently, the health impacts of harmful cyanobacteria blooms are becoming more frequently detected and reported. However, reports of human and animal illnesses or deaths associated with harmful cyanobacteria blooms tend to be investigated and reported separately. Consequently, professionals working in human or in animal health do not always communicate findings related to these events with one another. Using the One Health concept of integration and collaboration among health disciplines, we systematically review the existing literature to discover where harmful cyanobacteria-associated animal illnesses and deaths have served as sentinel events to warn of potential human health risks. We find that illnesses or deaths among livestock, dogs and fish are all potentially useful as sentinel events for the presence of harmful cyanobacteria that may impact human health. We also describe ways to enhance the value of reports of cyanobacteria-associated illnesses and deaths in animals to protect human health. Efficient monitoring of environmental and animal health in a One Health collaborative framework can provide vital warnings of cyanobacteria-associated human health risks.

  8. Causes of death in patients with chronic sarcoidosis.

    Science.gov (United States)

    Hu, Xiaowen; Carmona, Eva M; Yi, Eunhee S; Pellikka, Patricia A; Ryu, Jay

    2016-10-07

    Sarcoidosis is a multi-system, granulomatous disorder of unknown etiology that is associated with a variable prognosis and sometimes results in death. There are conflicting reports regarding the causes of death in patients with sarcoidosis. Forty-four consecutive patients with sarcoidosis who underwent an autopsy (35 patients) or died at Mayo Clinic (Rochester, MN, USA) over a 20-yr period, from January 1, 1994 to December 31, 2013 were analyzed. The median age at death was 63 years (range, 33-94 years) and there were 22 (50%) women. Sarcoidosis had not been clinically diagnosed in 16 (36%) patients before death. Fifteen deaths (34%) were related to sarcoidosis and included seven deaths (16%) from cardiac sarcoidosis and four deaths (9%) from progressive pulmonary sarcoidosis. Other sarcoidosis-related causes of death included advanced hepatic sarcoidosis (5%) and opportunistic infections (5%) related to immunosuppressive therapy for treating sarcoidosis. Among seven patients dying from cardiac sarcoidosis, three had been diagnosed with sarcoidosis during life and cardiac involvement was known in two of them. Six of seven deaths from cardiac sarcoidosis occurred in the autopsied cohort while all four deaths from pulmonary sarcoidosis occurred in those not autopsied. In the majority of patients dying with sarcoidosis the cause of death is unrelated to sarcoidosis. Cardiac involvement is the most common cause of sarcoidosis-related deaths in patients subjected to postmortem examination and was usually undiagnosed during life. The cause distribution of death in patients with sarcoidosis differed depending on whether autopsy was performed.

  9. Cause of the Scion Death in Green Pepper Grafting System by a Tobamovirus

    Directory of Open Access Journals (Sweden)

    Gug-Seoun Choi

    2011-08-01

    Full Text Available This experiment was attempted to investigate a cause of the scion death in green pepper grafting system. A tobamovirus particle examined in the rootstock of the sample but not in the scion showing necrosis. The virus isolated from the rootstock was identified as Pepper mild mottle virus (PMMoV, pepper tobamovirus pathotype P1.2. (PMMoV-2, by nucleotide sequence analysis and host plant reaction. The virus isolate infected systematically in 6 commercial rootstock varieties using for green pepper grafting seedling production. Green pepper varieties ``Long green mart`` and ``Daechan`` represented resistance to the virus showing local lesions only on the inoculated leaves and ``Manitda`` was systematically infected. In the experiment with grafting ``Long green mart`` or ``Daechan`` onto the those rootstocks, the upper leaves of the scions first showed vein necrosis and wilt symptoms 7 days after inoculation with PMMoV-2 on the cotyledon of the rootstock, following to the scion stem necrosis and then only the scion death. The virus was detected in the rootstock but not in the scion. However, ``Manitda`` of susceptible variety in the grafting system showed mottle symptom on the leaves of the scion but not necrosis on the plant. PMMoV-3 isolate, pepper tobamovirus pathotype P1.2.3, did not cause the scion death in the grafting system. All of the varieties were susceptible to PMMoV-3. These results suggest that the scion death is caused by infecting with pepper tobamovirus pathotype P1.2. in the green pepper grafting system combined with the susceptible rootstock and the resistance scion to the virus pathotype.

  10. Potential for erroneous interpretation of poisoning outcomes due to changes in National Poison Data System reporting.

    Science.gov (United States)

    Anderson, Bruce; Ke, Xuehua; Klein-Schwartz, Wendy

    2010-08-01

    In 2006, the annual report of poison centers in the United States changed the method of reporting profiles for generic substance categories from all exposures to single-substance exposures only. The objective of this study is to describe the potential impact of this reporting change on longitudinal analysis of outcomes. Generic substance categories with data available for all years of the study were manually extracted from Table 22 of the National Poison Data System (NPDS) annual reports for 2002-2007. For each generic substance category, the following data were extracted for each of the 6 years: total number of substance mentions (2002-2005) or single-substance exposures (2006-2007), reason (unintentional or intentional), pediatric exposures (children age average annual number of reported deaths by substance category decreased by 80.8%, from 2,229 in year 2002-2005 to 428 after the 2006 reporting change (p average annual number of reported major outcomes by substance category dropped by 76.0% (p average number of deaths and major effects by substance category decreased by about 50% from 394 and 4,639 per year during 2002-2005 to 198 deaths (p average rates of reported deaths (61.7 and 35.9%) and major effects (36.3 and 11.2%) for drug categories and nondrug categories, respectively (p change in 2006 will yield inaccurate results if the change in reporting methodology is not taken into account.

  11. Death and Death Anxiety

    OpenAIRE

    Gonca Karakus; Zehra Ozturk; Lut Tamam

    2012-01-01

    Although death and life concepts seem so different from each other, some believe that death and life as a whole that death is accepted as the goal of life and death completes life. In different cultures, societies and disciplines, there have been very different definitions of death which changes according to personality, age, religion and cultural status of the individual. Attitudes towards death vary dramatically according to individuals. As for the death anxiety, it is a feeling which start...

  12. Classification systems for causes of stillbirth and neonatal death, 2009-2014: an assessment of alignment with characteristics for an effective global system.

    Science.gov (United States)

    Leisher, Susannah Hopkins; Teoh, Zheyi; Reinebrant, Hanna; Allanson, Emma; Blencowe, Hannah; Erwich, Jan Jaap; Frøen, J Frederik; Gardosi, Jason; Gordijn, Sanne; Gülmezoglu, A Metin; Heazell, Alexander E P; Korteweg, Fleurisca; Lawn, Joy; McClure, Elizabeth M; Pattinson, Robert; Smith, Gordon C S; Tunçalp, Ӧzge; Wojcieszek, Aleena M; Flenady, Vicki

    2016-09-15

    To reduce the burden of 5.3 million stillbirths and neonatal deaths annually, an understanding of causes of deaths is critical. A systematic review identified 81 systems for classification of causes of stillbirth (SB) and neonatal death (NND) between 2009 and 2014. The large number of systems hampers efforts to understand and prevent these deaths. This study aimed to assess the alignment of current classification systems with expert-identified characteristics for a globally effective classification system. Eighty-one classification systems were assessed for alignment with 17 characteristics previously identified through expert consensus as necessary for an effective global system. Data were extracted independently by two authors. Systems were assessed against each characteristic and weighted and unweighted scores assigned to each. Subgroup analyses were undertaken by system use, setting, type of death included and type of characteristic. None of the 81 systems were aligned with more than 9 of the 17 characteristics; most (82 %) were aligned with four or fewer. On average, systems were aligned with 19 % of characteristics. The most aligned system (Frøen 2009-Codac) still had an unweighted score of only 9/17. Alignment with individual characteristics ranged from 0 to 49 %. Alignment was somewhat higher for widely used as compared to less used systems (22 % v 17 %), systems used only in high income countries as compared to only in low and middle income countries (20 % vs 16 %), and systems including both SB and NND (23 %) as compared to NND-only (15 %) and SB-only systems (13 %). Alignment was higher with characteristics assessing structure (23 %) than function (15 %). There is an unmet need for a system exhibiting all the characteristics of a globally effective system as defined by experts in the use of systems, as none of the 81 contemporary classification systems assessed was highly aligned with these characteristics. A particular concern in terms of

  13. Violent Deaths Among Georgia Workers: An Examination of Suicides and Homicides by Occupation, 2006-2009.

    Science.gov (United States)

    Lavender, Antionette; Ramirez-Irizarry, Viani; Bayakly, A Rana; Koplan, Carol; Bryan, J Michael

    2016-11-01

    Workers in certain occupations may be at an increased risk of a violent-related death such as homicide or suicide. The purpose of this study is to describe rates of violent deaths among Georgia workers by occupation, including cases occurring at work and outside of the workplace, and identify leading circumstances surrounding suicides and homicides for the occupations most at risk. Data from the 2006-2009 Georgia Violent Death Reporting System were used. Occupational text fields were recoded into 23 major occupation categories based on the 2010 Standard Occupational Classification system. Crude rates and standardized mortality ratios for violent deaths (suicides and homicides) were calculated by occupation among Georgia workers aged ≥16 years. The leading circumstances precipitating violent deaths among the high-risk occupations were described. Analyses were conducted during 2012-2013 and 2015. A total of 4,616 Georgia resident workers were victims of a violent death during 2006-2009. Of these deaths, 2,888 (62.6%) were suicides and 1,728 (37.4%) were homicides. Farming, fishing, and forestry occupations had the highest rate of violent deaths at 80.5 per 100,000 workers followed by construction and extraction occupations at 65.5 per 100,000. The most common suicide circumstances among workers were having a current depressed mood, a current mental health problem, and an intimate partner problem. Use of the Violent Death Reporting System provides a unique opportunity to explore violent deaths among workers. This analysis shows the need to ensure that workers have access to workplace and community-based suicide and violence prevention services. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  14. [Ill-defined causes of death and unattended deaths, Brazil, 2003].

    Science.gov (United States)

    Santo, Augusto Hasiak

    2008-01-01

    We studied the distribution of deaths from ill-defined causes that occurred in Brazil during 2003, from which was identified the proportion of unattended deaths. Data were obtained from the Mortality Information System, coordinated by the Ministry of Health. Causes of death included in "Chapter XVIII - Symptoms, signs and abnormal clinical and laboratory findings, not classified elsewhere" of the International Statistical Classification of Diseases and Related Health Problems, tenth revision, were considered ill-defined, among which the category R98 identified "unattended deaths". In Brazil during 2003 the underlying causes of 13.3% of deaths were included in the Chapter of ill-defined causes, and the highest proportions of these deaths occurred in the Northeast and North Regions. Considering the total deaths from ill-defined causes, 53 % correspond to unattended deaths. This proportion increased to over 70% in the states of Maranhão, Piauí, Rio Grande do Norte, Pernambuco, Bahia, Paraíba and Alagoas. Due to the decentralized structure of data collection in the country, we believe that the municipalities bear the major responsibility, followed by the states, for upgrading the quality of mortality statistics.

  15. 22 CFR 72.4 - Notifications of death.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Notifications of death. 72.4 Section 72.4... DEATHS AND ESTATES Reporting Deaths of United States Nationals § 72.4 Notifications of death. The... legal representative (if any, and if different from the next of kin), of the death of a United States...

  16. Comparison of death certificate and autopsy diagnoses - Hiroshima. [Cause of death

    Energy Technology Data Exchange (ETDEWEB)

    Stone, R S; Anderson, Jr, P S

    1960-09-14

    In this report evaluation of the death certificates has been on the basis of comparison with recorded autopsy diagnoses without review of the latter. An attempt has been made to evaluate limitations inherent in this method. The cases analyzed here represent the ABCC Hiroshima autopsy series from 1949 through 1959. Post mortem examinations on stillbirths and neonatal deaths that were collected during the years 1948 through 1953 were excluded from consideration because such cases are not pertinent to the general problems under study. With this limitation 1304 cases were available for matching. In 139 of these cases the death certificates were not available through the mechanisms of the overall study, so 1165 cases remained. Before comparisons are made the most important questions that must be answered about the materials and methods of the present investigation are: (1) is the autopsy-death certificate series a representative sample of all deaths in the population; (2) are the autopsy diagnoses correct; (3) are the death certificates properly understood and coded; and (4) are biologically meaningful groupings chosen for comparison between autopsy cause of death and death certificate cause of death. Because it is not possible to provide exact answers to all of these questions the doubt that they raise must be admitted but evaluated in the perspective of that part of the answer which is known.

  17. Medication incidents reported to an online incident reporting system.

    LENUS (Irish Health Repository)

    Alrwisan, Adel

    2011-01-15

    AIMS: Approximately 20% of deaths from adverse events are related to medication incidents, costing the NHS an additional £500 million annually. Less than 5% of adverse events are reported. This study aims to assess the reporting rate of medication incidents in NHS facilities in the north east of Scotland, and to describe the types and outcomes of reported incidents among different services. Furthermore, we wished to quantify the proportion of reported incidents according to the reporters\\' profession. METHODS: A retrospective description was made of medication incidents reported to an online reporting system (DATIX) over a 46-month-period (July 2005 to April 2009). Reports originated from acute and community hospitals, mental health, and primary care facilities. RESULTS: Over the study period there were 2,666 incidents reported with a mean monthly reporting rate of 78.2\\/month (SD±16.9). 6.1% of all incidents resulted in harm, with insulin being the most commonly implicated medication. Nearly three-quarters (74.2%, n=1,978) of total incidents originated from acute hospitals. Administration incidents were implicated in the majority of the reported medication incidents (59%), followed by prescribing (10.8%) and dispensing (9.9%), while the nondescript "other medication incidents" accounted for 20.3% of total incidents. The majority of reports were made by nursing and midwifery staff (80%), with medical and dental professionals reporting the lowest number of incidents (n=56, 2%). CONCLUSIONS: The majority of medication incidents in this study were reported by nursing and midwifery staff, and were due to administration incidents. There is a clear need to elucidate the reasons for the limited contribution of the medical and dental professionals to reporting medication incidents.

  18. The Inability of Criminal Justice System in Brazil and the Death Penalty Application Extrajudicial

    Directory of Open Access Journals (Sweden)

    João Paulo Calves

    2016-12-01

    Full Text Available The inability of the criminal justice system in Brazil to contain the advances of crime in society awakens a sense of impunity and the desire for immediate answers from the government to stop the advances of violence. This article aims to analyze the main reasons contributing to the inefficiency of judicial assistance, and describes, based on literature review of Beccaria, Kant and Bobbio, the foundations abolitionists and antiabolicionistas of the death penalty. It was concluded that Brazil prohibits the punishment of judicial death, but society and the State apply the death penalty in extra-judicial manner.

  19. Lupus - An Unrecognized Leading Cause of Death in Young Women: Population-based Study Using Nationwide Death Certificates, 2000-2015.

    Science.gov (United States)

    Yen, Eric Y; Singh, Ram R

    2018-04-18

    Mortality statistics from the Centers for Disease Control and Prevention (CDC) is used for planning healthcare policy and allocating resources. CDC uses this data to compile its annual leading-causes-of-death ranking based on a selected list of 113 causes. SLE is not included on this list. Since the cause-of-death ranking is a useful tool for assessing the relative burden of cause-specific mortality, we ranked SLE deaths among CDC's leading causes-of-death to see whether SLE is a significant cause of death among women. Death counts were obtained from the CDC's Wide-ranging Online Data for Epidemiologic Research database in U.S. female population, and then grouped by age and race/ethnicity. Data on the leading causes-of-death were obtained from the Web-based Injury Statistics Query and Reporting System database. During 2000 to 2015, there were 28,411 female deaths with SLE recorded as the underlying or contributing causes of death. SLE ranked among the top 20 leading-causes-of-death in females between 5 and 64 years of age. SLE ranked 10 th in the 15-24 years, 14 th in the 25-34 and the 35-44 years, and 15 th in the 10-14 years age groups. Among black and Hispanic females, SLE ranked 5 th in the 15-24 years, 6 th in the 25-34 years, and 8 th -9 th in the 35-44 years age groups, after excluding the three common external injury causes of death from analysis. SLE is among the leading-causes-of-death in young women, underscoring its impact as an important public health issue. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  20. Sudden death due to inhalant abuse in youth: Case report

    Directory of Open Access Journals (Sweden)

    Ramazan Akcan

    2010-06-01

    Full Text Available Intentional inhalation or abuse of volatile substances is a common public health problem all over the world. As these substances generate euphoria frequency of use among adolescents and young adults is increasing steadily. In cases using inhalants to achieve a euphoric state -without knowing possible consequences- sudden death may occurdue to acute cardio-pulmonary dysfunction.Here we present a case of sudden death of a nineteen-year-old female due to inhalation of volatile from butane containing lighter gas tube, with the findings of autopsy and death scene investigation.In the context of this case; it was aimed to draw attention to the risk of sudden death and steady increase of frequencyof volatile substance abuse among adolescents and young adults due to various psycho-social factors.

  1. Safety of currently licensed hepatitis B surface antigen vaccines in the United States, Vaccine Adverse Event Reporting System (VAERS), 2005-2015.

    Science.gov (United States)

    Haber, Penina; Moro, Pedro L; Ng, Carmen; Lewis, Paige W; Hibbs, Beth; Schillie, Sarah F; Nelson, Noele P; Li, Rongxia; Stewart, Brock; Cano, Maria V

    2018-01-25

    Currently four recombinant hepatitis B (HepB) vaccines are in use in the United States. HepB vaccines are recommended for infants, children and adults. We assessed adverse events (AEs) following HepB vaccines reported to the Vaccine Adverse Event Reporting System (VAERS), a national spontaneous reporting system. We searched VAERS for reports of AEs following single antigen HepB vaccine and HepB-containing vaccines (either given alone or with other vaccines), from January 2005 - December 2015. We conducted descriptive analyses and performed empirical Bayesian data mining to assess disproportionate reporting. We reviewed serious reports including reports of special interest. VAERS received 20,231 reports following HepB or HepB-containing vaccines: 10,291 (51%) in persons 18 years; for 1485 (7.3%) age was missing. Dizziness and nausea (8.4% each) were the most frequently reported AEs following a single antigen HepB vaccine: fever (23%) and injection site erythema (11%) were most frequent following Hep-containing vaccines. Of the 4444 (22%) reports after single antigen HepB vaccine, 303 (6.8%) were serious, including 45 deaths. Most commonly reported cause of death was Sudden Infant Death Syndrome (197). Most common non-death serious reports following single antigen HepB vaccines among infants aged children aged 1-23 months; infections and infestation (8) among persons age 2-18 years blood and lymphatic systemic disorders; and general disorders and administration site conditions among persons age >18 years. Most common vaccination error following single antigen HepB was incorrect product storage. Review current U.S.-licensed HepB vaccines administered alone or in combination with other vaccines did not reveal new or unexpected safety concerns. Vaccination errors were identified which indicate the need for training and education of providers on HepB vaccine indications and recommendations. Published by Elsevier Ltd.

  2. Systematic review of statistics on causes of deaths in hospitals: strengthening the evidence for policy-makers.

    Science.gov (United States)

    Rampatige, Rasika; Mikkelsen, Lene; Hernandez, Bernardo; Riley, Ian; Lopez, Alan D

    2014-11-01

    To systematically review the reliability of hospital data on cause of death and encourage periodic reviews of these data using a standard method. We searched Google Scholar, Pubmed and Biblioteca Virtual de la Salud for articles in English, Spanish and Portuguese that reported validation studies of data on cause of death. We analysed the results of 199 studies that had used medical record reviews to validate the cause of death reported on death certificates or by the vital registration system. The screened studies had been published between 1983 and 2013 and their results had been reported in English (n = 124), Portuguese (n = 25) or Spanish (n = 50). Only 29 of the studies met our inclusion criteria. Of these, 13 had examined cause of death patterns at the population level - with a view to correcting cause-specific mortality fractions - while the other 16 had been undertaken to identify discrepancies in the diagnosis for specific diseases before and after medical record review. Most of the selected studies reported substantial misdiagnosis of causes of death in hospitals. There was wide variation in study methodologies. Many studies did not describe the methods used in sufficient detail to be able to assess the reproducibility or comparability of their results. The assumption that causes of death are being accurately reported in hospitals is unfounded. To improve the reliability and usefulness of reported causes of death, national governments should do periodic medical record reviews to validate the quality of their hospital cause of death data, using a standard.

  3. Mortality and causes of death among workers exposed to phosgene in 1943-45

    International Nuclear Information System (INIS)

    Polednak, A.P.; Hollis, D.R.

    1985-01-01

    Mortality and causes of death from death certificates were analyzed among workers exposed to phosgene while working at a uranium-processing plant in Tennessee in 1943-45. Standardized mortality ratios (SMRs) were calculated by using death rates for U.S. white males. As of 1979, SMRs for all causes and for various selected causes were similar in 694 male chemical workers chronically exposed to low levels of phosgene in 1943-45 and in 9280 male controls who worked at the same plant. SMRs for diseases of the respiratory system were 107 (14 observed vs. 13.07 expected) in the chemical workers and 119 (292 observed vs. 245.75 expected) in the controls. In a group of 106 males who were acutely exposed to high levels of phosgene, there were 41 deaths observed vs. 33.87 expected (SMR = 121; 95% confidence limits = 86 and 165). One death, occurring within 24 hours of exposure, was from pulmonary edema due to phosgene poisoning (coded to accidental causes). Five deaths were coded to diseases of the respiratory system (SMR = 266; 95% CL = 86 and 622); in 2 of these 5 deaths, bronchitis due to phosgene exposure had been reported in 1945. Among 91 female workers with acute high-level phosgene exposure, frequencies of symptoms and early health effects (pneumonitis and bronchitis) differed from those reported for the 106 male cases; preliminary data on vital status of these females are too incomplete for analysis, and further follow-up is needed

  4. Death from Nitrous Oxide.

    Science.gov (United States)

    Bäckström, Björn; Johansson, Bengt; Eriksson, Anders

    2015-11-01

    Nitrous oxide is an inflammable gas that gives no smell or taste. It has a history of abuse as long as its clinical use, and deaths, although rare, have been reported. We describe two cases of accidental deaths related to voluntary inhalation of nitrous oxide, both found dead with a gas mask covering the face. In an attempt to find an explanation to why the victims did not react properly to oncoming hypoxia, we performed experiments where a test person was allowed to breath in a closed system, with or without nitrous oxide added. Vital signs and gas concentrations as well as subjective symptoms were recorded. The experiments indicated that the explanation to the fact that neither of the descendents had reacted to oncoming hypoxia and hypercapnia was due to the inhalation of nitrous oxide. This study raises the question whether nitrous oxide really should be easily, commercially available. © 2015 American Academy of Forensic Sciences.

  5. Eyelid closure at death

    Directory of Open Access Journals (Sweden)

    A D Macleod

    2009-01-01

    Full Text Available Aim: To observe the incidence of full or partial eyelid closure at death. Materials and Methods: The presence of ptosis was recorded in 100 consecutive hospice patient deaths. Results: Majority (63% of the patients died with their eyes fully closed, however, 37% had bilateral ptosis at death, with incomplete eye closure. In this study, central nervous system tumor involvement and/or acute hepatic encephalopathy appeared to be pre-mortem risk factors of bilateral ptosis at death. Conclusion: Organicity and not psychogenicity is, therefore, the likely etiology of failure of full eyelid closure at death.

  6. Maternal death audit in Rwanda 2009-2013: a nationwide facility-based retrospective cohort study.

    Science.gov (United States)

    Sayinzoga, Felix; Bijlmakers, Leon; van Dillen, Jeroen; Mivumbi, Victor; Ngabo, Fidèle; van der Velden, Koos

    2016-01-22

    Presenting the results of 5 years of implementing health facility-based maternal death audits in Rwanda, showing maternal death classification, identification of substandard (care) factors that have contributed to death, and conclusive recommendations for quality improvements in maternal and obstetric care. Nationwide facility-based retrospective cohort study. All cases of maternal death audited by district hospital-based audit teams between January 2009 and December 2013 were reviewed. Maternal deaths that were not subjected to a local audit are not part of the cohort. 987 audited cases of maternal death. Characteristics of deceased women, timing of onset of complications, place of death, parity, gravida, antenatal clinic attendance, reported cause of death, service factors and individual factors identified by committees as having contributed to death, and recommendations made by audit teams. 987 cases were audited, representing 93.1% of all maternal deaths reported through the national health management information system over the 5-year period. Almost 3 quarters of the deaths (71.6%) occurred at district hospitals. In 44.9% of these cases, death occurred in the post-partum period. Seventy per cent were due to direct causes, with post-partum haemorrhage as the leading cause (22.7%), followed by obstructed labour (12.3%). Indirect causes accounted for 25.7% of maternal deaths, with malaria as the leading cause (7.5%). Health system failures were identified as the main responsible factor for the majority of cases (61.0%); in 30.3% of the cases, the main factor was patient or community related. The facility-based maternal death audit approach has helped hospital teams to identify direct and indirect causes of death, and their contributing factors, and to make recommendations for actions that would reduce the risk of reoccurrence. Rwanda can complement maternal death audits with other strategies, in particular confidential enquiries and near-miss audits, so as to

  7. Drug Poisoning Deaths according to Ethnicity in Utah

    Directory of Open Access Journals (Sweden)

    Ray M. Merrill

    2013-01-01

    Full Text Available This study characterizes drug-related deaths according to ethnicity in Utah during 2005–2010, based on data from the Utah Violent Death Reporting System (UTVDRS. Hispanics made up 12.1% (12.5% male and 11.7% female of deaths. The most frequently identified drugs among decedents were opiates, then illicit drugs, benzodiazepines, over-the-counter medication, and antidepressants. Death rates for each drug were significantly greater in non-Hispanics than Hispanics. Most decedents used a combination of drugs. For each combination, rates were significantly greater for non-Hispanics than Hispanics, with an exception for opiates and illicit drugs combined, where there was no significant difference. Approximately 79% of non-Hispanics and 65% of Hispanics had one or more of the selected problems (e.g., mental, physical, or crisis related. Rates for each combination of problems were significantly greater in non-Hispanics, with the exception of crisis. Hispanics were less affected by the rise in prescription drug abuse. Hispanic decedents had a greater proportion of illegal drugs, consistent with it being more difficult to obtain prescription drugs. Hispanic decedents were less likely to have physical and mental health problems, which may be related to a smaller chance of diagnosis of such problems through the healthcare system.

  8. Experiencing patient death in clinical practice: nurses' recollections of their earliest memorable patient death.

    Science.gov (United States)

    Anderson, Natalie Elizabeth; Kent, Bridie; Owens, R Glynn

    2015-03-01

    Death and dying are inevitable life encounters, but a nurse's first experience with patient death may pose considerable cognitive, emotional and clinical challenges. This paper reports the findings of the second phase of a study; the first has been reported elsewhere. This phase explored the earliest memorable patient death experiences of New Zealand registered nurses. A purposeful, self-selected sub-sample of a larger study of New Zealand registered nurses, took part in individual face-to-face semi-structured interviews. Interpretative phenomenological analysis was utilised to seek to understand participants' experiences. Thematic analysis was undertaken to identify emerging themes, with participants' own words used as theme headings, where their phrases provided succinct or powerful descriptors. A diverse participant group of twenty, currently practising, New Zealand registered nurses provided rich and detailed descriptions of their earliest memorable experience with patient death. Participants from a variety of training backgrounds described patient deaths, which occurred in a range of settings - some only a few months prior, others - more than thirty years ago. Seven emergent themes, and features of more positive, or negative experiences were identified: Event Significance; Emotional Challenges; Sharing the Experience; Learning; Feeling Unprepared, Responses to Death and Finding Benefits. For participants in this study, there was considerable evidence that their earliest memorable patient death was a significant event. Furthermore, although most participants' experiences were characterised by emphatic or poignant description, there was most often a balance of challenges and rewards. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. Causes of death among full term stillbirths and early neonatal deaths in the Region of Southern Denmark.

    Science.gov (United States)

    Basu, Millie Nguyen; Johnsen, Iben Birgit Gade; Wehberg, Sonja; Sørensen, Rikke Guldberg; Barington, Torben; Nørgård, Bente Mertz

    2018-02-23

    We examined the causes of death amongst full term stillbirths and early neonatal deaths. Our cohort includes women in the Region of Southern Denmark, who gave birth at full term to a stillborn infant or a neonate who died within the first 7 days from 2010 through 2014. Demographic, biometric and clinical variables were analyzed to assess the causes of death using two classification systems: causes of death and associated conditions (CODAC) and a Danish system based on initial causes of fetal death (INCODE). A total of 95 maternal-infant cases were included. Using the CODAC and INCODE classification systems, we found that the causes of death were unknown in 59/95 (62.1%). The second most common cause of death in CODAC was congenital anomalies in 10/95 (10.5%), similar to INCODE with fetal, genetic, structural and karyotypic anomalies in 11/95 (11.6%). The majority of the mothers were healthy, primiparous, non-smokers, aged 20-34 years and with a normal body mass index (BMI). Based on an unselected cohort from an entire region in Denmark, the cause of stillbirth and early neonatal deaths among full term infants remained unknown for the vast majority.

  10. Sudden death in the first 2 years of life following immunization in the Republic of Korea.

    Science.gov (United States)

    Choe, Young June; Kim, Jong-Hee; Son, Hyun Jin; Bae, Geun-Ryang; Lee, Duk-hyoung

    2012-12-01

    Because the peak age for incidence of sudden deaths in infancy temporally coincides with the age of infant primary immunization, some have raised the question as to whether immunization is a risk factor for sudden death in infancy. Recent occurrence of two sudden deaths in infants in Korea has renewed concerns about the causal association between immunization and sudden deaths in infants. We carried out a retrospective review of data from the Korea Centers for Disease Control and Prevention Adverse Events Following Immunization Surveillance System and Vaccine Compensation programs. From 1994 to 2011, a total of 45 cases of sudden deaths in the first 2 years of life following immunization were reported in Korea. The causes of death were classified as follows: infectious diseases (n= 13); accidental injuries (n= 7); congenital abnormalities (n= 2); and malignancy (n= 1). Of 20 sudden deaths in infancy, nine deaths met Brighton Collaboration case definition level I and II, and therefore were classified as possible sudden infant death syndrome cases. Hepatitis B vaccine (n= 13) was the most frequent vaccine with temporal association with sudden deaths in the first 2 years of life. Few sudden deaths in the first 2 years of life following immunization have been reported, despite the use of universal immunization in Korea. The majority of deaths in infancy did not meet case definition for sudden infant death syndrome. Encouraging investigators to perform thorough investigation, including postmortem autopsy and death scene examination, may promote data comparability and provide guidance on decision-making in the vaccine-safety monitoring and response system in Korea. © 2012 The Authors. Pediatrics International © 2012 Japan Pediatric Society.

  11. Pulmonary thromboembolism and sudden death in psychiatric patients: Two cases reports

    Directory of Open Access Journals (Sweden)

    Marinković Nadica

    2017-01-01

    Full Text Available Introduction. Pulmonary thromboembolism occurs usually by running a thrombus from the deep veins of the legs rarely periprostatic or periuteric veins. Virchow's triad of necessary conditions for the occurrence of thrombosis involves disruption of blood flow, disruption of blood chemistry and damage to the vessel wall. Venous thrombosis is often associated with the implementation of antipsychotic therapy. Case report. We reported two cases of sudden death of psychiatric patients who were in both cases fixed during hospitalization. The first case was a 26-year-old woman treated a year with the diagnose of postpartum reactive psychosis. She was hospitalized because of mental state worsening with a dominant depressed mood, visual and auditory hallucinations. Her therapy was determined by diazepam, clozapine, haloperidol and lamotrigine. Suddenly, the patient died on the fifth day of hospitalization. The autopsy showed massive thromboembolism of the pulmonary artery branches. Toxicological analysis revealed the presence of therapeutic doses of antipsychotics. The second case was a-45-yearold men, a long-time alcoholic. On admission, the diagnosis of delirium tremens was established, and diazepam and haloperidol were administered. On the fifth day of hospitalization, he suddenly died. The autopsy showed thromboembolism of the branch of the pulmonary artery. Toxicological analysis established the presence of nordiazepam in urine (0.06 mg/L. Both patients were fixed during hospitalization. Conclusion. Both presented psychiatric patients were younger than 50 years, were not overweight, did not have changes of the venous blood vessels. Nowadays, when the issue of medical responsibility often arises in these and similar cases of sudden death in patients treated in psychiatric clinics, the questions on medical malpractice could be expected.

  12. Uncovering the 2010 Haiti earthquake death toll

    Science.gov (United States)

    Daniell, J. E.; Khazai, B.; Wenzel, F.

    2013-05-01

    Casualties are estimated for the 12 January 2010 earthquake in Haiti using various reports calibrated by observed building damage states from satellite imagery and reconnaissance reports on the ground. By investigating various damage reports, casualty estimates and burial figures, for a one year period from 12 January 2010 until 12 January 2011, there is also strong evidence that the official government figures of 316 000 total dead and missing, reported to have been caused by the earthquake, are significantly overestimated. The authors have examined damage and casualties report to arrive at their estimation that the median death toll is less than half of this value (±137 000). The authors show through a study of historical earthquake death tolls, that overestimates of earthquake death tolls occur in many cases, and is not unique to Haiti. As death toll is one of the key elements for determining the amount of aid and reconstruction funds that will be mobilized, scientific means to estimate death tolls should be applied. Studies of international aid in recent natural disasters reveal that large distributions of aid which do not match the respective needs may cause oversupply of help, aggravate corruption and social disruption rather than reduce them, and lead to distrust within the donor community.

  13. Sudden cardiac death in children (1-18 years)

    DEFF Research Database (Denmark)

    Winkel, Bo Gregers; Risgaard, Bjarke; Sadjadieh, Golnaz

    2014-01-01

    AIMS: Hitherto, sudden cardiac death in children (SCDc)-defined as sudden cardiac death (SCD) in the 1-18 years old-has been incompletely described in the general population. Knowledge on incidence rates, causes of death and symptoms prior to death is sparse and has been affected by reporting...... and referral bias. METHODS AND RESULTS: In a nationwide setting all deaths in children aged 1-18 years in Denmark in 2000-06 were included. To chart causes of death and incidence rates, death certificates and autopsy reports were collected and read. By additional use of the extensive healthcare registries...... in Denmark, we were also able to investigate prior disease and symptoms. During the 7-year study period there was an average of 1.11 million persons aged 1-18 years. There were a total of 1504 deaths (214 deaths per year) from 7.78 million person-years. A total of 114 (7.5%) were sudden and unexpected...

  14. A 'beautiful death': mortality, death, and holidays in a Mexican municipality.

    Science.gov (United States)

    Wilches-Gutiérrez, José L; Arenas-Monreal, Luz; Paulo-Maya, Alfredo; Peláez-Ballestas, Ingris; Idrovo, Alvaro J

    2012-03-01

    Several studies have reported increased mortality during holidays. Using a cultural epidemiological, sequential mixed-methods approach, this study explored holiday-related trends using mortality data from Yautepec (Morelos, Mexico) collected between 1986 and 2008 (N=5027 deaths). This analysis found that mortality increased on Christmas Day and All Saints' Day. Mortality increased on Candlemas Day among women, and increased on New Year's Day among men. More deaths caused by cardiovascular disease among women and traumatic injuries among men occurred during holidays than in non-holiday periods. To ascertain the elements comprising the health/illness/death process in the context of a holiday in this municipality, we conducted semi-structured interviews in March and April 2009 with relatives of seven individuals who had died during holidays in the previous 4 years (N=11); data from these interviews were analyzed from a grounded theory perspective to ascertain common conceptual themes. The "beautiful death" emerged as the main concept in the interpretation of death; this concept was related to the expectation of a good death and the particularly special nature of death during a holiday because of the involvement of religious entities, such as God, the Virgin Mary, and/or a saint, at the moment of death. Quantitative and qualitative results provided information about the important effects of holidays, culture, and religious belief on mortality patterns within a Mexican context, and contributed to a better understanding of the relationships among mortality, the nature of death, and holidays. Our results suggest that, in the studied region, death can be interpreted as a "beautiful process". More research is needed to explore this process in other similar contexts and to address topics related to the care and attention given the dying person and the expectation of a good death. Copyright © 2012 Elsevier Ltd. All rights reserved.

  15. Sudden Cardiac Death

    DEFF Research Database (Denmark)

    Risgaard, Bjarke; Winkel, Bo Gregers; Jabbari, Reza

    2017-01-01

    Objectives This study sought to describe the use of pharmacotherapy in a nationwide cohort of young patients with sudden cardiac death (SCD). Background Several drugs have been associated with an increased risk of SCD and sudden arrhythmic death syndrome (SADS). It remains unclear how...... pharmacotherapy may contribute to the overall burden of SCD in the general population. Methods This was a nationwide study that included all deaths that occurred between 2000 and 2009 and between 2007 and 2009 in people age 1 to 35 years and 36 to 49 years, respectively. Two physicians identified all SCDs through...... review of death certificates. Autopsy reports were collected. Pharmacotherapy prescribed within 90 days before SCD was identified in the Danish Registry of Medicinal Product Statistics. Results We identified 1,363 SCDs; median age was 38 years (interquartile range: 29 to 45 years), and 72% (n = 975) were men...

  16. Coupling of Rigor Mortis and Intestinal Necrosis during C. elegans Organismal Death

    Directory of Open Access Journals (Sweden)

    Evgeniy R. Galimov

    2018-03-01

    Full Text Available Organismal death is a process of systemic collapse whose mechanisms are less well understood than those of cell death. We previously reported that death in C. elegans is accompanied by a calcium-propagated wave of intestinal necrosis, marked by a wave of blue autofluorescence (death fluorescence. Here, we describe another feature of organismal death, a wave of body wall muscle contraction, or death contraction (DC. This phenomenon is accompanied by a wave of intramuscular Ca2+ release and, subsequently, of intestinal necrosis. Correlation of directions of the DC and intestinal necrosis waves implies coupling of these death processes. Long-lived insulin/IGF-1-signaling mutants show reduced DC and delayed intestinal necrosis, suggesting possible resistance to organismal death. DC resembles mammalian rigor mortis, a postmortem necrosis-related process in which Ca2+ influx promotes muscle hyper-contraction. In contrast to mammals, DC is an early rather than a late event in C. elegans organismal death.

  17. A whiff of death: fatal volatile solvent inhalation abuse.

    Science.gov (United States)

    Steffee, C H; Davis, G J; Nicol, K K

    1996-09-01

    Inhalation abuse of volatile solvents, previously known generically as "glue sniffing," is typically pursued by adolescents. A wide range of legal, easily obtained products containing volatile substances are available for abuse. We report two illustrative cases of fatal volatile substance abuse: gasoline sniffing in a 20-year-old man and aerosol propellant gas inhalation (aerosol air freshener) in a 16-year-old girl with underlying reactive airway disease. Although the ratio of deaths to nonfatal inhalation escapades is extremely low, volatile solvent abuse carries the risk of sudden death due to cardiac arrest after a dysrhythmia or vasovagal event, central nervous system respiratory depression, hypoxia and hypercapnia due to the techniques of inhalation, and other mechanisms. Investigation of the patient's substance abuse history, examination of the scene of death, and special toxicologic analyses are critical to identifying volatile substance inhalation abuse as the cause of death because anatomic autopsy findings will typically be nonspecific. Above all, physicians must suspect the diagnosis of volatile substance inhalation abuse, especially in any case of sudden death involving an otherwise healthy young person.

  18. The prolongation of somatic support in a pregnant woman with brain-death: a case report

    Directory of Open Access Journals (Sweden)

    Amaral Eliana

    2006-04-01

    Full Text Available Abstract Background Medical literature has increasingly reported cases of maternal brain death during pregnancy. This is a rare situation which demands the decision and, depending on the gestational age, the implementation of a set of measures to prolong the homeostasis of the human body after brain death for the purpose of maintaining the foetus alive until its viability. Case presentation A 40 year old woman suffered an intracranial haemorrhage during the 25th week of pregnancy. Despite neurosurgical drainage of a gross intraparenchymatous haematoma, the patient developed brain death. Upon confirmation of this diagnosis, she received full ventilatory and nutritional support, vasoactive drugs, maintenance of normothermia, hormone replacement and other supportive measures required to prolong gestation and improve the survival prognosis of her foetus. All decisions regarding the patient's treatment were taken in consensus with her family. She also received corticosteroids to accelerate foetal lung maturity. During the twenty-five days of somatic support, the woman's condition remained stable; however, during the last seven days the foetus developed oligohydramnios and brain-sparring, which led the medical team to take the decision to perform a Caesarean section at that moment. After delivery, the patient's organs were removed for donation. The male infant was born weighing 815 g, with an Apgar score of 9 and 10 at the first and fifth minutes, respectively. The infant was admitted to the neonatal intensive care unit, but did not require mechanical ventilation and had no major complications. He was discharged at 40 days of life, with no sequelae and weighing 1850 g. Conclusion These results are in accordance with findings from previous studies and case reports suggesting the appropriateness and safety of extended somatic support during pregnancy under certain circumstances. They also suggest the need for prompt diagnosis of brain death before the

  19. Current status of pregnancy-related maternal mortality in Japan: a report from the Maternal Death Exploratory Committee in Japan.

    Science.gov (United States)

    Hasegawa, Junichi; Sekizawa, Akihiko; Tanaka, Hiroaki; Katsuragi, Shinji; Osato, Kazuhiro; Murakoshi, Takeshi; Nakata, Masahiko; Nakamura, Masamitsu; Yoshimatsu, Jun; Sadahiro, Tomohito; Kanayama, Naohiro; Ishiwata, Isamu; Kinoshita, Katsuyuki; Ikeda, Tomoaki

    2016-03-21

    To clarify the problems related to maternal deaths in Japan, including the diseases themselves, causes, treatments and the hospital or regional systems. Descriptive study. Maternal death registration system established by the Japan Association of Obstetricians and Gynecologists (JAOG). Women who died during pregnancy or within a year after delivery, from 2010 to 2014, throughout Japan (N=213). The preventability and problems in each maternal death. Maternal deaths were frequently caused by obstetric haemorrhage (23%), brain disease (16%), amniotic fluid embolism (12%), cardiovascular disease (8%) and pulmonary disease (8%). The Committee considered that it was impossible to prevent death in 51% of the cases, whereas they considered prevention in 26%, 15% and 7% of the cases to be slightly, moderately and highly possible, respectively. It was difficult to prevent maternal deaths due to amniotic fluid embolism and brain disease. In contrast, half of the deaths due to obstetric haemorrhage were considered preventable, because the peak duration between the initial symptoms and initial cardiopulmonary arrest was 1-3 h. A range of measures, including individual education and the construction of good relationships among regional hospitals, should be established in the near future, to improve primary care for patients with maternal haemorrhage and to save the lives of mothers in Japan. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  20. Sudden fetal death due to dualism of the sino-atrial node.

    Science.gov (United States)

    Pusiol, Teresa; Roncati, Luca; Lavezzi, Anna Maria; Taddei, Fabrizio; Piscioli, Francesco; Ottaviani, Giulia

    2016-01-01

    First, we report a sudden fetal death at 33(+3)weeks due to sino-atrial node dualism. The female stillborn was delivered by induced labor. The postmortem examination of the cardiac conduction system revealed a dualism of the sino-atrial node, associated with fragmentation of the atrio-ventricular node and His bundle. These abnormalities of the cardiac conduction system represent the morphological substrate for the development of malignant arrhythmias. In particular, the dualism of the sino-atrial node can cause the dissociation of the longitudinal nodal impulse into two distinct ways of different pulse generation, resulting in supraventricular tachyarrhythmias. This observation suggests new avenues of research on the pathogenesis of the sudden unexpected fetal death. Moreover, our findings confirm the need for an accurate postmortem examination, including serial sectioning of the cardiac conduction system, in every case of unexplained fetal death, following standardized autoptic protocols. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. An examination of pregnancy- related deaths among adolescents

    African Journals Online (AJOL)

    maternal deaths (direct maternal causes of death) and pregnancy- related deaths (all deaths including ... The study was set in SA, where adolescent pregnancies are high and generally .... reported sexual behaviours of youth, it was found that termination .... engagement and education, especially among adolescents, could.

  2. Fournier gangrene and unexpected death.

    Science.gov (United States)

    Bury, Danielle; Byard, Roger W

    2012-11-01

    Fournier gangrene represents a rare but progressive perineal infection that may result in rapid death. A 70-year-old man with poorly controlled diabetes mellitus and alcohol abuse is reported who was found unexpectedly dead. He had last been contacted the night before his death. At autopsy, the most striking finding was deep necrotic ulceration of the scrotum with exposure of underlying deep muscles and testicles, with blood cultures positive for Escherichia coli. Death was, therefore, attributed to necrotic ulceration/gangrene of the perineum (Fournier gangrene) that was due to E. coli sepsis with underlying contributing factors of diabetes mellitus and alcoholism. In addition there was morbid obesity (body mass index 46.9), cirrhosis of the liver, and marked focal coronary artery atherosclerosis with significant cardiomegaly. Fournier gangrene may be an extremely aggressive condition that can result in rapid death, as was demonstrated by the rapid progression in the reported case. © 2012 American Academy of Forensic Sciences.

  3. Responsibility for reporting patient death due to hospital error in Japan when an error occurred at a referring institution.

    Science.gov (United States)

    Maeda, Shoichi; Starkey, Jay; Kamishiraki, Etsuko; Ikeda, Noriaki

    2013-12-01

    In Japan, physicians are required to report unexpected health care-associated patient deaths to the police. Patients needing to be transferred to another institution often have complex medical problems. If a medical error occurs, it may be either at the final or the referring institution. Some fear that liability will fall on the final institution regardless of where the error occurred or that the referring facility may oppose such reporting, leading to a failure to report to police or to recommend an autopsy. Little is known about the actual opinions of physicians and risk managers in this regard. The authors sent standardised, self-administered questionnaires to all hospitals in Japan that participate in the national general residency program. Most physicians and risk managers in Japan indicated that they would report a patient's death to the police where the patient has been transferred. Of those who indicated they would not report to the police, the majority still indicated they would recommend an autopsy

  4. Local perceptions of causes of death in rural South Africa: a comparison of perceived and verbal autopsy causes of death.

    Science.gov (United States)

    Hussain-Alkhateeb, Laith; Fottrell, Edward; Petzold, Max; Kahn, Kathleen; Byass, Peter

    2015-01-01

    Understanding how lay people perceive the causes of mortality and their associated risk factors is important for public health. In resource-limited settings, where verbal autopsy (VA) is used as the most expedient method of determining cause of death, it is important to understand how pre-existing concepts of cause of death among VA-informants may influence their VA-responses and the consequential impact on cause of death assessment. This study describes the agreement between VA-derived causes of death and informant-perceived causes and associated influential factors, which also reflects lay health literacy in this setting. Using 20 years of VA data (n=11,228) from the Agincourt Health and Demographic Surveillance System (HDSS) site in rural South Africa, we explored the agreement between the causes of death perceived by the VA-informants and those assigned by the automated Inter-VA tool. Kappa statistics and concordance correlation coefficients were applied to measure agreement at individual and population levels, respectively. Multivariable regression models were used to explore factors associated with recognised lay perceptions of causes of mortality. Agreement between informant-perceived and VA-derived causes of death at the individual level was limited, but varied substantially by cause of death. However, agreement at the population level, comparing cause-specific mortality fractions was higher, with the notable exception of bewitchment as a cause. More recent deaths, those in adults aged 15-49 years, deaths outside the home, and those associated with external causes showed higher concordance with InterVA. Overall, informant perception of causes of death was limited, but depended on informant characteristics and causes of death, and to some extent involved non-biomedical constructs. Understanding discordance between perceived and recognised causes of death is important for public health planning; low community understanding of causes of death may be

  5. Local perceptions of causes of death in rural South Africa: a comparison of perceived and verbal autopsy causes of death

    Science.gov (United States)

    Hussain-Alkhateeb, Laith; Fottrell, Edward; Petzold, Max; Kahn, Kathleen; Byass, Peter

    2015-01-01

    Background Understanding how lay people perceive the causes of mortality and their associated risk factors is important for public health. In resource-limited settings, where verbal autopsy (VA) is used as the most expedient method of determining cause of death, it is important to understand how pre-existing concepts of cause of death among VA-informants may influence their VA-responses and the consequential impact on cause of death assessment. This study describes the agreement between VA-derived causes of death and informant-perceived causes and associated influential factors, which also reflects lay health literacy in this setting. Method Using 20 years of VA data (n=11,228) from the Agincourt Health and Demographic Surveillance System (HDSS) site in rural South Africa, we explored the agreement between the causes of death perceived by the VA-informants and those assigned by the automated Inter-VA tool. Kappa statistics and concordance correlation coefficients were applied to measure agreement at individual and population levels, respectively. Multivariable regression models were used to explore factors associated with recognised lay perceptions of causes of mortality. Results Agreement between informant-perceived and VA-derived causes of death at the individual level was limited, but varied substantially by cause of death. However, agreement at the population level, comparing cause-specific mortality fractions was higher, with the notable exception of bewitchment as a cause. More recent deaths, those in adults aged 15–49 years, deaths outside the home, and those associated with external causes showed higher concordance with InterVA. Conclusion Overall, informant perception of causes of death was limited, but depended on informant characteristics and causes of death, and to some extent involved non-biomedical constructs. Understanding discordance between perceived and recognised causes of death is important for public health planning; low community

  6. Violent Deaths and Traumatic Bereavement: The Importance of Appropriate Death Notification

    Directory of Open Access Journals (Sweden)

    Diego de Leo

    2015-10-01

    Full Text Available The communication of a death due to unexpected and traumatic causes is considered a very sensitive issue that can deeply affect both operators responsible for reporting the incident and the mourning process of family members, relatives, and other survivors. By focusing particularly on cases of traumatic death, this article tries to explain how inadequate communication of death may adversely affect the course of mourning. The article also illustrates the basic principles of correct notification of death. In this way, we hope to contribute to the ongoing dialogue on this topic and the promotion of new studies aimed at setting best practices for those professionally involved in the challenging task of communicating that a life has ended. This would be important in order to safeguard the emotional integrity of notifiers whilst effectively helping the survivors to cope with the early stages of their difficult mourning process.

  7. Non-intentional motor vehicle-related carbon monoxide deaths-revisited

    Energy Technology Data Exchange (ETDEWEB)

    Copeland, A.R.

    1986-01-01

    A study of non-intentional, motor vehicle-related, carbon monoxide-related deaths was performed on the case files of the Office of the Medical Examiner of Metropolitan Dade Country in Miami, FL (USA) during the years 1980-1984. A total of 15 cases were collected during that time period. These are presented in some detail. A discussion ensues that compares the similar circumstances of these cases, notably running the engine of an automobile in an enclosed space, with older reports in the literature which emphasized defective vehicle exhaust systems as the leading etiology for these deaths.

  8. Causes of death among full term stillbirths and early neonatal deaths in the Region of Southern Denmark

    DEFF Research Database (Denmark)

    Basu, Millie; Johnsen, Iben Birgit Gade; Wehberg, Sonja

    2018-01-01

    OBJECTIVE: We examined the causes of death amongst full term stillbirths and early neonatal deaths. METHODS: Our cohort includes women in the Region of Southern Denmark, who gave birth at full term to a stillborn infant or a neonate who died within the first 7 days from 2010 through 2014. Demogra......OBJECTIVE: We examined the causes of death amongst full term stillbirths and early neonatal deaths. METHODS: Our cohort includes women in the Region of Southern Denmark, who gave birth at full term to a stillborn infant or a neonate who died within the first 7 days from 2010 through 2014....... Demographic, biometric and clinical variables were analyzed to assess the causes of death using two classification systems: causes of death and associated conditions (CODAC) and a Danish system based on initial causes of fetal death (INCODE). RESULTS: A total of 95 maternal-infant cases were included. Using...

  9. Sudden unexpected death in infancy: place and time of death.

    Science.gov (United States)

    Glasgow, J F T; Thompson, A J; Ingram, P J

    2006-01-01

    In recent years, many babies who die of Sudden Unexpected Death in Infancy (SUDI) in Northern Ireland are found dead in bed--i.e. co-sleeping--with an adult. In order to assess its frequency autopsy reports between April 1996 and August 2001 were reviewed and linked to temporal factors. The day and month of death, and the place where the baby was found were compared to a reference population of infant deaths between one week of age and the second birthday. Although the rate of SUDI was lower than the UK average, 43 cases of SUDI were identified, and two additional deaths with virtually identical autopsy findings that were attributed to asphyxia caused by suffocation due to overlaying. Thirty-two of the 45 (71%) were less than four months of age. In 30 of the 45 cases (67%) the history stated that the baby was bed sharing with others; 19 died sleeping in an adult bed, and 11 on a sofa or armchair. In 16 of the 30 (53%) there were at least two other people sharing the sleeping surface, and in one case, three. SUDI was twice as frequent at weekends (found dead Saturday-Monday mornings) compared to weekdays (psharing a place of sleep per se may not increase the risk of death, our findings may be linked to factors such as habitual smoking, consumption of alcohol or illicit drugs as reported in case-control studies. In advising parents on safer childcare practices, health professionals must be knowledgeable of current research and when, for example, giving advice on co-sleeping this needs to be person-specific cognisant of the risks within a household. New and better means of targeting such information needs to be researched if those with higher risk life-styles are to be positively influenced.

  10. Life and death.

    Science.gov (United States)

    Lloyd, J W

    1983-03-01

    In contrast with the other lectures given in the course on humanics and bioethics at the UOEH, which address the questions of life and death from the standpoint of the physician or the philosopher, this lecture considers these issues as seen by the cancer patient who has had a close encounter with death. The attitudes of Americans concerning abortion, the use of life-support systems, "mercy killings", suicide and the use of cancer chemotherapy are discussed with particular emphasis on restraints imposed by the courts, the churches and the family systems. An attempt is made to contrast the American and Japanese attitudes on these questions but this is difficult because of different cultural and religious backgrounds. The author describes his own experiences as a cancer patient who has approached death very closely and the changes in his own attitude toward life which results from the encounter with death. He also talks about the joy of being alive and describes his own experience with receiving cancer chemotherapy, the resulting discomfort and inconveniences and his feelings about a "tolerable" existence. Finally, the author considers the question of the "quality of life" for the cancer patient who has a violent reaction to certain forms of chemotherapy. This is a dilemma for the patient and the doctor who must consider the choice between death and a miserable existence.

  11. Residual entanglement and sudden death: A direct connection

    International Nuclear Information System (INIS)

    Oliveira, J.G.G. de; Peixoto de Faria, J.G.; Nemes, M.C.

    2011-01-01

    We explore the results of [V. Coffman, et al., Phys. Rev. A 61 (2000) 052306] derived for general tripartite states in a dynamical context. We study a class of physically motivated tripartite systems. We show that whenever entanglement sudden death occurs in one of the partitions residual entanglement will appear. For fourpartite systems however, the appearance of residual entanglement is not conditioned by sudden death of entanglement. We can only say that if sudden death of entanglement occurs in some partition there will certainly be residual entanglement. -- Highlights: ► For tripartite systems we show there exists residual entanglement if sudden death occurs. ► For fourpartite systems, the residual entanglement is not conditioned by sudden death. ► If sudden death of entanglement occurs there will certainly be residual entanglement.

  12. Toxicologic Laboratory Findings in Cases Reported with Hanging Death: a Two-Year Retrospective Study in Northeast Iran

    Directory of Open Access Journals (Sweden)

    Mohammad Ranjbar

    2013-09-01

    How to cite this article: Ranjbar R, Liaghat AR, Ranjbar A, Mohabbati H. Toxicologic Laboratory Findings in Cases Reported with Hanging Death: a Two-Year Retrospective Study in Northeast Iran. Asia Pac J Med Toxicol 2013;2:92-5.

  13. Post-licensure safety monitoring of quadrivalent human papillomavirus vaccine in the Vaccine Adverse Event Reporting System (VAERS), 2009-2015.

    Science.gov (United States)

    Arana, Jorge E; Harrington, Theresa; Cano, Maria; Lewis, Paige; Mba-Jonas, Adamma; Rongxia, Li; Stewart, Brock; Markowitz, Lauri E; Shimabukuro, Tom T

    2018-03-20

    The Food and Drug Administration (FDA) approved quadrivalent human papillomavirus vaccine (4vHPV) for use in females and males aged 9-26 years, since 2006 and 2009 respectively. We characterized reports to the Vaccine Adverse Event Reporting System (VAERS), a US spontaneous reporting system, in females and males who received 4vHPV vaccination. We searched VAERS for US reports of adverse events (AEs) following 4vHPV from January 2009 through December 2015. Signs and symptoms were coded using Medical Dictionary for Regulatory Activities (MedDRA). We calculated reporting rates and conducted empirical Bayesian data mining to identify disproportional reports. Clinicians reviewed available information, including medical records, and reports of selected pre-specified conditions. VAERS received 19,760 reports following 4vHPV; 60.2% in females, 17.2% in males, and in 22.6% sex was missing. Overall, 94.2% of reports were non-serious; dizziness, syncope and injection site reactions were commonly reported in both males and females. Headache, fatigue and nausea were commonly reported serious AEs. More than 60 million 4vHPV doses were distributed during the study period. Crude AE reporting rates were 327 reports per million 4vHPV doses distributed for all reports, and 19 per million for serious reports. Among 29 verified reports of death, there was no pattern of clustering of deaths by diagnosis, co-morbidities, age, or interval from vaccination to death. No new or unexpected safety concerns or reporting patterns of 4vHPV with clinically important AEs were detected. Safety profile of 4vHPV is consistent with data from pre-licensure trials and postmarketing safety data. Published by Elsevier Ltd.

  14. Scintigraphic evaluation of brain death with 99mTc-d,l-hexamethyl-propyleneamine oxime (HMPAO)

    International Nuclear Information System (INIS)

    Takehara, Yasuo; Isoda, Haruo; Sakai, Tsuneo; Tanaka, Tokutaro; Sato, Haruhiko; Yamamoto, Takamichi; Takahashi, Motoichiro; Kaneko, Masao.

    1989-01-01

    Lately, the criteria of brain death is being discussed. Cerebral scintigram, especially scintigraphic evaluation of brain death by dynamic study, has been previously reported. Cerebral imaging using radiolabeled amines such as 123 I-IMP N-isopropyl-p-iodoamphetamin (IMP) or 99m Tc d, l-hexamethyl-propyleneamine oxime (HMPAO) offers a significant information of brain death by the finding of 'non visualized brain'. However, the dynamic scintigram acquired during the bolus injection of 99m Tc-HMPAO provides an additional information of brain death by classical 'hot nose sign'. 99m Tc-HMPAO is able to be administered relatively in a large amount of dose. This cerebral perfusion tracer is lipophilic and remains in the central nervous system, which characterize its role as a reliable indicator of cerebral blood flow. As a result, this compound became suitable for the non-invasive study of brain circulation when the diagnosis of brain death is uncertain. We report a case of brain death in which diagnosis was made by the classical 'hot nose sign' in dynamic scintigraphy performed when 99 mTc-HMPAO was injected as well as the SPECT which showed a lack of cerebral visualization at the equilibrium state. As far as we are informed, this additional procedure used in the diagnosis of brain death has not reported before. The importance of performing a dynamic scintigram at the administration of 99m Tc-HMPAO is also discussed in this report. (author)

  15. Death and consciousness--an overview of the mental and cognitive experience of death.

    Science.gov (United States)

    Parnia, Sam

    2014-11-01

    Advances in resuscitation science have indicated that, contrary to perception, death by cardiorespiratory criteria can no longer be considered a specific moment but rather a potentially reversible process that occurs after any severe illness or accident causes the heart, lungs, and brain to stop functioning. The resultant loss of vital signs of life (and life processes) is used to declare a specific time of death by physicians globally. When medical attempts are made to reverse this process, it is commonly referred to as cardiac arrest; however, when these attempts do not succeed or when attempts are not made, it is called death by cardiorespiratory criteria. Thus, biologically speaking, cardiac arrest and death by cardiorespiratory criteria are synonymous. While resuscitation science has provided novel opportunities to reverse death by cardiorespiratory criteria and treat the potentially devastating consequences of the resultant postresuscitation syndrome, it has also inadvertently provided intriguing insights into the likely mental and cognitive experience of death. Recollections reported by millions of people in relation to death, so-called out-of-body experiences (OBEs) or near-death experiences (NDEs), are often-discussed phenomena that are frequently considered hallucinatory or illusory in nature; however, objective studies on these experiences are limited. To date, many consistent themes corresponding to the likely experience of death have emerged, and studies have indicated that the scientifically imprecise terms of NDE and OBE may not be sufficient to describe the actual experience of death. While much remains to be discovered, the recalled experience surrounding death merits a genuine scientific investigation without prejudice. © 2014 New York Academy of Sciences.

  16. Verbal autopsy of 80,000 adult deaths in Tamilnadu, South India

    Directory of Open Access Journals (Sweden)

    Peto Richard

    2004-10-01

    Full Text Available Abstract Background Registration of the fact of death is almost complete in the city of Chennai and not so in the rural Villupuram district in Tamilnadu, India. The cause of death is often inadequately recorded on the death certificate in developing countries like India. A special verbal autopsy (VA study of 48 000 adult (aged ≥ 25 yrs deaths in the city of Chennai (urban during 1995–97 and 32 000 in rural Villupuram during 1997–98 was conducted to arrive at the probable underlying cause of death to estimate cause specific mortality. Methods A ten day training on writing verbal autopsy (VA report for adult deaths was given to non-medical graduates with at least 15 years of formal education. They interviewed surviving spouse/close associates of the deceased to write a verbal autopsy report in local language (Tamil on the complaints, symptoms, signs, duration and treatment details of illness prior to death. Each report was reviewed centrally by two physicians independently. Random re-interviewing of 5% of the VA reports was done to check the reliability and reproducibility of the VA report. The validity of VA diagnosis was assessed only for cancer deaths. Results Verbal autopsy reduced the proportion of deaths attributed to unspecified and unknown causes from 54% to 23% (p Conclusion A ten day training programme to write verbal autopsy report with adequate feed back sessions and random sampling of 5% of the verbal autopsy reports for re-interview worked very well in Tamilnadu, to arrive at the probable underlying cause of death reliably for deaths in early adult life or middle age (25–69 years and less reliably for older ages (70+. Thus VA is practicable for deaths in early adult life or middle age and is of more limited value in old age.

  17. Maternal and pregnancy-related death: causes and frequencies in an autopsy study population.

    Science.gov (United States)

    Buschmann, Claas; Schmidbauer, Martina; Tsokos, Michael

    2013-09-01

    Maternal deaths during pregnancy, both from pregnancy-related or other causes, are rare in Western industrialized countries. In this study we report maternal and pregnancy-related deaths in a large autopsy population focusing on medical history, autopsy findings and histological examinations. Medico-legal autopsy files (n = 11,270) from the Institute of Legal Medicine and Forensic Sciences, University Medical Centre Charité, University of Berlin, and the State Institute of Legal and Social Medicine, Berlin, from 2005 to 2010 were reviewed. All female cases between 15 and 49 years were checked for maternal and pregnancy-related death, and deaths of pregnant women from non-natural causes were also included. Fatalities that met the chosen criteria were classified as "direct gestational death," "indirect gestational death" or "non-gestational death." 13 female fatalities (0.12 %) met the chosen criteria (median age 28 years ± 6.87 SD). Eight (61.5 %) women died in-hospital, four (30.8 %) at home, and one woman died in public. Three cases (23.1 %) were "non-gestational deaths," and one case (7.7 %) remained unclear after autopsy and additional examinations. Of the remaining nine cases, six cases (46.5 %) were "direct gestational deaths," and two cases (15.4 %) were "indirect gestational deaths." One case (7.7 %) was not to be defined as "late maternal death," but the cause of death seemed to be directly related to previous gestation ["(very) late maternal death"]. Maternal deaths during pregnancy, both from pregnancy-related or other causes, remain an uncommon event in routine forensic autopsy practice. We report on the collection and analysis of maternal and pregnancy-related deaths in a large autopsy population, with particular attention to the phenomenology of pregnancy, pathophysiological changes in different organ systems and their detection, and the forensic autopsy assessment.

  18. Trends in reporting injury as a cause of death among people with epilepsy in the U.S., 1981-2010.

    Science.gov (United States)

    Chang, Chia-Yu; Lu, Tsung-Hsueh; Cheng, Tain-Junn

    2014-11-01

    To examine trends in reporting injury as a cause of death among people with epilepsy in the U.S. during the past three decades. We analyzed the U.S. multiple causes of death data from death certificates in 1981-2010 to compare rate and odds ratios (OR) of reporting injury as cause of death among cases with vs. without mention of epilepsy across years. The trends in reporting epilepsy with and without injury were similar in most age groups but were inconsistent in most external causes of injury. The OR of reporting injury was 1.02 (95% confidence intervals (CI) 0.97-1.07) in 1981-1985 and decreased to 0.52 (95% CI 0.48-0.55) in 2006-2010. The decline in OR was prominent among people aged 15-24 followed by people aged 25-44. For the five external causes of injury, the OR of suffocation and drowning were 6.32 (95% CI 5.91-6.75) and 5.64 (95% CI 5.16-6.16) in 1981-1985 and decreased to 3.03 (95% CI 2.74-3.35) and 2.56 (95% CI 2.18-3.00) in 2006-2010. The OR for poisoning and traffic crashes were 0.70 (95% CI 0.57-0.85) and 0.08 (95% CI 0.07-0.09) in 1981-1985 and 0.21 (95% CI 0.18-0.25) and 0.06 (95% CI 0.05-0.08) in 2006-2010. The risk of fatal injury among people with epilepsy decreased drastically during the past three decades in most age groups and for most external causes of injury except falls. People with epilepsy had lower risks of dying from injury due to poisoning or traffic crashes, had higher risks of dying from suffocation and drowning. Copyright © 2014 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  19. Sudden death in young persons with uncontrolled asthma--a nationwide cohort study in Denmark

    DEFF Research Database (Denmark)

    Gullach, Anders Juul; Risgaard, Bjarke; Lynge, Thomas Hadberg

    2015-01-01

    BACKGROUND: Asthma is a common chronic disease among young adults, and several studies have reported increased mortality rates in patients with asthma. However, no study has described sudden unexpected death in a nationwide setting in patients with uncontrolled asthma. We defined uncontrolled...... in preventing sudden unexpected deaths. We therefore aimed to describe clinical characteristics, symptoms, causes of death, and contact with the healthcare system prior to sudden unexpected death in young persons with uncontrolled asthma. METHODS: Through the review of death certificates, we found 625 sudden...... individuals who suffered from uncontrolled asthma. This corresponds to an incidence rate of 0.32 per 100,000 person-years. The cause of death in 31 cases (63%) was sudden cardiac death, and in 13 cases (27%), it was a fatal asthma attack. Symptoms (chest pain, dyspnea, seizures, general malaise, syncope...

  20. Power and death: Mortality salience increases power seeking while feeling powerful reduces death anxiety.

    Science.gov (United States)

    Belmi, Peter; Pfeffer, Jeffrey

    2016-05-01

    According to Terror Management Theory, people respond to reminders of mortality by seeking psychological security and bolstering their self-esteem. Because previous research suggests that having power can provide individuals a sense of security and self-worth, we hypothesize that mortality salience leads to an increased motivation to acquire power, especially among men. Study 1 found that men (but not women) who wrote about their death reported more interest in acquiring power. Study 2A and Study 2B demonstrated that when primed with reminders of death, men (but not women) reported behaving more dominantly during the subsequent week, while both men and women reported behaving more prosocially during that week. Thus, mortality salience prompts people to respond in ways that help them manage their death anxiety but in ways consistent with normative gender expectations. Furthermore, Studies 3-5 showed that feeling powerful reduces anxiety when mortality is salient. Specifically, we found that when primed to feel more powerful, both men and women experienced less mortality anxiety. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  1. Technical assistance contractor occurrence reporting and processing system

    International Nuclear Information System (INIS)

    1996-08-01

    Members of the Uranium Mill Tailings Remedial Action (UMTRA) Project Technical Assistance Contractor (TAC) are responsible to notify management of TAC occurrence reporting and processing system (ORPS) classified occurrences .An ORPS occurrence is an unexpected or unplanned event on DOE property which causes bodily harm, death, damage to government property, exposure to toxic or hazardous substances above acceptable limits to workers, the environment, or general public. Examples of potential reportable occurrences include, but not limited to, site personnel exposures to airborne contaminants, incidents which could expose the general public to high levels of radiation or other contaminants, a vehicle accident resulting in property damage or personnel injuries. Listed TAC manager/staff contacts, with the assistance of TAC ORPS Program Coordinators, will determine if the occurrence is reportable under Department of Energy (DOE) Order M 232.1-2. The reportable occurrences will be classified as emergency, unusual, or off-normal. If determined to be reportable, listed TAC manager/staff will verbally report the details of the occurrence to the DOE Duty Officer within 2 hours of initial notification, and provide a written report of the event by noon the following work day

  2. Coupling of Rigor Mortis and Intestinal Necrosis during C. elegans Organismal Death.

    Science.gov (United States)

    Galimov, Evgeniy R; Pryor, Rosina E; Poole, Sarah E; Benedetto, Alexandre; Pincus, Zachary; Gems, David

    2018-03-06

    Organismal death is a process of systemic collapse whose mechanisms are less well understood than those of cell death. We previously reported that death in C. elegans is accompanied by a calcium-propagated wave of intestinal necrosis, marked by a wave of blue autofluorescence (death fluorescence). Here, we describe another feature of organismal death, a wave of body wall muscle contraction, or death contraction (DC). This phenomenon is accompanied by a wave of intramuscular Ca 2+ release and, subsequently, of intestinal necrosis. Correlation of directions of the DC and intestinal necrosis waves implies coupling of these death processes. Long-lived insulin/IGF-1-signaling mutants show reduced DC and delayed intestinal necrosis, suggesting possible resistance to organismal death. DC resembles mammalian rigor mortis, a postmortem necrosis-related process in which Ca 2+ influx promotes muscle hyper-contraction. In contrast to mammals, DC is an early rather than a late event in C. elegans organismal death. VIDEO ABSTRACT. Copyright © 2018 The Author(s). Published by Elsevier Inc. All rights reserved.

  3. Motor Vehicle Occupant Death Rate, by Age and Gender, 2012 & 2014, All States

    Data.gov (United States)

    U.S. Department of Health & Human Services — Rate of deaths by age/gender (per 100,000 population) for motor vehicle occupants killed in crashes, 2012 & 2014. 2012 Source: Fatality Analysis Reporting System...

  4. Causes of death in the Taabo health and demographic surveillance system, Côte d'Ivoire, from 2009 to 2011.

    Science.gov (United States)

    Koné, Siaka; Fürst, Thomas; Jaeger, Fabienne N; Esso, Emmanuel L J C; Baïkoro, Nahoua; Kouadio, Kouamé A; Adiossan, Lukas G; Zouzou, Fabien; Boti, Louis I; Tanner, Marcel; Utzinger, Jürg; Bonfoh, Bassirou; Dao, Daouda; N'Goran, Eliézer K

    2015-01-01

    Current vital statistics from governmental institutions in Côte d'Ivoire are incomplete. This problem is particularly notable for remote rural areas that have limited access to the health system. To record all deaths from 2009 to 2011 and to identify the leading causes of death in the Taabo health and demographic surveillance system (HDSS) in south-central Côte d'Ivoire. Deaths recorded in the first 3 years of operation of the Taabo HDSS were investigated by verbal autopsy (VA), using the InterVA-4 model. InterVA-4 is based on the World Health Organization 2012 VA tool in terms of input indicators and categories of causes of death. Overall, 948 deaths were recorded, of which 236 (24.9%) had incomplete VA data. Among the 712 deaths analyzed, communicable diseases represented the leading causes (58.9%), with most deaths attributed to malaria (n=129), acute respiratory tract infections (n=110), HIV/AIDS (n=80), and pulmonary tuberculosis (n=46). Non-communicable diseases accounted for 18.9% of the deaths and included mainly acute abdomen (n=38), unspecified cardiac diseases (n=15), and digestive neoplasms (n=13). Maternal and neonatal conditions accounted for 8.3% of deaths, primarily pneumonia (n=19) and birth asphyxia (n=16) in newborns. Among the 3.8% of deaths linked to trauma and injury, the main causes were assault (n=6), accidental drowning (n=4), contact with venomous plants/animals (n=4), and traffic-related accidents (n=4). No clear causes were determined in 10.0% of the analyzed deaths. Communicable diseases remain the predominant cause of death in rural Côte d'Ivoire. Based on these findings, measures are now being implemented in the Taabo HDSS. It will be interesting to monitor patterns of mortality and causes of death in the face of rapid demographic and epidemiological transitions in this part of West Africa.

  5. Sudden unexpected death in infancy in Denmark

    DEFF Research Database (Denmark)

    Winkel, Bo Gregers; Holst, Anders Gaarsdal; Theilade, Juliane

    2011-01-01

    Abstract Background. Incidence of sudden unexpected death in infancy (SUDI) and sudden infant death syndrome (SIDS) differs among studies and non-autopsied cases are difficult to assess. Objectives. To investigate causes of sudden death in infancy in a nationwide setting. Validate the use...... of the ICD-10 code for SIDS (R95) in the Danish Cause of Death registry. Design. A retrospective analysis of all infant deaths (death certificates and autopsy reports were read. Results. We identified 192 SUDI cases (10% of total deaths, 0.42 per 1000 births......) with autopsy performed in 87% of cases. In total, 49% of autopsied SUDI cases were defined as SIDS (5% of all deaths, 0.22 per 1000 births); Cardiac cause of death was denoted in 24% of cases. The Danish Cause of Death Registry misclassified 30% of SIDS cases. Conclusions. A large proportion of infant deaths...

  6. Chest HRCT signs predict deaths in long-term follow-up among asbestos exposed workers

    Energy Technology Data Exchange (ETDEWEB)

    Vehmas, Tapio, E-mail: tapio.vehmas@ttl.fi [Health and Work Ability, Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, FI-00250 Helsinki (Finland); Oksa, Panu, E-mail: panu.oksa@ttl.fi [Health and Work Ability, Finnish Institute of Occupational Health, Uimalankatu 1, FI-33101 Tampere (Finland)

    2014-10-15

    Highlights: • Much lung and pleural pathology is found in chest CT studies. • HRCT signs were screened and subsequent mortality followed up. • Several signs were related to all-cause and disease specific deaths. • The HRCT classification system used was able to predict mortality. • Secondary preventive strategies should be developed for patients with such signs. - Abstract: Objectives: To study associations between chest HRCT signs and subsequent deaths in long-term follow-up. Methods: Lung and pleural signs of 633 asbestos exposed workers (age 45–86, mean 65) screened with HRCT were recorded by using the International Classification of Occupational and Environmental Respiratory Diseases (ICOERD) system, which contains detailed instructions for use and reference images. Subsequent mortality was checked from the national register. Cox regression adjusted for covariates (age, sex, BMI, asbestos exposure, pack-years) was used to explore the relations between HRCT signs and all-cause deaths, cardiovascular and benign respiratory deaths, and deaths from neoplasms – all according to the ICD-10 diagnostic system. Results: The follow-up totalled 5271.9 person-years (mean 8.3 y/person, range .04–10.3). 119 deaths were reported. Irregular/linear opacities, honeycombing, emphysema, large opacities, visceral pleural abnormalities and bronchial wall thickening were all significantly related to all-cause deaths. Most of these signs were associated also with deaths from neoplasms and benign respiratory disease. Deaths from cardiovascular disease were predicted by emphysema and visceral pleural abnormalities. Conclusions: Several HRCT signs predicted deaths. Careful attention should be paid on subjects with radiological signs predictive of deaths and new secondary preventive strategies developed. This calls for further focused studies among different populations.

  7. Capturing deaths not informed to the Ministry of Health: proactive search of deaths in Brazilian municipalities.

    Science.gov (United States)

    Almeida, Wanessa da Silva de; Szwarcwald, Célia Landmann; Frias, Paulo Germano de; Souza, Paulo Roberto Borges de; Lima, Raquel Barbosa de; Rabello, Dácio de Lyra; Escalante, Juan José Cortez

    2017-01-01

    The proactive search of deaths is a strategy for capturing events that were not informed to the Mortality Information System of Ministry of Health. Its importance to reduce underreporting of deaths and to evaluate the operation of the information system is widely known. To describe the methodology and main findings of the Proactive Search of Deaths, 2013, establishing the contribution of different information sources. The research was carried out in 79 Brazilian municipalities. We investigated several official and unofficial sources of information about deaths of municipality residents. Every information source investigated and all cases found in each source were typed in an on-line panel. The second stage of the research was the confirmation of cases to verify information of year and residence and to complete missing information. For all confirmed cases, we estimated the completeness of death registration and correction factors according to the adequacy level of mortality information. We found 2,265 deaths that were not informed to the Mortality Information System. From those, 49.3% were found in unofficial sources, cemeteries and funeral homes. In some rural municipalities, precarious burial conditions were found in cemeteries in the middle of the forest and no registration of the deceased. Correction factors were inversely associated to the adequacy level of mortality information. The findings confirm the association between level of information adequacy and completeness of death registration, and indicate that the application of the proactive search is an effective method to capture deaths not informed to the Ministry of Health.

  8. The analysis of Sudden Infant Death Syndrome in Poland

    Directory of Open Access Journals (Sweden)

    Anna Lewandowska

    2017-05-01

    Full Text Available Introduction: Sudden Infant Death Syndrome is defined in literature similarly as a sudden and unexpected death of an infant occurring during sleep and, at the same time, causes of which cannot be explained based on anamnesis, circumstances of death or comprehensive post-mortem examinations. Sudden Infant Death Syndrome is considered to be the most frequent cause of death among infants in the developed countries. Incidence of SIDS in the whole world ranges from about 0.1 to 6.0/1,000 live births. As much as 90% concerns deaths in the first year of life of a child, whereas 70% stands for deaths for which the cause remains unknown. In SIDS, about 90% of cases concern children under 1 year old and, in particular, at the age of between 2 and 4 months. The aim: The aim of the study was to present the most significant aspects of SIDS as well as description and analysis of risk factors for occurrence of sudden infant death syndrome based on statistical data. Materials and methods: For the purpose of the study, the secondary data analysis and desk research technique have been applied. The analysis is based on statistical data from the time period 2009-2014 released by the Central Statistical Office of Poland. Results: In 2009-2014, the highest number of deaths of infants and new-borns was reported in 2009 with the number being as high as 2,327. In the following years, the number of deaths of new-borns and infants systematically decreased. In 2010 it was 2,057 and in 2011 – 1,836, in 2012 – 1,791, in 2013 – 1,684, and in 2014 – 1,583. The highest number of deaths of boys was reported in 2009 – 1,298, while the number of deaths of girls in that year, although it was the highest in the analysed period, was lower – 1,029. Conclusions: cases of death were more frequent among boys rather than girls. The highest number of deaths was reported among infants under the age of one month and the number decreased with an increasing infants’ age. More

  9. Sudden Death Following Exercise; a Case Series Study

    Directory of Open Access Journals (Sweden)

    Fares Najari

    2016-04-01

    Full Text Available Introduction: Natural and unexpected death that happens within less than one hour of first symptom occurrence is called sudden death. Cardiovascular diseases are the main known reason of sudden death and more than 75% of sudden deaths in athletes are assigned to it. Here we reported the autopsy results of all cases with sudden death following exercise that were referred to forensic center of Tehran, Iran, from 2009 to 2014. Methods: In this cross sectional study all subjects who were registered to forensic medicine center of Tehran, Iran, from 2009 to 2014, as a case of sudden death following exercise were evaluated. Demographic data and medical history as well as autopsy and toxicology findings were retrospectively gathered using profiles of the deceased. Results were reported using descriptive analysis. Results: 14 cases were registered as sudden death following exercise in forensic medicine profiles during the study period. Exploring the files of the mentioned deceased, revealed five non-compatible cases in this regard. Finally, 9 eligible cases were enrolled (88.9% male. The mean age of the deceased was 28.66 ± 10.86 years (range: 7 – 40. Toxicological tests were available for 7 cases, one of which was positive for tramadol. Sudden death following football was reported most frequently (44.4%. Only 3 (33.3% cases had herald signs such as chest pain, syncope, or loss of consciousness. 1 case (11.11% had a positive history of sudden death in relatives. Conclusion: Although most sudden death victims are asymptomatic until the event, all those who suffer from symptoms such as chest pain, shortness of breath, dizziness, fatigue and irregular heart rate during physical activities, should be screened regarding common probable causes of sudden death.

  10. Forensic investigation of medical treatment related deaths.

    Science.gov (United States)

    Ibrahim, Joseph E; Ranson, David L; O'Brien, Adam; Charles, Amanda; Young, Carmel

    2009-04-01

    Patients suffer preventable harm from their medical treatment. The traditional approaches to investigating medical treatment related deaths are the 'hospital mortality audit' and legal or coroners investigation. The aim is to describe how the patient safety movement in the late 1990s is changing traditional approaches to the investigation. The prevention of medical treatment related death involves an investigation as one of five major stages. These are Stage I Preparedness; Stage II Recognition and reporting; Stage III Investigation and analysis; Stage IV Findings and recommendations; and Stage V Response. The influence of the patient safety approach is considered at each stage with a particular focus on Stage I. It is at this stage that the concepts of clinical governance, culture and systems of care have a major influence on the nature of an investigation. The genesis of the modern forensic investigation into medical treatment related deaths in Victoria, Australia is described. The formation of the Clinical Liaison Service incorporates concepts from the patient safety approach with clinical staff to transform the traditional Coroner's investigation. Benefits of a modern forensic investigation include improving appropriateness of cases proceeding to investigation and a focus on prevention. Achieving a reduction in medical treatment related death requires substantial shifts towards an approach consistent with the patient safety.

  11. Death certificates underestimate infections as proximal causes of death in the U.S.

    Directory of Open Access Journals (Sweden)

    Sushant Govindan

    Full Text Available Death certificates are a primary data source for assessing the population burden of diseases; however, there are concerns regarding their accuracy. Diagnosis-Related Group (DRG coding of a terminal hospitalization may provide an alternative view. We analyzed the rate and patterns of disagreement between death certificate data and hospital claims for patients who died during an inpatient hospitalization.We studied respondents from the Health and Retirement Study (a nationally representative sample of older Americans who had an inpatient death documented in the linked Medicare claims from 1993-2007. Causes of death abstracted from death certificates were aggregated to the standard National Center for Health Statistics List of 50 Rankable Causes of Death. Centers for Medicare and Medicaid Services (CMS-DRGs were manually aggregated into a parallel classification. We then compared the two systems via 2×2, focusing on concordance. Our primary analysis was agreement between the two data sources, assessed with percentages and Cohen's kappa statistic.2074 inpatient deaths were included in our analysis. 36.6% of death certificate cause-of-death codes agreed with the reason for the terminal hospitalization in the Medicare claims at the broad category level; when re-classifying DRGs without clear alignment as agreements, the concordance only increased to 61%. Overall Kappa was 0.21, or "fair." Death certificates in this cohort redemonstrated the conventional top 3 causes of death as diseases of the heart, malignancy, and cerebrovascular disease. However, hospitalization claims data showed infections, diseases of the heart, and cerebrovascular disease as the most common diagnoses for the same terminal hospitalizations.There are significant differences between Medicare claims and death certificate data in assigning cause of death for inpatients. The importance of infections as proximal causes of death is underestimated by current death certificate

  12. Development of a Microfluidic Platform to Analyze Evolution of Programmed Bacterial Death

    Science.gov (United States)

    2015-12-20

    droplet-based microfluidic technology to generate population ‘bottleneck’. This platform will serve as a critical foundation for our long-term goal to...Final Report: Development of a Microfluidic Platform to Analyze Evolution of Programmed Bacterial Death The views, opinions and/or findings contained...Triangle Park, NC 27709-2211 Microfluidics , systems biology REPORT DOCUMENTATION PAGE 11. SPONSOR/MONITOR’S REPORT NUMBER(S) 10. SPONSOR/MONITOR’S ACRONYM

  13. Development of an online morbidity, mortality, and near-miss reporting system to identify patterns of adverse events in surgical patients.

    Science.gov (United States)

    Bilimoria, Karl Y; Kmiecik, Thomas E; DaRosa, Debra A; Halverson, Amy; Eskandari, Mark K; Bell, Richard H; Soper, Nathaniel J; Wayne, Jeffrey D

    2009-04-01

    To design a Web-based system to track adverse and near-miss events, to establish an automated method to identify patterns of events, and to assess the adverse event reporting behavior of physicians. A Web-based system was designed to collect physician-reported adverse events including weekly Morbidity and Mortality (M&M) entries and anonymous adverse/near-miss events. An automated system was set up to help identify event patterns. Adverse event frequency was compared with hospital databases to assess reporting completeness. A metropolitan tertiary care center. Identification of adverse event patterns and completeness of reporting. From September 2005 to August 2007, 15,524 surgical patients were reported including 957 (6.2%) adverse events and 34 (0.2%) anonymous reports. The automated pattern recognition system helped identify 4 event patterns from M&M reports and 3 patterns from anonymous/near-miss reporting. After multidisciplinary meetings and expert reviews, the patterns were addressed with educational initiatives, correction of systems issues, and/or intensive quality monitoring. Only 25% of complications and 42% of inpatient deaths were reported. A total of 75.2% of adverse events resulting in permanent disability or death were attributed to the nature of the disease. Interventions to improve reporting were largely unsuccessful. We have developed a user-friendly Web-based system to track complications and identify patterns of adverse events. Underreporting of adverse events and attributing the complication to the nature of the disease represent a problem in reporting culture among surgeons at our institution. Similar systems should be used by surgery departments, particularly those affiliated with teaching hospitals, to identify quality improvement opportunities.

  14. One Health and Cyanobacteria in Freshwater Systems: Animal Illnesses and Deaths are Sentinel Events for Human Health Risks

    Science.gov (United States)

    Harmful cyanobacterial blooms have adversely impacted human and animal health for thousands of years. Recently, the health impacts of harmful cyanobacteria blooms are becoming more frequently detected and reported. However, reports of human and animal illnesses or deaths associat...

  15. Death and Dying Anxiety among Elderly Arab Muslims in Israel

    Science.gov (United States)

    Azaiza, Faisal; Ron, Pnina; Shoham, Meyrav; Gigini, Ibrahim

    2010-01-01

    Death and dying anxiety were examined among elderly Arab Muslims in Israel. A total of 145 people aged 60 and over were interviewed using a standardized questionnaire. Nursing home residents reported higher death anxiety than others; women and uneducated participants reported greater levels of fear of death and dying than others. There were no…

  16. Swordfish Attack—Death by Penetrating Head Injury

    Directory of Open Access Journals (Sweden)

    Boon Hui Gooi

    2007-04-01

    Full Text Available There have been very few reports of swordfish attacks on humans and none have resulted in death. Although there are no reports of unprovoked attacks on humans, swordfish can be very dangerous when provoked and they can jump and use their swords to pierce their target. We describe here an unusual case of death that resulted from intracranial penetrating injury caused by a swordfish.

  17. Reporting a sudden death due to accidental gasoline inhalation.

    Science.gov (United States)

    Martínez, María Antonia; Ballesteros, Salomé; Alcaraz, Rafael

    2012-02-10

    The investigation of uncertain fatalities requires accurate determination of the cause of death, with assessment of all factors that may have contributed to it. Gasoline is a complex and highly variable mixture of aliphatic and aromatic hydrocarbons that can lead to cardiac arrhythmias due to sensitization of the myocardium to catecholamines or acts as a simple asphyxiant if the vapors displace sufficient oxygen from the breathing atmosphere. This work describes a sudden occupational fatality involving gasoline. The importance of this petroleum distillate detection and its quantitative toxicological significance is discussed using a validated analytical method. A 51 year-old Caucasian healthy man without significant medical history was supervising the repairs of the telephone lines in a manhole near to a gas station. He died suddenly after inhaling gasoline vapors from an accidental leak. Extensive blistering and peeling of skin were observed on the skin of the face, neck, anterior chest, upper and lower extremities, and back. The internal examination showed a strong odor of gasoline, specially detected in the respiratory tract. The toxicological screening and quantitation of gasoline was performed by means of gas chromatography with flame ionization detector and confirmation was performed using gas chromatography-mass spectrometry. Disposition of gasoline in different tissues was as follows: heart blood, 35.7 mg/L; urine, not detected; vitreous humor, 1.9 mg/L; liver, 194.7 mg/kg; lung, 147.6 mg/kg; and gastric content, 116,6 mg/L (2.7 mg total). Based upon the toxicological data along with the autopsy findings, the cause of death was determined to be gasoline poisoning and the manner of death was accidental. We would like to alert on the importance of testing for gasoline, and in general for volatile hydrocarbons, in work-related sudden deaths involving inhalation of hydrocarbon vapors and/or exhaust fumes. Copyright © 2011 Elsevier Ireland Ltd. All rights

  18. Maternal deaths in the Nordic countries

    DEFF Research Database (Denmark)

    Vangen, Siri; Bødker, Birgit; Ellingsen, Liv

    2017-01-01

    reporting from hospitals. Each case was then assessed to determine the cause of death, and level of care provided. Potential improvements to care were evaluated. RESULTS: We registered 168 maternal deaths, 90 direct and 78 indirect cases. The maternal mortality ratio was 7.2/100 000 live births ranging from......INTRODUCTION: Despite the seriousness of the event, maternal deaths are substantially underreported. There is often a missed opportunity to learn from such tragedies. The aim of the study was to identify maternal deaths in the five Nordic countries, to classify causes of death based...... on internationally acknowledged criteria, and to identify areas that would benefit from further teaching, training or research to possibly reduce the number of maternal deaths. MATERIAL AND METHODS: We present data for the years 2005-2013. National audit groups collected data by linkage of registers and direct...

  19. Direct maternal deaths in Norway 1976-1995

    DEFF Research Database (Denmark)

    Andersgaard, Alice Beate; Langhoff-Roos, J.; Oian, P.

    2008-01-01

    AIMS: To report direct maternal mortality ratio (MMR) in Norway between 1976 and 1995 including a description of the underlying complications in pregnancy, the causes of death and assessment of standard of care. METHODS: The maternal deaths were identified through the Cause of Death Registry......, Statistics Norway, and Medical Birth Registry of Norway. We requested copies of the hospital case records and the maternal death autopsies. The direct maternal deaths were classified on the basis underlying causes and assessed for substandard care according to the guidelines at the time of death...... and preventability provided optimal conditions and up to date guidelines. RESULTS: In the period 1976-1995 we identified 61 direct maternal deaths in Norway. The direct MMR was 5.5/100,000 births. Sufficient information was available for analysis in 51 of these cases. Six deaths occurred in early pregnancy. Among...

  20. Breast milk donation after neonatal death in Australia: a report

    OpenAIRE

    Carroll, Katherine E; Lenne, Brydan S; McEgan, Kerri; Opie, Gillian; Amir, Lisa H; Bredemeyer, Sandra; Hartmann, Ben; Jones, Rachel; Koorts, Pieter; McConachy, Helen; Mumford, Patricia; Polverino, Jan

    2014-01-01

    Lactation and breast milk can hold great value and meaning for grieving mothers who have experienced a recent death of an infant. Donation to a human milk bank (HMB) as an alternative to discarding breast milk is one means of respecting the value of breast milk. There is little research, national policy discussion, or organizational representation in Australia on the subject of breast milk donation after infant death. On 29 November 2013 the Mercy Hospital for Women in Melbourne, Australia ho...

  1. Motor Vehicle Occupant Death Rate, by Age and Gender, 2012 & 2014, Region 10 - Seattle

    Data.gov (United States)

    U.S. Department of Health & Human Services — Rate of deaths by age/gender (per 100,000 population) for motor vehicle occupants killed in crashes, 2012 & 2014. 2012 Source: Fatality Analysis Reporting System...

  2. Motor Vehicle Occupant Death Rate, by Age and Gender, 2012 & 2014, Region 6 - Dallas

    Data.gov (United States)

    U.S. Department of Health & Human Services — Rate of deaths by age/gender (per 100,000 population) for motor vehicle occupants killed in crashes, 2012 & 2014. 2012 Source: Fatality Analysis Reporting System...

  3. Motor Vehicle Occupant Death Rate, by Age and Gender, 2012 & 2014, Region 5 - Chicago

    Data.gov (United States)

    U.S. Department of Health & Human Services — Rate of deaths by age/gender (per 100,000 population) for motor vehicle occupants killed in crashes, 2012 & 2014. 2012 Source: Fatality Analysis Reporting System...

  4. Motor Vehicle Occupant Death Rate, by Age and Gender, 2012 & 2014, Region 8 - Denver

    Data.gov (United States)

    U.S. Department of Health & Human Services — Rate of deaths by age/gender (per 100,000 population) for motor vehicle occupants killed in crashes, 2012 & 2014. 2012 Source: Fatality Analysis Reporting System...

  5. Motor Vehicle Occupant Death Rate, by Age and Gender, 2012 & 2014, Region 4 - Atlanta

    Data.gov (United States)

    U.S. Department of Health & Human Services — Rate of deaths by age/gender (per 100,000 population) for motor vehicle occupants killed in crashes, 2012 & 2014. 2012 Source: Fatality Analysis Reporting System...

  6. Motor Vehicle Occupant Death Rate, by Age and Gender, 2012 & 2014, Region 3 - Philadelphia

    Data.gov (United States)

    U.S. Department of Health & Human Services — Rate of deaths by age/gender (per 100,000 population) for motor vehicle occupants killed in crashes, 2012 & 2014. 2012 Source: Fatality Analysis Reporting System...

  7. Mortality due to systemic mycoses as a primary cause of death or in association with AIDS in Brazil: a review from 1996 to 2006.

    Science.gov (United States)

    Prado, Marli; Silva, Marcelo Barbosa da; Laurenti, Ruy; Travassos, Luiz R; Taborda, Carlos P

    2009-05-01

    Deaths caused by systemic mycoses such as paracoccidioidomycosis, cryptococcosis, histoplasmosis, candidiasis, aspergillosis, coccidioidomycosis and zygomycosis amounted to 3,583 between 1996-2006 in Brazil. When analysed as the underlying cause of death, paracoccidioidomycosis represented the most important cause of deaths among systemic mycoses (approximately 51.2%). When considering AIDS as the underlying cause of death and the systemic mycoses as associated conditions, cryptococcosis (50.9%) appeared at the top of the list, followed by candidiasis (30.2%), histoplasmosis (10.1%) and others. This mortality analysis is useful in understanding the real situation of systemic mycoses in Brazil, since there is no mandatory notification of patients diagnosed with systemic mycoses in the official health system.

  8. Mortality due to systemic mycoses as a primary cause of death or in association with AIDS in Brazil: a review from 1996 to 2006

    Directory of Open Access Journals (Sweden)

    Marli Prado

    2009-05-01

    Full Text Available Deaths caused by systemic mycoses such as paracoccidioidomycosis, cryptococcosis, histoplasmosis, candidiasis, aspergillosis, coccidioidomycosis and zygomycosis amounted to 3,583 between 1996-2006 in Brazil. When analysed as the underlying cause of death, paracoccidioidomycosis represented the most important cause of deaths among systemic mycoses (~ 51.2%. When considering AIDS as the underlying cause of death and the systemic mycoses as associated conditions, cryptococcosis (50.9% appeared at the top of the list, followed by candidiasis (30.2%, histoplasmosis (10.1% and others. This mortality analysis is useful in understanding the real situation of systemic mycoses in Brazil, since there is no mandatory notification of patients diagnosed with systemic mycoses in the official health system.

  9. Unreported births and deaths, a severe obstacle for improved neonatal survival in low-income countries; a population based study

    Directory of Open Access Journals (Sweden)

    Wallin Lars

    2008-03-01

    Full Text Available Abstract Background In order to improve child survival there is a need to target neonatal mortality. In this pursuit, valid local and national statistics on child health are essential. We analyze to what extent births and neonatal deaths are unreported in a low-income country and discuss the consequences at local and international levels for efforts to save newborn lives. Methods Information on all births and neonatal deaths in Quang Ninh province in Northern Vietnam in 2005 was ascertained by systematic inventory through group interviews with key informants, questionnaires and examination of health facility records. Health care staff at 187 Community Health Centers (CHC and 18 hospitals, in addition to 1372 Village Health Workers (VHW, were included in the study. Results were compared with the official reports of the Provincial Health Bureau. Results The neonatal mortality rate (NMR was 16/1000 (284 neonatal deaths/17 519 births, as compared to the official rate of 4.2/1000. The NMR varied between 44/1000 and 10/1000 in the different districts of the province. The under-reporting was mainly attributable to a dysfunctional reporting system and the fact that families, not the health system, were made responsible to register births and deaths. This under-reporting has severe consequences at local, national and international levels. At a local level, it results in a lack of awareness of the magnitude and differentials in NMR, leading to an indifference towards the problem. At a national and international level the perceived low mortality rate is manifested in a lack of investments in perinatal health programs. Conclusion This example of a faulty health information system is reportedly not unique in low and middle income countries where needs for neonatal health reforms are greatest. Improving reporting systems on births and neonatal deaths is a matter of human rights and a prerequisite for reducing neonatal mortality in order to reach the fourth

  10. Reducing one million child deaths from birth asphyxia – a survey of health systems gaps and priorities

    Directory of Open Access Journals (Sweden)

    Manandhar Ananta

    2007-05-01

    Full Text Available Abstract Background Millions of child deaths and stillbirths are attributable to birth asphyxia, yet limited information is available to guide policy and practice, particularly at the community level. We surveyed selected policymakers, programme implementers and researchers to compile insights on policies, programmes, and research to reduce asphyxia-related deaths. Method A questionnaire was developed and pretested based on an extensive literature review, then sent by email (or airmail or fax, when necessary to 453 policymakers, programme implementers, and researchers active in child health, particularly at the community level. The survey was available in French and English and employed 5-point scales for respondents to rate effectiveness and feasibility of interventions and indicators. Open-ended questions permitted respondents to furnish additional details based on their experience. Significance testing was carried out using chi-square, F-test and Fisher's exact probability tests as appropriate. Results 173 individuals from 32 countries responded (44%. National newborn survival policies were reported to exist in 20 of 27 (74% developing countries represented, but respondents' answers were occasionally contradictory and revealed uncertainty about policy content, which may hinder policy implementation. Respondents emphasized confusing terminology and a lack of valid measurement indicators at community level as barriers to obtaining accurate data for decision making. Regarding interventions, birth preparedness and essential newborn care were considered both effective and feasible, while resuscitation at community level was considered less feasible. Respondents emphasized health systems strengthening for both supply and demand factors as programme priorities, particularly ensuring wide availability of skilled birth attendants, promotion of birth preparedness, and promotion of essential newborn care. Research priorities included operationalising

  11. Dementia in the National Cause of Death Registry in Norway 1969-2010

    Directory of Open Access Journals (Sweden)

    Vidar Hjellvik

    2012-11-01

    Full Text Available Background: The prevalence of dementia is expected to increase markedly during the coming decades. Epidemiological studies involving the National Cause of Death Registry (NCDR may be useful for exploring the aetiology of dementia. We therefore wanted to study developments in the reporting of dementia in the NCDR over the last four decades.Methods: We calculated the age- and gender specific proportion of deaths with dementia reported in the NCDR (dementia deaths in the period 1969-2010, and the proportion of vascular dementia and Alzheimer’s disease deaths in 1986-2010. Separate analyses were done for deaths occurring in nursing homes in 1996-2010. The proportion of dementia deaths where dementia was coded as underlying cause of death was also calculated.Results: The proportion of dementia deaths increased more than threefold in the period 1969-2010 among women (from 4% to 15%, and more than doubled among men (from 3% to 7%. In nursing homes the proportion increased from 17% to 26% for women and from 13% to 18% for men. The proportion of dementia deaths with Alzheimer’s disease reported in the NCDR increased from practically zero in 1986 to a maximum of 28% in 2005. The proportion of dementia deaths with dementia as underlying cause of death increased from a minimum of 6% in 1972 to a maximum of 51% in 2009.Conclusion: Although the reporting of dementia in the NCDR increased markedly from 1969 to 2010, dementia is still under-reported for old people and for deaths occurring in nursing homes when compared to prevalence estimates.

  12. Post-mortem toxicology in young sudden cardiac death victims

    DEFF Research Database (Denmark)

    Bjune, Thea; Risgaard, Bjarke; Kruckow, Line

    2017-01-01

    Aims: Several drugs increase the risk of ventricular fibrillation and sudden cardiac death (SCD). We aimed to investigate in detail the toxicological findings of all young SCD throughout Denmark. Methods and results: Deaths in persons aged 1-49 years were included over a 10-year period. Death...... certificates and autopsy reports were retrieved and read to identify cases of sudden death and establish cause of death. All medico-legal autopsied SCD were included and toxicological reports collected. Positive toxicology was defined as the presence of any substance (licit and/or illicit). All toxicological...... findings had previously been evaluated not to have caused the death (i.e. lethal concentrations were excluded). We identified 620 medico-legal autopsied cases of SCD, of which 77% (n = 477) were toxicologically investigated post-mortem, and 57% (n = 270) had a positive toxicology profile. Sudden cardiac...

  13. Two cases of death due to plastic bag suffocation.

    Science.gov (United States)

    Nadesan, K; Beng, O B

    2001-01-01

    Deaths due to plastic bag suffocation or plastic bag asphyxia are not reported in Malaysia. In the West many suicides by plastic bag asphyxia, particularly in the elderly and those who are chronically and terminally ill, have been reported. Accidental deaths too are not uncommon in the West, both among small children who play with shopping bags and adolescents who are solvent abusers. Another well-known but not so common form of accidental death from plastic bag asphyxia is sexual asphyxia, which is mostly seen among adult males. Homicide by plastic bag asphyxia too is reported in the West and the victims are invariably infants or adults who are frail or terminally ill and who cannot struggle. Two deaths due to plastic bag asphyxia are presented. Both the autopsies were performed at the University Hospital Mortuary, Kuala Lumpur. Both victims were 50-year old married Chinese males. One death was diagnosed as suicide and the other as sexual asphyxia. Sexual asphyxia is generally believed to be a problem associated exclusively with the West. Specific autopsy findings are often absent in deaths due to plastic bag asphyxia and therefore such deaths could be missed when some interested parties have altered the scene and most importantly have removed the plastic bag. A visit to the scene of death is invariably useful.

  14. Near-death-like experiences without life-threatening conditions or brain disorders: a hypothesis from a case report

    Directory of Open Access Journals (Sweden)

    Enrico eFacco

    2012-11-01

    Full Text Available Near-death experiences (NDEs are profound psychic experiences commonly occurring in life-threatening conditions. They include feeling a sense of peace, of seeing a bright light, encountering deceased relatives or religious figures, and of transcending space and time. To explain them, it has been suggested that they stem from brain disorders and/or psychological reactions to approaching death, a sort of wishful thinking in response to the perceived threat.This is a report on a case with most of the features typical of NDEs except that it occurred entirely without any life-threatening conditions. This evidence is theoretically incompatible with either of the above hypotheses, suggesting that a broader interpretation of the phenomenon is needed.

  15. Health system costs by sex, age and proximity to death, and implications for estimation of future expenditure.

    Science.gov (United States)

    Blakely, Tony; Atkinson, June; Kvizhinadze, Giorgi; Nghiem, Nhung; McLeod, Heather; Wilson, Nick

    2014-05-02

    Health expenditure increases with age, but some of this increase is due to costs proximal to death. We used linked health datasets (HealthTracker) to determine health expenditure by proximity to death. We then determined the impact on future health expenditure projections of accounting for proximity to death in costs. 2007 to 2009 national health event data were linked for hospitalisations, inpatient procedures, outpatient events, pharmaceuticals, laboratory tests, and primary care consultations. Each event was assigned a cost. Health expenditure by sex, age and whether in last 6 or 12 months of life or not were calculated. Future health expenditure trends were then estimated for the Statistics New Zealand median projection population counts, with 2010-12 mortality rates reducing by 2% per annum into the future. A total of $8.1, $8.8 and $9.2 billion dollars (inflation-adjusted to 2011 NZ$) was allocated to individual health events in HealthTracker in 2007, 2008 and 2009, respectively. Citizen costs for people not within 6 months of death ranged from $498 per person-year (10-14 year old females) to $6900 per person-year (90-94 year old males). Per person-year costs in the last 6 months of life were 10-fold higher on average, being maximal at $30,000 or more among infants and the older elderly (80+ years). Similar patterns were apparent for costs within 12 months of death. For people hypothetically exposed to these 2007-09 health system costs over their full life, the cumulative costs for a person dying at age 70 years was $113,000, and doubled to $223,000 for a person dying at age 90. The proportion of cumulative health expenditure in the last year of life declined with increasing age of death: e.g. 24%, 13% and 10% for someone aged 40, 70 and 90 respectively. Projections of future health system expenditure were overestimated by 2.3% to 3.5% in 2041 when not accounting for proximity to death in costs. New Zealand is fortunate to have access to rich data on health

  16. [Deaths in hotels].

    Science.gov (United States)

    Risse, Manfred; Weilbächer, Nadine; Birngruber, Christoph; Verhoff, Marcel A

    2010-01-01

    There are no verified statistics about deaths occurring in hotels, and only a few cases have been described in the literature. A recent case induced us to conduct a systematic search for deaths in hotels in the autopsy reports of the Institute of Legal Medicine in Giessen for the period from 1968 to 2009. This search yielded 22 evaluable cases in which persons had been found dead or had died in hotels. Data evaluated in the study were sex and age of the deceased, reason for the stay in the hotel and cause of death. Among the deaths, 18 were males and 4 females and the average age was 41 and 40 years respectively. 6 of the male guests had died from a natural and 10 from a non-natural cause. In the remaining two cases, the cause of death could not be determined, but as there was no evidence that another party had been involved, the cases were not further investigated. Of the 4 female guests, 3 had died of a natural cause; in one case, the cause of death remained unclear even after morphological and toxicological investigations. Surprisingly, a third of the men were found to be temporarily living in hotels due to social circumstances. This was not true for any of the women. Our retrospective analysis is based on a comparatively small number of deaths in what were mostly hotels in small to medium-sized towns. Interestingly, the gender ratio of 18:4 for deceased men and women was significantly higher than the usual gender ratio of 2:1 found for forensic autopsies. To be able to draw further conclusions, a greater number of cases would have to be analysed, for example by recruiting additional case files from other institutes of legal medicine. This would also open up the option of investigating possible regional variations.

  17. Most drug overdose deaths from nonprescription opioids

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2016-12-01

    Full Text Available No abstract available. Article truncated at 150 words. The Centers for Disease Control (CDC is reporting in Morbidity and Mortality Weekly that the number of people dying from an opioid overdose rose 15.5% from 2014 to 2015, but the increase had little to do with prescription painkillers such as oxycodone or hydrocodone (1. Roughly 52,000 people died from drug overdoses in 2015 and of those deaths 33,091 involved an opioid. The increases in “death rates were driven by synthetic opioids other than methadone (72.2%, most likely illicitly-manufactured fentanyl, and heroin (20.6%”. Deaths from methadone, which is usually prescribed by physicians, decreased 9.1%. The largest increase in deaths occurred in the South and Northeast with 3% and 24% increases in deaths from synthetic opioids from 2014 to 2015. In the Midwest and West, there were more modest 17% and 9% increases during the same period. States in the Southwest with “good” to “excellent” reporting included Colorado, Nevada, and New …

  18. Emergence of amplitude death scenario in a network of oscillators under repulsive delay interaction

    Energy Technology Data Exchange (ETDEWEB)

    Bera, Bidesh K., E-mail: bideshbera18@gmail.com [Physics and Applied Mathematics Unit, Indian Statistical Institute, Kolkata 700108 (India); Hens, Chittaranjan, E-mail: chittaranjanhens@gmail.com [Department of Mathematics, Bar-Ilan University, Ramat Gan 52900 (Israel); Ghosh, Dibakar, E-mail: dibakar@isical.ac.in [Physics and Applied Mathematics Unit, Indian Statistical Institute, Kolkata 700108 (India)

    2016-07-15

    Highlights: • Amplitude death is observed using repulsive mean coupling. • Analytical conditions for amplitude death are derived. • Effect of asymmetry time delay coupling for death is discussed. - Abstract: We report the existence of amplitude death in a network of identical oscillators under repulsive mean coupling. Amplitude death appears in a globally coupled network of identical oscillators with instantaneous repulsive mean coupling only when the number of oscillators is more than two. We further investigate that, amplitude death may emerge even in two coupled oscillators as well as network of oscillators if we introduce delay time in the repulsive mean coupling. We have analytically derived the region of amplitude death island and find out how strength of delay controls the death regime in two coupled or a large network of coupled oscillators. We have verified our results on network of delayed Mackey–Glass systems where parameters are set in hyperchaotic regime. We have also tested our coupling approach in two paradigmatic limit cycle oscillators: Stuart–Landau and Van der Pol oscillators.

  19. Emergence of amplitude death scenario in a network of oscillators under repulsive delay interaction

    International Nuclear Information System (INIS)

    Bera, Bidesh K.; Hens, Chittaranjan; Ghosh, Dibakar

    2016-01-01

    Highlights: • Amplitude death is observed using repulsive mean coupling. • Analytical conditions for amplitude death are derived. • Effect of asymmetry time delay coupling for death is discussed. - Abstract: We report the existence of amplitude death in a network of identical oscillators under repulsive mean coupling. Amplitude death appears in a globally coupled network of identical oscillators with instantaneous repulsive mean coupling only when the number of oscillators is more than two. We further investigate that, amplitude death may emerge even in two coupled oscillators as well as network of oscillators if we introduce delay time in the repulsive mean coupling. We have analytically derived the region of amplitude death island and find out how strength of delay controls the death regime in two coupled or a large network of coupled oscillators. We have verified our results on network of delayed Mackey–Glass systems where parameters are set in hyperchaotic regime. We have also tested our coupling approach in two paradigmatic limit cycle oscillators: Stuart–Landau and Van der Pol oscillators.

  20. Baicalein induces cell death in murine T cell lymphoma via inhibition of thioredoxin system.

    Science.gov (United States)

    Patwardhan, Raghavendra S; Pal, Debojyoti; Checker, Rahul; Sharma, Deepak; Sandur, Santosh K

    2017-10-01

    We have earlier demonstrated the radioprotective potential of baicalein using murine splenic lymphocytes. Here, we have studied the effect of baicalein on murine T cell lymphoma EL4 cells and investigated the underlying mechanism of action. We observed that baicalein induced a dose dependent cell death in EL4 cells in vitro and significantly reduced the frequency of cancer stem cells. Previously, we have reported that murine and human T cell lymphoma cells have increased oxidative stress tolerance capacity due to active thioredoxin system. Hence, we monitored the effect of baicalein on thioredoxin system in EL4 cells. Docking studies revealed that baicalein could bind to the active site of thioredoxin reductase. Baicalein treatment led to significant reduction in the activity of thioredoxin reductase and nuclear levels of thioredoxin-1 thereby increasing ASK1 levels and caspase-3 activity. Interestingly, CRISPR-Cas9 based knock-out of ASK1 or over-expression of thioredoxin-1 abolished anti-tumor effects of baicalein in EL4 cells. Further, baicalein administration significantly reduced intra-peritoneal tumor burden of EL4 cells in C57BL/6 mice. Thus, our study describes anti-tumor effects of baicalein in EL4 cells via inhibition of thioredoxin system. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Lost life years due to premature deaths caused by diseases of the digestive system in Poland in 2013

    Science.gov (United States)

    Paciej, Paulina; Ciabiada, Beata; Maniecka-Bryła, Irena

    In order to evaluate the health status of a population, besides indicators measuring the incidence of diseases and deaths, potential measures are becoming more frequently used, ie. measures that take into account life-time potential of the individuals in the population. They can particularly by applied to analyse the problem of premature mortality, which is measured by lost life years. The aim of the study was to evaluate life years lost due to diseases of digestive system in Polish population in 2013. The study was based on a dataset containing 387,312 death certificates of Poles who died in 2013, provided by the Central Statistical Office in Poland. Data on deaths caused by diseases of digestive system (K00-K93 by ICD-10) were used in the study – that were 16,543 records (4.3% of all the deaths). Lost life years were assessed with the measures: SEYLL (Standard Expected Years of Life Lost), SEYLLp (Standard Expected Years of Life Lost per living person), SEYLLd (Standard Expected Years of Life Lost per death). In the analysed year among men there were 9,275 deaths caused by diseases of digestive system and in women 7,268 deaths. SEYLL in the group of men amounted to 102 230.7 and in the group of women it was 53,475.5. The number of lost life years calculated per 10 000 male inhabitants was 54.9, and for 10,000 females it was 26.9. The highest share in lost life years had alcoholic liver disease (SEYLLp for men – 20.87, for women – 6.1), fibrosis and cirrhosis of the liver (SEYLLp for men- 9.7, for women- 5.6) and acute pancreatitis (SEYLLp for men – 5.3, for women – 2.1). The results of the study indicate that diseases of digestive system have an important contribution to the loss of life-time potential in Polish population (6.6% of all SEYLL in 2013). The dominant role in this class of diseases played alcoholic liver disease – K70, fibrosis and cirrhosis of the liver – K74 and acute pancreatitis – K85.

  2. Death in the United States, 2011

    Science.gov (United States)

    ... Order from the National Technical Information Service NCHS Death in the United States, 2011 Recommend on Facebook ... 2011 SOURCE: National Vital Statistics System, Mortality. Do death rates vary by state? States experience different mortality ...

  3. Determination of Minimum Data Set (MSD) in Echocardiography Reporting System to Exchange with Iran's Electronic Health Record (EHR) System.

    Science.gov (United States)

    Mahmoudvand, Zahra; Kamkar, Mehran; Shahmoradi, Leila; Nejad, Ahmadreza Farzaneh

    2016-04-01

    Determination of minimum data set (MDS) in echocardiography reports is necessary for documentation and putting information in a standard way, and leads to the enhancement of electrocardiographic studies through having access to precise and perfect reports and also to the development of a standard database for electrocardiographic reports. to determine the minimum data set of echocardiography reporting system to exchange with Iran's electronic health record (EHR) system. First, a list of minimum data set was prepared after reviewing texts and studying cardiac patients' records. Then, to determine the content validity of the prepared MDS, the expert views of 10 cardiologists and 10 health information management (HIM) specialists were obtained; to estimate the reliability of the set, test-retest method was employed. Finally, the data were analyzed using SPSS software. The highest degree of consensus was found for the following MDSs: patient's name and family name (5), accepting doctor's name and family name, familial death records due to cardiac disorders, the image identification code, mitral valve, aortic valve, tricuspid valve, pulmonary valve, left ventricle, hole, atrium valve, Doppler examination of ventricular and atrial movement models and diagnoses with an average of. To prepare a model of echocardiography reporting system to exchange with EHR system, creation a standard data set is the vital point. Therefore, based on the research findings, the minimum reporting system data to exchange with Iran's electronic health record system include information on entity, management, medical record, carried-out acts, and the main content of the echocardiography report, which the planners of reporting system should consider.

  4. Western Scientific Approaches to Near-Death Experiences

    Directory of Open Access Journals (Sweden)

    Bruce Greyson

    2015-11-01

    Full Text Available Near-death experiences (NDEs are vivid experiences that often occur in life-threatening conditions, usually characterized by a transcendent tone and clear perceptions of leaving the body and being in a different spatiotemporal dimension. Such experiences have been reported throughout history in diverse cultures, and are reported today by 10% to 20% of people who have come close to death. Although cultural expectations and parameters of the brush with death influence the content of some NDEs, near-death phenomenology is invariant across cultures. That invariance may reflect universal psychological defenses, neurophysiological processes, or actual experience of a transcendent or mystical domain. Research into these alternative explanations has been hampered by the unpredictable occurrence of NDEs. Regardless of the causes or interpretations of NDEs, however, they are consistently associated with profound and long-lasting aftereffects on experiencers, and may have important implications for non-experiencers as well.

  5. The debate about death: an imperishable discussion?

    Directory of Open Access Journals (Sweden)

    FÉLIX BACIGALUPO

    2007-01-01

    Full Text Available In this concise review we discuss some of the complex edges of the concept of death that arose after the notorious advances in science and medicine over the last 50 years, in which the classical cardio-pulmonary criteria have led to the neurological criteria of death. New complicated questions like the definition of death and the operational criteria for diagnosing it have arisen and we think that they are far from being adequately and satisfactorily solved. A number of important issues -like the reliability and differences between cardio-pulmonary versus brain based criteria of death, if death is an event or a process, the meaning of integration and irreversibility- have not yet received sufficient attention. Here we have approached the death problem from two (biological complex system perspectives: the organism level and the cellular-molecular level. We also discuss issues from a third systemic approach, that is, the entire society, thus involving legal, religious, bioethical and political aspects of death. Our aim is to integrate new perspectives in order to promote further discussion on these critical yet frequently neglected issues

  6. Motor Vehicle Occupant Death Rate, by Age and Gender, 2012 & 2014, Region 7 - Kansas City

    Data.gov (United States)

    U.S. Department of Health & Human Services — Rate of deaths by age/gender (per 100,000 population) for motor vehicle occupants killed in crashes, 2012 & 2014. 2012 Source: Fatality Analysis Reporting System...

  7. Motor Vehicle Occupant Death Rate, by Age and Gender, 2012 & 2014, Region 9 - San Francisco

    Data.gov (United States)

    U.S. Department of Health & Human Services — Rate of deaths by age/gender (per 100,000 population) for motor vehicle occupants killed in crashes, 2012 & 2014. 2012 Source: Fatality Analysis Reporting System...

  8. Motor Vehicle Occupant Death Rate, by Age and Gender, 2012 & 2014, HHS Region 1 - Boston

    Data.gov (United States)

    U.S. Department of Health & Human Services — Rate of deaths by age/gender (per 100,000 population) for motor vehicle occupants killed in crashes, 2012 & 2014. 2012 Source: Fatality Analysis Reporting System...

  9. Motor Vehicle Occupant Death Rate, by Age and Gender, 2012 & 2014, Region 2 - New York

    Data.gov (United States)

    U.S. Department of Health & Human Services — Rate of deaths by age/gender (per 100,000 population) for motor vehicle occupants killed in crashes, 2012 & 2014. 2012 Source: Fatality Analysis Reporting System...

  10. Comparison of intensive care unit medication errors reported to the United States' MedMarx and the United Kingdom's National Reporting and Learning System: a cross-sectional study.

    Science.gov (United States)

    Wahr, Joyce A; Shore, Andrew D; Harris, Lindsay H; Rogers, Philippa; Panesar, Sukhmeet; Matthew, Linda; Pronovost, Peter J; Cleary, Kevin; Pham, Julius C

    2014-01-01

    The objective was to compare the characteristics of medication errors reported to 2 national error reporting systems by conducting a cross-sectional analysis of errors reported from adult intensive care units to the UK National Reporting and Learning System and the US MedMarx system. Outcome measures were error types, severity of patient harm, stage of medication process, and involved medications. The authors analyzed 2837 UK error reports and 56 368 US reports. Differences were observed between UK and US errors for wrong dose (44% vs 29%), omitted dose (8.6% vs 27%), and stage of medication process (prescribing: 14% vs 49%; administration: 71% vs 42%). Moderate/severe harm or death was reported in 4.9% of UK versus 3.4% of US errors. Gentamicin was cited in 7.4% of the UK versus 0.7% of the US reports (odds ratio = 9.25). There were differences in the types of errors reported and the medications most often involved. These differences warrant further examination.

  11. Prediction of cause of death from forensic autopsy reports using text classification techniques: A comparative study.

    Science.gov (United States)

    Mujtaba, Ghulam; Shuib, Liyana; Raj, Ram Gopal; Rajandram, Retnagowri; Shaikh, Khairunisa

    2018-07-01

    Automatic text classification techniques are useful for classifying plaintext medical documents. This study aims to automatically predict the cause of death from free text forensic autopsy reports by comparing various schemes for feature extraction, term weighing or feature value representation, text classification, and feature reduction. For experiments, the autopsy reports belonging to eight different causes of death were collected, preprocessed and converted into 43 master feature vectors using various schemes for feature extraction, representation, and reduction. The six different text classification techniques were applied on these 43 master feature vectors to construct a classification model that can predict the cause of death. Finally, classification model performance was evaluated using four performance measures i.e. overall accuracy, macro precision, macro-F-measure, and macro recall. From experiments, it was found that that unigram features obtained the highest performance compared to bigram, trigram, and hybrid-gram features. Furthermore, in feature representation schemes, term frequency, and term frequency with inverse document frequency obtained similar and better results when compared with binary frequency, and normalized term frequency with inverse document frequency. Furthermore, the chi-square feature reduction approach outperformed Pearson correlation, and information gain approaches. Finally, in text classification algorithms, support vector machine classifier outperforms random forest, Naive Bayes, k-nearest neighbor, decision tree, and ensemble-voted classifier. Our results and comparisons hold practical importance and serve as references for future works. Moreover, the comparison outputs will act as state-of-art techniques to compare future proposals with existing automated text classification techniques. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  12. Births and deaths including fetal deaths

    Data.gov (United States)

    U.S. Department of Health & Human Services — Access to a variety of United States birth and death files including fetal deaths: Birth Files, 1968-2009; 1995-2005; Fetal death file, 1982-2005; Mortality files,...

  13. Trends in Alabama teen driving death and injury.

    Science.gov (United States)

    Monroe, Kathy; Irons, Elizabeth; Crew, Marie; Norris, Jesse; Nichols, Michele; King, William D

    2014-09-01

    Motor vehicle crashes (MVCs) are a leading cause of morbidity and mortality in teens. Alabama has been in the Top 5 states for MVC fatality rate among teens in the United States for several years. Twelve years of teen MVC deaths and injuries were evaluated. Our hypothesis is that the teen driving motor vehicle-related deaths and injuries have decreased related to legislative and community awareness activities. A retrospective analysis of Alabama teen MVC deaths and injury for the years 2000 to 2011 was conducted. MVC data were obtained from a Fatality Analysis Reporting System data set managed by the Center for Advanced Public Safety at the University of Alabama. A Lowess regression-scattergram analysis was used to identify period specific changes in deaths and injury over time. Statistical analysis was conducted using True Epistat 5.0 software. When the Lowess regression was applied, there was an obvious change in the trend line in 2007. To test that observation, we then compared medians in the pre-2007 and post-2007 periods, which validated our observation. Moreover, it provided a near-even number of observations for comparison. The Spearman rank correlation was used to test for correlation of deaths and injury over time. The Mann-Whitney U-test was used to evaluate median differences in deaths and injury comparing pre-2007 and post-2007 data. Alabama teen MVC deaths and injury demonstrated a significant negative correlation over the 12-year period (Rs for deaths and injury, -0.87 [p teen driver deaths and injury have decreased during the 12-year study period, most notably after 2006. Factors that may have contributed to this trend may include stricter laws for teen drivers (enacted in 2002 and updated in 2010), less teen driving because of a nationwide economic downturn, delayed licensing in teens, steady improvements in overall seat belt use, and heightened public awareness of risky behaviors in teen driving.

  14. Cell Death, Neuronal Plasticity and Functional Loading in the Development of the Central Nervous System

    Science.gov (United States)

    Keefe, J. R.

    1985-01-01

    Research on the precise timing and regulation of neuron production and maturation in the vestibular and visual systems of Wistar rats and several inbred strains of mice (C57B16 and Pallid mutant) concentrated upon establishing a timing baseline for mitotic development of the neurons of the vestibular nuclei and the peripheral vestibular sensory structures (maculae, cristae). This involved studies of the timing and site of neuronal cell birth and preliminary studies of neuronal cell death in both central and peripheral elements of the mammalian vestibular system. Studies on neuronal generation and maturation in the retina were recently added to provide a mechanism for more properly defining the in utero' developmental age of the individual fetal subject and to closely monitor potential transplacental effects of environmentally stressed maternal systems. Information is given on current efforts concentrating upon the (1) perinatal period of development (E18 thru P14) and (2) the role of cell death in response to variation in the functional loading of the vestibular and proprioreceptive systems in developing mammalian organisms.

  15. Staging Death, Translating Death, Rehearsing Death: A Photographer’s Apprenticeship in Dying

    Directory of Open Access Journals (Sweden)

    Daniela Fargione

    2010-10-01

    Full Text Available The preponderance of death imagery in the mass media and a recent interest of photography in the practice of death suggest the need to reevaluate our approach to death and dying, especially when violence is involved. This essay is a case study of History of Violence, Claudio Cravero's last photographic project. His collection of "portraits" reproduce apparent dead bodies, mostly attacked in their own domestic spheres, but neither the perpetrator of death (a mysterious murderer?, nor the weapon used (an omnipresent knife, should be considered as main focal points of the artist's inquiry. The undoubtful protagonist of these photographs, instead, is the light, that illuminates fear: not of death itself, rather of the obnoxious indifference to it, as the result of generalized death imagery saturation.     The staged apparent death displayed in Cravero's photographs serve both as a memento mori and as a strategy to come to terms with the idea of death. In short, it is an apprentship in dying through a domesticating translation practice. Eventually, Cravero's History of Violence offers a complex reflection on the interplay between each individual story and macrolevel social History, thus providing some hypotheses of where violence and death fit in that odd geometry of time and space that we call life.

  16. Tritium releases, birth defects and infant deaths

    International Nuclear Information System (INIS)

    1991-01-01

    The AECB has published a report 'Tritium releases from the Pickering Nuclear Generating Station and Birth Defects and Infant Mortality in Nearby Communities 1971-1988' (report number INFO-0401). This presents the results of a detailed analysis of deaths and birth defects occurring in infants born to mothers living in the area (25 Km radius) of the Pickering nuclear power plant, over an 18-year period. The analysis looked at the frequency of these defects and deaths in comparison to the general rate for Ontario, and also in relation to airborne and waterborne releases of tritium from the power plant. The overall conclusion was that the rates of infant death and birth defects were generally not higher in the study population than in all of Ontario. There was no prevalent relationship between these deaths and defects and tritium releases measured either at the power plant or by ground monitoring stations t some distance from the facility

  17. Forensic DNA evidence and the death penalty in the Philippines.

    Science.gov (United States)

    De Ungria, M C A; Sagum, M S; Calacal, G C; Delfin, F C; Tabbada, K A; Dalet, M R M; Te, T O; Diokno, J I; Diokno, M S I; Asplen, C A

    2008-09-01

    The death penalty remains a contentious issue even though it has been abolished in countries such as Australia, New Zealand, Canada, European Union member nations and some Asian countries such as Cambodia, East Timor and Nepal. Many argue that the irrevocability of the death penalty, in the face of potential erroneous convictions, can never justify its imposition. The Philippines, the first Asian country that abolished the death penalty in 1987, held the record for the most number of mandatory death offenses (30 offenses) and death eligible offenses (22 offenses) after it was re-imposed in 1994. Majority of death penalty convictions were decided based on testimonial evidence. While such cases undergo automatic review by the Supreme Court, the appellate process in the Philippines is not structured to accept post-conviction evidence, including DNA evidence. Because of the compelling nature of post-conviction DNA evidence in overturning death penalty convictions in the United States, different groups advocated its use in the Philippines. In one such case, People v Reynaldo de Villa, the defendant was charged with raping his 13-year-old niece that supposedly led to birth of a female child, a situation commonly known as 'criminal paternity'. This paper reports the results of the first post-conviction DNA test using 16 Short Tandem Repeat (STR) DNA markers in a criminal paternity case (People v Reynaldo de Villa) and discusses the implications of these results in the Philippine criminal justice system.

  18. Definition of Sudden Infant Death and Sudden Intrauterine Unexpected Death Syndromes (SIDS and SIUDS with Regard to the Anatomo-Pathological Examination

    Directory of Open Access Journals (Sweden)

    Giulia Ottaviani

    2016-09-01

    Full Text Available Crib death, or sudden infant death syndrome (SIDS, is the most frequent form of death in the first year of life, striking one baby in every 1,700–2,000. Yet despite advances in maternal-infant care, sudden intrauterine unexplained/unexpected death syndrome (SIUDS, has a six-eightfold greater incidence than that of SIDS. Frequent congenital abnormalities, likely morphological substrates for SIDS-SIUDS, were detected, mainly represented by alterations of the cardiac conduction system, such as accessory pathways and abnormal resorptive degeneration, and hypoplasia/agenesis of the vital brainstem structures. On the basis of these considerations, the new common definition of the SIDS-SIUDS complex is The sudden death of a fetus after the 25th gestational week or infant under one year of age which is unexpected by history and remains unexplained after a thorough case investigation, including examination of the death scene, performance of a general autopsy and examination of the fetal adnexa. Therefore, given that the general autopsy does not disclose any cause of death, a more in-depth histopathological analysis of the cardiac conduction system and autonomic nervous system by specialized pathologists will become necessary.

  19. Death and population dynamics affect mutation rate estimates and evolvability under stress in bacteria.

    Science.gov (United States)

    Frenoy, Antoine; Bonhoeffer, Sebastian

    2018-05-01

    The stress-induced mutagenesis hypothesis postulates that in response to stress, bacteria increase their genome-wide mutation rate, in turn increasing the chances that a descendant is able to better withstand the stress. This has implications for antibiotic treatment: exposure to subinhibitory doses of antibiotics has been reported to increase bacterial mutation rates and thus probably the rate at which resistance mutations appear and lead to treatment failure. More generally, the hypothesis posits that stress increases evolvability (the ability of a population to generate adaptive genetic diversity) and thus accelerates evolution. Measuring mutation rates under stress, however, is problematic, because existing methods assume there is no death. Yet subinhibitory stress levels may induce a substantial death rate. Death events need to be compensated by extra replication to reach a given population size, thus providing more opportunities to acquire mutations. We show that ignoring death leads to a systematic overestimation of mutation rates under stress. We developed a system based on plasmid segregation that allows us to measure death and division rates simultaneously in bacterial populations. Using this system, we found that a substantial death rate occurs at the tested subinhibitory concentrations previously reported to increase mutation rate. Taking this death rate into account lowers and sometimes removes the signal for stress-induced mutagenesis. Moreover, even when antibiotics increase mutation rate, we show that subinhibitory treatments do not increase genetic diversity and evolvability, again because of effects of the antibiotics on population dynamics. We conclude that antibiotic-induced mutagenesis is overestimated because of death and that understanding evolvability under stress requires accounting for the effects of stress on population dynamics as much as on mutation rate. Our goal here is dual: we show that population dynamics and, in particular, the

  20. Exophiala angulospora Causes Systemic Mycosis in Atlantic Halibut: a Case Report.

    Science.gov (United States)

    Overy, David P; Groman, David; Giles, Jan; Duffy, Stephanie; Rommens, Mellisa; Johnson, Gerald

    2015-03-01

    Filamentous black yeasts from the genus Exophiala are ubiquitous, opportunistic pathogens causing both superficial and systemic mycoses in warm- and cold-blooded animals. Infections by black yeasts have been reported relatively frequently in a variety of captive and farmed freshwater and marine fishes. In November 2012, moribund and recently dead, farm-raised Atlantic Halibut Hippoglossus hippoglossus were necropsied to determine the cause of death. Histopathology revealed that three of seven fish were affected by a combination of an ascending trans-ductual granulomatous mycotic nephritis, necrotizing histiocytic encephalitis, and in one fish the addition of a fibrogranulomatous submucosal branchitis. Microbial cultures of kidney using selective mycotic media revealed pure growth of a black-pigmenting septated agent. Application of molecular and phenotypic taxonomy methodologies determined that all three isolates were genetically consistent with Exophiala angulospora. This is the first report of E. angulospora as the causal agent of systemic mycosis in Atlantic Halibut.

  1. Survival, causes of death, and prognostic factors in systemic sclerosis: analysis of 947 Brazilian patients.

    Science.gov (United States)

    Sampaio-Barros, Percival D; Bortoluzzo, Adriana B; Marangoni, Roberta G; Rocha, Luiza F; Del Rio, Ana Paula T; Samara, Adil M; Yoshinari, Natalino H; Marques-Neto, João Francisco

    2012-10-01

    To analyze survival, prognostic factors, and causes of death in a large cohort of patients with systemic sclerosis (SSc). From 1991 to 2010, 947 patients with SSc were treated at 2 referral university centers in Brazil. Causes of death were considered SSc-related and non-SSc-related. Multiple logistic regression analysis was used to identify prognostic factors. Survival at 5 and 10 years was estimated using the Kaplan-Meier method. One hundred sixty-eight patients died during the followup. Among the 110 deaths considered related to SSc, there was predominance of lung (48.1%) and heart (24.5%) involvement. Most of the 58 deaths not related to SSc were caused by infection, cardiovascular or cerebrovascular disease, and cancer. Male sex, modified Rodnan skin score (mRSS) > 20, osteoarticular involvement, lung involvement, and renal crisis were the main prognostic factors associated to death. Overall survival rate was 90% for 5 years and 84% for 10 years. Patients presented worse prognosis if they had diffuse SSc (85% vs 92% at 5 yrs, respectively, and 77% vs 87% at 10 yrs, compared to limited SSc), male sex (77% vs 90% at 5 yrs and 64% vs 86% at 10 yrs, compared to female sex), and mRSS > 20 (83% vs 90% at 5 yrs and 66% vs 86% at 10 yrs, compared to mRSS < 20). Survival was worse in male patients with diffuse SSc, and lung and heart involvement represented the main causes of death in this South American series of patients with SSc.

  2. Quasi-Birth-Death Processes, Tree-Like QBDs, Probabilistic 1-Counter Automata, and Pushdown Systems

    NARCIS (Netherlands)

    K. Etessami (Kousha); D.K. Wojtczak (Dominik); M. Yannakakis

    2010-01-01

    textabstractWe begin by observing that (discrete-time) Quasi-Birth-Death Processes (QBDs) are equivalent, in a precise sense, to probabilistic 1-Counter Automata (p1CAs), and both Tree-Like QBDs (TL-QBDs) and Tree-Structured QBDs (TS-QBDs) are equivalent to both probabilistic Pushdown Systems

  3. Systemic Steroid Application Caused Sudden Death of a Patient with Sudden Deafness

    Directory of Open Access Journals (Sweden)

    Eriko Ogino-Nishimura

    2013-01-01

    Full Text Available A 63-year-old man, who was diagnosed with sudden sensorineural hearing loss (SSHL, showed severe hypertension 10 hours after prednisolone administration. Subsequently, the patient suddenly died due to pulmonary edema. The autopsy indicated a pheochromocytoma in the right adrenal gland, and the cause of death was determined to be a pheochromocytoma crisis induced by systemic administration of prednisolone. Pheochromocytoma crisis is a life-threatening condition and can result from the use of corticosteroids. Physicians should consider the risk of a pheochromocytoma crisis due to systemic corticosteroids in the treatment of patients with sudden sensorineural hearing loss.

  4. Reporting of meticillin-resistant and -susceptible Staphylococcus aureus on death certificates in Irish hospitals.

    LENUS (Irish Health Repository)

    Collins, C J

    2011-02-01

    The documentation of infection with meticillin-resistant Staphylococcus aureus (MRSA) on death certificates has been the subject of considerable public discussion. Using data from five tertiary referral hospitals in Ireland, we compared the documentation of MRSA and meticillin-susceptible S. aureus (MSSA) on death certificates in those patients who died in hospital within 30 days of having MRSA or MSSA isolated from blood cultures. A total of 133 patients had MRSA or MSSA isolated from blood cultures within 30 days of death during the study period. One patient was excluded as the death certificate information was not available; the other 132 patients were eligible for inclusion. MRSA and MSSA were isolated from blood cultures in 59 (44.4%) and 74 (55.6%) cases respectively. One patient was included as a case in both categories as both MRSA and MSSA were isolated from a blood culture. In 15 (25.4%) of the 59 MRSA cases, MRSA was documented on the death certificate. In nine (12.2%) of the 74 patients with MSSA cases, MSSA was documented on the death certificate. MRSA was more likely to be documented on the death certificate than MSSA (odds ratio: 2.46; 95% confidence interval: 1.01-6.01; P < 0.05). These findings indicate that there may be inconsistencies in the way organisms and infections are documented on death certificates in Ireland and that death certification data may underestimate the mortality related to certain organisms. In particular, there appears to be an overemphasis by certifiers on the documentation of MRSA compared with MSSA.

  5. A multiple system governed by a quasi-birth-and-death process

    International Nuclear Information System (INIS)

    Perez-Ocon, Rafael; Montoro-Cazorla, Delia

    2004-01-01

    The system we consider comprises n units, of which one has to operate for the system to work. The other units are in repair, in cold standby, or waiting for repair. Only the working unit can fail. The operational and repair times follow phase-type distributions. Upon failure, it is replaced by a standby unit and goes to the repair facility. There is only one repairman. When one unit operates the system is up and when all the units are in repair or waiting for repair, the system is down. This system is governed by a finite quasi-birth-and-death process. The stationary probability vector and useful performance measures in reliability, such as the availability and the rate of occurrence of failures are explicitly calculated. This model extends other previously considered in the literature. The case with an infinite number of units in cold standby is also studied. Computational implementation of the results is performed via a numerical example, and the different systems considered are compared from the reliability measures determined

  6. Review of causes of maternal deaths in Botswana in 2010

    African Journals Online (AJOL)

    Method. Fifty-six case notes from the 80 reported maternal deaths in 2010 were reviewed. ... Sixty-six percent of deaths occurred in Botswana's two referral hospitals. Cases in .... with meningitis, pre-eclampsia and heart failure. ... General anaesthetic. 2 .... Several equipment failures were reported, involving X-ray, blood.

  7. Recovering missing mesothelioma deaths in death certificates using hospital records.

    Science.gov (United States)

    Santana, Vilma S; Algranti, Eduardo; Campos, Felipe; Cavalcante, Franciana; Salvi, Leonardo; Santos, Simone A; Inamine, Rosemeire N; Souza, William; Consonni, Dario

    2018-04-02

    In Brazil, underreporting of mesothelioma and cancer of the pleura (MCP) is suspected to be high. Records from death certificates (SIM) and hospital registers (SIH-SUS) can be combined to recover missing data but only anonymous databases are available. This study shows how common data can be used for linkage and as an assessment of accuracy. Mesothelioma (all sites, ICD-10 codes C45.0-C45.9) and cancer of the pleura (C38.4) were retrieved from both information systems and combined using a linkage algorithm. Accuracy was examined with non-anonymous databases, limited to the state of São Paulo. We found 775 cases in death certificates and 283 in hospital registers. The linkage matched 57 cases, all accurately paired. Three cases, 0.4% in SIM and 1.3% in SIH-SUS, could not be matched because of data inconsistencies. A computer linkage can recover MCP cases from hospital records not found in death certificates in Brazil. © 2018 Wiley Periodicals, Inc.

  8. Marketing reporting system

    OpenAIRE

    Hanić Hasan M.

    2004-01-01

    The main components of a developed and good organized marketing information system are: internal reporting system, marketing reporting system, market research system and analytical marketing system. Marketing reporting system provides data and information about changes in business and micro marketing environment. This component of MIS ensures that marketing managers are up-to-date with what is going on, and to be informed about changes in company marketing environment.

  9. Marketing reporting system

    Directory of Open Access Journals (Sweden)

    Hanić Hasan M.

    2004-01-01

    Full Text Available The main components of a developed and good organized marketing information system are: internal reporting system, marketing reporting system, market research system and analytical marketing system. Marketing reporting system provides data and information about changes in business and micro marketing environment. This component of MIS ensures that marketing managers are up-to-date with what is going on, and to be informed about changes in company marketing environment.

  10. Patient deaths blamed on long waits at the Phoenix VA

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2014-04-01

    Full Text Available No abstract available. Article truncated at 150 words. This morning the lead article in the Arizona Republic was a report blaming as many as 40 deaths at the Phoenix VA on long waits (1. Yesterday, Rep. Jeff Miller, the chairman of the House Committee on Veterans Affairs, held a hearing titled “A Continued Assessment of Delays in VA Medical Care and Preventable Veteran Deaths.” “It appears as though there could be as many as 40 veterans whose deaths could be related to delays in care,” Miller announced to a stunned audience. The committee has spent months investigating patient-care scandals and allegations at VA facilities in Pittsburgh, Atlanta, Miami and other cities. said that dozens of VA hospital patients in Phoenix may have died while awaiting medical care. He went on to say that staff investigators have evidence that the Phoenix VA Health Care System keeps two sets of records to conceal prolonged waits that patients must endure for ...

  11. Neonatal Death

    Science.gov (United States)

    ... Home > Complications & Loss > Loss & grief > Neonatal death Neonatal death E-mail to a friend Please fill in ... cope with your baby’s death. What is neonatal death? Neonatal death is when a baby dies in ...

  12. Scintigraphic evaluation of brain death

    International Nuclear Information System (INIS)

    Park, C. H.; Bai, M. S.; Cho, K. K.; Kim, S. J.; Yoon, S. N.; Cho, C. W.

    1997-01-01

    A law recognizing brain death is a life saving legal measure in patients suffering from badly diseased organs such as kidney, liver, heart, and lung. Such law is being discussed for legalization at the Korean National Assembly. There are various criteria used for brain death in western world and brain scintiscan is one of them. However, the scintiscan is not considered in establishing brain death in the draft of the law. The purpose of this report is to spread this technique in nuclear medicine society as well as in other medical societies. We evaluated 7 patients with clinical suspicion of brain death by various causes. The patient's age ranged from 5 to 39 years. We used 5-20mCi 99m Tc-HMPAO (d.1-hexamethyl propylene amine oxime) or ECD (Ethyl Cysteinate Dimer), lipophilic agents that cross BBB (blood brain barrier). A dynamic study followed by static or SPECT (single photon emission tomography) was performed. Interpretive criteria used for brain death were 1) no intracranial circulation 2) no brain uptake. The second criteria is heavily used. Five of 7 patients were scintigraphically brain dead and the remaining 2 had some brain uptake excluding the diagnosis of scintigraphic brain death. In conclusion, cerebral perfusion study using a lipophilic brain tracer offers a noninvasive, rapid, easy, accurate and reliable mean in the diagnosis of brain death. We believe that this modality should be included in the criteria of brain death in the draft of the proposed Korean law

  13. Rip current related drowning deaths and rescues in Australia 2004-2011

    Science.gov (United States)

    Brighton, B.; Sherker, S.; Brander, R.; Thompson, M.; Bradstreet, A.

    2013-04-01

    Rip currents are a common hazard to beachgoers found on many beaches around the world, but it has proven difficult to accurately quantify the actual number of rip current related drowning deaths in many regions and countries. Consequently, reported estimates of rip current drowning can fluctuate considerably and are often based on anecdotal evidence. This study aims to quantify the incidence of rip current related drowning deaths and rescues in Australia from 2004 to 2011. A retrospective search was undertaken for fatal and non-fatal rip-related drowning incidents from Australia's National Coronial Information System (NCIS), Surf Life Saving Australia's (SLSA, 2005-2011) SurfGuard Incident Report Database (IRD), and Media Monitors for the period 1 July 2004 to 30 June 2011. In this time, rip currents were recorded as a factor in 142 fatalities of a total of 613 coastal drowning deaths (23.2%), an average of 21 per year. Rip currents were related to 44% of all beach-related drowning deaths and were involved in 57.4% of reported major rescues in Australian locations where rips occur. A comparison with international operational statistics over the same time period describes rip-related rescues as 53.7% of the total rescues in the US, 57.9% in the UK and 49.4% in New Zealand. The range 49-58% is much lower than 80-89% traditionally cited. The results reported are likely to underestimate the size of the rip current hazard, because we are limited by the completeness of data on rip-related events; however this is the most comprehensive estimate to date. Beach safety practitioners need improved data collection and standardized definitions across organisations. The collection of drowning data using consistent categories and the routine collection of rip current information will allow for more accurate global comparisons.

  14. Death Cafe.

    Science.gov (United States)

    Miles, Lizzy; Corr, Charles A

    2017-06-01

    This article explains the meaning of the phrase Death Cafe and describes what typically occurs at a Death Cafe gathering. The article traces the history of the Death Cafe movement, explores some reasons why people take part in a Death Cafe gathering, and gives examples of what individuals think they might derive from their participation. In addition, this article notes similarities between the Death Cafe movement and three other developments in the field of death, dying, and bereavement. Finally, this article identifies two provisional lessons that can be drawn from Death Cafe gatherings and the Death Cafe movement itself.

  15. Loss of confidence in vaccines following media reports of infant deaths after hepatitis B vaccination in China.

    Science.gov (United States)

    Yu, Wenzhou; Liu, Dawei; Zheng, Jingshan; Liu, Yanmin; An, Zhijie; Rodewald, Lance; Zhang, Guomin; Su, Qiru; Li, Keli; Xu, Disha; Wang, Fuzhen; Yuan, Ping; Xia, Wei; Ning, Guijun; Zheng, Hui; Chu, Yaozhu; Cui, Jian; Duan, Mengjuan; Hao, Lixin; Zhou, Yuqing; Wu, Zhenhua; Zhang, Xuan; Cui, Fuqiang; Li, Li; Wang, Huaqing

    2016-04-01

    China reduced hepatitis B virus (HBV) infection by 90% among children under 5 years old with safe and effective hepatitis B vaccines (HepB). In December 2013, this success was threatened by widespread media reports of infant deaths following HepB administration. Seventeen deaths and one case of anaphylactic shock following HBV vaccination had been reported. We conducted a telephone survey to measure parental confidence in HepB in eleven provinces at four points in time; reviewed maternal HBV status and use of HepB for newborns in birth hospitals in eight provinces before and after the event; and monitored coverage with hepatitis B vaccine and other programme vaccines in ten provinces. HepB from the implicated company was suspended during the investigation, which showed that the deaths were not caused by HepB vaccination. Before the event, 85% respondents regarded domestic vaccines as safe, decreasing to 26.7% during the event. During the height of the crisis, 30% of parents reported being hesitant to vaccinate and 18.4% reported they would refuse HepB. Use of HepB in the monitored provinces decreased by 18.6%, from 53 653 doses the week before the event to 43 688 doses during the week that Biokangtai HepB was suspended. Use of HepB within the first day of life decreased by 10% among infants born to HBsAg-negative mothers, and by 6% among infants born to HBsAg-positive mothers. Vaccine refusal and HepB birth dose rates returned to baseline within 2 months; confidence increased, but remained below baseline. The HBV vaccine event resulted in the suspension of a safe vaccine, which was associated with a decline of parental confidence, and refusal of vaccination. Suspension of a vaccine can lead to loss of confidence that is difficult to recover. Timely and credible investigation, accompanied by proactive outreach to stakeholders and the media, may help mitigate negative impact of future coincidental adverse events following immunization. © The Author 2016; all rights

  16. Modes of death in neonatal intensive care units.

    LENUS (Irish Health Repository)

    Finan, E

    2006-04-01

    With the ever-increasing availability of aggressive medical treatment and technical support, neonatologists are offered an increasing ability to prolong life. While "end-of-life" decisions within NICUs have been studied internationally, there is limited data available for Ireland. Through the auspices of the Irish Faculty of Paediatrics 2002 Neonatal Mortality Ouestionnaire, decisions made around the time of death in Irish Neonatal Intensive Care Units were examined. The overall response rate to the questionnaire was 96% (n=25). One hundred and eighty seven deaths were reported for 2002. Information pertaining to the mode of death was available in 53% of cases. Seventy seven percent of those paediatricians who answered this question, reported either withdrawing or withholding treatment in babies thought to have a hopeless outcome, with the greatest proportion of these deaths occurring in premature infants (n=30) and babies with congenital defects (n=40).

  17. Supravalvular aortic stenosis with sudden cardiac death

    Directory of Open Access Journals (Sweden)

    Pradeep Vaideeswar

    2015-01-01

    Full Text Available Sudden cardiac death (SCD most commonly results from previously undiagnosed congenital, acquired, or hereditary cardiac diseases. Congenital aortic valvular, subvalvular, and supravalvular disease with left ventricular outflow tract obstruction is an important preventable cause of sudden death. This report documents sudden death presumably due to acute myocardial ischemia in a young male with an undiagnosed supravalvular aortic stenosis (SVAS due to a rare association of isolation of coronary sinuses of Valsalva. Congenital supravalvular pulmonary stenosis and mitral valvular dysplasia were also present.

  18. Caffeine-Related Deaths: Manner of Deaths and Categories at Risk.

    Science.gov (United States)

    Cappelletti, Simone; Piacentino, Daria; Fineschi, Vittorio; Frati, Paola; Cipolloni, Luigi; Aromatario, Mariarosaria

    2018-05-14

    Caffeine is the most widely consumed psychoactive compound worldwide. It is mostly found in coffee, tea, energizing drinks and in some drugs. However, it has become really easy to obtain pure caffeine (powder or tablets) on the Internet markets. Mechanisms of action are dose-dependent. Serious toxicities such as seizure and cardiac arrhythmias, seen with caffeine plasma concentrations of 15 mg/L or higher, have caused poisoning or, rarely, death; otherwise concentrations of 3⁻6 mg/kg are considered safe. Caffeine concentrations of 80⁻100 mg/L are considered lethal. The aim of this systematic review, performed following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement for the identification and selection of studies, is to review fatal cases in which caffeine has been recognized as the only cause of death in order to identify potential categories at risk. A total of 92 cases have been identified. These events happened more frequently in infants, psychiatric patients, and athletes. Although caffeine intoxication is relatively uncommon, raising awareness about its lethal consequences could be useful for both clinicians and pathologists to identify possible unrecognized cases and prevent related severe health conditions and deaths.

  19. Precisely Tracking Childhood Death.

    Science.gov (United States)

    Farag, Tamer H; Koplan, Jeffrey P; Breiman, Robert F; Madhi, Shabir A; Heaton, Penny M; Mundel, Trevor; Ordi, Jaume; Bassat, Quique; Menendez, Clara; Dowell, Scott F

    2017-07-01

    Little is known about the specific causes of neonatal and under-five childhood death in high-mortality geographic regions due to a lack of primary data and dependence on inaccurate tools, such as verbal autopsy. To meet the ambitious new Sustainable Development Goal 3.2 to eliminate preventable child mortality in every country, better approaches are needed to precisely determine specific causes of death so that prevention and treatment interventions can be strengthened and focused. Minimally invasive tissue sampling (MITS) is a technique that uses needle-based postmortem sampling, followed by advanced histopathology and microbiology to definitely determine cause of death. The Bill & Melinda Gates Foundation is supporting a new surveillance system called the Child Health and Mortality Prevention Surveillance network, which will determine cause of death using MITS in combination with other information, and yield cause-specific population-based mortality rates, eventually in up to 12-15 sites in sub-Saharan Africa and south Asia. However, the Gates Foundation funding alone is not enough. We call on governments, other funders, and international stakeholders to expand the use of pathology-based cause of death determination to provide the information needed to end preventable childhood mortality.

  20. Causes of death in Vanuatu.

    Science.gov (United States)

    Carter, Karen; Tovu, Viran; Langati, Jeffrey Tila; Buttsworth, Michael; Dingley, Lester; Calo, Andy; Harrison, Griffith; Rao, Chalapati; Lopez, Alan D; Taylor, Richard

    2016-01-01

    The population of the Pacific Melanesian country of Vanuatu was 234,000 at the 2009 census. Apart from subsistence activities, economic activity includes tourism and agriculture. Current completeness of vital registration is considered too low to be usable for national statistics; mortality and life expectancy (LE) are derived from indirect demographic estimates from censuses/surveys. Some cause of death (CoD) data are available to provide information on major causes of premature death. Deaths 2001-2007 were coded for cause (ICDv10) for ages 0-59 years from: hospital separations (HS) (n = 636), hospital medical certificates (MC) of death (n = 1,169), and monthly reports from community health facilities (CHF) (n = 1,212). Ill-defined causes were 3 % for hospital deaths and 20 % from CHF. Proportional mortality was calculated by cause (excluding ill-defined) and age group (0-4, 5-14 years), and also by sex for 15-59 years. From total deaths by broad age group and sex from 1999 and 2009 census analyses, community deaths were estimated by deduction of hospital deaths MC. National proportional mortality by cause was estimated by a weighted average of MC and CHF deaths. National estimates indicate main causes of deaths <5 years were: perinatal disorders (45 %) and malaria, diarrhea, and pneumonia (27 %). For 15-59 years, main causes of male deaths were: circulatory disease 27 %, neoplasms 13 %, injury 13 %, liver disease 10 %, infection 10 %, diabetes 7 %, and chronic respiratory disease 7 %; and for females: neoplasms 29 %, circulatory disease 15 %, diabetes 10 %, infection 9 %, and maternal deaths 8 %. Infection included tuberculosis, malaria, and viral hepatitis. Liver disease (including hepatitis and cancer) accounted for 18 % of deaths in adult males and 9 % in females. Non-communicable disease (NCD), including circulatory disease, diabetes, neoplasm, and chronic respiratory disease, accounted for 52 % of premature deaths in adult

  1. KAROSHI (WORK TO DEATH

    Directory of Open Access Journals (Sweden)

    Moh. Toriqul Chaer

    2017-05-01

    Full Text Available When the tide of unemployment hit the USA and Europe, in Japan the opposite phenomenon occurs. In 2002, in Japan deaths were recorded because of excessive works. In this country, the phenomenon of death because of excessive works is called Karoshi. Karoshi is common in Japan.  It becomes deadly syndrome as a consequence of long hours works. The debate about deaths from excessive work already sticking out in Japan since the 70s. The first official case of Karoshi was reported in 1969 when a 29-year-old male worker died because of stroke. It is estimated over ten thousand workers died each year due to death by brain and stroke caused by an overload work. Karoshi often happen to male workers dominantly. The main cause of karoshi is stress due to high pressure in the work environment, and work habits of exceeding a  standard of normal working time (8 hours. In addition, their extra time to work is imbalance with and the salary they earn. In its development, the phenomenon of karoshi contributes to the term salaryman and workaholic.

  2. An examination of pregnancy- related deaths among adolescents

    African Journals Online (AJOL)

    (SA) reports the current maternal mortality rate at 147.7 deaths per. 100 000 live ... decreased from 299 deaths per 100 000 live births in 2007 to 147.7 in 2013, SA ... The data were anonymised by Statistics SA before becoming available for ...

  3. Determination of Minimum Data Set (MSD) in Echocardiography Reporting System to Exchange with Iran’s Electronic Health Record (EHR) System

    Science.gov (United States)

    Mahmoudvand, Zahra; Kamkar, Mehran; Shahmoradi, Leila; Nejad, Ahmadreza Farzaneh

    2016-01-01

    Background: Determination of minimum data set (MDS) in echocardiography reports is necessary for documentation and putting information in a standard way, and leads to the enhancement of electrocardiographic studies through having access to precise and perfect reports and also to the development of a standard database for electrocardiographic reports. Aim: to determine the minimum data set of echocardiography reporting system to exchange with Iran’s electronic health record (EHR) system. Methods: First, a list of minimum data set was prepared after reviewing texts and studying cardiac patients’ records. Then, to determine the content validity of the prepared MDS, the expert views of 10 cardiologists and 10 health information management (HIM) specialists were obtained; to estimate the reliability of the set, test-retest method was employed. Finally, the data were analyzed using SPSS software. Results: The highest degree of consensus was found for the following MDSs: patient’s name and family name (5), accepting doctor’s name and family name, familial death records due to cardiac disorders, the image identification code, mitral valve, aortic valve, tricuspid valve, pulmonary valve, left ventricle, hole, atrium valve, Doppler examination of ventricular and atrial movement models and diagnoses with an average of. Conclusions: To prepare a model of echocardiography reporting system to exchange with EHR system, creation a standard data set is the vital point. Therefore, based on the research findings, the minimum reporting system data to exchange with Iran’s electronic health record system include information on entity, management, medical record, carried-out acts, and the main content of the echocardiography report, which the planners of reporting system should consider. PMID:27147803

  4. Risk profile for drowning deaths in children in the Indian state of Bihar: results from a population-based study.

    Science.gov (United States)

    Dandona, Rakhi; Kumar, G Anil; George, Sibin; Kumar, Amit; Dandona, Lalit

    2018-05-19

    We report on incidence of drowning deaths and related contextual factors in children from a population-based study in the Indian state of Bihar which estimated the causes of death using verbal autopsy (VA). Interviews were conducted for deaths in 1-14 years population that occurred from January 2012 to March 2014 in 109 689 households (87.1% participation) in 1017 clusters representative of the state. The Population Health Metrics Research Consortium shortened VA questionnaire was used for interview and cause of death was assigned using the SmartVA automated algorithm. The annualised unintentional drowning death incidence, activity prior to drowning, the body of water where drowning death had occurred and contextual information are reported. The survey covered 224 077 children aged 1-14 years. Drowning deaths accounted for 7.2%, 12.5% and 5.8% of all deaths in 1-4, 5-9 and 10-14 years age groups, respectively. The adjusted incidence of drowning deaths was 14.3 (95% CI 14.0 to 14.7) per 100 000 children, with it being higher in urban (16.1, 95% CI 14.8 to 17.3) areas. Nearly half of the children drowned in a river (5.9, 95% CI 5.6 to 6.1) followed by in a pond (2.8, 95% CI 2.6 to 2.9). Drowning death incidence was the highest while playing (5.1, 95% CI 4.9 to 5.4) and bathing (4.0, 95% CI 3.8 to 4.2) with the former accounting for more deaths in 1-4 years age group. Sixty per cent of children were already dead when found. None of these deaths were reported to the civil registration system to obtain death certificate. The findings from this large representative sample of children document the magnitude of and variations in unintentional drowning deaths in Bihar. Urgent targeted drowning interventions are needed to address the risk in children. Gross under-reporting of drowning deaths in children in India needs attention. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No

  5. Competing causes of death: a death certificate study

    NARCIS (Netherlands)

    Mackenbach, J. P.; Kunst, A. E.; Lautenbach, H.; Oei, Y. B.; Bijlsma, F.

    1997-01-01

    BACKGROUND: Despite the widespread interest in competing causes of death, empirical information on interrelationships between causes of death is scarce. We have used death certificate information to estimate the prevalence of competing causes of death at the moment of dying from specific underlying

  6. [Analysis on probability of premature death and cause eliminated life expectancy of major non-communicable diseases in Chongqing Municipality, 2016].

    Science.gov (United States)

    Ding, X B; Tang, W W; Mao, D Q; Jiao, Y; Shen, Z Z

    2017-11-06

    Objective: To analyze the premature death probability and cause-eliminated life expectancy of cardiovascular disease, cancer, chronic respiratory disease and diabetes in Chongqing residents in 2016 so as to provide recommendation for non-communicable diseases (NCDs) prevention and control in Chongqing. Methods: Death cases of Chongqing Municipality between January 1(st) and December 31(st), 2016 were reported through death case registry system of national center for disease prevention and control. Death cases were sorted by international classification of disease (ICD-10). Mortality rate, standardized mortality rate, constituent ratio, premature death probability, life expectancy, and cause-eliminated life expectancy of four major NCDs were analyzed. Results: A total of 218 004 death cases were reported in Chongqing, 2016, and the mortality rate was 731.73/100 000. Of them, a total of 179 637 death cases of the four major NCDs including cardiovascular disease, cancer, chronic respiratory disease and diabetes were reported, accounting for 82.40% of all death cases. The mortality rate and standardized mortality rate of four major NCDs was 602.95/100 000 and 455.82/100 000, respectively. The premature death probability of four major NCDs was 15.96%, and males (25.39%) had a higher premature death probability than females (10.78%). The premature death probability of cardiovascular disease, cancer, chronic respiratory disease, and diabetes were 6.01%, 8.32%, 2.05%, and 0.43%, respectively. Life expectancy would increase by 6.02, 3.19, 1.89, and 0.19 years, after eliminating cardiovascular disease, cancer, chronic respiratory disease and diabetes respectively. Conclusion: The premature death probability of major NCDs was high in Chongqing, and males had a higher premature death probability than females did. Intervention and health management of the population should be conducted according to different gender-based risk factors to reduce the premature death probability.

  7. Post-Marketing Surveillance of Human Rabies Diploid Cell Vaccine (Imovax in the Vaccine Adverse Event Reporting System (VAERS in the United States, 1990‒2015.

    Directory of Open Access Journals (Sweden)

    Pedro L Moro

    2016-07-01

    Full Text Available In 1980, human diploid cell vaccine (HDCV, Imovax Rabies, Sanofi Pasteur, was licensed for use in the United States.To assess adverse events (AEs after HDCV reported to the US Vaccine Adverse Event Reporting System (VAERS, a spontaneous reporting surveillance system.We searched VAERS for US reports after HDCV among persons vaccinated from January 1, 1990-July 31, 2015. Medical records were requested for reports classified as serious (death, hospitalization, prolonged hospitalization, disability, life-threatening-illness, and those suggesting anaphylaxis and Guillain-Barré syndrome (GBS. Physicians reviewed available information and assigned a primary clinical category to each report using MedDRA system organ classes. Empirical Bayesian (EB data mining was used to identify disproportional AE reporting after HDCV.VAERS received 1,611 reports after HDCV; 93 (5.8% were serious. Among all reports, the three most common AEs included pyrexia (18.2%, headache (17.9%, and nausea (16.5%. Among serious reports, four deaths appeared to be unrelated to vaccination.This 25-year review of VAERS did not identify new or unexpected AEs after HDCV. The vast majority of AEs were non-serious. Injection site reactions, hypersensitivity reactions, and non-specific constitutional symptoms were most frequently reported, similar to findings in pre-licensure studies.

  8. Doxycycline Impairs Mitochondrial Function and Protects Human Glioma Cells from Hypoxia-Induced Cell Death: Implications of Using Tet-Inducible Systems.

    Science.gov (United States)

    Luger, Anna-Luisa; Sauer, Benedikt; Lorenz, Nadja I; Engel, Anna L; Braun, Yannick; Voss, Martin; Harter, Patrick N; Steinbach, Joachim P; Ronellenfitsch, Michael W

    2018-05-17

    Inducible gene expression is an important tool in molecular biology research to study protein function. Most frequently, the antibiotic doxycycline is used for regulation of so-called tetracycline (Tet)-inducible systems. In contrast to stable gene overexpression, these systems allow investigation of acute and reversible effects of cellular protein induction. Recent reports have already called for caution when using Tet-inducible systems as the employed antibiotics can disturb mitochondrial function and alter cellular metabolism by interfering with mitochondrial translation. Reprogramming of energy metabolism has lately been recognized as an important emerging hallmark of cancer and is a central focus of cancer research. Therefore, the scope of this study was to systematically analyze dose-dependent metabolic effects of doxycycline on a panel of glioma cell lines with concomitant monitoring of gene expression from Tet-inducible systems. We report that doxycycline doses commonly used with inducible expression systems (0.01⁻1 µg/mL) substantially alter cellular metabolism: Mitochondrial protein synthesis was inhibited accompanied by reduced oxygen and increased glucose consumption. Furthermore, doxycycline protected human glioma cells from hypoxia-induced cell death. An impairment of cell growth was only detectable with higher doxycycline doses (10 µg/mL). Our findings describe settings where doxycycline exerts effects on eukaryotic cellular metabolism, limiting the employment of Tet-inducible systems.

  9. Death Notification: Someone Needs To Call the Family.

    Science.gov (United States)

    Ombres, Rachel; Montemorano, Lauren; Becker, Daniel

    2017-06-01

    The death notification process can affect family grief and bereavement. It can also affect the well-being of involved physicians. There is no standardized process for making death notification phone calls. We assumed that residents are likely to be unprepared before and troubled after. We investigated current death notification practices to develop an evidence-based template for standardizing this process. We used results of a literature review and open-ended interviews with faculty, residents, and widows to develop a survey regarding resident training and experience in death notification by phone. We invited all internal medicine (IM) residents at our institution to complete the survey. Sixty-seven of 93 IM residents (72%) responded to the survey. Eighty-seven percent of responders reported involvement in a death that required notification by phone. Eighty percent of residents felt inadequately trained for this task. Over 25% reported that calls went poorly. Attendings were involved in 17% of cases. Primary care physicians were not involved. Nurses and chaplains were not involved. Respondents never delayed notification of death until family arrived at the hospital. There was no consistent approach to rehearsing or making the call, advising families about safe travel to the hospital, greeting families upon arrival, or following up with expressions of condolence. Poor communication skills during death notification may contribute to complicated grief for surviving relatives and stress among physicians. This study is the first to describe current practices of death notification by IM residents. More training is needed and could be combined with training in disclosure of medical error.

  10. Increasing deaths involving oxycodone, Victoria, Australia, 2000-09.

    Science.gov (United States)

    Rintoul, Angela C; Dobbin, Malcolm D H; Drummer, Olaf H; Ozanne-Smith, Joan

    2011-08-01

    In light of an emerging epidemic identified in the United States and Canada, to identify trends in fatal drug toxicity involving oxycodone and the demographic characteristics and indicators of socioeconomic disadvantage of the deceased. Population-based observational study in Victoria, Australia. Decedents whose death was reported to the Victorian Coroner between 2000 and 2009 and where oxycodone was detected. Association between supply of oxycodone and deaths. Demographic characteristics of decedents. Rate ratios of the rural or metropolitan location and socioeconomic indicators of disadvantage of the deceased. Supply to Victoria has increased nine-fold from 7.5 mg per capita in 2000 to 67.5 mg per capita in 2009. Detection of oxycodone in deaths reported to the Victorian Coroner has increased from 4 (0.08/100,000 population) in 2000 to 97 (1.78/100,000 population) in 2009-a 21-fold increase in deaths. Of the 320 cases described, 53.8% (172) were the result of drug toxicity. Of these, 52.3% were unintentional and 19.8% intentional self-harm; the remaining 27.9% are either still under investigation by the coroner or intent is unknown. Drug toxicity deaths were overrepresented in both rural areas and areas indexed with high levels of disadvantage. The substantial increase in the number of deaths involving oxycodone is strongly and significantly associated with the increase in supply. Most drug toxicity deaths involving oxycodone were unintentional. This newly identified trend in fatalities in Victoria supports concerns that a pattern of increasing deaths involving oxycodone is emerging globally.

  11. Where have all the gun deaths gone? | Matzopoulos | South African ...

    African Journals Online (AJOL)

    Background. The low number of firearm assaults and overall assault-related deaths in Statistics South Africa's death notification reports is incongruous with other recently released data, including police crime statistics. Methods. We conducted a review of all gunshot injuries recorded in death notifications from 1997 to 2013, ...

  12. Sudden death in eating disorders

    Directory of Open Access Journals (Sweden)

    Jáuregui-Garrido B

    2012-02-01

    Full Text Available Beatriz Jáuregui-Garrido1, Ignacio Jáuregui-Lobera2,31Department of Cardiology, University Hospital Virgen del Rocío, 2Behavioral Sciences Institute, 3Pablo de Olavide University, Seville, SpainAbstract: Eating disorders are usually associated with an increased risk of premature death with a wide range of rates and causes of mortality. “Sudden death” has been defined as the abrupt and unexpected occurrence of fatality for which no satisfactory explanation of the cause can be ascertained. In many cases of sudden death, autopsies do not clarify the main cause. Cardiovascular complications are usually involved in these deaths. The purpose of this review was to report an update of the existing literature data on the main findings with respect to sudden death in eating disorders by means of a search conducted in PubMed. The most relevant conclusion of this review seems to be that the main causes of sudden death in eating disorders are those related to cardiovascular complications. The predictive value of the increased QT interval dispersion as a marker of sudden acute ventricular arrhythmia and death has been demonstrated. Eating disorder patients with severe cardiovascular symptoms should be hospitalized. In general, with respect to sudden death in eating disorders, some findings (eg, long-term eating disorders, chronic hypokalemia, chronically low plasma albumin, and QT intervals >600 milliseconds must be taken into account, and it must be highlighted that during refeeding, the adverse effects of hypophosphatemia include cardiac failure. Monitoring vital signs and performing electrocardiograms and serial measurements of plasma potassium are relevant during the treatment of eating disorder patients.Keywords: sudden death, cardiovascular complications, refeeding syndrome, QT interval, hypokalemia

  13. The Janus face of death receptor signalling during tumour immunoediting.

    Directory of Open Access Journals (Sweden)

    Eimear O' Reilly

    2016-10-01

    Full Text Available Cancer immune-surveillance is essential for the inhibition of carcinogenesis. Malignantly transformed cells can be recognised by both the innate and adaptive immune systems through different mechanisms. Immune effector cells induce extrinsic cell death in the identified tumour cells by expressing death ligand cytokines of the tumour necrosis factor ligand family. However, some tumour cells can escape immune elimination and progress. Acquisition of resistance to the death-ligand induced apoptotic pathway can be obtained through cleavage of effector-cell expressed death-ligands into a poorly active form, mutations or silencing of the death receptors or overexpression of decoy receptors and pro-survival proteins. Although the immune system is highly effective in the elimination of malignantly transformed cells, abnormal/ dysfunctional death-ligand signalling curbs its cytotoxicity. Moreover, death receptors can also transmit pro-survival and pro-migratory signals. Consequently, dysfunctional death receptor-mediated apoptosis/necroptosis signalling does not only give a passive resistance against cell death, but actively drives tumour cell motility, invasion and contributes to consequent metastasis. This dual contribution of the death ligand-death receptor signalling in both the early, elimination phase and then in the late, escape phase of the tumour immunoediting process is discussed in this review. Death receptor agonists still hold potential for cancer therapy since they can execute the tumour-eliminating immune-effector function even in the absence of activation of the immune system against the tumour. The opportunities and challenges of developing death receptor agonists into effective cancer therapeutics are also discussed.

  14. Tuberculosis and HIV are the leading causes of adult death in northwest Ethiopia: evidence from verbal autopsy data of Dabat health and demographic surveillance system, 2007-2013.

    Science.gov (United States)

    Kebede, Yigzaw; Andargie, Gashaw; Gebeyehu, Abebaw; Awoke, Tadesse; Yitayal, Mezgebu; Mekonnen, Solomon; Wubshet, Mamo; Azmeraw, Temesgen; Lakew, Yihunie; Alemu, Kassahun

    2017-07-17

    Reliable data on causes of death form the basis for building evidence on health policy, planning, monitoring, and evaluation. In Ethiopia, the majority of deaths occur at home and civil registration systems are not yet functional. The main objective of verbal autopsy (VA) is to describe the causes of death at the community or population level where civil registration and death certification systems are weak and where most people die at home without having had contact with the health system. Causes of death were classified and prepared based on the International Classification of Diseases (ICD-10). The cause of a death was ascertained based on an interview with next of kin or other caregivers using a standardized questionnaire that draws information on signs, symptoms, medical history, and circumstances preceding death. The cause of death, or the sequence of causes that led to death, is assigned based on the data collected by the questionnaire. The complete VA questionnaires were given to two blinded physicians and reviewed independently. A third physician was assigned to review the case when disagreements in diagnosis arose. Communicable diseases (519 deaths [48.0%]), non-communicable diseases (377 deaths [34.8%]), and external causes (113 deaths [10.4%]) were the main causes of death between 2007 and 2013. Of communicable diseases, tuberculosis (207 deaths [19.7%]), HIV/AIDS (96 deaths [8.9%]) and meningitis (76 deaths [7.0%]) were the most common causes of death. Tuberculosis, HIV/AIDS, and meningitis were the most common causes of deaths among adults. Death due to non-communicable diseases showed an increasing trend. Increasing community awareness of infections and their interrelationships, tuberculosis case finding, effective local TB programs, successful treatment, and interventions for HIV are supremely important.

  15. Preference for place-of-death among terminally ill cancer patients in Denmark

    DEFF Research Database (Denmark)

    Neergaard, Mette Asbjørn; Jensen, Anders Bonde; Sondergaard, Jens

    2011-01-01

    Scand J Caring Sci; 2011 Preference for place-of-death among terminally ill cancer patients in Denmark Achieving home death is often seen as an important endpoint in palliative care, but no studies of the preferred place-of-death have yet been conducted in Scandinavia. Furthermore, we do not know...... if professionals' report on deceased patients' preference of place-of-death is a valid information. The aim of this study was to describe where terminally ill Danish cancer patients prefer to die and to determine if their preference changed during the palliative period, as reported retrospectively by bereaved...... GPs and CNs) report retrospectively that most terminally ill cancer patients wish to die at home. The preference weakened significantly as death approached. The agreement between relatives' and GPs' accounts on patients' preferences at the end of the palliative period was 'substantial', whereas...

  16. Cytotoxic T lymphocyte-mediated cytolysis: an example of programmed cell death in the immune system

    International Nuclear Information System (INIS)

    Duke, R.C.

    1985-01-01

    Target cells are programmed to die following interaction with cytotoxic T lymphocytes (CTLs). Within minutes of exposure to CTL the target cell's nuclear DNA is fragmented. Target cell lysis, as measured by 51 Cr release, occurs about 60 minutes after induction of DNA fragmentation. DNA fragmentation results from the action of an endonuclease which cleaves DNA in the linker region between nucleosomes. The origin of this nuclease, whether transferred to the target by the CTL or endogenous to the target cell, has not been resolved. DNA fragmentation occurs only when appropriately sensitized CTL are used and is not merely the result of cell death because killing of target cells by extreme deviation from homeostasis, by interruption of energy production, or by lysis with antibody and complement does not induce DNA cleavage. When Triton X-100 is added to target cells which have interacted with CTL, the DNA fragments do not remain in association with the nucleus. This observation suggests that breakdown of overall nuclear structure is induced concomitantly with DNA fragmentation. Morphologically, disruption of nuclear structure and DNA fragmentation are observed as widespread chromatin condensation (apoptosis). Apoptosis is observed in metabolically active target cells and is not a consequence of cell death. A cell whose DNA is extensively fragmented is condemmed to die. Induction of oligonucleosome-sized DNA is also an early event in glucocorticoid-induced thymocyte death and death of T cells upon removal of growth factor. Several similarities exist between these systems and CTL-mediated cytolysis suggesting a final common biochemical pathway for all three types of cell death

  17. Risk factors and causes of sudden noncardiac death

    DEFF Research Database (Denmark)

    Risgaard, Bjarke; Lynge, Thomas Hadberg; Wissenberg, Mads

    2015-01-01

    was to report the risk factors and causes of SNCD. METHODS: We conducted a retrospective, nationwide study including all deaths between 2000 and 2006 of individuals aged 1-35 years and all deaths between 2007 and 2009 of individuals aged 1-49 years. Two physicians identified all sudden death cases through.......3-2.3; OR 3.0, 95% CI 2.0-4.4; and OR 4.3, 95% CI 2.5-7.4, respectively). The most common cause of SNCD was pulmonary disease (n = 115 [40%]). CONCLUSION: Sudden death among individuals aged caused by noncardiac diseases in 28% of cases. Risk factors were female sex, age, and the absence......BACKGROUND: On the performance of an autopsy, sudden deaths may be divided into 2 classifications: (1) sudden cardiac deaths and (2) sudden noncardiac deaths (SNCDs). Families of SNCD victims should not be followed up as a means of searching for cardiac disease. OBJECTIVE: The purpose of this study...

  18. Continuous sedation until death with or without the intention to hasten death--a nationwide study in nursing homes in Flanders, Belgium.

    Science.gov (United States)

    Rys, Sam; Deschepper, Reginald; Mortier, Freddy; Deliens, Luc; Bilsen, Johan

    2014-08-01

    Continuous sedation until death (CSD), the removal of consciousness of an incurably ill patient until death, has become a controversial practice. Some consider CSD a palliative treatment, whereas others claim that CSD is frequently used with the intention to hasten death. In nursing homes in Flanders, the rate of CSD has tripled over the past decade, whereas legal euthanasia remains a rare practice. This study wants to investigate to what extent CSD is used to hasten death (CSD+) and to identify possible associated factors. Nationwide cross-sectional retrospective survey, conducted in 2012. Nursing homes in Flanders, Belgium. Coordinating and advisory physicians of all nursing homes in Flanders (n = 660). Physician reports of their most recent patient treated with CSD. The response rate was 57.3%, and 159 of the 378 responding physicians reported a case of CSD (42.1%). According to the reported intentions involved, 62.2% of these cases were considered CSD- cases (no life-shortening pursued), whereas 37.8% were labeled CSD+ (life-shortening pursued). Physician factors such as experience in end-of-life care, palliative care training, training in sedation, or knowledge of sedation guidelines did not affect the outcome distribution (CSD- or CSD+). In CSD+, the patient has a longer life expectancy, is more competent, is clearly longing for death, and requests for euthanasia more frequently. In nursing homes in Flanders, CSD is frequently used to hasten the patient's death. In some cases, CSD can even be considered a substitute for legal euthanasia. Copyright © 2014 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  19. Documenting death: public access to government death records and attendant privacy concerns.

    Science.gov (United States)

    Boles, Jeffrey R

    2012-01-01

    This Article examines the contentious relationship between public rights to access government-held death records and privacy rights concerning the deceased, whose personal information is contained in those same records. This right of access dispute implicates core democratic principles and public policy interests. Open access to death records, such as death certificates and autopsy reports, serves the public interest by shedding light on government agency performance, uncovering potential government wrongdoing, providing data on public health trends, and aiding those investigating family history, for instance. Families of the deceased have challenged the release of these records on privacy grounds, as the records may contain sensitive and embarrassing information about the deceased. Legislatures and the courts addressing this dispute have collectively struggled to reconcile the competing open access and privacy principles. The Article demonstrates how a substantial portion of the resulting law in this area is haphazardly formed, significantly overbroad, and loaded with unintended consequences. The Article offers legal reforms to bring consistency and coherence to this currently disordered area of jurisprudence.

  20. The Hospice Information System and its association with the congruence between the preferred and actual place of death.

    Science.gov (United States)

    Lin, Huang-Ren; Wang, Jen-Hung; Hsieh, Jyh-Gang; Wang, Ying-Wei; Kao, Sheng-Lun

    2017-01-01

    A Hospice Information System (HIS) developed in eastern Taiwan in 2012 aimed to improve the quality of hospice care through an integrated system that provided telemetry-based vital sign records, online 24/7 consultations, online video interviews, and online health educations. The purpose of this study was to explore the congruence between the preferred and actual place of death (POD) among patients who received HIS services. A retrospective study was performed from January 2012 to August 2016. Data from patients enrolled in the HIS who died during this period were included. Data on basic characteristics and the actual and preferred POD were obtained from the HIS database. The primary outcome was the congruence between the preferred and actual POD. Secondary outcomes were comparisons between patients who did and did not achieve their preferred POD. Further comparisons between patients who did and did not achieve home death were also performed. In total, we enrolled 481 patients who received HIS services and died. Of them, 444 (92.3%) died at their preferred POD. Patients who preferred an inpatient hospice as their POD had higher achievement rate than those who wanted a home death. High-intensity HIS utilization was associated with a higher likelihood of home death than low-intensity HIS utilization. Patients living in areas distant from the medical center had lower achievement of home death than those living in local areas. This study suggested that patients enrolled in the HIS had high congruence between the actual and preferred POD.

  1. Mitochondrial and Cell Death Mechanisms in Neurodegenerative Diseases

    Directory of Open Access Journals (Sweden)

    Lee J. Martin

    2010-03-01

    Full Text Available Alzheimer’s disease (AD, Parkinson’s disease (PD and amyotrophic lateral sclerosis (ALS are the most common human adult-onset neurodegenerative diseases. They are characterized by prominent age-related neurodegeneration in selectively vulnerable neural systems. Some forms of AD, PD, and ALS are inherited, and genes causing these diseases have been identified. Nevertheless, the mechanisms of the neuronal cell death are unresolved. Morphological, biochemical, genetic, as well as cell and animal model studies reveal that mitochondria could have roles in this neurodegeneration. The functions and properties of mitochondria might render subsets of selectively vulnerable neurons intrinsically susceptible to cellular aging and stress and overlying genetic variations, triggering neurodegeneration according to a cell death matrix theory. In AD, alterations in enzymes involved in oxidative phosphorylation, oxidative damage, and mitochondrial binding of Aβ and amyloid precursor protein have been reported. In PD, mutations in putative mitochondrial proteins have been identified and mitochondrial DNA mutations have been found in neurons in the substantia nigra. In ALS, changes occur in mitochondrial respiratory chain enzymes and mitochondrial cell death proteins. Transgenic mouse models of human neurodegenerative disease are beginning to reveal possible principles governing the biology of selective neuronal vulnerability that implicate mitochondria and the mitochondrial permeability transition pore. This review summarizes how mitochondrial pathobiology might contribute to neuronal death in AD, PD, and ALS and could serve as a target for drug therapy.

  2. A clinical study on the investigation of the cause of a patient's death after cardiopulmonary arrest on arrival

    International Nuclear Information System (INIS)

    Kato, Akihito; Sato, Keizo; Fujishiro, Masaya

    2011-01-01

    The investigation of the cause of a patient's death after cardiopulmonary arrest (CPA) on arrival usually requires an autopsy. In most areas in Japan, however, such an autopsy is rarely performed, except for those areas with a medical examiner system. No reports demonstrating how to investigate the cause of the patient's death after CPA on arrival were found to our knowledge. From September 1, 2007 to August 31, 2010, 1121 CPA patients died in spite of cardiopulmonary resuscitation in the Emergency and Critical Care Center at Showa University Fujigaoka Hospital. In this paper, causes of their death were reexamined using medical records, roentgenograms of their chest and abdomen in addition to computed tomography (CT) films when taken. Further, the means by which to investigate the cause of death was studied. The detailed reexamination resulted in the estimation for causes of 652 (58.2%) patients' death as follows: 67 cardiac, 61 aortic, 75 respiratory, 44 cerebral, 25 alimentary, 20 renal, 57 systemic diseases and 303 external deaths. Causes of 469 (41.8%) patients' death were unknown. Although CT examination was performed for 219 patients (26.0%), the cause of 75 patient deaths could not be estimated. Reexaminations of medical records revealed 379 prodromes of 300 CPA patients (26.8%), but no prodromes indicated any specific disease. Anamneses were partly useful for specifying causes of their death. On the other hand, CT examinations were highly useful for not only diagnosing the specific disease but also denying it. Even when causes of their death could not be specified, reexaminations of both CT findings and other clinical data resulted in possible diagnoses of the disease for most cases. The spread of a medical examiner system throughout Japan is the most desirable for investigating causes of CPA patients' death. The postmortem CT examination seems to be preferable for such an investigation. (author)

  3. MRI of 'brain death'

    International Nuclear Information System (INIS)

    Nishino, Shigeki; Itoh, Takahiko; Tuchida, Shohei; Kinugasa, Kazushi; Asari, Shoji; Nishimoto, Akira; Sanou, Kazuo.

    1990-01-01

    Magnetic resonance imaging (MRI) was undertaken for two patients who suffered from severe cerebrovascular diseases and were clinically brain dead. The MRI system we used was Resona (Yokogawa Medical Systems, superconductive system 0.5 T) and the CT apparatus was Toshiba TCT-300. Initial CT and MRI were undertaken as soon as possible after admission, and repeated sequentially. After diagnosis of brain death, we performed angiography to determine cerebral circulatory arrest, and MRI obtained at the same time was compared with the angiogram and CT. Case 1 was a 77-year-old man who was admitted in an unconscious state. CT and MRI on the second day after hospitalization revealed cerebellar infarction. He was diagnosed as brain dead on day 4. Case 2 was a 35-year-old man. When he was transferred to our hospital, he was in cardiorespiratory arrested. Cardiac resuscitation was successful but no spontaneous respiration appeared. CT and MRI on admission revealed right intracerebral hemorrhage. Angiography revealed cessation of contrast medium in intracranial vessels in both of the patients. We found no 'flow signal void sign' in the bilateral internal carotid and basilar arteries on MRI images in both cases after brain death. MRI, showing us the anatomical changes of the brain, clearly revealed brain herniations, even though only nuclear findings of 'brain tamponade' were seen on CT. But in Case 1, we could not see the infarct lesions in the cerebellum on MR images obtained after brain death. This phenomenon was caused by the whole brain ischemia masking the initial ischemic lesions. We concluded that MRI was useful not only the anatomical display of lesions and brain herniation with high contrast resolution but for obtaining information on cerebral circulation of brain death. (author)

  4. Can Patient Safety Incident Reports Be Used to Compare Hospital Safety? Results from a Quantitative Analysis of the English National Reporting and Learning System Data.

    Science.gov (United States)

    Howell, Ann-Marie; Burns, Elaine M; Bouras, George; Donaldson, Liam J; Athanasiou, Thanos; Darzi, Ara

    2015-01-01

    The National Reporting and Learning System (NRLS) collects reports about patient safety incidents in England. Government regulators use NRLS data to assess the safety of hospitals. This study aims to examine whether annual hospital incident reporting rates can be used as a surrogate indicator of individual hospital safety. Secondly assesses which hospital characteristics are correlated with high incident reporting rates and whether a high reporting hospital is safer than those lower reporting hospitals. Finally, it assesses which health-care professionals report more incidents of patient harm, which report more near miss incidents and what hospital factors encourage reporting. These findings may suggest methods for increasing the utility of reporting systems. This study used a mix methods approach for assessing NRLS data. The data were investigated using Pareto analysis and regression models to establish which patients are most vulnerable to reported harm. Hospital factors were correlated with institutional reporting rates over one year to examine what factors influenced reporting. Staff survey findings regarding hospital safety culture were correlated with reported rates of incidents causing harm; no harm and death to understand what barriers influence error disclosure. 5,879,954 incident reports were collected from acute hospitals over the decade. 70.3% of incidents produced no harm to the patient and 0.9% were judged by the reporter to have caused severe harm or death. Obstetrics and Gynaecology reported the most no harm events [OR 1.61(95%CI: 1.12 to 2.27), p<0.01] and pharmacy was the hospital location where most near-misses were captured [OR 3.03(95%CI: 2.04 to 4.55), p<0.01]. Clinicians were significantly more likely to report death than other staff [OR 3.04(95%CI: 2.43 to 3.80) p<0.01]. A higher ratio of clinicians to beds correlated with reduced rate of harm reported [RR = -1.78(95%Cl: -3.33 to -0.23), p = 0.03]. Litigation claims per bed were

  5. Death from a driverless vehicle.

    Science.gov (United States)

    Das, Siddhartha; Menezes, Ritesh G

    2018-03-01

    Road traffic accidents are a major cause of fatalities around the world, and a number of deaths are caused by moving traffic on public roads. Deaths from vehicles that are off the highway may be called non-traffic fatalities which can be due to a vehicle reversing, carbon monoxide poisoning, weather-induced over-heating inside the vehicle and electric windows. Children (and animals) are the usual victims. We report a case from India where a man was found lying dead by the roadside with a lorry nearby. The autopsy findings indicated that he had been run over, but as there was no history of a vehicular collision and with no eyewitnesses, the investigators were unsure of the probable sequence of events that led to his death. The autopsy findings, history, circumstantial evidence and chemical analysis enabled us to work out what had happened.

  6. Deliberating death.

    Science.gov (United States)

    Landes, Scott D

    2010-01-01

    Utilizing a particular case study of a woman attempting to come to terms with her death, this article explores the difficult metaphors of death present within the Christian tradition. Tracing a Christian understanding of death back to the work of Augustine, the case study is utilized to highlight the difficulties presented by past and present theology embracing ideas of punishment within death. Following the trajectory of the case study, alternative understandings of death present in recent Christian theology and within Native American spirituality are presented in an attempt to find room for a fuller meaning of death post-reconciliation, but premortem.

  7. Docosahexaenoic acid counteracts attenuation of CD95-induced cell death by inorganic mercury

    Energy Technology Data Exchange (ETDEWEB)

    Gill, Randall [Department of Immunology and Microbiology, Wayne State University, Detroit MI (United States); Lanni, Lydia; Jen, K.-L. Catherine [Department of Nutrition and Food Science, Wayne State University, Detroit MI (United States); McCabe, Michael J. [Department of Environmental Medicine, University of Rochester, Rochester NY (United States); Rosenspire, Allen, E-mail: arosenspire@wayne.edu [Department of Immunology and Microbiology, Wayne State University, Detroit MI (United States)

    2015-01-01

    In the United States the principal environmental exposure to mercury is through dietary consumption of sea food. Although the mechanism by which low levels of mercury affect the nervous system is not well established, epidemiological studies suggest that low level exposure of pregnant women to dietary mercury can adversely impact cognitive development in their children, but that Docosahexaenoic acid (DHA), the most prominent n-polyunsaturated fatty acid (n-PUFA) present in fish may counteract negative effects of mercury on the nervous system. Aside from effects on the nervous system, epidemiological and animal studies have also suggested that low level mercury exposure may be a risk factor for autoimmune disease. However unlike the nervous system where a mechanism linking mercury to impaired cognitive development remains elusive, we have previously suggested a potential mechanism linking low level mercury exposures to immune system dysfunction and autoimmunity. In the immune system it is well established that disruption of CD95 mediated apoptosis leads to autoimmune disease. We have previously shown in vitro as well as in vivo that in lymphocytes burdened with low levels of mercury, CD95 mediated cell death is impaired. In this report we now show that DHA counteracts the negative effect of mercury on CD95 signaling in T lymphocytes. T cells which have been pre-exposed to DHA are able to cleave pro-caspase 3 and efficiently signal programmed cell death through the CD95 signaling pathway, whether or not they are burdened with low levels of mercury. Thus DHA may lower the risk of autoimmune disease after low level mercury exposures. - Highlights: • Inorganic mercury (Hg{sup 2+}) interferes with CD95 mediated cell death in Jurkat T cells • DHA restores the ability of CD95 to signal cell death in Hg{sup 2+} intoxicated T cells • The restoration of CD95 mediated cell death by DHA is correlated with increased activation of Caspase 3.

  8. Docosahexaenoic acid counteracts attenuation of CD95-induced cell death by inorganic mercury

    International Nuclear Information System (INIS)

    Gill, Randall; Lanni, Lydia; Jen, K.-L. Catherine; McCabe, Michael J.; Rosenspire, Allen

    2015-01-01

    In the United States the principal environmental exposure to mercury is through dietary consumption of sea food. Although the mechanism by which low levels of mercury affect the nervous system is not well established, epidemiological studies suggest that low level exposure of pregnant women to dietary mercury can adversely impact cognitive development in their children, but that Docosahexaenoic acid (DHA), the most prominent n-polyunsaturated fatty acid (n-PUFA) present in fish may counteract negative effects of mercury on the nervous system. Aside from effects on the nervous system, epidemiological and animal studies have also suggested that low level mercury exposure may be a risk factor for autoimmune disease. However unlike the nervous system where a mechanism linking mercury to impaired cognitive development remains elusive, we have previously suggested a potential mechanism linking low level mercury exposures to immune system dysfunction and autoimmunity. In the immune system it is well established that disruption of CD95 mediated apoptosis leads to autoimmune disease. We have previously shown in vitro as well as in vivo that in lymphocytes burdened with low levels of mercury, CD95 mediated cell death is impaired. In this report we now show that DHA counteracts the negative effect of mercury on CD95 signaling in T lymphocytes. T cells which have been pre-exposed to DHA are able to cleave pro-caspase 3 and efficiently signal programmed cell death through the CD95 signaling pathway, whether or not they are burdened with low levels of mercury. Thus DHA may lower the risk of autoimmune disease after low level mercury exposures. - Highlights: • Inorganic mercury (Hg 2+ ) interferes with CD95 mediated cell death in Jurkat T cells • DHA restores the ability of CD95 to signal cell death in Hg 2+ intoxicated T cells • The restoration of CD95 mediated cell death by DHA is correlated with increased activation of Caspase 3

  9. Childhood death rates declined in Sweden from 2000 to 2014 but deaths from external causes were not always investigated.

    Science.gov (United States)

    Otterman, Gabriel; Lahne, Klara; Arkema, Elizabeth V; Lucas, Steven; Janson, Staffan; Hellström-Westas, Lena

    2018-03-08

    Countries that conduct systematic child death reviews report a high proportion of modifiable characteristics among deaths from external causes, and this study examined the trends in Sweden. We analysed individual-level data on external, ill-defined and unknown causes from the Swedish cause of death register from 2000 to 2014, and mortality rates were estimated for children under the age of one and for those aged 1-14 and 15-17 years. Child deaths from all causes were 7914, and 2006 (25%) were from external, ill-defined and unknown causes: 610 (30%) were infants, 692 (34%) were 1-14 and 704 (35%) were 15-17. The annual average was 134 cases (range 99-156) during the study period. Mortality rates from external, ill-defined and unknown causes in children under 18 fell 19%, from 7.4 to 6.0 per 100 000 population. A sizeable number of infant deaths (8.0%) were registered without a death certificate during the study period, but these counts were lower in children aged 1-14 (1.3%) and 15-17 (0.9%). Childhood deaths showed a sustained decline from 2000 to 2014 in Sweden and a quarter were from external, ill-defined or unknown causes. Systematic, interagency death reviews could yield information that could prevent future deaths. ©2018 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  10. Habitual sleep duration and insomnia and the risk of cardiovascular events and all-cause death: report from a community-based cohort.

    Science.gov (United States)

    Chien, Kuo-Liong; Chen, Pei-Chung; Hsu, Hsiu-Ching; Su, Ta-Chen; Sung, Fung-Chang; Chen, Ming-Fong; Lee, Yuan-Teh

    2010-02-01

    To investigate the relationship between sleep duration and insomnia severity and the risk of all-cause death and cardiovascular disease (CVD) events. Prospective cohort study. Community-based. A total of 3,430 adults aged 35 years or older. None. During a median 15.9 year (interquartile range, 13.1 to 16.9) follow-up period, 420 cases developed cardiovascular disease and 901 cases died. A U-shape association between sleep duration and all-cause death was found: the age and gender-adjusted relative risks (95% confidence interval [CI]) of all-cause death (with 7 h of daily sleep being considered for the reference group) for individuals reporting or = 9 h were 1.15 (0.91-1.45), 1.02 (0.85-1.25), 1.05 (0.88-1.27), and 1.43 (1.16-1.75); P for trend, 0.019. However, the relationship between sleep duration and risk of CVD were linear. The multivariate-adjusted relative risk (95% CI) for all-cause death (using individuals without insomnia) were 1.02 (0.86-1.20) for occasional insomnia, 1.15 (0.92-1.42) for frequent insomnia, and 1.70 (1.16-2.49) for nearly everyday insomnia (P for trend, 0.028). The multivariate adjusted relative risk (95% CI) was 2.53 (1.71-3.76) for all-cause death and 2.07 (1.11-3.85) for CVD rate in participants sleeping > or = 9 h and for those with frequent insomnia. Sleep duration and insomnia severity were associated with all-cause death and CVD events among ethnic Chinese in Taiwan. Our data indicate that an optimal sleep duration (7-8 h) predicted fewer deaths.

  11. Causes of death in Japanese patients with diabetes based on the results of a survey of 45,708 cases during 2001-2010: Report of the Committee on Causes of Death in Diabetes Mellitus.

    Science.gov (United States)

    Nakamura, Jiro; Kamiya, Hideki; Haneda, Masakazu; Inagaki, Nobuya; Tanizawa, Yukio; Araki, Eiichi; Ueki, Kohjiro; Nakayama, Takeo

    2017-05-01

    The principal causes of death among 45,708 patients with diabetes (29,801 men and 15,907 women) who died in 241 hospitals throughout Japan during 2001-2010 were determined based on a survey of the hospital records. Autopsy had been conducted in 978 of the 45,708 cases. The most frequent cause of death was malignant neoplasia (38.3%), followed by, in order of descending frequency: infections (17.0%); and then vascular diseases (14.9%), including renal failure (3.5%), ischemic heart diseases (4.8%) and cerebrovascular diseases (6.6%). Diabetic coma associated with hyperglycemia with or without ketoacidosis accounted for only 0.6% of the deaths. In regard to the relationship between the age and cause of death in patients with diabetes, the incidence of death due to vascular diseases was higher in patients over the age of 30 or 40 years, and the 97.0% of the total death due to vascular diseases was observed in patients over the age of 50 years. The incidence of death due to infectious diseases, especially pneumonia, increased in an age-dependent fashion, and the 80.7% of the total death due to pneumonia was observed in patients over the age of 70 years. 'Poorer' glycemic control was associated with the reduced lifespan of patients with diabetes, especially of those with nephropathy. The average age at death in the survey population was 72.6 years. The lifespan was 1.6 years shorter in patients with 'poorer' glycemic control than in those with 'better' glycemic control. In patients with diabetes of less than 10 years' duration, the incidence of death due to macroangiopathy was higher than that due to nephropathy. Of the 45,708 patients with diabetes, 33.9% were on oral medication, 41.9% received insulin therapy and 18.8% were treated by diet alone. Among the patients in whom the cause of death was diabetic nephropathy, a high percentage, 53.7%, was on insulin therapy. The average age at death of the 45,708 patients with diabetes was 71.4 years in men and 75.1

  12. Maternal Mortality Ratio and Causes of Death in IRI Between 2009 and 2012

    Directory of Open Access Journals (Sweden)

    Marzieh Vahiddastjerdy

    2016-12-01

    Full Text Available Objective: The Maternal Mortality Ratio is an important health indicator. We presented the distribution and causes of maternal mortality in Islamic Republic of Iran.Materials and methods: After provision of an electronic Registry system for date entry, a descriptive-retrospective data collection had been performed for all maternal Deaths in March 2009- March 2012. All maternal deaths and their demographic characteristic were identified by using medical registries, death certificates, and relevant codes according to International Classification of Diseases (ICD-9 during pregnancy, labor, and 42 days after parturition.Results: During 3 years, there were 5094317 deliveries and 941 maternal deaths (MMR of 18.5 per 1000000 live births. We had access to pertained data of 896 cases (95.2% for review in our study. Of 896 reported deaths, 549 were classified as direct, 302 as indirect and 45 as unknown. Hemorrhage was the most common cause of maternal mortality, followed by Preeclampsia, Eclampsia and sepsis. Among all indirect causes, cardio -vascular diseases were responsible for 10% of maternal deaths, followed by thromboembolism, HTN and renal diseases.Conclusion: Although maternal mortality ratio in IRI could be comparable with the developed countries but its pattern is following developing countries and with this study we had provided reliable data for other prospective studies.

  13. General birth-death processes: probabilities, inference, and applications

    OpenAIRE

    Crawford, Forrest Wrenn

    2012-01-01

    A birth-death process is a continuous-time Markov chain that counts the number of particles in a system over time. Each particle can give birth to another particle or die, and the rate of births and deaths at any given time depends on how many extant particles there are. Birth-death processes are popular modeling tools in evolution, population biology, genetics, epidemiology, and ecology. Despite the widespread interest in birth-death models, no efficient method exists to evaluate the fini...

  14. Death caused by heat stroke: Case report

    Directory of Open Access Journals (Sweden)

    Savić Slobodan

    2014-01-01

    Full Text Available Introduction. Heat stroke is the most dangerous among numerous disorders caused by elevated environmental temperature. It is characterized by an increased body temperature of over 40°C, the dysfunction of the central nervous system and the development of multiple organ failure. The aim of this paper was to highlight problems in the clinical and post-mortal diagnosis of fatal heat stroke. Case Outline. A 20-year-old male was found unconscious on the street; on admission at the Emergency Center, Clinical Center of Serbia, Belgrade, he was in a coma. The body temperature of 40°C was maintained despite the applied therapy, meningeal signs were negative, tachycardia with gallop rhythm, hypotension, bleeding from the nose and mouth, and presence of skin bruises. Laboratory findings: highly elevated LDH and creatine kinase, elevated serum creatinine, AST, and signs of DIC. Lethal outcome occurred 6 hours after admission, and the case remained clinically unsolved. Autopsy showed signs of hemorrhagic diathesis, brain and pulmonary edema, and microscopic examination revealed general congestion, internal bleeding in various organs, cerebral edema, massive blood aspiration and pulmonary edema. Toxicological and bacteriological examinations were negative. Based on these findings and subsequently obtained data on the conditions at the workplace where the young man had a part-time job, it was concluded that the violent death was caused by heat stroke. Conclusion. Since heat stroke is associated with a high mortality rate and high incidence of serious and permanent organ damage in survivors, it is important to make the diagnosis of heat stroke as quickly as possible and apply appropriate treatment. Misdiagnosis of heat stroke, and consequently inadequate treatment, with a potential fatal outcome for the patient, can be the reason for blaming doctors for the legal offense of medical malpractice in failing to administer first aid.

  15. Mechanism of neem limonoids-induced cell death in cancer: Role of oxidative phosphorylation.

    Science.gov (United States)

    Yadav, Neelu; Kumar, Sandeep; Kumar, Rahul; Srivastava, Pragya; Sun, Leimin; Rapali, Peter; Marlowe, Timothy; Schneider, Andrea; Inigo, Joseph R; O'Malley, Jordan; Londonkar, Ramesh; Gogada, Raghu; Chaudhary, Ajay K; Yadava, Nagendra; Chandra, Dhyan

    2016-01-01

    We have previously reported that neem limonoids (neem) induce multiple cancer cell death pathways. Here we dissect the underlying mechanisms of neem-induced apoptotic cell death in cancer. We observed that neem-induced caspase activation does not require Bax/Bak channel-mediated mitochondrial outer membrane permeabilization, permeability transition pore, and mitochondrial fragmentation. Neem enhanced mitochondrial DNA and mitochondrial biomass. While oxidative phosphorylation (OXPHOS) Complex-I activity was decreased, the activities of other OXPHOS complexes including Complex-II and -IV were unaltered. Increased reactive oxygen species (ROS) levels were associated with an increase in mitochondrial biomass and apoptosis upon neem exposure. Complex-I deficiency due to the loss of Ndufa1-encoded MWFE protein inhibited neem-induced caspase activation and apoptosis, but cell death induction was enhanced. Complex II-deficiency due to the loss of succinate dehydrogenase complex subunit C (SDHC) robustly decreased caspase activation, apoptosis, and cell death. Additionally, the ablation of Complexes-I, -III, -IV, and -V together did not inhibit caspase activation. Together, we demonstrate that neem limonoids target OXPHOS system to induce cancer cell death, which does not require upregulation or activation of proapoptotic Bcl-2 family proteins. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. A Good Death? Report of the Second Newcastle Meeting on Laboratory Animal Euthanasia

    Directory of Open Access Journals (Sweden)

    Penny Hawkins

    2016-08-01

    Full Text Available Millions of laboratory animals are killed each year worldwide. There is an ethical, and in many countries also a legal, imperative to ensure those deaths cause minimal suffering. However, there is a lack of consensus regarding what methods of killing are humane for many species and stages of development. In 2013, an international group of researchers and stakeholders met at Newcastle University, United Kingdom to discuss the latest research and which methods could currently be considered most humane for the most commonly used laboratory species (mice, rats and zebrafish. They also discussed factors to consider when making decisions about appropriate techniques for particular species and projects, and priorities for further research. This report summarises the research findings and discussions, with recommendations to help inform good practice for humane killing.

  17. Preliminary evaluation of the importance of existing hydraulic-head observation locations to advective-transport predictions, Death Valley regional flow system, California and Nevada

    International Nuclear Information System (INIS)

    Hill, M.C.; Ely, D.M.; Tiedeman, C.R.; O'Brien, G.M.; D'Agnese, F.A.; Faunt, C.C.

    2001-01-01

    When a model is calibrated by nonlinear regression, calculated diagnostic statistics and measures of uncertainty provide a wealth of information about many aspects of the system. This report presents a method of ranking the likely importance of existing observation locations using measures of prediction uncertainty. It is suggested that continued monitoring is warranted at more important locations, and unwarranted or less warranted at less important locations. The report develops the methodology and then demonstrates it using the hydraulic-head observation locations of a three-layer model of the Death Valley regional flow system (DVRFS). The predictions of interest are subsurface transport from beneath Yucca Mountain and 14 underground Test Area (UGTA) sites. The advective component of transport is considered because it is the component most affected by the system dynamics represented by the regional-scale model being used. The problem is addressed using the capabilities of the U.S. Geological Survey computer program MODFLOW-2000, with its ADVective-Travel Observation (ADV) Package, and an additional computer program developed for this work

  18. Sudden Death Phenomenon While Bathing in Japan - Mortality Data.

    Science.gov (United States)

    Suzuki, Masaru; Shimbo, Takuro; Ikaga, Toshiharu; Hori, Shingo

    2017-07-25

    Bath-related sudden cardiac arrest frequently occurs in Japan, but the mortality data have not been sufficiently reported.Methods and Results:This prospective cross-sectional observational study was conducted in the Tokyo Metropolis, Saga Prefecture and Yamagata Prefecture between October 2012 and March 2013 (i.e., in winter). We investigated the data for all occurrences in these areas for which the emergency medical system needed to be activated because of an accident or acute illness related to bathing. Emergency personnel enrolled the event when activation of the emergency medical system was related to bathing. Of the 4,599 registered bath-related events, 1,527 (33%) were identified as bath-related cardiac arrest events. Crude mortality (no. deaths per 100,000) during the observational period was 10.0 in Tokyo, 11.6 in Yamagata and 8.5 in Saga. According to the mortality data for age and sex, the estimated number of bath-related deaths nationwide was 13,369 in winter, for the 6 months from October (95% CI: 10,862-16,887). Most cardiac arrest events occurred in tubs filled with water with the face submerged in the water. This suggests that drowning plays a crucial role in the etiology of such phenomena. The estimated nationwide number of deaths was 13,369 (95% CI: 10,862-16,887) in winter, for the 6 months from October. Crude mortality during the winter season was 10.0 in Tokyo, 11.6 in Yamagata and 8.5 in Saga.

  19. Amplitude death induced by mixed attractive and repulsive coupling in the relay system

    Science.gov (United States)

    Zhao, Nannan; Sun, Zhongkui; Xu, Wei

    2018-01-01

    The amplitude death (AD) phenomenon is found in the relay system in the presence of the mixed couplings composed of attractive coupling and repulsive coupling. The generation mechanism of AD is revealed and shows that the middle oscillator achieving AD is a prerequisite to further suppress oscillation of the outermost oscillators for the paradigmatic Stuart-Landau and Rössler models. Moreover, regarding the Stuart-Landau relay system as a small motif of star network, we also observe that the mixed couplings can facilitate AD state of the whole network system. Particularly, the threshold of coupling strength is invariable with the change of network size. Our findings may shed a new insight to explore the effects of hybrid coupling on complex systems, also provide a new strategy to control dynamic behaviors in engineering science and neuroscience fields.

  20. Life Experience with Death: Relation to Death Attitudes and to the Use of Death-Related Memories

    Science.gov (United States)

    Bluck, Susan; Dirk, Judith; Mackay, Michael M.; Hux, Ashley

    2008-01-01

    The study examines the relation of death experience to death attitudes and to autobiographical memory use. Participants (N = 52) completed standard death attitude measures and wrote narratives about a death-related autobiographical memory and (for comparison) a memory of a low point. Self-ratings of the memory narratives were used to assess their…

  1. Domestic/family violence death reviews: an international comparison.

    Science.gov (United States)

    Bugeja, Lyndal; Dawson, Myrna; McIntyre, Sara-Jane; Walsh, Carolyn

    2015-04-01

    Domestic/Family Violence Death Reviews (D/FVDRs) have been established in a number of high-income countries since 1990 as a mechanism to inform prevention-focused interventions to reduce domestic/family violence. D/FVDRs differ in their structure, governance, case identification processes and inclusion criteria, review measures, and outputs. Outside of the United States, the extent of heterogeneity across and within countries has not been explored. This study comprised an international comparison of D/FVDRs and their core elements to inform the establishment of D/FVDRs in other developed countries, and potentially low- and middle-income countries where violence is a leading cause of death. Such a review is also a necessary foundation for any future evaluation D/FVDRs. The review identified 71 jurisdictions where a D/FVDRs had been established in the past two decades, 25 of which met the inclusion criteria. All D/FVDRs examined stated a reduction in deaths as a goal of the review process; however, none reported an actual reduction. The focus of the D/FVDRs examined was on intimate partner homicides; however, more recently established D/FVDRs include other familial relationships. Almost one third of the D/FVDRs examined reported changes to the domestic/family system that occurred as a result of recommendations made from the review process. While similar in many ways, D/FVDRs differ along a number of important dimensions that make it difficult to identify best practices for jurisdictions considering the establishment of such an initiative. To share knowledge, existing networks should be expanded nationally and internationally to include jurisdictions that may be considering this initiative. © The Author(s) 2013.

  2. Neonatal death dwarfism - a new form

    Energy Technology Data Exchange (ETDEWEB)

    Colavita, N.; Kozlowski, K.

    1984-09-01

    A new type of neonatal death dwarfism is reported. Although it resembles superficially the metatropic dysplasia group of diseases it has some distinctive radiographic features which help to delineate it as a separate entity.

  3. HSF-1 activates the ubiquitin proteasome system to promote non-apoptotic developmental cell death in C. elegans.

    Science.gov (United States)

    Kinet, Maxime J; Malin, Jennifer A; Abraham, Mary C; Blum, Elyse S; Silverman, Melanie R; Lu, Yun; Shaham, Shai

    2016-03-08

    Apoptosis is a prominent metazoan cell death form. Yet, mutations in apoptosis regulators cause only minor defects in vertebrate development, suggesting that another developmental cell death mechanism exists. While some non-apoptotic programs have been molecularly characterized, none appear to control developmental cell culling. Linker-cell-type death (LCD) is a morphologically conserved non-apoptotic cell death process operating in Caenorhabditis elegans and vertebrate development, and is therefore a compelling candidate process complementing apoptosis. However, the details of LCD execution are not known. Here we delineate a molecular-genetic pathway governing LCD in C. elegans. Redundant activities of antagonistic Wnt signals, a temporal control pathway, and mitogen-activated protein kinase kinase signaling control heat shock factor 1 (HSF-1), a conserved stress-activated transcription factor. Rather than protecting cells, HSF-1 promotes their demise by activating components of the ubiquitin proteasome system, including the E2 ligase LET-70/UBE2D2 functioning with E3 components CUL-3, RBX-1, BTBD-2, and SIAH-1. Our studies uncover design similarities between LCD and developmental apoptosis, and provide testable predictions for analyzing LCD in vertebrates.

  4. A case report: Pavlovian conditioning as a risk factor of heroin 'overdose' death

    Directory of Open Access Journals (Sweden)

    Bácskai Erika

    2005-07-01

    Full Text Available Abstract Background The authors present a case illustrating a mechanism leading directly to death which is not rare but has received little attention. Case presentation The case was evaluated by autopsy, investigation of morphine concentration in the blood, and clinical data. The heroin dose causing the 'overdose' death of a young man who had previously been treated a number of times for heroin addiction did not differ from his dose of the previous day taken in the accustomed circumstances. The accustomed dose taken in a strange environment caused fatal complications because the conditioned tolerance failed to operate. The concentration of morphine in the blood did not exceed the level measured during earlier treatment. Conclusion These results are in line with the data in the literature indicating that morphine concentrations measured in cases of drug-related death do not differ substantially from those measured in cases where the outcome is not fatal. A knowledge of the conditioning mechanism can contribute to prevention of fatal cases of a similar type. The harm reduction approach places great stress on preventive intervention based on data related to drug-related death.

  5. Factors associated with congruence between preferred and actual place of death.

    Science.gov (United States)

    Bell, Christina L; Somogyi-Zalud, Emese; Masaki, Kamal H

    2010-03-01

    Congruence between preferred and actual place of death may be an essential component in terminal care. Most patients prefer a home death, but many patients do not die in their preferred location. Specialized (physician, hospice, and palliative) home care visits may increase home deaths, but factors associated with congruence have not been systematically reviewed. This study sought to review the extent of congruence reported in the literature and examine factors that may influence congruence. In July 2009, a comprehensive literature search was performed using MEDLINE, PsychInfo, CINAHL, and Web of Science. Reference lists, related articles, and the past five years of six palliative care journals were also searched. Overall congruence rates (percentage of met preferences for all locations of death) were calculated for each study using reported data to allow cross-study comparison. Eighteen articles described 30%-91% congruence. Eight specialized home care studies reported 59%-91% congruence. A physician-led home care program reported 91% congruence. Of the 10 studies without specialized home care for all patients, seven reported 56%-71% congruence and most reported unique care programs. Of the remaining three studies without specialized home care for all patients, two reported 43%-46% congruence among hospital inpatients, and one elicited patient preference "if everything were possible," with 30% congruence. Physician support, hospice enrollment, and family support improved congruence in multiple studies. Research in this important area must consider potential sources of bias, the method of eliciting patient preference, and the absence of a single ideal place of death. (c) 2010 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

  6. The use of coroner's autopsy reports to validate the use of targeted swabbing rather than tissue collection for rapid confirmation of virological causes of sudden death in the community.

    Science.gov (United States)

    Moore, Catherine; Jones, Rachel

    2015-02-01

    In this study, coroner's autopsy reports were used to validate results obtained from respiratory virus screening of swabs rather than tissue collected during autopsy in cases of adult death of unknown cause. Coroner's autopsy samples collected for respiratory virus screening between October 2010 and February 2011, were identified. Autopsy reports were requested from cases positive for a virus. Each report was reviewed to correlate findings at autopsy with the virology result and to determine whether the virus found was listed as a contributing factor in the death. Sixty-four coroner's autopsy cases were identified and a respiratory virus was found in 25 cases. Influenza A(H1N1)pdm09 virus was found most frequently, then RSV and influenza B with a dual influenza A and B infection and a parainfluenza type 1. Where multiple sites were swabbed, the virus was detected in all sites. Autopsy reports for 12 cases were obtained each reporting findings consistent with respiratory infection. Influenza A was always listed as a contributing factor in the death whereas RSV was listed once and influenza B was omitted in one case. The quality of the reports was variable and full histology was less likely to be performed in the elderly. While coroner's reports supported the use of swabbing rather than tissue collection, the lack of consistency and omission of the virology findings as contributing factors to death means that the burden of viruses on mortality statistics will remain under-estimated particularly in the elderly. Copyright © 2014 Elsevier B.V. All rights reserved.

  7. Accidental drug deaths in Fulton County, Georgia, 2002: characteristics, case management and certification issues.

    Science.gov (United States)

    Graham, Jason K; Hanzlick, Randy

    2008-09-01

    , thus emphasizing the strong importance of scene information/investigative reports in evaluating drug-death cases and in formulating plans of action to handle each individual case. Among the drug-death cases handled by 6 staff medical examiners at the Fulton County Medical Examiner's Office, variation existed in autopsy performance and death certification practices. These issues are discussed in the context of the National Association of Medical Examiners' (NAME) Position Paper on Cocaine, NAME Forensic Autopsy Performance Standards, and other relevant literature. Most variations relate to completeness of the cause-of-death statement (whether or not comorbid conditions are included) rather than classification of manner of death within the office. However, specific wording in the cause of death may have significant ramifications regarding drug-related mortality statistics processed by the vital statistics system, with possible under-representation of drug-related deaths in single-cause mortality data.

  8. Life Expectancy and Death by Diseases of the Circulatory System in Patients with Bipolar Disorder or Schizophrenia in the Nordic Countries

    Science.gov (United States)

    Laursen, Thomas Munk; Wahlbeck, Kristian; Hällgren, Jonas; Westman, Jeanette; Ösby, Urban; Alinaghizadeh, Hassan; Gissler, Mika; Nordentoft, Merete

    2013-01-01

    Objective Excess mortality from diseases and medical conditions (natural death) in persons with psychiatric disorders has been extensively reported. Even in the Nordic countries with well-developed welfare systems, register based studies find evidence of an excess mortality. In recent years, cardiac mortality and death by diseases of the circulatory system has seen a decline in all the Nordic countries, but a recent paper indicates that women and men in Denmark, Finland, and Sweden, who had been hospitalised for a psychotic disorder, had a two to three-fold increased risk of dying from a cardiovascular disease. The aim of this study was to compare the mortality by diseases of the circulatory system among patients with bipolar disorder or schizophrenia in the three Nordic countries Denmark, Sweden, and Finland. Furthermore, the aim was to examine and compare life expectancy among these patients. Cause specific Standardized Mortality Rates (SMRs) were calculated for each specific subgroup of mortality. Life expectancy was calculated using Wiesler’s method. Results The SMR for bipolar disorder for diseases of the circulatory system was approximately 2 in all countries and both sexes. SMR was slightly higher for people with schizophrenia for both genders and in all countries, except for men in Denmark. Overall life expectancy was much lower among persons with bipolar disorder or schizophrenia, with life expectancy being from 11 to 20 years shorter. Conclusion Our data show that persons in the Nordic countries with schizophrenia or bipolar disorder have a substantially reduced life expectancy. An evaluation of the reasons for these increased mortality rates should be prioritized when planning healthcare in the coming years. PMID:23826212

  9. Neonatal death dwarfism - a new form

    International Nuclear Information System (INIS)

    Colavita, N.; Kozlowski, K.; Universita Cattolica del Sacro Cuore di Milano, Rome

    1984-01-01

    A new type of neonatal death dwarfism is reported. Although it resembles superficially the metatropic dysplasia group of diseases it has some distinctive radiographic features which help to delineate it as a separate entity. (orig.)

  10. Severe Respiratory Acidosis in Status Epilepticus as a Possible Etiology of Sudden Death in Lesch-Nyhan Disease: A Case Report and Review of the Literature.

    Science.gov (United States)

    Christy, Alison; Nyhan, William; Wilson, Jenny

    2017-01-01

    Lesch-Nyhan disease (LND) is an X-linked disorder of purine metabolism, associated with self-mutilation, dystonia, and chorea. Seizures are uncommon in LND. Patients with LND are at risk for sudden and unexpected death. The etiology of this is unknown, but appears to occur from a respiratory process. We propose that respiratory failure secondary to subclinical seizure may lead to sudden death in these patients. We report a case of an 11-year-old boy with LND who had two episodes of nocturnal gasping. The second event was immediately followed by a 10 min generalized seizure. Upon arrival at the hospital, an arterial blood gas test revealed a severe respiratory acidosis. Following aggressive treatment of his seizures, this patient did well, and was discharged home on oxcarbazepine with rectal diazepam. No further seizures have been noted in 1 year of follow-up. In this case report and review, we hypothesize that sudden death from respiratory failure in Lesch-Nyhan disease may in some cases be due to seizure-induced respiratory failure, akin to sudden unexpected death in epilepsy (SUDEP). We suggest screening for paroxysmal respiratory events; consideration of electroencephalography for patients with LND presenting in respiratory distress or failure; and consideration of more aggressive treatment of seizures in these patients. Brief Summary:We present an 11-year-old boy with Lesch-Nyhan disease (LND) who developed respiratory failure and severe respiratory acidosis from his first known seizure, which evolved to subclinical status epilepticus. We propose that patients with LND have a predisposition to respiratory failure and sudden death, which in some cases may be provoked by seizure (sudden unexpected death in epilepsy, or SUDEP).

  11. Dengue Deaths in Puerto Rico: Lessons Learned from the 2007 Epidemic

    Science.gov (United States)

    Tomashek, Kay M.; Gregory, Christopher J.; Rivera Sánchez, Aidsa; Bartek, Matthew A.; Garcia Rivera, Enid J.; Hunsperger, Elizabeth; Muñoz-Jordán, Jorge L.; Sun, Wellington

    2012-01-01

    Background The incidence and severity of dengue in Latin America has increased substantially in recent decades and data from Puerto Rico suggests an increase in severe cases. Successful clinical management of severe dengue requires early recognition and supportive care. Methods Fatal cases were identified among suspected dengue cases reported to two disease surveillance systems and from death certificates. To be included, fatal cases had to have specimen submitted for dengue diagnostic testing including nucleic acid amplification for dengue virus (DENV) in serum or tissue, immunohistochemical testing of tissue, and immunoassay detection of anti-DENV IgM from serum. Medical records from laboratory-positive dengue fatal case-patients were reviewed to identify possible determinants for death. Results Among 10,576 reported dengue cases, 40 suspect fatal cases were identified, of which 11 were laboratory-positive, 14 were laboratory-negative, and 15 laboratory-indeterminate. The median age of laboratory-positive case-patients was 26 years (range 5 months to 78 years), including five children aged Dengue was listed on the death certificate in only 5 instances. Conclusions During a dengue epidemic in an endemic area, none of the 11 laboratory-positive case-patients who died were managed according to current WHO Guidelines. Management issues identified in this case-series included failure to recognize warning signs for severe dengue and shock, prolonged ED stays, and infrequent patient monitoring. PMID:22530072

  12. NCHS Data on Drug-poisoning Deaths

    Science.gov (United States)

    ... Explore opportunities to link electronic death records to electronic health records. Develop capacity to support monthly reporting of drug- ... RSS ABOUT About CDC Jobs Funding LEGAL Policies Privacy FOIA No Fear Act OIG 1600 Clifton Road ...

  13. Quantifying underreporting of law-enforcement-related deaths in United States vital statistics and news-media-based data sources: A capture-recapture analysis.

    Science.gov (United States)

    Feldman, Justin M; Gruskin, Sofia; Coull, Brent A; Krieger, Nancy

    2017-10-01

    Prior research suggests that United States governmental sources documenting the number of law-enforcement-related deaths (i.e., fatalities due to injuries inflicted by law enforcement officers) undercount these incidents. The National Vital Statistics System (NVSS), administered by the federal government and based on state death certificate data, identifies such deaths by assigning them diagnostic codes corresponding to "legal intervention" in accordance with the International Classification of Diseases-10th Revision (ICD-10). Newer, nongovernmental databases track law-enforcement-related deaths by compiling news media reports and provide an opportunity to assess the magnitude and determinants of suspected NVSS underreporting. Our a priori hypotheses were that underreporting by the NVSS would exceed that by the news media sources, and that underreporting rates would be higher for decedents of color versus white, decedents in lower versus higher income counties, decedents killed by non-firearm (e.g., Taser) versus firearm mechanisms, and deaths recorded by a medical examiner versus coroner. We created a new US-wide dataset by matching cases reported in a nongovernmental, news-media-based dataset produced by the newspaper The Guardian, The Counted, to identifiable NVSS mortality records for 2015. We conducted 2 main analyses for this cross-sectional study: (1) an estimate of the total number of deaths and the proportion unreported by each source using capture-recapture analysis and (2) an assessment of correlates of underreporting of law-enforcement-related deaths (demographic characteristics of the decedent, mechanism of death, death investigator type [medical examiner versus coroner], county median income, and county urbanicity) in the NVSS using multilevel logistic regression. We estimated that the total number of law-enforcement-related deaths in 2015 was 1,166 (95% CI: 1,153, 1,184). There were 599 deaths reported in The Counted only, 36 reported in the NVSS

  14. Simultaneous activation of mitophagy and autophagy by staurosporine protects against dopaminergic neuronal cell death.

    Science.gov (United States)

    Ha, Ji-Young; Kim, Ji-Soo; Kim, Seo-Eun; Son, Jin H

    2014-02-21

    Abnormal autophagy is frequently observed during dopaminergic neurodegeneration in Parkinson's disease (PD). However, it is not yet firmly established whether active autophagy is beneficial or pathogenic with respect to dopaminergic cell loss. Staurosporine, a common inducer of apoptosis, is often used in mechanistic studies of dopaminergic cell death. Here we report that staurosporine activates both autophagy and mitophagy simultaneously during dopaminergic neuronal cell death, and evaluate the physiological significance of these processes during cell death. First, staurosporine treatment resulted in induction of autophagy in more than 75% of apoptotic cells. Pharmacological inhibition of autophagy by bafilomycin A1 decreased significantly cell viability. In addition, staurosporine treatment resulted in activation of the PINK1-Parkin mitophagy pathway, of which deficit underlies some familial cases of PD, in the dopaminergic neuronal cell line, SN4741. The genetic blockade of this pathway by PINK1 null mutation also dramatically increased staurosporine-induced cell death. Taken together, our data suggest that staurosporine induces both mitophagy and autophagy, and that these pathways exert a significant neuroprotective effect, rather than a contribution to autophagic cell death. This model system may therefore be useful for elucidating the mechanisms underlying crosstalk between autophagy, mitophagy, and cell death in dopaminergic neurons. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  15. Brain death and the historical understanding of bioethics.

    Science.gov (United States)

    Belkin, Gary S

    2003-07-01

    In a 1968 Report, the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death promulgated influential criteria for the idea and practice known as "brain death." Before and since the Committee met, brain death has been a focal point of visions and nightmares of medical progress, purpose, and moral authority. Critics of the Committee felt it was deaf to apparently central moral considerations and focused on the self-serving purpose of expanding transplantation. Historical characterizations of the uses and meanings of brain death and the work of the Committee have tended to echo these themes, which means also generally repeating a widely held bioethical self-understanding of how the field appeared-that is, as a necessary antidote of moral expertise. This paper looks at the Committee and finds that historical depictions of it have been skewed by such a bioethical agenda. Entertaining different possibilities as to the motives and historical circumstances behind the Report it famously produced may point to not only different histories of the Committee, but also different perspectives on the historical legacy and role of bioethics as a discourse for addressing anxieties about medicine.

  16. Impact of child death on paediatric trainees.

    Science.gov (United States)

    Hollingsworth, Clare E; Wesley, Carla; Huckridge, Jaymie; Finn, Gabrielle M; Griksaitis, Michael J

    2018-01-01

    To assess the prevalence of symptoms of acute stress reactions (ASR) and post-traumatic stress disorder (PTSD) in paediatric trainees following their involvement in child death. A survey designed to identify trainees' previous experiences of child death combined with questions to identify features of PTSD. Quantitative interpretation was used alongside a χ 2 test. A p value of death of a child, although 190/284 (67%) had no training in child death. 118/248 (48%) of trainees were given a formal debrief session following their most recent experience. 203/251 (81%) of trainees reported one or more symptoms or behaviours that could contribute to a diagnosis of ASR/PTSD. 23/251 (9%) of trainees met the complete criteria for ASR and 13/251 (5%) for PTSD. Attending a formal debrief and reporting feelings of guilt were associated with an increase in diagnostic criteria for ASR/PTSD (p=0.036 and pdeath of a child. The feeling of guilt should be identified and acknowledged to allow prompt signposting to further support, including psychological assessment or intervention if required. Clear recommendations need to be made about the safety of debriefing sessions as, in keeping with existing evidence, our data suggest that debrief after the death of a child may be associated with the development of symptoms suggestive of ASR/PTSD. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  17. Burden of sudden cardiac death in persons aged 1 to 49 years

    DEFF Research Database (Denmark)

    Risgaard, Bjarke; Winkel, Bo Gregers; Jabbari, Reza

    2014-01-01

    : All deaths in persons aged 1 to 49 years were included in 2007 to 2009. Death certificates were reviewed by 2 physicians. History of previous admissions to hospital was assessed, and discharge summaries were read. Sudden unexpected death cases were identified and autopsy reports were collected...

  18. Causes and pattern of death in a tertiary hospital in south eastern Nigeria

    Directory of Open Access Journals (Sweden)

    C C Nwafor Chukwuemeka Charles

    2014-01-01

    Full Text Available Background: Morbidity and mortality pattern is a reflection of disease burden. The aim of this study is to provide a comprehensive report of the causes of death in a tertiary hospital in Nigeria, a developing tropical nation. Methods and Material: We carried out a retrospective descriptive cross-sectional study of all records of deaths from January 2004 to December 2008 in Federal Medical Centre Umuahia, Abia, State in Southeast Nigeria. Results: Of a total of 18,107 patients were admitted during the study period, 2;172 deaths representing 12% mortality rate and comprising 1;230 (56.6% males and 942 (43.4% females were recorded. The age of patients ranged from birth to 100 years with a mean of 41.41 ± 26.30 years and 25-44 years age group being the most affected (n = 587, 27.1%. The overall leading cause of death was the infections group, which accounted for 837 (37.6% deaths. Other major causes were cardiovascular system -related deaths 534 (24.7%, neonatal causes 173 (8.0%, trauma 155 (7.1%, diabetes mellitus complications 144 (6.6% and neoplasia 76 (3.5%. Conclusion: Majority of the leading causes of mortality in this study are preventable. Our data reflects the effects of double disease burden of infections and non- communicable communicable diseases in a developing nation.

  19. A computer code for Cohort Analysis of Increased Risks of Death (CAIRD). Technical report

    International Nuclear Information System (INIS)

    Cook, J.R.; Bunger, B.M.; Barrick, M.K.

    1978-06-01

    The most serious health risk confronting individuals exposed to radiation is death from an induced cancer. Since cancers usually do no develop until many years after exposure, other causes of death may intervene and take the lives of those destined to die from cancer. This computer code has been developed to aid risk analysis by calculating the number of premature deaths and loss of years of life produced by a hypothetical population after exposure to a given risk situation. The code generates modified life tables and estimates the impact of increased risk through several numerical comparisons with the appropriate reference life tables. One of the code's frequent applications is in estimating the number of radiation induced deaths that would result from exposing an initial population of 100,000 individuals to an annual radiation dose. For each risk situation analyzed, the computer code generates a summary table which documents the input, data and contains the results of the comparisons with reference life tables

  20. Quality insights of university teachers on dying, death, and death education.

    Science.gov (United States)

    Mak, Mui-Hing June

    One of the main responsibilities of teachers is to help individual students cope with life difficulties such as grief following a death. However, very little research explores teachers' views on death, dying, and how they handle grief and loss in schools. This study aims to explore university teachers' knowledge and attitudes on dying, death, and death education. Fifteen university teachers were recruited using a qualitative method. This study reveals that most teachers' views on death and related issues are largely affected by their death experiences, religious beliefs, professional background, and the mass media. Although they have a general negative response toward death and dying, some teachers begin to affirm their meanings of life and death. Most teachers agree that they do not feel adequate about managing and teaching on life and death issues, so they strongly support including death education in the formal programs in Hong Kong.

  1. Early CT findings to predict early death in patients with traumatic brain injury: Marshall and Rotterdam CT scoring systems compared in the major academic tertiary care hospital in northeastern Japan.

    Science.gov (United States)

    Mata-Mbemba, Daddy; Mugikura, Shunji; Nakagawa, Atsuhiro; Murata, Takaki; Ishii, Kiyoshi; Li, Li; Takase, Kei; Kushimoto, Shigeki; Takahashi, Shoki

    2014-05-01

    Computed tomography (CT) plays a crucial role in early assessment of patients with traumatic brain injury (TBI). Marshall and Rotterdam are the mostly used scoring systems, in which CT findings are grouped differently. We sought to determine the scoring system and initial CT findings predicting the death at hospital discharge (early death) in patients with TBI. We included 245 consecutive adult patients with mild-to-severe TBI. Their initial CT and status at hospital discharge (dead or alive) were reviewed, and both CT scores were calculated. We examined whether each score was related to early death; compared the two scoring systems' performance in predicting early death, and identified the CT findings that are independent predictors of early death. More deaths occurred among patients with higher Marshall and Rotterdam scores (both P death (Marshall, AUC = 0. 85 vs. Rotterdam, AUC = 0.85). Basal cistern absence (odds ratio [OR] = 771.5, P death. Both Marshall and Rotterdam scoring systems can be used to predict early death in patients with TBI. The performance of the Marshall score is at least equal to that of the Rotterdam score. Thus, although older, the Marshall score remains useful in predicting patients' prognosis. Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.

  2. Near-death experiences, posttraumatic growth, and life satisfaction among burn survivors.

    Science.gov (United States)

    Royse, David; Badger, Karen

    2017-03-01

    Survivors of large burns may face positive and negative psychological after-effects from close-to-death injuries. This study is the first to examine their near-death experiences (NDEs) and posttraumatic growth (PTG) and life satisfaction afterwards. With an available sample of 92 burn survivors, half met the criteria for an NDE using an objective scale. Those who indicated religion was a source of strength and comfort had high scores on life satisfaction, PTG, and the NDE Scale. Individuals with larger burns reported greater PTG than those with smaller total body surface area burned (TBSA). There were no significant differences on life satisfaction, PTG, or NDEs when examined by gender or years since the burn injury. Elements of the NDE most frequently reported were: An altered sense of time, a sense of being out of the physical body, a feeling of peace, vivid sensations, and sense of being in an "other worldly" environment. Social workers and other health providers need to be comfortable helping burn survivors discuss any NDEs and process these through survivors' spirituality and religious belief systems as they recover.

  3. [Death of Napoleon Bonaparte].

    Science.gov (United States)

    Camici, M

    2003-06-01

    The causa mortis of Napoleon Bonaparte has been vexata quaestio for a long time. The author tries to outline a picture of Napoleon from a sanitary point of view. From the report of doctor Francesco Antonmarchi who performed the autopsy, the author tries to understans the cause of death: gastric perforation due to malignant ulcer and subsequent peritonitis with pulmonary tubercolosis.

  4. Otolaryngological aspects of sudden infant death syndrome.

    Science.gov (United States)

    Marom, Tal; Cinamon, Udi; Castellanos, Paul F; Cohen, Marta C

    2012-03-01

    Sudden infant death syndrome (SIDS) is characterized by the sudden death of an apparently otherwise healthy infant, typically during sleep, and with no obvious case after a thorough post-mortem and scene death examination. To address the problem from the otolaryngologist's perspective, describe relevant pathologies, discuss controversies and suggest preventive measures in high-risk populations. A MEDLINE search and hand search were conducted to identify reports published between 1969 and 2011 in the English language on the pathophysiology of SIDS related to the head and neck organs. Search terms included SIDS (MeSH term), SIDS and pathophysiology (text words), and SIDS and autopsy (text words). A growing number of reports suggested head and neck organs involvement in SIDS autopsies. Laryngeal, oropharyngeal, maxillofacial, otologic, cervical vascular abnormalities and infectious etiologies, were recognized and discussed. Otolaryngologists should be aware of relevant pathologies, as some are treatable, if identified early enough in infancy. A proactive risk-management approach is warranted in infants presenting with certain abnormalities reviewed here. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  5. Declining risk of sudden death in heart failure

    DEFF Research Database (Denmark)

    Shen, Li; Jhund, Pardeep S.; Petrie, Mark C.

    2017-01-01

    BACKGROUND The risk of sudden death has changed over time among patients with symptomatic heart failure and reduced ejection fraction with the sequential introduction of medications including angiotensin-converting-enzyme inhibitors, angiotensin-receptor blockers, beta-blockers, and mineralocorti......BACKGROUND The risk of sudden death has changed over time among patients with symptomatic heart failure and reduced ejection fraction with the sequential introduction of medications including angiotensin-converting-enzyme inhibitors, angiotensin-receptor blockers, beta...... cardioverter-defibrillator at the time of trial enrollment were excluded. Weighted multivariable regression was used to examine trends in rates of sudden death over time. Adjusted hazard ratios for sudden death in each trial group were calculated with the use of Cox regression models. The cumulative incidence...... rates of sudden death were assessed at different time points after randomization and according to the length of time between the diagnosis of heart failure and randomization. RESULTS Sudden death was reported in 3583 patients. Such patients were older and were more often male, with an ischemic cause...

  6. Changes in siblings after the death of a child from cancer.

    Science.gov (United States)

    Foster, Terrah L; Gilmer, Mary Jo; Vannatta, Kathryn; Barrera, Maru; Davies, Betty; Dietrich, Mary S; Fairclough, Diane L; Gerhardt, Cynthia A

    2012-01-01

    Few studies have examined changes in siblings after the death of a brother or sister, particularly from mother, father, and sibling perspectives within the first year after death. This descriptive study identified and assessed the frequency of changes in siblings after a child's death from cancer. Participants were recruited from cancer registries at 3 hospitals in the United States and Canada 3 to 12 months after the child's death. Thirty-six mothers, 24 fathers, and 39 siblings from 40 families were included. Semistructured interviews using open-ended questions were conducted with each parent and sibling separately in the home. Content analysis identified emerging themes, and the McNemar tests compared frequencies between each paired set of reports (sibling vs mother, sibling vs father, mother vs father). Sixty-nine percent of participants reported personal changes in siblings (eg, changes in personality, school work, goals/life perspective, activities/interests). Forty-seven percent noted changes in siblings' relationships with family members and peers. Only 21% of participants reported no changes attributed to the death. Comparisons of frequencies across informants were not significant. Most siblings experienced changes in multiple areas of their lives after the death of a brother or sister to cancer. Some changes reflected siblings that were positively adapting to the death, whereas other changes reflected difficulties. Our findings offer guidance to improve aftercare for bereaved siblings and their families. Additional research is needed to further delineate the needs of bereaved siblings and to develop strategies to promote adaptation to loss.

  7. Left Ventricular Aneurysm: Sudden Unexpected Deaths in a 29-Year-Old Man.

    Science.gov (United States)

    Srettabunjong, Supawon

    2018-05-01

    Left ventricular aneurysm (LVA) is an abnormal dilated heart structure, either congenital or acquired. LVA is a rare cardiac condition with no symptoms in most cases, thus occasionally diagnosed during investigations of other diseases. Its association with certain cardiac complications and sudden cardiac deaths has been reported. However, its role as a cause of sudden unexpected death is rare. The author reported a sudden cardiac death in a 29-year-old man with LVA. Without a significant coronary artery disease and known etiologies of LVA, such an abnormal heart structure in the present case was considered congenital LVA. As no other possible mechanisms of death could be identified other than LVA with its associated pathologic lesions, mural thrombi, and dilated cardiomegaly, his death was attributable to fatal cardiac arrhythmia (most commonly ventricular tachycardia) secondary to LVA. © 2017 American Academy of Forensic Sciences.

  8. Use of the Coding Causes of Death in HIV in the classification of deaths in Northeastern Brazil.

    Science.gov (United States)

    Alves, Diana Neves; Bresani-Salvi, Cristiane Campello; Batista, Joanna d'Arc Lyra; Ximenes, Ricardo Arraes de Alencar; Miranda-Filho, Demócrito de Barros; Melo, Heloísa Ramos Lacerda de; Albuquerque, Maria de Fátima Pessoa Militão de

    2017-01-01

    Describe the coding process of death causes for people living with HIV/AIDS, and classify deaths as related or unrelated to immunodeficiency by applying the Coding Causes of Death in HIV (CoDe) system. A cross-sectional study that codifies and classifies the causes of deaths occurring in a cohort of 2,372 people living with HIV/AIDS, monitored between 2007 and 2012, in two specialized HIV care services in Pernambuco. The causes of death already codified according to the International Classification of Diseases were recoded and classified as deaths related and unrelated to immunodeficiency by the CoDe system. We calculated the frequencies of the CoDe codes for the causes of death in each classification category. There were 315 (13%) deaths during the study period; 93 (30%) were caused by an AIDS-defining illness on the Centers for Disease Control and Prevention list. A total of 232 deaths (74%) were related to immunodeficiency after application of the CoDe. Infections were the most common cause, both related (76%) and unrelated (47%) to immunodeficiency, followed by malignancies (5%) in the first group and external causes (16%), malignancies (12 %) and cardiovascular diseases (11%) in the second group. Tuberculosis comprised 70% of the immunodeficiency-defining infections. Opportunistic infections and aging diseases were the most frequent causes of death, adding multiple disease burdens on health services. The CoDe system increases the probability of classifying deaths more accurately in people living with HIV/AIDS. Descrever o processo de codificação das causas de morte em pessoas vivendo com HIV/Aids, e classificar os óbitos como relacionados ou não relacionados à imunodeficiência aplicando o sistema Coding Causes of Death in HIV (CoDe). Estudo transversal, que codifica e classifica as causas dos óbitos ocorridos em uma coorte de 2.372 pessoas vivendo com HIV/Aids acompanhadas entre 2007 e 2012 em dois serviços de atendimento especializado em HIV em

  9. Estimating external causes of death in Thailand 1996-2009 based on the 2005 Verbal Autopsy study

    Directory of Open Access Journals (Sweden)

    Nuntaporn Klinjun

    2014-12-01

    Full Text Available This study aimed to develop models based on Verbal Autopsy (VA data and to estimate correct number of deaths from external causes in Thailand from 1996 to 2009. Logistic regression was used to create models of the three external causes of death classified by province, gender-age group and Vital registration (VR cause-location group. Receiver operating characteristic (ROC curves were used to validate the models by matching the number of reported deaths to the number of deaths predicted by the models. The models provided accurate prediction results, with false positive error rates 1.6%, 2.0% and 0.6% and sensitivities 73.8%, 46.3% and 62.0%, respectively. The results reveal that under-reporting of external causes of death increased over the 14-year period. Our statistical method confirms that the Thai 2005 VA data can be used to estimate external causes of death from VR report in Thailand to allow for the under-reporting rate.

  10. Changes in parents after the death of a child from cancer.

    Science.gov (United States)

    Gilmer, Mary Jo; Foster, Terrah L; Vannatta, Kathryn; Barrera, Maru; Davies, Betty; Dietrich, Mary S; Fairclough, Diane L; Grollman, Jamie; Gerhardt, Cynthia A

    2012-10-01

    Few studies have compared multiple perspectives of changes experienced by parents after a child's death. This study used interviews with bereaved parents and siblings to examine changes in parents during the first year after the death of a child from cancer. Mothers (n=36), fathers (n=24), and siblings (n=39) from 40 families were recruited from three hospitals in the U.S. and Canada three to 12 months after the death (M=10.7, SD=3.5). Semistructured interviews with open-ended questions were conducted in the home with each participating parent and sibling separately. Content analysis identified emerging themes, and frequencies were compared between each paired set of reports (mother vs. sibling, father vs. sibling, and mother vs. father). Parents and siblings identified two major categories of change experienced by bereaved parents. These changes occurred in their personal lives (e.g., emotions, perspectives and priorities, physical state, work habits, coping/behaviors, spiritual beliefs, and feeling something is missing) and relationships (e.g., family, others). Ninety-four percent of the mothers, 87% of the fathers, and 69% of the siblings reported parental changes in at least one of these categories. Parents were more likely to report changes in priorities, whereas siblings reported more sadness in parents after the death. Positive and negative changes in parents after the death of a child from cancer occur in both personal and relational domains. Additional research is needed to determine the impact of a child's death on bereaved parents over time and to develop strategies to promote healthy adjustment. Copyright © 2012 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

  11. Exploring children's understanding of death: through drawings and the Death Concept Questionnaire.

    Science.gov (United States)

    Bonoti, Fotini; Leondari, Angeliki; Mastora, Adelais

    2013-01-01

    To investigate whether children's understanding of the concept of death varies as a function of death experience and age, 52 children aged 7, 9, and 11 years (26 had a personal death experience), drew a picture reflecting the meaning of the word death and completed the Death Concept Questionnaire for examination of Human and Animal Death. The results showed that the 2 methodological tools used offered complementary information and that children's understanding of death is related both to age and past experience. Children with death experience seem to have a more realistic understanding of death than their inexperienced age-mates. As regards to the effect of age, our findings support the assumption that the different components of death develop through different processes.

  12. Near-Death Experiences and the "Fantasy-Prone" Personality: Preliminary Findings.

    Science.gov (United States)

    Council, James R.; Greyson, Bruce

    Near-death experiences (NDEs) are subjective experiences at the threshold of death which can include strong positive affect, dissociation from the physical body, and paranormal/transcendental phenomena. Empirical investigation of NDEs has typically relied upon retrospective reports and personality studies of individuals who have come close to…

  13. Population-based studies of antithyroid drugs and sudden cardiac death

    NARCIS (Netherlands)

    C. van Noord (Charlotte); M.C.J.M. Sturkenboom (Miriam); S.M.J.M. Straus (Sabine); A. Hofman (Albert); J.C.M. Witteman (Jacqueline); B.H.Ch. Stricker (Bruno)

    2009-01-01

    textabstractWHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • Thyroid hormone free T4 is associated with QTc-interval prolongation, which is a risk factor for sudden cardiac death. • The association between hyperthyroidism and ventricular arrhythmias or sudden cardiac death has been reported in several

  14. Autophagic cell death: Loch Ness monster or endangered species?

    Science.gov (United States)

    Shen, Han-Ming; Codogno, Patrice

    2011-05-01

    The concept of autophagic cell death was first established based on observations of increased autophagic markers in dying cells. The major limitation of such a morphology-based definition of autophagic cell death is that it fails to establish the functional role of autophagy in the cell death process, and thus contributes to the confusion in the literature regarding the role of autophagy in cell death and cell survival. Here we propose to define autophagic cell death as a modality of non-apoptotic or necrotic programmed cell death in which autophagy serves as a cell death mechanism, upon meeting the following set of criteria: (i) cell death occurs without the involvement of apoptosis; (ii) there is an increase of autophagic flux, and not just an increase of the autophagic markers, in the dying cells; and (iii) suppression of autophagy via both pharmacological inhibitors and genetic approaches is able to rescue or prevent cell death. In light of this new definition, we will discuss some of the common problems and difficulties in the study of autophagic cell death and also revisit some well-reported cases of autophagic cell death, aiming to achieve a better understanding of whether autophagy is a real killer, an accomplice or just an innocent bystander in the course of cell death. At present, the physiological relevance of autophagic cell death is mainly observed in lower eukaryotes and invertebrates such as Dictyostelium discoideum and Drosophila melanogaster. We believe that such a clear definition of autophagic cell death will help us study and understand the physiological or pathological relevance of autophagic cell death in mammals.

  15. Survival and sudden cardiac death after septal ablation for hypertrophic obstructive cardiomyopathy

    DEFF Research Database (Denmark)

    Jensen, Morten Kvistholm; Havndrup, Ole; Hassager, Christian

    2011-01-01

    Reports of long-term survival and the risk of sudden cardiac death (SCD) after percutaneous transluminal septal myocardial ablation (PTSMA) in patients with hypertrophic obstructive cardiomyopathy (HOCM) are sparse.......Reports of long-term survival and the risk of sudden cardiac death (SCD) after percutaneous transluminal septal myocardial ablation (PTSMA) in patients with hypertrophic obstructive cardiomyopathy (HOCM) are sparse....

  16. National data system on near miss and maternal death: shifting from maternal risk to public health impact in Nigeria

    Directory of Open Access Journals (Sweden)

    Oladapo Olufemi T

    2009-06-01

    Full Text Available Abstract Background The lack of reliable and up-to-date statistics on maternal deaths and disabilities remains a major challenge to the implementation of Nigeria's Road Map to Accelerate the Millennium Development Goal related to Maternal Health (MDG-5. There are currently no functioning national data sources on maternal deaths and disabilities that could serve as reference points for programme managers, health advocates and policy makers. While awaiting the success of efforts targeted at overcoming the barriers facing establishment of population-based data systems, referral institutions in Nigeria can contribute their quota in the quest towards MDG-5 by providing good quality and reliable information on maternal deaths and disabilities on a continuous basis. This project represents the first opportunity to initiate a scientifically sound and reliable quantitative system of data gathering on maternal health profile in Nigeria. Objective The primary objective is to create a national data system on maternal near miss (MNM and maternal mortality in Nigerian public tertiary institutions. This system will conduct periodically, both regionally and at country level, a review of the magnitude of MNM and maternal deaths, nature of events responsible for MNM and maternal deaths, indices for the quality of care for direct obstetric complications and the health service events surrounding these complications, in an attempt to collectively define and monitor the standard of comprehensive emergency obstetric care in the country. Methods This will be a nationwide cohort study of all women who experience MNM and those who die from pregnancy, childbirth and puerperal complications using uniform criteria among women admitted in tertiary healthcare facilities in the six geopolitical zones in Nigeria. This will be accomplished by establishing a network of all public tertiary obstetric referral institutions that will prospectively collect specific information on

  17. Mathematical model of reproductive death of irradiated eukaryotic cells, which considers saturation of DNA reparation system

    International Nuclear Information System (INIS)

    Knyigavko, V.G.; Ponomarenko, N.S.; Meshcheryakova, O.P.; Protasenya, S.Yu.

    2009-01-01

    A mathematical model of the processes determining reproductive death of the exposed cells was built. The model takes into account the phenomenon of saturation of the system of DNA radiation lesion reparation and structural functional peculiarities of chromatin structure in eukaryotes. The problem of assessment of the model parameters using experimental data was discussed.

  18. Cell death in Pseudomonas aeruginosa biofilm development

    DEFF Research Database (Denmark)

    Webb, J.S.; Thompson, L.S.; James, S.

    2003-01-01

    Bacteria growing in biofilms often develop multicellular, three-dimensional structures known as microcolonies. Complex differentiation within biofilms of Pseudomonas aeruginosa occurs, leading to the creation of voids inside microcolonies and to the dispersal of cells from within these voids....... However, key developmental processes regulating these events are poorly understood. A normal component of multicellular development is cell death. Here we report that a repeatable pattern of cell death and lysis occurs in biofilms of P. aeruginosa during the normal course of development. Cell death...... occurred with temporal and spatial organization within biofilms, inside microcolonies, when the biofilms were allowed to develop in continuous-culture flow cells. A subpopulation of viable cells was always observed in these regions. During the onset of biofilm killing and during biofilm development...

  19. Reliability of cause of death coding: an international comparison.

    Science.gov (United States)

    Antini, Carmen; Rajs, Danuta; Muñoz-Quezada, María Teresa; Mondaca, Boris Andrés Lucero; Heiss, Gerardo

    2015-07-01

    This study evaluates the agreement of nosologic coding of cardiovascular causes of death between a Chilean coder and one in the United States, in a stratified random sample of death certificates of persons aged ≥ 60, issued in 2008 in the Valparaíso and Metropolitan regions, Chile. All causes of death were converted to ICD-10 codes in parallel by both coders. Concordance was analyzed with inter-coder agreement and Cohen's kappa coefficient by level of specification ICD-10 code for the underlying cause and the total causes of death coding. Inter-coder agreement was 76.4% for all causes of death and 80.6% for the underlying cause (agreement at the four-digit level), with differences by the level of specification of the ICD-10 code, by line of the death certificate, and by number of causes of death per certificate. Cohen's kappa coefficient was 0.76 (95%CI: 0.68-0.84) for the underlying cause and 0.75 (95%CI: 0.74-0.77) for the total causes of death. In conclusion, causes of death coding and inter-coder agreement for cardiovascular diseases in two regions of Chile are comparable to an external benchmark and with reports from other countries.

  20. Gender differences in sudden cardiac death in the young-a nationwide study

    DEFF Research Database (Denmark)

    Winkel, Bo Gregers; Risgaard, Bjarke; Bjune, Thea

    2017-01-01

    Background: Hitherto, sudden cardiac death (SCD) in the young has been described with no distinction between genders. SCD occurs more often in men (SCDm) than women (SCDw), but this disparity is not understood and has not been investigated systematically in a nationwide setting. Our objective......=0.02) and died less often in a public place (16 vs. 26%, p=0.01). Age at death, ratios of autopsies and sudden unexplained deaths, and comorbidities, did not differ. Causes of SCD were largely comparable between genders. The incidence rate of SCDw was half of that of SCDm (1.8 vs. 3.6 per 100...... was to report gender differences in SCD in the young in a nationwide (Denmark) setting. Methods: All deaths in persons aged 1-35 years nationwide in Denmark between 2000 and 2009 were included. Death certificates and autopsy reports were obtained. The extensive health care registries in Denmark were used...

  1. Deaths Due to Accidental Air Conditioner Compressor Explosion: A Case Series.

    Science.gov (United States)

    Behera, Chittaranjan; Bodwal, Jatin; Sikary, Asit K; Chauhan, Mohit Singh; Bijarnia, Manjul

    2017-01-01

    In an air-conditioning system, the compressor is a large electric pump that pressurizes the refrigerant gas as part of the process of turning it back into a liquid. The explosion of an air conditioner (AC) compressor is an uncommon event, and immediate death resulted from the blast effect is not reported in forensic literature. We report three such cases in which young AC mechanics were killed on the spot due to compressor blast, while repairing the domestic split AC unit. The autopsy findings, the circumstances leading to the explosion of the compressor, are discussed in this study. © 2016 American Academy of Forensic Sciences.

  2. Maternal Death Reviews of a Tertiary Care Hospital

    Directory of Open Access Journals (Sweden)

    Indira Upadhyaya

    2014-03-01

    Full Text Available Introduction: All pregnant women are at risk of obstetrical complications which occurs during labour and delivary that lead to maternal death. Here to report a 10 year review of maternal mortality ratio in "Paropakar Maternity and Women's Hospital (PMWH" Thapathali Kathmandu, Nepal. Methods: Medical records of 66 maternal deaths were reviewed to study the likely cause of each death over the study period. Results: There were a total of 66 maternal deaths. While 192487 deliveries conducted over the 10 year period. The maternal mortality ratio (MMR was 356.64/100000 live birth. The highest MMR of 74.22/100,000 was observed in 2059 and lowest was 17.42/100,000 in 2068 B.S. Leading cause of MMR was remained hemorrhage accounting for 30.30% followed by eclampsia 24.24%. Sepsis, suspected cases of pulmonary embolism and amniotic fluid embolism each contributing 15.15%, 4.54% and 3.03% respectively. Where as anesthetic complication and abortion constiuates 6.06 % each equally for maternal death. The death noted in older women (30+year were 36.36%. Primipara accounted for more deaths (51.51%. Conclusions: The fall in maternal mortality rate has been observed except for year 2063 BS. Haemorrhage is the main contributing cause behind maternal mortality.

  3. Postmortem computed tomography for diagnosis of cause of death in male prisoners

    International Nuclear Information System (INIS)

    Sohail, S.; Khan, Q.S.; Mirza, F.H.

    2010-01-01

    To determine the utility of postmortem CT (PMCT) examination in establishing the cause of death among male prisoners dying in Karachi jails. A descriptive study was carried out from February 2006 to September 2007, CT Scan section, Civil Hospital Karachi and the Mortuary, Dow Medical College, Dow University of Health Sciences, Karachi. Adult male prisoners dying in the Karachi central prison and referred to the study setting for determining the cause of death for medico legal purpose were included. Female prisoners and those cases where the final report of cause of death was not available were excluded. CT scan of the vital body regions (head, neck, thorax, abdomen and pelvis) was carried out in all cases. The scan was read and reported by two radiologists. Anatomical dissection based autopsy was carried out by the forensic expert. Final report regarding the cause of death was issued by the forensic expert based on the combined findings, histopathology, toxicology results and circumstantial evidence. The CT scan and autopsy findings were compared and percentage agreement was determined using kappa statistics. There were 14 cases in all with mean age of 41.2 +- 17 years. The alleged mode of death was custodial torture in all cases. CT scan determined the cause of death to be natural cardio-respiratory failure in 10, strangulation in 01, pulmonary tuberculosis (TB) in 02 and trauma to spine in 01 case. The autopsy determined natural death in 11 and pulmonary TB in 02 and asphyxia in 01. The percentage agreement between CT and autopsy was 92% (k=0.92) and between CT and finalized cause of death was 100% (k=1.0). PMCT is as effective as dissection autopsy in identifying pulmonary infections and natural causes of death. It is more effective in identifying vertebral fractures which may exclude hanging and corroborate trauma to spine (JPMA 60:4; 2010). (author)

  4. Deaths of cancer cells observed after X-Ray irradiation

    International Nuclear Information System (INIS)

    Kuwahara, Yoshikazu; Oikawa, Toshiyuki; Ochiai, Yasushi; Fukumoto, Motoi; Kurihara, Ai; Noma, Naoto; Shimura, Tsutomu; Fukumoto, Manabu; Ohkubo, Yasuhito

    2011-01-01

    Radiation induces cell death by apoptosis, autophagy (autophagic cell death, APCD), necrosis, which are respectively called type I, II, III programmed cell death, senescence, mitotic catastrophe, etc. This paper mainly describes details of authors' studies on APCD of clinically relevant radioresistant (CRR) HepG2-8960-R cells established from proliferating survivor even after repeated X-irradiation of >30 days x 2 Gy/day to the parent HepG2 cells. Autophagy forms autophagosome where many proteins are thoroughly degraded differing from proteasomal ubiquitin system, has been known essentially related to death and survival of injured cells under certain tissue conditions, and is distinguishable from other modes of cell death by morphological and cytochemical means. One of important authors' findings is as follows. APCD of CRR cells is normally seen in 20% and of the parent strain, 5%. When they are X-irradiated at 10 Gy, APCD of the latter is more (70%) than the former (40%), and no APCD is induced by 2 Gy x 5 days in the former in contrast to the latter. APCD by radiation is thus conceivably suppressed in CRR cells, suggesting that their radioresistance can be reversed by treatment to induce APCD. Autophagy is usually suppressed by mammalian target of rapamycin (mTOR), and when CRR cells are treated with rapamycin, they become radiosensitive to the comparable level to the parent HepG2. When HepG2 cells are treated with 3-methyladenine, an inhibitor of autophagy, or Beclin siRNA, they become radioresistant. For effectiveness of APCD induction and suppression on cancer therapy, results are contradictory in certain reports and autophagy should be a problem to be further elucidated from radiation biology aspect. (author)

  5. anaesthetic registrars' experiences of perioperative death

    African Journals Online (AJOL)

    Death on the table: anaesthetic registrars' experiences of perioperative ... aDepartment of Anaesthesiology and Critical Care, University of KwaZulu-Natal, Durban, South Africa ... Results: Themes expressed by participants fell into three broad categories: ... number (up to 70%) of anaesthetists report experiencing adverse.

  6. Estimation of date of death through wound healing of an extraction socket: A case report.

    Science.gov (United States)

    Viciano, Joan; D'Anastasio, Ruggero; D'Ovidio, Cristian; Costantini, Sara; Carnevale, Aldo; Capasso, Luigi

    2017-06-01

    Surgical extraction of teeth due to dental pathologies is a relatively common procedure in modern man. The healing of the wound that results occurs in gradual and sequential stages, such that the analysis of this repair process can be very useful in forensic investigations on human remains. The following study reports on a particular case where the remodeling of a tooth socket allowed an estimation of the time that had elapsed from the day of the surgical extraction of the tooth to the time of death. The corpse was that of a woman of 34 years. It was in an advanced state of decomposition, as it was largely skeletonized. Macroscopic, radiographic, and histological examinations of the oral cavity showed the initial stages of alveolar bone remodeling of the first left mandibular molar, which was characterized by: (i) a small reduction in the vertical height of the vestibular surface with respect to the theoretical original position of the tooth; (ii) resorption of the intra-alveolar septum and lamina dura; and (iii) formation of new immature bone, which covered the entire inner surface of the socket. This study established that the subject died 13-42days after the tooth extraction. Knowing the date of the dental extraction provided by the police investigation, it was possible to provide an estimate of the date of death. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Top 10 Causes of Death in the World

    Science.gov (United States)

    ... the-top-10-causes-of-death","@context":"http://schema.org","@type":"Article"}; العربية 中文 français русский español ... income countries have systems in place for collecting information on causes of death. Many low- and middle- ...

  8. Death by hanging while watching violent pornographic videos on the Internet - suicide or accidental autoerotic death?

    Science.gov (United States)

    Vennemann, B; Pollak, S

    2006-03-01

    In deaths by hanging, it may sometimes be difficult to differentiate between autoerotic accident and suicide. Our report deals with a 30-year-old man who was found hanged in the living room of his flat. The deceased was wearing headphones connected to a PC. Within the deceased's view was a computer screen showing the last picture of a video file downloaded from the Internet with the head of an unclothed, allegedly hanged female. The deceased's left hand was inside his trousers in the genital region. The autopsy did not only show findings typical for hanging, but also advanced sarcoidosis, which was known to the victim. Although this basic illness could have been a possible motive for suicide, the circumstances in the presented case pointed more in the direction of an accidental autoerotic death. As far as we know, this is the first description of a death during autoerotic activity in which sexual stimulation was achieved by watching a video file downloaded from the Internet.

  9. Causes of deaths data, linkages and big data perspectives.

    Science.gov (United States)

    Rey, Grégoire; Bounebache, Karim; Rondet, Claire

    2018-07-01

    The study of cause-specific mortality data is one of the main sources of information for public health monitoring. In most industrialized countries, when a death occurs, it is a legal requirement that a medical certificate based on the international form recommended by World Health Organization's (WHO) is filled in by a physician. The physician reports the causes of death that directly led or contributed to the death on the death certificate. The death certificate is then forwarded to a coding office, where each cause is coded, and one underlying cause is defined, using the rules of the International Classification of Diseases and Related Health Problems, now in its 10th Revision (ICD-10). Recently, a growing number of countries have adopted, or have decided to adopt, the coding software Iris, developed and maintained by an international consortium 1 . This whole standardized production process results in a high and constantly increasing international comparability of cause-specific mortality data. While these data could be used for international comparisons and benchmarking of global burden of diseases, quality of care and prevention policies, there are also many other ways and methods to explore their richness, especially when they are linked with other data sources. Some of these methods are potentially referring to the so-called "big data" field. These methods could be applied both to the production of the data, to the statistical processing of the data, and even more to process these data linked to other databases. In the present note, we depict the main domains in which this new field of methods could be applied. We focus specifically on the context of France, a 65 million inhabitants country with a centralized health data system. Finally we will insist on the importance of data quality, and the specific problematics related to death certification in the forensic medicine domain. Copyright © 2016 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All

  10. Accidental death due to complete autoerotic asphyxia associated with transvestic fetishism and anal self-stimulation - case report.

    Science.gov (United States)

    Atanasijević, Tatjana; Jovanović, Aleksandar A; Nikolić, Slobodan; Popović, Vesna; Jasović-Gasić, Miroslava

    2009-06-01

    A case is reported of a 36-year-old male, found dead in his locked room, lying on a bed, dressed in his mother's clothes, with a plastic bag over his head, hands tied and with a barrel wooden cork in his rectum. Two pornographic magazines were found on a chair near the bed, so that the deceased could see them well. Asphyxia was controlled with a complex apparatus which consisted of two elastic luggage rack straps, the first surrounding his waist, perineum, and buttocks, and the second the back of his body, and neck. According to the psychological autopsy based on a structured interview (SCID-I, SCID-II) with his father, the deceased was single, unemployed and with a part college education. He had grown up in a poor family with a reserved father and dominant mother, and was indicative of fulfilling DSM-IV diagnostic criteria for alcohol dependence, paraphilia involving hypoxyphilia with transvestic fetishism and anal masturbation and a borderline personality disorder. There was no evidence of previous psychiatric treatment. The Circumstances subscale of Beck's Suicidal Intent Scale (SIS-CS) pointed at the lack of final acts (thoughts or plans) in anticipation of death, and absence of a suicide note or overt communication of suicidal intent before death. Integration of the crime scene data with those of the forensic medicine and psychological autopsy enabled identification of the event as an accidental death, caused by neck strangulation, suffocation by a plastic bag, and vagal stimulation due to a foreign body in the rectum.

  11. Death and Dying Anxiety among Bereaved and Nonbereaved Elderly Parents

    Science.gov (United States)

    Azaiza, Faisal; Ron, Pnina; Shoham, Meyrav; Tinsky-Roimi, Tal

    2011-01-01

    This study examines differences in death and dying anxiety between bereaved and nonbereaved elderly Israeli parents, as well as correlates of these factors among bereaved parents. A total of 97 parents (49 bereaved, 48 nonbereaved) completed measures of death and dying anxiety and religiosity. Bereaved parents reported significantly higher dying…

  12. Revised licensee event report system

    International Nuclear Information System (INIS)

    Mays, G.T.; Poore, W.P.

    1985-01-01

    Licensee Event Reports (LERs) provide the basis for evaluating and assessing operating experience information from nuclear power plants. The reporting requirements for submitting LERs to the Nuclear Regulatory Commission have been revised. Effective Jan. 1, 1984, all events were to be submitted in accordance with 10 CFR 50.73 of the Code of Federal Regulations. Report NUREG-1022, Licensee Event Report System-Description of System and Guidelines for Reporting, describes the guidelines on reportability of events. This article summarizes the reporting requirements as presented in NUREG-1022, high-lights differences in data reported between the revised and previous LER systems, and presents results from a preliminary assessment of LERs submitted under the revised LER reporting system

  13. Congenital infantile myofibroma causing intrauterine death in a twin

    Science.gov (United States)

    Aye, Christina Yi Ling; Gould, Steve; Akinsola, S Adeyemi

    2011-01-01

    While infantile myofibromatosis is the most common mesenchymal tumour of infancy, only around 300 cases have been reported. The authors report a 33-year-old para 1 with an uncomplicated, dichorionic diamniotic twin pregnancy who was diagnosed with an intrauterine death of one twin at 36+5 weeks gestation. At caesarean section, a macerated male stillborn weighing 2.72 kg was delivered. Postmortem examination revealed a pedunculated lesion attached to the left shoulder and underlying muscle consistent with a congenital myofibroma. The cause of death was postulated to be haemorrhage from the tumour surface causing fetal anaemia. PMID:22674951

  14. Dysregulation of Cell Death and Its Epigenetic Mechanisms in Systemic Lupus Erythematosus

    Directory of Open Access Journals (Sweden)

    Haijing Wu

    2016-12-01

    Full Text Available Systemic lupus erythematosus (SLE is a systemic autoimmune disease involving multiple organs and tissues, which is characterized by the presence of excessive anti-nuclear autoantibodies. The pathogenesis of SLE has been intensively studied but remains far from clear. Increasing evidence has shown that the genetic susceptibilities and environmental factors-induced abnormalities in immune cells, dysregulation of apoptosis, and defects in the clearance of apoptotic materials contribute to the development of SLE. As the main source of auto-antigens, aberrant cell death may play a critical role in the pathogenesis of SLE. In this review, we summarize up-to-date research progress on different levels of cell death—including increasing rate of apoptosis, necrosis, autophagy and defects in clearance of dying cells—and discuss the possible underlying mechanisms, especially epigenetic modifications, which may provide new insight in the potential development of therapeutic strategies for SLE.

  15. Evidence-based guideline update: determining brain death in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology.

    Science.gov (United States)

    Wijdicks, Eelco F M; Varelas, Panayiotis N; Gronseth, Gary S; Greer, David M

    2010-06-08

    To provide an update of the 1995 American Academy of Neurology guideline with regard to the following questions: Are there patients who fulfill the clinical criteria of brain death who recover neurologic function? What is an adequate observation period to ensure that cessation of neurologic function is permanent? Are complex motor movements that falsely suggest retained brain function sometimes observed in brain death? What is the comparative safety of techniques for determining apnea? Are there new ancillary tests that accurately identify patients with brain death? A systematic literature search was conducted and included a review of MEDLINE and EMBASE from January 1996 to May 2009. Studies were limited to adults. In adults, there are no published reports of recovery of neurologic function after a diagnosis of brain death using the criteria reviewed in the 1995 American Academy of Neurology practice parameter. Complex-spontaneous motor movements and false-positive triggering of the ventilator may occur in patients who are brain dead. There is insufficient evidence to determine the minimally acceptable observation period to ensure that neurologic functions have ceased irreversibly. Apneic oxygenation diffusion to determine apnea is safe, but there is insufficient evidence to determine the comparative safety of techniques used for apnea testing. There is insufficient evidence to determine if newer ancillary tests accurately confirm the cessation of function of the entire brain.

  16. Proxy reporting in after-death interviews: the use of proxy respondents in retrospective assessment of chronic diseases and symptom burden in the terminal phase of life

    NARCIS (Netherlands)

    Klinkenberg, M.; Smit, J. H.; Deeg, D. J. H.; Willems, D. L.; Onwuteaka-Philipsen, B. D.; van der Wal, G.

    2003-01-01

    This study evaluates the quality of data obtained from after-death interviews with significant others of deceased older persons regarding the prevalence of chronic diseases and symptoms in the terminal phase of life. These data are compared with reports from physicians and earlier self-reports from

  17. Impact of a hospital-level intervention to reduce heart disease overreporting on leading causes of death.

    Science.gov (United States)

    Al-Samarrai, Teeb; Madsen, Ann; Zimmerman, Regina; Maduro, Gil; Li, Wenhui; Greene, Carolyn; Begier, Elizabeth

    2013-05-16

    The quality of cause-of-death reporting on death certificates affects the usefulness of vital statistics for public health action. Heart disease deaths are overreported in the United States. We evaluated the impact of an intervention to reduce heart disease overreporting on other leading causes of death. A multicomponent intervention comprising training and communication with hospital staff was implemented during July through December 2009 at 8 New York City hospitals reporting excessive heart disease deaths. We compared crude, age-adjusted, and race/ethnicity-adjusted proportions of leading, underlying causes of death reported during death certification by intervention and nonintervention hospitals during preintervention (January-June 2009) and postintervention (January-June 2010) periods. We also examined trends in leading causes of death for 2000 through 2010. At intervention hospitals, heart disease deaths declined by 54% postintervention; other leading causes of death (ie, malignant neoplasms, influenza and pneumonia, cerebrovascular disease, and chronic lower respiratory diseases) increased by 48% to 232%. Leading causes of death at nonintervention hospitals changed by 6% or less. In the preintervention period, differences in leading causes of death between intervention and nonintervention hospitals persisted after controlling for race/ethnicity and age; in the postintervention period, age accounted for most differences observed between intervention and nonintervention hospitals. Postintervention, malignant neoplasms became the leading cause of premature death (ie, deaths among patients aged 35-74 y) at intervention hospitals. A hospital-level intervention to reduce heart disease overreporting led to substantial changes to other leading causes of death, changing the leading cause of premature death. Heart disease overreporting is likely obscuring the true levels of cause-specific mortality.

  18. INTRAUTERINE FETAL DEATH CASES AT TERTIARY CENTER

    Directory of Open Access Journals (Sweden)

    Babu Lal Bishnoi

    2018-01-01

    Full Text Available BACKGROUND Intrauterine fetal death is a tragic event for the parents and a great cause of stress for the caregiver. It is an important indicator of maternal and perinatal health of a given population. This study was undertaken to study the maternal and fetal factors associated with intrauterine fetal death. Aim and Objective- This was an Analytical study aimed to evaluate and understand the prevalence, socio-epidemiological and etiological factors of IUFD methodology should not be mixed with aims and objectives MATERIALS AND METHODS The study was carried out at March 2017 to June 2017 (4 months study which was conducted at Dr. S. N. Medical College, Jodhpur, Rajasthan. The details were entered in a preformed proforma. IUD is defined as fetal death beyond 20 weeks of gestation and/or birth weight >500g. The details of complaints at admission, obstetrics history, menstrual history, examination findings, per vaginal examination findings, mode and method of delivery and fetal outcomes and investigation reports were recorded. RESULTS A total of 227 intrauterine fetal deaths were reported amongst 6264 deliveries conducted during the study period. The incidence rate of intrauterine fetal death was 36/1000 live births. 192 (84.56% deliveries were unbooked and unsupervised and 133 (58.59% belonged to rural population and 126 (55.5% were preterm and 221 (97.55% were singleton pregnancy. Among the identifiable causes hypertensive disorders (24.22% and severe anemia (13.10% were most common followed by placental causes (9.97%. Congenital malformations were responsible for 12.39% and unidentifiable causes were 11.01%. Induction was done in 103 patients, 94 patients had spontaneous onset of labour and caesarean section was done in 30 patients. Incidence of intrauterine foetal demise gradually decreased as parity advanced. CONCLUSION Institutional deliveries should be promoted to prevent intrapartum fetal deaths. Decrease in the incidence of IUD would

  19. Characteristics of Infant Deaths during Sleep While Under Nonparental Supervision.

    Science.gov (United States)

    Lagon, Elena; Moon, Rachel Y; Colvin, Jeffrey D

    2018-03-28

    To compare risk factors for infant sleep-related deaths under the supervision of parents and nonparents. We conducted a secondary analysis of sleep-related infant deaths from 2004 to 2014 in the National Center for Fatality Review and Prevention Child Death Review Case Reporting System. The main exposure was supervisor at time of death. Primary outcomes included sleep position, location, and objects in the environment. Risk factors for parental vs nonparental supervisor were compared using χ 2 and multivariable logistic regression models. Risk factors associated with different nonparental supervisors were analyzed using χ 2 . Of the 10 490 deaths, 1375 (13.1%) occurred under nonparental supervision. Infants who died under nonparental supervision had higher adjusted odds of dying outside the home (OR 12.87, 95% CI 11.31-14.65), being placed prone (OR 1.61, 95% CI 1.39-1.86) or on their side (OR 1.35, 95% CI 1.12-1.62), or being found prone (OR 1.74, 95% CI 1.50-2.02). Among infants who died under nonparental supervision, those supervised by relatives or friends were more often placed on an adult bed or couch for sleep and bed sharing (P < .0001), and to have objects in the sleep environment (P = .01). Infants who died of sleep-related causes under nonparental supervision were more likely to have been placed nonsupine. Among nonparental supervisors, relatives and friends were more likely to use unsafe sleep environments, such as locations other than a crib or bassinet and bed sharing. Pediatricians should educate parents that all caregivers must always follow safe sleep practices. Copyright © 2018 Elsevier Inc. All rights reserved.

  20. Childhood deaths from external causes in Estonia, 2001-2005.

    Science.gov (United States)

    Väli, Marika; Lang, Katrin; Soonets, Ruth; Talumäe, Marika; Grjibovski, Andrej M

    2007-07-17

    In 2000, the overall rate of injury deaths in children aged 0-14 was 28.7 per 100000 in Estonia, which is more than 5 times higher than the corresponding rate in neighbouring Finland. This paper describes childhood injury mortality in Estonia by cause and age groups, and validates registration of these deaths in the Statistical Office of Estonia against the autopsy data. The data on causes of all child deaths in Estonia in 2001-2005 were abstracted from the autopsy protocols at the Estonian Bureau of Forensic Medicine. Average annual mortality rates per 100,000 were calculated. Coverage (proportion of the reported injury deaths from the total number of injury deaths) and accuracy (proportion of correctly classified injury deaths) of the registration of causes of death in Statistical Office of Estonia were assessed by comparing the Statistical Office of Estonia data with the data from Estonian Bureau of Forensic Medicine. Average annual mortality from external causes in 0-14 years-old children in Estonia was 19.1 per 100,000. Asphyxia and transport accidents were the major killers followed by poisoning and suicides. Relative contribution of these causes varied greatly between age groups. Intent of death was unknown for more than 10% of injury deaths. Coverage and accuracy of registration of injury deaths by Statistical Office of Estonia were 91.5% and 95.3%, respectively. Childhood mortality from injuries in Estonia is among the highest in the EU. The number of injury deaths in Statistical Office of Estonia is slightly underestimated mostly due to misclassification for deaths from diseases. Accuracy of the Statistical Office of Estonia data was high with some underestimation of intentional deaths. Moreover, high proportion of death with unknown intent suggests underestimation of intentional deaths. Reduction of injury deaths should be given a high priority in Estonia. More information on circumstances around death is needed to enable establishing the intent of death.

  1. Hydrogen Peroxide-induced Cell Death in Arabidopsis : Transcriptional and Mutant Analysis Reveals a Role of an Oxoglutarate-dependent Dioxygenase Gene in the Cell Death Process

    NARCIS (Netherlands)

    Gechev, Tsanko S.; Minkov, Ivan N.; Hille, Jacques

    2005-01-01

    Hydrogen peroxide is a major regulator of plant programmed cell death (PCD) but little is known about the downstream genes from the H2O2-signaling network that mediate the cell death. To address this question, a novel system for studying H2O2-induced programmed cell death in Arabidopsis thaliana was

  2. Radiation, nitric oxide and cellular death

    International Nuclear Information System (INIS)

    Dubner, D.; Perez, M.R. Del; Michelin, S.C.; Gisone, P.A.

    1997-01-01

    The mechanisms of radiation induced cellular death constitute an objective of research ever since the first biological effects of radiation were first observed. The explosion of information produced in the last 20 years calls for a careful analysis due to the apparent contradictory data related to the cellular system studied and the range of doses used. This review focuses on the role of the active oxygen species, in particular the nitric oxides, in its relevance as potential mediator of radiation induced cellular death

  3. Aetiology of stillbirths and neonatal deaths in rural Ghana: implications for health programming in developing countries.

    Science.gov (United States)

    Edmond, Karen M; Quigley, Maria A; Zandoh, Charles; Danso, Samuel; Hurt, Chris; Owusu Agyei, Seth; Kirkwood, Betty R

    2008-09-01

    In developing countries many stillbirths and neonatal deaths occur at home and cause of death is not recorded by national health information systems. A community-level verbal autopsy tool was used to obtain data on the aetiology of stillbirths and neonatal deaths in rural Ghana. Objectives were to describe the timing and distribution of causes of stillbirths and neonatal deaths according to site of death (health facility or home). Data were collected from 1 January 2003 to 30 June 2004; 20,317 deliveries, 696 stillbirths and 623 neonatal deaths occurred over that time. Most deaths occurred in the antepartum period (28 weeks gestation to the onset of labour) (33.0%). However, the highest risk periods were during labour and delivery (intrapartum period) and the first day of life. Infections were a major cause of death in the antepartum (10.1%) and neonatal (40.3%) periods. The most important cause of intrapartum death was obstetric complications (59.3%). There were significantly fewer neonatal deaths resulting from birth asphyxia in the home than in the health facilities and more deaths from infection. Only 59 (20.7%) mothers of neonates who died at home reported that they sought care from an appropriate health care provider (doctor, nurse or health facility) during their baby's illness. The results from this study highlight the importance of studying community-level data in developing countries and the high risk of intrapartum stillbirths and infectious diseases in the rural African mother and neonate. Community-level interventions are urgently needed, especially interventions that reduce intrapartum deaths and infection rates in the mother and infant.

  4. Religiosity and the Construction of Death in Turkish Death Announcements, 1970-2009

    Science.gov (United States)

    Ergin, Murat

    2012-01-01

    Death and rituals performed after death reflect and reproduce social distinctions despite death's popular reputation as a great leveler. This study examines expressions of religiosity and constructions of death in Turkish death announcements, paying particular attention to gendered, ethnic, and temporal variations as well as markers of status and…

  5. A computer case definition for sudden cardiac death.

    Science.gov (United States)

    Chung, Cecilia P; Murray, Katherine T; Stein, C Michael; Hall, Kathi; Ray, Wayne A

    2010-06-01

    To facilitate studies of medications and sudden cardiac death, we developed and validated a computer case definition for these deaths. The study of community dwelling Tennessee Medicaid enrollees 30-74 years of age utilized a linked database with Medicaid inpatient/outpatient files, state death certificate files, and a state 'all-payers' hospital discharge file. The computerized case definition was developed from a retrospective cohort study of sudden cardiac deaths occurring between 1990 and 1993. Medical records for 926 potential cases had been adjudicated for this study to determine if they met the clinical definition for sudden cardiac death occurring in the community and were likely to be due to ventricular tachyarrhythmias. The computerized case definition included deaths with (1) no evidence of a terminal hospital admission/nursing home stay in any of the data sources; (2) an underlying cause of death code consistent with sudden cardiac death; and (3) no terminal procedures inconsistent with unresuscitated cardiac arrest. This definition was validated in an independent sample of 174 adjudicated deaths occurring between 1994 and 2005. The positive predictive value of the computer case definition was 86.0% in the development sample and 86.8% in the validation sample. The positive predictive value did not vary materially for deaths coded according to the ICO-9 (1994-1998, positive predictive value = 85.1%) or ICD-10 (1999-2005, 87.4%) systems. A computerized Medicaid database, linked with death certificate files and a state hospital discharge database, can be used for a computer case definition of sudden cardiac death. Copyright (c) 2009 John Wiley & Sons, Ltd.

  6. [Cause-of-death statistics and ICD, quo vadis?

    Science.gov (United States)

    Eckert, Olaf; Vogel, Ulrich

    2018-07-01

    The International Statistical Classification of Diseases and Related Health Problems (ICD) is the worldwide binding standard for generating underlying cause-of-death statistics. What are the effects of former revisions of the ICD on underlying cause-of-death statistics and which opportunities and challenges are becoming apparent in a possible transition process from ICD-10 to ICD-11?This article presents the calculation of the exploitation grade of ICD-9 and ICD-10 in the German cause-of-death statistics and quality of documentation. Approximately 67,000 anonymized German death certificates are processed by Iris/MUSE and official German cause-of-death statistics are analyzed.In addition to substantial changes in the exploitation grade in the transition from ICD-9 to ICD-10, regional effects become visible. The rate of so-called "ill-defined" conditions exceeds 10%.Despite substantial improvement of ICD revisions there are long-known deficits in the coroner's inquest, filling death certificates and quality of coding. To make better use of the ICD as a methodological framework for mortality statistics and health reporting in Germany, the following measures are necessary: 1. General use of Iris/MUSE, 2. Establishing multiple underlying cause-of-death statistics, 3. Introduction of an electronic death certificate, 4. Improvement of the medical assessment of cause of death.Within short time the WHO will release the 11th revision of the ICD that will provide additional opportunities for the development of underlying cause-of-death statistics and their use in science, public health and politics. A coordinated effort including participants in the process and users is necessary to meet the related challenges.

  7. Rural and Urban Differences in Passenger-Vehicle-Occupant Deaths and Seat Belt Use Among Adults - United States, 2014.

    Science.gov (United States)

    Beck, Laurie F; Downs, Jonathan; Stevens, Mark R; Sauber-Schatz, Erin K

    2017-09-22

    Motor-vehicle crashes are a leading cause of death in the United States. Compared with urban residents, rural residents are at an increased risk for death from crashes and are less likely to wear seat belts. These differences have not been well described by levels of rurality. 2014. Data from the Fatality Analysis Reporting System (FARS) and the Behavioral Risk Factor Surveillance System (BRFSS) were used to identify passenger-vehicle-occupant deaths from motor-vehicle crashes and estimate the prevalence of seat belt use. FARS, a census of U.S. motor-vehicle crashes involving one or more deaths, was used to identify passenger-vehicle-occupant deaths among adults aged ≥18 years. Passenger-vehicle occupants were defined as persons driving or riding in passenger cars, light trucks, vans, or sport utility vehicles. Death rates per 100,000 population, age-adjusted to the 2000 U.S. standard population and the proportion of occupants who were unrestrained at the time of the fatal crash, were calculated. BRFSS, an annual, state-based, random-digit-dialed telephone survey of the noninstitutionalized U.S. civilian population aged ≥18 years, was used to estimate prevalence of seat belt use. FARS and BRFSS data were analyzed by a six-level rural-urban designation, based on the U.S. Department of Agriculture 2013 rural-urban continuum codes, and stratified by census region and type of state seat belt enforcement law (primary or secondary). Within each census region, age-adjusted passenger-vehicle-occupant death rates per 100,000 population increased with increasing rurality, from the most urban to the most rural counties: South, 6.8 to 29.2; Midwest, 5.3 to 25.8; West, 3.9 to 40.0; and Northeast, 3.5 to 10.8. (For the Northeast, data for the most rural counties were not reported because of suppression criteria; comparison is for the most urban to the second-most rural counties.) Similarly, the proportion of occupants who were unrestrained at the time of the fatal crash

  8. Accidents and undetermined deaths: re-evaluation of nationwide samples from the Scandinavian countries.

    Science.gov (United States)

    Tøllefsen, Ingvild Maria; Thiblin, Ingemar; Helweg-Larsen, Karin; Hem, Erlend; Kastrup, Marianne; Nyberg, Ullakarin; Rogde, Sidsel; Zahl, Per-Henrik; Østevold, Gunvor; Ekeberg, Øivind

    2016-05-27

    National mortality statistics should be comparable between countries that use the World Health Organization's International Classification of Diseases. Distinguishing between manners of death, especially suicides and accidents, is a challenge. Knowledge about accidents is important in prevention of both accidents and suicides. The aim of the present study was to assess the reliability of classifying deaths as accidents and undetermined manner of deaths in the three Scandinavian countries and to compare cross-national differences. The cause of death registers in Norway, Sweden and Denmark provided data from 2008 for samples of 600 deaths from each country, of which 200 were registered as suicides, 200 as accidents or undetermined manner of deaths and 200 as natural deaths. The information given to the eight experts was identical to the information used by the Cause of Death Register. This included death certificates, and if available external post-mortem examinations, forensic autopsy reports and police reports. In total, 69 % (Sweden and Norway) and 78 % (Denmark) of deaths registered in the official mortality statistics as accidents were confirmed by the experts. In the majority of the cases where disagreement was seen, the experts reclassified accidents to undetermined manner of death, in 26, 25 and 19 % of cases, respectively. Few cases were reclassified as suicides or natural deaths. Among the extracted accidents, the experts agreed least with the official mortality statistics concerning drowning and poisoning accidents. They also reported most uncertainty in these categories of accidents. In a second re-evaluation, where more information was made available, the Norwegian psychiatrist and forensic pathologist increased their agreement with the official mortality statistics from 76 to 87 %, and from 85 to 88 %, respectively, regarding the Norwegian and Swedish datasets. Among the extracted undetermined deaths in the Swedish dataset, the two experts

  9. Epidemiology of Deaths from Road Traffic Accidents in Nigeria: A ...

    African Journals Online (AJOL)

    The purpose of this study is to examine the epidemiology of deaths from Road Traffic Accidents (RTAs) in Nigeria using Lagos State as a baseline study and to suggest preventive and corrective safety measures towards reducing the traffic accidents in the study area. The reported number of deaths from road traffic accidents ...

  10. On social death: ostracism and the accessibility of death thoughts.

    Science.gov (United States)

    Steele, Caroline; Kidd, David C; Castano, Emanuele

    2015-01-01

    Being rejected, excluded, or simply ignored is a painful experience. Ostracism researchers have shown its powerful negative consequences (Williams, 2007), and sociologists have referred to such experiences as social death (Bauman, 1992). Is this is just a metaphor or does being ostracized make death more salient in people's minds? An experiment was conducted in which participants experienced ostracism or inclusion using the Cyberball manipulation, and the accessibility of death-related thoughts was measured via a word-stem completion puzzle. Results showed enhanced death-thought accessibility in the ostracism condition, as well as a negative effect of dispositional self-esteem on the accessibility of death-related thoughts.

  11. Mycobacterial secretion systems ESX-1 and ESX-5 play distinct roles in host cell death and inflammasome activation

    KAUST Repository

    Abdallah, Abdallah; Bestebroer, Jovanka; Savage, Nigel D L; De Punder, Karin; Van Zon, Maaike; Wilson, Louis D.; Korbee, Cees J.; Van Der Sar, Astrid M.; Ottenhoff, Tom Hm M; Van Der Wel, Nicole N.; Bitter, Wilbert M.; Peters, Peter J.

    2011-01-01

    for the translocation of Mycobacterium tuberculosis or Mycobacterium marinum to the cytosol of host cells. However, the M. marinum ESX-5 mutant does not induce inflammasome activation and IL-1b activation. The ESX-5 system also induces a caspase-independent cell death

  12. [What Lessons Should We Learn from the Death of Patients on Xeplion?].

    Science.gov (United States)

    Fujii, Yasuo

    2015-01-01

    From the launch of the long-acting injectable antipsychotic paliperidone palmitate (XEPLION) on November 19, 2013, 32 fatal cases had been reported up to May 18, 2014 (estimated number of users is approximately 11,000 patients) in the Early Post-marketing Phase Vigilance. The most common cause of death was sudden death (12 cases were sudden death defined by ICD-10 codes 96.0 and 96.1 and 4 cases suspected sudden death), followed by suicide (7 cases), and neuroleptic malignant syndrome (4 cases). Several deaths occurred involving patients with serious somatic disorder, such as a malignant tumor or pneumonia. The risk of all-cause mortality on XEPLION was not high in comparison with other investigations; the sudden death risk on XEPLION may be higher than on ZODIAC. According to many reports from foreign countries, mortality rates associated with schizophrenia are two to three times higher than those of the general population, corresponding to a 10-25-year reduction in life expectancy. Natural deaths account for about 60% of the excess mortality of schizophrenia patients, and such patients are more likely to die from ischemic heart disease. Since it has been suggested that more than half of sudden deaths in schizophrenic patients have a cardiac origin, sudden cardiac deaths are chiefly responsible for their reduced life expectancy. This sudden death-related problem of patients with schizophrenia has been forgotten or ignored in the psychiatric care of Japan. Taking advantage of this opportunity, we should tackle this problem seriously, and make an effort to reduce the mortality gap.

  13. A Context-Aware Indoor Air Quality System for Sudden Infant Death Syndrome Prevention

    Directory of Open Access Journals (Sweden)

    Daniel H. De La Iglesia

    2018-03-01

    Full Text Available Context-aware monitoring systems designed for e-Health solutions and ambient assisted living (AAL play an important role in today’s personalized health-care services. The majority of these systems are intended for the monitoring of patients’ vital signs by means of bio-sensors. At present, there are very few systems that monitor environmental conditions and air quality in the homes of users. A home’s environmental conditions can have a significant influence on the state of the health of its residents. Monitoring the environment is the key to preventing possible diseases caused by conditions that do not favor health. This paper presents a context-aware system that monitors air quality to prevent a specific health problem at home. The aim of this system is to reduce the incidence of the Sudden Infant Death Syndrome, which is triggered mainly by environmental factors. In the conducted case study, the system monitored the state of the neonate and the quality of air while it was asleep. The designed proposal is characterized by its low cost and non-intrusive nature. The results are promising.

  14. Infant Mortality Statistics From the 2013 Period Linked Birth/Infant Death Data Set.

    Science.gov (United States)

    Matthews, T J; MacDorman, Marian F; Thoma, Marie E

    2015-08-06

    This report presents 2013 period infant mortality statistics from the linked birth/infant death data set (linked file) by maternal and infant characteristics. The linked file differs from the mortality file, which is based entirely on death certificate data. Descriptive tabulations of data are presented and interpreted. The U.S. infant mortality rate was 5.96 infant deaths per 1,000 live births in 2013, similar to the rate of 5.98 in 2012. The number of infant deaths was 23,446 in 2013, a decline of 208 infant deaths from 2012. From 2012 to 2013, infant mortality rates were stable for most race and Hispanic origin groups; declines were reported for two Hispanic subgroups: Cuban and Puerto Rican. Since 2005, the most recent high, the U.S. infant mortality rate has declined 13% (from 6.86), with declines in both neonatal and postneonatal mortality overall and for most groups. In 2013, infants born at 37–38 weeks of gestation (early term) had mortality rates that were 63% higher than for full-term (39–40 week) infants. For multiple births, the infant mortality rate was 25.84, 5 times the rate of 5.25 for singleton births. In 2013, 36% of infant deaths were due to preterm-related causes of death, and an additional 15% were due to causes grouped into the sudden unexpected infant death category. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

  15. Disability occurrence and proximity to death

    NARCIS (Netherlands)

    Klijs, Bart; Mackenbach, Johan P.; Kunst, Anton E.

    2010-01-01

    Purpose. This paper aims to assess whether disability occurrence is related more strongly to proximity to death than to age. Method. Self reported disability and vital status were available from six annual waves and a subsequent 12-year mortality follow-up of the Dutch GLOBE longitudinal study.

  16. Nationwide study of sudden cardiac death in persons aged 1-35 years

    DEFF Research Database (Denmark)

    Winkel, Bo Gregers; Holst, Anders Gaarsdal; Theilade, Juliane

    2011-01-01

    Aims The aim of this investigation was to study the incidence of sudden cardiac death (SCD) in persons aged 1-35 years in a nationwide setting (5.38 million people) by systematic evaluation of all deaths. Methods and results All deaths in persons aged 1-35 years in Denmark in 2000-06 were included....... Death certificates were read independently by two physicians. The National Patient Registry was used to retrieve information on prior medical history. All autopsy reports were read and the cause of death was revised based on autopsy findings. We identified 625 cases of sudden unexpected death (10......% of all deaths), of which 156 (25%) were not autopsied. Of the 469 autopsied cases, 314 (67%) were SCD. The most common cardiac cause of death was ischaemic heart disease (13%); 29% of autopsied sudden unexpected death cases were unexplained. In 45% of SCD cases, the death was witnessed; 34% died during...

  17. Place of death for people with HIV: a population-level comparison of eleven countries across three continents using death certificate data.

    Science.gov (United States)

    Harding, Richard; Marchetti, Stefano; Onwuteaka-Philipsen, Bregje D; Wilson, Donna M; Ruiz-Ramos, Miguel; Cardenas-Turanzas, Maria; Rhee, YongJoo; Morin, Lucas; Hunt, Katherine; Teno, Joan; Hakanson, Cecilia; Houttekier, Dirk; Deliens, Luc; Cohen, Joachim

    2018-01-25

    With over 1 million HIV-related deaths annually, quality end-of-life care remains a priority. Given strong public preference for home death, place of death is an important consideration for quality care. This 11 country study aimed to i) describe the number, proportion of all deaths, and demographics of HIV-related deaths; ii) identify place of death; iii) compare place of death to cancer patients iv), determine patient/health system factors associated with place of HIV-related death. In this retrospective analysis of death certification, data were extracted for the full population (ICD-10 codes B20-B24) for 1-year period: deceased's demographic characteristics, place of death, healthcare supply. i) 19,739 deaths were attributed to HIV. The highest proportion (per 1000 deaths) was for Mexico (9.8‰), and the lowest Sweden (0.2‰). The majority of deaths were among men (75%), and those aged <50 (69.1%). ii) Hospital was most common place of death in all countries: from 56.6% in the Netherlands to 90.9% in South Korea. The least common places were hospice facility (3.3%-5.7%), nursing home (0%-17.6%) and home (5.9%-26.3%).iii) Age-standardised relative risks found those with HIV less likely to die at home and more likely to die in hospital compared with cancer patients, and in most countries more likely to die in a nursing home. iv) Multivariate analysis found that men were more likely to die at home in UK, Canada, USA and Mexico; a greater number of hospital beds reduced the likelihood of dying at home in Italy and Mexico; a higher number of GPs was associated with home death in Italy and Mexico. With increasing comorbidity among people ageing with HIV, it is essential that end-of-life preferences are established and met. Differences in place of death according to country and diagnosis demonstrate the importance of ensuring a "good death" for people with HIV, alongside efforts to optimise treatment.

  18. Medico legal investigations into sudden sniffing deaths linked with trichloroethylene.

    Science.gov (United States)

    Da Broi, Ugo; Colatutto, Antonio; Sala, Pierguido; Desinan, Lorenzo

    2015-08-01

    Sudden deaths attributed to sniffing trichloroethylene are caused by the abuse of this solvent which produces pleasant inebriating effects with rapid dissipation. In the event of repeated cycles of inhalation, a dangerous and uncontrolled systemic accumulation of trichloroethylene may occur, followed by central nervous system depression, coma and lethal cardiorespiratory arrest. Sometimes death occurs outside the hospital environment, without medical intervention or witnesses and without specific necroscopic signs. Medico legal investigations into sudden sniffing deaths associated with trichloroethylene demand careful analysis of the death scene and related circumstances, a detailed understanding of the deceased's medical history and background of substance abuse and an accurate evaluation of all autopsy and laboratory data, with close cooperation between the judiciary, coroners and toxicologists. Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  19. [Maternal deaths related to social vulnerabilities. Results from the French confidential enquiry into maternal deaths, 2010-2012].

    Science.gov (United States)

    Tessier, V; Leroux, S; Guseva-Canu, I

    2017-12-01

    The theme of deprivation is new for the ENCMM. In view of the perceived increase in the number of maternal deaths that may be related to a deprivation situation, we sought to understand the main dimensions that could contribute to maternal death in this context, in order to propose a definition. The selection of cases made a posteriori is mainly based on a qualitative judgment. Between 2010 and 2012, among the deaths evaluated by the CNEMM, one or more elements related to social vulnerability were identified in 8.6% of the cases (18 deaths). The direct criteria used were the concepts of "deprivation" or "social difficulties", difficulties of housing, language barriers and isolation. The absence of prenatal care was retained as an indirect marker. We excluded cases where psychiatric pathology and/or addiction were predominant. Of the 18 cases identified with deprivation factors, death was considered "unavoidable" in 2 cases (11%), "certainly avoidable" or "possibly avoidable" in 13 cases (72%). In 3 cases (17%), avoidability could not be determined. Avoidability was related to the content and adequacy of care in 11 cases out of 13 (85%) and the patient's interaction with the health care system in 10 of 18 cases (56%). The analysis of maternal deaths among women in precarious situations points out that the link between socio-economic deprivation and poor maternal health outcomes potentially includes a specific risk of maternal death. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  20. When the Simulator Dies: Experiential Education about Death Designed for Undergraduate Nursing Students

    Science.gov (United States)

    Foltz-Ramos, Kelly

    2017-01-01

    Background and Objectives: Graduates from undergraduate nursing programs report inadequate death education. Most death education is focused on end-of-life care and taught by lecture. Students are not provided opportunities to reflect on their own feelings about death. Due to lack of clinical nursing faculty and shortage of clinical sites, students…

  1. Death certificate data and causes of death in patients with parkinsonism.

    Science.gov (United States)

    Moscovich, Mariana; Boschetti, Gabriela; Moro, Adriana; Teive, Helio A G; Hassan, Anhar; Munhoz, Renato P

    2017-08-01

    Assessment of variables related to mortality in Parkinson disease (PD) and other parkinsonian syndromes relies, among other sources, on accurate death certificate (DC) documentation. We assessed the documentation of the degenerative disorder on DCs and evaluated comorbidities and causes of death among parkinsonian patients. Demographic and clinical data were systematically and prospectively collected on deceased patients followed at a tertiary movement disorder clinic. DCs data included the documentation of parkinsonism, causes, and place of death. Among 138 cases, 84 (60.9%) male, mean age 77.9 years, mean age of onset 66.7, and mean disease duration 10.9 years. Clinical diagnoses included PD (73.9%), progressive supranuclear palsy (10.9%), multiple system atrophy (7.2%), Lewy body dementia (7.2%) and corticobasal degeneration (0.7%). Psychosis occurred in 60.1% cases, dementia in 48.5%. Most PD patients died due to heterogeneous causes before reaching advanced stages. Non-PD parkinsonian patients died earlier due to causes linked to the advanced neurodegenerative process. PD was documented in 38.4% of DCs with different forms of inconsistencies. That improved, but remained significant when it was signed by a specialist. More than half of PD cases died while still ambulatory and independent, after a longer disease course and due to causes commonly seen in that age group. Deaths among advanced PD patients occurred due to causes similar to what we found in non-PD cases. These findings can be useful for clinical, prognostic and counseling purposes. Underlying parkinsonian disorders are poorly documented in DCs, undermining its' use as sources of data collection. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Autopsy study of traumatic/violent deaths in Rivers State of Nigeria ...

    African Journals Online (AJOL)

    Methods: Archived autopsy reports of victims of violent deaths were reviewed for age, gender, circumstances, causes and mechanisms of death between 1998 and 2008. The autopsies were medicolegal cases carried out in different government and privately owned mortuaries located in Rivers state in accordance with the ...

  3. Profile of sudden death in an adult population (1999-2008).

    LENUS (Irish Health Repository)

    Downes, M R

    2010-06-01

    Sudden death is the sudden and unexpected death of an individual within 24 hours of symptom onset. The vast majority of these cases are found, at autopsy, to be due to underlying ischaemic cardiac disease. We retrospectively reviewed all adult post mortems performed at Beaumont Hospital over a decade (1999-2008). Our aim was to identify all sudden death cases (natural and accidental) and subclassify them according to age profile and organ system involved. We identified 1230 sudden death cases in the review period with 775 (63%) deaths attributable to ischaemic heart disease. The rate of sudden death remained constant over the decade with 663 (54%) deaths occurring in the first five years. Our negative autopsy rate was 2.8% corresponding to 35 cases. This is the first Irish study to retrospectively review all adult sudden deaths within a defined catchment area and analyse them as outlined above.

  4. Reporting detection of Chlamydia trachomatis DNA in tissues of neonatal death cases

    Directory of Open Access Journals (Sweden)

    Maria Hernandez Trejo

    2014-04-01

    Full Text Available OBJECTIVE: to determine whether C. trachomatis was present in neonates with infection, but without an isolated pathogen, who died during the first week of life. METHODS: early neonatal death cases whose causes of death had been previously adjudicated by the institutional mortality committee were randomly selected. End-point and real-time polymerase chain reaction of the C. trachomatis omp1 gene was used to blindly identify the presence of chlamydial DNA in the paraffinized samples of five organs (from authorized autopsies of each of the dead neonates. Additionally, differential diagnoses were conducted by amplifying a fragment of the 16S rRNA of Mycoplasma spp. RESULTS: in five cases (35.7%, C. trachomatis DNA was found in one or more organs. Severe neonatal infection was present in three cases; one of them corresponded to genotype D of C. trachomatis. Interestingly, another case fulfilled the same criteria but had a positive polymerase chain reaction for Mycoplasma hominis, a pathogen known to produce sepsis in newborns. CONCLUSION: the use of molecular biology techniques in these cases of early infant mortality demonstrated that C. trachomatis could play a role in the development of severe infection and in early neonatal death, similarly to that observed with Mycoplasma hominis. Further study is required to determine the pathogenesis of this perinatal infection.

  5. the z-transform applied to a birth-death process having varying birth

    African Journals Online (AJOL)

    DEPT OF AGRICULTURAL ENGINEERING

    model can be used to study practical queuing and birth-death systems where the arrival, birth, ser- vice and death rates ... for systems operating in fading environments (Hueda and ... mobile computing (Lee et al., 1999) and the transmission ...

  6. Quantifying cause-related mortality by weighting multiple causes of death

    Science.gov (United States)

    Moreno-Betancur, Margarita; Lamarche-Vadel, Agathe; Rey, Grégoire

    2016-01-01

    Abstract Objective To investigate a new approach to calculating cause-related standardized mortality rates that involves assigning weights to each cause of death reported on death certificates. Methods We derived cause-related standardized mortality rates from death certificate data for France in 2010 using: (i) the classic method, which considered only the underlying cause of death; and (ii) three novel multiple-cause-of-death weighting methods, which assigned weights to multiple causes of death mentioned on death certificates: the first two multiple-cause-of-death methods assigned non-zero weights to all causes mentioned and the third assigned non-zero weights to only the underlying cause and other contributing causes that were not part of the main morbid process. As the sum of the weights for each death certificate was 1, each death had an equal influence on mortality estimates and the total number of deaths was unchanged. Mortality rates derived using the different methods were compared. Findings On average, 3.4 causes per death were listed on each certificate. The standardized mortality rate calculated using the third multiple-cause-of-death weighting method was more than 20% higher than that calculated using the classic method for five disease categories: skin diseases, mental disorders, endocrine and nutritional diseases, blood diseases and genitourinary diseases. Moreover, this method highlighted the mortality burden associated with certain diseases in specific age groups. Conclusion A multiple-cause-of-death weighting approach to calculating cause-related standardized mortality rates from death certificate data identified conditions that contributed more to mortality than indicated by the classic method. This new approach holds promise for identifying underrecognized contributors to mortality. PMID:27994280

  7. Symptoms Before Sudden Arrhythmic Death Syndrome: A Nationwide Study Among the Young in Denmark.

    Science.gov (United States)

    Glinge, Charlotte; Jabbari, Reza; Risgaard, Bjarke; Lynge, Thomas Hadberg; Engstrøm, Thomas; Albert, Christine M; Haunsø, Stig; Winkel, Bo Gregers; Tfelt-Hansen, Jacob

    2015-07-01

    No studies in an unselected and nationwide setting have characterized the symptoms and medical history of patients with sudden arrhythmic death syndrome (SADS). The aim of this study was to identify and describe the symptoms and medical history of patients before the presentation of SADS. We have previously identified all of the autopsied sudden cardiac deaths (SCD; n = 314) in Danes aged 1-35 years between 2000 and 2006. After comprehensive pathological and toxicological investigation did not reveal a cause of SCD, 136 of the patients were identified as SADS. The National Patient Registry was utilized to obtain information on all in- and outpatient activity in Danish hospitals. All medical records from hospitals and general practitioners, including death certificates and autopsy reports were reviewed. Before death, 48 (35%) SADS patients had cardiac symptoms; among these, 30 (22%) had contacted the healthcare system. Antecedent symptoms (symptoms >24 hours before death) were present in 34 (25%) patients. Prodromal symptoms (symptoms ≤24 hours before death) were present in 23 (17%) patients. Cardiac symptoms included chest pain (n = 16, 12%), dyspnea (n = 18, 13%), palpitations (n = 2, 1%), presyncope/syncope (n = 23, 17%), and aborted SCD (n = 2, 1%). In addition, seizures (n = 25, 18%) were prevalent. In 61 (45%) SADS cases, no previous medical history were recorded. In this unselected, nationwide study of 136 young SADS patients, 35% had experienced cardiac symptoms before death, most commonly presyncope/syncope, but only one out of five had contacted a healthcare provider with cardiac symptoms. © 2015 Wiley Periodicals, Inc.

  8. Preventable trauma deaths: from panel review to population based-studies

    Directory of Open Access Journals (Sweden)

    Vesconi Sergio

    2006-04-01

    Full Text Available Abstract Preventable trauma deaths are defined as deaths which could be avoided if optimal care has been delivered. Studies on preventable trauma deaths have been accomplished initially with panel reviews of pre-hospital and hospital charts. However, several investigators questioned the reliability and validity of this method because of low reproducibility of implicit judgments when they are made by different experts. Nevertheless, number of studies were published all around the world and ultimately gained some credibility, particularly in regions where comparisons were made before and after trauma system implementation with a resultant fall in mortality. During the last decade of century the method of comparing observed survival with probability of survival calculated from large trauma registries has obtained popularity. Preventable trauma deaths were identified as deaths occurred notwithstanding a high calculated probability of survival. In recent years, preventable trauma deaths studies have been replaced by population-based studies, which use databases representative of overall population, therefore with high epidemiologic value. These databases contain readily available information which carry out the advantage of objectivity and large numbers. Nowadays, population-based researches provide the strongest evidence regarding the effectiveness of trauma systems and trauma centers on patient outcomes.

  9. Epidemiology of deaths due to traffic accidents in Kermanshah province (2012

    Directory of Open Access Journals (Sweden)

    Azam Malekifar

    2016-01-01

    Full Text Available Background: The increasing trend of traffic accidents is one of the most serious problems of public health. The aim of this paper was to investigate the fatal traffic accidents in Kermanshah province. Method: All research data required were obtained from Legal Medicine Organization and analyzed by Stata-11 software. Traffic statistics available on the Road Maintenance and Transportation Organization website were used to study the death rate per month and day according to traffic level on suburban highways. Results: The incidence rate of age-standardized deaths due to road traffic accidents was 26.1per 100,000 people, and the mean age of the dead was 39.98±21.60 years. The mortality rate was higher in men, those more than 40 years old, married, illiterate and self-employed. Considering the traffic rate on suburban roads, the highest death rate occurred in the warmest months of the year during the day. Furthermore, most deaths were due to collisions and the highest frequency of death was reported for the car occupants. In most cases, head injuries and head traumas were the final cause of death. A significant correlation was reported between the type of vehicle and the cause of death and how the accident occurred (P<0.05. Conclusion: The mortality rate due to traffic accidents in Kermanshah province is high. Surveillance over the suburban roads in hot seasons and male drivers is of particular importance.

  10. VSRR Provisional Drug Overdose Death Counts

    Data.gov (United States)

    U.S. Department of Health & Human Services — This data contains provisional counts for drug overdose deaths based on a current flow of mortality data in the National Vital Statistics System. National...

  11. Death following intravascular administration of contrast media

    International Nuclear Information System (INIS)

    Shehadi, W.H.

    1985-01-01

    Adverse reactions to intravascularly administered contrast media preceding death and the autopsy findings in 44 patients are presented. There is a wide scatter of the age distribution of fatal reactions. The highest incidence is in the 50-70 year age group. Similar observations were obtained from the 405 deaths due to contrast media reported to the Food and Drug Administration of the United States. In the same age group the number of reactions is highest, likewise the autopsy findings. The predominant autopsy findings are pulmonary edema, congestion and hemorrhage; arteriosclerosis, both general and coronary. In the younger age group the autopsy findings are limited mostly to the respiratory tract. Fatal reactions to contrast media occur often without warning and most deaths occur within 15 min to 6 hours. Reactions to contrast media occur without relation to sex or age. (orig.)

  12. Child mortality in South Africa: Fewer deaths but better data are needed

    Directory of Open Access Journals (Sweden)

    P Barron

    2018-03-01

    Full Text Available South Africa is committed to reducing under-5 mortality rates in line with the Sustainable Development Goal (SDG targets. Policymakers and healthcare service managers require accurate and complete data on the number and causes of child deaths to plan and monitor healthcare service delivery and health outcomes. This study aimed to review nationally representative data on under-5 mortality and the cause of deaths among children under 5 years of age. We also reviewed systems that are currently used for generating these data. Child mortality has declined substantially in the past decade. Under-5 mortality in 2015 is estimated at 37 - 40 deaths per 1 000 live births, with an estimated infant mortality rate of 27 - 33 deaths per 1 000 live births. Approximately one-third of under-5 deaths occur during the newborn period, while diarrhoea, pneumonia and HIV infection remain the most important causes of death outside of the newborn period. The proportion of deaths owing to non-natural causes, congenital disorders and non-communicable diseases has increased. However, many discrepancies in data collected through different systems are noted, especially at the sub-national level. There is a need to improve the completeness and accuracy of existing data systems and to strengthen reconciliation and triangulation of data.

  13. Adverse events following quadrivalent meningococcal CRM-conjugate vaccine (Menveo®) reported to the Vaccine Adverse Event Reporting system (VAERS), 2010-2015.

    Science.gov (United States)

    Myers, Tanya R; McNeil, Michael M; Ng, Carmen S; Li, Rongxia; Lewis, Paige W; Cano, Maria V

    2017-03-27

    Limited data are available describing the post-licensure safety of meningococcal vaccines, including Menveo®. We reviewed reports of adverse events (AEs) to the Vaccine Adverse Event Reporting System (VAERS) to assess safety in all age groups. VAERS is a national spontaneous vaccine safety surveillance system co-administered by the Centers for Disease Control and Prevention and the US Food and Drug Administration. We searched the VAERS database for US reports of adverse events in persons who received Menveo from 1 January 2010 through 31 December 2015. We clinically reviewed reports and available medical records for serious AEs, selected pre-specified outcomes, and vaccination during pregnancy. We used empirical Bayesian data mining to identify AEs that were disproportionately reported after receipt of Menveo. During the study period, VAERS received 2614 US reports after receipt of Menveo. Of these, 67 were classified as serious, including 1 report of death. Adolescents (aged 11-18years) accounted for 74% of reports. Most of the reported AEs were non-serious and described AEs consistent with data from pre-licensure studies. Anaphylaxis and syncope were the two most common events in the serious reports. We did not identify any new safety concerns after review of AEs that exceeded the data mining threshold, although we did observe disproportionate reporting for terms that were not associated with an adverse event (e.g., "incorrect drug dosage form administered", "wrong technique in drug usage process"). Although reports were limited, we did not find any evidence for concern regarding the use of Menveo during pregnancy. In our review of VAERS reports, findings of AEs were consistent with the data from pre-licensure studies. Vaccine providers should continue to emphasize and adhere to proper administration of the vaccine. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Life and death in Kardecist Spiritism

    Directory of Open Access Journals (Sweden)

    Maria Laura Viveiros de Castro Cavalcanti

    2006-01-01

    Full Text Available The paper analyses from an anthropological perspective how Brazilian Spiritism resignifies the current notions of life and death, comparing the notion of reincarnation with the Christian and Catholic notion of purgatory. The search for understanding of the processes of identity construction in this religious system leads to the examination of the notions of reincarnation, karma, evolution, mediumship and probation, which are central to Kardecian cosmology. With this active set of notions, Spiritism proposes a rich set of perspectives about the self, and simultaneously graduates and softens the otherness of death.

  15. BRAIN DEATH DIAGNOSIS

    Directory of Open Access Journals (Sweden)

    Calixto Machado

    2009-10-01

    Full Text Available Brain death (BD diagnosis should be established based on the following set of principles, i.e. excluding major confusing factors, identifying the cause of coma, determining irreversibility, and precisely testing brainstem reflexes at all levels of the brainstem. Nonetheless, most criteria for BD diagnosis do not mention that this is not the only way of diagnosing death. The Cuban Commission for the Determination of Death has emphasized the aforesaid three possible situations for diagnosing death: a outside intensive care environment (without life support physicians apply the cardio-circulatory and respiratory criteria; b in forensic medicine circumstances, physicians utilize cadaveric signs (they do not even need a stethoscope; c in the intensive care environment (with life support when cardiorespiratory arrest occurs physicians utilize the cardio-circulatory and respiratory criteria. This methodology of diagnosing death, based on finding any of the death signs, is not related to the concept that there are different types of death. The irreversible loss of cardio-circulatory and respiratory functions can only cause death when ischemia and anoxia are prolonged enough to produce an irreversible destruction of the brain. The sign of irreversible loss of brain functions, that is to say BD diagnosis, is fully reviewed.

  16. Retrospective Reports of the Lived School Experience of Adolescents after the Death of a Parent

    Science.gov (United States)

    Masterson, Ann

    2013-01-01

    This qualitative phenomenological study was done to better understand the school experience of adolescents after the death of a parent. The participants were adults over the age of 19 and between 3 and 43 years past the death of a parent during adolescence. The study involved personal, reflective interviews with each of the participants. The…

  17. Asian-American deaths near the Harvest Moon Festival.

    Science.gov (United States)

    Smith, Gary

    2004-01-01

    Reexamine the claim that elderly Chinese-American women are able to prolong their lives until after the celebration of the Harvest Moon Festival. See if independent 1985 to 2000 data for Chinese-, Korean-, and Vietnamese-Americans replicate results that were reported using 1960 to 1984 data for Chinese-Americans. The original 1960 to 1984 data do not support the death-postponement theory unless deaths that occur on the festival day are classified as having occurred after the festival. The new data do not support the theory, no matter how deaths on the festival day are classified. These data do not support the hypothesis that elderly Chinese-, Korean-, or Vietnamese-American women are able to prolong their lives until after the celebration of the Harvest Moon Festival.

  18. Terminally ill cancer patients' wish to hasten death.

    Science.gov (United States)

    Kelly, B; Burnett, P; Pelusi, D; Badger, S; Varghese, F; Robertson, M

    2002-07-01

    This exploratory study investigated factors associated with the wish to hasten death among a sample of terminally ill cancer patients. Semi-structured interviews conducted on a total of 72 hospice and home palliative care patients were subjected to qualitative analysis using QSR-NUDIST. The main themes to emerge suggested that patients with a high wish to hasten death had greater concerns with physical symptoms and psychological suffering, perceived themselves to be more of a burden to others, and experienced higher levels of demoralization, while also reporting less confidence in symptom control, fewer social supports, less satisfaction with life experiences and fewer religious beliefs when compared with patients who had a moderate or no wish to hasten death. The implications of these findings will be discussed.

  19. 99mTc-HMPAO SPECT in brain death

    International Nuclear Information System (INIS)

    Tsuchida, Tatsuro; Sadato, Norihiro; Nishizawa, Sadahiko

    1993-01-01

    Brain single photon emission computed tomography (SPECT) with 99m Tc-d,l-hexamethyl-propyleneamine oxime (HMPAO) was performed twice in a 78-year-old man clinically diagnosed as brain death according to the standard criteria of the Japanese Ministry of Welfare. The first brain SPECT demonstrated the tracer accumulation in the brain, indicating preserved cerebral blood flow. The second brain SPECT performed 3 days later revealed cessation of the blood flow. In patients with preserved cerebral blood flow, the diagnosis of brain death cannot be made, even if they meet the existing criteria, because previous report noted the recovery in some of those patients. Brain perfusion SPECT plays an important role as a confirmatory test for the diagnosis of brain death. (author)

  20. Sudden cardiac death and coronary disease in the young

    DEFF Research Database (Denmark)

    Zachariasardóttir, Sára; Risgaard, Bjarke; Ågesen, Frederik Nybye

    2017-01-01

    BACKGROUND: Sudden cardiac death caused by coronary artery disease (CAD-SCD) is the most frequent cause of SCD in persons ..., CAD-SCD victims aged 36-49years had more severe atherosclerosis in all coronary arteries, more multi-vessel disease (29% vs. 15%, p=0.049) and less commonly (38% vs. 54%, p=0.039) acute coronary occlusion than victims ... to death. CONCLUSION: This nationwide study found several differences in the pathologic lesions of the heart in victims aged 18-35 and 36-49years, which might be associated with different disease progression leading to death in these age groups. We also report a high frequency of cardiac symptoms prior...

  1. Reducing deaths in single vehicle collisions.

    NARCIS (Netherlands)

    Adminaite, D. Jost, G. Stipdonk, H. & Ward, H.

    2017-01-01

    A third of road deaths in the EU are caused by collisions that involve a single motorised vehicle where the driver, rider and/or passengers are killed but no other road users are involved. These single vehicle collisions (SVCs), and how to prevent them occurring, are the subject of this report.

  2. MRI of 'brain death'

    Energy Technology Data Exchange (ETDEWEB)

    Nishino, Shigeki; Itoh, Takahiko; Tuchida, Shohei; Kinugasa, Kazushi; Asari, Shoji; Nishimoto, Akira (Okayama Univ. (Japan). School of Medicine); Sanou, Kazuo

    1990-12-01

    Magnetic resonance imaging (MRI) was undertaken for two patients who suffered from severe cerebrovascular diseases and were clinically brain dead. The MRI system we used was Resona (Yokogawa Medical Systems, superconductive system 0.5 T) and the CT apparatus was Toshiba TCT-300. Initial CT and MRI were undertaken as soon as possible after admission, and repeated sequentially. After diagnosis of brain death, we performed angiography to determine cerebral circulatory arrest, and MRI obtained at the same time was compared with the angiogram and CT. Case 1 was a 77-year-old man who was admitted in an unconscious state. CT and MRI on the second day after hospitalization revealed cerebellar infarction. He was diagnosed as brain dead on day 4. Case 2 was a 35-year-old man. When he was transferred to our hospital, he was in cardiorespiratory arrested. Cardiac resuscitation was successful but no spontaneous respiration appeared. CT and MRI on admission revealed right intracerebral hemorrhage. Angiography revealed cessation of contrast medium in intracranial vessels in both of the patients. We found no 'flow signal void sign' in the bilateral internal carotid and basilar arteries on MRI images in both cases after brain death. MRI, showing us the anatomical changes of the brain, clearly revealed brain herniations, even though only nuclear findings of 'brain tamponade' were seen on CT. But in Case 1, we could not see the infarct lesions in the cerebellum on MR images obtained after brain death. This phenomenon was caused by the whole brain ischemia masking the initial ischemic lesions. We concluded that MRI was useful not only the anatomical display of lesions and brain herniation with high contrast resolution but for obtaining information on cerebral circulation of brain death. (author).

  3. Immotile Active Matter: Activity from Death and Reproduction

    Science.gov (United States)

    Kalziqi, Arben; Yanni, David; Thomas, Jacob; Ng, Siu Lung; Vivek, Skanda; Hammer, Brian K.; Yunker, Peter J.

    2018-01-01

    Unlike equilibrium atomic solids, biofilms—soft solids composed of bacterial cells—do not experience significant thermal fluctuations at the constituent level. However, living cells stochastically reproduce and die, provoking a mechanical response. We investigate the mechanical consequences of cellular death and reproduction by measuring surface-height fluctuations of biofilms containing two mutually antagonistic strains of Vibrio cholerae that kill one another on contact via the type VI secretion system. While studies of active matter typically focus on activity via constituent mobility, here, activity is mediated by reproduction and death events in otherwise immobilized cells. Biofilm surface topography is measured in the nearly homeostatic limit via white light interferometry. Although biofilms are far from equilibrium systems, measured surface-height fluctuation spectra resemble the spectra of thermal permeable membranes but with an activity-mediated effective temperature, as predicted by Risler, Peilloux, and Prost [Phys. Rev. Lett. 115, 258104 (2015), 10.1103/PhysRevLett.115.258104]. By comparing the activity of killer strains of V. cholerae with that of genetically modified strains that cannot kill each other and validating with individual-based simulations, we demonstrate that extracted effective temperatures increase with the amount of death and reproduction and that death and reproduction can fluidize biofilms. Together, these observations demonstrate the unique physical consequences of activity mediated by death and reproduction events.

  4. Parent & Child Perceptions of Child Health after Sibling Death.

    Science.gov (United States)

    Roche, Rosa M; Brooten, Dorothy; Youngblut, JoAnne M

    Understanding children's health after a sibling's death and what factors may affect it is important for treatment and clinical care. This study compared children's and their parents' perceptions of children's health and identified relationships of children's age, gender, race/ethnicity, anxiety, and depression and sibling's cause of death to these perceptions at 2 and 4 months after sibling death. 64 children and 48 parents rated the child's health "now" and "now vs before" the sibling's death in an ICU or ER or at home shortly after withdrawal of life-prolonging technology. Children completed the Child Depression Inventory and Spence Children's Anxiety Scale. Sibling cause of death was collected from hospital records. At 2 and 4 months, 45% to 54% of mothers' and 53% to 84% of fathers' ratings of their child's health "now" were higher than their children's ratings. Child health ratings were lower for: children with greater depression; fathers whose children reported greater anxiety; mothers whose child died of a chronic condition. Children's ratings of their health "now vs before" their sibling's death did not differ significantly from mothers' or fathers' ratings at 2 or 4 months. Black fathers were more likely to rate the child's health better "now vs before" the death; there were no significant differences by child gender and cause of death in child's health "now vs before" the death. Children's responses to a sibling's death may not be visually apparent or become known by asking parents. Parents often perceive their children as healthier than children perceive themselves at 2 and 4 months after sibling death, so talking with children separately is important. Children's perceptions of their health may be influenced by depression, fathers' perceptions by children's anxiety, and mother's perceptions by the cause of sibling death.

  5. Maternal deaths databases analysis: Ecuador 2003-2013

    Directory of Open Access Journals (Sweden)

    Antonio Pino

    2016-08-01

    Full Text Available Background: Maternal mortality ratio in Ecuador is the only millennium goal on which national agencies are still making strong efforts to reach 2015 target. The purpose of the study was to process national maternal death databases to identify a specific association pattern of variable included in the death certificate. Design and methods: The study processed mortality databases published yearly by the National Census and Statistics Institute (INEC. Data analysed were exclusively maternal deaths. Data corresponds to the 2003-2013 period, accessible through INEC’s website. Comparisons are based on number of deaths and use an ecological approach for geographical coincidences. Results: The study identified variable association into the maternal mortality national databases showing that to die at home or in a different place than a hospital is closely related to women’s socioeconomic characteristics; there was an association with the absence of a public health facility. Also, to die in a different place than the usual residence could mean that women and families are searching for or were referred to a higher level of attention when they face complications. Conclusions: Ecuadorian maternal deaths showed Patterns of inequity in health status, health care provision and health risks. A predominant factor seems unclear to explain the variable association found processing national databases; perhaps every pattern of health systems development played a role in maternal mortality or factors different from those registered by the statistics system may remain hidden. Some random influences might not be even considered in an explanatory model yet.

  6. Associations and predictions of readmission or death in acutely admitted older medical patients using self-reported frailty and functional measures. A Danish cohort study

    DEFF Research Database (Denmark)

    Andreasen, Jane; Aadahl, Mette; Sørensen, Erik Elgaard

    2018-01-01

    OBJECTIVE: To assess whether frailty in acutely admitted older medical patients, assessed by a self-report questionnaire and evaluation of functional level at discharge, was associated with readmission or death within 6 months after discharge. A second objective was to assess the predictive...... measured. Associations were assessed using Cox regression with first unplanned readmission or death (all-causes) as the outcome. Prediction models including the three exposure variables and known risk factors were modelled using logistic regression and C-statistics. RESULTS: Of 1328 included patients, 50......% were readmitted or died within 6 months. When adjusted for gender and age, there was an 88% higher risk of readmission or death if the TFI scores were 8-13 points compared to 0-1 points (HR 1.88, CI 1.38;2.58). Likewise, higher TUG and lower GS scores were associated with higher risk of readmission...

  7. Designing and evaluating an electronic patient falls reporting system: perspectives for the implementation of health information technology in long-term residential care facilities.

    Science.gov (United States)

    Mei, Yi You; Marquard, Jenna; Jacelon, Cynthia; DeFeo, Audrey L

    2013-11-01

    Patient falls are the leading cause of unintentional injury and death among older adults. In 2000, falls resulted in over 10,300 elderly deaths, costing the United States approximately $179 million in incidence and medical costs. Furthermore, non-fatal injuries caused by falls cost the United States $19 billion annually. Health information technology (IT) applications, specifically electronic falls reporting systems, can aid quality improvement efforts to prevent patient falls. Yet, long-term residential care facilities (LTRCFs) often do not have the financial resources to implement health IT, and workers in these settings are often not ready to adopt such systems. Additionally, most health IT evaluations are conducted in large acute-care settings, so LTRCF administrators currently lack evidence to support the value of health IT. In this paper, we detail the development of a novel, easy-to-use system to facilitate electronic patient falls reporting within a LTRCF using off-the-shelf technology that can be inexpensively implemented in a wide variety of settings. We report the results of four complimentary system evaluation measures that take into consideration varied organizational stakeholders' perspectives: (1) System-level benefits and costs, (2) system usability, via scenario-based use cases, (3) a holistic assessment of users' physical, cognitive, and marcoergonomic (work system) challenges in using the system, and (4) user technology acceptance. We report the viability of collecting and analyzing data specific to each evaluation measure and detail the relative merits of each measure in judging whether the system is acceptable to each stakeholder. The electronic falls reporting system was successfully implemented, with 100% reporting at 3-months post-implementation. The system-level benefits and costs approach showed that the electronic system required no initial investment costs aside from personnel costs and significant benefits accrued from user time savings

  8. Continuous stochastic approach to birth and death processes and co-operative behaviour of systems far from equilibrium

    Energy Technology Data Exchange (ETDEWEB)

    Chechetkin, V.R.; Lutovinov, V.S.

    1986-09-11

    The continuous stochastic formalism for the description of systems with birth and death processes randomly distributed in space is developed with the use of local birth and death operators and local generalization of the corresponding Chapman-Kolmogorov equation. The functional stochastic equation for the evolution of the probability functional is derived and its modifications for evolution of the characteristic functional and the first passage time problem are given. The corresponding evolution equations for equal-time correlators are also derived. The results are generalized then on the exothermic and endothermic chemical reactions. As examples of the particular applications of the results the small fluctuations near stable equilibrium state and fluctuations in mono-molecular reactions, Lotka-Volterra model, Schloegl reaction and brusselator are considered. It is shown that the two-dimensional Lotka-Volterra model may exhibit synergetic phase transition analogous to the topological transition of the Kosterlitz-Thouless-Berezinskii type. At the end of the paper some general consequences from stochastic evolution of the birth and death processes are discussed and the arguments on their importance in evolution of populations, cellular dynamics and in applications to various chemical and biological problems are presented.

  9. Effectiveness of a Death-Education Program in Reducing Death Anxiety of Nursing Students.

    Science.gov (United States)

    Johansson, Noreen; Lally, Terry

    1991-01-01

    Evaluated effectiveness of death education program in reducing death anxiety experienced by 22 junior and senior nursing students. Subjects were pre- and posttested with State Form of State-Trait Anxiety Inventory and viewed film of death experience. Posttest analysis indicated that death education program was effective in decreasing death anxiety…

  10. Death and Grief

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Death and Grief KidsHealth / For Teens / Death and Grief What's in this article? What Is ... the reaction we have in response to a death or loss. Grief can affect our body, mind, ...

  11. The extrinsic cell death pathway and the élan mortel.

    Science.gov (United States)

    Wallach, D; Kang, T-B; Kovalenko, A

    2008-10-01

    Early in the exploration of the chemical nature of life, it was widely believed that the molecules of living organisms, by their very nature, differ from those of inorganic material molecules and possess a vital force ('élan vital'). Similarly, early scientific thinking on the subject of cell death and its induction by cytotoxic cells of the immune system was pervaded by a sense that the molecules mediating these functions possess intrinsic deadly activity and are dedicated exclusively to death-related tasks. This impression was also reflected in the initial notions of the mode of action of intracellular proteins that signal for death. It is now gradually becoming clear, however, that proteins participating in death induction also have functions unrelated to death. Nevertheless, as exemplified by studies of the function of caspase-8 (an enzyme that signals both for activation of the extrinsic cell-death pathway and for non-death-related effects), analysis of the mechanistic basis for such heterogeneity might allow identification of distinct structural determinants in the proteins participating in death induction that do bear death specificity.

  12. Identity after Death

    DEFF Research Database (Denmark)

    Gerstrøm, Anna

    2015-01-01

    Purpose: The purpose of this paper is to explore how legacy organizational identity and death relate to each other and, thereby, contribute to closing the gap in knowledge on organizational identity constructions in times of death. Design/methodology/approach: The paper opted for an exploratory....../value: This paper addresses an apparent gap in the literature on identity and death; exploring identity narratives in a bankrupted bank, the paper considers constructions of legacy organizational identities in times of disruptive death....

  13. Review of Canine Deaths While in Service in US Civilian Law Enforcement (2002-2012).

    Science.gov (United States)

    Stojsih, Sarah E; Baker, Janice L; Les, Clifford M; Bir, Cynthia A

    2014-01-01

    Working dogs have been proven effective in multiple military and law enforcement applications. Similar to their human counterparts, understanding mortality while still in service can help improve treatment of injuries, and improve equipment and training, to potentially reduce deaths. This is a retrospective study to characterize mortality of working dogs used in civilian law enforcement. Reported causes of death were gathered from two working dog and law enforcement officer memorial websites. Of the 867 civilian law enforcement dogs reported to these memorial websites from 2002 to 2012 with reported causes of death while in service, the deaths of 318 were categorized as traumatic. The leading reported causes of traumatic death or euthanasia include trauma as a result of a vehicle strike, 25.8% (n=82); heatstroke, 24.8% (n=79); and penetrating ballistic trauma, 23.0% (n=73). Although the information gathered was from online sources, this study casts some light on the risks that civilian law enforcement dogs undergo as part of the tasks to which they are assigned. These data underscore the need for a comprehensive database for this specialized population of working dogs to provide the robust, reliable data needed to develop prevention and treatment strategies for this valuable resource. 2014.

  14. A Death in the Family: Death as a Zen Concept

    Science.gov (United States)

    Black, Helen K.; Rubinstein, Robert L.

    2013-01-01

    This study is based on original research that explored family reaction to the death of an elderly husband and father. We interviewed 34 families (a family included a widow and two adult biological children) approximately 6 to 10 months after the death. In one-on-one interviews, we discussed family members' initial reaction to the death, how the…

  15. Deaths ascribed to non-communicable diseases among rural Kenyan adults are proportionately increasing: evidence from a health and demographic surveillance system, 2003-2010.

    Directory of Open Access Journals (Sweden)

    Penelope A Phillips-Howard

    Full Text Available Non-communicable diseases (NCDs result in more deaths globally than other causes. Monitoring systems require strengthening to attribute the NCD burden and deaths in low and middle-income countries (LMICs. Data from health and demographic surveillance systems (HDSS can contribute towards this goal.Between 2003 and 2010, 15,228 deaths in adults aged 15 years (y and older were identified retrospectively using the HDSS census and verbal autopsy in rural western Kenya, attributed into broad categories using InterVA-4 computer algorithms; 37% were ascribed to NCDs, 60% to communicable diseases (CDs, 3% to injuries, and <1% maternal causes. Median age at death for NCDs was 66y and 71y for females and males, respectively, with 43% (39% male, 48% female of NCD deaths occurring prematurely among adults aged below 65y. NCD deaths were mainly attributed to cancers (35% and cardio-vascular diseases (CVDs; 29%. The proportionate mortality from NCDs rose from 35% in 2003 to 45% in 2010 (χ2 linear trend 93.4; p<0.001. While overall annual mortality rates (MRs for NCDs fell, cancer-specific MRs rose from 200 to 262 per 100,000 population, mainly due to increasing deaths in adults aged 65y and older, and to respiratory neoplasms in all age groups. The substantial fall in CD MRs resulted in similar MRs for CDs and NCDs among all adult females by 2010. NCD MRs for adults aged 15y to <65y fell from 409 to 183 per 100,000 among females and from 517 to 283 per 100,000 population among males. NCD MRs were higher among males than females aged both below, and at or above, 65y.NCDs constitute a significant proportion of deaths in rural western Kenya. Evidence of the increasing contribution of NCDs to overall mortality supports international recommendations to introduce or enhance prevention, screening, diagnosis and treatment programmes in LMICs.

  16. Seizure-related death in children with epilepsy

    African Journals Online (AJOL)

    2016-08-16

    Aug 16, 2016 ... mortality risk and improve health outcomes in ... lepsy may dwarf the wish of the parents and the patient to report to ... awareness of the increased risk for premature death as- sociated with ... food in his mouth. Such a child ...

  17. Childhood deaths from external causes in Estonia, 2001–2005

    Science.gov (United States)

    Väli, Marika; Lang, Katrin; Soonets, Ruth; Talumäe, Marika; Grjibovski, Andrej M

    2007-01-01

    Background In 2000, the overall rate of injury deaths in children aged 0–14 was 28.7 per 100000 in Estonia, which is more than 5 times higher than the corresponding rate in neighbouring Finland. This paper describes childhood injury mortality in Estonia by cause and age groups, and validates registration of these deaths in the Statistical Office of Estonia against the autopsy data. Methods The data on causes of all child deaths in Estonia in 2001–2005 were abstracted from the autopsy protocols at the Estonian Bureau of Forensic Medicine. Average annual mortality rates per 100,000 were calculated. Coverage (proportion of the reported injury deaths from the total number of injury deaths) and accuracy (proportion of correctly classified injury deaths) of the registration of causes of death in Statistical Office of Estonia were assessed by comparing the Statistical Office of Estonia data with the data from Estonian Bureau of Forensic Medicine. Results Average annual mortality from external causes in 0–14 years-old children in Estonia was 19.1 per 100,000. Asphyxia and transport accidents were the major killers followed by poisoning and suicides. Relative contribution of these causes varied greatly between age groups. Intent of death was unknown for more than 10% of injury deaths. Coverage and accuracy of registration of injury deaths by Statistical Office of Estonia were 91.5% and 95.3%, respectively. Conclusion Childhood mortality from injuries in Estonia is among the highest in the EU. The number of injury deaths in Statistical Office of Estonia is slightly underestimated mostly due to misclassification for deaths from diseases. Accuracy of the Statistical Office of Estonia data was high with some underestimation of intentional deaths. Moreover, high proportion of death with unknown intent suggests underestimation of intentional deaths. Reduction of injury deaths should be given a high priority in Estonia. More information on circumstances around death is

  18. Childhood deaths from external causes in Estonia, 2001–2005

    Directory of Open Access Journals (Sweden)

    Soonets Ruth

    2007-07-01

    Full Text Available Abstract Background In 2000, the overall rate of injury deaths in children aged 0–14 was 28.7 per 100000 in Estonia, which is more than 5 times higher than the corresponding rate in neighbouring Finland. This paper describes childhood injury mortality in Estonia by cause and age groups, and validates registration of these deaths in the Statistical Office of Estonia against the autopsy data. Methods The data on causes of all child deaths in Estonia in 2001–2005 were abstracted from the autopsy protocols at the Estonian Bureau of Forensic Medicine. Average annual mortality rates per 100,000 were calculated. Coverage (proportion of the reported injury deaths from the total number of injury deaths and accuracy (proportion of correctly classified injury deaths of the registration of causes of death in Statistical Office of Estonia were assessed by comparing the Statistical Office of Estonia data with the data from Estonian Bureau of Forensic Medicine. Results Average annual mortality from external causes in 0–14 years-old children in Estonia was 19.1 per 100,000. Asphyxia and transport accidents were the major killers followed by poisoning and suicides. Relative contribution of these causes varied greatly between age groups. Intent of death was unknown for more than 10% of injury deaths. Coverage and accuracy of registration of injury deaths by Statistical Office of Estonia were 91.5% and 95.3%, respectively. Conclusion Childhood mortality from injuries in Estonia is among the highest in the EU. The number of injury deaths in Statistical Office of Estonia is slightly underestimated mostly due to misclassification for deaths from diseases. Accuracy of the Statistical Office of Estonia data was high with some underestimation of intentional deaths. Moreover, high proportion of death with unknown intent suggests underestimation of intentional deaths. Reduction of injury deaths should be given a high priority in Estonia. More information on

  19. Nitrosothiol signaling and protein nitrosation in cell death.

    Science.gov (United States)

    Iyer, Anand Krishnan V; Rojanasakul, Yon; Azad, Neelam

    2014-11-15

    Nitric oxide, a reactive free radical, is an important signaling molecule that can lead to a plethora of cellular effects affecting homeostasis. A well-established mechanism by which NO manifests its effect on cellular functions is the post-translational chemical modification of cysteine thiols in substrate proteins by a process known as S-nitrosation. Studies that investigate regulation of cellular functions through NO have increasingly established S-nitrosation as the primary modulatory mechanism in their respective systems. There has been a substantial increase in the number of reports citing various candidate proteins undergoing S-nitrosation, which affects cell-death and -survival pathways in a number of tissues including heart, lung, brain and blood. With an exponentially growing list of proteins being identified as substrates for S-nitrosation, it is important to assimilate this information in different cell/tissue systems in order to gain an overall view of protein regulation of both individual proteins and a class of protein substrates. This will allow for broad mapping of proteins as a function of S-nitrosation, and help delineate their global effects on pathophysiological responses including cell death and survival. This information will not only provide a much better understanding of overall functional relevance of NO in the context of various disease states, it will also facilitate the generation of novel therapeutics to combat specific diseases that are driven by NO-mediated S-nitrosation. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. [Toxicomania: death beyond risk. Analysis of cause-of-death in drug addicts].

    Science.gov (United States)

    Jeanmonod, R; Fryc, O

    1990-11-03

    Violent deaths are of considerable importance among young adults, since they account for half the deaths in this age group (average age 26.4 years). Suicide and accidents (both categories including drug overdoses) are the most frequent categories of deaths from non-natural causes, while in the USA deaths by homicide are also of considerable importance. Current repressive policies have not brought the problem of drug addiction under control. Each year deaths by overdose among drug abusers occur. Nevertheless, 40% of deaths among drug addicts are from other causes, principally accidents and suicides. In the near future, AIDS may well account for the majority of deaths among drug addicts, thus adding to the mortality from overdose, both accidental and suicidal. Has the time come to reconsider the problem of drug abuse and to find radical solutions which would previously have been unthinkable?

  1. Activation of AMP-activated protein kinase by tributyltin induces neuronal cell death

    International Nuclear Information System (INIS)

    Nakatsu, Yusuke; Kotake, Yaichiro; Hino, Atsuko; Ohta, Shigeru

    2008-01-01

    AMP-activated protein kinase (AMPK), a member of the metabolite-sensing protein kinase family, is activated by energy deficiency and is abundantly expressed in neurons. The environmental pollutant, tributyltin chloride (TBT), is a neurotoxin, and has been reported to decrease cellular ATP in some types of cells. Therefore, we investigated whether TBT activates AMPK, and whether its activation contributes to neuronal cell death, using primary cultures of cortical neurons. Cellular ATP levels were decreased 0.5 h after exposure to 500 nM TBT, and the reduction was time-dependent. It was confirmed that most neurons in our culture system express AMPK, and that TBT induced phosphorylation of AMPK. Compound C, an AMPK inhibitor, reduced the neurotoxicity of TBT, suggesting that AMPK is involved in TBT-induced cell death. Next, the downstream target of AMPK activation was investigated. Nitric oxide synthase, p38 phosphorylation and Akt dephosphorylation were not downstream of TBT-induced AMPK activation because these factors were not affected by compound C, but glutamate release was suggested to be controlled by AMPK. Our results suggest that activation of AMPK by TBT causes neuronal death through mediating glutamate release

  2. Sudden death victims

    NARCIS (Netherlands)

    Ceelen, Manon; van der Werf, Christian; Hendrix, Anneke; Naujocks, Tatjana; Woonink, Frits; de Vries, Philip; van der Wal, Allard; Das, Kees

    2015-01-01

    The goal of this study was to ascertain accordance between cause of death established by the forensic physician and autopsy results in young sudden death victims in the Netherlands. Sudden death victims aged 1-45 years examined by forensic physicians operating in the participating regions which also

  3. The Death Penalty: Pancasila, with Efforts to Eradicated Drugs

    OpenAIRE

    R., Anggun Ariena; Ky, Ade Oktariatas

    2015-01-01

    The rise of drugs criminal in Indonesia at this time, making Indonesia would be drugs emergency. Drugs is an extraordinary crime and need special attention in the eradication effort. Therefore it takes great strength to use legal action heaviest where Indonesia has a death penalty sentence. The purpose of the death penalty is to give hard effect for drugs criminal and as warning for the others. The reality of the death penalty in Indonesia shows the operation of the judicial system is not go...

  4. A 3-year surveillance on causes of death or reasons for euthanasia of domesticated dogs in Taiwan.

    Science.gov (United States)

    Huang, Wei-Hsiang; Liao, Albert Taiching; Chu, Pei-Yi; Zhai, Shao-Hua; Yen, I-Feng; Liu, Chen-Hsuan

    2017-11-01

    Over the last 2 decades, there has been growing interest in research on the mortality of domesticated pets. These studies relied on an effective data-collecting system. During 2012-2014, a real-time reporting system was designed for mortality data in owned dogs and cats. The present retrospective study aimed to report on the causes of death (CODs) or reasons for euthanasia (RFEs) in domesticated dogs in Taiwan, and to investigate CODs/RFEs segregated by demographic variables. Data from 2306 domesticated dogs were acquired during the 3-year period in the present study. The median age at death of the study population was 10.2 years (median interquartile range 7.0-14.0; range 0.0-25.0). Crossbred, female, and neutered dogs showed greater ages at death than other groups. The most common COD/RFE was neoplasia, followed by multiple organ involvement (MOI) and cardiovascular diseases. Segregated by cut-off ages, the most common COD/RFE was infection among dogs younger than 3 years or 1year, and neoplasia among dogs at or older than 3 years or 1year of age; the most common COD/RFE was neoplasia among dogs younger than median age, and MOI among dogs at or older than median age. Segregated by geographic variables, the ranking and frequency of CODs/RFEs displayed different patterns between the capital city/non-capital areas, and among areas stratified by human population densities. The study provides various insights into age at death and CODs/RFEs in owned-dog population in Taiwan, and provides new directions for future research. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Triglyceride-induced macrophage cell death is triggered by caspase-1.

    Science.gov (United States)

    Son, Sin Jee; Rhee, Ki-Jong; Lim, Jaewon; Kim, Tae Ue; Kim, Tack-Joong; Kim, Yoon Suk

    2013-01-01

    Triglyceride (TG) induces macrophage cell death which contributes to the development of atherosclerosis. We confirmed that exogenous TG accumulates in human THP-1 macrophages and causes cell death. TG treated THP-1 macrophages exhibited no change in tumor necrosis factor (TNF)-α, interleukin (IL)-18, macrophage inflammatory protein (MIP)-1α, and IL-1R1 receptor mRNA expression. However, there was a marked decrease in IL-1β mRNA expression but an increase in IL-1β protein secretion. Decreased expression of IL-1β mRNA and increased secretion of IL-1β protein was not the direct cause of cell death. Until now, TG was assumed to induce necrotic cell death in macrophages. Since caspase-1 is known to be involved in activation and secretion of IL-1β protein and pyroptotic cell death, next we determined whether caspase-1 is associated with TG-induced macrophage cell death. We found an increase in caspase-1 activity in TG-treated THP-1 macrophages and inhibition of caspase-1 activity using a specific inhibitor partially rescued cell death. These results suggest activation of the pyroptotic pathway by TG. This is the first report implicating the activation of caspase-1 and the triggering of the pyroptosis pathway in TG-induced macrophage cell death.

  6. Ionizing radiation-induced cell death

    International Nuclear Information System (INIS)

    Szumiel, I.

    1994-01-01

    Selected aspects of radiation-induced cell death, connected with signal transduction pathways are reviewed. Cell death is defined as insufficiency of the cellular signal transducing system to maintain the cell's physiological functions. The insufficiency may be due to impaired signal reception and/or transduction, lack or erroneous transcription activation, and eventual cellular ''misexpression'' of the signal. The molecular basis of this insufficiency would be damage to genomic (but also other cellular) structures and closing of specific signalling pathways or opening of others (like those leading to apoptosis). I describe experimental data that suggest an important role of RAS/NFI and p53/p105 Rb proteins in cell cycle control-coupled responses to DNA damage. (Author)

  7. The place of death of patients with cancer in Kuwait.

    Science.gov (United States)

    Alshemmari, Salem H; Elbasmi, Amani A; Alsirafy, Samy A

    2015-12-01

    The place of death (PoD) has a significant effect on end-of-life care for patients dying of cancer. Little is known about the place of cancer deaths in our region. To identify the PoD of patients with cancer in Kuwait, we reviewed the death certificates submitted to the Kuwait Cancer Registry in 2009. Of 611 cancer deaths, 603 (98.7%) died in hospitals and only 6 (1%) patients died at home. More than half (57.3%) of inhospital deaths were in the Kuwait Cancer Control Center. Among those for whom the exact PoD within the hospital was identified (484 patients), 116 (24%) patients died in intensive care units and 12 (2.5%) patients died in emergency rooms. This almost exclusive inhospital death of patients with cancer in Kuwait is the highest ever reported. Research is needed to identify the reasons behind this pattern of PoD and to explore interventions promoting out-of-hospital death among terminally ill cancer patients in Kuwait. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  8. Grief after patient death: direct care staff in nursing homes and homecare.

    Science.gov (United States)

    Boerner, Kathrin; Burack, Orah R; Jopp, Daniela S; Mock, Steven E

    2015-02-01

    Patient death is common in long-term care (LTC). Yet, little attention has been paid to how direct care staff members, who provide the bulk of daily LTC, experience patient death and to what extent they are prepared for this experience. To 1) determine how grief symptoms typically reported by bereaved family caregivers are experienced among direct care staff, 2) explore how prepared the staff members were for the death of their patients, and 3) identify characteristics associated with their grief. This was a cross-sectional study of direct care staff experiencing recent patient death. Participants were 140 certified nursing assistants and 80 homecare workers. Standardized assessments and structured questions addressed staff (e.g., preparedness for death), institutional (e.g., support availability), and patient/relational factors (e.g., relationship quality). Data analyses included bivariate group comparisons and hierarchical regression. Grief reactions of staff reflected many of the core grief symptoms reported by bereaved family caregivers in a large-scale caregiving study. Feelings of being "not at all prepared" for the death and struggling with "acceptance of death" were prevalent among the staff. Grief was more intense when staff-patient relationships were closer, care was provided for longer, and staff felt emotionally unprepared for the death. Grief symptoms like those experienced by family caregivers are common among direct care workers after patient death. Increasing preparedness for this experience via better training and support is likely to improve the occupational experience of direct care workers and ultimately allow them to provide better palliative care in nursing homes and homecare. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  9. Vaccine adverse event text mining system for extracting features from vaccine safety reports.

    Science.gov (United States)

    Botsis, Taxiarchis; Buttolph, Thomas; Nguyen, Michael D; Winiecki, Scott; Woo, Emily Jane; Ball, Robert

    2012-01-01

    To develop and evaluate a text mining system for extracting key clinical features from vaccine adverse event reporting system (VAERS) narratives to aid in the automated review of adverse event reports. Based upon clinical significance to VAERS reviewing physicians, we defined the primary (diagnosis and cause of death) and secondary features (eg, symptoms) for extraction. We built a novel vaccine adverse event text mining (VaeTM) system based on a semantic text mining strategy. The performance of VaeTM was evaluated using a total of 300 VAERS reports in three sequential evaluations of 100 reports each. Moreover, we evaluated the VaeTM contribution to case classification; an information retrieval-based approach was used for the identification of anaphylaxis cases in a set of reports and was compared with two other methods: a dedicated text classifier and an online tool. The performance metrics of VaeTM were text mining metrics: recall, precision and F-measure. We also conducted a qualitative difference analysis and calculated sensitivity and specificity for classification of anaphylaxis cases based on the above three approaches. VaeTM performed best in extracting diagnosis, second level diagnosis, drug, vaccine, and lot number features (lenient F-measure in the third evaluation: 0.897, 0.817, 0.858, 0.874, and 0.914, respectively). In terms of case classification, high sensitivity was achieved (83.1%); this was equal and better compared to the text classifier (83.1%) and the online tool (40.7%), respectively. Our VaeTM implementation of a semantic text mining strategy shows promise in providing accurate and efficient extraction of key features from VAERS narratives.

  10. Explosive death of conjugate coupled Van der Pol oscillators on networks

    Science.gov (United States)

    Zhao, Nannan; Sun, Zhongkui; Yang, Xiaoli; Xu, Wei

    2018-06-01

    Explosive death phenomenon has been gradually gaining attention of researchers due to the research boom of explosive synchronization, and it has been observed recently for the identical or nonidentical coupled systems in all-to-all network. In this work, we investigate the emergence of explosive death in networked Van der Pol (VdP) oscillators with conjugate variables coupling. It is demonstrated that the network structures play a crucial role in identifying the types of explosive death behaviors. We also observe that the damping coefficient of the VdP system not only can determine whether the explosive death state is generated but also can adjust the forward transition point. We further show that the backward transition point is independent of the network topologies and the damping coefficient, which is well confirmed by theoretical analysis. Our results reveal the generality of explosive death phenomenon in different network topologies and are propitious to promote a better comprehension for the oscillation quenching behaviors.

  11. [Sudden death from hypoglycemia].

    Science.gov (United States)

    Asmundo, A; Aragona, M; Gualniera, P; Aragona, F

    1995-12-01

    The sudden death by hypoglycemia is an aspect of the forensic pathology frequently neglected. Authors initially described the pathogenesis of different hypoglycemia forms, distinguishing the primary ones due to hyperinsulinism and the secondary ones due to functional insufficiency of other organs (hypophysis, thyroid, adrenal gland, liver); after that Authors described three cases of sudden death induced hypoglycemia by hyperinsulinism: two were unweaned with nesidioblastosis and one adolescent. In any form of hypoglycemia the central nervous system damage is present with evident neuronal degenerative-necrotic phenomena, widespread edema with microhemorrhage, swollen and dissociation of myelin sheath, glial cells hyperplasia. Death caused by primary hypoglycemia is histopathologically different from the secondary one because of the maintenance of hepatic glycogen content in the former, that increase in striated muscles, including the heart, in spite of the constant secretion of catecholamine from the adrenal medulla. Glycogen is depleted in secondary hypoglycemia. In the primary form, behind the adrenal medulla hyperfunction, the increased functional activity of the adrenal cortex is moderate, contrasting with the seriousness of the syndrome, due prevalently to inhibit the gluconeogenesis response conditioned by the persistence of stored glycogen in the liver, heart and striated muscles. The rare anoxic processes coming with resynthesis of hepatic glycogen have to be considered in the differential diagnosis. The primary hypoglycemic death, especially in unweaned, is frequently promoted by other processes inducing hypoxia (fetal asphyxia outcome, pneumonia, etc.) or worsening the hypoglycemia (hypothyroidism, etc.). The secondary hypoglycemias are characterized by the normality of exocrine pancreas and by organic alterations that cause glycogen depletion from the liver.

  12. An integrated national mortality surveillance system for death registration and mortality surveillance, China.

    Science.gov (United States)

    Liu, Shiwei; Wu, Xiaoling; Lopez, Alan D; Wang, Lijun; Cai, Yue; Page, Andrew; Yin, Peng; Liu, Yunning; Li, Yichong; Liu, Jiangmei; You, Jinling; Zhou, Maigeng

    2016-01-01

    In China, sample-based mortality surveillance systems, such as the Chinese Center for Disease Control and Prevention's disease surveillance points system and the Ministry of Health's vital registration system, have been used for decades to provide nationally representative data on health status for health-care decision-making and performance evaluation. However, neither system provided representative mortality and cause-of-death data at the provincial level to inform regional health service needs and policy priorities. Moreover, the systems overlapped to a considerable extent, thereby entailing a duplication of effort. In 2013, the Chinese Government combined these two systems into an integrated national mortality surveillance system to provide a provincially representative picture of total and cause-specific mortality and to accelerate the development of a comprehensive vital registration and mortality surveillance system for the whole country. This new system increased the surveillance population from 6 to 24% of the Chinese population. The number of surveillance points, each of which covered a district or county, increased from 161 to 605. To ensure representativeness at the provincial level, the 605 surveillance points were selected to cover China's 31 provinces using an iterative method involving multistage stratification that took into account the sociodemographic characteristics of the population. This paper describes the development and operation of the new national mortality surveillance system, which is expected to yield representative provincial estimates of mortality in China for the first time.

  13. Imaging spectrum of sudden athlete cardiac death

    Energy Technology Data Exchange (ETDEWEB)

    Arrigan, M.T., E-mail: martinarrigan@gmail.co [Department of Radiology, Adelaide and Meath Hospital incorporating the National Children' s Hospital, Dublin (Ireland); Killeen, R.P. [Department of Radiology, Adelaide and Meath Hospital incorporating the National Children' s Hospital, Dublin (Ireland); Dodd, J.D. [Department of Radiology, St Vincent' s University Hospital, Dublin (Ireland); Torreggiani, W.C. [Department of Radiology, Adelaide and Meath Hospital incorporating the National Children' s Hospital, Dublin (Ireland)

    2011-03-15

    Sudden athlete death (SAD) is a widely publicized and increasingly reported phenomenon. For many, the athlete population epitomize human physical endeavour and achievement and their unexpected death comes with a significant emotional impact on the public. Sudden deaths within this group are often without prior warning. Preceding symptoms of exertional syncope and chest pain do, however, occur and warrant investigation. Similarly, a positive family history of sudden death in a young person or a known family history of a condition associated with SAD necessitates further tests. Screening programmes aimed at detecting those at risk individuals also exist with the aim of reducing fatalities. In this paper we review the topic of SAD and discuss the epidemiology, aetiology, and clinical presentations. We then proceed to discuss each underlying cause, in turn discussing the pathophysiology of each condition. This is followed by a discussion of useful imaging methods with an emphasis on cardiac magnetic resonance and cardiac computed tomography and how these address the various issues raised by the pathophysiology of each entity. We conclude by proposing imaging algorithms for the investigation of patients considered at risk for these conditions and discuss the various issues raised in screening.

  14. Imaging spectrum of sudden athlete cardiac death

    International Nuclear Information System (INIS)

    Arrigan, M.T.; Killeen, R.P.; Dodd, J.D.; Torreggiani, W.C.

    2011-01-01

    Sudden athlete death (SAD) is a widely publicized and increasingly reported phenomenon. For many, the athlete population epitomize human physical endeavour and achievement and their unexpected death comes with a significant emotional impact on the public. Sudden deaths within this group are often without prior warning. Preceding symptoms of exertional syncope and chest pain do, however, occur and warrant investigation. Similarly, a positive family history of sudden death in a young person or a known family history of a condition associated with SAD necessitates further tests. Screening programmes aimed at detecting those at risk individuals also exist with the aim of reducing fatalities. In this paper we review the topic of SAD and discuss the epidemiology, aetiology, and clinical presentations. We then proceed to discuss each underlying cause, in turn discussing the pathophysiology of each condition. This is followed by a discussion of useful imaging methods with an emphasis on cardiac magnetic resonance and cardiac computed tomography and how these address the various issues raised by the pathophysiology of each entity. We conclude by proposing imaging algorithms for the investigation of patients considered at risk for these conditions and discuss the various issues raised in screening.

  15. Imaging spectrum of sudden athlete cardiac death.

    LENUS (Irish Health Repository)

    Arrigan, M T

    2012-02-01

    Sudden athlete death (SAD) is a widely publicized and increasingly reported phenomenon. For many, the athlete population epitomize human physical endeavour and achievement and their unexpected death comes with a significant emotional impact on the public. Sudden deaths within this group are often without prior warning. Preceding symptoms of exertional syncope and chest pain do, however, occur and warrant investigation. Similarly, a positive family history of sudden death in a young person or a known family history of a condition associated with SAD necessitates further tests. Screening programmes aimed at detecting those at risk individuals also exist with the aim of reducing fatalities. In this paper we review the topic of SAD and discuss the epidemiology, aetiology, and clinical presentations. We then proceed to discuss each underlying cause, in turn discussing the pathophysiology of each condition. This is followed by a discussion of useful imaging methods with an emphasis on cardiac magnetic resonance and cardiac computed tomography and how these address the various issues raised by the pathophysiology of each entity. We conclude by proposing imaging algorithms for the investigation of patients considered at risk for these conditions and discuss the various issues raised in screening.

  16. Verbal autopsy completion rate and factors associated with undetermined cause of death in a rural resource-poor setting of Tanzania

    Directory of Open Access Journals (Sweden)

    Maliti Deodatus V

    2011-08-01

    Full Text Available Abstract Background Verbal autopsy (VA is a widely used tool to assign probable cause of death in areas with inadequate vital registration systems. Its uses in priority setting and health planning are well documented in sub-Saharan Africa (SSA and Asia. However, there is a lack of data related to VA processing and completion rates in assigning causes of death in a community. There is also a lack of data on factors associated with undetermined causes of death documented in SSA. There is a need for such information for understanding the gaps in VA processing and better estimating disease burden. Objective The study's intent was to determine the completion rate of VA and factors associated with assigning undetermined causes of death in rural Tanzania. Methods A database of deaths reported from the Ifakara Health and Demographic Surveillance System from 2002 to 2007 was used. Completion rates were determined at the following stages of processing: 1 death identified; 2 VA interviews conducted; 3 VA forms submitted to physicians; 4 coding and assigning of cause of death. Logistic regression was used to determine factors associated with deaths coded as "undetermined." Results The completion rate of VA after identification of death and the VA interview ranged from 83% in 2002 and 89% in 2007. Ninety-four percent of deaths submitted to physicians were assigned a specific cause, with 31% of the causes coded as undetermined. Neonates and child deaths that occurred outside health facilities were associated with a high rate of undetermined classification (33%, odds ratio [OR] = 1.33, 95% confidence interval [CI] (1.05, 1.67, p = 0.016. Respondents reporting high education levels were less likely to be associated with deaths that were classified as undetermined (24%, OR = 0.76, 95% CI (0.60, -0.96, p = 0.023. Being a child of the deceased compared to a partner (husband or wife was more likely to be associated with undetermined cause of death classification

  17. Discrepant comorbidity between minority and white suicides: a national multiple cause-of-death analysis

    Directory of Open Access Journals (Sweden)

    Stack Steven

    2009-03-01

    Full Text Available Abstract Background Clinician training deficits and a low and declining autopsy rate adversely impact the quality of death certificates in the United States. Self-report and records data for the general population indicate that proximate mental and physical health of minority suicides was at least as poor as that of white suicides. Methods This cross-sectional mortality study uses data from Multiple Cause-of-Death (MCOD public use files for 1999–2003 to describe and evaluate comorbidity among black, Hispanic, and white suicides. Unintentional injury decedents are the referent for multivariate analyses. Results One or more mentions of comorbid psychopathology are documented on the death certificates of 8% of white male suicides compared to 4% and 3% of black and Hispanic counterparts, respectively. Corresponding female figures are 10%, 8%, and 6%. Racial-ethnic discrepancies in the prevalence of comorbid physical disease are more attenuated. Cross-validation with National Violent Death Reporting System data reveals high relative underenumeration of comorbid depression/mood disorders and high relative overenumeration of schizophrenia on the death certificates of both minorities. In all three racial-ethnic groups, suicide is positively associated with depression/mood disorders [whites: adjusted odds ratio (AOR = 31.9, 95% CI = 29.80–34.13; blacks: AOR = 60.9, 95% CI = 42.80–86.63; Hispanics: AOR = 34.7, 95% CI = 23.36–51.62] and schizophrenia [whites: AOR = 2.4, 95% CI = 2.07–2.86; blacks: AOR = 4.2, 95% CI = 2.73–6.37; Hispanics: AOR = 4.1, 95% CI = 2.01–8.22]. Suicide is positively associated with cancer in whites [AOR = 1.8, 95% CI = 1.69–1.93] and blacks [AOR = 1.8, 95% CI = 1.36–2.48], but not with HIV or alcohol and other substance use disorders in any group under review. Conclusion The multivariate analyses indicate high consistency in predicting suicide-associated comorbidities across racial-ethnic groups using MCOD data

  18. Public Opinion and the Death Penalty: A Qualitative Approach

    Science.gov (United States)

    Falco, Diana L.; Freiburger, Tina L.

    2011-01-01

    Strong public support for capital punishment is arguably the number one reason why the death penalty continues to be used as a form of correctional policy in the U.S. criminal justice system. Therefore, it is fundamental that the measure of death penalty opinion be heavily scrutinized. Utilizing a methodological approach not typically employed in…

  19. Causes of adult female deaths in Bangladesh: findings from two National Surveys.

    Science.gov (United States)

    Nahar, Quamrun; El Arifeen, Shams; Jamil, Kanta; Streatfield, Peter Kim

    2015-09-18

    Assessment of causes of death and changes in pattern of causes of death over time are needed for programmatic purposes. Limited national level data exist on the adult female causes of death in Bangladesh. Using data from two nationally representation surveys, the 2001 and 2010 Bangladesh Maternal Mortality Surveys (BMMS), the paper examines the causes of adult female death, aged 15-49 years, and changes in the patterns of these deaths. In both surveys, all household deaths three years prior to the survey were identified. Adult female deaths were then followed by a verbal autopsy (VA) using the WHO structured questionnaire. Two physicians independently reviewed the VA forms to assign a cause of death using the ICD-10; in case of disagreement, a third physician made an independent review and assigned a cause of death. The overall mortality rates for women aged 15-49 in 2001 and 2010 were 182 per 100,000 and 120 per 100,000 respectively. There is a shift in the pattern of causes of death during the period covered by the two surveys. In the 2001 survey, the main causes of death were maternal (20 %), followed by diseases of the circulatory system (15 %), malignancy (14 %) and infectious diseases (13 %). However, in the 2010 survey, malignancies were the leading cause (21 %), followed by diseases of the circulatory system (16 %), maternal causes (14 %) and infectious diseases (8 %). While maternal deaths remained the number one cause of death among 20-34 years old in both surveys, unnatural deaths were the main cause for teenage deaths, and malignancies were the main cause of death for older women. Although there is an increasing trend in the proportion of women who died in hospitals, in both surveys most women died at home (74 % in 2001 and 62 % in 2010). The shift in the pattern of causes of adult female deaths is in agreement with the overall change in the disease pattern from communicable to non-communicable diseases in Bangladesh. Suicide and other violent deaths as

  20. Death during laparoscopy: can 1 gas push out another? Danger of argon electrocoagulation.

    Science.gov (United States)

    Sezeur, Alain; Partensky, Christian; Chipponi, Jacques; Duron, Jean-Jacques

    2008-08-01

    We report the death of a young man during a laparoscopic partial splenectomy performed with an argon plasma coagulator to remove a benign cyst. The report analyzes the very particular mechanism of a gas embolism, which caused death here. This analysis leads us to recommend a close attention on the use of argon coagulators during laparoscopy. The aim of this article is to draw surgeons' attention to the conclusions of a court-ordered expert assessment intended to elucidate the mechanisms responsible for the death of a 20-year-old man during a laparoscopic partial splenectomy performed with an argon plasma coagulator to remove a benign cyst.

  1. A Good Death? Report of the Second Newcastle Meeting on Laboratory Animal Euthanasia

    Science.gov (United States)

    Hawkins, Penny; Prescott, Mark J.; Carbone, Larry; Dennison, Ngaire; Johnson, Craig; Makowska, I. Joanna; Marquardt, Nicole; Readman, Gareth; Weary, Daniel M.; Golledge, Huw D. R.

    2016-01-01

    Simple Summary Millions of laboratory animals are killed each year worldwide. However, there is a lack of consensus regarding what methods of killing are humane for many species and stages of development. This report summarises research findings and discussions from an international meeting of experts and stakeholders, with recommendations to inform good practice for humane killing of mice, rats and zebrafish. It provides additional guidance and perspectives for researchers designing projects that involve euthanasing animals, researchers studying aspects of humane killing, euthanasia device manufacturers, regulators, and institutional ethics or animal care and use committees that wish to review local practice. Abstract Millions of laboratory animals are killed each year worldwide. There is an ethical, and in many countries also a legal, imperative to ensure those deaths cause minimal suffering. However, there is a lack of consensus regarding what methods of killing are humane for many species and stages of development. In 2013, an international group of researchers and stakeholders met at Newcastle University, United Kingdom to discuss the latest research and which methods could currently be considered most humane for the most commonly used laboratory species (mice, rats and zebrafish). They also discussed factors to consider when making decisions about appropriate techniques for particular species and projects, and priorities for further research. This report summarises the research findings and discussions, with recommendations to help inform good practice for humane killing. PMID:27563926

  2. Sudden Death: An Uncommon Occurrence in Dementia with Lewy Bodies.

    Science.gov (United States)

    Molenaar, Joery P; Wilbers, Joyce; Aerts, Marjolein B; Leijten, Quinten H; van Dijk, Jan G; Esselink, Rianne A; Bloem, Bastiaan R

    2016-01-01

    We present a 75-year-old woman with dementia and parkinsonism who developed severe orthostatic hypotension and eventually died. Autopsy revealed extensive Lewy body formation in the midbrain, limbic system, intermediate spinal cord, and medulla oblongata. Furthermore, a vast amount of Lewy bodies was seen in the paravertebral sympathetic ganglia which likely explained the severe autonomic failure. We speculate that this autonomic failure caused sudden death through dysregulation of respiration or heart rhythm, reminiscent of sudden death in multiple system atrophy (MSA). Clinicians should be aware of this complication in patients presenting with parkinsonism and autonomic dysfunction, and that sudden death may occur in dementia with Lewy bodies (DLB) as it does in MSA.

  3. Deaths from international terrorism compared with road crash deaths in OECD countries.

    Science.gov (United States)

    Wilson, N; Thomson, G

    2005-12-01

    To estimate the relative number of deaths in member countries of the Organisation for Economic Co-operation and Development (OECD) from international terrorism and road crashes. Data on deaths from international terrorism (US State Department database) were collated (1994-2003) and compared to the road injury deaths (year 2000 and 2001 data) from the OECD International Road Transport Accident Database. In the 29 OECD countries for which comparable data were available, the annual average death rate from road injury was approximately 390 times that from international terrorism. The ratio of annual road to international terrorism deaths (averaged over 10 years) was lowest for the United States at 142 times. In 2001, road crash deaths in the US were equal to those from a September 11 attack every 26 days. There is a large difference in the magnitude of these two causes of deaths from injury. Policy makers need to be aware of this when allocating resources to preventing these two avoidable causes of mortality.

  4. Young, Black, and Sentenced To Die: Black Males and the Death Penalty.

    Science.gov (United States)

    Joseph, Janice

    1996-01-01

    Explores the death penalty as imposed on young black males in the United States and examines the disparity in death penalty rates for homicides with black offenders and white victims. States continue to impose the death penalty rather than viewing youth violence as a failure of the social system. (SLD)

  5. BID links ferroptosis to mitochondrial cell death pathways

    Directory of Open Access Journals (Sweden)

    Sandra Neitemeier

    2017-08-01

    Full Text Available Ferroptosis has been defined as an oxidative and iron-dependent pathway of regulated cell death that is distinct from caspase-dependent apoptosis and established pathways of death receptor-mediated regulated necrosis. While emerging evidence linked features of ferroptosis induced e.g. by erastin-mediated inhibition of the Xc- system or inhibition of glutathione peroxidase 4 (Gpx4 to an increasing number of oxidative cell death paradigms in cancer cells, neurons or kidney cells, the biochemical pathways of oxidative cell death remained largely unclear. In particular, the role of mitochondrial damage in paradigms of ferroptosis needs further investigation.In the present study, we find that erastin-induced ferroptosis in neuronal cells was accompanied by BID transactivation to mitochondria, loss of mitochondrial membrane potential, enhanced mitochondrial fragmentation and reduced ATP levels. These hallmarks of mitochondrial demise are also established features of oxytosis, a paradigm of cell death induced by Xc- inhibition by millimolar concentrations of glutamate. Bid knockout using CRISPR/Cas9 approaches preserved mitochondrial integrity and function, and mediated neuroprotective effects against both, ferroptosis and oxytosis. Furthermore, the BID-inhibitor BI-6c9 inhibited erastin-induced ferroptosis, and, in turn, the ferroptosis inhibitors ferrostatin-1 and liproxstatin-1 prevented mitochondrial dysfunction and cell death in the paradigm of oxytosis. These findings show that mitochondrial transactivation of BID links ferroptosis to mitochondrial damage as the final execution step in this paradigm of oxidative cell death. Keywords: Ferroptosis, BID, Mitochondria, CRISPR, Oxytosis, Neuronal death

  6. 2014 Runtime Systems Summit. Runtime Systems Report

    Energy Technology Data Exchange (ETDEWEB)

    Sarkar, Vivek [US Dept. of Energy, Washington, DC (United States); Budimlic, Zoran [US Dept. of Energy, Washington, DC (United States); Kulkani, Milind [US Dept. of Energy, Washington, DC (United States)

    2016-09-19

    This report summarizes runtime system challenges for exascale computing, that follow from the fundamental challenges for exascale systems that have been well studied in past reports, e.g., [6, 33, 34, 32, 24]. Some of the key exascale challenges that pertain to runtime systems include parallelism, energy efficiency, memory hierarchies, data movement, heterogeneous processors and memories, resilience, performance variability, dynamic resource allocation, performance portability, and interoperability with legacy code. In addition to summarizing these challenges, the report also outlines different approaches to addressing these significant challenges that have been pursued by research projects in the DOE-sponsored X-Stack and OS/R programs. Since there is often confusion as to what exactly the term “runtime system” refers to in the software stack, we include a section on taxonomy to clarify the terminology used by participants in these research projects. In addition, we include a section on deployment opportunities for vendors and government labs to build on the research results from these projects. Finally, this report is also intended to provide a framework for discussing future research and development investments for exascale runtime systems, and for clarifying the role of runtime systems in exascale software.

  7. Sibling death and death fear in relation to depressive symptomatology in older adults.

    Science.gov (United States)

    Cicirelli, Victor G

    2009-01-01

    Previously overlooked factors in elders' depressive symptomatology were examined, including death fear, sibling death, and sibling closeness. Participants were 150 elders (61 men, 89 women) aged 65-97 years with at least one sibling. Measures were proportion of deceased siblings, sibling closeness, the Death Fear Subscale of the Death Attitude Profile-Revised, and the Center for Epidemiological Studies-Depression scale (20-item adult form). Age and education were exogenous variables in a structural equation model. Death fear, sibling closeness, and proportion of dead siblings were directly related to depression, with path coefficients of .42, -.24, and .13, respectively. Proportion of dead siblings had indirect effects on depression, as did age and education. Depressive symptomatology in old age is influenced by death fear related to sibling death as well as by poor relationships with them; it must be understood within a situational context including death fear and sibling relationships.

  8. Nephrogenic systemic fibrosis associated with gadolinium based contrast agents: A summary of the medical literature reporting

    International Nuclear Information System (INIS)

    Broome, Dale R.

    2008-01-01

    Nephrogenic systemic fibrosis (NSF) is a systemic fibrosing disorder that principally affects the skin, but can involve virtually any tissue in the human body and result in significant disability and even death. Since 2006 numerous retrospective case reports and case series have reported a very strong association of this disease with exposure to gadolinium-based contrast agents (Gd-CA) for MR imaging in the setting of severe or end-stage renal disease. The purpose of this report is to summarize the medical literature reporting of biopsy-proven NSF cases in which the authors specifically investigated patient exposure to Gd-CA. A Pub Med MEDLINE search was performed using the key words-nephrogenic systemic fibrosis and nephrogenic fibrosing dermopathy. All case reports and case series of NSF were reviewed to determine if patients had a preceding exposure to Gd-CA and which specific Gd-CA was involved. If the original reports did not clarify the specific Gd-CA, I reviewed follow-up letters to the editors or contacted the authors to clarify which specific Gd-CA were linked to the NSF cases. If several reports originated from the same institution, clarification was also obtained to avoid redundant reporting. As of February 1, 2008 there have been 190 biopsy-proven cases of NSF published in the peer-reviewed literature with the following associations: 157 gadodiamide (Omniscan, GE Healthcare), 8 gadopentetate (Magnevist, Bayer Healthcare), 3 gadoversetamide (OptiMARK, Covidien), and 18 unspecified Gd-CA, and 4 confounded cases with more than one Gd-CA. Five cases of NSF were unassociated with Gd-CA

  9. Sudden Oak Death - Eastern (Pest Alert)

    Science.gov (United States)

    Joseph O' Brien; Manfred Mielke; Steve Oak; Bruce Moltzan

    2002-01-01

    A phenomenon known as Sudden Oak Death was first reported in 1995 in central coastal California. Since then, tens of thousands of tanoaks (Lithocarpus densiflorus), coast live oaks (Quercus agrifolia), and California black oaks (Quercus kelloggii) have been killed by a newly identified fungus, Phytophthora ramorum. On these hosts, the fungus causes a bleeding canker on...

  10. Increased anion channel activity is an unavoidable event in ozone-induced programmed cell death.

    Directory of Open Access Journals (Sweden)

    Takashi Kadono

    Full Text Available BACKGROUND: Ozone is a major secondary air pollutant often reaching high concentrations in urban areas under strong daylight, high temperature and stagnant high-pressure systems. Ozone in the troposphere is a pollutant that is harmful to the plant. PRINCIPAL FINDINGS: By exposing cells to a strong pulse of ozonized air, an acute cell death was observed in suspension cells of Arabidopsis thaliana used as a model. We demonstrated that O(3 treatment induced the activation of a plasma membrane anion channel that is an early prerequisite of O(3-induced cell death in A. thaliana. Our data further suggest interplay of anion channel activation with well known plant responses to O(3, Ca(2+ influx and NADPH-oxidase generated reactive oxygen species (ROS in mediating the oxidative cell death. This interplay might be fuelled by several mechanisms in addition to the direct ROS generation by O(3; namely, H(2O(2 generation by salicylic and abscisic acids. Anion channel activation was also shown to promote the accumulation of transcripts encoding vacuolar processing enzymes, a family of proteases previously reported to contribute to the disruption of vacuole integrity observed during programmed cell death. SIGNIFICANCE: Collectively, our data indicate that anion efflux is an early key component of morphological and biochemical events leading to O(3-induced programmed cell death. Because ion channels and more specifically anion channels assume a crucial position in cells, an understanding about the underlying role(s for ion channels in the signalling pathway leading to programmed cell death is a subject that warrants future investigation.

  11. The epileptic seizure and the mystery of death in Christian painting.

    Science.gov (United States)

    Mann, Michael W

    2010-02-01

    The epileptic seizure is in many cultures associated with death. Indo-European tradition perceives death not necessarily as the end but as a step, as a point the life cycle is passing through. The epileptic seizure may be seen as a transient form of death, which offers some symmetry with the biblical story of the death and resurrection of Christ. This article, originating from a case report, shows how some Christian painting alludes to renaissance after a seizure and to the parallelism between the patient with epilepsy and the destiny of Christ. Special attention is paid to Raphael's, in this respect particularly complex work, The Transfiguration. (c) 2009 Elsevier Inc. All rights reserved.

  12. Parental Death in Childhood and Loneliness in Young Adults.

    Science.gov (United States)

    Murphy, Patricia Ann

    1987-01-01

    Examined relationship between self-esteem and reported mourning behavior as it pertains to loneliness in young adults who, as children, had experienced parental death. Subjects (N=184) aged 18 to 25 completed four questionnaires. Revealed that self-esteem was the single best predictor of loneliness; reported mourning behaviors significantly added…

  13. Sudden unexpected death due to Graves' disease during physical altercation.

    Science.gov (United States)

    Wei, Dengming; Yuan, Xiaogang; Yang, Tiantong; Chang, Lin; Zhang, Xiang; Burke, Allen; Fowler, David; Li, Ling

    2013-09-01

    We report a case of a 30-year-old woman who suddenly collapsed after having a physical altercation with her husband. Despite immediate resuscitation, she died on arrival at the hospital. The victim's parents requested an autopsy because they believed that their daughter was killed by her husband. Postmortem examination revealed that the victim had a diffusely enlarged thyroid gland and cardiomegaly with left ventricular hypertrophy. There was no evidence of significant trauma on the body. Further postmortem thyroid function tests and review of her medical history indicated that her death was due to Graves' disease. To the best of our knowledge, this is the first case reported of sudden death due to cardiac arrhythmia from Graves' disease induced by physical and emotional stress associated with the criminal activity of another person. The autopsy findings are described. In addition, the literature is reviewed and the significance of postmortem evaluation of thyroid hormones in the cases of sudden death is discussed. © 2013 American Academy of Forensic Sciences.

  14. A 23-year review of sudden natural death autopsies in the Niger ...

    African Journals Online (AJOL)

    Background: Death occurring suddenly especially when the victim was active and recently fit, call for attention and thorough investigation to rule out secret homicide. Aim: To study the pattern of sudden natural death in the Niger Delta region of Nigeria. Methodology: The coroner's autopsy reports and hospital autopsy ...

  15. Years of Life Lost (YLL in Colombia 1998-2011: Overall and Avoidable Causes of Death Analysis.

    Directory of Open Access Journals (Sweden)

    Liliana Castillo-Rodríguez

    Full Text Available Estimate the Years of Life Lost (YLL for overall and avoidable causes of death (CoD in Colombia for the period 1998-2011.From the reported deaths to the Colombian mortality database during 1998-2011, we classified deaths from avoidable causes. With the reference life table of the Global Burden of Disease (GBD 2010 study, we estimated the overall YLL and YLL due to avoidable causes. Calculations were performed with the difference between life expectancy and the age of death. Results are reported by group of cause of death, events, sex, year and department. Comparative analysis between number of deaths and YLL was carried out.A total of 83,856,080 YLL were calculated in Colombia during period 1998-2011, 75.9% of them due to avoidable CoD. The year 2000 reported the highest number of missed YLL by both overall and avoidable CoD. The departments with the highest YLL rates were Caquetá, Guaviare, Arauca, Meta, and Risaralda. In men, intentional injuries and cardiovascular and circulatory diseases had the higher losses, while in women YLL were mainly due to cardiovascular and circulatory diseases.The public health priorities should focus on preventing the loss of YLL due to premature death and differentiated interventions by sex.

  16. The sudden death and sudden birth of quantum discord.

    Science.gov (United States)

    Xia, Wei; Hou, Jin-Xing; Wang, Xiao-Hui; Liu, Si-Yuan

    2018-03-28

    The interaction of quantum system and its environment brings out abundant quantum phenomenons. The sudden death of quantum resources, including entanglement, quantum discord and coherence, have been studied from the perspective of quantum breaking channels (QBC). QBC of quantum resources reveal the common features of quantum resources. The definition of QBC implies the relationship between quantum resources. However, sudden death of quantum resources can also appear under some other quantum channels. We consider the dynamics of Bell-diagonal states under a stochastic dephasing noise along the z-direction, and the sudden death and sudden birth of quantum discord are investigated. Next we explain this phenomenon from the geometric structure of quantum discord. According to the above results, the states with sudden death and sudden birth can be filtered in three-parameter space. Then we provide two necessary conditions to judge which kind of noise channels can make Bell-diagonal states sudden death and sudden birth. Moreover, the relation between quantum discord and coherence indicates that the sudden death and sudden birth of quantum discord implies the sudden death and sudden birth of coherence in an optimal basis.

  17. Structural imaging biomarkers of sudden unexpected death in epilepsy.

    Science.gov (United States)

    Wandschneider, Britta; Koepp, Matthias; Scott, Catherine; Micallef, Caroline; Balestrini, Simona; Sisodiya, Sanjay M; Thom, Maria; Harper, Ronald M; Sander, Josemir W; Vos, Sjoerd B; Duncan, John S; Lhatoo, Samden; Diehl, Beate

    2015-10-01

    Sudden unexpected death in epilepsy is a major cause of premature death in people with epilepsy. We aimed to assess whether structural changes potentially attributable to sudden death pathogenesis were present on magnetic resonance imaging in people who subsequently died of sudden unexpected death in epilepsy. In a retrospective, voxel-based analysis of T1 volume scans, we compared grey matter volumes in 12 cases of sudden unexpected death in epilepsy (two definite, 10 probable; eight males), acquired 2 years [median, interquartile range (IQR) 2.8] before death [median (IQR) age at scanning 33.5 (22) years], with 34 people at high risk [age 30.5 (12); 19 males], 19 at low risk [age 30 (7.5); 12 males] of sudden death, and 15 healthy controls [age 37 (16); seven males]. At-risk subjects were defined based on risk factors of sudden unexpected death in epilepsy identified in a recent combined risk factor analysis. We identified increased grey matter volume in the right anterior hippocampus/amygdala and parahippocampus in sudden death cases and people at high risk, when compared to those at low risk and controls. Compared to controls, posterior thalamic grey matter volume, an area mediating oxygen regulation, was reduced in cases of sudden unexpected death in epilepsy and subjects at high risk. The extent of reduction correlated with disease duration in all subjects with epilepsy. Increased amygdalo-hippocampal grey matter volume with right-sided changes is consistent with histo-pathological findings reported in sudden infant death syndrome. We speculate that the right-sided predominance reflects asymmetric central influences on autonomic outflow, contributing to cardiac arrhythmia. Pulvinar damage may impair hypoxia regulation. The imaging findings in sudden unexpected death in epilepsy and people at high risk may be useful as a biomarker for risk-stratification in future studies. The Author (2015). Published by Oxford University Press on behalf of the Guarantors of

  18. Variation in the place of death among nursing home residents in France.

    Science.gov (United States)

    Morin, Lucas; Johnell, Kristina; Aubry, Régis

    2015-05-01

    recent studies have reported that hospitals have become a common place of death for nursing home residents. This study aimed to (i) measure variations in the proportion of in-hospital deaths across regions after adjustment for facility-level characteristics and (ii) identify environmental risk factors that might explain these variations in France. a cross-sectional retrospective survey was conducted in 2013. coordinating physicians in 3,705 nursing homes in France. a regression model was used to construct risk-adjusted rates of in-hospital deaths considering the facilities' characteristics. At the regional level, the outcome was defined as the difference between the observed rate of in-hospital deaths and the expected risk-adjusted rate. Values exceeding zero indicated rates that exceeded the national predicted rate of in-hospital deaths and thus highlighted regions in which the risk-adjusted probability for nursing home residents to die in a hospital was greater than average. among 70,119 nursing home decedents, 25.4% (n = 17,789) died in hospitals. The characteristics of the facilities had a significant influence on the proportion of in-hospital deaths among the nursing home decedents. However, after adjustment for these facility-level risk factors, the proportion of nursing homes that reported worse-than-average outcomes showed significant variation (range 26.0-79.6%). At the regional level, both the rate of acute hospital beds and the rate of general practitioners were found to be strongly correlated with the probability of reporting worse-than-average outcomes (P nursing home facilities. © The Author 2015. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  19. [Coding Causes of Death with IRIS Software. Impact in Navarre Mortality Statistic].

    Science.gov (United States)

    Floristán Floristán, Yugo; Delfrade Osinaga, Josu; Carrillo Prieto, Jesus; Aguirre Perez, Jesus; Moreno-Iribas, Conchi

    2016-08-02

    There are few studies that analyze changes in mortality statistics derived from the use of IRIS software, an automatic system for coding multiple causes of death and for the selection of the underlying cause of death, compared to manual coding. This study evaluated the impact of the use of IRIS in the Navarre mortality statistic. We proceeded to double coding 5,060 death certificates corresponding to residents in Navarra in 2014. We calculated coincidence between the two encodings for ICD10 chapters and for the list of causes of the Spanish National Statistics Institute (INE-102) and we estimated the change on mortality rates. IRIS automatically coded 90% of death certificates. The coincidence to 4 characters and in the same chapter of the CIE10 was 79.1% and 92.0%, respectively. Furthermore, coincidence with the short INE-102 list was 88.3%. Higher matches were found in death certificate of people under 65 years. In comparison with manual coding there was an increase in deaths from endocrine diseases (31%), mental disorders (19%) and disease of nervous system (9%), while a decrease of genitourinary system diseases was observed (21%). The coincidence at level of ICD10 chapters coding by IRIS in comparison to manual coding was 9 out of 10 deaths, similar to what is observed in other studies. The implementation of IRIS has led to increased of endocrine diseases, especially diabetes and hyperlipidaemia, and mental disorders, especially dementias.

  20. Sudden cardiac death in young athletes

    Directory of Open Access Journals (Sweden)

    Östman-Smith I

    2011-07-01

    Full Text Available Ingegerd Östman-SmithDivision of Paediatric Cardiology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, SwedenAbstract: Athletic activity is associated with an increased risk of sudden death for individuals with some congenital or acquired heart disorders. This review considers in particular the causes of death affecting athletes below 35 years of age. In this age group the largest proportion of deaths are caused by diseases with autosomal dominant inheritance such as hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, long QT-syndrome, and Marfan’s syndrome. A policy of early cascade-screening of all first-degree relatives of patients with these disorders will therefore detect a substantial number of individuals at risk. A strictly regulated system with preparticipation screening of all athletes following a protocol pioneered in Italy, including school-age children, can also detect cases caused by sporadic new mutations and has been shown to reduce excess mortality among athletes substantially. Recommendations for screening procedure are reviewed. It is concluded that ECG screening ought to be part of preparticipation screening, but using criteria that do not cause too many false positives among athletes. One such suggested protocol will show positive in approximately 5% of screened individuals, among whom many will be screened for these diseases. On this point further research is needed to define what kind of false-positive and false-negative rate these new criteria result in. A less formal system based on cascade-screening of relatives, education of coaches about suspicious symptoms, and preparticipation questionnaires used by athletic clubs, has been associated over time with a sizeable reduction in sudden cardiac deaths among Swedish athletes, and thus appears to be worth implementing even for junior athletes not recommended for formal preparticipation screening. It is strongly argued

  1. Sudden Cardiac Death in Brazil: A Community-Based Autopsy Series (2006-2010

    Directory of Open Access Journals (Sweden)

    Maria Fernanda Braggion-Santos

    2015-02-01

    Full Text Available Background: Sudden cardiac death (SCD is a sudden unexpected event, from a cardiac cause, that occurs in less than one hour after the symptoms onset, in a person without any previous condition that would seem fatal or who was seen without any symptoms 24 hours before found dead. Although it is a relatively frequent event, there are only few reliable data in underdeveloped countries. Objective: We aimed to describe the features of SCD in Ribeirão Preto, Brazil (600,000 residents according to Coroners’ Office autopsy reports. Methods: We retrospectively reviewed 4501 autopsy reports between 2006 and 2010, to identify cases of SCD. Specific cause of death as well as demographic information, date, location and time of the event, comorbidities and whether cardiopulmonary resuscitation (CPR was attempted were collected. Results: We identified 899 cases of SCD (20%; the rate was 30/100000 residents per year. The vast majority of cases of SCD involved a coronary artery disease (CAD (64% and occurred in men (67%, between the 6th and the 7th decades of life. Most events occurred during the morning in the home setting (53.3% and CPR was attempted in almost half of victims (49.7%. The most prevalent comorbidity was systemic hypertension (57.3%. Chagas’ disease was present in 49 cases (5.5%. Conclusion: The majority of victims of SCD were men, in their sixties and seventies and the main cause of death was CAD. Chagas’ disease, an important public health problem in Latin America, was found in about 5.5% of the cases.

  2. Epilepsy and risk of death and sudden unexpected death in the young

    DEFF Research Database (Denmark)

    Holst, Anders Gaarsdal; Winkel, Bo Gregers; Risgaard, Bjarke

    2013-01-01

    Patients with epilepsy are at increased risk of premature death from all causes and likely also from sudden unexplained death (SUD). Many patients with epilepsy have significant comorbidity, and it is unclear how much of the increased risk can be explained by epilepsy itself. We aimed to chart...... the incidence of sudden unexpected death in epilepsy (SUDEP) and estimate the risk of death from all causes and SUD conferred by epilepsy independently....

  3. Discerning suicide in drug intoxication deaths: Paucity and primacy of suicide notes and psychiatric history.

    Science.gov (United States)

    Rockett, Ian R H; Caine, Eric D; Connery, Hilary S; D'Onofrio, Gail; Gunnell, David J; Miller, Ted R; Nolte, Kurt B; Kaplan, Mark S; Kapusta, Nestor D; Lilly, Christa L; Nelson, Lewis S; Putnam, Sandra L; Stack, Steven; Värnik, Peeter; Webster, Lynn R; Jia, Haomiao

    2018-01-01

    A paucity of corroborative psychological and psychiatric evidence may be inhibiting detection of drug intoxication suicides in the United States. We evaluated the relative importance of suicide notes and psychiatric history in the classification of suicide by drug intoxication versus firearm (gunshot wound) plus hanging/suffocation-the other two major, but overtly violent methods. This observational multilevel (individual/county), multivariable study employed a generalized linear mixed model (GLMM) to analyze pooled suicides and undetermined intent deaths, as possible suicides, among the population aged 15 years and older in the 17 states participating in the National Violent Death Reporting System throughout 2011-2013. The outcome measure was relative odds of suicide versus undetermined classification, adjusted for demographics, precipitating circumstances, and investigation characteristics. A suicide note, prior suicide attempt, or affective disorder was documented in less than one-third of suicides and one-quarter of undetermined deaths. The prevalence gaps were larger among drug intoxication cases than gunshot/hanging cases. The latter were more likely than intoxication cases to be classified as suicide versus undetermined manner of death (adjusted odds ratio [OR], 41.14; 95% CI, 34.43-49.15), as were cases documenting a suicide note (OR, 33.90; 95% CI, 26.11-44.05), prior suicide attempt (OR, 2.42; 95% CI, 2.11-2.77), or depression (OR, 1.61; 95% CI, 1.38 to 1.88), or bipolar disorder (OR, 1.41; 95% CI, 1.10-1.81). Stratification by mechanism/cause intensified the association between a note and suicide classification for intoxication cases (OR, 45.43; 95% CI, 31.06-66.58). Prior suicide attempt (OR, 2.64; 95% CI, 2.19-3.18) and depression (OR, 1.48; 95% CI, 1.17-1.87) were associated with suicide classification in intoxication but not gunshot/hanging cases. Without psychological/psychiatric evidence contributing to manner of death classification, suicide by

  4. The aviation safety reporting system

    Science.gov (United States)

    Reynard, W. D.

    1984-01-01

    The aviation safety reporting system, an accident reporting system, is presented. The system identifies deficiencies and discrepancies and the data it provides are used for long term identification of problems. Data for planning and policy making are provided. The system offers training in safety education to pilots. Data and information are drawn from the available data bases.

  5. AN AUDIT OF MATERNAL DEATHS

    Directory of Open Access Journals (Sweden)

    Basavana Gowda

    2015-03-01

    Full Text Available OBJECTIVES: A study of maternal death conducted to evaluate various factors responsible for maternal deaths. To identify complications in pregnancy, a childbirth which result in maternal death, and to identify opportunities for preventive intervention and understand the events leading to death; so that improving maternal health and reducing maternal mortality rate significantly. To analyze the causes and epidemiological amounts maternal mortality e.g. age parity, socioeconomic status and literacy. In order to reduce maternal mortality and to implement safe motherhood program and complications of pregnancy and to find out safe motherhood program. METHODS: The data collected was a retrograde by a proforma containing particulars of the diseased, detailed history and relatives were interviewed for additional information. The data collected was analysed. RESULTS: Maternal mortality rate in our own institution is 200/ 100,000 live births. Among 30 maternal deaths, 56% deaths (17 were among low socio - economic status, groups 60% deaths among unbooked 53.5% deaths more along illiterates evidenced by direct and indirect deaths about 25% of deaths were preventable. CONCLUSION: Maternal death is a great tragedy in the family life. It is crusade to know not just the medical cause of the death but the circumstances what makes these continued tragic death even more unacceptable is that deaths are largely preventable

  6. SUDDEN NATURAL DEATHS IN MEDICOLEGAL CASES- AN AUTOPSY BASED STUDY

    Directory of Open Access Journals (Sweden)

    C. S. Sreedevi

    2017-01-01

    Full Text Available BACKGROUND Death occurring in apparently healthy individual in a case of natural death may arise suspicion of foul play. In these circumstances these cases may be subjected to medicolegal autopsy. The disease condition may be unknown to the individual and the relatives. This study was done to review the exact cause of death in sudden unexpected deaths, and enabling or assisting the legal authorities in detection of crime, to prove or disprove the foul play. Body mass index is the most frequently used indicator of body fatness. An attempt is made to find out whether there is any significant relationship between BMI and the risk for sudden cardiac death. MATERIALS AND METHODS Data of 50 cases of sudden unexpected death brought for medicolegal autopsy at govt. T.D. medical college Alappuzha in the year 2010 were studied and information were collected from the postmortem records. Data was entered in the proforma. The histopathological examination findings of relevant cases were studied. Analysis was done using MS EXCEL and Chi-square test was used as the test of significance in the comparison between two categorical variables. RESULTS In 50 cases, male predominance was observed and 88% were males in which 50% of males died of atherosclerotic occlusive coronary artery disease and among females 33% died of myocardial infarction. While considering the systemic distribution of cause of death, the cardiovascular system was found to be most commonly affected, 33 cases (66% followed by respiratory system 7 cases (14%. In 4 (8% cases gastrointestinal system was affected. In Two cases (4% central nervous system was affected and others were generalized infection, which constituted 2 cases. Out of 33 cases observed in cardiovascular system the commonest cause being the atherosclerotic occlusive coronary artery diseases involving 27 cases (81.81% in which the predominant involvement was seen in left anterior descending artery 21 cases (77.77% followed by right

  7. C/EBPβ LIP augments cell death by inducing osteoglycin.

    Science.gov (United States)

    Wassermann-Dozorets, Rina; Rubinstein, Menachem

    2017-04-06

    Many types of tumor cell are devoid of the extracellular matrix proteoglycan osteoglycin (Ogn), but its role in tumor biology is poorly studied. Here we show that RNAi of Ogn attenuates stress-triggered cell death, whereas its overexpression increases cell death. We found that the transcription factor C/EBPβ regulates the expression of Ogn. C/EBPβ is expressed as a full-length, active form (LAP) and as a truncated, dominant-negative form (LIP), and the LIP/LAP ratio is positively correlated with the extent of cell death under stress. For example, we reported that drug-resistant tumor cells lack LIP altogether, and its supplementation abolished their resistance to chemotherapy and to endoplasmic reticulum (ER) stress. Here we further show that elevated LIP/LAP ratio robustly increased Ogn expression and cell death under stress by modulating the mitogen-activated protein kinase/activator protein 1 pathway (MAPK/AP-1). Our findings suggest that LIP deficiency renders tumor cell resistant to ER stress by preventing the induction of Ogn.

  8. Sudden cardiac death

    Directory of Open Access Journals (Sweden)

    Neeraj Parakh

    2015-01-01

    Full Text Available Sudden cardiac death is one of the most common cause of mortality worldwide. Despite significant advances in the medical science, there is little improvement in the sudden cardiac death related mortality. Coronary artery disease is the most common etiology behind sudden cardiac death, in the above 40 years population. Even in the apparently healthy population, there is a small percentage of patients dying from sudden cardiac death. Given the large denominator, this small percentage contributes to the largest burden of sudden cardiac death. Identification of this at risk group among the apparently healthy individual is a great challenge for the medical fraternity. This article looks into the causes and methods of preventing SCD and at some of the Indian data. Details of Brugada syndrome, Long QT syndrome, Genetics of SCD are discussed. Recent guidelines on many of these causes are summarised.

  9. Adolescents' Experiences 7 and 13 Months Following the Death of a Brother or Sister.

    Science.gov (United States)

    Brooten, Dorothy; Youngblut, JoAnne M; Roche, Rosa M

    2017-06-01

    This qualitative study used semi-structured interviews to describe adolescents' responses at 7 and 13 months to siblings' NICU/PICU/ED death. At 7 months, adolescents were asked about events around the sibling's death; at 7 and 13 months, about concerns/fears, feelings, and life changes. Seventeen adolescents participated (13-18 years; M=15); 65% Black, 24% Hispanic, 11% White. Themes included death circumstances, burial events, thinking about the deceased sibling, fears, and life changes. Adolescents reported shock and disbelief that the sibling died; 80% knew the reason for the death; many had difficulty getting through burials; all thought about the sibling. From 7 - 13 months fears increased including losing someone and thoughts of dying. Adolescents reported more changes in family life and greater life changes in them (more considerate, mature) by 13 months; some felt friends abandoned them after the sibling's death. Girls had more fears and changes in family life and themselves. Adolescent's responses to sibling death may not be visually apparent. One recommendation from this study is to ask adolescents how they are doing separately from parents since adolescents may hide feelings to protect their parents, especially their mothers. Older adolescents (14-18 years) and girls may have more difficulty after sibling death.

  10. Book review: Diane Ravitch "The death and life of the great American school system". New York: Basic Books , 2010

    Directory of Open Access Journals (Sweden)

    Beals K.

    2015-09-01

    Full Text Available The current paper is a translation of Katharine Beals' review of the book "The death and life of the great American school system" by Diane Ravich. The article analyses the views on the causes of the inefficiency of the American school system expressed by Ravich, as well as the ways of its improvement suggested by her. A change of stance compared to her previous works is also noted. Translator: Vinogradova K.N.

  11. Death Certification Errors and the Effect on Mortality Statistics.

    Science.gov (United States)

    McGivern, Lauri; Shulman, Leanne; Carney, Jan K; Shapiro, Steven; Bundock, Elizabeth

    Errors in cause and manner of death on death certificates are common and affect families, mortality statistics, and public health research. The primary objective of this study was to characterize errors in the cause and manner of death on death certificates completed by non-Medical Examiners. A secondary objective was to determine the effects of errors on national mortality statistics. We retrospectively compared 601 death certificates completed between July 1, 2015, and January 31, 2016, from the Vermont Electronic Death Registration System with clinical summaries from medical records. Medical Examiners, blinded to original certificates, reviewed summaries, generated mock certificates, and compared mock certificates with original certificates. They then graded errors using a scale from 1 to 4 (higher numbers indicated increased impact on interpretation of the cause) to determine the prevalence of minor and major errors. They also compared International Classification of Diseases, 10th Revision (ICD-10) codes on original certificates with those on mock certificates. Of 601 original death certificates, 319 (53%) had errors; 305 (51%) had major errors; and 59 (10%) had minor errors. We found no significant differences by certifier type (physician vs nonphysician). We did find significant differences in major errors in place of death ( P statistics. Surveillance and certifier education must expand beyond local and state efforts. Simplifying and standardizing underlying literal text for cause of death may improve accuracy, decrease coding errors, and improve national mortality statistics.

  12. Validation of birth outcomes from the Society for Assisted Reproductive Technology Clinic Outcome Reporting System (SART CORS): population-based analysis from the Massachusetts Outcome Study of Assisted Reproductive Technology (MOSART).

    Science.gov (United States)

    Stern, Judy E; Gopal, Daksha; Liberman, Rebecca F; Anderka, Marlene; Kotelchuck, Milton; Luke, Barbara

    2016-09-01

    To assess the validity of outcome data reported to the Society for Assisted Reproductive Technology Clinic Outcome Reporting System (SART CORS) compared with data from vital records and the birth defects registry in Massachusetts. Longitudinal cohort. Not applicable. A total of 342,035 live births and fetal deaths from Massachusetts mothers giving birth in the state from July 1, 2004, to December 31, 2008; 9,092 births and fetal deaths were from mothers who had conceived with the use of assisted reproductive technology (ART) and whose cycle data had been reported to the SART CORS. Not applicable. Percentage agreement between maternal race and ethnicity, delivery outcome (live birth or fetal death), plurality (singleton, twin, or triplet+), delivery date, and singleton birth weight reported in the SART CORS versus vital records; sensitivity and specificity for birth defects among singletons as reported in the SART CORS versus the Massachusetts Birth Defects Monitoring Program (BDMP). There was >95% agreement between the SART CORS and vital records for fields of maternal race/ethnicity, live birth/fetal death, and plurality; birth outcome date was within 1 day with 94.9% agreement and birth weight was within 100 g with 89.6% agreement. In contrast, sensitivity for report of any birth defect was 38.6%, with a range of 18.4%-50.0%, for specific birth defect categories. Although most SART CORS outcome fields are accurately reported, birth defect variables showed poor sensitivity compared with the gold standard data from the BDMP. We suggest that reporting of birth defects be discontinued. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  13. Factors associated with death from dengue in the state of Minas Gerais, Brazil: historical cohort study.

    Science.gov (United States)

    Campos, Kauara Brito; Amâncio, Frederico Figueiredo; de Araújo, Valdelaine Etelvina Miranda; Carneiro, Mariângela

    2015-02-01

    To analyse the clinical and epidemiological profiles of dengue haemorrhagic fever (DHF), dengue shock syndrome (DSS) and complicated dengue cases and deaths from 2008 to 2010 that occurred in the state of Minas Gerais, south-eastern Brazil, and to identify factors associated with death from dengue. Historical cohort study using data from the Brazilian Information System for Notifiable Diseases. A descriptive analysis of the DHF, DSS and complicated dengue cases and deaths was performed; the incidence, mortality and case-fatality rates were estimated. Logistic regression analysis was used to identify factors associated with death from dengue. Comorbidities were not included in the analysis because the information system does not contain such data. During the study period, 2214 DHF, DSS and complicated dengue cases were reported, including 156 deaths. The annual case-fatality rates for DHF/DSS and complicated dengue cases in the period of 2008-2010 were 7.3%, 4.8% and 7.9%, respectively. The factors associated with death from dengue included residence in a municipality with a population of fewer than 100,000 inhabitants [odds ratio (OR) 2.46; 95% confidence interval (CI) 1.71-3.55], age over 65 years (OR 3.05; 95% CI 1.99-4.68) and plasma leakage (OR 1.69; 95% CI 1.16-2.46). The results support the importance of plasma leakage as a warning sign associated with death from dengue as well as the signs and symptoms that allow the diagnosis of DHF. Moreover, our findings suggest that increased attention is necessary for individuals over 65 years of age and in municipalities with populations under 100,000 inhabitants to ensure a better quality of care during the management of severe patients of dengue in these locations. Differences in the interpretation of the DHF definition have hindered the comparison of data from different countries; it can improve from the WHO 2009 dengue classification. © 2014 John Wiley & Sons Ltd.

  14. Dump truck-related deaths in construction, 1992-2007.

    Science.gov (United States)

    McCann, Michael; Cheng, Mei-Tai

    2012-05-01

    Dump trucks are universally used in construction and other industries to haul materials to the location and to remove waste materials. The source for dump truck-related fatality data was the Bureau of Labor Statistics Census of Fatal Occupational Injuries (CFOI) Research File. From 1992 to 2007, 829 construction workers were killed in dump truck-related incidents nationwide. Of those, 336 were dump truck operators with 215 deaths occurring in street and highway incidents. Another 343 deaths involved workers on foot, three-quarters struck by dump trucks. Sixty-four of the construction workers killed were maintaining dump trucks, 22 when caught between the truck frame and a falling dump truck bed. Of the 86 other deaths, 55 involved streets and highways. Recommendations include: (i) improving the reporting of seat belt usage in fatality reports; (ii) requiring use of seat belts; (iii) requiring the use of backup alarms, spotters, or other methods to alert dump truck operators to workers in their blind spots; (iv) prohibiting direct dumping at river banks and embankments; (v) using cameras or radar to enforce stopping at railway crossings; and (xi) enforcing worker safety practices (e.g., lockout/tagout procedures on elevated dump truck beds). Copyright © 2011 Wiley Periodicals, Inc.

  15. Characteristics of visiting nurse agencies with high home death rates: A prefecture-wide study in Japan.

    Science.gov (United States)

    Kashiwagi, Masayo; Tamiya, Nanako; Murata, Masako

    2015-08-01

    The purpose of the present study was to identify characteristics of visiting nurse agencies (VNA) in Japan with high home death rates by a prefecture-wide survey. A cross-sectional study of visiting nurse agencies (n = 101) in Ibaraki Prefecture, Japan, was completed. Data included the basic characteristics of each VNA, the type of services provided, level of coordination with other service providers, total number of VNA patients who died per year and place of death and contractual relationship with home-care supporting clinics providing end-of-life care services in the home 24 h a day. The VNA characteristics were analyzed by logistic regression, using the home death rate per VNA as a dependent variable. A total 69 agencies, excluding those that did not report number of deaths (n = 14) and those without deaths during the year (n = 6), were analyzed. The median home death rate of the 69 VNA was 29.8%. The results of logistic regression analysis showed that higher home death rate was significantly associated with lack of attachment to a hospital, existence of a contractual relationship with home-care supporting clinics and existence of an interactive information exchange through telephone/face-to-face communication with attending physicians. In order to increase the home death rate of people using VNA, policymakers must consider establishing home-based service systems within the community that can provide home end-of-life care services 24 h a day, and support the interactive exchange of information between the visiting nurse and the attending physician. © 2014 The Authors. Geriatrics & Gerontology International published by Wiley Publishing Asia Pty Ltd on behalf of Japanese Geriatrics Society.

  16. Sudden entanglement death, and ways to avoid it

    International Nuclear Information System (INIS)

    Eberly, J.H.; Ting Yu

    2005-01-01

    We report that non-communicating but entangled qubit pairs are almost universally liable to sudden entanglement death. In the presence of minor and purely local environmental noises their mixed-state entanglement may abruptly become zero long before the noises are able to destroy the local qubit coherence. Despite the inability of unitary transformations to alter entanglement, for example of Werner states, unitary transformations have been found to delay or defeat the sudden death event. These results upset the conventional understanding that entanglement lifetime can be estimated from qubit lifetime. This is not even approximately or qualitatively true. (author)

  17. Nursing care after death in Northern Ireland.

    Science.gov (United States)

    Pearce, Lynne

    2017-06-30

    Essential facts According to the Registrar General Annual Report published in August 2016 there were 15,548 deaths in Northern Ireland in 2015, with almost two thirds being of people aged 75 or more. Almost half (48%) occurred in NHS hospitals, with a further 20% in other hospitals or nursing homes.

  18. Nonseizure SUDEP: Sudden unexpected death in epilepsy without preceding epileptic seizures.

    Science.gov (United States)

    Lhatoo, Samden D; Nei, Maromi; Raghavan, Manoj; Sperling, Michael; Zonjy, Bilal; Lacuey, Nuria; Devinsky, Orrin

    2016-07-01

    To describe the phenomenology of monitored sudden unexpected death in epilepsy (SUDEP) occurring in the interictal period where death occurs without a seizure preceding it. We report a case series of monitored definite and probable SUDEP where no electroclinical evidence of underlying seizures was found preceding death. Three patients (two definite and one probable) had SUDEP. They had a typical high SUDEP risk profile with longstanding intractable epilepsy and frequent generalized tonic-clonic seizures (GTCS). All patients had varying patterns of respiratory and bradyarrhythmic cardiac dysfunction with profound electroencephalography (EEG) suppression. In two patients, patterns of cardiorespiratory failure were similar to those seen in some patients in the Mortality in Epilepsy Monitoring Units Study (MORTEMUS). SUDEP almost always occur postictally, after GTCS and less commonly after a partial seizure. Monitored SUDEP or near-SUDEP cases without a seizure have not yet been reported in literature. When nonmonitored SUDEP occurs in an ambulatory setting without an overt seizure, the absence of EEG information prevents the exclusion of a subtle seizure. These cases confirm the existence of nonseizure SUDEP; such deaths may not be prevented by seizure detection-based devices. SUDEP risk in patients with epilepsy may constitute a spectrum of susceptibility wherein some are relatively immune, death occurs in others with frequent GTCS with one episode of seizure ultimately proving fatal, while in others still, death may occur even in the absence of a seizure. We emphasize the heterogeneity of SUDEP phenomena. Wiley Periodicals, Inc. © 2016 International League Against Epilepsy.

  19. Death with dignity

    Science.gov (United States)

    Allmark, P.

    2002-01-01

    The purpose of this article is to develop a conception of death with dignity and to examine whether it is vulnerable to the sort of criticisms that have been made of other conceptions. In this conception "death" is taken to apply to the process of dying; "dignity" is taken to be something that attaches to people because of their personal qualities. In particular, someone lives with dignity if they live well (in accordance with reason, as Aristotle would see it). It follows that health care professionals cannot confer on patients either dignity or death with dignity. They can, however, attempt to ensure that the patient dies without indignity. Indignities are affronts to human dignity, and include such things as serious pain and the exclusion of patients from involvement in decisions about their lives and deaths. This fairly modest conception of death with dignity avoids the traps of being overly subjective or of viewing the sick and helpless as "undignified". PMID:12161582

  20. Deaths from Adenovirus in the US Military

    Centers for Disease Control (CDC) Podcasts

    Dr. Joel Gaydos, science advisor for the Armed Forces Health Surveillance Center, and Dr. Robert Potter, a research associate for the Armed Forces Medical Examiner System, discuss deaths from adenovirus in the US military.

  1. Existential Concerns About Death

    DEFF Research Database (Denmark)

    Moestrup, Lene; Hansen, Helle Ploug

    2015-01-01

    psychology or Kübler-Ross’ theory about death stages. The complex concerns might be explained using Martin Heidegger’s phenomenological thinking. We aimed to illuminate dying patients´ existential concerns about the impending death through a descriptive analysis of semi-structured interviews with 17 cancer...... patients in Danish hospices. The main findings demonstrated how the patients faced the forthcoming death without being anxious of death but sorrowful about leaving life. Furthermore, patients expressed that they avoided thinking about death. However, some had reconstructed specific and positive ideas about...... afterlife and made accurate decisions for practical aspects of their death. The patients wished to focus on positive aspects in their daily life at hospice. It hereby seems important to have ongoing reflections and to include different theoretical perspectives when providing existential support to dying...

  2. Pattern of sudden death at Ladoke Akintola University of Technology Teaching Hospital, Osogbo, South West Nigeria

    Directory of Open Access Journals (Sweden)

    Akinwusi PO

    2013-06-01

    Full Text Available Patience Olayinka Akinwusi,1,2 Akinwumi Oluwole Komolafe,3 Olanrewaju Olayinka Olayemi,2 Adeleye Abiodun Adeomi41Department of Medicine, College of Health Sciences, Osun State University, 2Department of Medicine, LAUTECH Teaching Hospital, Osogbo, 3Department of Morbid Anatomy, Obafemi Awolowo University Teaching, Hospitals Complex, Ile-Ife, Osun State, 4Department of Community Medicine, LAUTECH Teaching Hospital, Ogbomoso, Oyo State, NigeriaBackground: The purpose of this study was to determine the etiology and epidemiologic characteristics of sudden death at Ladoke Akintola University of Technology (LAUTECH Teaching Hospital, South West Nigeria.Methods: This was a retrospective descriptive study of all cases of natural unexpected death, either occurring out of hospital or less than 24 hours after admission to LAUTECH Teaching Hospital, over a nine-year period from January 2003 to December 2011. Data were generated from information in the case notes and autopsy reports for these cases.Results: Sudden death accounted for 29 (4.0% of 718 adult medical deaths and 1.0% of all adult medical admissions. Out-of-hospital deaths occurred in 72.4% of cases. The mean age of the patients was 46.8 ± 11.5 (range 25–74 years. The male to female ratio was 6.25:1. Cardiovascular disease were the most common cause of death (51.7%, followed by respiratory disease (20.7%, pulmonary thromboembolism (10.4%, central nervous system disease (13.8%, gastrointestinal disorders (13.8%, severe chemical/drug poisoning (13.8%, and combined cardiovascular and central nervous system disease (13.8%. Hypertension-related causes were responsible for 14/29 (48.3% of the sudden deaths. Hypertensive heart disease accounted for 86.7% of the cardiovascular deaths, hypertensive heart failure accounted for 73.3%, whilst all heart failure cases accounted for 80.0%. Left ventricular hypertrophy was present in 69.2% of the patients with hypertensive heart disease. Moderate to severe

  3. Causes of death in Prader-Willi syndrome: Prader-Willi Syndrome Association (USA) 40-year mortality survey.

    Science.gov (United States)

    Butler, Merlin G; Manzardo, Ann M; Heinemann, Janalee; Loker, Carolyn; Loker, James

    2017-06-01

    Prader-Willi syndrome (PWS) is a rare, complex, neurodevelopmental genetic disorder that is associated with hyperphagia and morbid obesity in humans and leads to a shortened life expectancy. This report summarizes the primary causes of death and evaluates mortality trends in a large cohort of individuals with PWS. The US Prader-Willi Syndrome Association (PWSA (USA)) syndrome-specific database of death reports was collected through a cursory bereavement program for PWSA (USA) families using a brief survey created in 1999. Causes of death were descriptively characterized and statistically examined using Cox proportional hazards. A total of 486 deaths were reported (263 males, 217 females, 6 unknown) between 1973 and 2015, with mean age of 29.5 ± 16 years (2 months-67 years); 70% occurred in adulthood. Respiratory failure was the most common cause, accounting for 31% of all deaths. Males were at increased risk for presumed hyperphagia-related accidents/injuries and cardiopulmonary factors compared to females. PWS maternal disomy 15 genetic subtype showed an increased risk of death from cardiopulmonary factors compared to the deletion subtype. These findings highlight the heightened vulnerability to obesity and hyperphagia-related mortality in PWS. Future research is needed to address critical vulnerabilities such as gender and genetic subtype in the cause of death in PWS.Genet Med advance online publication 17 November 2016.

  4. Dialysis Disequilibrium Syndrome: Brain death following hemodialysis for metabolic acidosis and acute renal failure – A case report

    Directory of Open Access Journals (Sweden)

    Bagshaw Sean M

    2004-08-01

    Full Text Available Abstract Background Dialysis disequilibrium syndrome (DDS is the clinical phenomenon of acute neurologic symptoms attributed to cerebral edema that occurs during or following intermittent hemodialysis (HD. We describe a case of DDS-induced cerebral edema that resulted in irreversible brain injury and death following acute HD and review the relevant literature of the association of DDS and HD. Case Presentation A 22-year-old male with obstructive uropathy presented to hospital with severe sepsis syndrome secondary to pneumonia. Laboratory investigations included a pH of 6.95, PaCO2 10 mmHg, HCO3 2 mmol/L, serum sodium 132 mmol/L, serum osmolality 330 mosmol/kg, and urea 130 mg/dL (46.7 mmol/L. Diagnostic imaging demonstrated multifocal pneumonia, bilateral hydronephrosis and bladder wall thickening. During HD the patient became progressively obtunded. Repeat laboratory investigations showed pH 7.36, HCO3 19 mmol/L, potassium 1.8 mmol/L, and urea 38.4 mg/dL (13.7 mmol/L (urea-reduction-ratio 71%. Following HD, spontaneous movements were absent with no pupillary or brainstem reflexes. Head CT-scan showed diffuse cerebral edema with effacement of basal cisterns and generalized loss of gray-white differentiation. Brain death was declared. Conclusions Death is a rare consequence of DDS in adults following HD. Several features may have predisposed this patient to DDS including: central nervous system adaptations from chronic kidney disease with efficient serum urea removal and correction of serum hyperosmolality; severe cerebral intracellular acidosis; relative hypercapnea; and post-HD hemodynamic instability with compounded cerebral ischemia.

  5. Mechanical Stress Promotes Cisplatin-Induced Hepatocellular Carcinoma Cell Death

    Science.gov (United States)

    Riad, Sandra; Bougherara, Habiba

    2015-01-01

    Cisplatin (CisPt) is a commonly used platinum-based chemotherapeutic agent. Its efficacy is limited due to drug resistance and multiple side effects, thereby warranting a new approach to improving the pharmacological effect of CisPt. A newly developed mathematical hypothesis suggested that mechanical loading, when coupled with a chemotherapeutic drug such as CisPt and immune cells, would boost tumor cell death. The current study investigated the aforementioned mathematical hypothesis by exposing human hepatocellular liver carcinoma (HepG2) cells to CisPt, peripheral blood mononuclear cells, and mechanical stress individually and in combination. HepG2 cells were also treated with a mixture of CisPt and carnosine with and without mechanical stress to examine one possible mechanism employed by mechanical stress to enhance CisPt effects. Carnosine is a dipeptide that reportedly sequesters platinum-based drugs away from their pharmacological target-site. Mechanical stress was achieved using an orbital shaker that produced 300 rpm with a horizontal circular motion. Our results demonstrated that mechanical stress promoted CisPt-induced death of HepG2 cells (~35% more cell death). Moreover, results showed that CisPt-induced death was compromised when CisPt was left to mix with carnosine 24 hours preceding treatment. Mechanical stress, however, ameliorated cell death (20% more cell death). PMID:25685789

  6. Mechanical Stress Promotes Cisplatin-Induced Hepatocellular Carcinoma Cell Death

    Directory of Open Access Journals (Sweden)

    Laila Ziko

    2015-01-01

    Full Text Available Cisplatin (CisPt is a commonly used platinum-based chemotherapeutic agent. Its efficacy is limited due to drug resistance and multiple side effects, thereby warranting a new approach to improving the pharmacological effect of CisPt. A newly developed mathematical hypothesis suggested that mechanical loading, when coupled with a chemotherapeutic drug such as CisPt and immune cells, would boost tumor cell death. The current study investigated the aforementioned mathematical hypothesis by exposing human hepatocellular liver carcinoma (HepG2 cells to CisPt, peripheral blood mononuclear cells, and mechanical stress individually and in combination. HepG2 cells were also treated with a mixture of CisPt and carnosine with and without mechanical stress to examine one possible mechanism employed by mechanical stress to enhance CisPt effects. Carnosine is a dipeptide that reportedly sequesters platinum-based drugs away from their pharmacological target-site. Mechanical stress was achieved using an orbital shaker that produced 300 rpm with a horizontal circular motion. Our results demonstrated that mechanical stress promoted CisPt-induced death of HepG2 cells (~35% more cell death. Moreover, results showed that CisPt-induced death was compromised when CisPt was left to mix with carnosine 24 hours preceding treatment. Mechanical stress, however, ameliorated cell death (20% more cell death.

  7. Deaths from abdominal trauma: analysis of 1888 forensic autopsies

    Directory of Open Access Journals (Sweden)

    POLYANNA HELENA COELHO BORDONI

    Full Text Available ABSTRACT Objective: to evaluate the epidemiological profile of deaths due to abdominal trauma at the Forensic Medicine Institute of Belo Horizonte, MG - Brazil. Methods: we conducted a retrospective study of the reports of deaths due to abdominal trauma autopsied from 2006 to 2011. Results: we analyzed 1.888 necropsy reports related to abdominal trauma. Penetrating trauma was more common than blunt one and gunshot wounds were more prevalent than stab wounds. Most of the individuals were male, brown-skinned, single and occupationally active. The median age was 34 years. The abdominal organs most injured in the penetrating trauma were the liver and the intestines, and in blunt trauma, the liver and the spleen. Homicide was the most prevalent circumstance of death, followed by traffic accidents, and almost half of the cases were referred to the Forensic Medicine Institute by a health unit. The blood alcohol test was positive in a third of the necropsies where it was performed. Cocaine and marijuana were the most commonly found substances in toxicology studies. Conclusion: in this sample. there was a predominance of penetrating abdominal trauma in young, brown and single men, the liver being the most injured organ.

  8. Post-Marketing Regulation of Medicines Withdrawn from the Market Because of Drug-Attributed Deaths: An Analysis of Justification.

    Science.gov (United States)

    Onakpoya, Igho J; Heneghan, Carl J; Aronson, Jeffrey K

    2017-05-01

    Several medicinal products have been withdrawn from the market because of drug-attributed deaths. However, there has been no investigation of whether such withdrawals were justified, and the extent to which confirmatory studies are used to investigate drug-adverse event relationships when deaths are reported is uncertain. We documented medicinal products withdrawn from the market because of drug-attributed deaths, identified confirmatory studies investigating the drug-adverse event relationships, examined whether withdrawals of medicinal products because of drug-attributed deaths after marketing were justified based on a mechanistic analysis, and examined the trends over time. We searched electronic and non-electronic sources to identify medicinal products that were withdrawn because of drug-attributed deaths. We used a previously published algorithm to examine whether the withdrawals of products were justified. We then searched PubMed and Google Scholar to identify studies investigating the drug-adverse event relationships, used the Oxford Centre for Evidence-Based Medicine criteria to document the levels of evidence, and assessed whether the evidence of an association was confirmed. We included 83 medicinal products. The reasons for withdrawal appeared to have been justified in 80 cases (96%). The median interval between the first reported adverse reaction that was related to the cause of death and the first reported death was 1 year (interquartile range = 1-3); products were withdrawn sooner when the interval between the first reported relevant adverse reaction and the first death was shorter. Confirmatory studies were conducted in 57 instances (69%), and there was evidence of an association in 52 cases (63%). Four products (5%) were re-introduced after initial withdrawal. Regulatory authorities have been justified in making withdrawal decisions when deaths have been attributed to medicinal products, using the precautionary principle when alternative decisions

  9. Making death 'good': instructional tales for dying in newspaper accounts of Jade Goody's death.

    Science.gov (United States)

    Frith, Hannah; Raisborough, Jayne; Klein, Orly

    2013-03-01

    Facilitating a 'good' death is a central goal for hospices and palliative care organisations. The key features of such a death include an acceptance of death, an open awareness of and communication about death, the settling of practical and interpersonal business, the reduction of suffering and pain, and the enhancement of autonomy, choice and control. Yet deaths are inherently neither good nor bad; they require cultural labour to be 'made over' as good. Drawing on media accounts of the controversial death of UK reality television star Jade Goody, and building on existing analyses of her death, we examine how cultural discourses actively work to construct deaths as good or bad and to position the dying and those witnessing their death as morally accountable. By constructing Goody as bravely breaking social taboos by openly acknowledging death, by contextualising her dying as occurring at the end of a life well lived and by emphasising biographical continuity and agency, newspaper accounts serve to position themselves as educative rather than exploitative, and readers as information-seekers rather than ghoulishly voyeuristic. We argue that popular culture offers moral instruction in dying well which resonates with the messages from palliative care. © 2012 The Authors. Sociology of Health & Illness © 2012 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

  10. Mycobacterial secretion systems ESX-1 and ESX-5 play distinct roles in host cell death and inflammasome activation

    KAUST Repository

    Abdallah, Abdallah

    2011-09-28

    During infection of humans and animals, pathogenic mycobacteria manipulate the host cell causing severe diseases such as tuberculosis and leprosy. To understand the basis of mycobacterial pathogenicity, it is crucial to identify the molecular virulence mechanisms. In this study, we address the contribution of ESX-1 and ESX-5 - two homologous type VII secretion systems of mycobacteria that secrete distinct sets of immune modulators - during the macrophage infection cycle. Using wild-type, ESX-1- and ESX-5-deficient mycobacterial strains, we demonstrate that these secretion systems differentially affect subcellular localization and macrophage cell responses. We show that in contrast to ESX-1, the effector proteins secreted by ESX-5 are not required for the translocation of Mycobacterium tuberculosis or Mycobacterium marinum to the cytosol of host cells. However, the M. marinum ESX-5 mutant does not induce inflammasome activation and IL-1b activation. The ESX-5 system also induces a caspase-independent cell death after translocation has taken place. Importantly, by means of inhibitory agents and small interfering RNA experiments, we reveal that cathepsin B is involved in both the induction of cell death and inflammasome activation upon infection with wild-type mycobacteria. These results reveal distinct roles for two different type VII secretion systems during infection and shed light on how virulent mycobacteria manipulate the host cell in various ways to replicate and spread. Copyright © 2011 by The American Association of Immunologists, Inc.

  11. Risk factors and causes of sudden noncardiac death: A nationwide cohort study in Denmark.

    Science.gov (United States)

    Risgaard, Bjarke; Lynge, Thomas Hadberg; Wissenberg, Mads; Jabbari, Reza; Glinge, Charlotte; Gislason, Gunnar Hilmar; Haunsø, Stig; Winkel, Bo Gregers; Tfelt-Hansen, Jacob

    2015-05-01

    On the performance of an autopsy, sudden deaths may be divided into 2 classifications: (1) sudden cardiac deaths and (2) sudden noncardiac deaths (SNCDs). Families of SNCD victims should not be followed up as a means of searching for cardiac disease. The purpose of this study was to report the risk factors and causes of SNCD. We conducted a retrospective, nationwide study including all deaths between 2000 and 2006 of individuals aged 1-35 years and all deaths between 2007 and 2009 of individuals aged 1-49 years. Two physicians identified all sudden death cases through review of death certificates. Autopsy reports were collected. A multivariable logistic regression model was used to identify both clinical characteristics and risk factors associated with SNCD. We identified 1039 autopsied cases of sudden death, of which 286 (28%) were classified as SNCD. The median age in the SNCD death population was 32 years. Increasing age was inversely associated with SNCD (odds ratio [OR] 0.93, 95% confidence interval [CI] 0.87-0.98). Female sex, in-hospital location, and the absence of cardiac comorbidities were positively associated with SNCD (OR 1.7, 95% CI 1.3-2.3; OR 3.0, 95% CI 2.0-4.4; and OR 4.3, 95% CI 2.5-7.4, respectively). The most common cause of SNCD was pulmonary disease (n = 115 [40%]). Sudden death among individuals aged caused by noncardiac diseases in 28% of cases. Risk factors were female sex, age, and the absence of cardiac comorbidities. These data may guide future strategies for the follow-up of family members of nonautopsied sudden death victims, improve risk stratification, and influence public health strategies. Copyright © 2015 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  12. [The registration of deaths in Venezuela: an evaluation of coverage].

    Science.gov (United States)

    Bidegain, G; Lopez, D

    1987-08-01

    "This paper presents six indirect techniques for estimating the degree of death coverage as applied to vital statistics information in Venezuela between 1960 and 1982, collected by two public institutions, namely, the 'Oficina Central de Estadistica e Informatica' (OCEI) and the Ministry of Health and Social Assistance (MSAS).... The results show remarkable improvements in the death registry coverage for both institutions, that amount to 97 or 98 per cent at the beginning of the 80's. Nevertheless, great differences can be observed between them regarding both structure and volume of deaths by sex and age." Among the problems discussed are the impact of immigration and errors in age reporting. (SUMMARY IN ENG) excerpt

  13. Zinc as a paracrine effector in pancreatic islet cell death.

    Science.gov (United States)

    Kim, B J; Kim, Y H; Kim, S; Kim, J W; Koh, J Y; Oh, S H; Lee, M K; Kim, K W; Lee, M S

    2000-03-01

    Because of a huge amount of Zn2+ in secretory granules of pancreatic islet beta-cells, Zn2+ released in certain conditions might affect the function or survival of islet cells. We studied potential paracrine effects of endogenous Zn2+ on beta-cell death. Zn2+ induced insulinoma/islet cell death in a dose-dependent manner. Chelation of released endogenous Zn2+ by CaEDTA significantly decreased streptozotocin (STZ)-induced islet cell death in an in vitro culture system simulating in vivo circumstances but not in the conventional culture system. Zn2+ chelation in vivo by continuous CaEDTA infusion significantly decreased the incidence of diabetes after STZ administration. N-(6-methoxy-quinolyl)-para-toluene-sulfonamide staining revealed that Zn2+ was densely deposited in degenerating islet cells 24 h after STZ treatment, which was decreased by CaEDTA infusion. We show here that Zn2+ is not a passive element for insulin storage but an active participant in islet cell death in certain conditions, which in time might contribute to the development of diabetes in aged people.

  14. Activation of Cyclin-Dependent Kinase 5 Is a Consequence of Cell Death

    Directory of Open Access Journals (Sweden)

    Yixia Ye

    2009-01-01

    Full Text Available Cyclin-dependent kinase 5 (Cdk5 is similar to other Cdks but is activated during cell differentiation and cell death rather than cell division. Since activation of Cdk5 has been reported in many situations leading to cell death, we attempted to determine if it was required for any form of cell death. We found that Cdk5 is activated during apoptotic deaths and that the activation can be detected even when the cells continue to secondary necrosis. This activation can occur in the absence of Bim, calpain, or neutral cathepsins. The kinase is typically activated by p25, derived from p35 by calpain-mediated cleavage, but inhibition of calpain does not affect cell death or the activation of Cdk5. Likewise, RNAi-forced suppression of the synthesis of Cdk5 does not affect the incidence or kinetics of cell death. We conclude that Cdk5 is activated as a consequence of metabolic changes that are common to many forms of cell death. Thus its activation suggests processes during cell death that will be interesting or important to understand, but activation of Cdk5 is not necessary for cells to die.

  15. The Message Reporting System of the ATLAS DAQ System

    CERN Document Server

    Caprini, M; Kolos, S; 10th ICATPP Conference on Astroparticle, Particle, Space Physics, Detectors and Medical Physics Applications

    2008-01-01

    The Message Reporting System (MRS) in the ATLAS data acquisition system (DAQ) is one package of the Online Software which acts as a glue of various elements of DAQ, High Level Trigger (HLT) and Detector Control System (DCS). The aim of the MRS is to provide a facility which allows all software components