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  1. 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 ...

  2. Antenatal steroids in preterm labour for the prevention of neonatal deaths due to complications of preterm birth.

    Science.gov (United States)

    Mwansa-Kambafwile, Judith; Cousens, Simon; Hansen, Thomas; Lawn, Joy E

    2010-04-01

    In high-income countries, administration of antenatal steroids is standard care for women with anticipated preterm labour. However, although >1 million deaths due to preterm birth occur annually, antenatal steroids are not routine practice in low-income countries where most of these deaths occur. To review the evidence for and estimate the effect on cause-specific neonatal mortality of administration of antenatal steroids to women with anticipated preterm labour, with additional analysis for the effect in low- and middle-income countries. We conducted systematic reviews using standardized abstraction forms. Quality of evidence was assessed using an adapted GRADE approach. Existing meta-analyses were reviewed for relevance to low/middle-income countries, and new meta-analysis was performed. We identified 44 studies, including 18 randomised control trials (RCTs) (14 in high-income countries) in a Cochrane meta-analysis, which suggested that antenatal steroids decrease neonatal mortality among preterm infants (preterm babies currently receive little or no medical care. It is plausible that antenatal steroids may be of even greater effect when tested in these settings. Based on high-grade evidence, antenatal steroid therapy is very effective in preventing neonatal mortality and morbidity, yet remains at low coverage in low/middle-income countries. If fully scaled up, this intervention could save up to 500 000 neonatal lives annually.

  3. Death losses due to stillbirth, neonatal death and diseases in cloned cattle derived from somatic cell nuclear transfer and their progeny: a result of nationwide survey in Japan.

    Science.gov (United States)

    Watanabe, Shinya; Nagai, Takashi

    2009-06-01

    To obtain the data concerning death losses due to stillbirth, neonatal death and diseases in cloned cattle derived from somatic cell nuclear transfer (SCNT) and their progeny produced by Japanese institutions, a nationwide survey was carried out in July-August, 2006. As a result, lifetime data concerning 482 SCNT cattle (97.5% of cattle produced in the country at that time) and 202 progeny of SCNT cattle were accumulated and the death loss of these cattle was analyzed. Although 1/3 of delivered SCNT calves died during the perinatal period due to stillbirth and neonatal death, incidence of death loss due to diseases in SCNT cattle surviving more than 200 days after birth seems to be the same as these in conventionally bred cattle. In contrast, progeny of SCNT cattle showed the same level in death loss as observed in conventionally bred cattle throughout their lifetime. These results suggest that robust health would be expected in SCNT cattle surviving to adulthood and their progeny.

  4. 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

  5. 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.

  6. 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.)

  7. Autoerotic death due to electrocution

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    Piotr Arkuszewski

    2014-08-01

    Full Text Available Autoerotic death is a very rare case in forensic medicine. It is usually caused by asphyxia, but other reasons are also possible. Herein we present a case of autoerotic death due to electrocution caused by a self-made electrical device. The device was constructed to increase sexual feelings through stimulation of the scrotal area.

  8. Cause of neonatal deaths in Northern Ethiopia: a prospective cohort study

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    Hayelom Gebrekirstos Mengesha

    2017-01-01

    Full Text Available Abstract Background Despite the significant reduction in childhood mortality, neonatal mortality has shown little or no concomitant decline worldwide. The dilemma arises in that the lack of documentation of cause of death in developing countries, where registration of vital events is virtually nonexistent. Understanding of the causes of death in neonates is important to guide public health interventions. The present study identifies the common causes of neonatal death in Ethiopia. Methods A prospective cohort study was conducted among neonates born between April 2014 and July 2014 in seven hospitals, in Tigray region, Ethiopia. Mothers were interviewed by midwifes respecting risk factors and infant survival. For neonates who died in hospital, causes of death were extracted from medical records, whereas a verbal autopsy method provided presumptive assignment of cause of death for those infants who died at home. Results Of the1152 live births, there were 68 deaths (63 per 1000 live births. Two thirds of deaths were attributable to prematurity 23 (34% or asphyxia 21 (31%. Slight variance was seen between the morality patterns in early and late neonatal periods. In the early neonatal period, 37% were due to prematurity, while asphyxia (35% was more common in the late neonatal period. All infection-related deaths occurred in neonate-mother dyads from rural areas. Conclusion Prematurity, asphyxia, and infections were the leading causes of neonatal deaths in Tigray region during the study period. Causes of deaths identified during early and late neonatal mortality differed, which clearly indicates the need for responsive and evidence-based interventions and policies.

  9. Maternal education and age: inequalities in neonatal death.

    Science.gov (United States)

    Fonseca, Sandra Costa; Flores, Patricia Viana Guimarães; Camargo, Kenneth Rochel; Pinheiro, Rejane Sobrino; Coeli, Claudia Medina

    2017-11-17

    Evaluate the interaction between maternal age and education level in neonatal mortality, as well as investigate the temporal evolution of neonatal mortality in each stratum formed by the combination of these two risk factors. A nonconcurrent cohort study, resulting from a probabilistic relationship between the Mortality Information System and the Live Birth Information System. To investigate the risk of neonatal death we performed a logistic regression, with an odds ratio estimate for the combined variable of maternal education and age, as well as the evaluation of additive and multiplicative interaction. The neonatal mortality rate time series, according to maternal education and age, was estimated by the Joinpoint Regression program. The neonatal mortality rate in the period was 8.09‰ and it was higher in newborns of mothers with low education levels: 12.7‰ (adolescent mothers) and 12.4‰ (mother 35 years old or older). Low level of education, without the age effect, increased the chance of neonatal death by 25% (OR = 1.25, 95%CI 1.14-1.36). The isolated effect of age on neonatal death was higher for adolescent mothers (OR = 1.39, 95%CI 1.33-1.46) than for mothers aged ≥ 35 years (OR = 1.16, 95%CI 1.09-1.23). In the time-trend analysis, no age group of women with low education levels presented a reduction in the neonatal mortality rate for the period, as opposed to women with intermediate or high levels of education, where the reduction was significant, around 4% annually. Two more vulnerable groups - adolescents with low levels of education and older women with low levels of education - were identified in relation to the risk of neonatal death and inequality in reducing the mortality rate.

  10. [Sensorineural hearing loss due to neonatal hyperbilirubinemia].

    Science.gov (United States)

    Clarós, P; Turcanu, D; Caballero, M; Costa, C; Clavería, M A; Clarós, A; Clarós, A

    2003-01-01

    In this article, the sensorineural hearing loss is presented as a possible sequelae of neonatal hyperbilirubinemia. In our program of early hipoacusia detection, 241 babies were examined from January 1996 until November 1999; 7 cases had a history of hyperbilirubinemia in the neonatal period and 2 of them were diagnosed of sensorineural hearing loss. We discuss how the bilirubin or any other associated factor might have been the cause and this could explain the selective affectation of some children.

  11. Reducing neonatal deaths in South Africa: Progress and challenges

    Directory of Open Access Journals (Sweden)

    N Rhoda

    2018-03-01

    Full Text Available Although current levels of the neonatal mortality rate (NMR are within reach of the Sustainable Development Goal (SDG target of 12 per 1 000 live births, the absolute number of deaths is unacceptably high for a lower-middle-income country such as South Africa (SA. Neonatal mortality over the last decade has declined very slowly, and is not commensurate with the level of government investment in healthcare. The recent neonatal mortality rate of 21 per 1 000 live births reported by the SA Demographic Health Survey is of major concern. This paper reviews recent efforts to reduce the neonatal mortality rate, including support for the implementation of neonatal policies and plans, and strengthening programmes to deliver low-cost, high-impact interventions. We review recent estimates of the NMR and causes of neonatal deaths, and discuss how the mortality from preventable causes of death could be reduced. If SA is to meet the SDG target, special attention should be given to the availability of high-impact interventions, providing an adequate number of appropriately trained healthcare providers and a more active role played by ward-based community health workers and district clinical specialist teams.

  12. Neonatal Hyperglycemia due to Transient Neonatal Diabetes Mellitus in Puerto Rico.

    Science.gov (United States)

    Fargas-Berríos, N; García-Fragoso, L; García-García, I; Valcárcel, M

    2015-01-01

    Neonatal hyperglycemia is a metabolic disorder found in the neonatal intensive care units. Neonatal diabetes mellitus (NDM) is a very uncommon cause of hyperglycemia in the newborn, occurring in 1 in every 400,000 births. There are two subtypes of neonatal diabetes mellitus: permanent neonatal diabetes mellitus (PNDM) and transient neonatal diabetes mellitus (TNDM). We describe a term, small for gestational age, female neonate with transient neonatal diabetes mellitus who presented with poor feeding tolerance and vomiting associated with hyperglycemia (385 mg/dL), glycosuria, and metabolic acidosis within the first 12 hours of life. The neonate was treated with intravenous insulin, obtaining a slight control of hyperglycemia. An adequate glycemia was achieved at 5 weeks of life. The molecular studies showed complete loss of maternal methylation at the TND differentially methylated region on chromosome 6q24. The etiology of this neonate's hyperglycemia was a hypomethylation of the maternal TND locus. A rare cause of neonatal diabetes mellitus must be considered if a neonate presents refractory hyperglycemia. To our knowledge, this is the first case reported in Puerto Rico of transient neonatal mellitus due to the uncommon mechanism of maternal hypomethylation of the TND locus. Its prevalence in Puerto Rico is unknown.

  13. Neonatal Hyperglycemia due to Transient Neonatal Diabetes Mellitus in Puerto Rico

    Directory of Open Access Journals (Sweden)

    N. Fargas-Berríos

    2015-01-01

    Full Text Available Neonatal hyperglycemia is a metabolic disorder found in the neonatal intensive care units. Neonatal diabetes mellitus (NDM is a very uncommon cause of hyperglycemia in the newborn, occurring in 1 in every 400,000 births. There are two subtypes of neonatal diabetes mellitus: permanent neonatal diabetes mellitus (PNDM and transient neonatal diabetes mellitus (TNDM. We describe a term, small for gestational age, female neonate with transient neonatal diabetes mellitus who presented with poor feeding tolerance and vomiting associated with hyperglycemia (385 mg/dL, glycosuria, and metabolic acidosis within the first 12 hours of life. The neonate was treated with intravenous insulin, obtaining a slight control of hyperglycemia. An adequate glycemia was achieved at 5 weeks of life. The molecular studies showed complete loss of maternal methylation at the TND differentially methylated region on chromosome 6q24. The etiology of this neonate’s hyperglycemia was a hypomethylation of the maternal TND locus. A rare cause of neonatal diabetes mellitus must be considered if a neonate presents refractory hyperglycemia. To our knowledge, this is the first case reported in Puerto Rico of transient neonatal mellitus due to the uncommon mechanism of maternal hypomethylation of the TND locus. Its prevalence in Puerto Rico is unknown.

  14. 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).

  15. Reducing neonatal deaths in South Africa: Progress and challenges

    African Journals Online (AJOL)

    2018-03-09

    Mar 9, 2018 ... in sub-Saharan Africa and South Asia.[2]. Since the ... subsequent increase in the proportion of neonatal deaths accounting for 45% of the .... plans, and strengthening programmes to deliver low-cost, high-impact interventions. ...... Mortality in Children under 5 Years (CoMMiC): 2014 (Abridged version).

  16. Socioeconomic factors and adolescent pregnancy outcomes: distinctions between neonatal and post-neonatal deaths?

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    Flick Louise H

    2005-07-01

    Full Text Available Abstract Background Young maternal age has long been associated with higher infant mortality rates, but the role of socioeconomic factors in this association has been controversial. We sought to investigate the relationships between infant mortality (distinguishing neonatal from post-neonatal deaths, socioeconomic status and maternal age in a large, retrospective cohort study. Methods We conducted a population-based cohort study using linked birth-death certificate data for Missouri residents during 1997–1999. Infant mortality rates for all singleton births to adolescent women (12–17 years, n = 10,131; 18–19 years, n = 18,954 were compared to those for older women (20–35 years, n = 28,899. Logistic regression was used to estimate adjusted odds ratios (OR and 95% confidence intervals (CI for all potential associations. Results The risk of infant (OR 1.95, CI 1.54–2.48, neonatal (1.69, 1.24–2.31 and post-neonatal mortality (2.47, 1.70–3.59 were significantly higher for younger adolescent (12–17 years than older (20–34 years mothers. After adjusting for race, marital status, age-appropriate education level, parity, smoking status, prenatal care utilization, and poverty status (indicated by participation in WIC, food stamps or Medicaid, the risk of post-neonatal mortality (1.73, 1.14–2.64 but not neonatal mortality (1.43, 0.98–2.08 remained significant for younger adolescent mothers. There were no differences in neonatal or post-neonatal mortality risks for older adolescent (18–19 years mothers. Conclusion Socioeconomic factors may largely explain the increased neonatal mortality risk among younger adolescent mothers but not the increase in post-neonatal mortality risk.

  17. Preventing newborn deaths due to prematurity.

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    Azad, Kishwar; Mathews, Jiji

    2016-10-01

    Preterm births (PTBs), defined as births before 37 weeks of gestation account for the majority of deaths in the newborn period. Prediction and prevention of PTB is challenging. A history of preterm labour or second trimester losses and accurate measurement of cervical length help to identify women who would benefit from progesterone and cerclage. Fibronectin estimation in the cervicovaginal secretions of a symptomatic woman with an undilated cervix can predict PTB within 10 days of testing. Antibiotics should be given to women with preterm prelabour rupture of membranes but tocolysis has a limited role in the management of preterm labour. Antenatal corticosteroids to prevent complications in the neonate should be given only when gestational age assessment is accurate PTB is considered imminent, maternal infection and the preterm newborn can receive adequate care. Magnesium sulphate for fetal neuroprotection should be given when delivery is imminent. After birth, most babies respond to simple interventions essential newborn care, basic care for feeding support, infections and breathing difficulties. Newborns weighing 2000 g or less, benefit from KMC. Babies, who are clinically unstable or cannot be given KMC may be nursed in an incubator or under a radiant warmer. Treatment modalities include oxygen therapy, CPAP, surfactant and assisted ventilation. Copyright © 2016. Published by Elsevier Ltd.

  18. Possible Prevention of Neonatal Death: A Regional Population-Based Study in Japan.

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    Koshida, Shigeki; Yanagi, Takahide; Ono, Tetsuo; Tsuji, Shunichiro; Takahashi, Kentaro

    2016-03-01

    The neonatal mortality rate in Japan has currently been at the lowest level in the world. However, it is unclear whether there are still some potentially preventable neonatal deaths. We, therefore, aimed to examine the backgrounds of neonatal death and the possibilities of prevention in a region of Japan. This is a population-based study of neonatal death in Shiga Prefecture of Japan. The 103 neonatal deaths in our prefecture between 2007 and 2011 were included. After reviewing by a peer-review team, we classified the backgrounds of these neonatal deaths and analyzed end-of-life care approaches associated with prenatal diagnosis. Furthermore, we evaluated the possibilities of preventable neonatal death, suggesting specific recommendations for its prevention. We analyzed 102 (99%) of the neonatal deaths. Congenital malformations and extreme prematurity were the first and the second most common causes of death, respectively. More than half of the congenital abnormalities (59%) including malformations and chromosome abnormality had been diagnosed before births. We had 22 neonates with non-intensive care including eighteen cases with congenital abnormality and four with extreme prematurity. Twenty three cases were judged to have had some possibility of prevention with one having had a strong possibility of prevention. Among specific recommendations of preventable neonatal death, more than half of them were for obstetricians. There is room to reduce neonatal deaths in Japan. Prevention of neonatal death requires grater prenatal care by obstetricians before birth rather than improved neonatal care by neonatologists after birth.

  19. High risk pregnancies and factors associated with neonatal death.

    Science.gov (United States)

    Demitto, Marcela de Oliveira; Gravena, Angela Andréia França; Dell'Agnolo, Cátia Millene; Antunes, Marcos Benatti; Pelloso, Sandra Marisa

    2017-04-03

    To identify the factors associated with intra-hospital neonatal mortality based on the individual characteristics of at-risk pregnant mothers, delivery and newborns. This was a cross-sectional epidemiological study of live newborns delivered by women attended at the high-risk outpatient unit of a philanthropic hospital in Maringá, Paraná, Brazil between September 2012 and September 2013. Six hundred and eighty-eight women participated in the study. The neonatal mortality coefficient found was 17.7/1,000 live births, most in the early neonatal phase. Premature labor, fetal malformation and multiple gestations were associated with neonatal death. Premature, very low birth weight newborns and those with an Apgar score of less than seven, five minutes after birth were at high risk of death. Identifying risk factors can help plan actions to consolidate the perinatal network. Specific programs should be incentivized in other countries, in the search for significant perinatal results such as reducing neonatal mortality. Identificar os fatores associados à mortalidade neonatal intra-hospitalar com base nas características individuais de gestantes de risco, do parto e do recém-nascido. Estudo epidemiológico do tipo transversal, realizado com crianças nascidas vivas de partos hospitalares de mulheres acompanhadas pelo ambulatório de alto risco de um hospital filantrópico de Maringá, Paraná, Brasil, no período de setembro de 2012 a setembro de 2013.RESULTADOS Fizeram parte da pesquisa 688 mulheres. O coeficiente de mortalidade neonatal foi de 17,7 óbitos/1.000 nascidos vivos, sendo sua maioria no período neonatal precoce. Trabalho de parto prematuro, malformação fetal e gestação múltipla foram as intercorrências associadas ao óbito neonatal. Recém-nascidos prematuros, com muito baixo peso ao nascer e Índice de Apgar menor que sete no quinto minuto de vida apresentaram risco elevado de morte. A identificação de fatores de risco pode auxiliar no

  20. 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.

  1. Analysis of In-hospital Neonatal Death in the Tertiary Neonatal Intensive Care Unit in China: A Multicenter Retrospective Study

    Institute of Scientific and Technical Information of China (English)

    Chen-Hong Wang; Li-Zhong Du; Xiao-Lu Ma; Li-Ping Shi; Xiao-Mei Tong; Hong Liu; Guo-Fang Ding

    2016-01-01

    Background:Globally,the proportion of child deaths that occur in the neonatal period remains a high level of 37-41%.Differences of cause in neonate death exist in different regions as well as in different economic development countries.The specific aim of this study was to investigate the causes,characteristics,and differences of death in neonates during hospitalization in the tertiary Neonatal Intensive Care Unit (NICU) of China.Methods:All the dead neonates admitted to 26 NICUs were included between January 1,2011,and December 31,2011.All the data were collected retrospectively from clinical records by a designed questionnaire.Data collected from each NICU were delivered to the leading institution where the results were analyzed.Results:A total of 744 newborns died during the l-year survey,accounting for 1.2% of all the neonates admitted to 26 NICUs and 37.6% of all the deaths in children under 5 years of age in these hospitals.Preterm neonate death accounted for 59.3% of all the death.The leading causes of death in preterm and term infants were pulmonary disease and infection,respectively.In early neonate period,pulmonary diseases (56.5%) occupied the largest proportion ofpreterm deaths while infection (27%) and neurologic diseases (22%) were the two main causes of term deaths.In late neonate period,infection was the leading cause of both preterm and term neonate deaths.About two-thirds of neonate death occurred after medical care withdrawal.Of the cases who might survive if receiving continuing treatment,parents' concern about the long-term outcomes was the main reason of medical care withdrawal.Conclusions:Neonate death still accounts for a high proportion of all the deaths in children under 5 years of age.Our study showed the majority of neonate death occurred in preterm infants.Cause of death varied with the age of death and gestational age.Accurate and prompt evaluation of the long-term outcomes should be carried out to guide the critical

  2. 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...

  3. Neonatal resuscitation and immediate newborn assessment and stimulation for the prevention of neonatal deaths: a systematic review, meta-analysis and Delphi estimation of mortality effect

    Science.gov (United States)

    2011-01-01

    Background Of 136 million babies born annually, around 10 million require assistance to breathe. Each year 814,000 neonatal deaths result from intrapartum-related events in term babies (previously “birth asphyxia”) and 1.03 million from complications of prematurity. No systematic assessment of mortality reduction from tactile stimulation or resuscitation has been published. Objective To estimate the mortality effect of immediate newborn assessment and stimulation, and basic resuscitation on neonatal deaths due to term intrapartum-related events or preterm birth, for facility and home births. Methods We conducted systematic reviews for studies reporting relevant mortality or morbidity outcomes. Evidence was assessed using GRADE criteria adapted to provide a systematic approach to mortality effect estimates for the Lives Saved Tool (LiST). Meta-analysis was performed if appropriate. For interventions with low quality evidence but strong recommendation for implementation, a Delphi panel was convened to estimate effect size. Results We identified 24 studies of neonatal resuscitation reporting mortality outcomes (20 observational, 2 quasi-experimental, 2 cluster randomized controlled trials), but none of immediate newborn assessment and stimulation alone. A meta-analysis of three facility-based studies examined the effect of resuscitation training on intrapartum-related neonatal deaths (RR= 0.70, 95%CI 0.59-0.84); this estimate was used for the effect of facility-based basic neonatal resuscitation (additional to stimulation). The evidence for preterm mortality effect was low quality and thus expert opinion was sought. In community-based studies, resuscitation training was part of packages with multiple concurrent interventions, and/or studies did not distinguish term intrapartum-related from preterm deaths, hence no meta-analysis was conducted. Our Delphi panel of 18 experts estimated that immediate newborn assessment and stimulation would reduce both intrapartum

  4. Early maternal death due to acute encephalitis

    Directory of Open Access Journals (Sweden)

    M Vidanapathirana

    2014-03-01

    Full Text Available Maternal death in an unmarried woman poses a medico-legal challenge. A 24-year-old unmarried schoolteacher, residing at a boarding place, had been admitted to hospital in a state of cardiac arrest. At the autopsy, mild to moderate congestion of subarachnoid vessels and oedema of the brain was noted. An un-interfered foetus of 15 weeks with an intact sac and placental tissues were seen. Genital tract injuries were not present. Histopathological examination showed diffuse perivascular cuffing by mononuclear cells suggestive of viral encephalitis, considering the circumstances of death and the social stigma of pregnancy in this unmarried teacher, the possibility of attempted suicide by ingestion of a poison was considered. Abrus precatorius (olinda seeds commonly found in the area is known to produce acute encephalitis as well as haemorrhagic gastroenteritis and pulmonary congestion was also considered as a possible cause for this unusual presentation

  5. Neonatal Hyperglycemia due to Transient Neonatal Diabetes Mellitus in Puerto Rico

    OpenAIRE

    Fargas-Berríos, N.; García-Fragoso, L.; García-García, I.; Valcárcel, M.

    2015-01-01

    Neonatal hyperglycemia is a metabolic disorder found in the neonatal intensive care units. Neonatal diabetes mellitus (NDM) is a very uncommon cause of hyperglycemia in the newborn, occurring in 1 in every 400,000 births. There are two subtypes of neonatal diabetes mellitus: permanent neonatal diabetes mellitus (PNDM) and transient neonatal diabetes mellitus (TNDM). We describe a term, small for gestational age, female neonate with transient neonatal diabetes mellitus who presented with poor ...

  6. Predictors of positive blood culture and deaths among neonates with suspected neonatal sepsis in a tertiary hospital, Mwanza- Tanzania

    Directory of Open Access Journals (Sweden)

    Jeremiah Seni

    2010-06-01

    Full Text Available Abstract Background Neonatal sepsis is a significant cause of morbidity and mortality in neonates. Appropriate clinical diagnosis and empirical treatment in a given setting is crucial as pathogens of bacterial sepsis and antibiotic sensitivity pattern can considerably vary in different settings. This study was conducted at Bugando Medical Centre (BMC, Tanzania to determine the prevalence of neonatal sepsis, predictors of positive blood culture, deaths and antimicrobial susceptibility, thus providing essential information to formulate a policy for management of neonatal sepsis. Methods This was a prospective cross sectional study involving 300 neonates admitted at BMC neonatal unit between March and November 2009. Standard data collection form was used to collect all demographic data and clinical characteristics of neonates. Blood culture was done on Brain Heart Infusion broth followed by identification of isolates using conventional methods and testing for their susceptibility to antimicrobial agents using the disc diffusion method. Results Among 770 neonates admitted during the study period; 300 (38.9% neonates were diagnosed to have neonatal sepsis by WHO criteria. Of 300 neonates with clinical neonatal sepsis 121(40% and 179(60% had early and late onset sepsis respectively. Positive blood culture was found in 57 (47.1% and 92 (51.4% among neonates with early and late onset neonatal sepsis respectively (p = 0.466. Predictors of positive blood culture in both early and late onset neonatal sepsis were inability to feed, lethargy, cyanosis, meconium stained liquor, premature rupture of the membrane and convulsion. About 49% of gram negatives isolates were resistant to third generation cephalosporins and 28% of Staphylococcus aureus were found to be Methicillin resistant Staphylococcus aureus (MRSA. Deaths occurred in 57 (19% of neonates. Factors that predicted deaths were positive blood culture (p = 0.0001, gram negative sepsis (p = 0.0001 and

  7. Neonatal Meningoventriculitis Due to Proteus Mirabilis – A Case Report

    Science.gov (United States)

    Juyal, Deepak; Rathaur, Vyas Kumar; Sharma, Neelam

    2013-01-01

    A five day old full term born baby was admitted to our Neonatal Intensive Care Unit with seizures, opisthotonous posture and was icteric upto thigh. Baby had a three day history of poor feeding, lethargy and abnormal body movements. Mother was a 29 years old primigravida and had a normal vaginal delivery at home. Sepsis profile of the patient was requested, lumbar puncture and ventricular tap was performed. Patient was put on third generation cephalosporins, aminoglycosides and phenobarbitone. Culture and sensitivity report of blood, Cerebro spinal fluid and ventricular fluid showed Proteus mirabilis. Computerized Tomography scan showed a large parenchymal lesion in the right frontal lobe and diffuse ependymal enhancement along both the lateral ventricles suggestive of meningoventriculitis. We hereby present a fatal case of neonatal meningoventriculitis due to Proteus mirabilis. PMID:23543669

  8. 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.

  9. Risk factors associated with neonatal deaths: a matched case-control study in Indonesia.

    Science.gov (United States)

    Abdullah, Asnawi; Hort, Krishna; Butu, Yuli; Simpson, Louise

    2016-01-01

    Similar to global trends, neonatal mortality has fallen only slightly in Indonesia over the period 1990-2010, with a high proportion of deaths in the first week of life. This study aimed to identify risk factors associated with neonatal deaths of low and normal birthweight infants that were amenable to health service intervention at a community level in a relatively poor province of Indonesia. A matched case-control study of neonatal deaths reported from selected community health centres (puskesmas) was conducted over 10 months in 2013. Cases were singleton births, born by vaginal delivery, at home or in a health facility, matched with two controls satisfying the same criteria. Potential variables related to maternal and neonatal risk factors were collected from puskesmas medical records and through home visit interviews. A conditional logistic regression was performed to calculate odds ratios using the clogit procedure in Stata 11. Combining all significant variables related to maternal, neonatal, and delivery factors into a single multivariate model, six factors were found to be significantly associated with a higher risk of neonatal death. The factors identified were as follows: neonatal complications during birth; mother noting a health problem during the first 28 days; maternal lack of knowledge of danger signs for neonates; low Apgar score; delivery at home; and history of complications during pregnancy. Three risk factors (neonatal complication at delivery; neonatal health problem noted by mother; and low Apgar score) were significantly associated with early neonatal death at age 0-7 days. For normal birthweight neonates, three factors (complications during delivery; lack of early initiation of breastfeeding; and lack of maternal knowledge of neonatal danger signs) were found to be associated with a higher risk of neonatal death. The study identified a number of factors amenable to health service intervention associated with neonatal deaths in normal and low

  10. Risk factors associated with neonatal deaths: a matched case–control study in Indonesia

    Directory of Open Access Journals (Sweden)

    Asnawi Abdullah

    2016-02-01

    Full Text Available Background: Similar to global trends, neonatal mortality has fallen only slightly in Indonesia over the period 1990–2010, with a high proportion of deaths in the first week of life. Objective: This study aimed to identify risk factors associated with neonatal deaths of low and normal birthweight infants that were amenable to health service intervention at a community level in a relatively poor province of Indonesia. Design: A matched case–control study of neonatal deaths reported from selected community health centres (puskesmas was conducted over 10 months in 2013. Cases were singleton births, born by vaginal delivery, at home or in a health facility, matched with two controls satisfying the same criteria. Potential variables related to maternal and neonatal risk factors were collected from puskesmas medical records and through home visit interviews. A conditional logistic regression was performed to calculate odds ratios using the clogit procedure in Stata 11. Results: Combining all significant variables related to maternal, neonatal, and delivery factors into a single multivariate model, six factors were found to be significantly associated with a higher risk of neonatal death. The factors identified were as follows: neonatal complications during birth; mother noting a health problem during the first 28 days; maternal lack of knowledge of danger signs for neonates; low Apgar score; delivery at home; and history of complications during pregnancy. Three risk factors (neonatal complication at delivery; neonatal health problem noted by mother; and low Apgar score were significantly associated with early neonatal death at age 0–7 days. For normal birthweight neonates, three factors (complications during delivery; lack of early initiation of breastfeeding; and lack of maternal knowledge of neonatal danger signs were found to be associated with a higher risk of neonatal death. Conclusion: The study identified a number of factors amenable to

  11. MRI findings of brain damage due to neonatal hypoglycemia

    International Nuclear Information System (INIS)

    Wang Lu; Fan Guoguang; Ji Xu; Sun Baohai; Guo Qiyong

    2009-01-01

    ) on T 2 weighted images. Conclusion: The findings suggest that posterior parieto-occipital regions are most frequently injured in neonatal period due to severe hypoglycemia. DWI is a useful technique in the early detection and evaluation of hypoglycemic brain injury of neonates. (authors)

  12. Underlying causes of neonatal deaths in term singleton pregnancies: home births versus hospital births in the United States.

    Science.gov (United States)

    Grünebaum, Amos; McCullough, Laurence B; Arabin, Birgit; Dudenhausen, Joachim; Orosz, Brooke; Chervenak, Frank A

    2017-04-01

    The objective of this study was to evaluate the underlying causes of neonatal mortality (NNM) in midwife-attended home births and compare them to hospital births attended by a midwife or a physician in the United States (US). A retrospective cohort study of the Centers for Disease Control (CDC) linked birth/infant death data set (linked files) for 2008 through 2012 of singleton, term (≥37 weeks) births and normal newborn weights (≥2500 grams). Midwife-attended home births had the highest rate of neonatal deaths [122/95,657 neonatal mortality (NNM) 12.75/10,000; relative risk (RR): 3.6, 95% confidence interval (CI) 3-4.4], followed by hospital physician births (8695/14,447,355 NNM 6.02/10,000; RR: 1.7 95% CI 1.6-1.9) and hospital midwife births (480/1,363,199 NNM 3.52/10,000 RR: 1). Among midwife-assisted home births, underlying causes attributed to labor and delivery caused 39.3% (48/122) of neonatal deaths (RR: 13.4; 95% CI 9-19.9) followed by 29.5% due to congenital anomalies (RR: 2.5; 95% CI 1.8-3.6), and 12.3% due to infections (RR: 4.5; 95% CI 2.5-8.1). There are significantly increased risks of neonatal deaths among midwife-attended home births associated with three underlying causes: labor and delivery issues, infections, and fetal malformations. This analysis of the causes of neonatal death in planned home birth shows that it is consistently riskier for newborns to deliver at home than at the hospital. Physicians, midwives, and other health care providers have a professional responsibility to share information about the clinical benefits and risks of clinical management.

  13. Severe hyperglycaemia due to neonatal sepsis - A case report ...

    African Journals Online (AJOL)

    Neonatal sepsis is a clinical syndrome characterized by signs and symptoms of infection with or without accompanying bacteremia in the first month of life. The clinical signs of neonatal sepsis are neither specific nor uniform. Neonatal sepsis may present with fever, hypotonia, respiratory distress, apnea and hyperglycaemia.

  14. Resuscitation and Obstetrical Care to Reduce Intrapartum-Related Neonatal Deaths: A MANDATE Study.

    Science.gov (United States)

    Kamath-Rayne, Beena D; Griffin, Jennifer B; Moran, Katelin; Jones, Bonnie; Downs, Allan; McClure, Elizabeth M; Goldenberg, Robert L; Rouse, Doris; Jobe, Alan H

    2015-08-01

    To evaluate the impact of neonatal resuscitation and basic obstetric care on intrapartum-related neonatal mortality in low and middle-income countries, using the mathematical model, Maternal and Neonatal Directed Assessment of Technology (MANDATE). Using MANDATE, we evaluated the impact of interventions for intrapartum-related events causing birth asphyxia (basic neonatal resuscitation, advanced neonatal care, increasing facility birth, and emergency obstetric care) when implemented in home, clinic, and hospital settings of sub-Saharan African and India for 2008. Total intrapartum-related neonatal mortality (IRNM) was acute neonatal deaths from intrapartum-related events plus late neonatal deaths from ongoing intrapartum-related injury. Introducing basic neonatal resuscitation in all settings had a large impact on decreasing IRNM. Increasing facility births and scaling up emergency obstetric care in clinics and hospitals also had a large impact on decreasing IRNM. Increasing prevalence and utilization of advanced neonatal care in hospital settings had limited impact on IRNM. The greatest improvement in IRNM was seen with widespread advanced neonatal care and basic neonatal resuscitation, scaled-up emergency obstetric care in clinics and hospitals, and increased facility deliveries, resulting in an estimated decrease in IRNM to 2.0 per 1,000 live births in India and 2.5 per 1,000 live births in sub-Saharan Africa. With more deliveries occurring in clinics and hospitals, the scale-up of obstetric care can have a greater effect than if modeled individually. Use of MANDATE enables health leaders to direct resources towards interventions that could prevent intrapartum-related deaths. A lack of widespread implementation of basic neonatal resuscitation, increased facility births, and emergency obstetric care are missed opportunities to save newborn lives.

  15. 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.

  16. 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.

  17. When, Where, and Why Are Babies Dying? Neonatal Death Surveillance and Review in Bangladesh.

    Directory of Open Access Journals (Sweden)

    Abdul Halim

    Full Text Available Better data on cause of, and factors contributing to, neonatal deaths are needed to improve interventions aimed at reducing neonatal mortality in low- and middle-income countries.Community surveillance to identify all neonatal deaths across four districts in Bangladesh. Verbal autopsy for every fifth case and InterVA-4 used to assign likely cause of death.6748 neonatal deaths identified, giving a neonatal mortality rate of 24.4 per 1000 live births. Of these, 51.3% occurred in the community and 48.7% at or on the way to a health facility. Almost half (46.1% occurred within 24 hours of birth with 83.6% of all deaths occurring in the first seven days of life. Birth asphyxia was the leading cause of death (43%, followed by infections (29.3%, and prematurity (22.2%. In 68.3% of cases, care had been provided at a health facility before death occurred. Care-seeking was significantly higher among mothers who were educated (RR 1.18, 95% CI: 1.04-1.35 or who delivered at a health facility (RR 1.48, 95% CI 1.37-1.60 and lower among mothers who had 2-4 previous births (RR 0.89, 95% CI 0.82-0.96, for baby girls (RR 0.87, 95% CI 0.80-0.93, and for low birth weight babies (RR 0.89, 95% CI 0.82-0.96.Most parents of neonates who died had accessed and received care from a qualified healthcare provider. To further reduce neonatal mortality, it is important that the quality of care provided, particularly skilled birth attendance, emergency obstetric care, and neonatal care during the first month of life is improved, such that it is timely, safe, and effective.

  18. Feasibility of community neonatal death audits in rural Uttar Pradesh, India.

    Science.gov (United States)

    Patel, Z; Kumar, V; Singh, P; Singh, V; Yadav, R; Baqui, A H; Santosham, M; Awasthi, S; Singh, J V; Darmstadt, G L

    2007-09-01

    Medical audit is a widely promoted strategy in hospitals, but experience within community settings is scant. Community neonatal death audit is a form of audit, which involves a systematic analysis of the quality of care provided in the home, danger sign recognition and care seeking decision making for neonatal illness. This research was conducted in Uttar Pradesh, India, to investigate the feasibility and cultural acceptability of community neonatal death audits. During November-December 2004, we conducted three in-depth interviews with family members of deceased neonates, and six focus group discussions with family and community members. Three approaches were evaluated: in-depth interview with the family before engaging them in an audit with the community; preliminary meeting to build rapport with the family and community before conducting an audit; and audit with the family and community in a single focus group. Approaches were interactive processes, involving the community, to identify avoidable factors in a particular death and discuss solutions. Carried out in a culturally sensitive and non-punitive manner, community neonatal death audit was found to be acceptable and feasible. All approaches provoked formal investigation by community members, and stimulated sharing of views, leading to the self-discovery that community perception was a cumulatively amplified effect of individual perceptions. Presence of an educated/experienced community member or health worker served as a catalyst. No one optimal approach was identified. Community neonatal audit is an acceptable approach that shows promise as an effective intervention for improving neonatal health outcomes.

  19. Simultaneous occurrence of fetal and neonatal alloimmune thrombocytopenia and neonatal neutropenia due to maternal neutrophilic autoantibodies

    DEFF Research Database (Denmark)

    Taaning, Ellen; Jensen, Lise; Varming, Kim

    2012-01-01

    Foetal and neonatal alloimmune thrombocytopenia (FNAIT) and neonatal neutropenia caused by maternal autoantibodies against neutrophils are rare disorders. We describe a newborn with severe thrombocytopenia and intracerebral bleeding caused by maternal anti-HPA-3a alloantibodies and mild neutropenia...

  20. Programmed Necrosis: A Prominent Mechanism of Cell Death following Neonatal Brain Injury

    Directory of Open Access Journals (Sweden)

    Raul Chavez-Valdez

    2012-01-01

    Full Text Available Despite the introduction of therapeutic hypothermia, neonatal hypoxic ischemic (HI brain injury remains a common cause of developmental disability. Development of rational adjuvant therapies to hypothermia requires understanding of the pathways of cell death and survival modulated by HI. The conceptualization of the apoptosis-necrosis “continuum” in neonatal brain injury predicts mechanistic interactions between cell death and hydrid forms of cell death such as programmed or regulated necrosis. Many of the components of the signaling pathway regulating programmed necrosis have been studied previously in models of neonatal HI. In some of these investigations, they participate as part of the apoptotic pathways demonstrating clear overlap of programmed death pathways. Receptor interacting protein (RIP-1 is at the crossroads between types of cellular death and survival and RIP-1 kinase activity triggers formation of the necrosome (in complex with RIP-3 leading to programmed necrosis. Neuroprotection afforded by the blockade of RIP-1 kinase following neonatal HI suggests a role for programmed necrosis in the HI injury to the developing brain. Here, we briefly review the state of the knowledge about the mechanisms behind programmed necrosis in neonatal brain injury recognizing that a significant proportion of these data derive from experiments in cultured cell and some from in vivo adult animal models. There are still more questions than answers, yet the fascinating new perspectives provided by the understanding of programmed necrosis in the developing brain may lay the foundation for new therapies for neonatal HI.

  1. 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.

  2. Pre-pregnancy weight and the risk of stillbirth and neonatal death

    DEFF Research Database (Denmark)

    Kristensen, J; Vestergaard, M; Wisborg, K

    2005-01-01

    OBJECTIVE: To evaluate the association between maternal pre-pregnancy body mass index (BMI) and the risk of stillbirth and neonatal death and to study the causes of death among the children. DESIGN: Cohort study of pregnant women receiving routine antenatal care in Aarhus, Denmark. SETTING: Aarhus...... University Hospital, Denmark, 1989-1996. POPULATION: A total of 24,505 singleton pregnancies (112 stillbirths, 75 neonatal deaths) were included in the analyses. METHODS: Information on maternal pre-pregnancy weight, height, lifestyle factors and obstetric risk factors were obtained from self......-administered questionnaires and hospital files. We classified the population according to pre-pregnancy BMI as underweight (BMI

  3. Urticaria due to Urtica dioica in a neonate.

    Science.gov (United States)

    Uslu, Sinan; Bulbul, Ali; Diler, Betul; Bas, Evrim Kiray; Nuhoglu, Asiye

    2011-03-01

    Urticaria is one of the most common dermatoses during the childhood, but it is very rare in the neonates. A 17-day-old infant with a generalized urticaria was admitted to our pediatric emergency unit. The mother of the infant reported having applied water boiled with stinging nettle (Urtica dioica) onto her nipples twice a day (before and after each breastfeeding) for 2 days in order to heal her nipple cracks. Serum total immunoglobulin E (IgE) and specific IgE levels for stinging nettle were high in the infant and the mother. The rashes began to regress within the first day of the hospitalization and disappeared completely on the second day without treatment. The skin prick test with the water boiled with stinging nettle was positive for the infant with significant induration, but not for the mother. Conclusion Reporting the first urticaria case in newborns due to stinging nettle, the authors suggest that breastfeeding mothers should always consult a physician before using skincare products.

  4. Predictors of Neonatal Deaths in Ashanti Region of Ghana: A Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Gertrude Nancy Annan

    2018-01-01

    Full Text Available Background. Neonatal mortality continues to be a public health problem, especially in sub-Saharan Africa. This study was conducted to assess the maternal, neonatal, and health system related factors that influence neonatal deaths in the Ashanti Region, Ghana. Methods. 222 mothers and their babies who were within the first 28 days of life on admission at Mother and Baby unit (MBU at the Komfo Anokye Teaching Hospital (KATH in Kumasi, Ashanti Region of Ghana, were recruited through systematic random sampling. Data was collected by face to face interviewing using open and closed ended questions. A logistic regression analysis was conducted to determine the influence of proximal and facility related factors on the odds of neonatal death. Results. Out of the 222 mothers, there were 115 (51.8% whose babies did not survive. Majority, 53.9%, of babies died within 1–4 days, 31.3% within 5–14 days, and 14.8% within 15–28 days. The cause of death included asphyxia, low birth weight, congenital anomalies, infections, and respiratory distress syndrome. Neonatal deaths were influenced by proximal factors (parity, duration of pregnancy, and disease of the mother such as HIV/AIDS, neonatal factors (birth weight, gestational period, sex of baby, and Apgar score, and health related factors (health staff attitude, supervision of delivery, and hours spent at labour ward. Conclusion. This study shows a high level of neonatal deaths in the Ashanti Region of Ghana. This finding suggests the need for health education programmes to improve on awareness of the dangers that can militate against neonatal survival as well as strengthening the health system to support mothers and their babies through pregnancy and delivery and postpartum to help improve child survival.

  5. Brain injuries due to neonatal hypoglycemia: case report

    International Nuclear Information System (INIS)

    Kim, Dae Bong; Song, Chang Joon; Chang, Mae Young; Youn, Hyae Won

    2003-01-01

    Although hypoglycemia may be common among neonates, brain injuries resulting from isolated neonatal hypoglycemia are rare. The condition may cause neurological symptoms such as stupor, jitteriness, and seizures, though in their absence, diagnosis delayed or difficult. Hypoglycemia was diagnosed in a three-day-old neonate after he visited the emergency department with loose stool, poor oral intake, and decreased activity, first experienced two days earlier. Two days after his visity, several episodes of seizure occurred. T2 and diffusion-weighted magnetic resonance (MR) scanning, performed at 11 days of age, revealed bilateral and symmetrical high signal intensity lesions in occipital, parietal, and temporal lobes. We report the MR findings of hypoglycemic encephalopathy in a neonate

  6. Potential and Actual Neonatal Organ and Tissue Donation After Circulatory Determination of Death.

    Science.gov (United States)

    Stiers, Justin; Aguayo, Cecile; Siatta, Angela; Presson, Angela P; Perez, Richard; DiGeronimo, Robert

    2015-07-01

    The need for transplants continues to exceed organ and tissue donor availability. Although recent surgical advances have resulted in successful transplants using very small pediatric donors, including neonates, the actual practice of neonatal organ donation after circulatory determination of death (DCDD) remains uncommon. To describe the percentage of neonates potentially eligible for DCDD, including those who underwent successful donation, and reasons for ineligibility in those who did not in a single neonatal intensive care unit (NICU). We obtained data from the Children's Hospital Neonatal Database and Intermountain Donor Services (IDS) organ procurement records. The 136 deaths that occurred in the NICU of the Primary Children's Hospital, Salt Lake City, Utah, from January 1, 2010, through May 7, 2013, were reviewed retrospectively from January 12 through July 1, 2014, to determine potential eligibility for DCDD as determined by IDS minimum eligibility criteria (requirement of life-sustaining interventions and weight >2 kg). For patients who did not undergo DCDD, we reviewed records to determine the reasons for ineligibility. Potential eligibility for DCDD among neonates who died in the study NICU. Of 136 deaths in the NICU, 60 (44.1%) met criteria for DCDD; however, fewer than 10% were referred appropriately to the regional organ procurement organization for evaluation. Forty-five neonates (33.1%) ultimately died within 90 minutes of withdrawal of life-sustaining interventions and thus would have been eligible for organ donation based on warm ischemic time. The most common causes of death among the 60 potentially eligible neonatal donors were neonatal encephalopathy (n = 17) and multiple congenital anomalies (n = 14). Nonreferral or late referral by the medical team was the most frequent reason for donor ineligibility, including 49 neonates (36.0%). Overall, only 4 neonates (2.9%) underwent successful DCDD. Although almost half of all neonatal deaths

  7. Neonatal intestinal volvulus due to a persistent right vitelline artery.

    Science.gov (United States)

    Loh, Amos H P; Prasad, Sai T R; Chew, Sung-Hock; Jacobsen, Anette S

    2007-04-01

    We report a case of neonatal intestinal volvulus around a persistent right vitelline artery, presenting as an aberrant parieto-mesenteric band on exploratory laparotomy. To our knowledge, this is the first case report in the English literature of a persistent right vitelline artery causing axial intestinal volvulus in a neonate. A review of the literature and the embryopathogenesis is discussed, as well as the importance of emergent diagnoses of such lesions.

  8. Etiology of fetal and neonatal death is multifactorial

    OpenAIRE

    Huiza, Lilia; Pacora, Percy; Ayala, Máximo; Buzzio, Ytala

    2003-01-01

    Objetivo: Identificar los factores etiopatogénicos asociados a la muerte fetal y neonatal de una población de la ciudad de Lima, Perú. Lugar: Hospital San Bartolomé en Lima, entre 1 de enero de 1996 y 31 de diciembre de 2000. Material y métodos: Estudio retrospectivo de todos los casos de muerte fetal mayor de 20 semanas de gestación y muerte neonatal antes de los 28 días de nacimiento sometidos a estudio de autopsia y anatomía patológica. Resultados: La prevalencia de muerte fetal fue 1,68% ...

  9. AN ANALYTICAL STUDY OF DEATHS DUE TO POISONING IN VISAKHAPATNAM

    Directory of Open Access Journals (Sweden)

    V. Chandrasekhar

    2017-11-01

    Full Text Available BACKGROUND The aim of this study was to determine and classify the various types of poisoning deaths as seen at Andhra Medical College Mortuary, Visakhapatnam city. MATERIALS AND METHODS This is a retrospective study of all the deaths due to poisoning seen in the Department of Forensic Medicine & Toxicology, Andhra Medical College, Visakhapatnam City over a 15 year period (January 2001‐December 2015 as recorded in the autopsy registers and postmortem reports of the department. RESULTS Poisoning is one of the commonest methods of committing suicide especially in developing countries like India. A total of 22475 autopsies were done during the period. Two thousand seventy four cases representing 9.23% of all bodies received by the mortuary were deaths due to poisoning. Organophosphate compounds were the most commonly 78.98% abused substance. The common motive of poisoning was suicidal 93.43%with male to female ratio 6.69:1.Peak incidence was observed in the age group 21-40 years. Type of poison consumed, socioeconomic status and place of household are also ascertained. CONCLUSION This study shows the pattern of poisoning deaths in Visakhapatnam and this preliminary data will provide a baseline for future research and help in formulating policies to prevent deaths due to poisoning.

  10. A comparison of early neonatal deaths among preterm infants with ...

    African Journals Online (AJOL)

    Background: Prematurity is a common complication that contributes significantly to high neonatal mortality. In spite of many efforts by the government and other partners, non-significant decline has been achieved in the recent past. Globally, 15 million babies are born preterm (<37 weeks gestation) each year, and more than ...

  11. 7. A comparison of early neonatal deaths among preterm infants ...

    African Journals Online (AJOL)

    user

    ABSTRACT. Background: Prematurity is a common complication that contributes significantly to high neonatal mortality. In spite of many efforts by the government and other partners, non-significant decline has been achieved in the recent past. Globally, 15 million babies are born preterm (<37 weeks gestation) each year, ...

  12. Neonates with cancer and causes of death; lessons from 615 cases in the SEER databases.

    Science.gov (United States)

    Alfaar, Ahmad S; Hassan, Waleed M; Bakry, Mohamed Sabry; Qaddoumi, Ibrahim

    2017-07-01

    Neonatal tumors are rare with no standard treatment approaches to these diseases, and the patients experience poor outcomes. Our aim was to determine the distribution of cancers affecting neonates and compare survival between these cancers and older children. We analyzed SEER data (1973-2007) from patients who were younger than 2 years at diagnosis of malignancy. Special permission was granted to access the detailed (i.e., age in months) data of those patients. The Chi-square Log-rank test was used to compare survival between neonates (aged 1 month to cancers (454 solid tumors, 93 leukemia/lymphoma, and 68 CNS neoplasms). Neuroblastoma was the most common neonatal tumor followed by Germ cell tumors. The 5-year overall survival (OS) for all neonates was 60.3% (95% CI, 56.2-64.4). Neonates with solid tumors had the highest 5-year OS (71.2%; 95% CI, 66.9-75.5), followed by those with leukemia (39.1%; 95% CI, 28.3-49.9) or CNS tumors (15%; 95% CI, 5.4-24.6). Except for neuroblastoma, all neonatal tumors showed inferior outcomes compared to that in the older group. The proportion of neonates who died from causes other than cancer was significantly higher than that of the older children (37.9% vs. 16.4%; P cancers has not improved over the last 34 years. The distribution of neonatal cancer is different than other pediatric age groups. Although the progress in neonatal and cancer care over the last 30 years, only death from noncancer causes showed improvement. Studying neonatal tumors as part of national studies is essential to understand their etiology, determine the best treatment approaches, and improve survival and quality of life for those patients. © 2017 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  13. The OSR1 rs12329305 polymorphism contributes to the development of congenital malformations in cases of stillborn/neonatal death.

    Science.gov (United States)

    Lozić, Bernarda; Krželj, Vjekoslav; Kuzmić-Prusac, Ivana; Kuzmanić-Šamija, Radenka; Čapkun, Vesna; Lasan, Ružica; Zemunik, Tatijana

    2014-08-28

    Involvement of development-related gene polymorphisms in multifactorial/polygenic etiology of stillborn/neonatal deaths due to malformations has been insufficiently tested. Since these genes showed evolutional stability and their mutations are very rare, we can assume that their polymorphic variants may be a risk factor associated with the occurrence of developmental disorders of unknown etiology or can enhance the phenotypic variability of known genetic disorders. To determine the association of 3 polymorphisms involved in the regulation of the early embryonic development of different organs, we conducted an association study of their relation to the particular malformation. We selected 140 samples of archived paraffin tissue samples from deceased patients in which fetal/neonatal autopsy examination had shown congenital abnormalities as the most likely cause of death. The polymorphisms of OSR1 rs12329305, rs9936833 near FOXF1, and HOXA1 rs10951154 were genotyped using the TaqMan allelic discrimination assay. After Bonferroni correction for multiple testing, significant allelic association with stillborn/neonatal deaths was observed for rs12329305 (p=7×10-4). In addition, association analysis for the same polymorphism was shown in the subgroup with isolated anomalies (1.25×10^-5), particularly in the subgroup of cases with kidney and heart anomalies (p=4.18×10^-5, p=5.12×10^-8, respectively). The findings of the present study showed, for the first time, the role of the OSR1 rs12329305 polymorphism in the development of congenital malformations in cases of stillborn/neonatal death, particularly in those with congenital kidney and heart developmental defects.

  14. 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...

  15. 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.

  16. Transient methemoglobinemia in three neonates due to maternal pudendal anesthesia

    International Nuclear Information System (INIS)

    Erol, S.; Celik, I.H.; Demirel, N.

    2017-01-01

    Methemoglobin (MetHb) is a form of hemoglobin which contains iron in ferric state. The delivery of oxygen to tissues is impaired and cellular hypoxia develops with an increase in MetHb levels. Methemoglobinemia is a rare but potentially lethal complication of local anesthetics. In this clinical brief, three cases of transient neonatal methemoglobinemia, caused by maternal pudendal anesthesia with prilocaine, are reported. (author)

  17. Demographic and socio-economic determinants of post-neonatal deaths in a special project area of rural northern India.

    Science.gov (United States)

    Kabir, Zubair

    2003-07-01

    The demographic and socio-economic determinants of post-neonatal deaths (n = 475) in a special project area of rural northern India (Ballabgarh) were ascertained from 1991 to 1999 using the electronic database system of the project area for data extraction, and were compared with the eligible living children of the same age using a matched population-based case-control study design. Similar determinants were also ascertained in neonatal deaths (n = 212) using the same study design. After controlling for the potential confounders using conditional logistic regression analyses, lower caste (a proxy measure for low socio-economic conditions in rural India) was found to be significantly associated with higher post-neonatal deaths (OR = 2.21). Higher maternal age (>30 years) and fathers' lower educational levels were significantly associated with higher neonatal deaths, in addition to higher post-neonatal deaths in the same area.

  18. [Medical audit of neonatal deaths with the "three delay" model in a pediatric hospital in Ouagadougou].

    Science.gov (United States)

    Kouéta, Fla; Ouédraogo Yugbaré, Solange Odile; Dao, Lassina; Dao, Fousséni; Yé, Diarra; Kam, Kobena Ludovic

    2011-01-01

    To determine the causes of neonatal deaths and their contributing factors. We used the "three-delay model" to conduct an audit of the neonatal deaths that occurred between January 2006 and December 2010 at the Charles de Gaulle University Pediatric Hospital, in Ouagadougou. The neonatal mortality rate was 12.3%. The main direct causes were infections (70%), cerebral distress (10%), respiratory distress (7%), congenital malformations (5.5%), prematurity (4.5%) and hemorrhagic syndromes (3%). All three delays were found: in decision making in 64.4% of cases, in access to health services in 77%, and in receiving appropriate care in 66.9%; they multiplied the risk of death by a factor of 4, 3 and 5, respectively. To reduce deaths of newborn babies, it is necessary to overcome the three delays that contribute to it, pending the improvement of socioeconomic conditions of populations. This combat requires optimizing the implementation of the subsidies for obstetric and neonatal emergency care and strengthening the involvement of all stakeholders, specifically, policy makers, the community and health professionals.

  19. Pre-pregnancy weight and the risk of stillbirth and neonatal death

    DEFF Research Database (Denmark)

    Kristensen, J; Vestergaard, M; Wisborg, K

    2005-01-01

    or neonatal death was found among underweight or overweight women. Adjustment for maternal cigarette smoking, alcohol and caffeine intake, maternal age, height, parity, gender of the child, years of schooling, working status and cohabitation with partner did not change the conclusions, nor did exclusion...

  20. 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.

  1. Early neonatal deaths associated with perinatal asphyxia in infants ≥2500 g in Brazil,

    Directory of Open Access Journals (Sweden)

    Maria Fernanda Branco de Almeida

    Full Text Available Abstract Objective: To assess the annual burden of early neonatal deaths associated with perinatal asphyxia in infants weighing ≥2500 g in Brazil from 2005 to 2010. Methods: The population study enrolled all live births of infants with birth weight ≥2500 g and without malformations who died up to six days after birth with perinatal asphyxia, defined as intrauterine hypoxia, asphyxia at birth, or meconium aspiration syndrome. The cause of death was written in any field of the death certificate, according to International Classification of Diseases,10th Revision (P20.0, P21.0, and P24.0. An active search was performed in 27 Brazilian federative units. The chi-squared test for trend was applied to analyze early neonatal mortality ratios associated with perinatal asphyxia by study year. Results: A total of 10,675 infants weighing ≥2500 g without malformations died within six days after birth with perinatal asphyxia. Deaths occurred in the first 24 h after birth in 71% of the infants. Meconium aspiration syndrome was reported in 4076 (38% of these deaths. The asphyxia-specific early neonatal mortality ratio decreased from 0.81 in 2005 to 0.65 per 1000 live births in 2010 in Brazil (p < 0.001; the meconium aspiration syndrome-specific early neonatal mortality ratio remained between 0.20 and 0.29 per 1000 live births during the study period. Conclusions: Despite the decreasing rates in Brazil from 2005 to 2010, early neonatal mortality rates associated with perinatal asphyxia in infants in the better spectrum of birth weight and without congenital malformations are still high, and meconium aspiration syndrome plays a major role.

  2. Determinants of neonatal death with emphasis on health care during pregnancy, childbirth and reproductive history

    Directory of Open Access Journals (Sweden)

    Samir B. Kassar

    2013-05-01

    Full Text Available Objective: To identify risk factors for neonatal mortality, focusing on factors related to assistance care during the prenatal period, childbirth, and maternal reproductive history. Methods: This was a case-control study conducted in Maceió, Northeastern Brazil. The sample consisted of 136 cases and 272 controls selected from official Brazilian databases. The cases consisted of all infants who died before 28 days of life, selected from the Mortality Information System, and the controls were survivors during this period, selected from the Information System on Live Births, by random drawing among children born on the same date of the case. Household interviews were conducted with mothers. Results: The logistic regression analysis identified the following as determining factors for death in the neonatal period: mothers with a history of previous children who died in the first year of life (OR = 3.08, hospitalization during pregnancy (OR = 2.48, inadequate prenatal care (OR = 2.49, lack of ultrasound examination during prenatal care (OR = 3.89, transfer of the newborn to another unit after birth (OR = 5.06, admittance of the newborn at the ICU (OR = 5.00, and low birth weight (OR = 2.57. Among the socioeconomic conditions, there was a greater chance for neonatal mortality in homes with fewer residents (OR = 1.73 and with no children younger than five years (OR = 10.10. Conclusion: Several factors that were associated with neonatal mortality in this study may be due to inadequate care during the prenatal period and childbirth, and inadequate newborn care, all of which can be modified. Resumo: Objetivo: Identificar fatores de risco para mortalidade neonatal, com especial atenção aos fatores assistenciais relacionados com os cuidados durante o período pré-natal, parto e história reprodutiva materna. Métodos: Trata-se de um estudo caso-controle realizado em Maceió, Nordeste do Brasil. A amostra consistiu de 136 casos e 272

  3. 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

  4. Validity of a minimally invasive autopsy for cause of death determination in stillborn babies and neonates in Mozambique: An observational study

    Science.gov (United States)

    Jordao, Dercio; Lovane, Lucilia; Ismail, Mamudo R.; Carrilho, Carla; Lorenzoni, Cesaltina; Fernandes, Fabiola; Nhampossa, Tacilta; Navarro, Mireia; Casas, Isaac; Santos Ritchie, Paula; Bandeira, Sonia; Mocumbi, Sibone; Jaze, Zara; Mabota, Flora; Mandomando, Inacio; Goncé, Anna; Quintó, Llorenç; Macete, Eusebio; Alonso, Pedro; Ordi, Jaume

    2017-01-01

    Background Over 5 million stillbirths and neonatal deaths occur annually. Limited and imprecise information on the cause of these deaths hampers progress in achieving global health targets. Complete diagnostic autopsies (CDAs)—the gold standard for cause of death determination—are difficult to perform in most high-burden settings. Therefore, validation of simpler and more feasible methods is needed. Methods and findings In this observational study, the validity of a minimally invasive autopsy (MIA) method in determining the cause of death was assessed in 18 stillbirths and 41 neonatal deaths by comparing the results of the MIA with those of the CDA. Concordance between the categories of diseases obtained by the 2 methods was assessed by the Kappa statistic, and the sensitivity, specificity, positive, and negative predictive values of the MIA diagnoses were calculated. A cause of death was identified in 16/18 (89%) and 15/18 (83%) stillborn babies in the CDA and the MIA, respectively. Fetal growth restriction accounted for 39%, infectious diseases for 22%, intrapartum hypoxia for 17%, and intrauterine hypoxia for 11% of stillborn babies. Overall, the MIA showed in this group a substantial concordance with the CDA (Kappa = 0.78, 95% CI [0.56–0.99]). A cause of death was identified in all (100%) and 35/41 (85%) neonatal deaths in the CDA and the MIA, respectively. In this group, the majority of deaths were due to infectious diseases (66%). The overall concordance of the MIA with the CDA in neonates was moderate (Kappa = 0.40, 95% CI [0.18–0.63]). A high percentage of accuracy was observed for the MIA in all the diagnostic categories in both stillbirths and neonates (>75%). The main limitation of this study is that some degree of subjective interpretation is inherent to cause-of-death attribution in both the MIA and the CDA; this is especially so in stillbirths and in relation to fetal growth restriction. Conclusions The MIA could be a useful tool for cause-of-death

  5. Validity of a minimally invasive autopsy for cause of death determination in stillborn babies and neonates in Mozambique: An observational study.

    Directory of Open Access Journals (Sweden)

    Clara Menendez

    2017-06-01

    Full Text Available Over 5 million stillbirths and neonatal deaths occur annually. Limited and imprecise information on the cause of these deaths hampers progress in achieving global health targets. Complete diagnostic autopsies (CDAs-the gold standard for cause of death determination-are difficult to perform in most high-burden settings. Therefore, validation of simpler and more feasible methods is needed.In this observational study, the validity of a minimally invasive autopsy (MIA method in determining the cause of death was assessed in 18 stillbirths and 41 neonatal deaths by comparing the results of the MIA with those of the CDA. Concordance between the categories of diseases obtained by the 2 methods was assessed by the Kappa statistic, and the sensitivity, specificity, positive, and negative predictive values of the MIA diagnoses were calculated. A cause of death was identified in 16/18 (89% and 15/18 (83% stillborn babies in the CDA and the MIA, respectively. Fetal growth restriction accounted for 39%, infectious diseases for 22%, intrapartum hypoxia for 17%, and intrauterine hypoxia for 11% of stillborn babies. Overall, the MIA showed in this group a substantial concordance with the CDA (Kappa = 0.78, 95% CI [0.56-0.99]. A cause of death was identified in all (100% and 35/41 (85% neonatal deaths in the CDA and the MIA, respectively. In this group, the majority of deaths were due to infectious diseases (66%. The overall concordance of the MIA with the CDA in neonates was moderate (Kappa = 0.40, 95% CI [0.18-0.63]. A high percentage of accuracy was observed for the MIA in all the diagnostic categories in both stillbirths and neonates (>75%. The main limitation of this study is that some degree of subjective interpretation is inherent to cause-of-death attribution in both the MIA and the CDA; this is especially so in stillbirths and in relation to fetal growth restriction.The MIA could be a useful tool for cause-of-death determination in stillbirths and

  6. Acute Neonatal Parotitis with Late-Onset Septic Shock due to Streptococcus agalactiae

    Directory of Open Access Journals (Sweden)

    M. Boulyana

    2014-01-01

    Full Text Available Acute neonatal parotitis (ANP is a very rare disease. Most cases are managed conservatively; early antibiotics and adequate hydration may reduce the need for surgery. The most common cause of ANP is Staphylococcus aureus. We report a rare case of acute neonatal parotitis with late-onset septic shock due to Streptococcus agalactiae. The diagnosis was confirmed with ultrasound and isolation of Streptococcus agalactiae from blood culture. The patient was treated successfully with 10 days of intravenous antibiotics and supportive measures. Despite being rare, streptococcal ANP should be considered in the etiological diagnosis of neonatal sepsis. Early diagnosis and appropriate antibiotic might prevent serious complications.

  7. Still births, neonatal deaths and neonatal near miss cases attributable to severe obstetric complications: a prospective cohort study in two referral hospitals in Uganda.

    Science.gov (United States)

    Nakimuli, Annettee; Mbalinda, Scovia N; Nabirye, Rose C; Kakaire, Othman; Nakubulwa, Sarah; Osinde, Michael O; Kakande, Nelson; Kaye, Dan K

    2015-04-17

    Neonatal near miss cases occur more often than neonatal deaths and could enable a more comprehensive analysis of risk factors, short-term outcomes and prognostic factors in neonates born to mothers with severe obstetric complications. The objective was to assess the incidence, presentation and perinatal outcomes of severe obstetric morbidity in two referral hospitals in Central Uganda. A prospective cohort study was conducted between March 1, 2013 and February 28, 2014, in which all newborns from cases of severe pregnancy and childbirth complications were eligible for inclusion. The obstetric conditions included obstetric haemorrhage, hypertensive disorders, obstructed labour, chorioamnionitis and pregnancy-specific complications such as malaria, anemia and premature rupture of membranes. Still births, neonatal deaths and neonatal near miss cases (defined using criteria that employed clinical features, presence of organ-system dysfunction and management provided to the newborns were compiled). Stratified and multivariate logistic regression analysis was conducted to identify risk factors for perinatal death. Of the 3100 mothers, 192 (6.2%) had abortion complications. Of the remainder, there were 2142 (73.1%) deliveries, from whom the fetal outcomes were 257 (12.0%) still births, 369 (17.2%) neonatal deaths, 786 (36.7%) neonatal near misses and 730 (34.1%) were newborns with no or minimal life threatening complications. Of the 235 babies admitted to the neonatal intensive care unit (NICU), the main reasons for admission were prematurity for 64 (26.8%), birth asphyxia for 59 (23.7%), and grunting respiration for 26 (11.1%). Of the 235 babies, 38 (16.2%) died in the neonatal period, and of these, 16 died in the first 24 hours after admission. Ruptured uterus caused the highest case-specific mortality of 76.8%, and led to 16.9% of all newborn deaths. Across the four groups, there were significant differences in mean birth weight, p = 0.003. Antepartum hemorrhage

  8. An outbreak of gastroenteritis due to Escherichia coli 0142 H6 in a neonatal department

    NARCIS (Netherlands)

    Gerards, L. J.; Hennekam, R. C.; von Dijk, W. C.; Roord, J. J.; Fleer, A.

    1984-01-01

    An outbreak of gastroenteritis due to Escherichia coli 0142 H6 in a neonatal ward is described. The epidemic affected 16 of 24 infants (infection-rate 66 per cent), of whom one died due to necrotizing enterocolitis. Administration of antibiotics was of limited value in treatment or in eradicating E.

  9. A CLINICAL STUDY OF MATERNAL DEATHS DUE TO PPH

    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 mortality is a global problem, facing every country in the world. Target specific interventions are needed for specific population. Fifth millennium development goal (MDG is to reduce maternal mortality by 75% by the year 2015, worthwhile investment for every case provider, results that investing on mothers

  10. The Economic Cost of Implementing Maternal and Neonatal Death Review in a District of Bangladesh.

    Science.gov (United States)

    Biswas, Animesh; Halim, Abdul; Rahman, Fazlur; Eriksson, Charli; Dalal, Koustuv

    2016-12-09

    Maternal and neonatal death review (MNDR) introduced in Bangladesh and initially piloted in a district during 2010. MNDR is able to capture each of the maternal, neonatal deaths and stillbirths from the community and government facilities (hospitals). This study aimed to estimate the cost required to implement MNDR in a district of Bangladesh during 2010-2012. MNDR was implemented in Thakurgaon district in 2010 and later gradually extended until 2015. MNDR implementation framework, guidelines, tools and manual were developed at the national level with national level stakeholders including government health and family planning staff at different cadre for piloting at Thakurgaon. Programme implementation costs were calculated by year of costing and costing as per component of MNDR in 2013. The purchasing power parity conversion rate was 1 $INT = 24.46 BDT, as of 31 st Dec 2012. Overall programme implementation costs required to run MNDR were 109,02,754 BDT (445,738 $INT $INT) in the first year (2010). In the following years cost reduced to 8,208,995 BDT (335,609 $INT, during 2011) and 6,622,166 BDT (270,735 $INT, during 2012). The average cost per activity required was 3070 BDT in 2010, 1887 BDT and 2207 BDT required in 2011 and 2012 respectively. Each death notification cost 4.09 $INT, verbal autopsy cost 8.18 $INT, and social autopsy cost 16.35 $INT. Facility death notification cost 2.04 $INT and facility death review meetings cost 20.44 $INT. One death saved by MNDR costs 53,654 BDT (2193 $INT). Programmatic implementation cost of conducting MPDR give an idea on how much cost will be required to run a death review system for a low income country settings using government health system.

  11. The economic cost of implementing maternal and neonatal death review in a district of Bangladesh

    Directory of Open Access Journals (Sweden)

    Animesh Biswas

    2016-12-01

    Full Text Available Introduction: Maternal and neonatal death review (MNDR introduced in Bangladesh and initially piloted in a district during 2010. MNDR is able to capture each of the maternal, neonatal deaths and stillbirths from the community and government facilities (hospitals. This study aimed to estimate the cost required to implement MNDR in a district of Bangladesh during 2010-2012. Materials and methods: MNDR was implemented in Thakurgaon district in 2010 and later gradually extended until 2015. MNDR implementation framework, guidelines, tools and manual were developed at the national level with national level stakeholders including government health and family planning staff at different cadre for piloting at Thakurgaon. Programme implementation costs were calculated by year of costing and costing as per component of MNDR in 2013. The purchasing power parity conversion rate was 1 $INT = 24.46 BDT, as of 31st Dec 2012. Results: Overall programme implementation costs required to run MNDR were 109,02,754 BDT (445,738 $INT $INT in the first year (2010. In the following years cost reduced to 8,208,995 BDT (335,609 $INT, during 2011 and 6,622,166 BDT (270,735 $INT, during 2012. The average cost per activity required was 3070 BDT in 2010, 1887 BDT and 2207 BDT required in 2011 and 2012 respectively. Each death notification cost 4.09 $INT, verbal autopsy cost 8.18 $INT, and social autopsy cost 16.35 $INT. Facility death notification cost 2.04 $INT and facility death review meetings cost 20.44 $INT. One death saved by MNDR costs 53,654 BDT (2193 $INT.Conclusions: Programmatic implementation cost of conducting MPDR give an idea on how much cost will be required to run a death review system for a low income country settings using government health system.

  12. [Maternal death from severe malaria due to Plasmodium vivax].

    Science.gov (United States)

    Arróspide, Nancy; Espinoza, Máximo Manuel; Miranda-Choque, Edwin; Mayta-Tristán, Percy; Legua, Pedro; Cabezas, César

    2016-06-01

    Here we describe the case of a 19-year-old woman, in her 29th week of gestation, who was from Llumpe (Ancash, Peru) and had a history of traveling to Chanchamayo (Junín, Peru) and Rinconada (Ancash, Peru). The patient presented at Chacas Hospital (Chacas, Ancash, Peru) with general malaise, dehydration, respiratory distress, jaundice, the sensation of thermal rise, and abdominal pain. Analysis of blood smears revealed 60% hemoparasites. She was transferred to Ramos Guardia Hospital (Huaraz, Peru) where she presented increasing respiratory distress, choluria, hematuria, and decreased urine output, moreover she was positive for Plasmodium. From there she was transferred to Cayetano Heredia Hospital (Lima, Peru), where she was admitted to the intensive care unit (ICU) with multiple organ failure, stillbirth, and leading to death. She underwent mechanical ventilation, was administered clindamycin, and was prescribed quinine, which she did not received due a lack by availability. The evolution of the illness was torpid, and she ultimately developed multiple organ failure and died. Plasmodium vivax infection was confirmed. Accordingly, we emphasize the importance of improving our diagnostic capabilities and management techniques to enable clinicians to provide adequate and timely treatment.

  13. Sudden death of a child due to respiratory diphtheria.

    Science.gov (United States)

    Swain, Rajanikanta; Behera, Chittaranjan; Arava, Sudheer Kumar; Kundu, Naveen

    2016-06-01

    A four-year-old girl presented to the emergency department with respiratory distress. Death occurred despite attempted resuscitation. The illness was not clinically diagnosed. Her father revealed that she had a fever and sore throat for the last four days and was not immunised for diphtheria. Characteristic gross and microscopic pathology of respiratory diphtheria and microbiological findings were observed. The cause of death was acute respiratory failure consequent upon upper airway obstruction from diphtheria. Forensic pathologists should remember that the diphtheria cases can cause sudden death especially in developing countries. © The Author(s) 2016.

  14. Four deaths due to carbon monoxide poisoning in car washes.

    Science.gov (United States)

    Carson, H J; Stephens, P J

    1999-09-01

    In a period of 13 months, three separate incidents of lethal carbon monoxide (CO) poisoning in closed car wash bays resulted in the deaths of 4 white men aged 20 to 36 years. Each man appears to have been intoxicated with mind-altering substances, which may impair judgment, perception of outside conditions, and self-awareness. All four died in winter months. For three men, the deaths were ruled accidental, and for the remaining man, the previous deaths appear to have provided a model for suicide. Warning signs may not be effective to prevent future CO deaths in car washes because of the possible role of intoxication. Mechanical or electronic methods to prevent a bay door from closing completely may be preferable.

  15. Minocycline causes widespread cell death and increases microglial labeling in the neonatal mouse brain.

    Science.gov (United States)

    Strahan, J Alex; Walker, William H; Montgomery, Taylor R; Forger, Nancy G

    2017-06-01

    Minocycline, an antibiotic of the tetracycline family, inhibits microglia in many paradigms and is among the most commonly used tools for examining the role of microglia in physiological processes. Microglia may play an active role in triggering developmental neuronal cell death, although findings have been contradictory. To determine whether microglia influence developmental cell death, we treated perinatal mice with minocycline (45 mg/kg) and quantified effects on dying cells and microglial labeling using immunohistochemistry for activated caspase-3 (AC3) and ionized calcium-binding adapter molecule 1 (Iba1), respectively. Contrary to our expectations, minocycline treatment from embryonic day 18 to postnatal day (P)1 caused a > tenfold increase in cell death 8 h after the last injection in all brain regions examined, including the primary sensory cortex, septum, hippocampus and hypothalamus. Iba1 labeling was also increased in most regions. Similar effects, although of smaller magnitude, were seen when treatment was delayed to P3-P5. Minocycline treatment from P3 to P5 also decreased overall cell number in the septum at weaning, suggesting lasting effects of the neonatal exposure. When administered at lower doses (4.5 or 22.5 mg/kg), or at the same dose 1 week later (P10-P12), minocycline no longer increased microglial markers or cell death. Taken together, the most commonly used microglial "inhibitor" increases cell death and Iba1 labeling in the neonatal mouse brain. Minocycline is used clinically in infant and pediatric populations; caution is warrented when using minocycline in developing animals, or extrapolating the effects of this drug across ages. © 2016 Wiley Periodicals, Inc. Develop Neurobiol 77: 753-766, 2017. © 2016 Wiley Periodicals, Inc.

  16. Early neonatal deaths associated with perinatal asphyxia in infants ≥2500 g in Brazil

    Directory of Open Access Journals (Sweden)

    Maria Fernanda Branco de Almeida

    2017-11-01

    Full Text Available Objective: To assess the annual burden of early neonatal deaths associated with perinatal asphyxia in infants weighing ≥2500 g in Brazil from 2005 to 2010. Methods: The population study enrolled all live births of infants with birth weight ≥2500 g and without malformations who died up to six days after birth with perinatal asphyxia, defined as intrauterine hypoxia, asphyxia at birth, or meconium aspiration syndrome. The cause of death was written in any field of the death certificate, according to International Classification of Diseases, 10th Revision (P20.0, P21.0, and P24.0. An active search was performed in 27 Brazilian federative units. The chi-squared test for trend was applied to analyze early neonatal mortality ratios associated with perinatal asphyxia by study year. Results: A total of 10,675 infants weighing ≥2500 g without malformations died within six days after birth with perinatal asphyxia. Deaths occurred in the first 24 h after birth in 71% of the infants. Meconium aspiration syndrome was reported in 4076 (38% of these deaths. The asphyxia-specific early neonatal mortality ratio decreased from 0.81 in 2005 to 0.65 per 1000 live births in 2010 in Brazil (p < 0.001; the meconium aspiration syndrome-specific early neonatal mortality ratio remained between 0.20 and 0.29 per 1000 live births during the study period. Conclusions: Despite the decreasing rates in Brazil from 2005 to 2010, early neonatal mortality rates associated with perinatal asphyxia in infants in the better spectrum of birth weight and without congenital malformations are still high, and meconium aspiration syndrome plays a major role. Resumo: Objetivo: Avaliar a taxa anual de óbitos neonatais precoces associados à asfixia perinatal em neonatos de peso ≥2.500 g no Brasil de 2005 a 2010. Métodos: A população do estudo envolveu todos os nascidos vivos de neonatos com peso ao nascer ≥2.500 g e sem malformações que morreram até seis dias ap

  17. 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

  18. 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.

  19. Acute heart failure associated with congenital complete atrioventricular block due to neonatal lupus: case series report

    International Nuclear Information System (INIS)

    Velasquez F, Carlos J; Correa, Cindy; Molina, Monica; Fernanda, Luisa; Velasquez, Nataly; Diaz, Luis H

    2010-01-01

    Neonatal lupus (NL) defines a set of clinical syndromes characterized by maternal autoantibodies against the RNA protein complex (Ro/SSA or La/SSB) that cross the placenta and potentially lead to fetal tissue damage. Little is known about other cardiac manifestations of NL different from congenital heart block (CHB), as heart failure (HF). Four cases of LN with BCC and acute HF at the first three days of life on average were reported. No complications or deaths were reported at 4,9 months of follow-up. All infants had anti-Ro high titles at the time of diagnosis.

  20. Estimating the Burden of Maternal and Neonatal Deaths Associated With Jaundice in Bangladesh: Possible Role of Hepatitis E Infection

    Science.gov (United States)

    Halder, Amal K.; Streatfield, Peter K.; Sazzad, Hossain M.S.; Nurul Huda, Tarique M.; Hossain, M. Jahangir; Luby, Stephen P.

    2012-01-01

    Objectives. We estimated the population-based incidence of maternal and neonatal mortality associated with hepatitis E virus (HEV) in Bangladesh. Methods. We analyzed verbal autopsy data from 4 population-based studies in Bangladesh to calculate the maternal and neonatal mortality ratios associated with jaundice during pregnancy. We then reviewed the published literature to estimate the proportion of maternal deaths associated with liver disease during pregnancy that were the result of HEV in hospitals. Results. We found that 19% to 25% of all maternal deaths and 7% to 13% of all neonatal deaths in Bangladesh were associated with jaundice in pregnant women. In the published literature, 58% of deaths in pregnant women with acute liver disease in hospitals were associated with HEV. Conclusions. Jaundice is frequently associated with maternal and neonatal deaths in Bangladesh, and the published literature suggests that HEV may cause many of these deaths. HEV is preventable, and studies to estimate the burden of HEV in endemic countries are urgently needed. PMID:23078501

  1. Effect of Maternal and Pregnancy Risk Factors on Early Neonatal Death in Planned Home Births Delivering at Home.

    Science.gov (United States)

    Bachilova, Sophia; Czuzoj-Shulman, Nicholas; Abenhaim, Haim Arie

    2018-05-01

    The prevalence of home birth in the United States is increasing, although its safety is undetermined. The objective of this study was to investigate the effects of obstetrical risk factors on early neonatal death in planned home births delivering at home. The authors conducted a retrospective 3-year cohort study consisting of planned home births that delivered at home in the United States between 2011 and 2013. The study excluded infants with congenital and chromosomal anomalies and infants born at ≤34 weeks' gestation. Multivariate logistic regression models were used to estimate the adjusted effects of individual obstetrical variables on early neonatal deaths within 7 days of delivery. During the study period, there were 71 704 planned and delivered home births. The overall early neonatal death rate was 1.5 deaths per 1000 planned home births. The risks of early neonatal death were significantly higher in nulliparous births (OR 2.71; 95% CI 1.71-4.31), women with a previous CS (OR 2.62, 95% CI 1.25-5.52), non-vertex presentations (OR 4.27; 95% CI 1.33-13.75), plural births (OR 9.79; 95% CI 4.25-22.57), preterm births (OR 4.68; 95% CI 2.30-9.51), and births at ≥41 weeks of gestation (OR 1.76; 95% CI 1.09-2.84). Early neonatal deaths occur more commonly in certain obstetrical contexts. Patient selection may reduce adverse neonatal outcomes among planned home births. Copyright © 2018 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved.

  2. Premature delivery due to intrauterine Candida infection that caused neonatal congenital cutaneous candidiasis: a case report.

    Science.gov (United States)

    Ito, Fumitake; Okubo, Tomoharu; Yasuo, Tadahiro; Mori, Taisuke; Iwasa, Koichi; Iwasaku, Kazuhiro; Kitawaki, Jo

    2013-01-01

    Congenital cutaneous candidiasis is a very rare disease with less than 100 cases published in the medical literature. Neonates having this disease present with systemic skin lesions caused by intrauterine Candida infections. We present a case of threatened premature delivery due to Candida chorioamnionitis, which caused both maternal postpartum endometritis and neonatal congenital cutaneous candidiasis. A 34-year-old woman who was admitted for fetal membrane bulging at 20 weeks of gestation underwent McDonald cervical cerclage. We diagnosed threatened premature delivery due to intrauterine infection; therefore, we terminated the gestation by cesarean section at 24 weeks of gestation. Fungi-like yeast was detected in infantile gastric juice. Histopathological findings of the placenta revealed that Candida albicans mycelium invaded the placenta, chorioamniotic membrane and umbilical cord. © 2012 The Authors. Journal of Obstetrics and Gynaecology Research © 2012 Japan Society of Obstetrics and Gynecology.

  3. Diagnostic accuracy of WHO verbal autopsy tool for ascertaining causes of neonatal deaths in the urban setting of Pakistan: a hospital-based prospective study.

    Science.gov (United States)

    Soofi, Sajid Bashir; Ariff, Shabina; Khan, Ubaidullah; Turab, Ali; Khan, Gul Nawaz; Habib, Atif; Sadiq, Kamran; Suhag, Zamir; Bhatti, Zaid; Ahmed, Imran; Bhal, Rajiv; Bhutta, Zulfiqar Ahmed

    2015-10-05

    Globally, clinical certification of the cause of neonatal death is not commonly available in developing countries. Under such circumstances it is imperative to use available WHO verbal autopsy tool to ascertain causes of death for strategic health planning in countries where resources are limited and the burden of neonatal death is high. The study explores the diagnostic accuracy of WHO revised verbal autopsy tool for ascertaining the causes of neonatal deaths against reference standard diagnosis obtained from standardized clinical and supportive hospital data. All neonatal deaths were recruited between August 2006 -February 2008 from two tertiary teaching hospitals in Province Sindh, Pakistan. The reference standard cause of death was established by two senior pediatricians within 2 days of occurrence of death using the International Cause of Death coding system. For verbal autopsy, trained female community health worker interviewed mother or care taker of the deceased within 2-6 weeks of death using a modified WHO verbal autopsy tool. Cause of death was assigned by 2 trained pediatricians. The performance was assessed in terms of sensitivity and specificity. Out of 626 neonatal deaths, cause-specific mortality fractions for neonatal deaths were almost similar in both verbal autopsy and reference standard diagnosis. Sensitivity of verbal autopsy was more than 93% for diagnosing prematurity and 83.5% for birth asphyxia. However the verbal autopsy didn't have acceptable accuracy for diagnosing the congenital malformation 57%. The specificity for all five major causes of neonatal deaths was greater than 90%. The WHO revised verbal autopsy tool had reasonable validity in determining causes of neonatal deaths. The tool can be used in resource limited community-based settings where neonatal mortality rate is high and death certificates from hospitals are not available.

  4. Identification of important and potentially avoidable risk factors in a prospective audit study of neonatal deaths in a paediatric hospital in Vietnam

    DEFF Research Database (Denmark)

    Kruse, Alexandra Y; Phuong, Cam N; Ho, Binh T T

    2014-01-01

    AIM: Neonatal deaths (≤28 days) account for more than half of child mortality in Vietnam. Presumably most die in hospital, but data are scarce. This study aimed to identify risk factors of death among hospitalised neonates. METHODS: We prospectively studied all neonatal deaths and expected deaths...... (discharged alive after withdrawal of life-sustaining treatment) in a Vietnamese tertiary paediatric hospital during a 12-month period in 2009-2010. The medical files were audited classifying admission prognosis, discharge outcome, cause of death/expected death according to two classifications, and important...... and potentially avoidable risk factors during the hospital stay. RESULTS: Among 5763 neonates admitted, 235 deaths and 67 expected deaths were included. According to both classifications, major causes were congenital malformations, prematurity and severe infections. Six risk factors were identified in 85% (60...

  5. Death due to complications of anhidrotic ectodermal dysplasia.

    Science.gov (United States)

    Ogden, Emily; Schandl, Cynthia; Tormos, Lee Marie

    2014-11-01

    Ectodermal dysplasia comprises a group of disorders affecting ectodermal tissues. Severity depends on the genetic aberration; hyperpyrexia secondary to absence of sweat glands is a common complication. Treatment is supportive. This case report describes a 1-month, 27-day-old male infant with a diagnosis of X-linked recessive anhidrotic ectodermal dysplasia. On the day of his death, his mother swaddled him in a blanket and placed him on the couch at 5:30 am. When she picked him up at 8:00 am, he was unresponsive. At the emergency department, his rectal temperature was 40°C. Postmortem blood culture was positive for group B streptococcus, a possible etiology for fever. It is vital to teach parents that close monitoring of children with ectodermal dysplasia is necessary, as an increase in body temperature can become life threatening. © 2014 American Academy of Forensic Sciences.

  6. Recruiting bereaved parents for research after infant death in the neonatal intensive care unit.

    Science.gov (United States)

    Currie, Erin R; Roche, Cathy; Christian, Becky J; Bakitas, Marie; Meneses, Karen

    2016-11-01

    Understanding parental experiences following infant death in the neonatal intensive care unit (NICU) is a high research priority and a necessary first step to improving health services. However, recruiting bereaved parents to discuss their experiences on such an extremely sensitive topic can be challenging and research procedures must be planned carefully in order to get an adequate sample. There is little published in the literature detailing specific strategies for recruiting bereaved parents for grief research, especially strategies for contacting parents and identifying factors that might affect participation. The purpose of this paper is to describe the process of recruiting bereaved parents into a qualitative research study exploring parental NICU experiences and grief responses following infant death. We describe a successful recruitment plan that led to the enrollment of difficult to recruit participants such as fathers, and individuals representing minorities and those from lower socioeconomic (SES) groups. Bereaved parents of infants after an NICU hospitalization should continue to be recruited for research studies for their unique perspectives and valuable insights about the devastating experience of infant death. Participants in this study reported more benefits than harm and the results addressed a critical gap in the literature. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. [Maternal deaths due to infectious cause, results from the French confidential enquiry into maternal deaths, 2010-2012].

    Science.gov (United States)

    Rigouzzo, A; Tessier, V; Zieleskiewicz, L

    2017-12-01

    Over the period 2010-2012, maternal mortality from infectious causes accounted for 5% of maternal deaths by direct causes and 16% of maternal deaths by indirect causes. Among the 22 deaths caused by infection occurred during this period, 6 deaths were attributed to direct causes from genital tract origin, confirming thus the decrease in direct maternal deaths by infection during the last ten years. On the contrary, indirect maternal deaths by infection, from extragenital origin, doubled during the same period, with 16 deaths in the last triennium, dominated by winter respiratory infections, particularly influenza: the 2009-2010 influenza A (H1N1) virus pandemic was the leading cause of indirect maternal mortality by infection during the studied period. The main infectious agents involved in maternal deaths from direct causes were Streptococcus A, Escherichia Coli and Clostridium perfringens: these bacterias were responsible for toxic shock syndrome, severe sepsis, secondary in some cases to cellulitis or necrotizing fasciitis. Of the 6 deaths due to direct infection, 4 were considered avoidable because of inadequate management: delayed or missed diagnosis, delayed or inadequate initiation of a specific medical and/or surgical treatment. Of the 16 indirect maternal deaths due to infection causes, the most often involved infectious agents were influenza A (H1N1) virus and Streptococcus pneumonia with induced purpura fulminans: the absence of influenza vaccination during pregnancy, delayed diagnosis and emergency initiation of a specific treatment, were the main contributory factors to these deaths and their avoidability in 70% of the cases analyzed. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  8. Dyadic death due to family custom in marriage

    Directory of Open Access Journals (Sweden)

    Muhammet Mustafa Arslan

    2012-06-01

    Full Text Available In dyadic death, a there is a lack of studies addressingthe effectiveness of the family pressure through thesedeaths. In this study, the effectiveness of the customs onthe marriages is discussed with a related case of dyadicdeath.A 27 years old male and a 19 years old female were founddead in a car out of a city center away from hometown. Inthe external examination, there was an entrance woundon the right temporal region and an exit wound on theleft temporal region of the man, and the contrary for thewoman. Both of the exit wounds were contact wound.Both of the deceased were originally from the east partof Turkey and stated to be single; and the woman wasreported to the security units as missing two days beforethe incident. As the motivation of the suicide, a note nearto the man was explaining that the deceased couple lovedeach other for one year yet the family of the women hadnot let them to get married.Being an obstacle for the marriage even for adults and acause of suicide because of family pressure is indicativeof strict application of the family customs, in Turkey. Theauthors propose that issue of whether the 84. Article ofthe Turkish Penal Code should be or not applied as a deterrentfactor reducing pressure of family customs.

  9. Neonatal Death and Heart Failure in Mouse with Transgenic HSP60 Expression

    Directory of Open Access Journals (Sweden)

    Tsung-Hsien Chen

    2015-01-01

    Full Text Available Mitochondrial heat shock proteins, such as HSP60, are chaperones responsible for the folding, transport, and quality control of mitochondrial matrix proteins and are essential for maintaining life. Both prosurvival and proapoptotic roles have been proposed for HSP60, and HSP60 is reportedly involved in the initiation of autoimmune, metabolic, and cardiovascular diseases. The role of HSP60 in pathogenesis of these diseases remains unclear, partly because of the lack of mouse models expressing HSP60. In this study we generated HSP60 conditional transgenic mice suitable for investigating in vivo outcomes by expressing HSP60 at the targeted organ in disease models. Ubiquitous HSP60 induction in the embryonic stage caused neonatal death in mice at postnatal day 1. A high incidence of atrial septal defects was observed in HSP60-expressing mice, with increased apoptosis and myocyte degeneration that possibly contributed to massive hemorrhage and sponge-like cardiac muscles. Our results showed that neonatal heart failure through HSP60 induction likely involves developmental defects and excessive apoptosis. The conditional HSP60 mouse model is useful for studying crucial biological questions concerning HSP60.

  10. Idiopathic massive fetomaternal hemorrhage in the third trimester of pregnancy causing neonatal death.

    Science.gov (United States)

    Peng, X; Liu, C; Peng, B

    2016-01-01

    Fetomaternal hemorrhage (FMH), which can occur throughout pregnancy, is still a poorly understood clinical condition. It is very difficult to be timely diagnosed and often results in poor pregnancy outcomes. Here the authors reported two rare cases of silent massive FMH of unknown cause in the third trimester of pregnancy, which presented with non-reactive fetal heart rhythm or decreased fetal movement at the very beginning, and resulted in severe fetal anemia and neonatal deaths. A pregnant woman at late pregnancy with a com- plain of unspecific signs such as decreased fetal movement should arouse a high index of clinical suspicion of idiopathic FMH, and an urgent ultrasound or lab tests detecting FMH could be suggested. Considering emergent delivery versus expectantly management will de- pend upon acute or chronic FMH, gestational age, results of fetal testing, availability of experienced personnel, and procedural difficulty.

  11. 20 CFR 408.816 - When does SVB entitlement end due to death?

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false When does SVB entitlement end due to death? 408.816 Section 408.816 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS Suspensions and Terminations Termination § 408.816 When does SVB entitlement end due to death? Your SVB entitlement ends wit...

  12. Identification of important and potentially avoidable risk factors in a prospective audit study of neonatal deaths in a paediatric hospital in Vietnam.

    Science.gov (United States)

    Kruse, Alexandra Y; Phuong, Cam N; Ho, Binh T T; Stensballe, Lone G; Pedersen, Freddy K; Greisen, Gorm

    2014-02-01

    Neonatal deaths (≤28 days) account for more than half of child mortality in Vietnam. Presumably most die in hospital, but data are scarce. This study aimed to identify risk factors of death among hospitalised neonates. We prospectively studied all neonatal deaths and expected deaths (discharged alive after withdrawal of life-sustaining treatment) in a Vietnamese tertiary paediatric hospital during a 12-month period in 2009-2010. The medical files were audited classifying admission prognosis, discharge outcome, cause of death/expected death according to two classifications, and important and potentially avoidable risk factors during the hospital stay. Among 5763 neonates admitted, 235 deaths and 67 expected deaths were included. According to both classifications, major causes were congenital malformations, prematurity and severe infections. Six risk factors were identified in 85% (60/71) of the neonates with a relatively good prognosis: recognition or response to danger signs, internal transfers, nosocomial infections, sepsis management, access to usual equipment/staff, and family perception. Among 302 neonatal deaths/expected deaths, the major causes were congenital malformations, prematurity and severe infections. Six important and potentially avoidable risk factors could be addressed in the subgroup with relatively good admission prognosis, without implementing new technology or major organisational changes. ©2013 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  13. Causes of death in very preterm infants cared for in neonatal intensive care units: a population-based retrospective cohort study.

    Science.gov (United States)

    Schindler, Tim; Koller-Smith, Louise; Lui, Kei; Bajuk, Barbara; Bolisetty, Srinivas

    2017-02-21

    While there are good data to describe changing trends in mortality and morbidity rates for preterm populations, there is very little information on the specific causes and pattern of death in terms of age of vulnerability. It is well established that mortality increases with decreasing gestational age but there are limited data on the specific causes that account for this increased mortality. The aim of this study was to establish the common causes of hospital mortality in a regional preterm population admitted to a neonatal intensive care unit (NICU). Retrospective analysis of prospectively collected data of the Neonatal Intensive Care Units' (NICUS) Data Collection of all 10 NICUs in the region. Infants cause of death. There were 345 (7.7%) deaths out of 4454 infants. The most common cause of death across all gestational groups was major IVH (cause-specific mortality rate [CMR] 22 per 1000 infants), followed by acute respiratory illnesses [ARI] (CMR 21 per 1000 infants) and sepsis (CMR 12 per 1000 infants). The most common cause of death was different in each gestational group (22-25 weeks [ARI], 26-28 weeks [IVH] and 29-31 weeks [perinatal asphyxia]). Pregnancy induced hypertension, antenatal steroids and chorioamnionitis were all associated with changes in CMRs. Deaths due to ARI or major IVH were more likely to occur at an earlier age (median [quartiles] 1.4 [0.3-4.4] and 3.6 [1.9-6.6] days respectively) in comparison to NEC and miscellaneous causes (25.2 [15.4-37.3] and 25.8 [3.2-68.9] days respectively). Major IVH and ARI were the most common causes of hospital mortality in this extreme to very preterm population. Perinatal factors have a significant impact on cause-specific mortality. The varying timing of death provides insight into the prolonged vulnerability for diseases such as necrotising enterocolitis in our preterm population.

  14. Surgical evacuation of neonatal intracranial hemorrhage due to vitamin K deficiency bleeding.

    Science.gov (United States)

    Zidan, Ashraf Shaker; Abdel-Hady, Hesham

    2011-03-01

    Although the incidence of vitamin K deficiency bleeding (VKDB) in neonates has dramatically decreased in the developed world since the adoption of routine vitamin K prophylaxis, in developing countries the incidence is still high. Intracranial hemorrhage (ICH) is the most dangerous complication. Early recognition and management are important to decrease the mortality rate and neurological sequelae. The authors conducted a prospective study between January 2008 and June 2010. They included all full-term neonates referred to the Department of Neurosurgery at Mansoura University Children's Hospital with ICH complicating VKDB and necessitating surgical evacuation. The objective was to evaluate the clinical presentation, diagnosis, hospital course, and outcome of ICH in full-term neonates with VKDB after surgical evacuation. Thirty-two neonates with ICH due to VKDB were included. Diagnosis and classification of ICH were based on detailed history, physical examination, and the interpretation of CT or MR imaging studies. The diagnosis of VKDB was based on pretreatment coagulation studies (prothrombin time [PT] and partial thromboplastin time [PTT]), which are grossly abnormal, together with a normal platelet count and correction of coagulation results to normal after vitamin K administration. The mean age (± SD) at onset of symptoms was 20.4 ± 4.9 days. Two neonates (6.25%) had early VKDB, 7 (21.9%) had classic VKDB, and 23 (71.9%) had late VKDB. The most common neurological manifestations included focal seizures, disturbed consciousness level, and tense anterior fontanel. The most common general manifestations included pallor, respiratory distress, and bleeding from other sites. Radiological findings varied from acute subdural hemorrhage (SDH) in 18 cases (56.3%), intracerebral hemorrhage in 10 (31.3%), and acute SDH with underlying intracerebral hemorrhage, intraventricular hemorrhage, and/or subarachnoid hemorrhage in 4 (12.5%). Before administration of vitamin K

  15. Determinants of Public Attitudes towards Euthanasia in Adults and Physician-Assisted Death in Neonates in Austria: A National Survey.

    Directory of Open Access Journals (Sweden)

    Erwin Stolz

    Full Text Available Euthanasia remains a controversial topic in both public discourses and legislation. Although some determinants of acceptance of euthanasia and physician-assisted death have been identified in previous studies, there is still a shortage of information whether different forms of euthanasia are supported by the same or different sub-populations and whether authoritarian personality dispositions are linked to attitudes towards euthanasia.A large, representative face-to-face survey was conducted in Austria in 2014 (n = 1,971. Respondents faced three scenarios of euthanasia and one of physician assisted death differing regarding the level of specificity, voluntariness and subject, requiring either approval or rejection: (1 abstract description of euthanasia, (2 abstract description of physician-assisted suicide, (3 the case of euthanasia of a terminally-ill 79-year old cancer patient, and (4 the case of non-voluntary, physician assisted death of a severely disabled or ill neonate. A number of potential determinants for rejection ordered in three categories (socio-demographic, personal experience, orientations including authoritarianism were tested via multiple logistic regression analyses.Rejection was highest in the case of the neonate (69% and lowest for the case of the older cancer patient (35%. A consistent negative impact of religiosity on the acceptance across all scenarios and differential effects for socio-economic status, area of residence, religious confession, liberalism, and authoritarianism were found. Individuals with a stronger authoritarian personality disposition were more likely to reject physician-assisted suicide for adults but at the same time also more likely to approve of physician-assisted death of a disabled neonate.Euthanasia in adults was supported by a partially different sub-population than assisted death of disabled neonates.

  16. Determinants of Public Attitudes towards Euthanasia in Adults and Physician-Assisted Death in Neonates in Austria: A National Survey.

    Science.gov (United States)

    Stolz, Erwin; Burkert, Nathalie; Großschädl, Franziska; Rásky, Éva; Stronegger, Willibald J; Freidl, Wolfgang

    2015-01-01

    Euthanasia remains a controversial topic in both public discourses and legislation. Although some determinants of acceptance of euthanasia and physician-assisted death have been identified in previous studies, there is still a shortage of information whether different forms of euthanasia are supported by the same or different sub-populations and whether authoritarian personality dispositions are linked to attitudes towards euthanasia. A large, representative face-to-face survey was conducted in Austria in 2014 (n = 1,971). Respondents faced three scenarios of euthanasia and one of physician assisted death differing regarding the level of specificity, voluntariness and subject, requiring either approval or rejection: (1) abstract description of euthanasia, (2) abstract description of physician-assisted suicide, (3) the case of euthanasia of a terminally-ill 79-year old cancer patient, and (4) the case of non-voluntary, physician assisted death of a severely disabled or ill neonate. A number of potential determinants for rejection ordered in three categories (socio-demographic, personal experience, orientations) including authoritarianism were tested via multiple logistic regression analyses. Rejection was highest in the case of the neonate (69%) and lowest for the case of the older cancer patient (35%). A consistent negative impact of religiosity on the acceptance across all scenarios and differential effects for socio-economic status, area of residence, religious confession, liberalism, and authoritarianism were found. Individuals with a stronger authoritarian personality disposition were more likely to reject physician-assisted suicide for adults but at the same time also more likely to approve of physician-assisted death of a disabled neonate. Euthanasia in adults was supported by a partially different sub-population than assisted death of disabled neonates.

  17. Years of Life Lost Due to External Causes of Death in the Lodz Province, Poland

    Science.gov (United States)

    Pikala, Malgorzata; Bryla, Marek; Bryla, Pawel; Maniecka-Bryla, Irena

    2014-01-01

    Background The aim of the study is the analysis of years of life lost due to external causes of death, particularly due to traffic accidents and suicides. Materials and Methods The study material includes a database containing information gathered from 376,281 death certificates of inhabitants of the Lodz province who died between 1999 and 2010. The Lodz province is characterized by the highest mortality rates in Poland. The SEYLLp (Standard Expected Years of Life Lost per living person) and the SEYLLd (per death) indices were used to determine years of life lost. Joinpoint models were used to analyze time trends. Results In 2010, deaths due to external causes constituted 6.0% of the total number of deaths. The standardized death rate (SDR) due to external causes was 110.0 per 100,000 males and was five times higher than for females (22.0 per 100,000 females). In 2010, the SEYLLp due to external causes was 3746 per 100,000 males and 721 per 100,000 females. Among males, suicides and traffic accidents were the most common causes of death (the values of the SEYLLp were: 1098 years and 887 years per 100,000 people, respectively). Among females, the SEYLLp values were 183 years due to traffic accidents and 143 years due to suicides (per 100,000 people). Conclusions A decrease in the number of years of life lost due to external causes is much higher among females. The authors observe that a growing number of suicides contribute to an increase in the value of the SEYLLp index. This directly contributes to over-mortality of males due to external causes. The analysis of the years of life lost focuses on the social and economic aspects of premature mortality due to external causes. PMID:24810942

  18. 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

  19. [Forensic Analysis of 6 Cases of Sudden Death due to Hyperthyroid Heart Disease].

    Science.gov (United States)

    Zhang, M Z; Li, B X; Zhao, R; Guan, D W; Zhang, G H; Wu, X; Zhu, B L; Li, R B

    2017-10-01

    To analyse the cases of sudden death due to hyperthyroid heart disease, and explore the general information of deaths and the forensic pathological characteristics to provide reference evidence for forensic identification of such cases. Six cases of sudden death due to hyperthyroid heart disease between 2001 and 2016 were selected from School of Forensic Medicine, China Medical University. The general information (gender and age), clinical manifestations, medical history, anatomical and histopathological findings, biochemical parameters and cause of death were analysed retrospectively. Most of the 6 patients had definite history of hyperthyroidism, and they all showed certain degrees of symptoms of cardiovascular disease; had obvious incentive factors of death; histopathological examination of thyroid conformed to the performances of diffuse toxic goiter; with increase of cardiac weight, dilatation of cardiac chambers, myocardial hypertrophy and focal necrosis; postmortem biochemical analyses of pericardial fluid could be used as an additional method for diagnostic of sudden death due to hyperthyroid heart disease. The identification of death due to hyperthyroid heart disease should be based on the clinical history and the results of autopsy, histopathological examination, postmortem toxicology tests. The postmortem biochemical detection of thyroid and cardiac function should be performed if necessary. Copyright© by the Editorial Department of Journal of Forensic Medicine

  20. Trial of labour after caesarean section and the risk of neonatal and infant death: a nationwide cohort study.

    LENUS (Irish Health Repository)

    O'Neill, Sinéad M

    2017-02-27

    Caesarean section (CS) rates are increasing worldwide and as a result repeat CS is common. The optimal mode of delivery in women with one previous CS is widely debated and the risks to the infant are understudied. The aim of the current study was to evaluate if women with a trial of labour after caesarean (TOLAC) had an increased odds of neonatal and infant death compared to women with an elective repeat CS (ERCS).

  1. Diagnostic accuracy of S100B urinary testing at birth in full-term asphyxiated newborns to predict neonatal death.

    Directory of Open Access Journals (Sweden)

    Diego Gazzolo

    Full Text Available BACKGROUND: Neonatal death in full-term infants who suffer from perinatal asphyxia (PA is a major subject of investigation, since few tools exist to predict patients at risk of ominous outcome. We studied the possibility that urine S100B measurement may identify which PA-affected infants are at risk of early postnatal death. METHODOLOGY/PRINCIPAL FINDINGS: In a cross-sectional study between January 1, 2001 and December 1, 2006 we measured S100B protein in urine collected from term infants (n = 132, 60 of whom suffered PA. According to their outcome at 7 days, infants with PA were subsequently classified either as asphyxiated infants complicated by hypoxic ischemic encephalopathy with no ominous outcome (HIE Group; n = 48, or as newborns who died within the first post-natal week (Ominous Outcome Group; n = 12. Routine laboratory variables, cerebral ultrasound, neurological patterns and urine concentrations of S100B protein were determined at first urination and after 24, 48 and 96 hours. The severity of illness in the first 24 hours after birth was measured using the Score for Neonatal Acute Physiology-Perinatal Extension (SNAP-PE. Urine S100B levels were higher from the first urination in the ominous outcome group than in healthy or HIE Groups (p1.0 microg/L S100B had a sensitivity/specificity of 100% for predicting neonatal death. CONCLUSIONS/SIGNIFICANCE: Increased S100B protein urine levels in term newborns suffering PA seem to suggest a higher risk of neonatal death for these infants.

  2. The association of cerebral palsy and death with small-for-gestational-age birthweight in preterm neonates by individualized and population-based percentiles.

    LENUS (Irish Health Repository)

    Grobman, William A

    2013-10-01

    The objective of the study was to determine whether an individualized growth standard (IS) improves the identification of preterm small-for-gestational-age (SGA) neonates at risk of developing moderate\\/severe cerebral palsy (CP) or death.

  3. 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.

  4. Nationwide (Denmark) Study of Symptoms Preceding Sudden Death due to Arrhythmogenic Right Ventricular Cardiomyopathy

    DEFF Research Database (Denmark)

    Sadjadieh, Golnaz; Jabbari, Reza; Risgaard, Bjarke

    2014-01-01

    In this study, we investigated medical history and symptoms before death in all subjects aged 1 to 35 years who died a sudden cardiac death (SCD) from arrhythmogenic right ventricular cardiomyopathy (ARVC) in Denmark in the years 2000 to 2006. All deaths (n=6,629) in subjects aged 1 to 35 years...... control groups in the same age group and time interval: one consisting of subjects who died in traffic accidents (n=74) and the other consisting of patients who died a SCD due to coronary artery disease (CAD; n=34). In the case group, 8 of the 16 patients with ARVC experienced antecedent cardiac symptoms...

  5. Death from Barotrauma Due to Compressed Air: A Medico-legal Analysis.

    Science.gov (United States)

    Giugliano, Pasquale; Massoni, Francesco; Crisci, Antonello; Ricci, Serafino

    2016-11-01

    Lesions of the digestive tract due to barotrauma resulting from compressed air application are not common, are rarely lethal, and largely affect the sigmoid and descending colon. Moreover, their pathogenic mechanism is a topic of discussion because these lesions have multiple characteristics. Here, the authors describe an autoptic case of death from lesions of the ascending and transverse segments, with perforations and bleeding suffusions as well as ischemic areas covered the colonic wall that was extremely thinned, congested, and hemorrhagic, with considerable flattening leading to disappearance of the mucosal folds and with numerous petechial hemorrhages. The pathological framework of lung congestion made it possible to identify the mechanism responsible for this death as depletion of the heart's pumping function, which contributed significantly to the acute respiratory failure due to respiratory distress as well as to reduced mobility of the diaphragm due to intestinal distension. Acute heart failure played an important role in this death. © 2016 American Academy of Forensic Sciences.

  6. A neonate with mitral stenosis due to accessory mitral valve, ventricular septal defect, and patent ductus arteriosus: changes in echocardiographical findings during the neonatal period.

    Science.gov (United States)

    Ito, Tadahiko; Okubo, Tadashi

    2002-12-01

    A female neonate with mitral stenosis due to accessory mitral valve with ventricular septal defect and patent ductus arteriosus is described. She was referred to our hospital because of neonatal asphyxia. Asphyxia was improved by ventilator support, but rapid deterioration of respiration with pulmonary congestion and hemorrhage appeared 8 days after birth. Echocardiography revealed an accessory mitral valve attached to the anterior mitral leaflet with a perimembranous ventricular septal defect and patent ductus arteriosus. Although there were no echocardiographical findings indicating mitral stenosis on admission, the mitral stenosis blood flow patterns were detected by color and pulsed Doppler examination performed on the eighth day after admission. Transaortic resection of accessory mitral valve tissue was performed with patch closure of the ventricular septal defect and ligation of the ductus arteriosus 35 days after birth. After operation, pulmonary congestion and hemorrhage were improved. Postoperative echocardiography showed complete resection of the accessory mitral valve and no mitral insufficiency. We concluded that the combination of the accessory mitral valve and left-to-right shunt due to ventricular septal defect or patent ducturs arteriosus might have led to a critical hemodynamic condition due to relative mitral stenosis in the neonatal period with the decrease in pulmonary vascular resistance.

  7. Death due to fracture of thin calvarial bones after a fall: A forensic approach

    Directory of Open Access Journals (Sweden)

    Georgios Sioutas

    2017-06-01

    Full Text Available A 45-year-old male was autopsied. He had fallen backwards from a two-stairs height to the ground and passed away. A skull fracture was detected in the left occipital area, extending up to the left side of the skull base. The patient's death occurred due to the very low thickness of the calvarial bones, which led to the aforementioned fracture, and in turn resulted in subarachnoid hemorrhage and death. The cortical thickness was measured and compared with average values at standardized points. Uniform bone thinning was confirmed rather than localized. Calvarial thinning may result from various conditions. In the present case study, however, the exact mechanism which led to the low thickness of the calvarial bones of the patient is undetermined. Death due to the susceptible structure and fracture of calvarial bones has rarely been reported throughout relevant literature.

  8. Neonatal pyruvate dehydrogenase deficiency due to a R302H mutation in the PDHA1 gene: MRI findings

    International Nuclear Information System (INIS)

    Soares-Fernandes, Joao P.; Ribeiro, Manuel; Magalhaes, Zita; Rocha, Jaime F.; Teixeira-Gomes, Roseli; Cruz, Romeu; Leijser, Lara M.

    2008-01-01

    Pyruvate dehydrogenase (PDH) deficiency is one of the most common causes of congenital lactic acidosis. Correlations between the genetic defect and neuroimaging findings are lacking. We present conventional and diffusion-weighted MRI findings in a 7-day-old male neonate with PDH deficiency due to a mosaicism for the R302H mutation in the PDHA1 gene. Corpus callosum dysgenesis, widespread increased diffusion in the white matter, and bilateral subependymal cysts were the main features. Although confirmation of PDH deficiency depends on specialized biochemical analyses, neonatal MRI plays a role in evaluating the pattern and extent of brain damage, and potentially in early diagnosis and clinical decision making. (orig.)

  9. Nationwide (Denmark) study of symptoms preceding sudden death due to arrhythmogenic right ventricular cardiomyopathy.

    Science.gov (United States)

    Sadjadieh, Golnaz; Jabbari, Reza; Risgaard, Bjarke; Olesen, Morten S; Haunsø, Stig; Tfelt-Hansen, Jacob; Winkel, Bo G

    2014-04-01

    In this study, we investigated medical history and symptoms before death in all subjects aged 1 to 35 years who died a sudden cardiac death (SCD) from arrhythmogenic right ventricular cardiomyopathy (ARVC) in Denmark in the years 2000 to 2006. All deaths (n=6,629) in subjects aged 1 to 35 years in Denmark in the period 2000 to 2006 were included. A total of 16 cases of SCD due to ARVC were identified based on histopathologic examination. Information on medical history was retrieved from The National Patient Registry, general practitioners, and hospitals. Symptoms before death were compared with 2 control groups in the same age group and time interval: one consisting of subjects who died in traffic accidents (n=74) and the other consisting of patients who died a SCD due to coronary artery disease (CAD; n=34). In the case group, 8 of the 16 patients with ARVC experienced antecedent cardiac symptoms and 7 of them sought medical attention. None were diagnosed with ARVC before death. Only 1 patient in the healthy control group and 31 of the 39 patients with CAD experienced cardiac symptoms before death. A total of 6 patients of the 16 with ARVC died during strenuous physical activity and 4 of the deaths were sports-related SCDs. In conclusion, antecedent cardiac symptoms before SCD in the young were seen in 1/2 of the patients who died because of ARVC, and this is significantly higher than in the healthy control group. When considering the ARVC and CAD groups collectively, antecedent cardiac symptoms are seen in the majority. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. Lethal Progressive Thoracic Insufficiency in a Neonate Due to Jarcho Levin Syndrome

    Science.gov (United States)

    Bhutia, Euden; Maria, Arti; Verma, Arushi; Sethi, Sidharth Kumar

    2014-01-01

    A rare case of Jarcho Levin syndrome (JLS) presenting as a lethal progressive respiratory insufficiency in early neonatal period is reported. The neonate had classical features of this syndrome including vertebral segmentation defects, typical costo-vertebral fusion defects and scoliosis resulting in small thoracic volume and limited chest expansion; all consistent with a clinical diagnosis of JLS with thoracic insufficiency. In addition, our case had a rare association of dextrocardia and acyanotic congenital heart disease. PMID:24741543

  11. 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

  12. Sudden Cardiac Death of a Body Packer Due to Cocaine Cardiotoxicity

    Directory of Open Access Journals (Sweden)

    Parthasarathi Pramanik

    2016-01-01

    Full Text Available This article presents a case of sudden cardiac death due to the effects of cocaine concealed in the body of a male drug smuggler in his 40s, a so-called body packer. A total of 57 body packets filled with cocaine powder were discovered in his body cavities. The detailed autopsy examination, including histopathology and toxicology findings, is discussed with the aim of describing the mechanism of cocaine intoxication in the body packer and an analysis of cocaine-induced cardiotoxicity and sudden death.

  13. A case of death due to rescue action by a power shovel after being buried alive.

    Science.gov (United States)

    Watanabe-Suzuki, K; Nozawa, H; Ishii, A; Seno, H; Suzuki, O

    2001-12-01

    We report a rare case of death due to rescue using a power shovel. A 41-year-old female was accidentally buried alive by a landslide of the earth and sand upon working at a construction site. One of her colleagues started to save her using a power shovel. However, she was dug out dead at the spot about 10 min after the accident with marked head and face injuries. The autopsy disclosed that there was extensive laceration across the face and head with marked skull bone fractures. Around these injuries, extensive hemorrhage could be observed as a vital reaction. Asphyxial death had to be taken into consideration, because she was buried under the earth and sand for about 10 min; but we finally judged that the cause of her death was head injury by the power shovel inflicted during the attempted rescue.

  14. 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.

  15. Care during labor and birth for the prevention of intrapartum-related neonatal deaths: a systematic review and Delphi estimation of mortality effect

    Science.gov (United States)

    2011-01-01

    Background Our objective was to estimate the effect of various childbirth care packages on neonatal mortality due to intrapartum-related events (“birth asphyxia”) in term babies for use in the Lives Saved Tool (LiST). Methods We conducted a systematic literature review to identify studies or reviews of childbirth care packages as defined by United Nations norms (basic and comprehensive emergency obstetric care, skilled care at birth). We also reviewed Traditional Birth Attendant (TBA) training. Data were abstracted into standard tables and quality assessed by adapted GRADE criteria. For interventions with low quality evidence, but strong GRADE recommendation for implementation, an expert Delphi consensus process was conducted to estimate cause-specific mortality effects. Results We identified evidence for the effect on perinatal/neonatal mortality of emergency obstetric care packages: 9 studies (8 observational, 1 quasi-experimental), and for skilled childbirth care: 10 studies (8 observational, 2 quasi-experimental). Studies were of low quality, but the GRADE recommendation for implementation is strong. Our Delphi process included 21 experts representing all WHO regions and achieved consensus on the reduction of intrapartum-related neonatal deaths by comprehensive emergency obstetric care (85%), basic emergency obstetric care (40%), and skilled birth care (25%). For TBA training we identified 2 meta-analyses and 9 studies reporting mortality effects (3 cRCT, 1 quasi-experimental, 5 observational). There was substantial between-study heterogeneity and the overall quality of evidence was low. Because the GRADE recommendation for TBA training is conditional on the context and region, the effect was not estimated through a Delphi or included in the LiST tool. Conclusion Evidence quality is rated low, partly because of challenges in undertaking RCTs for obstetric interventions, which are considered standard of care. Additional challenges for evidence interpretation

  16. Care during labor and birth for the prevention of intrapartum-related neonatal deaths: a systematic review and Delphi estimation of mortality effect

    Directory of Open Access Journals (Sweden)

    Moran Neil F

    2011-04-01

    Full Text Available Abstract Background Our objective was to estimate the effect of various childbirth care packages on neonatal mortality due to intrapartum-related events (“birth asphyxia” in term babies for use in the Lives Saved Tool (LiST. Methods We conducted a systematic literature review to identify studies or reviews of childbirth care packages as defined by United Nations norms (basic and comprehensive emergency obstetric care, skilled care at birth. We also reviewed Traditional Birth Attendant (TBA training. Data were abstracted into standard tables and quality assessed by adapted GRADE criteria. For interventions with low quality evidence, but strong GRADE recommendation for implementation, an expert Delphi consensus process was conducted to estimate cause-specific mortality effects. Results We identified evidence for the effect on perinatal/neonatal mortality of emergency obstetric care packages: 9 studies (8 observational, 1 quasi-experimental, and for skilled childbirth care: 10 studies (8 observational, 2 quasi-experimental. Studies were of low quality, but the GRADE recommendation for implementation is strong. Our Delphi process included 21 experts representing all WHO regions and achieved consensus on the reduction of intrapartum-related neonatal deaths by comprehensive emergency obstetric care (85%, basic emergency obstetric care (40%, and skilled birth care (25%. For TBA training we identified 2 meta-analyses and 9 studies reporting mortality effects (3 cRCT, 1 quasi-experimental, 5 observational. There was substantial between-study heterogeneity and the overall quality of evidence was low. Because the GRADE recommendation for TBA training is conditional on the context and region, the effect was not estimated through a Delphi or included in the LiST tool. Conclusion Evidence quality is rated low, partly because of challenges in undertaking RCTs for obstetric interventions, which are considered standard of care. Additional challenges for

  17. Cause-specific Neonatal Deaths : Levels, Trend and Determinants in Rural Bangladesh, 1987-2005

    NARCIS (Netherlands)

    Saha, U.R.; van Soest, A.H.O.; Bijwaard, G.E.

    2012-01-01

    Abstract: Reducing neonatal mortality is a particularly important issue in Bangladesh. We employ a competing risks model incorporating both observed and unobserved heterogeneity and allowing the heterogeneity terms for various causes to be correlated. Data come from the Health and Demographic

  18. Early neonatal deaths associated with perinatal asphyxia in infants ≥2500 g in Brazil

    Directory of Open Access Journals (Sweden)

    Maria Fernanda Branco de Almeida

    2017-11-01

    Conclusions: Despite the decreasing rates in Brazil from 2005 to 2010, early neonatal mortality rates associated with perinatal asphyxia in infants in the better spectrum of birth weight and without congenital malformations are still high, and meconium aspiration syndrome plays a major role.

  19. Planned home compared with planned hospital births in the Netherlands: intrapartum and early neonatal death in low-risk pregnancies.

    Science.gov (United States)

    van der Kooy, Jacoba; Poeran, Jashvant; de Graaf, Johanna P; Birnie, Erwin; Denktasş, Semiha; Steegers, Eric A P; Bonsel, Gouke J

    2011-11-01

    The purpose of our study was to compare the intrapartum and early neonatal mortality rate of planned home birth with planned hospital birth in community midwife-led deliveries after case mix adjustment. The perinatal outcome of 679,952 low-risk women was obtained from the Netherlands Perinatal Registry (2000-2007). This group represents all women who had a choice between home and hospital birth. Two different analyses were performed: natural prospective approach (intention-to-treat-like analysis) and perfect guideline approach (per-protocol-like analysis). Unadjusted and adjusted odds ratios (ORs) were calculated. Case mix was based on the presence of at least one of the following: congenital abnormalities, small for gestational age, preterm birth, or low Apgar score. We also investigated the potential risk role of intended place of birth. Multivariate stepwise logistic regression was used to investigate the potential risk role of intended place of birth. Intrapartum and neonatal death at 0-7 days was observed in 0.15% of planned home compared with 0.18% in planned hospital births (crude relative risk 0.80, 95% confidence interval [CI] 0.71-0.91). After case mix adjustment, the relation is reversed, showing nonsignificant increased mortality risk of home birth (OR 1.05, 95% CI 0.91-1.21). In certain subgroups, additional mortality may arise at home if risk conditions emerge at birth (up to 20% increase). Home birth, under routine conditions, is generally not associated with increased intrapartum and early neonatal death, yet in subgroups, additional risk cannot be excluded.

  20. Vaginal isolation of beta-haemolytic Streptococcus from bitches with and without neonatal deaths in the litters.

    Science.gov (United States)

    Guerrero, A E; Stornelli, M C; Jurado, S B; Giacoboni, G; Sguazza, G H; de la Sota, R L; Stornelli, M A

    2018-02-18

    The aim of the study was to identify beta-haemolytic streptococci in the vagina of bitches who had delivered healthy litters and bitches who had delivered litters in which neonatal deaths occurred. Fifty-one bitches divided into two groups were used. Group 1 (G1) included 28 bitches that had delivered healthy litters and group 2 (G2) included 23 bitches that had delivered puppies who died in the neonatal period. Two vaginal samples were taken, one in proestrus and the other at the end of gestation (EG). Beta-haemolytic Streptococcus (BS) was isolated from 16 bitches (57%) in G1 and from 21 bitches (91%) in G2. The bacteriological cultures, serological tests (Streptex ® ) and PCR assay allowed identification of Streptococcus canis and Streptococcus dysgalactiae in G1 and G2. Ultramicroscopic studies allowed the observation of M Protein and capsules in strains of S. dysgalactiae and S. canis in G1 and G2. The S. canis strains isolated from G2 showed thicker capsules than S. canis strains isolated from G1 (234 ± 24.2 vs 151.23 ± 28.93 nm; p  .70). All strains of beta-haemolytic Streptococcus isolated were penicillin sensitive. Penicillin was administered from EG to 5 days post-partum in 10 G2 females with isolation of BS (G2A). Saline solution was administered in eleven G2 females with isolation of BS (G2B). Ninety per cent of the puppies survived in G2A and 25% survived in G2B. Our results suggest BS is involved in canine neonatal deaths. © 2018 Blackwell Verlag GmbH.

  1. Effect of case management on neonatal mortality due to sepsis and pneumonia

    Directory of Open Access Journals (Sweden)

    Black Robert

    2011-04-01

    Full Text Available Abstract Background Each year almost one million newborns die from infections, mostly in low-income countries. Timely case management would save many lives but the relative mortality effect of varying strategies is unknown. We have estimated the effect of providing oral, or injectable antibiotics at home or in first-level facilities, and of in-patient hospital care on neonatal mortality from pneumonia and sepsis for use in the Lives Saved Tool (LiST. Methods We conducted systematic searches of multiple databases to identify relevant studies with mortality data. Standardized abstraction tables were used and study quality assessed by adapted GRADE criteria. Meta-analyses were undertaken where appropriate. For interventions with biological plausibility but low quality evidence, a Delphi process was undertaken to estimate effectiveness. Results Searches of 2876 titles identified 7 studies. Among these, 4 evaluated oral antibiotics for neonatal pneumonia in non-randomised, concurrently controlled designs. Meta-analysis suggested reductions in all-cause neonatal mortality (RR 0.75 95% CI 0.64- 0.89; 4 studies and neonatal pneumonia-specific mortality (RR 0.58 95% CI 0.41- 0.82; 3 studies. Two studies (1 RCT, 1 observational study, evaluated community-based neonatal care packages including injectable antibiotics and reported mortality reductions of 44% (RR= 0.56, 95% CI 0.41-0.77 and 34% (RR =0.66, 95% CI 0.47-0.93, but the interpretation of these results is complicated by co-interventions. A third, clinic-based, study reported a case-fatality ratio of 3.3% among neonates treated with injectable antibiotics as outpatients. No studies were identified evaluating injectable antibiotics alone for neonatal pneumonia. Delphi consensus (median from 20 respondents effects on sepsis-specific mortality were 30% reduction for oral antibiotics, 65% for injectable antibiotics and 75% for injectable antibiotics on pneumonia-specific mortality. No trials were

  2. [Neonatal meningitis due to Listeria monocytogenes after 3 weeks of maternal treatment during pregnancy].

    Science.gov (United States)

    Fayol, L; Beizig, S; Le Monnier, A; Lacroze, V; Simeoni, U

    2009-04-01

    We report the case of a pregnant woman with listeriosis at 26 gestational weeks followed by premature labor at 30 gestational weeks. Bacterial meningitis was suspected in the neonate with ventriculitis on sonography, a high level of protein in the cerebrospinal fluid (CSF), and an identified specific bacterial genome of Listeria monocytogenes (PCR 16S rDNA and sequencing and specific amplification of L. monocytogenes hly gene) in CSF. Neonatal meningitis was complicated with cerebral venous sinus thrombosis and ventriculomegaly. Listeriosis during pregnancy can lead to severe complications in the neonate. Thus, listeriosis should be a diagnostic concern in febrile pregnant women at any stage of pregnancy. First-line treatment is based on high-dose amoxicillin (> or =6g/day) and must be used for at least 3 weeks for treatment of listeriosis during pregnancy. If the fetus survives, longer therapy until delivery can be discussed.

  3. Cyanosis and Stroke due to Functional Cor Triatriatum Dexter in a Neonate.

    Science.gov (United States)

    León, Rachel L; Zaban, Nicholas B; Schamberger, Marcus S; Ho, Chang Y; Mietzsch, Ulrike

    2018-01-01

    Small remnants of the right valve of the sinus venosus are commonly found in adults, but the incidence and risk associated with these embryonic remnants in neonates are not well studied. The following report describes a cyanotic neonate with a large Eustachian valve remnant creating a functional cor triatriatum dexter who was initially diagnosed with persistent pulmonary hypertension of the newborn. The cyanosis in this infant improved over the first postnatal week with conservative management, but she suffered multifocal subcortical stroke, likely related to her intracardiac shunt. The clinical presentation and questions regarding long-term management of this rare diagnosis are explored. © 2018 S. Karger AG, Basel.

  4. [Labor productivity losses attributable to premature deaths due to traffic injuries between 2002 and 2012].

    Science.gov (United States)

    Cubí-Mollá, Patricia; Peña-Longobardo, Luz María; Casal, Bruno; Rivera, Berta; Oliva-Moreno, Juan

    2015-09-01

    To estimate the years of potential life lost, years of potential productive life lost and the labor productivity losses attributable to premature deaths due to traffic injuries between 2002 and 2012 in Spain. Several statistical sources were combined (Spanish Registry of Deaths, Labor Force Survey and Wage Structure Survey) to develop a simulation model based on the human capital approach. This model allowed us to estimate the loss of labor productivity caused by premature deaths following traffic injuries from 2002 to 2012. In addition, mortality tables with life expectancy estimates were used to compute years of potential life lost and years of potential productive life lost. The estimated loss of labour productivity caused by fatal traffic injuries between 2002 and 2012 in Spain amounted to 9,521 million euros (baseline year 2012). The aggregate number of years of potential life lost in the period amounted to 1,433,103, whereas the years of potential productive life lost amounted to 875,729. Throughout the period analyzed, labor productivity losses and years of life lost diminished substantially. Labor productivity losses due to fatal traffic injuries decreased throughout the period analyzed. Nevertheless, the cumulative loss was alarmingly high. Estimation of the economic impact of health problems can complement conventional indicators of distinct dimensions and be used to support public policy making. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

  5. Death due to fracture of thin calvarial bones after a fall: A forensic approach.

    Science.gov (United States)

    Sioutas, Georgios; Karakasi, Maria-Valeria; Kapetanakis, Stylianos; Pavlidis, Pavlos

    2017-06-01

    A 45-year-old male was autopsied. He had fallen backwards from a two-stairs height to the ground and passed away. A skull fracture was detected in the left occipital area, extending up to the left side of the skull base. The patient's death occurred due to the very low thickness of the calvarial bones, which led to the aforementioned fracture, and in turn resulted in subarachnoid hemorrhage and death. The cortical thickness was measured and compared with average values at standardized points. Uniform bone thinning was confirmed rather than localized. Calvarial thinning may result from various conditions. In the present case study, however, the exact mechanism which led to the low thickness of the calvarial bones of the patient is undetermined. Death due to the susceptible structure and fracture of calvarial bones has rarely been reported throughout relevant literature. Copyright © 2017 Daping Hospital and the Research Institute of Surgery of the Third Military Medical University. Production and hosting by Elsevier B.V. All rights reserved.

  6. The death of neonates: the multi-professional team’s perceptions of the problem in the light of its complexity

    Directory of Open Access Journals (Sweden)

    Larissa Spies Subutzki

    2018-01-01

    Full Text Available Objective: to learn about the perception which the multi-professional team of a neonatal intensive care unit have of the process of dying and death of neonates. Method: this is a qualitative, exploratory-descriptive study, undertaken with three focus groups made up of 35 professionals from the multi-professional team of the neonatal and pediatric intensive care unit of a hospital located in the northwest region of the State of Rio Grande do Sul in Brazil. The data were decoded on the basis of content analysis. Results: the data yielded four thematic categories: Death: an interruption of the natural order; Death: dying is a complex process for which there are no answers; Death: awakening to a new state of life and Death: the coexistence of the tangible and the  intangible. Conclusion: is the study concluded that death is still conceived of as a fragmented phenomenon and it is dissociated from the process of human life, although there is evidence that the professionals believe in the prospect of being able to speak about and reflect on the matter and expand their theoretical and practical understanding of death.

  7. Effect of Poultry Litter Treatment (PLT) on death due to ascites in broilers.

    Science.gov (United States)

    Terzich, M; Quarles, C; Goodwin, M A; Brown, J

    1998-01-01

    The purposes of this study were to determine the effect of Poultry Litter Treatment (PLT) on levels of litter moisture, litter nitrogen, atmospheric ammonia, and death due to ascites. Data were collected from chicks raised in containment conditions that resembled commercial settings. The ascites death rate (5.9%) in broiler chicks on PLT-treated litter was significantly (chi 2 = 15.5, df = 1, P = 0.0001) lower than that (31.5%) in broiler chicks raised on untreated litter. Likewise, atmospheric ammonia levels in pens that had been treated with PLT were significantly (P litter moisture and litter nitrogen levels were not different (P > 0.05) among treatments at any sample interval.

  8. Roentgenographic appearance of ossification centers in the Japanese fetus, stillborn and neonatal death infants, Hiroshima and Nagasaki

    Energy Technology Data Exchange (ETDEWEB)

    Kawamoto, Sadahisa

    1964-01-01

    A roentgenographic study of the presence of the ossification centers has been made on a total of 235 cases of miscarriage, therapeutic abortion, stillbirth and neonatal death according to criteria of sex, length of gestational age, and weight at birth. The cases were aged from 16 to 42 gestational weeks. The weight of the cases ranged from 110 g to 3780 g at birth. The order of appearance of the eight centers in fetal life was as follows: Ischium, pubis, calcaneus, talus, distal epiphysis of femur, hyoid, proximal epiphysis of tibia, and cuboid bone. Some of the eight ossification centers appeared earlier in girls than in boys of the same gestational age and birth weight. The osseous development of Japanese fetuses and infants weighing over 2000 g was judged less mature than in similar Caucasian and Negro subjects. 10 references, 1 figure, 6 tables.

  9. Household fuels, low birth weight, and neonatal death in India: the separate impacts of biomass, kerosene, and coal.

    Science.gov (United States)

    Epstein, M B; Bates, M N; Arora, N K; Balakrishnan, K; Jack, D W; Smith, K R

    2013-08-01

    We examined the impact of maternal use of different household cooking fuels in India on low birth weight (LBWfuels for cooking - biomass, coal, and kerosene - using low-pollution fuels (gas and biogas) as the comparison "control" group. Taking socioeconomic and child-specific factors into account, we employed logistic regression to examine the impact of fuel use on fetal and infant health. The results indicate that household use of high-pollution fuels is significantly associated with increased odds of LBW and neonatal death. Compared to households using cleaner fuels (in which the mean birth weight is 2901g), the primary use of coal, kerosene, and biomass fuels is associated with significant decreases in mean birth weight (of -110g for coal, -107g for kerosene, and -78g for biomass). Kerosene and biomass fuel use are also associated with increased risk of LBW (pfuels. Copyright © 2012 Elsevier GmbH. All rights reserved.

  10. Nephron progenitor cell death elicits a limited compensatory response associated with interstitial expansion in the neonatal kidney

    Directory of Open Access Journals (Sweden)

    Sree Deepthi Muthukrishnan

    2018-01-01

    Full Text Available The final nephron number in an adult kidney is regulated by nephron progenitor cell availability and collecting duct branching in the fetal period. Fetal environmental perturbations that cause reductions in cell numbers in these two compartments result in low nephron endowment. Previous work has shown that maternal dietary factors influence nephron progenitor cell availability, with both caloric restriction and protein deprivation leading to reduced cell numbers through apoptosis. In this study, we evaluate the consequences of inducing nephron progenitor cell death on progenitor niche dynamics and on nephron endowment. Depletion of approximately 40% of nephron progenitor cells by expression of diphtheria toxin A at embryonic day 15 in the mouse results in 10-20% nephron reduction in the neonatal period. Analysis of cell numbers within the progenitor cell pool following induction of apoptosis reveals a compensatory response in which surviving progenitor cells increase their proliferation and replenish the niche. The proliferative response is temporally associated with infiltration of macrophages into the nephrogenic zone. Colony stimulating factor 1 (CSF1 has a mitogenic effect on nephron progenitor cells, providing a potential explanation for the compensatory proliferation. However, CSF1 also promotes interstitial cell proliferation, and the compensatory response is associated with interstitial expansion in recovering kidneys which can be pharmacologically inhibited by treatment with clodronate liposomes. Our findings suggest that the fetal kidney employs a macrophage-dependent compensatory regenerative mechanism to respond to acute injury caused by death of nephron progenitor cells, but that this regenerative response is associated with neonatal interstitial expansion.

  11. 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.

  12. Number of deaths due to lung diseases: How large is the problem?

    International Nuclear Information System (INIS)

    Wagener, D.K.

    1990-01-01

    The importance of lung disease as an indicator of environmentally induced adverse health effects has been recognized by inclusion among the Health Objectives for the Nation. The 1990 Health Objectives for the Nation (US Department of Health and Human Services, 1986) includes an objective that there should be virtually no new cases among newly exposed workers for four preventable occupational lung diseases-asbestosis, byssinosis, silicosis, and coal workers' pneumoconiosis. This brief communication describes two types of cause-of-death statistics- underlying and multiple cause-and demonstrates the differences between the two statistics using lung disease deaths among adult men. The choice of statistic has a large impact on estimated lung disease mortality rates. The choice of statistics also may have large effect on the estimated mortality rates due to other chromic diseases thought to be environmentally mediated. Issues of comorbidity and the way causes of death are reported become important in the interpretation of these statistics. The choice of which statistic to use when comparing data from a study population with national statistics may greatly affect the interpretations of the study findings

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

    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

    2016-10-05

    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

  14. Deaths due to abuse of dextromethorphan sold over-the-counter in Pakistan

    Directory of Open Access Journals (Sweden)

    Humera Shafi

    2016-09-01

    Full Text Available Dextromethorphan is the most commonly used over-the-counter anti-tussive and expectorant medicine at therapeutic doses. Due to easy availability, euphoric high and hallucinogenic effects at larger doses, dextromethorphan popularity amongst the drug abusers is growing day by day. It is often mixed with alcohol, opiates, cannabinoids or other drugs of abuse for recreational purposes despite their lethal synergistic effects. More than 50 deaths were reported the first time in Pakistan after consuming cough syrups containing dextromethorphan, manufactured by two local pharmaceutical industries. All deceased had the history of drug abuse. We report the deaths of nineteen males, ages ranged from 17 to 45 years, in two major cities of Pakistan who purposefully ingested large doses of dextromethorphan for recreational purposes and died as a result of direct toxic effects of the drug. Toxicological analysis revealed high levels of dextromethorphan ranging from 7.3 to 41.7 mg/L in the peripheral blood, 4.2–92.6 mg/kg in the liver and 9.9–349.6 mg/L in the gastric content by high performance liquid chromatography. The dextromethorphan concentrations in all subjects significantly exceeded the therapeutic range and were consistent with concentrations reported in other cases of dextromethorphan abuse and toxicity. Besides dextromethorphan other drugs of abuse like cannabinoids, opiates, benzodiazepines, ethanol and chlorpheniramine were also detected. The cause of death was determined to be acute dextromethorphan intoxication with lethal synergistic effect of other co-ingested drugs of abuse. The deaths resulted in the prosecution of all individuals involved in manufacturing, distribution or sale of the cough syrup.

  15. International comparisons of preterm birth: higher rates of late preterm birth are associated with lower rates of stillbirth and neonatal death.

    Science.gov (United States)

    Lisonkova, S; Sabr, Y; Butler, B; Joseph, K S

    2012-12-01

    To examine international rates of preterm birth and potential associations with stillbirths and neonatal deaths at late preterm and term gestation. Ecological study. Canada, USA and 26 countries in Europe. All deliveries in 2004. Information on preterm birth (Statistics Canada, the EURO-PERISTAT project and the National Center for Health Statistics. Pearson correlation coefficients and random-intercept Poisson regression were used to examine the association between preterm birth rates and gestational age-specific stillbirth and neonatal death rates. Rate ratios with 95% confidence intervals were estimated after adjustment for maternal age, parity and multiple births. Stillbirths and neonatal deaths ≥ 32 and ≥ 37 weeks of gestation. International rates of preterm birth (births. Preterm birth rates at 32-36 weeks were inversely associated with stillbirths at ≥ 32 weeks (adjusted rate ratio 0.94, 95% CI 0.92-0.96) and ≥ 37 weeks (adjusted rate ratio 0.88, 95% CI 0.85-0.91) of gestation and inversely associated with neonatal deaths at ≥ 32 weeks (adjusted rate ratio 0.88, 95% CI 0.85-0.91) and ≥ 37 weeks (adjusted rate ratio 0.82, 95% CI 0.78-0.86) of gestation. Countries with high rates of preterm birth at 32-36 weeks of gestation have lower stillbirth and neonatal death rates at and beyond 32 weeks of gestation. Contemporary rates of preterm birth are indicators of both perinatal health and obstetric care services. © 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.

  16. Lung abscess due to non-tuberculous, non-Mycobacterium fortuitum in a neonate.

    Science.gov (United States)

    Glatstein, Miguel; Scolnik, Dennis; Bensira, Liat; Domany, Keren Armoni; Shah, Mansi; Vala, Snehal

    2012-10-01

    Although Mycobacterium fortuitum (MF) is a non-tuberculous mycobacterium that rarely causes disease, there are reported cases of pneumonia, lung abscess, and empyema in subjects with predisposing lung disease. We report a neonate, without predisposing disease or risk factors, who manifested pneumonia and lung abscess. The patient was initially treated with amoxicillin-clavulanic acid and gentamycin, and subsequently with piperazilin, tazobactam, and vancomycin when there was no improvement. Pleural nodules were detected on computed tomography, and microbiology revealed MF in the absence of other pathogens and a week later the organism was identified in culture as MF, confirmed on four separate samples. The MF was sensitive to amikacin and clarithromycin and the patient was continued on oral clarithromycin for two more weeks until full recovery. To our knowledge, this is the first reported case of MF abscess in a neonate. MF should be sought in similar patients, especially when microbiology fails to detect the usual pathogens, and when the clinical picture is unclear. Copyright © 2012 Wiley Periodicals, Inc.

  17. Lack of mitochondrial trifunctional protein in mice causes neonatal hypoglycemia and sudden death

    OpenAIRE

    Ibdah, Jamal A.; Paul, Hyacinth; Zhao, Yiwen; Binford, Scott; Salleng, Ken; Cline, Mark; Matern, Dietrich; Bennett, Michael J.; Rinaldo, Piero; Strauss, Arnold W.

    2001-01-01

    Mitochondrial trifunctional protein (MTP) is a hetero-octamer of four α and four β subunits that catalyzes the final three steps of mitochondrial long chain fatty acid β-oxidation. Human MTP deficiency causes Reye-like syndrome, cardiomyopathy, or sudden unexpected death. We used gene targeting to generate an MTP α subunit null allele and to produce mice that lack MTP α and β subunits. The Mtpa–/– fetuses accumulate long chain fatty acid metabolites and have low birth weight compared with the...

  18. Mothers’ access to supportive hospital services after the loss of a baby through stillbirth or neonatal death

    Directory of Open Access Journals (Sweden)

    J Conry

    2008-11-01

    Full Text Available Every year, 3-5% of pregnant mothers in South Africa lose their babies to a stillbirth or neonatal death. These mothers need adequate services to prevent complications in their grieving process. Most of these babies are lost in hospital settings, so the treatment medical staff provide is vital. This study examined mothers’ experiences of accessing hospital, religious, formal and social services after a stillbirth or neonatal death. An exploratory research design was used to conduct applied research. A semi-structured interview schedule was used with a sample of 15 mothers who had lost a baby in the last 5 years. The findings were analysed quantitatively and qualitatively. The primary focus of this article is the quantitative findings relating to hospital services. The sample was small and these results cannot be generalised, but some conclusions are reached and recommendations are made to service providers in hospitals working with mothers who have lost babies. Mothers generally experienced the support services from hospitals as inadequate, compared to what hospitals could offer. Mothers that receive support after the loss of a baby generally cope better. This support thus assists them in the grieving process. Hospital staff can be trained to provide these services. Opsomming In Suid-Afrika verloor 3-5% swanger moeders hulle babas deur stilgeboorte of neonatale dood. Hierdie moeders benodig voldoende dienste om komplikasies in die rouproses te verhoed. Die behandeling deur mediese personeel is uiters belangrik omdat die meeste van dié babas in ‘n hospitaalopset sterf. Hierdie studie het moeders se ervarings van die toeganklikheid van hospitaal-, godsdienstige, formele en sosiale dienste na die dood van hulle babas deur stilgeboorte of neonatale dood ondersoek. Toegepaste navorsing is met behulp van ‘n verkennende navorsingsontwerp gedoen. ‘n Semi-gestruktureerde onderhoudskedule is gebruik met ‘n steekproef van 15 moeders wat hulle

  19. Occurrence of neonatal and postnatal mortality in range beef cattle. II. Factors contributing to calf death.

    Science.gov (United States)

    Bellows, R A; Patterson, D J; Burfening, P J; Phelps, D A

    1987-11-01

    Results are summarized of necropsy findings from 798 calves lost from birth to weaning over a 15-yr period. Autopsies determined cause of death and ascertained anatomical normalcy of the skeletal, musculature and organ systems and functinal status of the lungs. Of the 798 calves, 77.7% were anatomically normal and 22.3% were abnormal (P Conium maculatum) during gestation. Twelve calves died from peritonitis resulting from a perforated abomasal ulcer caused by accumulated hair. Of the 373 dystocia deaths in anatomically normal calves, 121 (32.4%) involved abnormal presentation, with calves involved in backward or breech presentation accounting for 62.0% of the losses from abnormal presentation. Calves experiencing hiplock or retained forelimb were heavier (P < 0.05) than calves presented in normal, back-ward or breech positions. Dystocia scores were assigned to 253 calves dying at parturition. Percentage losses within score were 52.6, 6.7, 30.8 and 9.9 (P < 0.05) and birth weights were 33.9, 36.1, 39.2 and 37.4 kg (P < 0.05) for scores of 1, 2, 3 and 4, respectively.

  20. The Effect of Body Position on Pain Due to Nasal Continuous Positive Airway Pressure (CPAP in Premature Neonates: A Cross-Over Clinical Trial Study

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    Mahnaz Jabraeili

    2018-01-01

    Full Text Available Background The most common cause of admission to neonatal intensive care units (NICU is respiratory distress syndrome. One of the respiratory assistance methods is using nasal continuous positive airway pressure (CPAP. Regarding the importance of pain control which is one of the major priorities in neonatal nursing care, this study aimed to evaluate the effect of body position on pain due to nasal CPAP in premature neonates. Materials and Methods In this cross-over clinical trial, 50 premature neonates who were receiving nasal CPAP admitted to the NICU of Imam Reza Hospital, Kermanshah, Iran, were included. The neonates were randomly placed at three body positions (fetal, supine, and prone positions. Pain was measured by Astrid Lindgren Children’s Hospital Pain Scale Neonates (ALPS-Neo pain assessment scale. The collected data were analyzed using the SPSS software (Version 22.0. Results Significant difference existed regarding pain of nasal CPAP among body positions (p< 0.001. Mean (SD pain was 5.15 (0.822 in fetal position, 6.260 (0.747 in prone position and 7.326 (0.792 in supine position. Conclusion Body positioning in premature neonates under nasal CPAP in NICU can be effective as a non-pharmacologic method in alleviating pain due to nasal CPAP. Among the studied positions, the lowest pain score was seen in fetal position.

  1. How do we reduce maternal deaths due to puerperal sepsis in ...

    African Journals Online (AJOL)

    Puerperal sepsis remains one of the leading causes of maternal deaths in South Africa and a large number of these deaths are avoidable. The National Committee on Confidential Enquiry into Maternal Deaths (NCCEMD) identified these avoidable factors which included missed diagnoses, lack of appreciation of the ...

  2. [Deaths due to non-AIDS diseases among HIV infected patients: A 14-year study (1998-2011)].

    Science.gov (United States)

    López, Cristina; Masiá, Mar; Padilla, Sergio; Aquilino, Ana; Bas, Cristina; Gutiérrez, Félix

    2016-04-01

    The objective of this study was to analyze the deaths caused by non-AIDS diseases in a cohort of HIV-infected patients treated between 1998 and 2011. Information on the causes of death was collected retrospectively, and then classified according to the deaths code (CoDe) algorithm. Patient characteristics and causes of death were compared for two periods: 1998-2004 and 2005-2011. A total of 159 out of the 1070 patients cared for in study period died, 56 (35%) due to AIDS events and 86 (54%) due to non-AIDS events (NAEs); in 17 (11%) the cause of death could not be determined. Overall, the main causes of death were infections (32%), cancer (17%), and unnatural deaths (17%). There was lower mortality from AIDS-related conditions during the second period (18.5% vs 47%; Pcauses of death in patients with HIV. In recent years the majority of deceased patients are on ART and with virological suppression. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  3. "These are not good things for other people to know": how rural Tanzanian women's experiences of pregnancy loss and early neonatal death may impact survey data quality.

    Science.gov (United States)

    Haws, Rachel A; Mashasi, Irene; Mrisho, Mwifadhi; Schellenberg, Joanna Armstrong; Darmstadt, Gary L; Winch, Peter J

    2010-11-01

    Little research in low-income countries has compared the social and cultural ramifications of loss in childbearing, yet the social experience of pregnancy loss and early neonatal death may affect demographers' ability to measure their incidence. Ninety-five qualitative reproductive narratives were collected from 50 women in rural southern Tanzania who had recently suffered infertility, miscarriage, stillbirth or early neonatal death. An additional 31 interviews with new mothers and female elders were used to assess childbearing norms and social consequences of loss in childbearing. We found that like pregnancy, stillbirth and early neonatal death are hidden because they heighten women's vulnerability to social and physical harm, and women's discourse and behaviors are under strong social control. To protect themselves from sorcery, spiritual interference, and gossip--as well as stigma should a spontaneous loss be viewed as an induced abortion--women conceal pregnancies and are advised not to mourn or grieve for "immature" (late-term) losses. Twelve of 30 respondents with pregnancy losses had been accused of inducing an abortion; 3 of these had been subsequently divorced. Incommensurability between Western biomedical and local categories of reproductive loss also complicates measurement of losses. Similar gender inequalities and understandings of pregnancy and reproductive loss in other low-resource settings likely result in underreporting of these losses elsewhere. Cultural, terminological, and methodological factors that contribute to inaccurate measurement of stillbirth and early neonatal death must be considered in designing surveys and other research methods to measure pregnancy, stillbirth, and other sensitive reproductive events. Copyright © 2010 Elsevier Ltd. All rights reserved.

  4. Suicidal Death due to Organophosphorus Compound Poisoning ─ an Experience of 67 Cases

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    Nashid Tabassum Khan

    2016-05-01

    Full Text Available Background: Bangladesh is an agro-based country. Suicide by agrochemical compounds are increasing day by day in this country. Organophosphorus compounds (OPC are commonly used for suicide. Mostly these are used for suicidal purpose in rural areas in our country due to low cost, toxicity and availability. Objective: To find out the relationship of age and sex variation along with the causes that influenced different income group people to ingest OPC for committing suicide. Materials and Methods: This study was conducted in the Department of Forensic Medicine, Dhaka Medical College during January to December 2010. Data were collected at the time of autopsy and from postmortem examination report of viscera. Viscera were preserved and sent to the Chief Chemical Examiner’s Office, Dhaka for toxicological analysis. Results: In this study, middle aged subjects (20–30 years were found to commit suicide using OPC in comparison to other age groups. Among the cases male were 57% and female 43%. Poverty was found as the most common cause (20% of OPC poisoning. Conclusion: Poverty is the leading cause of death of OPC poisoning followed by failure in love and adultery. Business failure, unhappiness in conjugal life, demand for dowry and violence against women are other causes to commit suicide by OPC.

  5. Diphtheria Toxin-Induced Cell Death Triggers Wnt-Dependent Hair Cell Regeneration in Neonatal Mice.

    Science.gov (United States)

    Hu, Lingxiang; Lu, Jingrong; Chiang, Hao; Wu, Hao; Edge, Albert S B; Shi, Fuxin

    2016-09-07

    Cochlear hair cells (HCs), the sensory cells that respond to sound, do not regenerate after damage in adult mammals, and their loss is a major cause of deafness. Here we show that HC regeneration in newborn mouse ears occurred spontaneously when the original cells were ablated by treatment with diphtheria toxin (DT) in ears that had been engineered to overexpress the DT receptor, but was not detectable when HCs were ablated in vivo by the aminoglycoside antibiotic neomycin. A variety of Wnts (Wnt1, Wnt2, Wnt2b, Wnt4, Wnt5a, Wnt7b, Wnt9a, Wnt9b, and Wnt11) and Wnt pathway component Krm2 were upregulated after DT damage. Nuclear β-catenin was upregulated in HCs and supporting cells of the DT-damaged cochlea. Pharmacological inhibition of Wnt decreased spontaneous regeneration, confirming a role of Wnt signaling in HC regeneration. Inhibition of Notch signaling further potentiated supporting cell proliferation and HC differentiation that occurred spontaneously. The absence of new HCs in the neomycin ears was correlated to less robust Wnt pathway activation, but the ears subjected to neomycin treatment nonetheless showed increased cell division and HC differentiation after subsequent forced upregulation of β-catenin. These studies suggest, first, that Wnt signaling plays a key role in regeneration, and, second, that the outcome of a regenerative response to damage in the newborn cochlea is determined by reaching a threshold level of Wnt signaling rather than its complete absence or presence. Sensory HCs of the inner ear do not regenerate in the adult, and their loss is a major cause of deafness. We found that HCs regenerated spontaneously in the newborn mouse after diphtheria toxin (DT)-induced, but not neomycin-induced, HC death. Regeneration depended on activation of Wnt signaling, and regeneration in DT-treated ears correlated to a higher level of Wnt activation than occurred in nonregenerating neomycin-treated ears. This is significant because insufficient

  6. Causes of Death, other than that due to Prostatic Cancer, in Males ...

    African Journals Online (AJOL)

    This consisted of hypertensive heart disease, coronary artery disease and cardiomyopathy. Next were the violent death/unnatural death group (24.1%) which included severe head injury following road traffic accident, gunshot injury, burns, electrocution, traumatic rupture of the spleen with associated liver rupture during ...

  7. Fatores de risco para óbito em unidade de terapia intensiva neonatal, utilizando a técnica de análise de sobrevida Risk factors for neonatal death in neonatal intensive care unit according to survival analysis

    Directory of Open Access Journals (Sweden)

    Susana de Paula Risso

    2010-03-01

    Full Text Available OBJETIVO: Identificar fatores de risco associados ao óbito de recém-nascidos internados na unidade de terapia intensiva neonatal do Hospital Universitário de Taubaté, SP. MÉTODOS: É um estudo longitudinal com informações obtidas dos prontuários dos recém-nascidos internados na unidade de terapia intensiva neonatal, do Hospital Universitário da Universidade de Taubaté. A variável dependente foi o tipo de desfecho: alta ou óbito. As variáveis independentes foram variáveis maternas e gestacionais: idade materna, hipertensão, diabetes, terapia com corticóide e parto; variáveis do recém-nascido: peso ao nascer, duração da gestação, escore de Apgar no primeiro e quinto minutos de vida, nascimento múltiplo, malformações congênitas e sexo; variáveis relativas à internação: relato de ventilação mecânica, ventilação pressão positiva, relato de nutrição parenteral prolongada, sepse, entubação, massagem cardíaca, fototerapia, doença da membrana hialina, oxigênioterapia, tempo de internação e fração inspirada de oxigênio. Foi construído um modelo de forma hierarquizada em três níveis para análise de sobrevida, através do modelo de Cox; o programa computacional utilizado foi o Stata v9 e permaneceram no modelo final as variáveis com pOBJECTIVE: To identify risk factors associated with death of infants admitted to neonatal intensive care unit of Taubaté University Hospital. METHODS: It is a longitudinal study with information obtained from medical records of newborns admitted to the neonatal intensive care unit of Taubaté University Hospital. Type of outcome, discharge or death, was dependent variable. The independent variables were maternal and gestational variables: maternal age, hypertension, diabetes, corticosteroid therapy and delivery; variables of the newborn: birth weight, gestation length, Apgar score in the first and fifth minutes of life, multiple birth, congenital malformations and sex

  8. No Geographic Correlation between Lyme Disease and Death Due to 4 Neurodegenerative Disorders, United States, 2001-2010.

    Science.gov (United States)

    Forrester, Joseph D; Kugeler, Kiersten J; Perea, Anna E; Pastula, Daniel M; Mead, Paul S

    2015-11-01

    Associations between Lyme disease and certain neurodegenerative diseases have been proposed, but supportive evidence for an association is lacking. Similar geographic distributions would be expected if 2 conditions were etiologically linked. Thus, we compared the distribution of Lyme disease cases in the United States with the distributions of deaths due to Alzheimer disease, amyotrophic lateral sclerosis (ALS), multiple sclerosis (MS), and Parkinson disease; no geographic correlations were identified. Lyme disease incidence per US state was not correlated with rates of death due to ALS, MS, or Parkinson disease; however, an inverse correlation was detected between Lyme disease and Alzheimer disease. The absence of a positive correlation between the geographic distribution of Lyme disease and the distribution of deaths due to Alzheimer disease, ALS, MS, and Parkinson disease provides further evidence that Lyme disease is not associated with the development of these neurodegenerative conditions.

  9. Hospitalizations and deaths due to pertussis in children from 1996 to 2013

    Directory of Open Access Journals (Sweden)

    Janayne F. Mançaneira

    2016-01-01

    Conclusions: There was a substantial increase in hospitalizations and deaths from pertussis in children for three consecutive years (2011, 2012, and 2013 in all Brazilian regions. The most affected age group was that of children younger than one year.

  10. [Update on congenital and neonatal herpes infections: infection due to cytomegalovirus and herpes simplex].

    Science.gov (United States)

    Baquero-Artigao, F

    2017-05-17

    Newborn infants are a population which is especially susceptible to viral infections that frequently affect the central nervous system. Herpes infections can be transmitted to the foetus and to the newborn infant, and give rise to severe clinical conditions with long-term sensory and cognitive deficits. Two thirds of newborn infants with encephalitis due to herpes simplex virus and half of the children with symptomatic congenital infection by cytomegalovirus develop sequelae, which results in high community health costs in the long term. Fortunately, the better knowledge about these infections gained in recent years together with the development of effective antiviral treatments have improved the patients' prognosis. Valganciclovir (32 mg/kg/day in two doses for six months) prevents the development of hypoacusis and improves the neurological prognosis in symptomatic congenital infection due to cytomegalovirus. Acyclovir (60 mg/kg/day in three doses for 2-3 weeks) prevents the development of severe forms in skin-eyes-mouth herpes disease, and lowers the rate of mortality and sequelae when the disease has disseminated and is located in the central nervous system.

  11. The disease related deaths due to differentiated thyroid carcinomas treated multidisciplinary, including radioiodine

    International Nuclear Information System (INIS)

    Stefanovic, Lj.; Kermeci, K.; Malesevic, M.; Mihailovic, J.; Srbovan, D.; Popadic, S.

    2002-01-01

    Aim: To analyse the disease related deaths of differentiated thyroid carcinoma (DTC) patients treated multidisciplinary, including radioiodine. Patients and Methods: 364 DTC patients were treated from 1977 to the end of 2000. All patients were operated, treated by radioiodine and by hormonal therapy, external radiotherapy was applied in 22 and chemotherapy in 6 of them. 54 treated patients were lost from the follow-up. The course of disease and outcomes are known in 310 patients, among them 53 patients died. The disease related deaths occurred in 33 (10.6%) patients. Results: Between 33 patients whose deaths were in relation with DTC the disease progression was the cause of deaths in 30 (9.7% of treated) patients (the locoregional disease in 10, distant metastases /M1/ in 17, locoregional disease + M1 in 3 patients). From the late complications of treatment died 3 (1%) patients (all of them were in complete remission to the deaths). The mean survival of these 33 patients from the diagnosis to the end of the life was 6.9 years, median 5.1 years, range 2 months to 23.9 years. The five years survived 54.6% of them, 10 years 21.2% and more than 20 years 3%. M1 had 72.7% of patients (lung and/or bone M1 were present in 91.7% of them), N1 had 69.7% and in 30.3% local tumor was T4. In relation to all treated patients died 14.6% men compared to 9% women (p<0.05), 15.7% of patients 45 years old or older compared to 4.4% of younger then 45 years (p<0.001) and 21.3% of patients with follicular type of DTC compared to 7.3% with papillary type (p<0.001). From all patients without radioiodine accumulation in tumor tissue died 60%. Conclusion: The DTC related deaths were the consequence of M1 and less frequently the result of locoregional disease (T4 and/or N1) in about 1/10 of all treated patients. The deaths as result of the late complications of treatment were exceptional. The deaths were significantly more frequent between males, patients 45 years old or older and patients

  12. An autopsy study of death due to Suicidal Hanging – 264 cases

    Directory of Open Access Journals (Sweden)

    Dinesh Rao

    2016-09-01

    Full Text Available The present study was carried out between 2010 and 2013, a total of 7968 Autopsies were conducted of which 3.31% (n – 264 cases were deaths due to hanging. The most preferred ligature materials were Stole (n – 79 and Bed spread/Sari (n – 68. In 88% of the cases, hanging was complete. Females (n – 136 and males (n – 128 were equally affected. The major age group involved in both the sexes was of 31–40 years, contributing to 50.76% (n – 136 of the self suspension. In 80.58% (n – 213 of the incidents, ligature mark showed discontinuity (incomplete. A Slip type of knot was used in majority of the noose, contributing to 97.73% (n – 258 of the suspensions. In 87.88% (n – 232 of hanging an oblique shaped ligature mark was noticed. The horizontal and near oblique ligature marks were seen only in cases of partial suspension. In 95.45% (n – 252 of the cases, the ligature mark showed blackening of the skin (friction burn. Only 4.54% (n – 12 showed intact skin. The outer layer of the skin over the ligature mark showed displacement in majority of the cases. Married victims contributed to 70.45% of cases. Domestic issues were the commonest reason (n – 82 for self suspension, of which female (n – 68 formed the majority of victims. In 70.83% (n – 187 of cases damage to neck muscle fibers and hemorrhage at the Sternal end of the Sternocleidomastoid muscle were present. In 85.61% (n – 226 of cases the cervical vertebra was intact. In 52.27% (n – 138 of the cases the internal carotid artery showed transverse tear. In 99.42% (n – 248 cases the thyroid cartilage was found intact. The hyoid bone was damaged in 6.06% (n – 16 of the victims. Majority of the victims, 59.09% (n – 156 belonged to low socioeconomic class.

  13. "Tampering to Death": A Fatal Codeine Intoxication Due to a Homemade Purification of a Medical Formulation.

    Science.gov (United States)

    Fais, Paolo; Pigaiani, Nicola; Cecchetto, Giovanni; Montisci, Massimo; Gottardo, Rossella; Viel, Guido; Pascali, Jennifer Paola; Tagliaro, Franco

    2017-11-01

    Many homemade tamper processes of medical codeine formulations are available on selected "forums" on the Internet, where recreational codeine users claim to be able to purify codeine by removing additives, such as acetaminophen, to avoid or limit adverse effects. In this work, it is reported and discussed a fatal case of codeine intoxication. The findings of objects such as jars, filters, and tablets, and amounts of unknown liquid material at the death scene investigation suggested a fatal codeine intoxication after the tampering procedure called "cold water extraction." Toxicological results obtained from the analysis of both the nonbiological material and the body fluids of the decedent integrated with the information collected at the death scene investigation confirmed the above-mentioned hypothesis. This report underlines the importance of a tight interconnection between criminalistics and legal medicine to strengthen the identification of the cause of death and the reconstruction of the event. © 2017 American Academy of Forensic Sciences.

  14. Morbilidad y mortalidad por sepsis neonatal en un hospital de tercer nivel de atención Morbidity and mortality due to neonatal sepsis in a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Miguel Angel Rodríguez-Weber

    2003-04-01

    significant risk factors for death. CONCLUSIONS: Epidemiological, clinical, laboratory, and microbiological variables are significant predictors of death in newborns with neonatal sepsis.

  15. Perfis de mortalidade neonatal precoce: um estudo para uma Maternidade Pública de Belo Horizonte (MG, 2001-2006 Profiles of early neonatal deaths: a study for a Public Maternity Hospital of Belo Horizonte (MG, 2001 - 2006

    Directory of Open Access Journals (Sweden)

    Heloísa Maria de Assis

    2008-12-01

    Full Text Available Trata-se de estudo seccional, com base em dados secundários, com o objetivo de traçar o perfil dos óbitos neonatais precoces ocorridos em uma Maternidade Pública de referência no Estado de Minas Gerais (Maternidade Odete Valadares, Belo Horizonte, no período de 2001 a 2006. Foram utilizadas variáveis relacionadas ao recém-nascido (período de ocorrência do óbito, idade ao óbito, sexo, idade gestacional e peso ao nascer, à mãe (tipo de gravidez, tipo de parto, idade, parturição e número de nascidos mortos, bem como causas múltiplas de mortalidade categorizadas. Obtiveram-se três perfis de óbitos neonatais precoces por meio do método Grade of Membership, que possibilitou também encontrar a prevalência destes perfis. O Perfil 1 foi caracterizado por óbitos de difícil redução e teve prevalência de 41,4%; o Perfil 2, pelos óbitos passíveis de redução (prevalência de 28,3%; e o Perfil 3, pelos óbitos redutíveis (prevalência de 30,4%. Estes perfis possibilitaram a compreensão da mortalidade neonatal precoce na Maternidade Odete Valadares e a análise da sua relação com a história reprodutiva e obstétrica materna, bem como com as condições do recém-nascido. Chama a atenção a elevada prevalência de óbitos evitáveis, realidade que deve ser enfrentada pelos profissionais e pela rede pública de saúde.This is a cross-sectional study with the aim of describing the early neonatal deaths that took place at a Public Maternity Hospital, Maternidade Odete Valadares in Belo Horizonte, Minas Gerais, Brazil, from 2001 to 2006. It used variables related to the newborn (period the death took place, age at death, gender, gestational age, and birth weight, to the mother (type of pregnancy, type of delivery, age, parity, and number of stillborn children, and to the multiple causes of death. Three profiles of early neonatal death were obtained through the Grade of Membership method (GoM, which also made it possible to find

  16. Nearly 800,000 deaths prevented due to declines in smoking

    Science.gov (United States)

    Twentieth-century tobacco control programs and policies were responsible for preventing more than 795,000 lung cancer deaths in the United States from 1975 through 2000. If all cigarette smoking in this country had ceased following the release of the firs

  17. Sudden death in a case of catatonia due to pulmonary embolism

    Directory of Open Access Journals (Sweden)

    Archana Javadekar

    2014-01-01

    Full Text Available Catatonic syndrome carries relatively high mortality. One of the causes of death is pulmonary embolism. Prolonged immobility, dehydration, use of low-potency antipsychotic drugs, and electroconvulsive therapy (ECT increase the risk of venous thromboembolism. Evaluating the risk of catatonic patients is of paramount importance. Prevention of venous thromboembolism by reducing the risk factors and relieving catatonic symptoms early is essential.

  18. Was the death of Alexander the Great due to poisoning? Was it Veratrum album?

    Science.gov (United States)

    Schep, Leo J; Slaughter, Robin J; Vale, J Allister; Wheatley, Pat

    2014-01-01

    To investigate the death of Alexander the Great to determine if he died from natural causes or was poisoned and, if the latter, what was the most likely poison. OVID MEDLINE (January 1950-May 2013) and ISI Web of Science (1900-May 2013) databases were searched and bibliographies of identified articles were screened for additional relevant studies. These searches identified 53 relevant citations. Classical literature associated with Alexander's death. There are two divergent accounts of Alexander's death. The first has its origins in the Royal Diary, allegedly kept in Alexander's court. The second account survives in various versions of the Alexander Romance. Nature of the terminal illness. The Royal Diary describes a gradual onset of fever, with a progressive inability to walk, leading to Alexander's death, without offering a cause of his demise. In contrast, the Romance implies that members of Alexander's inner circle conspired to poison him. The various medical hypotheses include cumulative debilitation from his previous wounds, the complications of alcohol imbibing (resulting in alcohol hepatitis, acute pancreatitis, or perforated peptic ulcer), grief, a congenital abnormality, and an unhealthy environment in Babylon possibly exacerbated by malaria, typhoid fever, or some other parasitic or viral illness. Was it poisoning? Of all the chemical and botanical poisons reviewed, we believe the alkaloids present in the various Veratrum species, notably Veratrum album, were capable of killing Alexander with comparable symptoms to those Alexander reportedly experienced over the 12 days of his illness. Veratrum poisoning is heralded by the sudden onset of epigastric and substernal pain, which may also be accompanied by nausea and vomiting, followed by bradycardia and hypotension with severe muscular weakness. Alexander suffered similar features for the duration of his illness. If Alexander the Great was poisoned, Veratrum album offers a more plausible cause than arsenic

  19. Early death after feline infectious peritonitis virus challenge due to recombinant vaccinia virus immunization.

    Science.gov (United States)

    Vennema, H; de Groot, R J; Harbour, D A; Dalderup, M; Gruffydd-Jones, T; Horzinek, M C; Spaan, W J

    1990-01-01

    The gene encoding the fusogenic spike protein of the coronavirus causing feline infectious peritonitis was recombined into the genome of vaccinia virus. The recombinant induced spike-protein-specific, in vitro neutralizing antibodies in mice. When kittens were immunized with the recombinant, low titers of neutralizing antibodies were obtained. After challenge with feline infectious peritonitis virus, these animals succumbed earlier than did the control group immunized with wild-type vaccinia virus (early death syndrome). Images PMID:2154621

  20. Geographic distribution of risk of death due to homicide in Puerto Rico, 2001-2010.

    Science.gov (United States)

    Zavala-Zegarra, Diego E; López-Charneco, Magdalena; Garcia-Rivera, Enid J; Concha-Eastman, Alberto; Rodriguez, José F; Conte-Miller, María

    2012-11-01

    To raise awareness of the impact of homicides in Puerto Rico based on the findings of the spatial and temporal distribution of homicides and the use of firearms, by age and gender, using reports of interpersonal violent deaths from the Institute of Forensic Science (IFS) headquartered in San Juan, Puerto Rico. This was a descriptive study of all homicide incidents in Puerto Rico reported by the IFS for the period 2001-2010. For each of the 8 542 cases, data analyzed included age, sex, municipality of incident, date of death, and mechanism. Crude sex- and age-specific mortality rates for Puerto Rico and for each municipality per year and for the 10-year period were calculated. Cumulative rate and cumulative risks were estimated and defined as lifetime risk. The relative distribution of cumulative rates for each municipality was categorized into quartiles of highest to lowest risk and displayed as a map. The risk of homicide death among males is 13 times greater than among females. The highest rates were observed among males 20-24 years of age (198.4 homicides per 100 000). In any given year, firearms were used in at least 80% of homicides. The average lifetime risk of homicide death for males is 1 in 34. Young adult males with access to firearms are at greatest risk of homicide in Puerto Rico. Also, highly urbanized municipalities are at highest risk; however, certain non-urban municipalities along the coast also have a very high homicide risk. Top priorities should be applying the WHO "ecological model" for violent injury prevention and establishing a surveillance system that will assist in identifying the role that socioeconomics, illegal firearms trade, and drug trafficking are playing.

  1. Neonatal Death Dwarfism in a Girl with Distinctive Bone Dysplasia Compatible with Grebe Chondrodysplasia: Analysis by CT Scan-based Phenotype

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    Ali Al Kaissi

    2014-01-01

    Full Text Available We report on a female fetus noted to have severe malformative type of skeletal dysplasia on ultrasonography done at 35 weeks gestation. The girl died shortly after birth. Clinical examination showed a fetus with severe dwarfism, extensive long and short bones, and bone deficiencies associated with multiple dislocations. Computed tomography (CT scan-based phenotype showed a complex constellation of malformations consistent with the diagnosis of Grebe syndrome. Parents being first cousins (consanguineous marriage strongly suggests autosomal recessive pattern of inheritance. To our knowledge, this is the first report of neonatal death dwarfism of Grebe syndrome analyzed by CT scan-based phenotype.

  2. Neonatal Death Dwarfism in a Girl with Distinctive Bone Dysplasia Compatible with Grebe Chondrodysplasia: Analysis by CT Scan-based Phenotype.

    Science.gov (United States)

    Al Kaissi, Ali; Chehida, Farid Ben; Ganger, Rudolf; Grill, Franz

    2014-01-01

    We report on a female fetus noted to have severe malformative type of skeletal dysplasia on ultrasonography done at 35 weeks gestation. The girl died shortly after birth. Clinical examination showed a fetus with severe dwarfism, extensive long and short bones, and bone deficiencies associated with multiple dislocations. Computed tomography (CT) scan-based phenotype showed a complex constellation of malformations consistent with the diagnosis of Grebe syndrome. Parents being first cousins (consanguineous marriage) strongly suggests autosomal recessive pattern of inheritance. To our knowledge, this is the first report of neonatal death dwarfism of Grebe syndrome analyzed by CT scan-based phenotype.

  3. A comparison of physicians and medical assistants in interpreting verbal autopsy interviews for allocating cause of neonatal death in Matlab, Bangladesh: can medical assistants be considered an alternative to physicians?

    Science.gov (United States)

    2010-01-01

    Objective This study assessed the agreement between medical physicians in their interpretation of verbal autopsy (VA) interview data for identifying causes of neonatal deaths in rural Bangladesh. Methods The study was carried out in Matlab, a rural sub-district in eastern Bangladesh. Trained persons conducted the VA interview with the mother or another family member at the home of the deceased. Three physicians and a medical assistant independently reviewed the VA interviews to assign causes of death using the International Classification of Diseases - Tenth Revision (ICD-10) codes. A physician assigned cause was decided when at least two physicians agreed on a cause of death. Cause-specific mortality fraction (CSMF), kappa (k) statistic, sensitivity, specificity, and positive predictive values were applied to compare agreement between the reviewers. Results Of the 365 neonatal deaths reviewed, agreement on a direct cause of death was reached by at least two physicians in 339 (93%) of cases. Physician and medical assistant reviews of causes of death demonstrated the following levels of diagnostic agreement for the main causes of deaths: for birth asphyxia the sensitivity was 84%, specificity 93%, and kappa 0.77. For prematurity/low birth weight, the sensitivity, specificity, and kappa statistics were, respectively, 53%, 96%, and 0.55, for sepsis/meningitis they were 48%, 98%, and 0.53, and for pneumonia they were 75%, 94%, and 0.51. Conclusion This study revealed a moderate to strong agreement between physician- assigned and medical assistant- assigned major causes of neonatal death. A well-trained medical assistant could be considered an alternative for assigning major causes of neonatal deaths in rural Bangladesh and in similar settings where physicians are scarce and their time costs more. A validation study with medically confirmed diagnosis will improve the performance of VA for assigning cause of neonatal death. PMID:20712906

  4. An epidemiology of homicidal deaths due to rifled firearms in Peshawar Pakistan.

    Science.gov (United States)

    Marri, Murad Zafar; Bashir, Muhammad Zahid

    2010-02-01

    To determine the pattern of homicidal deaths caused by rifled weapons in Peshawar as regards the parameters of age, gender, place of occurrence and the number and location of injuries on the body. Descriptive study. The study was conducted at the Department of Forensic Medicine and Toxicology, Khyber Medical College, Peshawar, from June 2005 to February 2006. The subjects were selected from victims presenting for autopsy at the Department of Forensic Medicine and Toxicology, Khyber Medical College, Peshawar. One hundred cases were selected where the weapon of offence was a rifled weapon and the manner of death was homicide on the basis of the police inquest, the autopsy and an interview with the relatives of the victim. After the autopsy, the findings were tabulated and analyzed. Homicides predominantly occurred in young males residing in a rural locality. The peak incidence was between 20-29 years in males and in females the age group most prone was 30-39 years. Male to female ratio was 6:1. The chest (33.8%) followed by the head and abdomen were the areas primarily targeted. High velocity automatic weapons are primarily being used to kill young people in rural areas. Prevention can be through strict gun control laws coupled with education and awareness.

  5. [Deaths due to motorcycle accidents and their association with variables related to social reproduction in a northeastern Brazilian state].

    Science.gov (United States)

    Silva, Paul Hindenburg Nobre de Vasconcelos; Lima, Maria Luiza Carvalho; Souza, Wayner Vieira; Moreira, Rafael da Silveira; Oliveira, Fernando José Moreira

    2015-09-01

    The objective of this article was to identify the association between motorcycle deaths and variables related to Samaja's theory of social reproduction in the period 2000-2005 in the state of Pernambuco. An ecological, case-control study was carried out, with municipalities as the unit of analysis. Cases were defined as the 20% of municipalities with the highest local empirical Bayesian coefficients for mortality due to motorcycle accidents, and controls as the 40% with the lowest coefficients. The municipalities with the greatest chances of high coefficients for mortality due to motorcycle accidents showed high population growth factors and increases in the total fleet of motorcycles, with low population densities, low GDP per capita, and more than 20 motorcycles per thousand inhabitants. We conclude that the variables related to macro-policies proved to have greater force in explaining higher chances of motorcycle death.

  6. Fatores de risco para óbitos neonatais no Recife: um estudo caso-controle Risk factors for neonatal death in Recife: a case-control study

    Directory of Open Access Journals (Sweden)

    Sílvia W. Sarinho

    2001-08-01

    Full Text Available OBJETIVOS: a mortalidade neonatal é o componente mais importante da mortalidade infantil na cidade do Recife. Este estudo teve como objetivo determinar os principais fatores de risco para morte neonatal no município do Recife em 1995. MÉTODOS: o desenho do estudo foi do tipo caso-controle. Realizou-se a validação dos bancos de dados do Sistema de Informação em Mortalidade e Sistema de Informação Nascido Vivo, para mães residentes no Recife, no ano de 1995. Obteve-se, após técnica do linkage entre os dois bancos de dados, amostra com 456 casos e 2.280 controles. Como medida de risco utilizou-se Odds Ratio, com intervalo de confiança de 95% e para a diferença de proporção, o teste qui quadrado. Utilizou-se na análise multivariada a técnica da regressão logística. RESULTADOS: verificou-se que 358 (79,7% das crianças que evoluíram para óbito foram de baixo peso ao nascer, com risco de morte 46 vezes superior (IC=33,8-59,0 P 2.500g. Por ordem decrescente de valores da medida de associação de morte neonatal com as variáveis estudadas através da análise multivariada, os principais fatores de risco foram peso ao nascer OBJECTIVE: Neonatal mortality is the main cause of infant mortality in the city of Recife. The objective of the present study was to determine the major risk factors for neonatal death in Recife in 1995. METHODS: This is a case control study. Information was obtained from the mortality and live birth databases after validation of the data set, between January and December 1995. A sample of 456 cases and 2,280 controls was obtained after using the linkage technique between the two data sets. The difference in proportion was analyzed by the chi square test. The odds ratio was calculated as a risk measure, with a 95% confidence interval. The logistic regression technique was used to adjust potential confounding factors. RESULTS: 212 deaths (46.6% occurred in the first 24 hours of life. We found that 358 (79.7% of

  7. Transient neonatal myasthenia gravis due to a mother with ocular onset of anti-muscle specific kinase myasthenia gravis.

    Science.gov (United States)

    Lee, Ju-Yeun; Min, Ju-Hong; Han, Sueng-Han; Han, Jinu

    2017-07-01

    We describe a 27-year-old pregnant female with new onset of conjugate gaze deficit during the third trimester of pregnancy. Repetitive nerve stimulation tests, neostigmine tests, and acetylcholine receptor antibody assays were all negative. The patient delivered a normal healthy baby at a local clinic via cesarean section. The baby became hypotonic and had respiratory failure several minutes after birth. The result of acetylcholine receptor antibody was negative in the neonate. The neonate became healthy spontaneously and was extubated after 21 days of ventilation care. Two months after delivery, the mother developed ptosis and generalized symptoms and subsequent workup revealed she was muscle specific kinase (MuSK) antibody positive. The neonate was presumed to have an anti-MuSK-mediated transient neonatal myasthenia gravis. Although MuSK antibody testing is rarely indicated in ocular myasthenia gravis, MuSK antibody testing is necessary in pregnant women who are presumed ocular myasthenia gravis to warn occurrence of transient neonatal myasthenia gravis. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Trends and risk factors of stillbirths and neonatal deaths in Eastern Uganda (1982-2011): a cross-sectional, population-based study.

    Science.gov (United States)

    Kujala, Sanni; Waiswa, Peter; Kadobera, Daniel; Akuze, Joseph; Pariyo, George; Hanson, Claudia

    2017-01-01

    To identify mortality trends and risk factors associated with stillbirths and neonatal deaths 1982-2011. Population-based cross-sectional study based on reported pregnancy history in Iganga-Mayuge Health and Demographic Surveillance Site (HDSS) in Uganda. A pregnancy history survey was conducted among women aged 15-49 years living in the HDSS during May-July 2011 (n = 10 540). Time trends were analysed with cubic splines and linear regression. Potential risk factors were examined with multilevel logistic regression with adjusted odds ratios (AOR) and 95% confidence intervals (CI). 34 073 births from 1982 to 2011 were analysed. The annual rate of decrease was 0.9% for stillbirths and 1.8% for neonatal mortality. Stillbirths were associated with several risk factors: multiple births (AOR 2.57, CI 1.66-3.99), previous adverse outcome (AOR 6.16, CI 4.26-8.88) and grand multiparity among 35- to 49-year-olds (AOR 1.97, CI 1.32-2.89). Neonatal deaths were associated with multiple births (AOR 6.16, CI 4.80-7.92) and advanced maternal age linked with parity of 1-4 (AOR 2.34, CI 1.28-4.25) and grand multiparity (AOR 1.44, CI 1.09-1.90). Education, marital status and household wealth were not associated with the outcomes. The slow decline in mortality rates and easily identifiable risk factors calls for improving quality of care at birth and a rethinking of how to address obstetric risks, potentially a revival of the risk approach in antenatal care. © 2016 John Wiley & Sons Ltd.

  9. Unusual death due to a bleeding from a varicose vein: a case report

    Directory of Open Access Journals (Sweden)

    Fragkouli Kleio

    2012-09-01

    Full Text Available Abstract Background Varicose veins are a common entity presenting a worldwide distribution. Although they are usually benign, sometimes are proved to be a threatening condition. Massive hemorrhage is an unusual complication of this common venous pathology that demands immediate medical intervention. Case presentation We present a case of a 66-year-old woman found dead in her house surrounded by a large quantity of blood. Autopsy revealed a 7 mm ulcer on the internal surface of the left lower leg communicating with a varicose vein, signs of exsanguinations and liver cirrhosis. Toxicological analysis was negative. Conclusion Massive hemorrhage from a ruptured varicosity is a severe medical emergency. Awareness of the risk of massive hemorrhage may provoke preventive treatment to be undertaken so as terminal loss of consciousness and a subsequent unattended death to be averted.

  10. An accidental death due to electric grinder: Dupatta as a strangulation hazard

    Directory of Open Access Journals (Sweden)

    Deepak Herald D′Souza

    2013-01-01

    Full Text Available Accidents could occur at home in any age group. Accidental ligature strangulation in adults could be prevented. We are reporting a case of a woman who died in her kitchen due to accidental strangulation by her dupatta while working with the electric grinder. This case highlights the need to educate the people about the safety and potential hazards of these machines.

  11. An accidental death due to electric grinder: Dupatta as a strangulation hazard

    OpenAIRE

    Deepak Herald D′Souza; Vina R Vaswani; Kishor Kumar Badiadka; Venkat Krishna Shenoy; Boban Babu

    2013-01-01

    Accidents could occur at home in any age group. Accidental ligature strangulation in adults could be prevented. We are reporting a case of a woman who died in her kitchen due to accidental strangulation by her dupatta while working with the electric grinder. This case highlights the need to educate the people about the safety and potential hazards of these machines.

  12. Two forensic autopsy cases of death due to upper gastrointestinal hemorrhage: a comparison of postmortem computed tomography and autopsy findings.

    Science.gov (United States)

    Suzuki, Hideto; Hasegawa, Iwao; Hoshino, Norio; Fukunaga, Tatsushige

    2015-05-01

    In this report, we describe two autopsy cases of death due to upper gastrointestinal hemorrhage (Case 1: gastric ulcer, Case 2: aortoduodenal fistula). Postmortem computed tomography (CT) images from both cases revealed pooling of gastric fluid, which contained high attenuation areas, although these images also mirrored the different sources of the gastrointestinal hemorrhage. Fluid collection was observed in the small intestine for both cases, although the high attenuation areas were only remarkable in Case 2. The autopsy in Case 1 revealed a peptic ulcer, with small vessels exposed on the surface of the ulcer. Melena was also observed throughout the intestine, although clotting was only observed inside the stomach. The autopsy in Case 2 revealed diffuse massive clotting from the stomach to the upper portion of the ileum, which was due to a primary aortoduodenal fistula. Given our autopsy findings, the extent of the high attenuation areas in the digestive tract during postmortem CT scanning may be correlated with the speed of the gastrointestinal hemorrhage before death. Carefully evaluating the radiodensity of the gastrointestinal contents during postmortem CT scanning may indicate the primary site of the hemorrhage before the autopsy, thereby facilitating the accurate identification of the cause of death during forensic autopsy. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  13. Perioperative period in cardiac transplantation from donors with brain death due to methanol poisoning

    Directory of Open Access Journals (Sweden)

    V. N. Poptsov

    2017-01-01

    Full Text Available The successful use of donor hearts from people died of methanol poisoning helps reducing the deficit of donor organs for patients requiring urgent cardiac transplantation [3]. We present our experience of successful cardiac transplantations from 2 donors who died due to methanol poisoning. Given the possibility of performing a cardiac transplant from this group of donors a protocol has been developed at the V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs of the Ministry of Healthcare of the Russian Federation which includes clinical, laboratory and instrumental criteria for the selection of heart donor and recipient. The possibility of delayed onset myocardial contractile dysfunction due to methanol poisoning means that a longer conditioningperiod is vital as well as compulsory clinical, laboratory and expert chocardiographic examinations of the potential donor heart.

  14. Sudden Death by Pulmonary Thromboembolism due to a Large Uterine Leiomyoma with a Parasitic Vein to the Mesentery

    Directory of Open Access Journals (Sweden)

    Varsha Podduturi

    2014-01-01

    Full Text Available The pathophysiology of venous thrombosis is classically attributed to alterations in one or more components of Virchow’s triad: hypercoagulability, stasis, and damage to the vascular endothelium. Deep vein thrombosis (DVT may lead to pulmonary thromboembolism (PE, and the latter is culpable for many deaths annually in the United States; however, DVT as a complication of uterine leiomyoma has rarely been reported. We report a case of a 57-year-old woman whose death was due to a large pedunculated subserosal leiomyoma externally compressing the pelvic veins resulting in stasis and venous thrombosis leading to fatal PE. The association of large pelvic masses with venous thrombosis has clinical implications, since prophylactic surgery could be life-saving.

  15. Are intrapartum and neonatal deaths in breech delivery at term potentially avoidable?--a blinded controlled audit

    DEFF Research Database (Denmark)

    Krebs, Lone; Langhoff-Roos, Jens; Bødker, Birgit

    2002-01-01

    -92 were studied. For each of the 12 deaths two controls matched by presentation and planned mode of delivery were selected. Eleven obstetricians assessed the care through narratives that ended when the infant was delivered to umbilicus and stated if the infant died, and whether the "possible death...

  16. 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.

  17. 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

  18. Homozygosity and risk of childhood death due to invasive bacterial disease

    Directory of Open Access Journals (Sweden)

    Williams Thomas N

    2009-06-01

    Full Text Available Abstract Background Genetic heterozygosity is increasingly being shown to be a key predictor of fitness in natural populations, both through inbreeding depression, inbred individuals having low heterozygosity, and also through chance linkage between a marker and a gene under balancing selection. One important component of fitness that is often highlighted is resistance to parasites and other pathogens. However, the significance of equivalent loci in human populations remains unclear. Consequently, we performed a case-control study of fatal invasive bacterial disease in Kenyan children using a genome-wide screen with microsatellite markers. Methods 148 cases, comprising children aged Results At five markers homozygosity was strongly associated with mortality (odds ratio range 4.7 – 12.2 with evidence of interactions between some markers. Mortality was associated with different non-overlapping marker groups in Gram positive and Gram negative bacterial disease. Homozygosity at susceptibility markers was common (prevalence 19–49% and, with the large effect sizes, this suggests that bacterial disease mortality may be strongly genetically determined. Conclusion Balanced polymorphisms appear to be more widespread in humans than previously appreciated and play a critical role in modulating susceptibility to infectious disease. The effect sizes we report, coupled with the stochasticity of exposure to pathogens suggests that infection and mortality are far from random due to a strong genetic basis.

  19. Clinical and laboratory characteristics and associated risk factors of infants hospitalized in neonatal unit due to indirect hyperbilirubinemia

    Directory of Open Access Journals (Sweden)

    Sami Hatipoğlu

    2012-03-01

    Full Text Available Objectives: The aim of this study was to investigate characteristicsof neonates hospitalized to Neonatal Unit dueto indirect hyperbilirubinemia and to determine risk factorsfor indirect hyperbilirubinemia.Materials and methods: Totally 222 newborns, aged≥35 weeks of gestational age and hospitalized in neonatalunit with indirect hyperbilirubinemia, were investigated.Physical examination and laboratory studies of childrenwere performed. Decision of phototherapy and exchangetransfusion was done according to total serum bilirubin(TSB level that notified in the Guidelines of AmericanAcademy of Pediatrics.Results: Study group consisted of 131 (60% male and91 (30% female newborns. No significant difference wasfound in TSB values between male and female neonates.There was 71.2% term and 19.8% late preterm newbornbabies. Babies born with spontaneous vaginal deliveryhad borderline higher TSB values compared with cesareansection deliveries (p=0.051. ABO blood group incompatibilitywas found in 30.1% and Rh incompatibilityin 6.7%. Insufficient nutrition and inadequate caloric intakewere found in 49 (22.7% of neonates, urinary tractinfection in 19 (8.5%, hypernatremic dehydration in 9(4.5% and hypothyroidism in 4 (2.0%. Exchange transfusionwas performed in 10 newborns and kernicterus occurredin two. A significant negative correlation was foundbetween TSB values at hospitalization and baby’s birth(p<0.05 and a positive correlation between initial TSBvalue and percent of patient weight loss (p<0.05.Conclusions: According to our results, the most frequentetiological causes of jaundice in newborns were ABOblood group incompatibility, insufficient nutrition and beinglate preterm. J Clin Exp Invest 2012; 3(1: 38-43

  20. Recurrent aborted sudden cardiac death with seizures and rhabdomyolysis due to bulimia-induced hypokalemia: report of one case.

    Science.gov (United States)

    Finsterer, Josef; Stöllberger, Claudia

    2014-06-01

    Recurrent vomiting due to bulimia associated with abuse of furosemide and laxatives causing severe hypokalemia may result in recurrent aborted sudden cardiac death (SCD) and seizures. We report a 25-year-old female with a history of bulimia associated with abuse of furosemide and laxatives since the age of 15 years, migraine since puberty, renal abscesses at age 20 y, and rhabdomyolysis of unknown cause at age 24 y. She experienced aborted SCD due to severe hypokalemia with symptomatic seizures at 21 and 25 years of age. Bulimia patients additionally taking laxatives or furosemide are at particular risk of SCD and rhabdomyolysis and require periodic determination of electrolytes, potassium substitution, and adequate psychiatric therapy and surveillance.

  1. Sudden unexpected infant death (SUDI in a newborn due to medium chain acyl CoA dehydrogenase (MCAD deficiency with an unusual severe genotype

    Directory of Open Access Journals (Sweden)

    Lovera Cristina

    2012-10-01

    Full Text Available Abstract Medium chain acyl CoA dehydrogenase deficiency (MCAD is the most common inborn error of fatty acid oxidation. This condition may lead to cellular energy shortage and cause severe clinical events such as hypoketotic hypoglycemia, Reye syndrome and sudden death. MCAD deficiency usually presents around three to six months of life, following catabolic stress as intercurrent infections or prolonged fasting, whilst neonatal-onset of the disease is quite rare. We report the case of an apparently healthy newborn who suddenly died at the third day of life, in which the diagnosis of MCAD deficiency was possible through peri-mortem blood-spot acylcarnitine analysis that showed very high concentrations of octanoylcarnitine. Genetic analysis at the ACADM locus confirmed the biochemical findings by demonstrating the presence in homozygosity of the frame-shift c.244dup1 (p.Trp82LeufsX23 mutation, a severe genotype that may explain the unusual and very early fatal outcome in this newborn. This report confirms that inborn errors of fatty acid oxidation represent one of the genetic causes of sudden unexpected deaths in infancy (SUDI and underlines the importance to include systematically specific metabolic screening in any neonatal unexpected death.

  2. A retrospective study on the unseen epidemic of road traffic injuries and deaths due to accidents in Mwanza City - Tanzania.

    Science.gov (United States)

    Ngallaba, S E; Majinge, C; Gilyoma, J; Makerere, D J; Charles, E

    2013-06-01

    Sixty percent of the global deaths and injuries occur in the developing world and mostly are due to Road traffic accidents (RTAs. looking at the etiological related factors which include, carelessness of the driver, condition of the vehicle or motorcycle, poor condition of roads, risky behavior of the driver, most of these factors can be prevented to some extent. This study therefore, determined the pattern of cases and deaths due to traffic road accidents in Mwanza City Tanzania. In this retrospective study, records, registers and case notes In the surgical ward and causality, medical records and central police station from 2008 to 2011 were used. The study focused on the two referral hospitals (Sekouture regional hospital and Bugando Medical Center). There were 3450 cases due to accidents reported at both centers (Sekouture regional hospital and Bugando Medical Center of which 3224 (93.4%) had complete information for analysis.2225 (69%) were male and 999 (31%) were female, and the most affected group were male. Among the RTAs2809 cases (87%) were due to motor cycle accidents which were the leading cause of RTAs with case fatality rate of 5% while motor vehicle has case fatality rate of 24% which is 5 times that of motor cycle. Among all RTAs the leading cause of injuries is Motor cycle traffic accidents followed by motor vehicle. RTAs are on increase particularly the motor cycle traffic accidents and has claimed a good number of innocent people's lives however most of them are preventable, therefore driving course to be introduced to motor cycle drivers with emphasize on the road posters signal, rules and regular checkup of their motor cycles especially commercial motor cycle.

  3. Doença de still na gravidez: relato de um caso com óbito neonatal Still's disease in pregnancy: report of a case with neonatal death

    Directory of Open Access Journals (Sweden)

    Ana Pacheco Ribeiro Cascaes

    2003-12-01

    was performed. The newborn had a 7/8 Apgar score, weighted 1,500 g and was admitted to an intensive care unit presenting breathing discomfort, icterus, exanthema and necrotizing enterocolitis, among other complications which led to his death after 41 days in the intensive care unit. The patient presented clinical and laboratorial symptoms suggesting adult-onset Still disease although other feverish pathologies were investigated as differential diagnosis. There was a satisfactory evolution with use of indomethacin, prednisone and methotrexate and the patient is currently in remission, using only methotrexate. The patient has presented a definite diagnosis for adult-onset Still disease according to the criteria proposed for the disease. The newborn's death was a consequence of prematurity and infectious risk, factors which could have been minimized had the mother's condition been precociously diagnosed.

  4. 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.

  5. Sudden death of an Indian peafowl (Pavo cristatus) at a zoo due to non-pigmented Serratia marcescens infection.

    Science.gov (United States)

    Lee, Seung-Hun; Park, Sang-Joon; Kwak, Dongmi; Kim, Kyoo-Tae

    2017-12-22

    A 16-year-old female Indian peafowl (Pavo cristatus) died two days after recognition of conjunctivitis in the right eye, anorexia and depression. Gross necropsy revealed a thick pseudomembrane under the eyelid and hydropericardium. Histopathological examination revealed hepatocellular necrosis, sinusoidal and vascular congestion and infiltrated inflammatory cells. Infiltration by inflammatory cells was noted in the epicardium. The lungs had mild interstitial pneumonia with the extensive congestion within the capillaries of the air sacs. Tubular interstitial congestion and necrosis was noted in the kidneys. Bacterial culture and nucleotide sequencing of the inflammatory specimens identified the causative agent as Serratia marcescens, an uncommon bacterium in birds. In summary, this study describes the sudden death of an Indian peafowl due to S. marcescens infection, which is rarely seen in animals.

  6. Years of life lost because of premature death due to intentional and unintentional accidents in Ghazvin province from 2004 till 2008

    Directory of Open Access Journals (Sweden)

    Nahid Jafari

    2015-01-01

    Full Text Available Background: Accidents are the second cause of death in Iran and one of the significant challenges in public health. They can affect people in all ages. In this study, we try to calculate years of life lost due to intentional and unintentional injuries, which is considered as one of the main indicators for prioritizing public health problems.  Methods: This study is a practical cross sectional survey research HSR (health system research that uses secondary analysis on the death data of Ghazvin province. The calculations also take into account the WHO standards in age group, sex and years of life lost (YLL due to death.  Results: This study showed that the unintentional accidents were the leading cause of death based on YLL from 2004 until 2008 in Ghazvin province. The number of deaths due to intentional and unintentional accidents was 3796 deaths as of which 2954 (77.8% was male and 842 (22.2% female. In general three quarter of the YLL due to early death relates to accidents for males and less than a quarter relates to accidents for females. Between 2004 until 2008, the maximum number of years of life lost (YLL in both sexes is for the age group of 15 to 49.  Conclusion: Considering the high level of years of life lost (YLL due to accident in this province, especially in men, more appropriate interventions for the more risk prone age groups and male in general need to be taken into account.

  7. Extreme hypertriglyceridemia, pseudohyponatremia, and pseudoacidosis in a neonate with lipoprotein lipase deficiency due to segmental uniparental disomy.

    Science.gov (United States)

    Ashraf, Ambika P; Hurst, Anna C E; Garg, Abhimanyu

    Extreme hypertriglyceridemia is rare in the neonatal period. We report a neonate with lipoprotein lipase (LPL) deficiency who presented with diagnostic and management conundrum. A full-term 36-day-old female was noted to have "Pepto-Bismol like" blood when repeating a newborn screening. The initial plasma triglyceride level was 24,318 mg/dL. The laboratory tests revealed serum bicarbonate level of severe anemia. There were no signs of acute distress. The point of care capillary blood testing, however, demonstrated normal serum pH (7.2), bicarbonate (25.4 mmol/L), and sodium (139 mmol/L). The patient had mild elevation of serum lactic acid and no ketonuria. A diagnosis of type I hyperlipoproteinemia was made. Oral feeding was stopped, and the infant received intravenous fluids for the next 7 days resulting in lowering of serum triglyceride levels to 1016 mg/dL. Oral feeding was initiated with an amino acid-rich formula to which medium chain triglycerides were slowly added, while maintaining the total fat content to A, p.(Gly215Glu) mutation. Subsequent analysis of the parental samples revealed that only the father, but not the mother, was a heterozygous carrier of the same mutation. Analysis of 18 informative microsatellite markers on chromosome 8 revealed paternal segmental uniparental disomy with partial absence of the maternal chromosome 8p, confirmed by single-nucleotide polymorphism microarray. We conclude that besides pseudohyponatremia, extreme hypertriglyceridemia can rarely present as pseudoacidosis and uniparental disomy can be an underlying mechanism for autosomal recessive diseases such as LPL deficiency. Published by Elsevier Inc.

  8. The common antitussive agent dextromethorphan protects against hyperoxia-induced cell death in established in vivo and in vitro models of neonatal brain injury.

    Science.gov (United States)

    Posod, A; Pinzer, K; Urbanek, M; Wegleiter, K; Keller, M; Kiechl-Kohlendorfer, U; Griesmaier, E

    2014-08-22

    Preterm infants are prematurely subjected to relatively high oxygen concentrations, even when supplemental oxygen is not administered. There is increasing evidence to show that an excess of oxygen is toxic to the developing brain. Dextromethorphan (DM), a frequently used antitussive agent with pleiotropic mechanisms of action, has been shown to be neuroprotective in various models of central nervous system pathology. Due to its numerous beneficial properties, it might also be able to counteract detrimental effects of a neonatal oxygen insult. The aim of the current study was to evaluate its therapeutic potential in established cell culture and rodent models of hyperoxia-induced neonatal brain injury. For in vitro studies pre- and immature oligodendroglial (OLN-93) cells were subjected to hyperoxic conditions for 48 h after pre-treatment with increasing doses of DM. For in vivo studies 6-day-old Wistar rat pups received a single intraperitoneal injection of DM in two different dosages prior to being exposed to hyperoxia for 24h. Cell viability and caspase-3 activation were assessed as outcome parameters at the end of exposure. DM significantly increased cell viability in immature oligodendroglial cells subjected to hyperoxia. In pre-oligodendroglial cells cell viability was not significantly affected by DM treatment. In vivo caspase-3 activation induced by hyperoxic exposure was significantly lower after administration of DM in gray and white matter areas. In control animals kept under normoxic conditions DM did not significantly influence caspase-3-dependent apoptosis. The present results indicate that DM is a promising and safe treatment strategy for neonatal hyperoxia-induced brain injury that merits further investigation. Copyright © 2014 IBRO. Published by Elsevier Ltd. All rights reserved.

  9. Genetic and environmental influences on risk of death due to infections assessed in Danish twins, 1943-2001

    DEFF Research Database (Denmark)

    Obel, Niels; Christensen, Kaare; Petersen, Inge

    2010-01-01

    Genetic differences have been proposed to play a strong role in risk of death from infectious diseases. The study base of 44,005 included all same-sex twin pairs born in 1870-2001, with both twins alive on January 1, 1943, or those born thereafter. Cause of death was obtained from the Danish Cause...... from infectious diseases could be demonstrated, the absolute effect of the genetic component on mortality was small....... genetic influence on the risk of death...

  10. Aborted Sudden Cardiac Death in a Female Patient Presenting with Takotsubo-Like Cardiomyopathy due to Epicardial Coronary Vasospasm

    Directory of Open Access Journals (Sweden)

    Sorin Giusca

    2017-01-01

    Full Text Available Takotsubo cardiomyopathy is characterized by apical ballooning of the left ventricle (LV in the absence of relevant coronary artery stenosis, which typically occurs in elderly women after emotional stress. Catecholamine cardiotoxicity, metabolic disturbance, and coronary microvascular impairment have previously been proposed as underlying pathophysiologic mechanisms of takotsubo cardiomyopathy, whereas myocardial stunning resulting from epicardial coronary artery vasospasm is not generally accepted as a cause of takotsubo cardiomyopathy. The prognosis of takotsubo cardiomyopathy is generally more favourable compared to myocardial infarction; however, severe complications such as rupture of the LV and life-threatening arrhythmias may occur. Herein, we describe a case of an 84-year-old female, who presented with aborted sudden cardiac death due to ventricular fibrillation. Echocardiography suggested LV apical ballooning with severely impaired LV-function, so that takotsubo cardiomyopathy was suspected. However, coronary angiography revealed epicardial spasm of the left anterior ascending, which resolved after intracoronary injection of 0.2 mg nitroglycerine. Cardiac magnetic resonance exhibited subendocardial late enhancement and echocardiography showed normalization of LV dysfunction during follow-up. The patient was put on conservative treatment with nitrates and calcium inhibitors and ICD implantation were deferred.

  11. [Excess mortality due to tuberculosis and factors associated to death in and annual cohort of patients diagnosed of tuberculosis].

    Science.gov (United States)

    Pina, J M; Domínguez, A; Alcaide, J; Alvarez, J; Camps, N; Díez, M; Godoy, P; Jansá, J M; Minquell, S; Arias, C

    2006-12-01

    To calculate excess mortality in an annual cohort of tuberculosis patients and study the factors associated with death. Cases of tuberculosis reported in Catalonia (May 1996-April 1997). Patients were classified as completed treatment/cured (compliant), non-compliant, failures, transfers out and deaths. Excess mortality was defined as the ratio actual deaths/expected deaths (according to general mortality figures for Catalonia, May 1996-April 1997). Factors associated with death were determined by a comparative study of variables (demographic, substance abuse, comorbidity, tuberculosis-related disease) in deaths after diagnosis and survivors. Time from diagnosis to death was recorded. Patients included: 2,085. Patients classified as: completed treatment/cured (compliant), 1,406 (67.43 %); noncompliant, 165 (7, 91%); failures, 5 (0.24%); transfers out, 25 (1.21%); deaths, 133 (6.38%), 28 of which occurred before diagnosis and 105 after diagnosis. Insufficient data in medical record for classification, 351 (16.83%) patients. Excess mortality: 5.98 (95% CI: 4.96-7.0). Factors associated with death: treatment with non-standardized guidelines, 46%; OR: 10.3 (6.2-17.4); HIV infection, 40%; OR: 13.0 (6.6-25.8); age greater than 64 years, 40%; OR: 14.6 (3.0-69.8); alcoholism, 25%; OR: 2.0 (1.1-3.6); neoplasm, 16%; OR: 3.9 (1.8-8.6; renal failure, 8%; OR: 10.1 (3.1-32.3). The shortest time from diagnosis to death was in patients with only one risk factor, except for HIV infection, where the time passed was the longest observed. We found substantial excess mortality in tuberculosis patients. Death was associated with the efficacy of treatment, HIV coinfection, advanced age, alcoholism and the coexistence of neoplasms or renal failure.

  12. 38 CFR 3.1000 - Entitlement under 38 U.S.C. 5121 to benefits due and unpaid upon death of a beneficiary.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Entitlement under 38 U.S.C. 5121 to benefits due and unpaid upon death of a beneficiary. 3.1000 Section 3.1000 Pensions... Dependency and Indemnity Compensation Accrued § 3.1000 Entitlement under 38 U.S.C. 5121 to benefits due and...

  13. Death qualification and prejudice: the effect of implicit racism, sexism, and homophobia on capital defendants' right to due process.

    Science.gov (United States)

    Butler, Brooke

    2007-01-01

    Two hundred venirepersons from the 12th Judicial Circuit in Bradenton, Florida completed the following measures: (1) one question that measured their level of support for the death penalty; (2) one question that categorized their death-qualification status; (3) 23 questions that measured their attitudes toward the death penalty (ATDP); (4) 22 questions that assessed their attitudes toward women (ATW); (5) 25 questions that measured their level of homophobia (H); (6) seven questions that assessed their level of modern racism (MR); (7) eight questions that measured their level of modern sexism (MS); and (8) standard demographic questions. Results indicated that as death-penalty support increased participants exhibited more positive attitudes toward the death penalty, more negative attitudes toward women, and higher levels of homophobia, modern racism, and modern sexism. Findings also suggested that death-qualified venirepersons exhibited more positive attitudes toward the death penalty and higher levels of homophobia, modern racism, and modern sexism. Finally, more positive attitudes toward the death penalty were correlated with more negative attitudes toward women and higher levels of homophobia, modern racism, and modern sexism. Legal implications are discussed. Copyright (c) 2007 John Wiley & Sons, Ltd.

  14. Counting indirect crisis-related deaths in the context of a low-resilience health system: the case of maternal and neonatal health during the Ebola epidemic in Sierra Leone.

    Science.gov (United States)

    Sochas, Laura; Channon, Andrew Amos; Nam, Sara

    2017-11-01

    Although the number of direct Ebola-related deaths from the 2013 to 2016 West African Ebola outbreak has been quantified, the number of indirect deaths, resulting from decreased utilization of routine health services, remains unknown. Such information is a key ingredient of health system resilience, essential for adequate allocation of resources to both 'crisis response activities' and 'core functions'. Taking stock of indirect deaths may also help the concept of health system resilience achieve political traction over the traditional approach of disease-specific surveillance. This study responds to these imperatives by quantifying the extent of the drop in utilization of essential reproductive, maternal and neonatal health services in Sierra Leone during the Ebola outbreak by using interrupted time-series regression to analyse Health Management Information System (HMIS) data. Using the Lives Saved Tool, we then model the implication of this decrease in utilization in terms of excess maternal and neonatal deaths, as well as stillbirths. We find that antenatal care coverage suffered from the largest decrease in coverage as a result of the Ebola epidemic, with an estimated 22 percentage point (p.p.) decrease in population coverage compared with the most conservative counterfactual scenario. Use of family planning, facility delivery and post-natal care services also decreased but to a lesser extent (-6, -8 and -13 p.p. respectively). This decrease in utilization of life-saving health services translates to 3600 additional maternal, neonatal and stillbirth deaths in the year 2014-15 under the most conservative scenario. In other words, we estimate that the indirect mortality effects of a crisis in the context of a health system lacking resilience may be as important as the direct mortality effects of the crisis itself. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved

  15. Asfixia perinatal associada à mortalidade neonatal precoce: estudo populacional dos óbitos evitáveis Asfixia perinatal asociada a la mortalidad neonatal temprana: estudio de población de los óbitos evitables Perinatal asphyxia associated with early neonatal mortality: populational study of avoidable deaths

    Directory of Open Access Journals (Sweden)

    Mandira Daripa

    2013-03-01

    TODOS: Cohorte de población constituida por 2.873 óbitos evitables hasta seis días de vida asociados a la asfixia perinatal ocurridos entre enero de 2001 y diciembre de 2003. Se consideró como asfixia perinatal la presencia de hipoxia intraútero, asfixia al nacer o síndrome de aspiración de meconio en cualquier línea de la Declaración de Óbito original. Variables epidemiológicas también fueron extraídas de las Declaraciones de Nacido Vivo. RESULTADOS: En el trienio, 1,71 muertes por 1.000 nacidos vivos estaban asociadas a la asfixia perinatal, correspondiendo al 22% de los óbitos neonatales tempranos. De los 2.873 óbitos evitables, 761 (27% tuvieron lugar en São Paulo, capital; 640 (22%, en la región metropolitana de la capital; y 1.472 (51% en el interior de la provincia. En las dos primeras regiones predominaron las muertes en hospitales públicos, recién nacidos con edad gestacional inferior a 37 semanas y peso inferior a 2.500g. En el interior, los óbitos fueron más frecuentes en entidades benéficas, recién nacidos a término y con peso superior a 2.500g. La mayoría de los bebés nació durante el día en el municipio de residencia materna y evolucionó a óbito en el hospital de nacimiento hasta 24 horas después del parto. El síndrome de aspiración de meconio estuvo presente en el 18% de los óbitos. CONCLUSIONES: La asfixia perinatal es un contribuyente frecuente a la muerte neonatal temprana evitable en la provincia con el más grande producto interno bruto per capita de Brasil, lo que evidencia la necesidad de intervenciones específicas con enfoque regionalizado en la asistencia al parto y al nacimiento.OBJECTIVE: To compare the epidemiological profile of avoidable early neonatal deaths associated with perinatal asphyxia according to region of death in the State of São Paulo, Brazil. METHODS: Population-based cohort study including 2,873 avoidable deaths up to six days of life associated with perinatal asphyxia from January 2001 to December

  16. Time course of cell death due to acoustic overstimulation in the mouse medial geniculate body and primary auditory cortex

    Directory of Open Access Journals (Sweden)

    Felix Frohlich

    2017-01-01

    Full Text Available It has previously been shown that acoustic overstimulation induces cell death and extensive cell loss in key structures of the central auditory pathway. A correlation between noise-induced apoptosis and cell loss was hypothesized for the cochlear nucleus and colliculus inferior. To determine the role of cell death in noise-induced cell loss in thalamic and cortical structures, the present mouse study (NMRI strain describes the time course following noise exposure of cell death mechanisms for the ventral medial geniculate body (vMGB, medial MGB (mMGB, and dorsal MGB (dMGB and the six histological layers of the primary auditory cortex (AI 1–6. Therefore, a terminal deoxynucleotidyl transferase dioxyuridine triphosphate nick-end labeling assay (TUNEL was performed in these structures 24 h, 7 days, and 14 days after noise exposure (3 h, 115 dB sound pressure level, 5–20 kHz, as well as in unexposed controls. In the dMGB, TUNEL was statistically significant elevated 24 h postexposure. AI-1 showed a decrease in TUNEL after 14 days. There was no statistically significant difference between groups for the other brain areas investigated. dMGB’s widespread connection within the central auditory pathway and its nontonotopical organization might explain its prominent increase in TUNEL compared to the other MGB subdivisions and the AI. It is assumed that the onset and peak of noise-induced cell death is delayed in higher areas of the central auditory pathway and takes place between 24 h and 7 days postexposure in thalamic and cortical structures.

  17. The patterns and causes of neonatal mortality at a tertiary hospital in oman.

    Science.gov (United States)

    Abdellatif, Mohamed; Ahmed, Masood; Bataclan, Maria Flordeliz; Khan, Ashfaq Ahmed; Al Battashi, Abeer; Al Maniri, Abdullah

    2013-11-01

    To report the patterns and causes of neonatal death from a tertiary care neonatal intensive care unit over a period of four years. This is a retrospective cohort study where four years data (January 2006 - December 2009) of all inborn neonatal admissions and deaths were collected from the neonatal intensive care unit at Sultan Qaboos University hospital on predesigned forms. All out born admissions and deaths were excluded. The causes of neonatal death were classified using Wigglesworth's classification. The number of inborn live births during the study period was 10064 and the total number of inborn neonatal admissions was 1475. The total deaths (neonatal and post neonatal) at the neonatal intensive care unit was 73 (63 inborn and 10 out born). Among the inborn, five deaths were post neonatal deaths and hence, excluded from analysis. Among the remaining inborn neonatal deaths (n=58), 34 (59%) were males and 24 (41%) were females. The number of neonatal admissions increased over the years during the study period from 248 to 356, while the number of deaths also increased from 10 deaths in 2006, to 20 deaths in 2009. The primary causes of neonatal deaths were prematurity and its complications 52% (n=30). Lethal congenital malformations lead to 17 (29%) newborn deaths, specific diagnosis in 7 newborns (12%), and birth asphyxia in four (7%) of cases. There was an increasing trend of neonatal admissions and deaths among inborn babies. Prematurity, with sepsis as its major complication and congenital malformations were the leading cause of neonatal mortality.

  18. 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.

  19. SURVEI KEMATIAN NEONATAL (STUDI AUTOPSI VERBAL DI KABUPATEN CIREBON, 2004

    Directory of Open Access Journals (Sweden)

    Sarimawar Djaja

    2012-09-01

    Full Text Available In its attempt to realize the intervention program to saving newborn babies with asphyxia, the Ministry of Health will initiate to train midwives in the village in order to that they know how to operate resuscitation equipment to save neonatal baby with asphyxia. The intervention program his dubbed successful if the mortality proportion due if asphyxia decreased to half as targeted. The survey was conducted in the rural area of Cirebon district. The sample was 200 neonatal death babies, calculated using the hypothesis test with different proportion; p1 0.3 (30% neonatal death cause of asphyxia, according household health survey 2001, p2 0.15, α 0.05, β 0.2, (l-β 0.8. Neonatal dead cases happened within 12 months prior to the survey were identified by rural midwives out of their personal records. The death cases were followed up by interviewing the mother of the neonatal baby concerning its birth, illness or disorder histories before death. The diagnosis of the diseases were based on the International Classification of Diseases 10 and Wigglesworth classification, determined in union by NIHRD researchers and neonatologists. The neonatal mortality rate was 13 out of 1,000 live births. The major cause of early neonatal mortality was respiration disorder mainly caused by birth asphyxia (45%, of which 90 percent could be intervened by doing resuscitation (for babies weighed more than 1.000 gram. The second and third order of the mortality causes was infection (22% and congenital disorders (11% respectively. The major cause of late neonatal mortality was infection (56%, followed by low birth weight and prematurely born, as well as neonatal jaundice (14 percent each, and congenital disorder comes in the third place. The option to handle asphyxia with the early neonatal babies is the right effort to decrease the neonatal mortality rate. And to achieve the utmost result, it is necessary that the rural midwives maintain their standard performance (in

  20. Long-term exposure to combination antiretroviral therapy and risk of death from specific causes: no evidence for any previously unidentified increased risk due to antiretroviral therapy

    DEFF Research Database (Denmark)

    Kowalska, Justyna D; Reekie, Joanne; Mocroft, Amanda

    2012-01-01

    were followed from baseline, which was defined as the time of starting cART or enrolment into EuroSIDA whichever occurred later, until death or six months after last follow-up visit. Incidence rates (IR) of death were calculated per 1000 person-years of follow-up (PYFU) and stratified by time...... of exposure to cART (=3 antiretrovirals): 8 years. Duration of cART exposure was the cumulative time actually receiving cART. Poisson regression models were fitted for each cause of death separately. RESULTS:: 1297 patients died during 70613 PYFU (IR 18.3 per 1000 PYFU, 95%CI: 17.4-19.4), 413 due to AIDS (5.......85, 95%CI: 5.28-6.41) and 884 due to non-AIDS-related cause (12.5, 95%CI: 11.7-13.3). After adjustment for confounding variables, including baseline CD4 cell count and HIV RNA, there was a significant decrease in the rate of all-cause and AIDS-related death between 2-3.99 years and longer exposure time...

  1. 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

  2. The South African child death review pilot: A multiagency approach ...

    African Journals Online (AJOL)

    health and demographic surveillance sites and facility-based data from the Child Healthcare Problem Identification Programme (Child .... We defined fatal child abuse and neglect as a death due to physical abuse or neglect or ..... Factors associated with lower RTI during infancy. Variable. OR. 95% CI p-value. Age. Neonate.

  3. Neonatal Listeriosis

    Directory of Open Access Journals (Sweden)

    Shih-Yu Chen

    2007-01-01

    Full Text Available In Western developed countries, Listeria monocytogenes is not an uncommon pathogen in neonates. However, neonatal listeriosis has rarely been reported in Taiwan. We describe two cases collected from a single medical institute between 1990 and 2005. Case 1 was a male premature baby weighing 1558 g with a gestational age of 31 weeks whose mother had fever with chills 3 days prior to delivery. Generalized maculopapular rash was found after delivery and subtle seizure developed. Both blood and cerebrospinal fluid culture collected on the 1st day yielded L. monocytogenes. In addition, he had ventriculitis complicated with hydrocephalus. Neurologic development was normal over 1 year of follow-up after ventriculoperitoneal shunt operation. Case 2 was a 28-weeks' gestation male premature baby weighing 1180 g. Endotracheal intubation and ventilator support were provided after delivery due to respiratory distress. Blood culture yielded L. monocyto-genes. Cerebrospinal fluid showed pleocytosis but the culture was negative. Brain ultrasonography showed ventriculitis. Sudden deterioration with cyanosis and bradycardia developed on the 8th day and he died on the same day. Neonatal listeriosis is uncommon in Taiwan, but has significant mortality and morbidity. Early diagnosis of perinatal infection relies on high index of suspicion in perinatal health care professionals. [J Formos Med Assoc 2007;106(2:161-164

  4. Phototherapy and exchange transfusion for neonatal ...

    African Journals Online (AJOL)

    The purpose of this document is to address the current lack of consensus regarding the management of hyperbilirubinaemia in neonates in South Africa. If left untreated, severe neonatal hyperbilirubinaemia may cause kernicterus and ultimately death and the severity of neonatal jaundice is often underestimated clinically.

  5. Morbid obesity as a risk factor for hospitalization and death due to 2009 pandemic influenza A(H1N1 disease.

    Directory of Open Access Journals (Sweden)

    Oliver W Morgan

    Full Text Available BACKGROUND: Severe illness due to 2009 pandemic A(H1N1 infection has been reported among persons who are obese or morbidly obese. We assessed whether obesity is a risk factor for hospitalization and death due to 2009 pandemic influenza A(H1N1, independent of chronic medical conditions considered by the Advisory Committee on Immunization Practices (ACIP to increase the risk of influenza-related complications. METHODOLOGY/PRINCIPAL FINDINGS: We used a case-cohort design to compare cases of hospitalizations and deaths from 2009 pandemic A(H1N1 influenza occurring between April-July, 2009, with a cohort of the U.S. population estimated from the 2003-2006 National Health and Nutrition Examination Survey (NHANES; pregnant women and children or=20 year olds, hospitalization was associated with being morbidly obese (BMI>or=40 for individuals with ACIP-recognized chronic conditions (OR = 4.9, 95% CI 2.4-9.9 and without ACIP-recognized chronic conditions (OR = 4.7, 95%CI 1.3-17.2. Among 2-19 year olds, hospitalization was associated with being underweight (BMIor=20 years without ACIP-recognized chronic medical conditions death was associated with obesity (OR = 3.1, 95%CI: 1.5-6.6 and morbid obesity (OR = 7.6, 95%CI 2.1-27.9. CONCLUSIONS/SIGNIFICANCE: Our findings support observations that morbid obesity may be associated with hospitalization and possibly death due to 2009 pandemic H1N1 infection. These complications could be prevented by early antiviral therapy and vaccination.

  6. Sickness absence and disability pension due to otoaudiological diagnoses: risk of premature death--a nationwide prospective cohort study.

    Science.gov (United States)

    Friberg, Emilie; Rosenhall, Ulf; Alexanderson, Kristina

    2014-02-08

    It is estimated that hearing difficulties will be one of the top ten leading burdens of disease by 2030. Knowledge of mortality among individuals on sick leave or disability pension due to hearing diagnoses is virtually non-existent. We aimed prospectively to examine the associations of diagnosis-specific sick leave and disability pension due to different otoaudiological diagnoses with risks of all-cause and cause-specific mortality. A cohort, based on Swedish registry data, including all 5,248,672 individuals living in Sweden in 2005, aged 20-64, and not on old-age pension, was followed through 2010. Otoaudiological diagnoses were placed in the following categories: otological, hearing, vertigo, and tinnitus. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using Cox proportional hazard models; individuals on sick leave or disability pension due to different otoaudiological diagnoses during 2005 were compared with those not on sick leave or disability pension. In multivariable models, individuals with sickness absence due to otoaudiological diagnoses showed a lower risk of mortality, while individuals on disability pension due to otoaudiological diagnoses showed a 14% (95% CI 1-29%) increased risk of mortality, compared with individuals not on sick leave or disability pension. The risk increase among individuals on disability pension was largely attributable to otological (HR 1.56; 95% CI = 1.04-2.33) and hearing diagnoses (HR 1.20; 95% CI = 1.00-1.43). This large nationwide population-based cohort study suggests an increased risk of mortality among individuals on disability pension due to otoaudiological diagnoses.

  7. Sickness absence and disability pension due to otoaudiological diagnoses: risk of premature death – a nationwide prospective cohort study

    Science.gov (United States)

    2014-01-01

    Background It is estimated that hearing difficulties will be one of the top ten leading burdens of disease by 2030. Knowledge of mortality among individuals on sick leave or disability pension due to hearing diagnoses is virtually non-existent. We aimed prospectively to examine the associations of diagnosis-specific sick leave and disability pension due to different otoaudiological diagnoses with risks of all-cause and cause-specific mortality. Methods A cohort, based on Swedish registry data, including all 5 248 672 individuals living in Sweden in 2005, aged 20–64, and not on old-age pension, was followed through 2010. Otoaudiological diagnoses were placed in the following categories: otological, hearing, vertigo, and tinnitus. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using Cox proportional hazard models; individuals on sick leave or disability pension due to different otoaudiological diagnoses during 2005 were compared with those not on sick leave or disability pension. Results In multivariable models, individuals with sickness absence due to otoaudiological diagnoses showed a lower risk of mortality, while individuals on disability pension due to otoaudiological diagnoses showed a 14% (95% CI 1-29%) increased risk of mortality, compared with individuals not on sick leave or disability pension. The risk increase among individuals on disability pension was largely attributable to otological (HR 1.56; 95% CI = 1.04-2.33) and hearing diagnoses (HR 1.20; 95% CI = 1.00-1.43). Conclusion This large nationwide population-based cohort study suggests an increased risk of mortality among individuals on disability pension due to otoaudiological diagnoses. PMID:24507477

  8. Foetal and neonatal alloimmune thrombocytopaenia

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    Kaplan Cecile

    2006-10-01

    Full Text Available Abstract Foetal/neonatal alloimmune thrombocytopaenia (NAIT results from maternal alloimmunisation against foetal platelet antigens inherited from the father and different from those present in the mother, and usually presents as a severe isolated thrombocytopaenia in otherwise healthy newborns. The incidence has been estimated at 1/800 to 1/1 000 live births. NAIT has been considered to be the platelet counterpart of Rh Haemolytic Disease of the Newborn (RHD. Unlike RHD, NAIT can occur during a first pregnancy. The spectrum of the disease may range from sub-clinical moderate thrombocytopaenia to life-threatening bleeding in the neonatal period. Mildly affected infants may be asymptomatic. In those with severe thrombocytopaenia, the most common presentations are petechiae, purpura or cephalohaematoma at birth, associated with major risk of intracranial haemorrhage (up to 20% of reported cases, which leads to death or neurological sequelae. Alloimmune thrombocytopaenia is more often unexpected and is usually diagnosed after birth. Once suspected, the diagnosis is confirmed by demonstration of maternal antiplatelet alloantibodies directed against a paternal antigen inherited by the foetus/neonate. Post-natal management involves transfusion of platelets devoid of this antigen, and should not be delayed by biological confirmation of the diagnosis (once the diagnosis is suspected, especially in case of severe thrombocytopaenia. Prompt diagnosis and treatment are essential to reduce the chances of death and disability due to haemorrhage. Due to the high rate of recurrence and increased severity of the foetal thrombocytopaenia in successive pregnancies, antenatal therapy should be offered. However, management of high-risk pregnancies is still a matter of discussion.

  9. Neonatal mortality in Utah.

    Science.gov (United States)

    Woolley, F R; Schuman, K L; Lyon, J L

    1982-09-01

    A cohort study of neonatal mortality (N = 106) in white singleton births (N = 14,486) in Utah for January-June 1975 was conducted. Using membership and activity in the Church of Jesus Christ of Latter-day Saints (LDS or Mormon) as a proxy for parental health practices, i.e., tobacco and alcohol abstinence, differential neonatal mortality rates were calculated. The influence of potential confounding factors was evaluated. Low activity LDS members were found to have an excess risk of neonatal death five times greater than high activity LDS, with an upper bound of a two-sided 95% confidence interval of 7.9. The data consistently indicate a lower neonatal mortality rate for active LDS members. Non-LDS were found to have a lower rate than either medium or low activity LDS.

  10. Dynamic Regression Model for Evaluating the Association Between Atmospheric Conditions and Deaths due to Respiratory Diseases in São Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    Ana Carla dos Santos Gomes

    Full Text Available Abstract The article reports the modeling of mortality due to respiratory diseases emanating from atmospheric conditions, capturing significant associations and verifying the ability of stochastic modeling to predict deaths arising from the relationship between weather conditions and air pollution. The statistical methods used in the analysis were cross-correlation and pre-whitening, in addition to dynamic regression modeling combining the dynamics of time series and the effect of explanatory variables. The results show there are significant associations between mortality and sulfur dioxide, air temperature, atmospheric pressure, relative humidity, and autoregressive structure. The cross-correlations captured significant lags between atmospheric variables and deaths, of two months for SO2 and relative humidity, eleven months for PM10, seven months for O3, and eight months for air temperature and the cross-correlation without lag with NO2. With CO variables, precipitation and atmospheric pressure, cross-correlations were not detected. Stochastic modeling showed that deaths due to respiratory diseases can be predicted from the combination of meteorological and air pollution variables, especially considering the existing trend and seasonality.

  11. Assessment of risk for asthma initiation and cancer and heart disease deaths among patrons and servers due to secondhand smoke exposure in restaurants and bars

    Science.gov (United States)

    Liu, Ruiling; Bohac, David L; Gundel, Lara A; Hewett, Martha J; Apte, Michael G; Hammond, S Katharine

    2014-01-01

    Background Despite efforts to reduce exposure to secondhand smoke (SHS), only 5% of the world's population enjoy smoke-free restaurants and bars. Methods Lifetime excess risk (LER) of cancer death, ischaemic heart disease (IHD) death and asthma initiation among non-smoking restaurant and bar servers and patrons in Minnesota and the US were estimated using weighted field measurements of SHS constituents in Minnesota, existing data on tobacco use and multiple dose-response models. Results A continuous approach estimated a LER of lung cancer death (LCD) of 18×10−6(95% CI 13 to 23×10−6) for patrons visiting only designated non-smoking sections, 80×10−6(95% CI 66 to 95×10−6) for patrons visiting only smoking venues/sections and 802×10−6(95% CI 658 to 936×10−6) for servers in smoking-permitted venues. An attributable-risk (exposed/non-exposed) approach estimated a similar LER of LCD, a LER of IHD death about 10−2 for non-smokers with average SHS exposure from all sources and a LER of asthma initiation about 5% for servers with SHS exposure at work only. These risks correspond to 214 LCDs and 3001 IHD deaths among the general non-smoking population and 1420 new asthma cases among non-smoking servers in the US each year due to SHS exposure in restaurants and bars alone. Conclusions Health risks for patrons and servers from SHS exposure in restaurants and bars alone are well above the acceptable level. Restaurants and bars should be a priority for governments’ effort to create smoke-free environments and should not be exempt from smoking bans. PMID:23407112

  12. Predictive value of long-term changes of growth differentiation factor-15 over a 27-year-period for heart failure and death due to coronary heart disease.

    Science.gov (United States)

    Fluschnik, Nina; Ojeda, Francisco; Zeller, Tanja; Jørgensen, Torben; Kuulasmaa, Kari; Becher, Peter Moritz; Sinning, Christoph; Blankenberg, Stefan; Westermann, Dirk

    2018-01-01

    Growth differentiation factor-15 (GDF-15), Cystatin C and C-reactive protein (CRP) have been discussed as biomarkers for prediction of cardiac diseases. The aim of this study was to investigate the predictive value of single and repeated measurements of GDF-15 compared to Cystatin C and CRP for incidence of heart failure (HF) and death due to coronary heart disease (CHD) in the general population. Levels of GDF-15, CRP and Cystatin C were determined in three repeated measurements collected 5 years apart in the DAN-MONICA (Danish-Multinational MONitoring of trends and determinants in Cardiovascular disease) cohort (participants at baseline n = 3785). Cox regression models adjusted for cardiovascular risk factors revealed significantly increased hazard ratios (HR) for GDF-15 for incident HF 1.36 (HR per interquartile range (IQR) increase, 95% confidence interval (CI): 1.16; 1.59) and for death from CHD 1.51 (HR per IQR increase, 95% CI: 1.31, 1.75) (both with p<0.001). Joint modeling of time-to-event and longitudinal GDF-15 over a median 27-year follow-up period showed that the marker evolution was positively associated with death of CHD (HR per IQR increase 3.02 95% CI: (2.26, 4.04), p < 0.001) and HF (HR per IQR increase 2.12 95% CI: (1.54, 2.92), p<0.001). However using Cox models with follow-up time starting at the time of the third examination, serial measurement of GDF-15, modeled as changes between the measurements, did not improve prediction over that of the most recent measurement. GDF-15 is a promising biomarker for prediction of HF and death due to CHD in the general population, which may provide prognostic information to already established clinical biomarkers. Repeated measurements of GDF-15 displayed only a slight improvement in the prediction of these endpoints compared to a single measurement.

  13. Neonatal orbital abscess

    Directory of Open Access Journals (Sweden)

    Khalil M Al-Salem

    2014-01-01

    Full Text Available Orbital complications due to ethmoiditis are rare in neonates. A case of orbital abscess due to acute ethmoiditis in a 28-day-old girl is presented. A Successful outcome was achieved following antimicrobial therapy alone; spontaneous drainage of the abscess occurred from the lower lid without the need for surgery. From this case report, we intend to emphasize on eyelid retraction as a sign of neonatal orbital abscess, and to review all the available literature of similar cases.

  14. Fatores perinatais associados ao óbito precoce em prematuros nascidos nos centros da Rede Brasileira de Pesquisas Neonatais Perinatal factors associated with early deaths of preterm infants born in Brazilian Network on Neonatal Research centers

    Directory of Open Access Journals (Sweden)

    Maria Fernanda Branco de Almeida

    2008-08-01

    Full Text Available OBJETIVO: Avaliar os fatores perinatais associados ao óbito neonatal precoce em prematuros com peso ao nascer entre 400 e 1.500 g. MÉTODOS: Coorte prospectiva e multicêntrica dos nascidos vivos com idade gestacional de 23 a 33 semanas e peso de 400-1.500 g, sem malformações em oito maternidades públicas terciárias universitárias entre junho de 2004 e maio de 2005. As características maternas e neonatais e a morbidade nas primeiras 72 horas de vida foram comparadas entre os prematuros que morreram ou sobreviveram até o sexto dia de vida. As variáveis perinatais associadas ao óbito neonatal precoce foram determinadas por regressão logística. RESULTADOS: No período, 579 recém-nascidos preencheram os critérios de inclusão. O óbito precoce ocorreu em 92 (16% neonatos, variando entre as unidades de 5 a 31%, e tal diferença persistiu controlando-se por um escore de gravidade clínica (SNAPPE-II. A análise multivariada para o desfecho óbito neonatal intra-hospitalar precoce mostrou associação com: idade gestacional de 23-27 semanas (odds ratio - OR = 5,0; IC95% 2,7-9,4, ausência de hipertensão materna (OR = 1,9; IC95% 1,0-3,7, Apgar 0-6 no 5º minuto (OR = 2,8; IC95% 1,4-5,4, presença de síndrome do desconforto respiratório (OR = 3,1; IC95% 1,4-6,6 e centro em que o paciente nasceu. CONCLUSÃO: Importantes fatores associados ao óbito neonatal precoce em prematuros de muito baixo peso são passíveis de intervenção, como a melhora da vitalidade fetal ao nascer e a diminuição da incidência e gravidade da síndrome do desconforto respiratório. As diferenças de mortalidade encontradas entre os centros apontam para a necessidade de identificar as melhores práticas e adotá-las de maneira uniforme em nosso meio.OBJECTIVE:To evaluate perinatal factors associated with early neonatal death in preterm infants with birth weights (BW of 400-1,500 g. METHODS: A multicenter prospective cohort study of all infants with BW of 400

  15. Causas básicas de las muertes neonatales en Brasil: conocer para prevenir Basic causes of neonatal deaths in Brazil: knowing to prevent

    Directory of Open Access Journals (Sweden)

    Linda Délia Carvalho de Oliveira Pedrosa

    2006-12-01

    Full Text Available La mortalidad neonatal es uno de los problemas de la salud pública más serios que enfrentan diversos países, incluido Brasil. Su análisis debe incluir la posibilidad de intervenciones con el objetivo de la prevención, y la evaluación de la atención es aplicada al binomio madre-neonato es un elemento que debe de considerarse centinela de esta ayuda. Una forma de analizar las muertes neonatales es clasificarlas. Con este propósito, algunas clasificaciones son usadas en todo el mundo. Todos estiman el conocimiento de la causa de la muerte neonatal y la disponibilidad de informaciones necesarias y fidedignas mediante el aporte de información estadística adecuada obtenida de documentos oficiales.

  16. Comparison of the Effectiveness of Oral Sucrose and Emla Cream in Reduction of Acute Pain Due to Heel Sticks for Blood Sampling in Neonates

    Directory of Open Access Journals (Sweden)

    S Abyari

    2007-04-01

    Full Text Available Introduction: Certain painful, invasive procedures are necessary for care, and are commonly performed in both healthly and sick neonates. Current evidence shows that the newborn infant has both physiologic and anatomic capacity to experience pain. Recent research suggests that pain experienced in the neonatal period might have long-term effects later in life. Previous research has shown that orally administered sweet-tasting solutions reduce signs of pain during painful procedures. This effect is considered to be mediated both by the release of endorphins and by a preabsorptive mechanism related to the sweet taste. Methods: This study was a controlled , randomized and double – blind study on 210 neonates. These newborns were randomly divided into 3 groups; A, B and C. Group A received 2 ml of 25% sucrose orally as well as base cream was applied at the site for heel stick, group B received 2 ml of distilled water and application of EMLA cream, while group C received 2 ml of distilled water and base cream. The heart rates of the newborn were recorded by the cardiac monitor before and after heel stick blood sampling and the duration of crying was determined as well. Pain was scored by DAN scale.There were no differences in demographic characteristics of all neonates. Results: The results showed that the DAN scale was significantly lower in the sucrose group (mean : 3.840 as compared to the EMLA group (mean: 3.366 and the placebo group(5.557, but the difference in the duration of crying was not significantly different in the sucrose group (mean: 10.5 second and the EMLA group(mean 8.76. Conclusion: Both sucrose and EMLA are effective in reducing stress associated with heel lancet in newborns, but as sucrose acts faster and is healthier, its usage is proposed in neonates requiring heel sticks for blood sampling.

  17. O envolvimento do enfermeiro no processo de morrer de bebês internados em Unidade Neonatal El involucramiento del enfermero en el proceso de morir de niños hospitalizados en una unidad de neonatología Nurses experiences with death in the neonatal intensive care unit

    Directory of Open Access Journals (Sweden)

    Isabella Rocha Aguiar

    2006-06-01

    úsqueda del equilibrio entre el cuidar del otro y de sí mismo.ABSTRACT OBJECTIVE: to understand Neonatal Intensive Care nurses experiences caring for dying neonates. METHODS: this was an qualitative exploratory study. Ten Neonatal Intensive Care Unit nurses from a school-affiliated hospital in Fortaleza, Ceará participated in this study. Data were collected during May and June, 2003. RESULTS: the following categories emerged from the analysis: feelings in the presence of death; interacting with the family in the process of dying; and, educational inadequacies coping with a terminally ill neonate. The feelings expressed by the nurses included loss, sadness, misery, weakness, and detachment. The nurses also see themselves involved with the grieving family, although the majority of them reported not having enough foundational knowledge with grief and thanatology. CONCLUSION: those nurses who deal with death in the workplace, such as the Neonatal Intensive Care Unit, are trying to keep a balance between caring for others and themselves.

  18. Hepatobiliary scan in neonatal Jaundice

    International Nuclear Information System (INIS)

    Nahar, Nurun; Hasan, Mizanul; Karim, M.A.

    2002-01-01

    Jaundice is more or less common in newborn babies. Through physiological jaundice is most common cause of neonatal jaundice, possibility of obstructive jaundice especially biliary atresia should be kept in mind. Early diagnosis of biliary atresia followed by surgical treatment can save baby's life. Otherwise death is inevitable due to liver failure. Hepatobiliary scan is the imaging study of choice in neonatal jaundice especially when there is persistent conjugated hyperbilirubinaemia. Total 27 newborn babies of suspected biliary atresia, aged 14 days to 4 months were referred to Institute of Nuclear Medicine for Hepatobiliary scan. All of them had high serum bilirubin ranged from 6.0 mg/dl with an average of 9.35 ng/dl serum bilirubin level. Ultrasonography of hepatobiliary system was performed in 14 cases showing normal sized liver in 4 cases and hepatomegaly in 10 cases. Hepatobiliary scan was done with 99m Tc-Mebrofenin (Br IDA) after preparing the baby with phenobarbitone for 3-5 days. 20 (67%) cases were scan positive suggesting biliary atresia (BA) and 7(27%) cases were scan negative. In BA there will be increased hepatic uptake of the radionuclide without any significant excretion even in 24 hours delayed images. Presence of radiotracer in the bowel exclude the diagnosis of BA. Early diagnosis of biliary atresia is very important because in this condition surgery should be performed early (within 60 days of life). Studies suggest that hepatobiliary scan after hepatic stimulation with phenobarbitone for a period of 3-5 days is highly accurate for differentiating biliary atresia from other causes of neonatal jaundice. It is very important to perform hepatobiliary scan in a case of neonatal jaundice to exclude biliary atresia for the sake of baby's life.(author)

  19. [Clinicopathologic characteristics and distribution of number of autopsies of patient death due to coccidioidomycosis at a referral hospital in northeastern México].

    Science.gov (United States)

    Calderón-Garcidueñas, Ana Laura; Piña-Osuna, Karina; Leal-Moreno, Ana María; López-Cárdenas, Adriana; Cerda-Flores, Ricardo M

    2004-01-01

    1. To describe clinical and pathologic characteristics of patients with coccidioidomycosis (CM) who died from 1983-2000 at a hospital in northeastern Mexico, and 2, to know distribution of number of deaths due to CM per year and month. From 4598 autopsies, 31 cases of CM were selected. Clinical chart and autopsy protocols were examined. Distribution of cases was analyzed by contingence table and Kolmogorov-Smirnov tests. There were 10 women and 21 men (aged 4 months to 60 years). In women, pregnancy was present in 40% of cases. In men, chronic renal failure (CRF) (38%) and AIDS (19%) were the pathologic conditions most frequently observed. Variation in distribution of cases throughout 18 years was not observed (p > 0.05). Mortality due to CM was 0.67% and variation in number of deaths was not found. In this endemic area, CM must be included in differential diagnosis of patients with risk factors such as pregnancy, CRF, and AIDS, especially if associated with pneumonia with miliary pattern or septicemia with splenomegaly.

  20. Time trends and risk factor associated with premature birth and infants deaths due to prematurity in Hubei Province, China from 2001 to 2012.

    Science.gov (United States)

    Xu, Haiqing; Dai, Qiong; Xu, Yusong; Gong, Zhengtao; Dai, Guohong; Ding, Ming; Duggan, Christopher; Hu, Zubin; Hu, Frank B

    2015-12-10

    The nutrition and epidemiologic transition has been associated with an increasing incidence of preterm birth in developing countries, but data from large observational studies in China have been limited. Our study was to describe the trends and factors associated with the incidence of preterm birth and infant mortality due to prematurity in Hubei Province, China. We conducted a population-based survey through the Maternal and Child Health Care Network in Hubei Province from January 2001 to December 2012. We used data from 16 monitoring sites to examine the trend and risk factors for premature birth as well as infant mortality associated with prematurity. A total of 818,481 live births were documented, including 76,923 preterm infants (94 preterm infants per 1,000 live births) and 2,248 deaths due to prematurity (2.75 preterm deaths per 1,000 live births). From 2001 to 2012, the incidence of preterm birth increased from 56.7 to 105.2 per 1,000 live births (P for trend prematurity declined from 95.0 to 13.4 per 1,000 live births (P for trend prematurity were observed in Hubei Province from 2001 to 2012. Our results provide important information for areas of improvements in reducing incidence and mortality of premature birth.

  1. Prevalence of neonatal septicaemia in the University of Port ...

    African Journals Online (AJOL)

    PROF. EZECHUKWU

    2013-04-30

    Apr 30, 2013 ... preterm.4 Neonatal septicaemia accounts for 13%-15% of all neonatal deaths globally.2 .... Small for gestational age. LGA = Large for gestational age .... note that the predominant organisms showed very high sensitivity to the ...

  2. The bereavement experience of adolescents and early young adults with cancer: Peer and parental loss due to death is associated with increased risk of adverse psychological outcomes.

    Directory of Open Access Journals (Sweden)

    Liza-Marie Johnson

    Full Text Available Adolescents commonly experience loss due to death, and perceived closeness to the deceased can often increase the intensity of bereavement. Adolescents and early young adult (AeYA oncology patients may recall previous losses or experience new losses, possibly of other children with cancer, while coping with their own increased risk of mortality. The bereavement experiences of AeYA patients are not well described in the literature.This analysis of bereavement sought to describe the prevalence and types of losses, the support following a death, and the impact of loss on AeYAs aged 13-21 years with malignant disease (or a hematologic disorder requiring allogeneic transplant. Participants were receiving active oncologic therapy or had completed therapy within the past 3 years. Participants completed a bereavement questionnaire and inventories on depression, anxiety, and somatization. The cross-sectional study enrolled 153 AeYAs (95% participation, most (88% of whom had experienced a loss due to death. The most commonly reported losses were of a grandparent (58% or friend (37%. Peer deaths were predominantly cancer related (66%. Many participants (39% self-identified a loss as "very significant." As loss significance increased, AeYAs were more likely to report that it had changed their life "a lot/enormously" (P<0.0001, that they were grieving "slowly or never got over it" (P<0.0001, and that they felt a need for more professional help (P = 0.026. Peer loss was associated with increased risk of adverse psychological outcomes (P = 0.029, as was parental loss (P = 0.018.Most AeYAs with serious illness experience the grief process as slow or ongoing. Peer or parental loss was associated with increased risk of negative mental health outcomes. Given the high prevalence of peer loss, screening for bereavement problems is warranted in AeYAs with cancer, and further research on grief and bereavement is needed in AeYAs with serious illness.

  3. Neonatal appendicitis: a survival case study

    Directory of Open Access Journals (Sweden)

    Izabela Linha Secco

    Full Text Available ABSTRACT Objective: To report a case of neonatal appendicitis in a children’s hospital in southern Brazil, demonstrating the impact on neonatal survival. Method: Case study with data collection from medical records, approved by the Institution and Ethics Committee for Research with Human Beings. Results: The clinical picture is initially characterized by food intolerance, evolving to hypoactivity, alteration of vital signs and septicemia due to intestinal perforation. Management is exclusively surgical, since no case described in the literature was diagnosed preoperatively and the findings usually point to acute abdomen. Conclusion: A focused clinical surveillance should be established when the infant presents peritoneal irritation. Follow-up of the evolution and the worsening of the symptoms by nurses, as part of the care team in partnership with the medical team, enables an early surgical intervention, thereby avoiding complications such as septicemia and death.

  4. Death and digital photography

    Directory of Open Access Journals (Sweden)

    Ennis, Helen

    2011-01-01

    Full Text Available This essay considers new possibilities for photographing the dying and dead in Australia that have been enabled by digital technologies. It argues that vernacular digital photographs demonstrate unprecedented degrees of control and privacy and further that they are purposefully withheld from public view, thus raising issues about visibility and secrecy.Some historical context is provided. Post mortem photographs were not uncommon in the nineteenth century but were in the domain of professional studio photographers. Commissioning post mortem portraits was rare for most of the twentieth century, due to changing attitudes to death and the transformation of the photographic industry. Photographing the deceased re-emerged in the 1980s, notably in the area of neonatal death.In the last five years death-related vernacular photographs have begun to proliferate. Unlike analogue processes, digital photography bypasses the involvement of others in processing and printing private images. Distribution to intimates can be achieved instantaneously via the internet, reinforcing social and familial connections.Vernacular digital photographs of the deceased do not address historical tradition but share their domestic and intimate contexts. Nor do they belong to a unified group, yet they have a common vocabulary which emphasises specificity and detail.

  5. Death and Digital Photography

    Directory of Open Access Journals (Sweden)

    Helen Ennis

    2011-03-01

    Full Text Available This essay considers new possibilities for photographing the dying and dead in Australia that have been enabled by digital technologies. It argues that vernacular digital photographs demonstrate unprecedented degrees of control and privacy and further that they are purposefully withheld from public view, thus raising issues about visibility and secrecy. Some historical context is provided. Post mortem photographs were not uncommon in the nineteenth century but were in the domain of professional studio photographers. Commissioning post mortem portraits was rare for most of the twentieth century, due to changing attitudes to death and the transformation of the photographic industry. Photographing the deceased re-emerged in the 1980s, notably in the area of neonatal death. In the last five years death-related vernacular photographs have begun to proliferate. Unlike analogue processes, digital photography bypasses the involvement of others in processing and printing private images. Distribution to intimates can be achieved instantaneously via the internet, reinforcing social and familial connections. Vernacular digital photographs of the deceased do not address historical tradition but share their domestic and intimate contexts. Nor do they belong to a unified group, yet they have a common vocabulary which emphasises specificity and detail.

  6. A case of death of the driver due to environmental asphyxia by liquid nitrogen leakage in the cabin of the car during a road accident

    Science.gov (United States)

    Raczkowska, Zuzanna; Samojłowicz, Dorota

    2013-01-01

    Nitrogen causes environmental asphyxia by displacing oxygen in the air leading to death. The study presents a case of a death of a driver death who was transporting flasks with liquid nitrogen that depressurized during an accident. The mechanism and cause of death were determined based on the result of the autopsy and histopathologic examination. The authors emphasize the relevance of accident scene inspection during establishing the cause of death in similar cases.

  7. Treatment of neonatal jaundice with filtered sunlight in Nigerian neonates: study protocol of a non-inferiority, randomized controlled trial

    OpenAIRE

    Slusher, Tina M; Olusanya, Bolajoko O; Vreman, Hendrik J; Wong, Ronald J; Brearley, Ann M; Vaucher, Yvonne E; Stevenson, David K

    2013-01-01

    Abstract Background Severe neonatal jaundice and its progression to kernicterus is a leading cause of death and disability among newborns in poorly-resourced countries, particularly in sub-Saharan Africa. The standard treatment for jaundice using conventional phototherapy (CPT) with electric artificial blue light sources is often hampered by the lack of (functional) CPT devices due either to financial constraints or erratic electrical power. ...

  8. Incidence of death from congenital toxoplasmosis in 0-4-year-old children in Japan.

    Science.gov (United States)

    Hoshino, Tatsuji; Kita, Masato; Imai, Yukihiro; Yamakawa, Masaru

    2014-08-01

    Congenital toxoplasmosis is caused by Toxoplasma gondii. The incidence of death due to congenital toxoplasmosis in Japan from 1974 to 2007 was calculated using the autopsy database of the Japanese Society of Pathology and vital statistics from the Ministry of Health, Labour and Welfare. Two neonatal deaths due to congenital toxoplasmosis were reported during that time. As there were 161,195 neonatal deaths during this period and 32,465 autopsies were performed, the yearly neonatal death from congenital toxoplasmosis was calculated as 2 × 161,195/32,465/34 = 0.29 and the autopsy rate as 32,465/161,195 = 0.2014 (20.14%). The calculated number of annual deaths in infants was 0.82 and in children aged 1-4 years it was 2.09; thus, although few, deaths from congenital toxoplasmosis do still occur in neonates, infants, and young children. Therefore, obstetricians and pediatricians should be aware of the potential for congenital toxoplasmosis, and pregnant women should make every effort to avoid T. gondii infection. © 2014 Japan Pediatric Society.

  9. 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...

  10. Successful transition to sulphonylurea therapy from insulin in a child with permanent neonatal diabetes due to a KCNJ11 gene mutation

    Directory of Open Access Journals (Sweden)

    Venkatesan Radha

    2018-01-01

    Full Text Available Neonatal diabetes mellitus (NDM is a monogenic form of diabetes mellitus that occurs in the first 6 months of life. It is a rare condition with a prevalence of 1 in 100,000–500,000 live births. We report a 3-month-old girl child with high blood glucose levels. She was diagnosed with diabetes mellitus during the 28th day of life and was on treatment with insulin. She was admitted for the control of high blood glucose levels during which she was started on multiple daily insulin treatment, but the control had been poor. As the age of onset is <6 months of life, genetic analysis has been done. It revealed the presence of a heterozygous mutation p. Gly334Val (p. G334V in KCNJ11 gene which confirmed the diagnosis of NDM. The child was successfully shifted from insulin to sulfonylureas, and the blood glucose levels are well maintained.

  11. Social representations of obstetricians and neonatologists about fetal and early neonatal death certificate in the city of São Paulo.

    Science.gov (United States)

    Schoeps, Daniela; Lefevre, Fernando; Silva, Zilda Pereira; Novaes, Hillegonda Maria Dutilh; Raspantini, Priscila Ribeiro; de Almeida, Márcia Furquim

    2014-01-01

    The insatisfactory completeness of the variables in the Death Certificate (DC) makes it difficult to obtain specific perinatal mortality indicators. To assess the social representation of physicians about the perinatal DC. Twenty-five physicians were interviewed in 15 hospitals in the city of São Paulo, in 2009. Qualitative analysis was performed with the Collective Subject Discourse technique. The DC is primarily considered according to its legal aspect. Physicians feel responsible for fulfilling the cause of death. The majority of them reported receiving help from other professionals to complete information on maternal characteristics and identification variables. There is lack of information on the mother's pre-natal conditions, which can make it difficult to identify the perinatal cause of death, mainly in the Unified Health System (SUS) hospitals. Some participants received specific DC training only when attending medical schools. The organization of medical work may affect the completion of the DC, especially in hospitals from SUS. Other professionals contributed to this task and their training can improve the quality of information.

  12. Tuberculosis neonatal

    OpenAIRE

    Pastor Durán, Xavier

    1986-01-01

    PROTOCOLOS TERAPEUTICOS. TUBERCULOSIS NEONATAL 1. CONCEPTO La tuberculosis neonatal es la infección del recién nacido producida por el bacilo de Koch. Es una situación rara pero grave que requiere un diagnóstico precoz y un tratamiento enérgico..

  13. Diffusion Weighted Imaging of the Neonatal Brain

    NARCIS (Netherlands)

    J. Dudink (Jeroen)

    2010-01-01

    textabstractAlthough in the last decades advances in fetal and neonatal medicine have reduced mortality in neonatal intensive care units in the Western world, the morbidity due to brain injury remains high. Patterns of neonatal brain injury can be roughly divided in (1) term and (2) preterm

  14. Quantitative in vivo detection of brain cell death after hypoxia ischemia using the lipid peak at 1.3 ppm of proton magnetic resonance spectroscopy in neonatal rats.

    Science.gov (United States)

    Ahn, So Yoon; Yoo, Hye Soo; Lee, Jang Hoon; Sung, Dong Kyung; Jung, Yu Jin; Sung, Se In; Lim, Keun Ho; Chang, Yun Sil; Lee, Jung Hee; Kim, Ki Soo; Park, Won Soon

    2013-07-01

    This study was performed to determine the accuracy of proton magnetic spectroscopy ((1)H-MRS) lipid peak as a noninvasive tool for quantitative in vivo detection of brain cell death. Seven day-old Sprague Dawley rats were subjected to 8% oxygen following a unilateral carotid artery ligation. For treatment, cycloheximide was given immediately after hypoxic ischemia (HI). Lipid peak was measured using (1)H-MRS at 24 hr after HI, and then brains were harvested for fluorocytometric analyses with annexin V/propidium iodide (PI) and fluorescent probe JC-1, and for adenosine-5'-triphosphate (ATP) and lactate. Increased lipid peak at 1.3 ppm measured with (1)H-MRS, apoptotic and necrotic cells, and loss of mitochondrial membrane potential (ΔΨ) at 24 hr after HI were significantly improved with cycloheximide treatment. Significantly reduced brain ATP and increased lactate levels observed at 24 hr after HI showed a tendency to improve without statistical significance with cycloheximide treatment. Lipid peak at 1.3 ppm showed significant positive correlation with both apoptotic and necrotic cells and loss of ΔΨ, and negative correlation with normal live cells. Lipid peak at 1.3 ppm measured by (1)H-MRS might be a sensitive and reliable diagnostic tool for quantitative in vivo detection of brain cell death after HI.

  15. The Patterns and Causes of Neonatal Mortality at a Tertiary Hospital in Oman

    Directory of Open Access Journals (Sweden)

    Mohamed Abdellatif

    2013-11-01

    Full Text Available Objective: To report the patterns and causes of neonatal death from a tertiary care neonatal intensive care unit over a period of four years.Methods: This is a retrospective cohort study where four years data (January 2006 - December 2009 of all inborn neonatal admissions and deaths were collected from the neonatal intensive care unit at Sultan Qaboos University hospital on predesigned forms. All out born admissions and deaths were excluded. The causes of neonatal death were classified using Wigglesworth's classification.Results: The number of inborn live births during the study period was 10064 and the total number of inborn neonatal admissions was 1475. The total deaths (neonatal and post neonatal at the neonatal intensive care unit was 73 (63 inborn and 10 out born. Among the inborn, five deaths were post neonatal deaths and hence, excluded from analysis. Among the remaining inborn neonatal deaths (n=58, 34 (59% were males and 24 (41% were females. The number of neonatal admissions increased over the years during the study period from 248 to 356, while the number of deaths also increased from 10 deaths in 2006, to 20 deaths in 2009. The primary causes of neonatal deaths were prematurity and its complications 52% (n=30. Lethal congenital malformations lead to 17 (29% newborn deaths, specific diagnosis in 7 newborns (12%, and birth asphyxia in four (7% of cases.Conclusion: There was an increasing trend of neonatal admissions and deaths among inborn babies. Prematurity, with sepsis as its major complication and congenital malformations were the leading cause of neonatal mortality.

  16. Patterns of civilian and child deaths due to war-related violence in Syria: a comparative analysis from the Violation Documentation Center dataset, 2011-16.

    Science.gov (United States)

    Guha-Sapir, Debarati; Schlüter, Benjamin; Rodriguez-Llanes, Jose Manuel; Lillywhite, Louis; Hicks, Madelyn Hsiao-Rei

    2018-01-01

    Since March, 2011, the Syrian civil war has lowered life expectancy by as much as 20 years. We describe demographic, spatial, and temporal patterns of direct deaths of civilians and opposition combatants from conflict-related violence in 6 years of war. We analysed conflict-related violent deaths with complete information on date, place, and cause of death and demographic group occurring from March 18, 2011, to Dec 31, 2016, recorded by the Violation Documentation Center (VDC). We included civilian and combatant deaths in all Syrian governorates, excluding government-controlled areas. We did not include detainees and missing persons, nor deaths from siege conditions or insufficient medical care. We categorised deaths based on VDC weapon type. We used χ 2 testing to compare deaths from different weapons in civilian men, women, boys, and girls and adult and child combatants. We analysed deaths by governorate and over time. The VDC recorded 143 630 conflict-related violent deaths with complete information between March 18, 2011, and Dec 31, 2016. Syrian civilians constituted 101 453 (70·6%) of the deaths compared with 42 177 (29·4%) opposition combatants. Direct deaths were caused by wide-area weapons of shelling and air bombardments in 58 099 (57·3%) civilians, including 8285 (74·6%) civilian women and 13 810 (79·4%) civilian children, and in 4058 (9·6%) opposition combatants. Proportions of children among civilian deaths increased from 8·9% (388 of 4254 civilian deaths) in 2011 to 19·0% (4927 of 25 972) in 2013 and to 23·3% (2662 of 11 444) in 2016. Of 7566 deaths from barrel bombs, 7351 (97·2%) were civilians, of whom 2007 (27·3%) were children. Of 20 281 deaths by execution, 18 747 (92·4%) were civilians and 1534 (7·6%) were opposition combatants. Compared with opposition child soldiers who were male (n=333), deaths of civilian male children (n=11 730) were caused more often by air bombardments (39·2% vs 5·4%, pwar crime. None

  17. Neuronal death induced by misfolded prion protein is due to NAD+ depletion and can be relieved in vitro and in vivo by NAD+ replenishment

    Science.gov (United States)

    Zhou, Minghai; Ottenberg, Gregory; Sferrazza, Gian Franco; Hubbs, Christopher; Fallahi, Mohammad; Rumbaugh, Gavin; Brantley, Alicia F.

    2015-01-01

    The mechanisms of neuronal death in protein misfolding neurodegenerative diseases such as Alzheimer’s, Parkinson’s and prion diseases are poorly understood. We used a highly toxic misfolded prion protein (TPrP) model to understand neurotoxicity induced by prion protein misfolding. We show that abnormal autophagy activation and neuronal demise is due to severe, neuron-specific, nicotinamide adenine dinucleotide (NAD+) depletion. Toxic prion protein-exposed neuronal cells exhibit dramatic reductions of intracellular NAD+ followed by decreased ATP production, and are completely rescued by treatment with NAD+ or its precursor nicotinamide because of restoration of physiological NAD+ levels. Toxic prion protein-induced NAD+ depletion results from PARP1-independent excessive protein ADP-ribosylations. In vivo, toxic prion protein-induced degeneration of hippocampal neurons is prevented dose-dependently by intracerebral injection of NAD+. Intranasal NAD+ treatment of prion-infected sick mice significantly improves activity and delays motor impairment. Our study reveals NAD+ starvation as a novel mechanism of autophagy activation and neurodegeneration induced by a misfolded amyloidogenic protein. We propose the development of NAD+ replenishment strategies for neuroprotection in prion diseases and possibly other protein misfolding neurodegenerative diseases. PMID:25678560

  18. Neonatal sepsis: Highlighting the principles of diagnosis and ...

    African Journals Online (AJOL)

    Neonatal sepsis is a clinical syndrome consisting of nonspecific symptoms and signs of infection, accompanied by a bacteraemia in the first 28 days of life. The risk of neonatal sepsis and death increases with decreasing birth weight and gestational age. South African data have reported the overall incidence of neonatal ...

  19. An audit of some health facilities and equipment for neonatal ...

    African Journals Online (AJOL)

    Background: Neonatal Mortality rates continue to be high in spite of the general decline in under-5 mortality rates in Nigeria. Available evidence has shown that the availability of a skilled birth attendant and equipment for basic neonatal resuscitation is necessary for the prevention of early neonatal death which accounts for ...

  20. Influence of iron status on risk of maternal or neonatal infection and on neonatal mortality with an emphasis on developing countries

    NARCIS (Netherlands)

    Brabin, Loretta; Brabin, Bernard J.; Gies, Sabine

    2013-01-01

    Infection is a major cause of neonatal death in developing countries. This review investigates whether host iron status affects the risk of maternal and/or neonatal infection, potentially contributing to neonatal death, and summarizes the iron acquisition mechanisms described for pathogens causing

  1. Neonatal hypertension.

    Science.gov (United States)

    Sharma, Deepak; Farahbakhsh, Nazanin; Shastri, Sweta; Sharma, Pradeep

    2017-03-01

    Neonatal hypertension (HT) is a frequently under reported condition and is seen uncommonly in the intensive care unit. Neonatal HT has defined arbitrarily as blood pressure more than 2 standard deviations above the base as per the age or defined as systolic BP more than 95% for infants of similar size, gestational age and postnatal age. It has been diagnosed long back but still is the least studied field in neonatology. There is still lack of universally accepted normotensive data for neonates as per gestational age, weight and post-natal age. Neonatal HT is an important morbidity that needs timely detection and appropriate management, as it can lead to devastating short-term effect on various organs and also poor long-term adverse outcomes. There is no consensus yet about the treatment guidelines and majority of treatment protocols are based on the expert opinion. Neonate with HT should be evaluated in detail starting from antenatal, perinatal, post-natal history, and drug intake by neonate and mother. This review article covers multiple aspects of neonatal hypertension like definition, normotensive data, various etiologies and methods of BP measurement, clinical features, diagnosis and management.

  2. Fetal and neonatal thyrotoxicosis

    Science.gov (United States)

    Batra, Chandar Mohan

    2013-01-01

    Fetal thyrotoxicosis is a rare disease occurring in 1 out of 70 pregnancies with Grave's disease or in 1 out of 4000-50,000 deliveries. The mortality is 12-20%, usually from heart failure, but other complications are tracheal compression, infections and thrombocytopenia. It results from transfer of thyroid stimulating immunoglobulins from mother to fetus through the placenta. This transplacental transfer begins around 20th week of pregnancy and reaches its maximum by 30th week. These autoantibodies bind to the fetal thyroid stimulating hormone (TSH) receptors and increase the secretion of the thyroid hormones. The mother has an active autoimmune thyroid disease or has been treated for it in the past. She may be absolutely euthyroid due to past treatment by drugs, surgery or radioiodine ablation, but still have active TSH receptor stimulating autoantibodies, which can cause fetal thyrotoxicosis. The other features of this disease are fetal tachycardia, fetal goiter and history of spontaneous abortions and findings of goiter, ascites, craniosyntosis, fetal growth retardation, maceration and hydrops at fetal autopsy. If untreated, this disease can result in intrauterine death. The treatment for this disease consists of giving carbimazole to the mother, which is transferred through the placenta to the fetus. The dose of carbimazole is titrated with the fetal heart rate. If the mother becomes hypothyroid due to carbimazole, thyroxine is added taking advantage of the fact that very little of thyroxine is transferred across the placenta. Neonatal thyrotoxicosis patients are very sick and require emergency treatment. The goal of the treatment is to normalize thyroid functions as quickly as possible, to avoid iatrogenic hypothyroidism while providing management and supportive therapy for the infant's specific signs and symptoms. PMID:24251220

  3. Neonatal retinoblastoma

    Directory of Open Access Journals (Sweden)

    Tero T Kivelä

    2017-01-01

    Full Text Available From 7% to 10% of all retinoblastomas and from 44% to 71% of familial retinoblastomas in developed countries are diagnosed in the neonatal period, usually through pre- or post-natal screening prompted by a positive family history and sometimes serendipitously during screening for retinopathy of prematurity or other reasons. In developing countries, neonatal diagnosis of retinoblastoma has been less common. Neonatal retinoblastoma generally develops from a germline mutation of RB1, the retinoblastoma gene, even when the family history is negative and is thus usually hereditary. At least one-half of infants with neonatal retinoblastoma have unilateral tumors when the diagnosis is made, typically the International Intraocular Retinoblastoma Classification (Murphree Group B or higher, but most germline mutation carriers will progress to bilateral involvement, typically Group A in the fellow eye. Neonatal leukokoria usually leads to the diagnosis in children without a family history of retinoblastoma, and a Group C tumor or higher is typical in the more advanced involved eye. Almost all infants with neonatal retinoblastoma have at least one eye with a tumor in proximity to the foveola, but the macula of the fellow eye is frequently spared. Consequently, loss of reading vision from both eyes is exceptional. A primary ectopic intracranial neuroblastic tumor known as trilateral retinoblastoma is no more common after neonatal than other retinoblastoma. For many reasons, neonatal retinoblastoma may be a challenge to eradicate, and the early age at diagnosis and relatively small tumors do not guarantee the preservation of both eyes of every involved child. Oncology nurses can be instrumental in contributing to better outcomes by ensuring that hereditary retinoblastoma survivors receive genetic counseling, by referring families of survivors to early screening programs when they are planning for a baby, and by providing psychological and practical support

  4. Neonatal euthanasia.

    Science.gov (United States)

    Kon, Alexander A

    2009-12-01

    Despite advances in the care of infants, there remain many newborns whose medical conditions are incompatible with sustained life. At times, healthcare providers and parents may agree that prolonging life is not an appropriate goal of care, and they may redirect treatment to alleviate suffering. While pediatric palliative treatment protocols are gaining greater acceptance, there remain some children whose suffering is unrelenting despite maximal efforts. Due to the realization that some infants suffer unbearably (ie, the burdens of suffering outweigh the benefits of life), the Dutch have developed a protocol for euthanizing these newborns. In this review, I examine the ethical aspects of 6 forms of end of life care, explain the ethical arguments in support of euthanasia, review the history and verbiage of the United States regulations governing limiting and withdrawing life-prolonging interventions in infants, describe the 3 categories of neonates for whom the Dutch provide euthanasia, review the published analyses of the Dutch protocol, and finally present some practical considerations should some form of euthanasia ever be deemed appropriate.

  5. Home delivery and neonatal mortality in North Carolina.

    Science.gov (United States)

    Burnett, C A; Jones, J A; Rooks, J; Chen, C H; Tyler, C W; Miller, C A

    1980-12-19

    Neonatal mortality examined by place and circumstances of delivery in North Carolina during 1974 through 1976 with attention given to home delivery. Planned home deliveries by lay-midwives resulted in three neonatal deaths per 1,000 live births; planned home deliveries without a lay-midwife, 30 neonatal deaths per 1,000 live births; and unplanned home deliveries, 120 neonatal deaths per 1,000 live births. The women babies were delivered by lay-midwives were screened in county health departments and found to be medically at low risk of complication, despite having demographic characteristics associated with high-risk of neonatal mortality. Conversely, the women delivered at home without known prenatal screening or a trained attendant had low-risk demographic characteristics but experienced a high rate of neonatal mortality. Planning, prenatal screening, and attendant-training were important in differentiating the risk of neonatal mortality in this uncontrolled, observational study.

  6. Causes of accidental childhood deaths in China in 2010

    DEFF Research Database (Denmark)

    Chan, Kit Yee; Yu, Xin-Wei; Lu, Jia-Peng

    2015-01-01

    -4 years in China, of which 31 633 (10.1%) were accidental. Accidental deaths contributed 7240 (4.0%) of all deaths in neonatal period, 8838 (10.5%) among all post-neonatal infant deaths, and 15 554 (31.7%) among children with 1-4 years of age. Among four tested models, the most predictive was used...

  7. Avaliação de preditores do óbito neonatal em uma série histórica de nascidos vivos no Nordeste brasileiro An evaluation of the predictors of neonatal death in a time series of live births in the Northeast Region of Brazil

    Directory of Open Access Journals (Sweden)

    Lygia Carmen de Moraes Vanderlei

    2010-12-01

    Full Text Available OBJETIVOS: avaliar tendência dos preditores do óbito neonatal entre os nascidos vivos e qualidade do preenchimento do Sistema de Informações para Nascidos Vivos (Sinasc institucional. MÉTODOS: série histórica do Sinasc do Instituto de Medicina Integral Prof. Fernando Figueira (1995-2006 em Recife, Pernambuco, Brasil. Foram avaliadas: completitude de preenchimento das variáveis e tendência dos indicadores de risco para mortalidade infantil (baixo peso ao nascer; anóxia; prematuridade; cesariana; ausência de pré-natal; mãe adolescente; analfabetismo e nenhum filho nascido vivo e morto. Significância estatística para teste t de Student foi de 5% em um modelo de regressão linear. RESULTADOS: 58.689 nascidos vivos com contínuo incremento a partir de 2002; baixo peso ao nascer, 22,8%; Apgar OBJECTVES: to evaluate predictors of neonatal death among live births and the quality of use of the institutional Live Birth Information System register (Sinasc. METHODS: a time serie based on data from the Sinasc of the Instituto de Medicina Integral Prof. Fernando Figueira (1995-2006 in the city Recife, Pernambuco, Brazil. The following were evaluated: the completeness of the forms and the tendency regarding risk factors for infant mortality (low birth weight; anoxia; premature birth; caesarian birth; lack of prenatal care; adolescent pregnancy; illiteracy; and having had no live or still born child. Statistical significance was tested using Student's t test with p<0.05 in a linear regression model. RESULTS: 58,689 live births occurred with a continued rise from 2002 onwards; low birth weight, 22.8%; Apgar <7 1º minute 15.3%; premature 22.4%; Caesarian birth 38,2%; adolescent mothers 27.2%; illiteracy 2.7% and 89% with no live or still born child. One percent of variables were not recorded. The following variables increased (p<0.05: Apgar in the 1st minute, low birth weight, premature birth and caesarian birth; and the following decreased (p<0

  8. Estimation of maternal and neonatal mortality at the subnational level in Liberia.

    Science.gov (United States)

    Moseson, Heidi; Massaquoi, Moses; Bawo, Luke; Birch, Linda; Dahn, Bernice; Zolia, Yah; Barreix, Maria; Gerdts, Caitlin

    2014-11-01

    To establish representative local-area baseline estimates of maternal and neonatal mortality using a novel adjusted sisterhood method. The status of maternal and neonatal health in Bomi County, Liberia, was investigated in June 2013 using a population-based survey (n=1985). The standard direct sisterhood method was modified to account for place and time of maternal death to enable calculation of subnational estimates. The modified method of measuring maternal mortality successfully enabled the calculation of area-specific estimates. Of 71 reported deaths of sisters, 18 (25.4%) were due to pregnancy-related causes and had occurred in the past 3 years in Bomi County. The estimated maternal mortality ratio was 890 maternal deaths for every 100 000 live births (95% CI, 497-1301]. The neonatal mortality rate was estimated to be 47 deaths for every 1000 live births (95% CI, 42-52). In total, 322 (16.9%) of 1900 women with accurate age data reported having had a stillbirth. The modified direct sisterhood method may be useful to other countries seeking a more regionally nuanced understanding of areas in which neonatal and maternal mortality levels still need to be reduced to meet Millennium Development Goals. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  9. Neonatal Nursing

    OpenAIRE

    Crawford, Doreen; Morris, Maryke

    1994-01-01

    "Neonatal Nursing" offers a systematic approach to the nursing care of the sick newborn baby. Nursing actions and responsibilities are the focus of the text with relevant research findings, clinical applications, anatomy, physiology and pathology provided where necessary. This comprehensive text covers all areas of neonatal nursing including ethics, continuing care in the community, intranatal care, statistics and pharmokinetics so that holistic care of the infant is described. This book shou...

  10. 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.

  11. 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.

  12. Reducing neonatal mortality in India: critical role of access to emergency obstetric care.

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    Anu Rammohan

    Full Text Available BACKGROUND: Neonatal mortality currently accounts for 41% of all global deaths among children below five years. Despite recording a 33% decline in neonatal deaths between 2000 and 2009, about 900,000 neonates died in India in 2009. The decline in neonatal mortality is slower than in the post-neonatal period, and neonatal mortality rates have increased as a proportion of under-five mortality rates. Neonatal mortality rates are higher among rural dwellers of India, who make up at least two-thirds of India's population. Identifying the factors influencing neonatal mortality will significantly improve child survival outcomes in India. METHODS: Our analysis is based on household data from the nationally representative 2008 Indian District Level Household Survey (DLHS-3. We use probit regression techniques to analyse the links between neonatal mortality at the household level and households' access to health facilities. The probability of the child dying in the first month of birth is our dependent variable. RESULTS: We found that 80% of neonatal deaths occurred within the first week of birth, and that the probability of neonatal mortality is significantly lower when the child's village is closer to the district hospital (DH, suggesting the critical importance of specialist hospital care in the prevention of newborn deaths. Neonatal deaths were lower in regions where emergency obstetric care was available at the District Hospitals. We also found that parental schooling and household wealth status improved neonatal survival outcomes. CONCLUSIONS: Addressing the main causes of neonatal deaths in India--preterm deliveries, asphyxia, and sepsis--requires adequacy of specialised workforce and facilities for delivery and neonatal intensive care and easy access by mothers and neonates. The slow decline in neonatal death rates reflects a limited attention to factors which contribute to neonatal deaths. The suboptimal quality and coverage of Emergency

  13. Death cap

    DEFF Research Database (Denmark)

    Rudbæk, Torsten R; Kofoed, Pernille Bouteloup; Bove, Jeppe

    2014-01-01

    Death cap (Amanita phalloides) is commonly found and is one of the five most toxic fungi in Denmark. Toxicity is due to amatoxin, and poisoning is a serious medical condition, causing organ failure with potential fatal outcome. Acknowledgement and clarification of exposure, symptomatic and focused...

  14. Neonatal neurosonography

    Energy Technology Data Exchange (ETDEWEB)

    Riccabona, Michael, E-mail: michael.riccabona@klinikum-graz.at

    2014-09-15

    Paediatric and particularly neonatal neurosonography still remains a mainstay of imaging the neonatal brain. It can be performed at the bedside without any need for sedation or specific monitoring. There are a number of neurologic conditions that significantly influence morbidity and mortality in neonates and infants related to the brain and the spinal cord; most of them can be addressed by ultrasonography (US). However, with the introduction of first CT and then MRI, neonatal neurosonography is increasingly considered just a basic first line technique that offers only orienting information and does not deliver much relevant information. This is partially caused by inferior US performance – either by restricted availability of modern equipment or by lack of specialized expertise in performing and reading neurosonographic scans. This essay tries to highlight the value and potential of US in the neonatal brain and briefly touching also on the spinal cord imaging. The common pathologies and their US appearance as well as typical indication and applications of neurosonography are listed. The review aims at encouraging paediatric radiologists to reorient there imaging algorithms and skills towards the potential of modern neurosonography, particularly in the view of efficacy, considering growing economic pressure, and the low invasiveness as well as the good availability of US that can easily be repeated any time at the bedside.

  15. Neonatal pain

    Science.gov (United States)

    Walker, Suellen M

    2014-01-01

    Effective management of procedural and postoperative pain in neonates is required to minimize acute physiological and behavioral distress and may also improve acute and long-term outcomes. Painful stimuli activate nociceptive pathways, from the periphery to the cortex, in neonates and behavioral responses form the basis for validated pain assessment tools. However, there is an increasing awareness of the need to not only reduce acute behavioral responses to pain in neonates, but also to protect the developing nervous system from persistent sensitization of pain pathways and potential damaging effects of altered neural activity on central nervous system development. Analgesic requirements are influenced by age-related changes in both pharmacokinetic and pharmacodynamic response, and increasing data are available to guide safe and effective dosing with opioids and paracetamol. Regional analgesic techniques provide effective perioperative analgesia, but higher complication rates in neonates emphasize the importance of monitoring and choice of the most appropriate drug and dose. There have been significant improvements in the understanding and management of neonatal pain, but additional research evidence will further reduce the need to extrapolate data from older age groups. Translation into improved clinical care will continue to depend on an integrated approach to implementation that encompasses assessment and titration against individual response, education and training, and audit and feedback. PMID:24330444

  16. Ictericia Neonatal

    OpenAIRE

    Blanco de la Fuente, María Isabel

    2014-01-01

    El motivo que ha llevado a la realización de este trabajo fin de grado sobre el tema de la ICTERICIA NEONATAL se debe a la elevada frecuencia de su aparición en la población. Un porcentaje elevado de RN la padecen al nacer siendo, en la mayor parte de los casos, un proceso fisiológico resuelto con facilidad debido a una inmadurez del sistema hepático y a una hiperproducción de bilirrubina. La ictericia neonatal es la pigmentación de color amarillo de la piel y mucosas en ...

  17. T-cell proliferative responses following sepsis in neonatal rats.

    Science.gov (United States)

    Dallal, Ousama; Ravindranath, Thyyar M; Choudhry, Mashkoor A; Kohn, Annamarie; Muraskas, Jonathan K; Namak, Shahla Y; Alattar, Mohammad H; Sayeed, Mohammed M

    2003-01-01

    Both experimental and clinical evidence suggest a suppression of T-cell function in burn and sepsis. The objective of the present study was to evaluate splenocyte and purified T-cell proliferative response and IL-2 production in septic neonatal rats. We also examined if alterations in T-cell proliferation and IL-2 production in neonatal sepsis is due to elevation in PGE2. PGE2 is known to play a significant role in T-cell suppression during sepsis in adults. Sepsis was induced in 15-day-old neonatal Sprague-Dawley rats by implanting 0.1 cm3 of fecal pellet impregnated with Escherichia coli (50 CFU) and Bacteroides fragilis (10(3) CFU). Animals receiving fecal pellets without the bacteria were designated as sterile. A group of septic and sterile rats were treated with PGE2 synthesis inhibitors, NS398 and resveratrol. These treatments of animals allowed us to evaluate the role of PGE2 in T-cell suppression during neonatal sepsis. Splenocytes as well as purified T cells were prepared and then proliferative response and IL-2 productive capacities were measured. A significant suppression of splenocyte proliferation and IL-2 production was noticed in both sterile and septic animals compared to the T cells from unoperated control rats. In contrast, the proliferation and IL-2 production by nylon wool purified T cells in sterile rats was not significantly different from control rats, whereas, a significant suppression in Con A-mediated T-cell proliferation and IL-2 production noticed in septic rat T cells compared to the sterile and control rat T cells. Such decrease in T-cell proliferation and IL-2 production was accompanied with 20-25% deaths in neonates implanted with septic pellets. No mortality was noted in sterile-implanted neonates. Treatment of animals with COX-1 inhibitor had no effect on T-cell proliferation response in both septic and sterile groups, whereas COX-2 inhibitor abrogated the decrease in T-cell proliferative response in the septic group. The treatment

  18. Quantitative risk assessment of listeriosis-associated deaths due to Listeria monocytogenes contamination of deli meats originating from manufacture and retail.

    Science.gov (United States)

    Pradhan, Abani K; Ivanek, Renata; Gröhn, Yrjö T; Bukowski, Robert; Geornaras, Ifigenia; Sofos, John N; Wiedmann, Martin

    2010-04-01

    The objective of this study was to estimate the relative risk of listeriosis-associated deaths attributable to Listeria monocytogenes contamination in ham and turkey formulated without and with growth inhibitors (GIs). Two contamination scenarios were investigated: (i) prepackaged deli meats with contamination originating solely from manufacture at a frequency of 0.4% (based on reported data) and (ii) retail-sliced deli meats with contamination originating solely from retail at a frequency of 2.3% (based on reported data). Using a manufacture-to-consumption risk assessment with product-specific growth kinetic parameters (i.e., lag phase and exponential growth rate), reformulation with GIs was estimated to reduce human listeriosis deaths linked to ham and turkey by 2.8- and 9-fold, respectively, when contamination originated at manufacture and by 1.9- and 2.8-fold, respectively, for products contaminated at retail. Contamination originating at retail was estimated to account for 76 and 63% of listeriosis deaths caused by ham and turkey, respectively, when all products were formulated without GIs and for 83 and 84% of listeriosis deaths caused by ham and turkey, respectively, when all products were formulated with GIs. Sensitivity analyses indicated that storage temperature was the most important factor affecting the estimation of per annum relative risk. Scenario analyses suggested that reducing storage temperature in home refrigerators to consistently below 7 degrees C would greatly reduce the risk of human listeriosis deaths, whereas reducing storage time appeared to be less effective. Overall, our data indicate a critical need for further development and implementation of effective control strategies to reduce L. monocytogenes contamination at the retail level.

  19. Hiperbilirrubinemia neonatal agravada Aggravated neonatal hyperbilirubinemia

    Directory of Open Access Journals (Sweden)

    Ana Campo González

    2010-09-01

    Full Text Available INTRODUCCIÓN. La mayoría de las veces la ictericia en el recién nacido es un hecho fisiológico, causado por una hiperbilirrubinemia de predominio indirecto, secundario a inmadurez hepática e hiperproducción de bilirrubina. El objetivo de este estudio fue determinar el comportamiento de la hiperbilirrubinemia neonatal en el Hospital Docente Ginecoobstétrico de Guanabacoa en los años 2007 a 2009. MÉTODOS. Se realizó un estudio descriptivo y retrospectivo de 173 recién nacidos que ingresaron al Departamento de Neonatología con diagnóstico de hiperbilirrubinemia agravada. RESULTADOS. La incidencia de hiperbilirrubinemia neonatal agravada fue del 3,67 % y predominó en hermanos con antecedentes de ictericia (56,65 %. El tiempo de aparición fue de 48 a 72 h (76,87 % y entre los factores agravantes se hallaron el nacimiento pretérmino y el bajo peso al nacer. La mayoría de los pacientes fueron tratados con luminoterapia (90,17 %. CONCLUSIÓN. La hiperbilirrubinemia neonatal agravada constituye un problema de salud. Los factores agravantes son la prematuridad y el bajo peso al nacer. La luminoterapia es una medida terapéutica eficaz para su tratamiento.INTRODUCTION. Most of times jaundice in newborn is a physiological fact due to hyperbilirubinemia of indirect predominance, secondary to liver immaturity and to bilirubin hyperproduction. The aim of present of present study was to determine the behavior of neonatal hyperbilirubinemia in the Gynecology and Obstetrics Teaching Hospital of Guanabacoa municipality from 2007 to 2009. METHODS. A retrospective and descriptive study was conducted in 173 newborn patients admitted in the Neonatology Department diagnosed with severe hyperbilirubinemia. RESULTS. The incidence of severe neonatal hyperbilirubinemia was of 3,67% with predominance in brothers with a history of jaundice (56,65%. The time of appearance was of 48 to 72 hrs (76,87% and among the aggravating factors were the preterm birth and

  20. Determinants of neonatal mortality in Indonesia

    Directory of Open Access Journals (Sweden)

    Agho Kingsley

    2008-07-01

    Full Text Available Abstract Background Neonatal mortality accounts for almost 40 per cent of under-five child mortality, globally. An understanding of the factors related to neonatal mortality is important to guide the development of focused and evidence-based health interventions to prevent neonatal deaths. This study aimed to identify the determinants of neonatal mortality in Indonesia, for a nationally representative sample of births from 1997 to 2002. Methods The data source for the analysis was the 2002–2003 Indonesia Demographic and Health Survey from which survival information of 15,952 singleton live-born infants born between 1997 and 2002 was examined. Multilevel logistic regression using a hierarchical approach was performed to analyze the factors associated with neonatal deaths, using community, socio-economic status and proximate determinants. Results At the community level, the odds of neonatal death was significantly higher for infants from East Java (OR = 5.01, p = 0.00, and for North, Central and Southeast Sulawesi and Gorontalo combined (OR = 3.17, p = 0.03 compared to the lowest neonatal mortality regions of Bali, South Sulawesi and Jambi provinces. A progressive reduction in the odds was found as the percentage of deliveries assisted by trained delivery attendants in the cluster increased. The odds of neonatal death were higher for infants born to both mother and father who were employed (OR = 1.84, p = 0.00 and for infants born to father who were unemployed (OR = 2.99, p = 0.02. The odds were also higher for higher rank infants with a short birth interval (OR = 2.82, p = 0.00, male infants (OR = 1.49, p = 0.01, smaller than average-sized infants (OR = 2.80, p = 0.00, and infant's whose mother had a history of delivery complications (OR = 1.81, p = 0.00. Infants receiving any postnatal care were significantly protected from neonatal death (OR = 0.63, p = 0.03. Conclusion Public health interventions directed at reducing neonatal death should

  1. Determinants of neonatal mortality in Indonesia.

    Science.gov (United States)

    Titaley, Christiana R; Dibley, Michael J; Agho, Kingsley; Roberts, Christine L; Hall, John

    2008-07-09

    Neonatal mortality accounts for almost 40 per cent of under-five child mortality, globally. An understanding of the factors related to neonatal mortality is important to guide the development of focused and evidence-based health interventions to prevent neonatal deaths. This study aimed to identify the determinants of neonatal mortality in Indonesia, for a nationally representative sample of births from 1997 to 2002. The data source for the analysis was the 2002-2003 Indonesia Demographic and Health Survey from which survival information of 15,952 singleton live-born infants born between 1997 and 2002 was examined. Multilevel logistic regression using a hierarchical approach was performed to analyze the factors associated with neonatal deaths, using community, socio-economic status and proximate determinants. At the community level, the odds of neonatal death was significantly higher for infants from East Java (OR = 5.01, p = 0.00), and for North, Central and Southeast Sulawesi and Gorontalo combined (OR = 3.17, p = 0.03) compared to the lowest neonatal mortality regions of Bali, South Sulawesi and Jambi provinces. A progressive reduction in the odds was found as the percentage of deliveries assisted by trained delivery attendants in the cluster increased. The odds of neonatal death were higher for infants born to both mother and father who were employed (OR = 1.84, p = 0.00) and for infants born to father who were unemployed (OR = 2.99, p = 0.02). The odds were also higher for higher rank infants with a short birth interval (OR = 2.82, p = 0.00), male infants (OR = 1.49, p = 0.01), smaller than average-sized infants (OR = 2.80, p = 0.00), and infant's whose mother had a history of delivery complications (OR = 1.81, p = 0.00). Infants receiving any postnatal care were significantly protected from neonatal death (OR = 0.63, p = 0.03). Public health interventions directed at reducing neonatal death should address community, household and individual level factors

  2. Pelayanan Kesehatan Ibu dan Kematian Neonatal

    Directory of Open Access Journals (Sweden)

    Desy Fitri Yani

    2013-03-01

    Full Text Available Indonesia bersama seluruh negara berkembang berupaya mencapai kesepakatan Millenium Development Goals (MDGs dengan salah satu sasaran menurunkan angka kematian neonatal dari 20 per 1.000 kelahiran hidup menjadi 15 per 1.000 kelahiran hidup. Penelitian ini bertujuan mengetahui hubungan pelayanan kesehatan ibu dengan kematian neonatal di Kabupaten Lampung Timur tahun 2011. Penelitian dengan desain studi kasus kontrol ini mengamati kasus ibu yang mengalami kematian neonatal dan kontrol ibu yang tidak mengalami kematian neonatal. Analisis multivariat menemukan pelayanan antenatal dan pertolongan persalinan berhubungan secara signifikan dengan kematian neonatal, setelah mengendalikan variabel umur ibu dan riwayat kehamilan (OR = 16,32; nilai p = 0,000; dan (OR = 18,36; nilai p = 0,31. Bayi yang dilahirkan dari Ibu dengan pelayanan antenatal tidak lengkap berisiko mengalami kematian neonatal 16,32 dan 18,36 kali lebih besar daripada bayi yang dilahirkan. Ibu dengan pelayanan antenatal lengkap dan penolong persalinan profesional. Tidak ada hubungan penolong persalinan dengan kematian neonatal, setelah mengontrol variabel pelayanan antenatal, umur ibu, riwayat kehamilan, riwayat penyakit, dan riwayat persalinan. Disarankan meningkatkan kualitas pelayanan antenatal dengan memerhatikan faktor umur ibu dan riwayat persalinan, mengembangkan kegiatan audit maternal perinatal serta meningkatkan keterampilan petugas penolong persalinan. All developing countries including Indonesia seek to reach agreement the Millennium Development Goals (MDG’s. It is objectives include reducing neonatal mortality by 25 percent from 20 per 1,000 live birth to 15 per 1,000 live births. This study aimed to determine the relationship of maternal health services with neonatal mortality in East Lampung District in 2011. This study used case control design to compare between the groups of mother whom have neonatal deaths (cases and neonatal life (control in East Lampung District in

  3. A Study On Neonatal Mortality In Jamnagar District Of Gujarat

    Directory of Open Access Journals (Sweden)

    Yadav Sudha

    1998-01-01

    Full Text Available Research question: Which are the maternal, socio-demographic and neonatal attributes responsible for neonatal mortality in rural areas of Gujarat? Objectives: (i To know various maternal, socio-demographic and neonatal factors responsible for neonatal mortality in rural areas of Gujarat (ii To estimate neonatal mortality rate in the area. Setting: Rural areas of six Primary Health Centers of Jamnagar district of Gujarat State. Study design: Community based cohort study. Sample size: Population of 40512 Participants: Members of the family in which neonatal deaths occurred. Outcome variable: Neonatal mortality Analysis: Sample proportions. Results: Neonatal mortality rate on the basis of follow-up of births during one year was found to be 47.27 per thousand live births. The major maternal and socio-demographic factors responsible for neonatal mortality were; maternal age, illiteracy, lack of antenatal care, closely spaced pregnancies, delivery conducted at home, delivery conducted untrained personnel and delayed initiation of breast feeding. The major neonatal factors responsible for mortality in neonates were; low birth weight, prematurity, first order of birth, early phase of neonatal period, male gender of the child. The leading causes of neonatal mortality were found to be prematurity, birth asphyxia, neonatal infections and congenital anomalies.

  4. Neonatal Jaundice

    DEFF Research Database (Denmark)

    Maimburg, Rikke Damkjær; Væth, Michael; Schendel, Diana

    2008-01-01

    In a previous study, we found that infants transferred to a neonatal ward after delivery had an almost twofold increased risk of being diagnosed with infantile autism later in childhood in spite of extensive controlling of obstetric risk factors. We therefore decided to investigate other reasons ...

  5. Effect of Spike Lavender Lakhlakhe on Pain Intensity Due to Phlebotomy Procedure in Premature Infants Hospitalized in Neonatal Intensive Care Unit: A Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Noushin Beheshtipoor

    2017-06-01

    Full Text Available Background: A Premature infants undergo multiple painful procedures during treatment; thus, it must be tried to limit complications caused by diagnostic and treatment procedures using simple and practical methods. This study was performed to evaluate the effect of spike lavender lakhlakhe on pain intensity due to phlebotomy in hospitalized premature infants.Methods: This single-arm, randomized clinical trial was performed on 30 infants chosen through convenience sampling method. Each newborn was considered as its own control. For the test group, one drop of pure (100% spike lavender lakhlakhe was taken by a standard dropper and diluted with 4 ml of warm distilled water by the research assistant. This mixture was stirred at 2-3 cm distance of the newborns’ nose from 60 minutes before until 2 minutes after phlebotomy, such that it could be smelled by the newborns. In both groups, heart rate and blood oxygen saturation were measured by a standard portable device, and the corresponding data was recorded in data collection sheets. Moreover, the infants’ facial expression changes were recorded by a camera and the intensity of pain was measured by Premature Infant Pain Profile before and after the procedure. Finally, the data was analyzed by paired comparison analysis test in SPSS, version 17.Results: Comparison of mean pain intensity caused by phlebotomy in the control and test groups showed a significant difference (7.667±0.311 vs. 4.882±0.311; P

  6. Pulmonary hypoplasia on preterm infant associated with diffuse chorioamniotic hemosiderosis caused by intrauterine hemorrhage due to massive subchorial hematoma: report of a neonatal autopsy case.

    Science.gov (United States)

    Yamada, Sohsuke; Marutani, Takamitsu; Hisaoka, Masanori; Tasaki, Takashi; Nabeshima, Atsunori; Shiraishi, Mika; Sasaguri, Yasuyuki

    2012-08-01

    A male infant born prematurely at 31 weeks of gestation weighed 789 g and had mildly brown-colored oral/tracheal aspirates at delivery. The amniotic fluid was also discolored, and its index was below 5. The patient died of hypoxemic respiratory and cardiac failure 2 hours after birth. The maternal profiles showed placenta previa and intrauterine growth restriction (IUGR) at 22 weeks of gestation, and revealed recurrent episodes of antenatal and substantial vaginal bleeding and oligohydramnios, indicating chronic abruption-oligohydramnios sequence. The thickened placenta, weighing 275 g, grossly displayed unevenness and diffuse opacity with green to brown discoloration in the chorioamniotic surface, and revealed chronic massive subchorial hematomas (Breus' mole) with old peripheral blood clot, circumvallation, and infarction. Microscopically, diffuse Berlin-blue staining-positive hemosiderin deposits were readily encountered in the chorioamniotic layers of the chorionic plate, consistent with diffuse chorioamniotic hemosiderosis (DCH) due to Breus' mole, accompanied by diffuse amniotic necrosis. At autopsy, an external examination showed several surface anomalies and marked pulmonary hypoplasia, 0.006 (less 0.012) of lung:body weight ratio. Since Breus' mole has a close relationship with intrauterine hemorrhage, resulting in DCH, IUGR, and/or pulmonary hypoplasia of the newborn, the present features might be typical. © 2012 The Authors. Pathology International © 2012 Japanese Society of Pathology and Blackwell Publishing Asia Pty Ltd.

  7. [Gastroschisis: Prenatal ultrasonography and obstetrical criteria for predicting neonatal outcome].

    Science.gov (United States)

    Ducellier, G; Moussy, P; Sahmoune, L; Bonneau, S; Alanio, E; Bory, J-P

    2016-09-01

    Prenatal diagnosis of complex laparoschisis is difficult and yet it is associated with a significantly increased morbidity and mortality. The aim of the study was to define ultrasonographic factor and obstetrical criteria to predicting adverse neonatal outcome. Retrospective cohort study over 10 years, of 35 gastroschisis cases in CHU of Reims (France). The primary outcome was the neonatal death due to gastroschisis. The sonographic markers was bowel dilatation intra- or extra-abdominale, amniotic fluid, intra-uterin growth. The obstetrical criteria was fetal vitality, fetal heart rate, type of delivery, the weight and the term of birth. There were 28 live births, 16 children with favorable outcome, 8 children with adverse perinatal outcome and 4 deaths. There were any sonographic criteria to predicting adverse neonatal outcome. Only the birth weight less than 2000g was associated with an increase gastrointestinal complications (P=0.049). The type of the delivery was not associated with an adverse prenatal outcome. The birth weight less than 2000g seems to be associate with an increase gastrointestinal complications. It is important to fight against prematurity in case of gastroschisis. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  8. Unpredicted Sudden Death due to Recurrent Infratentorial Hemangiopericytoma Presenting as Massive Intratumoral Hemorrhage: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Toshihide Tanaka

    2014-01-01

    Full Text Available Unpredicted sudden death arising from hemangiopericytoma with massive intracranial hemorrhage is quite rare. We encountered a patient with recurrent infratentorial hemangiopericytoma presenting as life-threatening massive intracerebral hemorrhage. A 43-year-old man who had undergone craniotomy for total resection of an infratentorial hemangiopericytoma 17 months earlier presented with morning headache and generalized convulsions. Computed tomography revealed a massive hematoma in the right infratentorial region causing tonsillar herniation and emergency surgery was performed to evacuate the hematoma. Histological findings revealed hemangiopericytoma with hemorrhage. Neurological status remained unimproved and brain death was confirmed postoperatively. Hemangiopericytoma presenting as massive hemorrhage is quite rare. Since the risk of life-threatening massive hemorrhage should be considered, careful postoperative long-term follow-up is very important to identify tumor recurrences, particularly in the posterior cranial fossa, even if the tumor is completely removed.

  9. A statistical approach to evaluate the performance of cardiac biomarkers in predicting death due to acute myocardial infarction: time-dependent ROC curve

    Science.gov (United States)

    Karaismailoğlu, Eda; Dikmen, Zeliha Günnur; Akbıyık, Filiz; Karaağaoğlu, Ahmet Ergun

    2018-04-30

    Background/aim: Myoglobin, cardiac troponin T, B-type natriuretic peptide (BNP), and creatine kinase isoenzyme MB (CK-MB) are frequently used biomarkers for evaluating risk of patients admitted to an emergency department with chest pain. Recently, time- dependent receiver operating characteristic (ROC) analysis has been used to evaluate the predictive power of biomarkers where disease status can change over time. We aimed to determine the best set of biomarkers that estimate cardiac death during follow-up time. We also obtained optimal cut-off values of these biomarkers, which differentiates between patients with and without risk of death. A web tool was developed to estimate time intervals in risk. Materials and methods: A total of 410 patients admitted to the emergency department with chest pain and shortness of breath were included. Cox regression analysis was used to determine an optimal set of biomarkers that can be used for estimating cardiac death and to combine the significant biomarkers. Time-dependent ROC analysis was performed for evaluating performances of significant biomarkers and a combined biomarker during 240 h. The bootstrap method was used to compare statistical significance and the Youden index was used to determine optimal cut-off values. Results : Myoglobin and BNP were significant by multivariate Cox regression analysis. Areas under the time-dependent ROC curves of myoglobin and BNP were about 0.80 during 240 h, and that of the combined biomarker (myoglobin + BNP) increased to 0.90 during the first 180 h. Conclusion: Although myoglobin is not clinically specific to a cardiac event, in our study both myoglobin and BNP were found to be statistically significant for estimating cardiac death. Using this combined biomarker may increase the power of prediction. Our web tool can be useful for evaluating the risk status of new patients and helping clinicians in making decisions.

  10. Immunization safety review: vaccinations and sudden unexpected death in infancy

    National Research Council Canada - National Science Library

    Institute of Medicine (U.S.). Immunization Safety Review Committee; Stratton, Kathleen R

    2003-01-01

    ...), and neonatal death (infant death, whether sudden or not, during the first 4 weeks of life). Based on this review, the committee concluded that the evidence favors rejection of a causal relationship between some vaccines and SIDS...

  11. Did professional attendance at home births improve early neonatal survival in Indonesia?

    Science.gov (United States)

    Hatt, Laurel; Stanton, Cynthia; Ronsmans, Carine; Makowiecka, Krystyna; Adisasmita, Asri

    2009-07-01

    BACKGROUND Early neonatal mortality has been persistently high in developing countries. Indonesia, with its national policy of home-based, midwife-assisted birth, is an apt context for assessing the effect of home-based professional birth attendance on early neonatal survival. METHODS We pooled four Indonesian Demographic and Health Surveys and used multivariate logistic regression to analyse trends in first-day and early neonatal mortality. We measured the effect of the context of delivery, including place and type of provider, and tested for changes in trend when the 'Midwife in the Village' programme was initiated. RESULTS Reported first-day mortality did not decrease significantly between 1986 and 2002, whereas early neonatal mortality decreased by an average of 3.2% annually. The rate of the decline did not change over the time period, either in 1989 when the Midwife in the Village programme was initiated, or in any year following when uptake of professional care increased. In simple and multivariate analyses, there were no significant differences in first-day or early neonatal death rates comparing home-based births with or without a professional midwife. Early neonatal mortality was higher in public facilities, likely due to selection. Biological determinants (twin births, male sex, short birth interval, previous early neonatal loss) were important for both outcomes. CONCLUSIONS Decreasing newborn death rates in Indonesia are encouraging, but it is not clear that these decreases are associated with greater uptake of professional delivery care at home or in health facilities. This may suggest a need for improved training in immediate newborn care, strengthened emergency referral, and continued support for family planning policies.

  12. Age spectrometry of infant death rates as a probe of immunity: Identification of two peaks due to viral and bacterial diseases respectively

    Science.gov (United States)

    Berrut, Sylvie; Richmond, Peter; Roehner, Bertrand M.

    2017-11-01

    After birth, setting up an effective immune system is a major challenge for all living organisms. In this paper we show that this process can be explored by using the age-specific infant death rate as a kind of sensor. This is made possible because, as shown by the authors in Berrut et al. (2016), between birth and a critical age tc, for all mammals the death rate decreases with age as a smooth hyperbolic function. For humans tc is equal to 10 years. It turns out that for some causes of deaths and specific ages the hyperbolic fall displays temporary spikes which, it is assumed, correspond to specific events in the organism's response to exogenous factors. One of these spikes occurs 10 days after birth and there is another at the age of 300 days. It is shown that the first spike is related to viral infections whereas the second is related to bacterial diseases. By going back to former time periods during which infant mortality was much higher than it is currently, one gets a magnified view of these peaks. They give us useful information about how an organism adapts to new conditions. Apart from the reaction to pathogens, the same methodology can be used to study the response to changes in other external conditions, e.g. temperature or oxygen level.

  13. Fetal and neonatal exposure to nicotine leads to augmented hepatic and circulating triglycerides in adult male offspring due to increased expression of fatty acid synthase

    International Nuclear Information System (INIS)

    Ma, Noelle; Nicholson, Catherine J.; Wong, Michael; Holloway, Alison C.; Hardy, Daniel B.

    2014-01-01

    While nicotine replacement therapy is assumed to be a safer alternative to smoking during pregnancy, the long-term consequences for the offspring remain elusive. Animal studies now suggest that maternal nicotine exposure during perinatal life leads to a wide range of adverse outcomes for the offspring including increased adiposity. The focus of this study was to investigate if nicotine exposure during pregnancy and lactation leads to alterations in hepatic triglyceride synthesis. Female Wistar rats were randomly assigned to receive daily subcutaneous injections of saline (vehicle) or nicotine bitartrate (1 mg/kg/day) for two weeks prior to mating until weaning. At postnatal day 180 (PND 180), nicotine exposed offspring exhibited significantly elevated levels of circulating and hepatic triglycerides in the male offspring. This was concomitant with increased expression of fatty acid synthase (FAS), the critical hepatic enzyme in de novo triglyceride synthesis. Given that FAS is regulated by the nuclear receptor Liver X receptor (LXRα), we measured LXRα expression in both control and nicotine-exposed offspring. Nicotine exposure during pregnancy and lactation led to an increase in hepatic LXRα protein expression and enriched binding to the putative LXRE element on the FAS promoter in PND 180 male offspring. This was also associated with significantly enhanced acetylation of histone H3 [K9,14] surrounding the FAS promoter, a hallmark of chromatin activation. Collectively, these findings suggest that nicotine exposure during pregnancy and lactation leads to an increase in circulating and hepatic triglycerides long-term via changes in the transcriptional and epigenetic regulation of the hepatic lipogenic pathway. - Highlights: • Our data reveals the links nicotine exposure in utero and long-term hypertriglyceridemia. • It is due to nicotine-induced augmented expression of hepatic FAS and LXRα activity. • Moreover, this involves nicotine-induced enhanced

  14. Fetal and neonatal exposure to nicotine leads to augmented hepatic and circulating triglycerides in adult male offspring due to increased expression of fatty acid synthase

    Energy Technology Data Exchange (ETDEWEB)

    Ma, Noelle [Department of Physiology and Pharmacology, The University of Western Ontario (Canada); Department of Obstetrics and Gynecology, The University of Western Ontario (Canada); The Lawson Health Research Institute, The University of Western Ontario (Canada); Nicholson, Catherine J. [Department of Obstetrics and Gynecology, McMaster University (Canada); Wong, Michael [Department of Physiology and Pharmacology, The University of Western Ontario (Canada); Department of Obstetrics and Gynecology, The University of Western Ontario (Canada); The Lawson Health Research Institute, The University of Western Ontario (Canada); Holloway, Alison C. [Department of Obstetrics and Gynecology, McMaster University (Canada); Hardy, Daniel B., E-mail: Daniel.Hardy@schulich.uwo.ca [Department of Physiology and Pharmacology, The University of Western Ontario (Canada); Department of Obstetrics and Gynecology, The University of Western Ontario (Canada); The Children' s Health Research Institute, The University of Western Ontario (Canada); The Lawson Health Research Institute, The University of Western Ontario (Canada)

    2014-02-15

    While nicotine replacement therapy is assumed to be a safer alternative to smoking during pregnancy, the long-term consequences for the offspring remain elusive. Animal studies now suggest that maternal nicotine exposure during perinatal life leads to a wide range of adverse outcomes for the offspring including increased adiposity. The focus of this study was to investigate if nicotine exposure during pregnancy and lactation leads to alterations in hepatic triglyceride synthesis. Female Wistar rats were randomly assigned to receive daily subcutaneous injections of saline (vehicle) or nicotine bitartrate (1 mg/kg/day) for two weeks prior to mating until weaning. At postnatal day 180 (PND 180), nicotine exposed offspring exhibited significantly elevated levels of circulating and hepatic triglycerides in the male offspring. This was concomitant with increased expression of fatty acid synthase (FAS), the critical hepatic enzyme in de novo triglyceride synthesis. Given that FAS is regulated by the nuclear receptor Liver X receptor (LXRα), we measured LXRα expression in both control and nicotine-exposed offspring. Nicotine exposure during pregnancy and lactation led to an increase in hepatic LXRα protein expression and enriched binding to the putative LXRE element on the FAS promoter in PND 180 male offspring. This was also associated with significantly enhanced acetylation of histone H3 [K9,14] surrounding the FAS promoter, a hallmark of chromatin activation. Collectively, these findings suggest that nicotine exposure during pregnancy and lactation leads to an increase in circulating and hepatic triglycerides long-term via changes in the transcriptional and epigenetic regulation of the hepatic lipogenic pathway. - Highlights: • Our data reveals the links nicotine exposure in utero and long-term hypertriglyceridemia. • It is due to nicotine-induced augmented expression of hepatic FAS and LXRα activity. • Moreover, this involves nicotine-induced enhanced

  15. 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

  16. 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

  17. 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

  18. 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.

  19. [Fetal and neonatal mortality from 22 weeks of amenorrhea in the Loire area].

    Science.gov (United States)

    Branger, B; Beringue, F; Nomballais, M F; Bouderlique, C; Brossier, J P; Savagner, C; Seguin, G; Boog, G; Rozé, J C

    1999-07-01

    The Pays de Loire has a low perinatal mortality indicators among French regions but this could be due to under-notification. To explore this hypothesis we undertook a survey in order to identify all fetal and neonatal deaths occurring at a gestionnal age of 22 weeks or more. We also tried to examine and analyze the causes of death. All maternity (26) and neonatal wards (5) in the region took part in the survey in 1995. Clinicians were asked to fill out a questionnaire for all deaths occurring from gestational age (GA) 22 weeks and/or concerning a birthweight of a least 500 g. Only perinatal deaths related to parents living in the Pays de Loire were included in the study. Two hundred and sixty seven perinatal deaths were identified out of a total 29,440 births (9.1 /1000). Eighty three (2.8 /1000) were termination of pregnancy for medical reasons, of which 82% were motivated by chromosomic illness. Ninety-nine stillbirths fell (3.4 /1000) into two GA periods: 24 to 27 weeks (20%) and 38 to 41 weeks (2%). The cause of stillbirths remained unknown in 50% of cases despite a post-mortem examination rate of 87%. There were 29 deaths (1 /1000) in the immediate per and post-partum, 40% of which occurred at GA 22 to 25 weeks. Another 38% occurred at GA 36 to 40 weeks and these were related to undectected malformations or infections. Neonatal and intensive care units reported 56 neonatal deaths (1.9 /1000). GA was under 33 weeks for 44% of them. Deaths were caused by usual complications of severe prematurity, neurologic diseases and malformations. Thirty-two percent of total deaths were not notified to the French Authority: 25% of deaths for termination of pregnancy for medical reasons and 7% for stillbirths and per and post partum deaths. This survey suggests that the Pays de Loire perinatal mortality indicators remained low compared with other French regions, even after adjustment for this under notification. This casts doubts on the validity of perinatal mortality

  20. Losartan in combination with propranolol slows the aortic root dilatation in neonatal Marfan syndrome

    Directory of Open Access Journals (Sweden)

    Lu-Hang Liu

    2018-04-01

    Full Text Available Neonatal Marfan syndrome, in contrast to classical Marfan syndrome, is characterized by rapidly progressive multi-valvular cardiac disease and death from congestive heart failure, typically within the first year of life. Due to the rarity of this condition, treatment for neonatal Marfan syndrome has not been well studied. In this report, a combination of losartan and propranolol reduced the aortic root dilatation rate after three months of losartan therapy. Genetic analysis in this patient revealed a mutation in exon 25 of the FBN1 gene, which typically results in a shorter life expectancy. However, the patient's heart failure was controlled by losartan, propranolol and other anti-congestive medications, which may have prolonged his survival. Key Words: FBN1, losartan, neonatal Marfan syndrome

  1. Autophagy fails to prevent glucose deprivation/glucose reintroduction-induced neuronal death due to calpain-mediated lysosomal dysfunction in cortical neurons.

    Science.gov (United States)

    Gerónimo-Olvera, Cristian; Montiel, Teresa; Rincon-Heredia, Ruth; Castro-Obregón, Susana; Massieu, Lourdes

    2017-06-29

    Autophagy is triggered during nutrient and energy deprivation in a variety of cells as a homeostatic response to metabolic stress. In the CNS, deficient autophagy has been implicated in neurodegenerative diseases and ischemic brain injury. However, its role in hypoglycemic damage is poorly understood and the dynamics of autophagy during the hypoglycemic and the glucose reperfusion periods, has not been fully described. In the present study, we analyzed the changes in the content of the autophagy proteins BECN1, LC3-II and p62/SQSTM1 by western blot, and autophagosome formation was followed through time-lapse experiments, during glucose deprivation (GD) and glucose reintroduction (GR) in cortical cultures. According to the results, autophagosome formation rapidly increased during GD, and was followed by an active autophagic flux early after glucose replenishment. However, cells progressively died during GR and autophagy inhibition reduced neuronal death. Neurons undergoing apoptosis during GR did not form autophagosomes, while those surviving up to late GR showed autophagosomes. Calpain activity strongly increased during GR and remained elevated during progressive neuronal death. Its activation led to the cleavage of LAMP2 resulting in lysosome membrane permeabilization (LMP) and release of cathepsin B to the cytosol. Calpain inhibition prevented LMP and increased the number of neurons containing lysosomes and autophagosomes increasing cell viability. Taken together, the present results suggest that calpain-mediated lysosome dysfunction during GR turns an adaptive autophagy response to energy stress into a defective autophagy pathway, which contributes to neuronal death. In these conditions, autophagy inhibition results in the improvement of cell survival.

  2. The simultaneous death of seven people due to the detonation of an antipersonnel landmine at the land borders of the European Union during peacetime.

    Science.gov (United States)

    Pavlidis, Pavlos; Karakasi, Valeria

    2015-01-01

    This incident concerns the simultaneous death of seven people as a result of the accidental triggering of an antipersonnel landmine during peacetime. The victims were illegal migrants who attempted to cross the Greek-Turkish border zone and accidentally entered a demarcated minefield. This incident is presented because of its rarity and highlights the devastating consequences of the residual mines on the European Union eastern frontiers in peacetime. It also showcases the difficulties and risks that arise during the identification process in illegal migration issues. The victims' positions at the moment of explosion are indicated by the detailed forensic examination and comparison of the injuries' anatomical dispersion and their severity.

  3. 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

  4. [Neonatal cholestasis

    Science.gov (United States)

    Roquete, M L

    2000-07-01

    OBJECTIVE: To warn pediatricians about the early recognition of cholestasis in newborns and infants. METHODS: A bibliographic research about cholestasis was performed using Medline, and emphasizing the most relevant publications of the last 30 years. RESULTS: The concept of cholestasis and the causes of cholestatic tendency in newborns and infants are described. Several causes of intra and extrahepatic cholestasis are reported as well. In this review, only the diseases with diagnostic, therapeutic or prognostic peculiarities are commented, including extrahepatic biliary atresia, idiopathic neonatal hepatitis, galactosemia, and Alagille s syndrome. Furthermore, several resources are discussed for the diagnosis of cholestasis. CONCLUSIONS: The establishment of the diagnosis of cholestasis through the detection of hyperbilirubinemia in newborns who present jaundice after 14 days of life is a goal that could change the prognosis of several diseases responsible for neonatal cholestasis.

  5. Mortes por doenças infecciosas em mulheres: ocorrências no ciclo gravídico-puerperal Deaths due to infectious diseases in women: occurrences in pregnancy and puerperium

    Directory of Open Access Journals (Sweden)

    Ruy Laurenti

    2009-01-01

    Full Text Available OBJETIVO: Descrever os óbitos por doenças infecciosas como causa básica ou múltipla, caracterizando os casos de doença infecciosa preexistente ou desenvolvida na gravidez, aqueles que são mortes maternas por causas obstétricas indiretas e os óbitos por Aids ou outras doenças infecciosas, ocorridos no ciclo gravídico puerperal, havendo dúvidas na classificação. MÉTODOS: Adotou-se a metodologia RAMOS (partindo-se da declaração de óbito -DO- original, dados reais são resgatados por entrevista domiciliar, consultas a prontuários hospitalares e laudos de autopsia; elaborando-se uma nova DO, com as reais causas de morte. População foi constituída pelos óbitos femininos de 10 a 49 anos, de residentes nas capitais brasileiras, do 1º semestre de 2002. As causas foram analisadas em básicas e múltiplas. RESULTADOS: Dos 7.332 óbitos, 917 apresentaram uma doença infecciosa como causa básica (Aids e tuberculose, principalmente. Em 37 casos, a falecida estava no ciclo gravídico puerperal ampliado (englobando, inclusive, mortes ocorridas de 43 dias até um ano pós-parto; 10 não foram classificadas como obstétricas indiretas permanecendo como infecciosas e 14 eram obstétricas indiretas. Quanto às causas múltiplas, para 791 mortes, cujas causas básicas não eram maternas nem infecciosas, houve 1.016 menções de doenças infecciosas (média de 1,28 menção/óbito. CONCLUSÃO: Como o número de mortes maternas é pequeno, recomenda-se, que investigações dos casos graves de complicações da gravidez, parto e puerpério que não faleceram (near-miss sejam feitas, pois, sendo mais numerosos, representam importante subsídio para estudos da mortalidade materna.OBJECTIVE: To describe deaths due to infectious diseases as an underlying or multiple cause, identifying cases of pre-existent infectious diseases or ones developed during pregnancy; deaths due to an indirect obstetric cause and deaths due to Aids or other infectious

  6. Neonatal Kraniefraktur

    DEFF Research Database (Denmark)

    Johannesen, Katrine Marie Harries; Stantchev, Hristo

    2015-01-01

    During the latest decades the incidence of birth traumas has decreased significantly. Even so the traumas still contribute to an increased mortality and morbidity. We present a case of spontaneous neonatal skull fracture following a normal vaginal delivery. Abnormal facial structure was seen, and......, and the fracture was identified with an MRI. The fractures healed without neurosurgical intervention. Case reports show that even in uncomplicated vaginal deliveries skull fractures can be seen and should be suspected in children with facial abnormalities....

  7. Correlation between relative rates of hospital treatment or death due to ischaemic heart disease (IHD) and of IHD-related medication among socio-occupational and economic activities groups in Denmark, 1996-2005

    DEFF Research Database (Denmark)

    Hannerz, Harald; Dalhoff, Kim; Burr, Hermann

    2014-01-01

    Standardised Hazard Ratios (SHR) for hospital treatment or death due to IHD and SHR for purchase of prescriptions for medicine that may prevent IHD from (re)occurring, among socio-occupational and economic activities groups in Denmark. The SHR were based on a 10-year prospective follow-up of 2 million people.......74 for the economic activities groups). We observed, however, one markedly contradictive result; the industrial group entitled 'general practitioner, dentists etc.' was associated both with significantly high rates of medicine usage (SHR = 1.15, 95% CI: 1.12-1.19) and significantly low rates of hospital treatment...... or death due to IHD (SHR = 0.80, 95% CI: 0.71-0.91). CONCLUSION: Apart from a few caveats, the strong correlations obtained in the present study signify that purchase of a prescription for IHD-related medication is a usable risk indicator for IHD in the working population of Denmark. The usage of medicine...

  8. Neonatal aspiration syndrome due to vernix caseosa

    International Nuclear Information System (INIS)

    Ohlsson, A.; Najjar, H.; Cumming, W.A.

    1985-01-01

    Fetal aspiration of meconium in amniotic fluid is a well-known cause of respiratory distress in newborn infants. It causes an irregular, coarse, nodular pattern on chest radiographs. Less known is that aspiration of vernix caseoasa causes a similar syncrome. We present a post-mature infant in whom aspiration of vernix caseosa caused respiratory distress, ventilatory difficulty, and radiographic changes essentially the same as aspiration of meconium. (orig.)

  9. Neonatal aspiration syndrome due to vernix caseosa

    Energy Technology Data Exchange (ETDEWEB)

    Ohlsson, A.; Najjar, H.; Cumming, W.A.

    1985-02-01

    Fetal aspiration of meconium in amniotic fluid is a well-known cause of respiratory distress in newborn infants. It causes an irregular, coarse, nodular pattern on chest radiographs. Less known is that aspiration of vernix caseoasa causes a similar syncrome. We present a post-mature infant in whom aspiration of vernix caseosa caused respiratory distress, ventilatory difficulty, and radiographic changes essentially the same as aspiration of meconium.

  10. Postmortem diagnosis of Marfan syndrome in a case of sudden death due to aortic rupture: Detection of a novel FBN1 frameshift mutation.

    Science.gov (United States)

    Wang, Yunyun; Chen, Shu; Wang, Rongshuai; Huang, Sizhe; Yang, Mingzhen; Liu, Liang; Liu, Qian

    2016-04-01

    To investigate the sudden death of a 36-year-old Chinese man, a medicolegal autopsy was performed, combining forensic pathological examinations and genetic sequencing analysis to diagnose the cause of death. Genomic DNA samples were extracted from blood and subjected to high-throughput sequencing. Major findings included a dilated aortic root with a ruptured and dissected aorta and consequent tamponade of the pericardial sac. Moreover, arachnodactyly and other skeletal deformities were noted. By sequencing the fibrillin-1 gene (FBN1), five genetic variations were found, including four previously known single nucleotide polymorphisms (SNPs) and a novel frameshift mutation, leading to the diagnosis of Marfan syndrome. The frameshift mutation (c.4921delG, p.glu1641llysFsX9) detected in exon 40 led to a stop codon after the next 8 amino acids. The four SNPs included a splice site mutation (c.3464-5 G>A, rs11853943), a synonymous mutation (p.Asn625Asn, rs25458), and two missense mutations (p.Pro1148Ala, rs140598; p.Cys472Tyr, rs4775765). Genetic screening was recommended for the relatives as it was reported that the father and brother of the deceased had died at the ages of 40 and 25, respectively, from sudden cardiac failure. The son of the deceased lacked the relevant mutations. This report emphasizes the important contribution of medicolegal postmortem analysis on the molecular pathogenesis study of Marfan syndrome and early diagnosis of at-risk relatives. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  11. What is the risk of death or severe harm due to bone cement implantation syndrome among patients undergoing hip hemiarthroplasty for fractured neck of femur? A patient safety surveillance study

    Science.gov (United States)

    Rutter, Paul D; Panesar, Sukhmeet S; Darzi, Ara; Donaldson, Liam J

    2014-01-01

    Objective To estimate the risk of death or severe harm due to bone cement implantation syndrome (BCIS) among patients undergoing hip hemiarthroplasty for fractured neck of femur. Setting Hospitals providing secondary and tertiary care throughout the National Health Service (NHS) in England and Wales. Participants Cases reported to the National Reporting and Learning System (NRLS) in which the reporter clearly describes severe acute patient deterioration associated with cement use in hip hemiarthroplasty for fractured neck of femur (assessed independently by two reviewers). Outcome measures Primary—number of reported deaths, cardiac arrests and periarrests per year. Secondary—timing of deterioration and outcome in relation to cement insertion. Results Between 2005 and 2012, the NRLS received 62 reports that clearly describe death or severe harm associated with the use of cement in hip hemiarthroplasty for fractured neck of femur. There was one such incident for every 2900 hemiarthroplasties for fractured neck of femur during the period. Of the 62 reports, 41 patients died, 14 were resuscitated from cardiac arrest and 7 from periarrest. Most reports (55/62, 89%) describe acute deterioration occurring during or within a few minutes of cement insertion. The vast majority of deaths (33/41, 80%) occurred on the operating table. Conclusions These reports provide narrative evidence from England and Wales that cement use in hip hemiarthroplasty for fractured neck of femur is associated with instances of perioperative death or severe harm consistent with BCIS. In 2009, the National Patient Safety Agency publicised this issue and encouraged the use of mitigation measures. Three-quarters of the deaths in this study have occurred since that alert, suggesting incomplete implementation or effectiveness of those mitigation measures. There is a need for stronger evidence that weighs the risks and benefits of cement in hip hemiarthroplasty for fractured neck of femur. PMID

  12. Risk Factors for Neonatal Mortality Among Very Low Birth Weight Neonates

    Directory of Open Access Journals (Sweden)

    Fatemeh Nayeri

    2013-05-01

    Full Text Available The objective of this study is to determine risk factors causing increase in very low birth way (VLBW neonatal mortality. The medical files of all neonates weighing ≤1500 g, born in Vali-e-Asr hospital (2001-2004 were studied. Two groups of neonates (living and dead were compared up to the time of hospital discharge or death. A total of 317 neonates were enrolled. A meaningful relationship existed between occurrence of death and low gestational age (P=0.02, low birth weight, lower than 1000 g (P=0.001, Apgar score <6 at 5th minutes (P=0.001, resuscitation at birth (P=0.001, respiratory distress syndrome (P=0.001 need for mechanical ventilation (P=0.001, neurological complications (P=0.001 and intraventricular hemorrhage (P=0.001. Regression analysis indicated that each 250 g weight increase up to 1250 g had protective effect, and reduced mortality rate. The causes of death of those neonates weighting over 1250 g should be sought in factors other than weight. Survival rate was calculated to be 80.4% for neonates weighing more than 1000 g. The most important high risk factors affecting mortality of neonates are: low birth weight, need for resuscitation at birth, need for ventilator use and intraventricular hemorrhage.

  13. Radiation Dose to Newborns in Neonatal Intensive Care Units

    International Nuclear Information System (INIS)

    Bahreyni Toossi, M. T.; Malekzadeh, M.

    2012-01-01

    With the increase of X-ray use for medical diagnostic purposes, knowing the given doses is necessary in patients for comparison with reference levels. The concept of reference doses or diagnostic reference levels has been developed as a practical aid in the optimization of patient protection in diagnostic radiology. To assess the radiation doses to neonates from diagnostic radiography (chest and abdomen). This study has been carried out in the neonatal intensive care unit of a province in Iran. Entrance surface dose was measured directly with thermoluminescent dosimeters. The population included 195 neonates admitted for a diagnostic radiography, in eight NICUs of different hospital types. The mean entrance surface dose for chest and abdomen examinations were 76.3 μGy and 61.5 μGy, respectively. Diagnostic reference levels for neonate in NICUs of the province were 88 μGy for chest and 98 μGy for abdomen examinations that were slightly higher than other studies. Risk of death due to radiation cancer incidence of abdomens examination was equal to 1.88 × 10 -6 for male and 4.43 × 10 -6 for female. For chest X-ray, it was equal to 2.54 × 10 -6 for male and 1.17 × 10 -5 for female patients. Diagnostic reference levels for neonates in our province were slightly higher than values reported by other studies such as European national diagnostic reference levels and the NRPB reference dose. The main reason was related to using a high mAs and a low kVp applied in most departments and also a low focus film distance. Probably lack of collimation also affected some exams in the NICUs.

  14. Spondyloepiphyseal dysplasia congenita. A cause of lethal neonatal dwarfism

    Energy Technology Data Exchange (ETDEWEB)

    Macpherson, R.I.; Wood, B.P.

    1980-07-01

    Spondyloepiphyseal dysplasia congenita is a form of primarily short trunk dwarfism, that is manifest at birth but generally has not been regarded as a cause of lethal neonatal dwarfism. Seven neonates with severe dwarfism are presented. The first survived the newborn period, but the other six were early neonatal deaths. All displayed the clinical and radiologic features of spondyloepiphyseal dysplasia congenita. The striking similarities between spondyloepiphyseal dysplasia congenita and achondrogenesis type 2 are discussed.

  15. Effect of training traditional birth attendants on neonatal mortality (Lufwanyama Neonatal Survival Project): randomised controlled study.

    Science.gov (United States)

    Gill, Christopher J; Phiri-Mazala, Grace; Guerina, Nicholas G; Kasimba, Joshua; Mulenga, Charity; MacLeod, William B; Waitolo, Nelson; Knapp, Anna B; Mirochnick, Mark; Mazimba, Arthur; Fox, Matthew P; Sabin, Lora; Seidenberg, Philip; Simon, Jonathon L; Hamer, Davidson H

    2011-02-03

    To determine whether training traditional birth attendants to manage several common perinatal conditions could reduce neonatal mortality in the setting of a resource poor country with limited access to healthcare. Prospective, cluster randomised and controlled effectiveness study. Lufwanyama, an agrarian, poorly developed district located in the Copperbelt province, Zambia. All births carried out by study birth attendants occurred at mothers' homes, in rural village settings. 127 traditional birth attendants and mothers and their newborns (3559 infants delivered regardless of vital status) from Lufwanyama district. Using an unblinded design, birth attendants were cluster randomised to intervention or control groups. The intervention had two components: training in a modified version of the neonatal resuscitation protocol, and single dose amoxicillin coupled with facilitated referral of infants to a health centre. Control birth attendants continued their existing standard of care (basic obstetric skills and use of clean delivery kits). The primary outcome was the proportion of liveborn infants who died by day 28 after birth, with rate ratios statistically adjusted for clustering. Secondary outcomes were mortality at different time points; and comparison of causes of death based on verbal autopsy data. Among 3497 deliveries with reliable information, mortality at day 28 after birth was 45% lower among liveborn infants delivered by intervention birth attendants than control birth attendants (rate ratio 0.55, 95% confidence interval 0.33 to 0.90). The greatest reductions in mortality were in the first 24 hours after birth: 7.8 deaths per 1000 live births for infants delivered by intervention birth attendants compared with 19.9 per 1000 for infants delivered by control birth attendants (0.40, 0.19 to 0.83). Deaths due to birth asphyxia were reduced by 63% among infants delivered by intervention birth attendants (0.37, 0.17 to 0.81) and by 81% within the first two days

  16. Effect of training traditional birth attendants on neonatal mortality (Lufwanyama Neonatal Survival Project): randomised controlled study

    Science.gov (United States)

    Phiri-Mazala, Grace; Guerina, Nicholas G; Kasimba, Joshua; Mulenga, Charity; MacLeod, William B; Waitolo, Nelson; Knapp, Anna B; Mirochnick, Mark; Mazimba, Arthur; Fox, Matthew P; Sabin, Lora; Seidenberg, Philip; Simon, Jonathon L; Hamer, Davidson H

    2011-01-01

    Objective To determine whether training traditional birth attendants to manage several common perinatal conditions could reduce neonatal mortality in the setting of a resource poor country with limited access to healthcare. Design Prospective, cluster randomised and controlled effectiveness study. Setting Lufwanyama, an agrarian, poorly developed district located in the Copperbelt province, Zambia. All births carried out by study birth attendants occurred at mothers’ homes, in rural village settings. Participants 127 traditional birth attendants and mothers and their newborns (3559 infants delivered regardless of vital status) from Lufwanyama district. Interventions Using an unblinded design, birth attendants were cluster randomised to intervention or control groups. The intervention had two components: training in a modified version of the neonatal resuscitation protocol, and single dose amoxicillin coupled with facilitated referral of infants to a health centre. Control birth attendants continued their existing standard of care (basic obstetric skills and use of clean delivery kits). Main outcome measures The primary outcome was the proportion of liveborn infants who died by day 28 after birth, with rate ratios statistically adjusted for clustering. Secondary outcomes were mortality at different time points; and comparison of causes of death based on verbal autopsy data. Results Among 3497 deliveries with reliable information, mortality at day 28 after birth was 45% lower among liveborn infants delivered by intervention birth attendants than control birth attendants (rate ratio 0.55, 95% confidence interval 0.33 to 0.90). The greatest reductions in mortality were in the first 24 hours after birth: 7.8 deaths per 1000 live births for infants delivered by intervention birth attendants compared with 19.9 per 1000 for infants delivered by control birth attendants (0.40, 0.19 to 0.83). Deaths due to birth asphyxia were reduced by 63% among infants delivered by

  17. Motion based Segmentation of Chest and Abdomen Region of Neonates

    NARCIS (Netherlands)

    Venkitaraman, A.; Makkapati, V.V.

    2015-01-01

    Respiration rate (RR) is one of the important vital signs used for clinical monitoring of neonates in intensive care units. Due to thefragile skin of the neonates, it is preferable to have monitoring systems with minimal contact with the neonate. Recently, several methods have been proposed for

  18. Neonatal hypoglycemia.

    Science.gov (United States)

    Straussman, Sharon; Levitsky, Lynne L

    2010-02-01

    Hypoglycemia in the newborn may be associated with both acute decompensation and long-term neuronal loss. Studies of the cause of hypoglycemic brain damage and the relationship of hypoglycemia to disorders associated with hyperinsulinism have aided in our understanding of this common clinical finding. A recent consensus workshop concluded that there has been little progress toward a precise numerical definition of neonatal hypoglycemia. Nonetheless, newer brain imaging modalities have provided insight into the relationship between neuronal energy deficiency and central nervous system damage. Laboratory studies have begun to reveal the mechanism of hypoglycemic damage. In addition, there is new information about hyperinsulinemic hypoglycemia of genetic, environmental, and iatrogenic origin. The quantitative definition of hypoglycemia in the newborn remains elusive because it is a surrogate marker for central nervous system energy deficiency. Nonetheless, the recognition that hyperinsulinemic hypoglycemia, which produces profound central nervous system energy deficiency, is most likely to lead to long-term central nervous system damage, has altered management of children with hypoglycemia. In addition, imaging studies on neonates and laboratory evaluation in animal models have provided insight into the mechanism of neuronal damage.

  19. Severe neonatal parechovirus infection and similarity with enterovirus infection

    NARCIS (Netherlands)

    Verboon-Maciolek, Malgorzata A.; Krediet, Tannette G.; Gerards, Leo J.; de Vries, Linda S.; Groenendaal, Floris; van Loon, Anton M.

    Background: Enteroviruses (EV) are an important cause of neonatal disease including hepatitis, meningoencephalitis, and myocarditis that can lead to death or severe long-term sequelae. Less is known about severe neonatal infection caused by the parechoviruses (PeV) of which type 1 (PeV1) and type 2

  20. Challenges and opportunities for neonatal respiratory support in ...

    African Journals Online (AJOL)

    Background: Neonatal health appears not to have received the deserved attention in the context of the Child Survival Strategies and this must have contributed to the non-attainment of the MDG-4 in Nigeria. Neonatal mortality contributes 40% or more to the current rate of child deaths globally, with birth asphyxia, prematurity ...

  1. Neonatal mortality at Leratong Hospital | Moundzika-Kibamba ...

    African Journals Online (AJOL)

    Background. There has been a high demand for delivery services at Leratong Hospital; however, no study on the causes of neonatal mortality has been conducted. It was therefore essential to identify the causes of newborn deaths so as to implement policies that would advance neonatal care. Objectives. To determine the ...

  2. Treatment of neonatal sepsis with intravenous immune globulin

    DEFF Research Database (Denmark)

    Brocklehurst, Peter; Farrell, Barbara; King, Andrew

    2011-01-01

    Neonatal sepsis is a major cause of death and complications despite antibiotic treatment. Effective adjunctive treatments are needed. Newborn infants are relatively deficient in endogenous immunoglobulin. Meta-analyses of trials of intravenous immune globulin for suspected or proven neonatal sepsis...

  3. Neonatal screening for absolute lymphopenia | El-Sayed | Egyptian ...

    African Journals Online (AJOL)

    Three neonates had congenital anomalies, one only experienced dysmorphic features and 8 (1.6%) had family history of unexplained death but these data could not be linked to the presence of lymphopenia in the studied sample. APGAR scores at 1 and 5 minutes were significantly lower in neonates with lymphopenia (p ...

  4. Evaluation of effective factors on low birth weight neonates' mortality using path analysis

    Directory of Open Access Journals (Sweden)

    Babaee Gh

    2008-06-01

    Full Text Available Background: This study have conducted in order to determine of direct or indirect effective factors on mortality of neonates with low birth weight by path analysis.Methods: In this cohort study 445 paired mothers and their neonates were participated in Tehran city. The data were gathered through an answer sheet contain mother age, gestational age, apgar score, pregnancy induced hypertension (PIH and birth weight. Sampling was convenience and neonates of women were included in this study who were referred to 15 government and private hospitals in Tehran city. Live being status of neonates was determined until 24 hours after delivery.Results: The most changes in mortality rate is related to birth weight and its negative score means that increasing in weight leads to increase chance of live being. Second score is related to apgar sore and its negative score means that increasing in apgar score leads to decrease chance of neonate death. Third score is gestational age and its negative score means that increasing in weight leads to increase chance of live being. The less changes in mortality rate is due to hypertensive disorders in pregnancy.Conclusion: The methodology has been used could be adopted in other investigations to distinguish and measuring effect of predictive factors on the risk of an outcome.

  5. Neonatal heart rate prediction.

    Science.gov (United States)

    Abdel-Rahman, Yumna; Jeremic, Aleksander; Tan, Kenneth

    2009-01-01

    Technological advances have caused a decrease in the number of infant deaths. Pre-term infants now have a substantially increased chance of survival. One of the mechanisms that is vital to saving the lives of these infants is continuous monitoring and early diagnosis. With continuous monitoring huge amounts of data are collected with so much information embedded in them. By using statistical analysis this information can be extracted and used to aid diagnosis and to understand development. In this study we have a large dataset containing over 180 pre-term infants whose heart rates were recorded over the length of their stay in the Neonatal Intensive Care Unit (NICU). We test two types of models, empirical bayesian and autoregressive moving average. We then attempt to predict future values. The autoregressive moving average model showed better results but required more computation.

  6. Design and rationale of a large, international, prospective cohort study to evaluate the occurrence of malformations and perinatal/neonatal death using insulin detemir in pregnant women with diabetes in comparison with other long-acting insulins

    DEFF Research Database (Denmark)

    Mathiesen, Elisabeth R.; Andersen, Henning; Kring, Sofia I.I.

    2017-01-01

    such as overweight neonates, as well as infant outcomes at 1 year of age. It has a fixed recruitment period from 2013 to 2018, enrolling all eligible patients, and is expected to inform future prescribing with basal insulins in diabetic pregnancy. Trial registration: ClinicalTrials.gov: NCT01892319(date registered...

  7. Neonatal vitamin A supplementation associated with a cluster of deaths and poor early growth in a randomised trial among low-birth-weight boys of vitamin A versus oral polio vaccine at birth

    DEFF Research Database (Denmark)

    Lund, Najaaraq; Biering-Sørensen, Sofie; Andersen, Andreas

    2014-01-01

    BACKGROUND: The effect of oral polio vaccine administered already at birth (OPV0) on child survival was not examined before being recommended in 1985. Observational data suggested that OPV0 was harmful for boys, and trials have shown that neonatal vitamin A supplementation (NVAS) at birth may...

  8. Latin American Clinical Epidemiology Network Series - Paper 5: Years of life lost due to premature death in traffic accidents in Bogota, Colombia.

    Science.gov (United States)

    Quitian-Reyes, Hoover; Gómez-Restrepo, Carlos; Gómez, Maria Juliana; Naranjo, Salome; Heredia, Patricia; Villegas, John

    2017-06-01

    This study aimed to quantify the number of years of life lost in traffic accidents in Bogota, Colombia. The years of life lost were calculated using the 'age-standardized expected years of life lost' method, the table of Japanese adjusted life expectancy and the database of the Institute of Legal Medicine and Forensic Science between September 2012 and August 2013. During a period of 1 year, 430 people died and 10,056.3 years of life were lost in Bogota due to traffic accidents. The mortality burden of traffic accidents in Bogota is high. Further studies are required in order to characterize the accidents and develop effective policy decisions. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. 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.

  10. Neonatal sepsis

    Directory of Open Access Journals (Sweden)

    Angelica Dessì

    2014-06-01

    Full Text Available In this paper on neonatal sepsis, after a short presentation of etiopathogenesis and physiopathology, we will briefly present the clinical picture, the diagnosis and the therapy. Concerning diagnosis, we will focus our attention on procalcitonin (PCT, serum amyloid A (SAA, presepsin (sCD14 and metabolomics. Three practical tables complete the review. Proceedings of the International Course on Perinatal Pathology (part of the 10th International Workshop on Neonatology · October 22nd-25th, 2014 · Cagliari (Italy · October 25th, 2014 · The role of the clinical pathological dialogue in problem solving Guest Editors: Gavino Faa, Vassilios Fanos, Peter Van Eyken

  11. Association of green tea consumption with mortality due to all causes and major causes of death in a Japanese population: the Japan Public Health Center-based Prospective Study (JPHC Study).

    Science.gov (United States)

    Saito, Eiko; Inoue, Manami; Sawada, Norie; Shimazu, Taichi; Yamaji, Taiki; Iwasaki, Motoki; Sasazuki, Shizuka; Noda, Mitsuhiko; Iso, Hiroyasu; Tsugane, Shoichiro

    2015-07-01

    We examined the association between green tea consumption and mortality due to all causes, cancer, heart disease, cerebrovascular disease, respiratory disease, injuries, and other causes of death in a large-scale population-based cohort study in Japan. We studied 90,914 Japanese (aged between 40 and 69 years) recruited between 1990 and 1994. After 18.7 years of follow-up, 12,874 deaths were reported. The association between green tea consumption and risk of all causes and major causes of mortality was assessed using the Cox proportional hazards regression model with adjustment for potential confounders. Hazard ratios for all-cause mortality among men who consumed green tea compared with those who drank less than 1 cup/day were 0.96 (0.89-1.03) for 1-2 cups/day, 0.88 (0.82-0.95) for 3-4 cups/day, and 0.87 (0.81-0.94) for more than 5 cups/day (P for trend death in Japan. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. A STUDY OF LABORATORY PROFILE OF NEONATAL SEPSIS AT NICU (SNCU, WARANGAL

    Directory of Open Access Journals (Sweden)

    Sudhakar

    2016-05-01

    Full Text Available BACKGROUND Of the 130 million babies born worldwide each year, 26 million are born in India alone. Four million babies die with in first 30 days of birth and another four million are stillborn. Newborn mortality represents 40% of all deaths of children less than five years of age. Of the four million deaths each year, nearly 98% occur in developing countries. Globally major causes of neonatal deaths are due to preterm births (28%, sepsis or pneumonia (26% and birth asphyxia (23%. Neonatal sepsis is one of the commonest causes of neonatal deaths in the developing world accounting to 30-50% of all neonatal deaths per year. The present study is intended to help the practising paediatrician to accurately diagnose the sepsis early using the specific laboratory tests and avert the progression of the disease. METHODS It is an observational cross-sectional study in NICU, Mahatma Gandhi Memorial Hospital. The study was conducted in the period November 2013 to October 2014. After admission, detailed history and thorough clinical examination was done. Required data was entered in a pre-set proforma and statistical analysis was done. Blood culture was sent. Bacterial culture and sensitivity was checked. RESULTS In proven sepsis, 50.25% were Gram-positive, 43.65% were Gram-negative and 6.09% were fungal sepsis Candida. Klebsiella (32.48% was the most common organism followed by Coagulase positive Staphylococcus (25.38% and CONS (20.81%. In this study, Gram-negative sepsis was more common in preterm and Gram-positive sepsis was more common in term neonates. Early onset sepsis was the common presentation of proven sepsis, Klebsiella was common organism causing EOS. Whereas CONS was commonest causing late onset sepsis. Among Gram-negative organisms, 58.1% and 27.9% were resistant to cefotaxime and ampicillin+sulbactam respectively. Among Gram-positive isolates, 35% and 22% were resistant to cefotaxime and ampicillin+sulbactam respectively. Klebsiella, most

  13. Neonatal opioid withdrawal syndrome.

    Science.gov (United States)

    Sutter, Mary Beth; Leeman, Lawrence; Hsi, Andrew

    2014-06-01

    Neonatal opioid withdrawal syndrome is common due to the current opioid addiction epidemic. Infants born to women covertly abusing prescription opioids may not be identified as at risk until withdrawal signs present. Buprenorphine is a newer treatment for maternal opioid addiction and appears to result in a milder withdrawal syndrome than methadone. Initial treatment is with nonpharmacological measures including decreasing stimuli, however pharmacological treatment is commonly required. Opioid monotherapy is preferred, with phenobarbital or clonidine uncommonly needed as adjunctive therapy. Rooming-in and breastfeeding may decease the severity of withdrawal. Limited evidence is available regarding long-term effects of perinatal opioid exposure. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Spontaneous neonatal gastrointestinal perforation: surgical or ...

    African Journals Online (AJOL)

    ... cases of spontaneous gastrointestinal perforation in neonates at the University of Benin Teaching Hospital, Benin City. The perinatal stress factors were caesarian delivery, prematurity and fetal distress due to prolonged obstructed labour.

  15. Two Neonates with Congenital Hydrocolpos

    Directory of Open Access Journals (Sweden)

    Vydehi Murthy

    2013-01-01

    Full Text Available Introduction. Neonatal hydrocolpos is a rare condition. Hydrocolpos is cystic dilatation of the vagina with fluid accumulation due to a combination of stimulation of secretary glands of the reproductive tract and vaginal obstruction. The differential for a neonatal presentation of lower abdominal mass includes urogenital anomalies, Hirschsprung’s, disease or sacrococcygeal teratoma. Prenatal diagnosis and early newborn imaging studies leads to early detection and treatment of these cases. Case. We report here two cases of neonatal hydrocolpos with prenatal diagnosis of lower abdominal mass. Postnatally, ultrasound, MRI imaging, and cystoscopy confirmed large cystic mass as hydrocolpos with distal vaginal obstruction. Both patients had enlarged renal system secondary to mass effect. Conclusion. High index of suspicion for hydrocolpos in a newborn presenting with fetal diagnosis of infraumbilical abdominal mass will facilitate timely intervention and prevention of complications.

  16. INVISIBLE MURDERER: NEONATAL TETANUS

    Directory of Open Access Journals (Sweden)

    Yonca SONMEZ

    2006-06-01

    Full Text Available Neonatal tetanus (NNT has been secondary in the whole world in the death list of diseases which can be protected by the help of vaccine. It’s an important community health problem in the less-developed countries in which pre-birth care services are limited, assisting a mother at childbirth by uneducated people in dirty atmosphere and the immunity against tetanus is not enough. Studies have shown that minor part of the cases have been expressed in most of the countries. Because of that NNT have been called as “silent/invisible murderer”. In Turkey, in the year of 2003 it has been seen 15 cases, and 12 of them have been resulted in death. The methods which will be applied to carry out the elimination of NNT are; the vaccination of pregnant women with at least two doses tetanus toxoid and providing clean birth conditions for all of the pregnant women. However, in Turkey the proportion of the women who have two doses of tetanus vaccine is 41%. To eliminate NNT in our country, all the pregnant women must be attained, the ones who are attained must be presented with qualified pre-birth care service which also includes tetanus immunity and the births must be carried out under healty conditions. As smallpox and polio eradication, NNT elimination will also be accomplished by self-sacrificing works of personnel in primary health care. [TAF Prev Med Bull 2006; 5(3.000: 229-233

  17. [Epidemiological characteristics of neonatal mortality in Peru, 2011-2012].

    Science.gov (United States)

    Ávila, Jeannette; Tavera, Mario; Carrasco, Marco

    2015-01-01

    Describe the epidemiological characteristics of neonatal deaths in Peru. Descriptive study based on notifications to the Perinatal and Neonatal National Epidemiological Surveillance Subsystem (PNNESS) made in 2011-2012. The capture-recapture method was used to calculate the registration of the notification and estimate the neonatal mortality rate (NMR) nationally and by regions. Responses were made to the questions: where, when, who and why the newborns died. 6,748 neonatal deaths were reported to PNNESS, underreport 52.9%. A national NMR of 12.8 deaths/1,000 live births was estimated. 16% of deaths occurred at home and 74.2% of these were in the highlands region, predominantly in rural areas and poor districts. 30% died in the first 24 hours and 42% between 1 and 7 days of life. 60.6% were preterm infants and 39.4% were term infants. 37% had normal weight, 29.4% low weight, and 33.6% very low weight. Preventable neonatal mortality was 33%, being higher in urban and highland areas. 25.1% died of causes related with prematurity-immaturity; 23.5% by infections; 14.1% by asphyxiation and causes related to care during childbirth and 11% by lethal congenital malformation. Neonatal mortality in Peru is differentiated by setting; harms related to prematurity-immaturity dominated on the coast, while the highlands and jungle recorded more preventable neonatal mortality with a predominance of asphyxia and infections.

  18. Why babies die in unplanned out-of-institution births: an enquiry into perinatal deaths in Norway 1999-2013.

    Science.gov (United States)

    Gunnarsson, Björn; Fasting, Sigurd; Skogvoll, Eirik; Smárason, Alexander K; Salvesen, Kjell Å

    2017-03-01

    The aims were to describe causes of death associated with unplanned out-of-institution births, and to study whether they could be prevented. Retrospective population-based observational study based on data from the Medical Birth Registry of Norway and medical records. Between 1 January 1999 and 31 December 2013, 69 perinatal deaths among 6027 unplanned out-of-institution births, whether unplanned at home, during transportation, or unspecified, were selected for enquiry. Hospital records were investigated and cases classified according to Causes of Death and Associated Conditions. 63 cases were reviewed. There were 25 (40%) antepartum deaths, 10 (16%) intrapartum deaths, and 24 neonatal (38%) deaths. Four cases were in the unknown death category (6%). Both gestational age and birthweight followed a bimodal distribution with modes at 24 and 38 weeks and 750 and 3400 g, respectively. The most common main cause of death was infection (n = 14, 22%), neonatal (n = 14, 22%, nine due to extreme prematurity) and placental (n = 12, 19%, seven placental abruptions). There were 86 associated conditions, most commonly perinatal (n = 32), placental (n = 15) and maternal (n = 14). Further classification revealed that the largest subgroup was associated perinatal conditions/sub-optimal care, involving 25 cases (40%), most commonly due to sub-optimal maternal use of available care (n = 14, 22%). Infections, neonatal, and placental causes accounted for almost two-thirds of perinatal mortality associated with unplanned out-of-institution births in Norway. Sub-optimal maternal use of available care was found in more than one-fifth of cases. © 2016 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).

  19. Critically ill neonates displayed stable vital parameters and reduced metabolic acidosis during neonatal emergency airborne transport in Sweden.

    Science.gov (United States)

    Frid, Ingrid; Ågren, Johan; Kjellberg, Mattias; Normann, Erik; Sindelar, Richard

    2018-02-26

    This study evaluated the medical quality of acute airborne transports carried out by a neonatal emergency transport service in a Swedish healthcare region from 2012 to 2015. The transport charts and patient records of all infants transported to the regional centre were reviewed for transport indications and vital parameters and outcomes. We identified 187 acute airborne transports and the main indications for referral were therapeutic hypothermia after perinatal asphyxia, extremely preterm birth and respiratory failure. There were 37 deaths, but none of these occurred during transport and none of the deaths that occurred within 24 hours after transport were found to be related to the transport per se. No differences were found in vital parameters or ventilator settings before and after transport, except for an improvement in blood pH (7.22 ± 0.13 versus 7.27 ± 0.13, mean ± SD, p < 0.01), due to a decrease in base deficit (-8.0 ± 6.8 versus -5.4 ± 6.3 mmol, p < 0.001), while the partial pressure of carbon dioxide remained unchanged. During air transport, critically ill neonates displayed stable vital parameters and reduced metabolic acidosis. No transport-related mortality was found, but the high number of extremely preterm infants transported indicates the potential for improving in-utero transport. ©2018 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  20. Adverse pregnancy and neonatal outcomes in polycystic ovary syndrome women

    Directory of Open Access Journals (Sweden)

    Roshan Nikbakht

    2016-02-01

    Full Text Available Background: Polycystic ovary syndrome (PCOS is the most common endocrine disorders in reproductive age women. These women confer with complications of pregnancy such as gestational diabetes, pregnancy-induced hypertension, preeclampsia and neonatal complications such as small for gestational diabetes (SGA are more prevalence in women with PCOS. The aim of this study was to evaluate the incidence of complications associated with PCOS in pregnant women. Methods: This was an observational and prospective study which recruited 205 pregnant women with PCOS from Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences (AJUMS between 2013 and 2014. Inclusion criteria were women with PCOS and gestational age over 20 weeks. The demographic and clinical variables including mother's age, body mass index (BMI and conditions of pregnancy including pregnancy-induced hypertension, preeclampsia, gestational diabetes and overt diabetes and neonatal complications such as preterm labor (PTL, SGA and intrauterine fetal death (IUFD were recorded. Results: The prevalence of hypertension disorders, preeclampsia, gestational diabetes and overt diabetes were observed in 44 (21.5%, 18 (8.8%, 29 (14% and 22 (11% patients, respectively. The history of familial diabetes was shown in 28 patients (13.6%. In addition, the history of pregnancy induced hypertension was reported in 25 patients (12.1%. Only 6 patients (2.9% had history of gestational diabetes. Among neonatal complications due to PCOS, SGA with 15.3% and then PTL with 12.6% had highest prevalence. IUFD was shown only in 2 patients. Conclusion: Pregnant women with PCOS are at the higher risk for pregnancy and neonatal complications. Specifically, these women should be evaluated for pregnancy induced hypertension during pregnancy than others.

  1. 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.

  2. An increase in the burden of neonatal admissions to a rural district hospital in Kenya over 19 years

    Directory of Open Access Journals (Sweden)

    Marsh Kevin

    2010-10-01

    Full Text Available Abstract Background Most of the global neonatal deaths occur in developing nations, mostly in rural homes. Many of the newborns who receive formal medical care are treated in rural district hospitals and other peripheral health centres. However there are no published studies demonstrating trends in neonatal admissions and outcome in rural health care facilities in resource poor regions. Such information is critical in planning public health interventions. In this study we therefore aimed at describing the pattern of neonatal admissions to a Kenyan rural district hospital and their outcome over a 19 year period, examining clinical indicators of inpatient neonatal mortality and also trends in utilization of a rural hospital for deliveries. Methods Prospectively collected data on neonates is compared to non-neonatal paediatric (≤ 5 years old admissions and deliveries' in the maternity unit at Kilifi District Hospital from January 1st 1990 up to December 31st 2008, to document the pattern of neonatal admissions, deliveries and changes in inpatient deaths. Trends were examined using time series models with likelihood ratios utilised to identify indicators of inpatient neonatal death. Results The proportion of neonatal admissions of the total paediatric ≤ 5 years admissions significantly increased from 11% in 1990 to 20% by 2008 (trend 0.83 (95% confidence interval 0.45 -1.21. Most of the increase in burden was from neonates born in hospital and very young neonates aged 7 mmol/l predicted inpatient neonatal death with a sensitivity of 81% and a specificity of 68%. Conclusions There is clear evidence of increasing burden in neonatal admissions at a rural district hospital in contrast to reducing numbers of non-neonatal paediatrics' admissions aged ≤ 5years. Though the inpatient case fatality for all admissions aged ≤ 5 years declined significantly, neonates now comprise close to 60% of all inpatient deaths. Simple indicators may identify

  3. SERUM SODIUM CHANGES IN NEONATES RECEIVING PHOTOTHERAPY FOR NEONATAL HYPERBILIRUBINEMIA

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    Sunil Kumar

    2015-07-01

    Full Text Available BACKGROUND : Neonates receiving phototherapy have side effects like hypocalcemia and electrolyte changes. Our study is hereby intended to study the serum sodium changes due to phototherapy. AIMS : To evaluate the serum sodium changes in neonates receiving phototherapy f or neonatal hyperbilirubinemia. SETTINGS AND DESIGN : A prospective hospital based comparative study conducted on neonates admitted in the Neonatal Intensive Care Unit receiving phototherapy. METHODS AND MATERIAL : A predesigned proforma has aided the enroll ment of 252 newborns into the study. Serum bilirubin and serum sodium were determined before and after termination of phototherapy. The first samples were considered as controls. A comparative study was made between before and after phototherapy groups to determine the incidence of serum sodium imbalances. STATISTICAL ANALYSIS USED : Proportions will be compared using chi - square test. All data of various groups will be tabulated and statistically analyzed using suitable statistical tests (Student's t test. RESULTS : Male to Female ratio was 1.45 : 1. Incidence of low birth weight babies was 23% and preterm was 20.2%. Mean birth weight and gestational age was 2.84±0.51 kg and 38.44±1.98 wks respectively. Mean duration of phototherapy was 37.65±11.06 hrs. The incidence of hyponatremia post phototherapy found to be 6% which was more in low birth weight (LBW babies (17.2% , p48 hrs (p<0.001. Even the decline in mean serum sodium values after phototherapy found to be statistically significant. CONCLUSION : Our study shows that neonates u nder phototherapy are at higher risk of hyponatremia. This risk is greater in premature and LBW babies and hence this group of babies should be closely monitored for changes in serum sodium and should be managed accordingly.

  4. Neonatal hypokalemia

    Directory of Open Access Journals (Sweden)

    Sarici D

    2012-03-01

    Full Text Available Dilek Sarici1, S Umit Sarici21Kecioren Research and Education Hospital, Kecioren, Ankara, 2Chief of Division of Neonatology, Division of Neonatology, Department of Pediatrics, Gulhane Military Medical Academy, Ankara, TurkeyAbstract: In this article, distribution of potassium (K+ in body fluids, pathophysiology, causes, clinical signs and symptoms, and the evaluation and treatment of neonatal hypokalemia are reviewed. K+ is the most important intracellular cation and normal serum K+ is stabilized between 3.5 and 5.5 mEq/L. Hypokalemia may be caused by increased renal losses, increased extrarenal (gastrointestinal losses, redistribution or prolonged insufficient K+ intake. Clinical signs and symptoms occur as the result of functional changes in striated muscle, smooth muscle, and the heart. Hypokalemia is usually asymptomatic when K+ levels are between 3.0 and 3.5 mEq/L; however, there may sometimes be slight muscle weakness. Moderate hypokalemia is observed when serum K+ is between 2.5 and 3.0 mEq/L. Proximal muscle weakness is observed most commonly in lower extremities; cranial muscles are normal, but constipation and distention are prominent. Severe hypokalemia develops when serum K+ falls below 2.5 mEq/L. Rhabdomyolysis, myoglobinuria, severe muscle weakness, paralysis, respiratory distress, and respiratory arrest are observed. The clinical signs and symptoms may be unremarkable in cases of chronically developing hypokalemia; however, appropriate treatment is essential when serum K+ level falls below 2.5 mEq/L as the most dangerous complication of hypokalemia is fatal cardiac arrythmia, and changes visible with electrocardiography may not always correlate with the level of hypokalemia. Sodium (Na+, K+, chloride (Cl-, bicarbonate, creatinine, blood sugar, magnesium (Mg, plasma renin activity, aldosterone, and blood gases should be investigated by laboratory testing. Aspartate aminotransferase, alanine aminotransferase, creatinine kinase, and

  5. The neonatal brain

    International Nuclear Information System (INIS)

    Flodmark, O.

    1987-01-01

    The clinical examination of the CNS in the neonate is often difficult in cases of complex pathology. Diagnostic imaging of the neonatal brain has become extremely useful and in the last decade has developed in two main directions: CT and US. MR imaging has been used recently with varying success in the diagnosis of pathology in the neonatal brain. Despite technical difficulties, this imaging method is likely to become increasingly important in the neonate. The paper examines the normal neonatal brain anatomy as seen with the different modalities, followed by pathologic conditions. Attention is directed to the common pathology, in asphyxiated newborns, the patholphysiology of intraventicular hemorrhage and periventricular leukomalacia in the preterm neonate, and hypoxic-ischemic brain injury in the term neonate. Pitfalls, artifacts, and problems in image interpretation are illustrated. Finally, the subsequent appearance of neonatal pathology later in infancy and childhood is discussed

  6. Minimally Invasive Epicardial Pacemaker Implantation in Neonates with Congenital Heart Block.

    Science.gov (United States)

    Costa, Roberto; Silva, Katia Regina da; Martinelli Filho, Martino; Carrillo, Roger

    2017-10-01

    Few studies have characterized the surgical outcomes following epicardial pacemaker implantation in neonates with congenital complete atrioventricular block (CCAVB). This study sought to assess the long-term outcomes of a minimally invasive epicardial approach using a subxiphoid access for pacemaker implantation in neonates. Between July 2002 and February 2015, 16 consecutive neonates underwent epicardial pacemaker implantation due to CCAVB. Among these, 12 (75.0%) had congenital heart defects associated with CCAVB. The patients had a mean age of 4.7 ± 5.3 days and nine (56.3%) were female. Bipolar steroid-eluting epicardial leads were implanted in all patients through a minimally invasive subxiphoid approach and fixed on the diaphragmatic ventricular surface. The pulse generator was placed in an epigastric submuscular position. All procedures were successful, with no perioperative complications or early deaths. Mean operating time was 90.2 ± 16.8 minutes. None of the patients displayed pacing or sensing dysfunction, and all parameters remained stable throughout the follow-up period of 4.1 ± 3.9 years. Three children underwent pulse generator replacement due to normal battery depletion at 4.0, 7.2, and 9.0 years of age without the need of ventricular lead replacement. There were two deaths at 12 and 325 days after pacemaker implantation due to bleeding from thrombolytic use and progressive refractory heart failure, respectively. Epicardial pacemaker implantation through a subxiphoid approach in neonates with CCAVB is technically feasible and associated with excellent surgical outcomes and pacing lead longevity.

  7. 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

  8. Neonatal morbidity associated with shoulder dystocia maneuvers.

    Science.gov (United States)

    Spain, Janine E; Frey, Heather A; Tuuli, Methodius G; Colvin, Ryan; Macones, George A; Cahill, Alison G

    2015-03-01

    We sought to examine neonatal morbidity associated with different maneuvers used among term patients who experience a shoulder dystocia. We conducted a retrospective cohort study of all women who experienced a clinically diagnosed shoulder dystocia at term requiring obstetric maneuvers at a single tertiary care hospital from 2005 through 2008. We excluded women with major fetal anomaly, intrauterine death, multiple gestation, and preterm. Women exposed to Rubin maneuver, Wood's screw maneuver, or delivery of the posterior arm were compared to women delivered by McRoberts/suprapubic pressure only, which served as the reference group. The primary outcome was a composite morbidity of neonatal injury (defined as clavicular or humeral fracture or brachial plexus injury) and neonatal depression (defined as Apgar dystocia, defined as time from delivery of fetal head to delivery of shoulders. Among the 231 women who met inclusion criteria, 135 were delivered by McRoberts/suprapubic pressure alone (57.9%), 83 women were exposed to Rubin maneuver, 53 women were exposed to Wood's screw, and 36 women were exposed to delivery of posterior arm. Individual maneuvers were not associated with composite morbidity, neonatal injury, or neonatal depression after adjusting for nulliparity and duration of shoulder dystocia. We found no association between shoulder dystocia maneuvers and neonatal morbidity after adjusting for duration, a surrogate for severity. Our results demonstrate that clinicians should utilize the maneuver most likely to result in successful delivery. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Update on neonatal hypoglycemia.

    Science.gov (United States)

    Rozance, Paul J

    2014-02-01

    Neonatal hypoglycemia is one of the most common biochemical abnormalities encountered in the newborn. However, controversy remains surrounding its definition and management especially in asymptomatic patients. New information has been published that describes the incidence and timing of low glucose concentrations in the groups most at risk for asymptomatic neonatal hypoglycemia. Furthermore, one large prospective study failed to find an association between repetitive low glucose concentrations and poor neurodevelopmental outcomes in preterm infants. But hypoglycemia due to hyperinsulinism, especially genetic causes, continued to be associated with brain injury. New advances were made in the diagnosis and management of hyperinsulinism, including acquired hyperinsulinism in small for gestational age infants and others. Continuous glucose monitoring remains an attractive strategy for future research in this area. The fundamental question of how best to manage asymptomatic newborns with low glucose concentrations remains unanswered. Balancing the risks of overtreating newborns with low glucose concentrations who are undergoing a normal transition following birth against the risks of undertreating those in whom low glucose concentrations are pathological, dangerous, and/or a harbinger of serious metabolic disease remains a challenge.

  10. Is neonatal group B streptococcal infection preventable?

    LENUS (Irish Health Repository)

    Azam, M

    2011-05-01

    Early onset group B streptococcal (EOGBS) infection causes significant neonatal morbidity and mortality. We determined the incidence of EOGBS at Galway University Hospital (GUH) and examined any "missed opportunities" for preventing neonatal infection between 2004 and 2009. Our obstetric approach is risk-based. The incidence was 0.45\\/1,000 live-births; one death and one with neurological sequelae. A single mother received IAP; however we could not determine any potential for reducing cases of EOGBS by improving current IAP usage.

  11. Neonatal resuscitation: advances in training and practice

    Directory of Open Access Journals (Sweden)

    Sawyer T

    2016-12-01

    Full Text Available Taylor Sawyer, Rachel A Umoren, Megan M Gray Department of Pediatrics, Division of Neonatology, Neonatal Education and Simulation-based Training (NEST Program, University of Washington School of Medicine, Seattle, WA, USA Abstract: Each year in the US, some four hundred thousand newborns need help breathing when they are born. Due to the frequent need for resuscitation at birth, it is vital to have evidence-based care guidelines and to provide effective neonatal resuscitation training. Every five years, the International Liaison Committee on Resuscitation (ILCOR reviews the science of neonatal resuscitation. In the US, the American Heart Association (AHA develops treatment guidelines based on the ILCOR science review, and the Neonatal Resuscitation Program (NRP translates the AHA guidelines into an educational curriculum. In this report, we review recent advances in neonatal resuscitation training and practice. We begin with a review of the new 7th edition NRP training curriculum. Then, we examine key changes to the 2015 AHA neonatal resuscitation guidelines. The four components of the NRP curriculum reviewed here include eSim®, Performance Skills Stations, Integrated Skills Station, and Simulation and Debriefing. The key changes to the AHA neonatal resuscitation guidelines reviewed include initial steps of newborn care, positive-pressure ventilation, endotracheal intubation and use of laryngeal mask, chest compressions, medications, resuscitation of preterm newborns, and ethics and end-of-life care. We hope this report provides a succinct review of recent advances in neonatal resuscitation. Keywords: neonatal resuscitation, Neonatal Resuscitation Program, NRP, simulation, deliberate practice, debriefing, eSIM

  12. Causes of Neonatal Mortality in the Neonatal Intensive Care Unit of Taleghani Hospital

    Directory of Open Access Journals (Sweden)

    Ali Hossein Zeinalzadeh

    2017-09-01

    Full Text Available Background: Neonatal survival is one of the most important challenges today. Over 99% of neonatal mortalities occur in the developing countries, and epidemiologic studies emphasize on this issue in the developed countries, as well. In this study, we attempted to investigate the causes of neonatal mortality in Taleghani Hospital, Tabriz, Iran.Methods: In this cross-sectional study, we studied causes of neonatal mortality in neonatal intensive care unit (NICU of Taleghani Hospital, Tabriz, Iran, during 2013-2014. Data collection was performed by the head nurse and treating physician using a pre-designed questionnaire. Most of the data were extracted from the neonatal records. Information regarding maternal underlying diseases and health care during pregnancy was extracted from mothers' records.Results: A total of 891 neonates were admitted to NICU of Taleghani Hospital of Tabriz, Iran, during 2013-2014, 68 (7.5% of whom died. Among these cases, 37 (%54.4 were male, 29 (29.4% were extremely low birth weight, and 16 (23.5% weighed more than 2.5 kg. The main causes of mortality were congenital anomalies (35.3%, prematurity (26.5%, and sepsis (10.3%, respectively.Conclusion: Congenital anomaly is the most common cause of mortality, and the pattern of death is changing from preventable diseases to unavoidable mortalities

  13. Patterns of admission and factors associated with neonatal mortality among neonates admitted to the neonatal intensive care unit of University of Gondar Hospital, Northwest Ethiopia

    Directory of Open Access Journals (Sweden)

    Demisse AG

    2017-05-01

    Full Text Available Abayneh Girma Demisse, Fentahun Alemu, Mahlet Abayneh Gizaw, Zemene Tigabu School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia Introduction: The neonatal period is a highly vulnerable time for an infant completing many of the physiologic adjustments required for life outside the uterus. As a result, there are high rates of morbidity and mortality. The three major causes of mortality in developing countries include prematurity, infection, and perinatal asphyxia. The aim of this study was to identify the patterns of neonatal admission and factors associated with mortality among neonates admitted at the Neonatal Intensive Care Unit (NICU of University of Gondar Hospital.Materials and methods: A retrospective cross-sectional study was conducted among all admitted neonates in the NICU of University of Gondar referral hospital from December 1, 2015 to August 31, 2016. Information was extracted retrospectively during admission from patient records and death certificates, using a pretested questionnaire. The data were entered and analyzed using SPSS version 20, and p-values <0.05 were considered statistically significant.Results: A total of 769 neonates was included in the study. There were 448 (58.3% male neonates, and 398 (51.8% neonates were rural residents. More than two-thirds of the 587 deliveries (76.3% were performed in tertiary hospitals. Neonatal morbidity included hypothermia 546 (71%, sepsis 522 (67.9%, prematurity 250 (34.9%, polycythemia 242 (31.5%, hypoglycemia 142 (18.5, meconium aspiration syndrome 113 (14.7%, and perinatal asphyxia 96 (12.5%. The overall mortality was 110 (14.3%; 95% confidence interval [CI]: 11.9–16.9 of which 69 (62.7% deaths occurred in the first 24 hours of age. In the multivariate analysis, mortality was associated with perinatal asphyxia (adjusted odds ratio [AOR]: 5.97; 95% CI: 3.06–11.64, instrumental delivery (AOR: 2.99; 95% CI: 1.08–8.31, and early onset

  14. Tendências da mortalidade neonatal em São Luís, Maranhão, Brasil, de 1979 a 1996 Neonatal mortality trends in São Luís, Maranhão, Brazil, from 1979 to 1996

    Directory of Open Access Journals (Sweden)

    Valdinar Sousa Ribeiro

    2000-06-01

    Full Text Available O propósito do presente trabalho é avaliar a evolução da mortalidade neonatal em São Luís nos últimos 18 anos, classificá-la de acordo com os dias de vida e pelo critério de evitabilidade de óbitos da Fundação SEADE, a partir de dados do IBGE e do Ministério da Saúde. Detectou-se aumento da mortalidade neonatal, às custas de aumento expressivo do seu componente precoce, especialmente pelas causas reduzíveis por diagnóstico e tratamento precoce, e parcialmente reduzíveis por adequado controle da gravidez. A mortalidade infantil, desse modo, manteve-se inalterada, apesar do decréscimo do seu componente pós-neonatal. O aumento expressivo no coeficiente de mortalidade neonatal a partir de 1995 aponta para a queda na qualidade da assistência obstétrica e neonatal, talvez motivada pelo elevado percentual de cesáreas e pela superlotação dos berçários. A tendência de estabilidade ou aumento da mortalidade neonatal é semelhante à observada recentemente no Brasil como um todo e difere da observada em outras cidades brasileiras, nas quais foi descrita queda lenta, mas persistente, da mortalidade neonatal, em oposição a uma redução mais dramática em países desenvolvidos.This study examined neonatal mortality trends in São Luís in the last 18 years. The early and late components were assessed and causes were classified according to SEADE Foundation criteria based on reducibility of deaths and timing of prevention (during prenatal care, childbirth, or neonatal care. Data were derived from official live birth and death records. We detected an unexpected increase in the neonatal mortality rate, due primarily to a steep rise in early neonatal deaths. Causes reducible by early diagnosis and treatment (other specific infections and other neonatal respiratory causes and those partially reducible by adequate monitoring of pregnancy (preterm births, low birth weight, and respiratory distress syndrome showed the largest increase

  15. Losartan in combination with propranolol slows the aortic root dilatation in neonatal Marfan syndrome.

    Science.gov (United States)

    Liu, Lu-Hang; Lin, Shan-Miao; Lin, Dar-Shong; Chen, Ming-Ren

    2018-04-01

    Neonatal Marfan syndrome, in contrast to classical Marfan syndrome, is characterized by rapidly progressive multi-valvular cardiac disease and death from congestive heart failure, typically within the first year of life. Due to the rarity of this condition, treatment for neonatal Marfan syndrome has not been well studied. In this report, a combination of losartan and propranolol reduced the aortic root dilatation rate after three months of losartan therapy. Genetic analysis in this patient revealed a mutation in exon 25 of the FBN1 gene, which typically results in a shorter life expectancy. However, the patient's heart failure was controlled by losartan, propranolol and other anti-congestive medications, which may have prolonged his survival. Copyright © 2017. Published by Elsevier B.V.

  16. [Clinical studies on flomoxef in neonates].

    Science.gov (United States)

    Tabuki, K; Nishimura, T

    1993-07-01

    Clinical studies on flomoxef (FMOX) were performed in neonates and the results obtained are summarized as follows. Treatment with FMOX was made in 4 cases of neonatal bacterial infections; 2 cases of sepsis (suspected) and 1 case each of infection of umbilicus and staphylococcal scalded skin syndrome. Results obtained were excellent in 1 case, good in 3 cases. No significant side effects due to the drug were observed in any cases.

  17. Causes of perinatal death at a tertiary care hospital in Northern Tanzania 2000–2010: a registry based study

    Directory of Open Access Journals (Sweden)

    Mmbaga Blandina T

    2012-12-01

    Full Text Available Abstract Background Perinatal mortality reflects maternal health as well as antenatal, intrapartum and newborn care, and is an important health indicator. This study aimed at classifying causes of perinatal death in order to identify categories of potentially preventable deaths. Methods We studied a total of 1958 stillbirths and early neonatal deaths above 500 g between July 2000 and October 2010 registered in the Medical Birth Registry and neonatal registry at Kilimanjaro Christian Medical Centre (KCMC in Northern Tanzania. The deaths were classified according to the Neonatal and Intrauterine deaths Classification according to Etiology (NICE. Results Overall perinatal mortality was 57.7/1000 (1958 out of 33 929, of which 1219 (35.9/1000 were stillbirths and 739 (21.8/1000 were early neonatal deaths. Major causes of perinatal mortality were unexplained asphyxia (n=425, 12.5/1000, obstetric complications (n=303, 8.9/1000, maternal disease (n=287, 8.5/1000, unexplained antepartum stillbirths after 37 weeks of gestation (n= 219, 6.5/1000, and unexplained antepartum stillbirths before 37 weeks of gestation (n=184, 5.4/1000. Obstructed/prolonged labour was the leading condition (251/303, 82.8% among the obstetric complications. Preeclampsia/eclampsia was the leading cause (253/287, 88.2% among the maternal conditions. When we excluded women who were referred for delivery at KCMC due to medical reasons (19.1% of all births and 36.0% of all deaths, perinatal mortality was reduced to 45.6/1000. This reduction was mainly due to fewer deaths from obstetric complications (from 8.9 to 2.1/1000 and maternal conditions (from 8.5 to 5.5/1000. Conclusion The distribution of causes of death in this population suggests a great potential for prevention. Early identification of mothers at risk of pregnancy complications through antenatal care screening, teaching pregnant women to recognize signs of pregnancy complications, timely access to obstetric care

  18. Neonatal intracranial hemorrhages (perinatal onset)

    International Nuclear Information System (INIS)

    Ban, Sadahiko; Ogata, Masahiro; Yamamoto, Toyoshiro; Nakao, Satoshi; Mizue, Hidenari; Kobayashi, Yutaka.

    1982-01-01

    1. We have reviewed 34 cases of neonatal intracranial hemorrhages (perinatal onset, 23 mature and 11 premature infants) experienced in 10-year period from 1971 to 1980, with special reference to gestational age, birth weight, type of delivery, presence or absence of asphyxia, symptoms and cause of death. 2. Regarding 9 autopsied cases and 7 cases diagnosed by CT-scan, 10 mature infants composed of 3 subarachnoid hemorrhages, 2 intraventricular hemorrhages, 2 subdural hematomas, 2 intracerebral and 1 subependymal hemorrhage; 6 premature infants consisted of 4 subependymal hemorrhages with ventricular rupture and 2 subarachnoid hemorrhages. Most of them presented with respiratory distress, vomiting and convulsive seizures which developed within 5 days after birth. 3. Poor outcome including death amounted 49% of mature and 63% of premature infants. Along with degree of intracranial hematoma, prematurity and pulmonary complication were felt to be important prognostic factors. 4. Introduction of CT-scan led to prompt diagnosis and treatment, thus lowering mortality rate of neonatal intracranial hemorrhages. (author)

  19. Prevalence and underlying etiologies of neonatal hypoglycemia.

    Science.gov (United States)

    Najati, N; Saboktakin, L

    2010-08-01

    This study aims at determining the prevalence of neonatal hypoglycemia and its underlying causes. In this prospective study 14168 newborns delivered in Tabriz Alzahra Hospital during 2 years were evaluated in regard to blood glucose level at first 24 h of life. Glucose oxidase method with 4-aminophenazone with a Greiner G-300 was the used method for determining the blood glucose level. Cases with blood glucose causes of this condition, as well as the short-term mortality rate were determined. Prevalence of neonatal hypoglycemia was 0.4% (52 newborns). Underlying causes of hypoglycemia were prematurity (61.5%), diabetic mother (13.6%), septicemia (9.6%), perinatal asphyxia (9.6%), stress (3.8%) and neonatal hyperinsulinism (1.9%). The mortality rate was 53.8%, with prematurity as the leading cause of death.

  20. Trends in causes of death among children under 5 in Bangladesh, 1993-2004: an exercise applying a standardized computer algorithm to assign causes of death using verbal autopsy data

    Directory of Open Access Journals (Sweden)

    Walker Neff

    2011-08-01

    Full Text Available Abstract Background Trends in the causes of child mortality serve as important global health information to guide efforts to improve child survival. With child mortality declining in Bangladesh, the distribution of causes of death also changes. The three verbal autopsy (VA studies conducted with the Bangladesh Demographic and Health Surveys provide a unique opportunity to study these changes in child causes of death. Methods To ensure comparability of these trends, we developed a standardized algorithm to assign causes of death using symptoms collected through the VA studies. The original algorithms applied were systematically reviewed and key differences in cause categorization, hierarchy, case definition, and the amount of data collected were compared to inform the development of the standardized algorithm. Based primarily on the 2004 cause categorization and hierarchy, the standardized algorithm guarantees comparability of the trends by only including symptom data commonly available across all three studies. Results Between 1993 and 2004, pneumonia remained the leading cause of death in Bangladesh, contributing to 24% to 33% of deaths among children under 5. The proportion of neonatal mortality increased significantly from 36% (uncertainty range [UR]: 31%-41% to 56% (49%-62% during the same period. The cause-specific mortality fractions due to birth asphyxia/birth injury and prematurity/low birth weight (LBW increased steadily, with both rising from 3% (2%-5% to 13% (10%-17% and 10% (7%-15%, respectively. The cause-specific mortality rates decreased significantly due to neonatal tetanus and several postneonatal causes (tetanus: from 7 [4-11] to 2 [0.4-4] per 1,000 live births (LB; pneumonia: from 26 [20-33] to 15 [11-20] per 1,000 LB; diarrhea: from 12 [8-17] to 4 [2-7] per 1,000 LB; measles: from 5 [2-8] to 0.2 [0-0.7] per 1,000 LB; injury: from 11 [7-17] to 3 [1-5] per 1,000 LB; and malnutrition: from 9 [6-13] to 5 [2-7]. Conclusions

  1. Management of neonatal abstinence syndrome in neonates born to opioid maintained women.

    Science.gov (United States)

    Ebner, Nina; Rohrmeister, Klaudia; Winklbaur, Bernadette; Baewert, Andjela; Jagsch, Reinhold; Peternell, Alexandra; Thau, Kenneth; Fischer, Gabriele

    2007-03-16

    Neonates born to opioid-maintained mothers are at risk of developing neonatal abstinence syndrome (NAS), which often requires pharmacological treatment. This study examined the effect of opioid maintenance treatment on the incidence and timing of NAS, and compared two different NAS treatments (phenobarbital versus morphine hydrochloride). Fifty-three neonates born to opioid-maintained mothers were included in this study. The mothers received methadone (n=22), slow-release oral morphine (n=17) or buprenorphine (n=14) throughout pregnancy. Irrespective of maintenance treatment, all neonates showed APGAR scores comparable to infants of non-opioid dependent mothers. No difference was found between the three maintenance groups regarding neonatal weight, length or head circumference. Sixty percent (n=32) of neonates required treatment for NAS [68% in the methadone-maintained group (n=15), 82% in the morphine-maintained group (n=14), and 21% in the buprenorphine-maintained group (n=3)]. The mean duration from birth to requirement of NAS treatment was 33 h for the morphine-maintained group, 34 h for the buprenorphine-maintained group and 58 h for the methadone-maintained group. In neonates requiring NAS treatment, those receiving morphine required a significantly shorter mean duration of treatment (9.9 days) versus those treated with phenobarbital (17.7 days). Results suggest that morphine hydrochloride is preferable for neonates suffering NAS due to opioid withdrawal.

  2. Adverse Maternal and Neonatal Outcomes in Indicated Compared with Spontaneous Preterm Birth in Healthy Nulliparas: A Secondary Analysis of a Randomized Trial.

    Science.gov (United States)

    Tita, Alan T; Doherty, Lindsay; Roberts, Jim M; Myatt, Leslie; Leveno, Kenneth J; Varner, Michael W; Wapner, Ronald J; Thorp, John M; Mercer, Brian M; Peaceman, Alan; Ramin, Susan M; Carpenter, Marshall W; Iams, Jay; Sciscione, Anthony; Harper, Margaret; Tolosa, Jorge E; Saade, George R; Sorokin, Yoram

    2018-06-01

     To compare the risks of adverse maternal and neonatal outcomes associated with spontaneous (SPTB) versus indicated preterm births (IPTB).  A secondary analysis of a multicenter trial of vitamin C and E supplementation in healthy low-risk nulliparous women. Outcomes were compared between women with SPTB (due to spontaneous membrane rupture or labor) and those with IPTB (due to medical or obstetric complications). A primary maternal composite outcome included: death, pulmonary edema, blood transfusion, adult respiratory distress syndrome (RDS), cerebrovascular accident, acute tubular necrosis, disseminated intravascular coagulopathy, or liver rupture. A neonatal composite outcome included: neonatal death, RDS, grades III or IV intraventricular hemorrhage (IVH), sepsis, necrotizing enterocolitis (NEC), or retinopathy of prematurity.  Of 9,867 women, 10.4% ( N  = 1,038) were PTBs; 32.7% ( n  = 340) IPTBs and 67.3% ( n  = 698) SPTBs. Compared with SPTB, the composite maternal outcome was more frequent in IPTB-4.4% versus 0.9% (adjusted odds ratio [aOR], 4.0; 95% confidence interval [CI], 1.4-11.8), as were blood transfusion and prolonged hospital stay (3.2 and 3.7 times, respectively). The frequency of composite neonatal outcome was higher in IPTBs (aOR, 1.8; 95% CI, 1.1-3.0), as were RDS (1.7 times), small for gestational age (SGA) < 5th percentile (7.9 times), and neonatal intensive care unit (NICU) admission (1.8 times).  Adverse maternal and neonatal outcomes were significantly more likely with IPTB than with SPTB. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  3. Acute symptomatic neonatal seizures in preterm neonates: etiologies and treatments.

    Science.gov (United States)

    Pisani, Francesco; Spagnoli, Carlotta

    2017-12-15

    Acute symptomatic neonatal seizures in preterm newborns are a relevant clinical challenge due to the presence of many knowledge gaps. Etiology-wise, acute symptomatic seizures have an age-specific epidemiology, with intraventricular hemorrhage and its complications representing the first cause in extremely and very preterm neonates, whereas other etiologies have similar occurrence rates as in full-term infants. Specific treatment strategies for the premature neonates are not yet available. Studies suggest a similarly low response rate with even more unfavorable prognosis than in full-term infants. Pharmacodynamic and pharmacokinetic changes are likely under way during the preterm period, with the potential to affect both effectiveness and safety of antiepileptic drugs in these patients. However, due to the lack of clear evidence to guide prioritization of second-line drugs, off-label medications are frequently indicated by review papers and flow-charts, and are prescribed in clinical practice. We therefore conclude by exploring potential future lines of research. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. EFFECT OF KANGAROO MOTHER CARE ON OUTCOME IN PRETERM AND LOW BIRTH WEIGHT NEONATES

    Directory of Open Access Journals (Sweden)

    Chandra Sekhar Kondapalli

    2017-09-01

    Full Text Available BACKGROUND The aim of the study is to study the effect of kangaroo mother care(KMC on preterm and LBW neonates’ vital parameters like temperature, respiratory rate, heart rate and oxygen saturation, establishment of breastfeeding and weight gain, morbidity and mortality, outcome in intramural and extramural neonates. MATERIALS AND METHODS Hospital-based prospective study, Katuri Medical College and Hospital, 300 newborns shifted to KMC ward. In our study group, female newborns were more than male newborns. Inborn were more than outborn, late preterm more than early preterm and term neonates. A significant increase in axillary temperature, increase in respiratory rate, decrease in heart rate and increase in oxygen saturation was seen in neonates. Higher proportion of neonates achieved transition from predominant expressed breast milk consumption to predominant direct breastfeeding during hospital stay. RESULTS The study showed significantly mean weight gain per day during in hospital KMC of 20 g/kg/day. Mean age when neonates started to gain weight was 8.5 days. Neonates were discharged early as they met our discharge criteria with mean age being 11.6 days. Morbidity of neonates requiring NICU admissions apart from LBW in our study were hyperbilirubinaemia (49.9%, sepsis (19.4%, respiratory illness (7.8% and hypothermia (6.4%. During KMC stay, sepsis and NEC seen in 2 each, apnoea, PDA, jaundice in one each and maternal acceptance of KMC was good. During follow up, it was observed that all neonates were exclusively breastfed and the rate of weight gain (148 g/week was satisfactory with an exception that only 8 requiring hospitalisation and only 1 death due to severe infection. The response of the family and/or the father was supportive. CONCLUSION KMC sustains improvement in LBW neonates’ physiological parameters and accelerates growth pattern. Practice of KMC promote breastfeeding, shorten hospital stay without compromising survival, growth

  5. Hazards of pentazocine for neonatal analgesia: a single-centre experience over 10 years.

    Science.gov (United States)

    Osifo, O D; Aghahowa, S E

    2008-09-01

    In developing countries, neonatal analgesia for surgical procedures is a major challenge where postoperative care is inadequate. To report experience of pentazocine for neonatal surgery in a Nigerian tertiary hospital. A retrospective study of surgical neonates who received pentazocine at the University of Benin Teaching Hospital in Benin City between January 1998 and December 2007. During the period, 2590 paediatric operations were performed including 368 (14.2%) neonates, 49 (13.3%) of whom had pentazocine. The other neonates received a variety of analgesics. Of 56 neonates who developed respiratory depression, 40 (71.4%) had pentazocine (pneonates aged between 9 hours and 28 days [mean (SD) 12 (1.2) days] died between 1 and 36 hours following 8-hourly administration of 0.5 mg/kg pentazocine. In older children who had pentazocine, over-sedation was also a problem but there were no deaths. Deaths in neonates were mainly owing to persistent respiratory depression which was compounded by the unavailability of a paediatric ventilator. However, many neonates responded to naloxone. All neonates who died had an autopsy and no lesion was found which could have compromised respiratory function. The use of pentazocine in neonates was associated with high morbidity and mortality. Caution is required when using pentazocine for neonatal analgesia where post-operative respiratory support is insufficient.

  6. Toxicity of benzyl alcohol in adult and neonatal mice

    International Nuclear Information System (INIS)

    McCloskey, S.E.

    1987-01-01

    Benzyl alcohol (BA) is an aromatic alcohol, which is used as a bacteriostat in a variety of parenteral preparations. In 1982, it was implicated as the agent responsible for precipitating The Gasping Syndrome in premature neonates. The investigate further this toxicity, BA was administered, intraperiotoneally, to adult and neonatal CD-1 male mice. Gross behavioral changes were monitored. Low doses produced minimal toxic effects within an initial 4 hour observation period. At the end of this time, the LD 50 was determined to be 1000 mg/kg for both age groups. Death was due to respiratory arrest in all cases. Rapid absorption and conversion of BA to its primary metabolite, benzaldehyde, was demonstrated by gas chromatographic analysis of plasma from both experimental groups. The conversion of BA to benzaldehyde was confirmed in in vitro by using both horse-liver and mouse liver ADH. The inhibition of alcohol dehydrogenase (ADH) by pyrazole was similarly demonstrated in both enzyme systems. 14 C-labelled BA was utilized to determine the distribution of BA and its metabolites in the body, and to possibly pinpoint a target organ of toxicity

  7. Modelling Blood Flow and Metabolism in the Preclinical Neonatal Brain during and Following Hypoxic-Ischaemia.

    Directory of Open Access Journals (Sweden)

    Matthew Caldwell

    Full Text Available Hypoxia-ischaemia (HI is a major cause of neonatal brain injury, often leading to long-term damage or death. In order to improve understanding and test new treatments, piglets are used as preclinical models for human neonates. We have extended an earlier computational model of piglet cerebral physiology for application to multimodal experimental data recorded during episodes of induced HI. The data include monitoring with near-infrared spectroscopy (NIRS and magnetic resonance spectroscopy (MRS, and the model simulates the circulatory and metabolic processes that give rise to the measured signals. Model extensions include simulation of the carotid arterial occlusion used to induce HI, inclusion of cytoplasmic pH, and loss of metabolic function due to cell death. Model behaviour is compared to data from two piglets, one of which recovered following HI while the other did not. Behaviourally-important model parameters are identified via sensitivity analysis, and these are optimised to simulate the experimental data. For the non-recovering piglet, we investigate several state changes that might explain why some MRS and NIRS signals do not return to their baseline values following the HI insult. We discover that the model can explain this failure better when we include, among other factors such as mitochondrial uncoupling and poor cerebral blood flow restoration, the death of around 40% of the brain tissue.

  8. CT findings in neonatal hypothermia

    International Nuclear Information System (INIS)

    Schulman, H.; Laufer, L.; Berginer, J.; Hertzanu, Y.; Hershkowitz, E.; Berenstein, T.; Sofer, S.; Maor, E.

    1998-01-01

    Background. Newborn infants are particularly prone to hypothermia, a condition with a high mortality. Objective. To study the CT brain patterns in infants with hypothermia and neurological symptoms. Materials and methods. We reviewed the brain CT of nine infants with neonatal hypothermia, multiple organ failure, seizures and coma. Results. Two infants had normal CT scans, acutely and at follow-up, and were clinically normal at follow-up. In seven infants, CT showed diffuse cerebral oedema, with reversal of the normal density relationship between grey and white matter and a relative increased density of the thalami, brainstem and cerebellum - the 'reversal sign'. In six surviving infants with severe developmental delay, follow-up CT revealed cerebral atrophy with multicystic encephalomalacia. Conclusions. The 'reversal sign' has been described in the abused child, birth asphyxia and anoxia due to drowning. Neonatal hypothermia is offered as a further cause. (orig.)

  9. CT findings in neonatal hypothermia

    Energy Technology Data Exchange (ETDEWEB)

    Schulman, H.; Laufer, L.; Berginer, J.; Hertzanu, Y. [Department of Radiology, Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, P. O. Box 151, Beer-Sheva 84101 (Israel); Hershkowitz, E.; Berenstein, T.; Sofer, S. [Pediatric Intensive Care Unit, Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva (Israel); Maor, E. [Department of Pathology, Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva (Israel)

    1998-06-01

    Background. Newborn infants are particularly prone to hypothermia, a condition with a high mortality. Objective. To study the CT brain patterns in infants with hypothermia and neurological symptoms. Materials and methods. We reviewed the brain CT of nine infants with neonatal hypothermia, multiple organ failure, seizures and coma. Results. Two infants had normal CT scans, acutely and at follow-up, and were clinically normal at follow-up. In seven infants, CT showed diffuse cerebral oedema, with reversal of the normal density relationship between grey and white matter and a relative increased density of the thalami, brainstem and cerebellum - the `reversal sign`. In six surviving infants with severe developmental delay, follow-up CT revealed cerebral atrophy with multicystic encephalomalacia. Conclusions. The `reversal sign` has been described in the abused child, birth asphyxia and anoxia due to drowning. Neonatal hypothermia is offered as a further cause. (orig.) With 6 figs., 1 tab., 13 refs.

  10. Determinants of neonatal mortality in rural Northern Ethiopia: A population based nested case control study.

    Directory of Open Access Journals (Sweden)

    Robel Yirgu

    Full Text Available In low income and middle income countries, neonatal mortality remains high despite the gradual reduction in under five mortality. Newborn death contributes for about 38% of all under five deaths. This study has identified the magnitude and independent predictors of neonatal mortality in rural Ethiopia.This population based nested case control study was conducted in rural West Gojam zone, Northern Ethiopia, among a cohort of pregnant women who gave birth between March 2011 and Feb 2012. The cohort was established by Maternal and Newborn Health in Ethiopia Partnership (MaNHEP project in 2010 by recruiting mothers in their third trimester, as identified by trained community volunteers. Once identified, women stayed in the cohort throughout their pregnancy period receiving Community Maternal and Newborn Health (CMNH training by health extension workers and community volunteers till the end of the first 48 hours postpartum. Cases were 75 mothers who lost their newborns to neonatal death and controls were 150 randomly selected mothers with neonates who survived the neonatal period. Data to identify cause of death were collected using the WHO standard verbal autopsy questionnaire after the culturally appropriate 40 days of bereavement period. Binomial logistic regression model was used to identify independent contributors to neonatal mortality.The neonatal mortality rate was AOR(95%CI = 18.6 (14.8, 23.2 per 1000 live births. Neonatal mortality declined with an increase in family size, neonates who were born among a family of more than two had lesser odds of death in the neonatal period than those who were born in a family of two AOR (95% CI = 0.13 (0.02, 0.71. Mothers who gave birth to 2-4 AOR(95%CI = 0.15 (0.05, 0.48 and 5+ children AOR(95%CI = 0.08 (0.02, 0.26 had lesser odds of losing their newborns to neonatal mortality. Previous history of losing a newborn to neonatal death also increased the odds of neonatal mortality during the last birth AOR

  11. Two denominators for one numerator: the example of neonatal mortality.

    Science.gov (United States)

    Harmon, Quaker E; Basso, Olga; Weinberg, Clarice R; Wilcox, Allen J

    2018-06-01

    Preterm delivery is one of the strongest predictors of neonatal mortality. A given exposure may increase neonatal mortality directly, or indirectly by increasing the risk of preterm birth. Efforts to assess these direct and indirect effects are complicated by the fact that neonatal mortality arises from two distinct denominators (i.e. two risk sets). One risk set comprises fetuses, susceptible to intrauterine pathologies (such as malformations or infection), which can result in neonatal death. The other risk set comprises live births, who (unlike fetuses) are susceptible to problems of immaturity and complications of delivery. In practice, fetal and neonatal sources of neonatal mortality cannot be separated-not only because of incomplete information, but because risks from both sources can act on the same newborn. We use simulations to assess the repercussions of this structural problem. We first construct a scenario in which fetal and neonatal factors contribute separately to neonatal mortality. We introduce an exposure that increases risk of preterm birth (and thus neonatal mortality) without affecting the two baseline sets of neonatal mortality risk. We then calculate the apparent gestational-age-specific mortality for exposed and unexposed newborns, using as the denominator either fetuses or live births at a given gestational age. If conditioning on gestational age successfully blocked the mediating effect of preterm delivery, then exposure would have no effect on gestational-age-specific risk. Instead, we find apparent exposure effects with either denominator. Except for prediction, neither denominator provides a meaningful way to define gestational-age-specific neonatal mortality.

  12. High third-generation cephalosporin resistant Enterobacteriaceae prevalence rate among neonatal infections in Dakar, Senegal

    OpenAIRE

    Breurec, Sebastien; Bouchiat, Coralie; Sire, Jean-Marie; Moquet, Olivier; Bercion, Raymond; Cisse, Moussa Fafa; Glaser, Philippe; Ndiaye, Ousmane; Ka, Sidy; Salord, Helene; Seck, Abdoulaye; Sy, Haby Signate; Michel, Remy; Garin, Benoit

    2016-01-01

    International audience; Background: Neonatal infection constitutes one of Senegal’s most important public health problems, with amortality rate of 41 deaths per 1,000 live births.Methods: Between January 2007 and March 2008, 242 neonates with suspected infection were recruited at threeneonatal intensive care units in three major tertiary care centers in Dakar, the capital of Senegal. Neonatal infections wereconfirmed by positive bacterial blood or cerebrospinal fluid culture. The microbiologi...

  13. Neonatal Tele-Homecare

    DEFF Research Database (Denmark)

    Holm, Kristina Garne

    Neonatal homecare (NH) implies that parents manage tube feeding and care of their preterm infant at home supported by home visits from neonatal nurses, to monitor infant growth and the well-being of the family. Home visits are costly and time consuming in rural areas. The overall aim of this study...

  14. MRI of neonatal encephalopathy

    International Nuclear Information System (INIS)

    Khong, P.L.; Lam, B.C.C.; Tung, H.K.S.; Wong, V.; Chan, F.L.; Ooi, G.C.

    2003-01-01

    We present the magnetic resonance imaging (MRI) findings in neonatal encephalopathy, including hypoxic-ischaemic encephalopathy, perinatal/neonatal stroke, metabolic encephalopathy from inborn errors of metabolism, congenital central nervous system infections and birth trauma. The applications of advanced MRI techniques, such as diffusion-weighted imaging and magnetic resonance spectroscopy are emphasized

  15. NEONATAL TOBACCO SYNDROME

    Directory of Open Access Journals (Sweden)

    R.A.Kireev

    2008-12-01

    Full Text Available The objective of the research is to study neonatal adaptation in new-born children from the tobacco abused mothers. A comparative analysis of clinical and neuroendochnal status and lipid metabolism in new-born children from smoking and non-smoking mothers was carried out Neonatal adaptation disorders were revealed in new-born children from the smoking mothers.

  16. Pattern, indications and review of complications of neonatal blood ...

    African Journals Online (AJOL)

    Background and objectives: There is a huge need for blood transfusion in the newborn particularly due to the reduced marrow activity in the neonatal period. Despite widely use of blood products in the neonatal period, there is paucity of local data on the pattern, indications and reactions to blood transfusions in Nigerian ...

  17. Empowerment of parents in the neonatal intensive care unit by ...

    African Journals Online (AJOL)

    Parents of infants who are admitted to the neonatal intensive care unit (NICU) need to be empowered to improve bonding, attachment and care-giving skills. Neonatal nurses play a critical role in the empowerment of such parents, but often find it difficult due to a lack of clarity on how it has to be done. A qualitative contextual ...

  18. Predictors of neonatal outcome in early-onset placental dysfunction

    NARCIS (Netherlands)

    Baschat, Ahmet A.; Cosmi, Erich; Bilardo, Catarina M.; Wolf, Hans; Berg, Christoph; Rigano, Serena; Germer, Ute; Moyano, Dolores; Turan, Sifa; Hartung, John; Bhide, Amarnath; Müller, Thomas; Bower, Sarah; Nicolaides, Kypros H.; Thilaganathan, Baskaran; Gembruch, Ulrich; Ferrazzi, Enrico; Hecher, Kurt; Galan, Henry L.; Harman, Chris R.

    2007-01-01

    To identify specific estimates and predictors of neonatal morbidity and mortality in early onset fetal growth restriction due to placental dysfunction. Prospective multicenter study of prenatally diagnosed growth-restricted liveborn neonates of less than 33 weeks of gestational age. Relationships

  19. Neonatal thyrotoxicosis caused by maternal autoimmune hyperthyroidism.

    Science.gov (United States)

    Correia, Miguel Fragata; Maria, Ana Teresa; Prado, Sara; Limbert, Catarina

    2015-03-06

    Neonatal immune hyperthyroidism is a rare but potentially fatal condition. It occurs in 1-5% of infants born to women with Graves' disease (GD). In most of the cases it is due to maternal antibodies transferred from the mother into the fetal compartment, stimulating the fetal thyroid by binding thyrotropin (thyroid-stimulating hormone, TSH) receptor. We present a case of neonatal thyrotoxicosis due to maternal GD detected at 25 days of age and discuss the potential pitfalls in the diagnosis. 2015 BMJ Publishing Group Ltd.

  20. Serum zinc status of neonates with seizure

    Directory of Open Access Journals (Sweden)

    Olia Sharmeen

    2016-08-01

    Full Text Available Background: Seizure is a common neurological disorder in neonatal age group!. Primary metabolic derangement is one of the important reason behind this convulsion during this period. Among primary metabolic derangement hypoglycemia, is most common followed by bypocalcaemia, hypomagnesaemia, low zinc status etc. As causes of many cases of convul­sion remain unknown in neonate. Objectives: To see the zinc status in the sera of neonate with convulsion. So that if needed early intervention can be taken up and thereby prevent complications. Method: A total of 50 neonates (1-28 days who had convulsion with no apparent reasons of convulsion were enrolled as cases and 50 healthy age and sex matched neonates were enrolled as controls. After a quick clinical evaluation serum zinc status was estimated from venous blood by atomic absorption method in Chemistry Division, Atomic Energy Centre. Low zinc was considered if serum value was <0.7mg/L. Results: Among a total of 50 cases 6% had low zinc value & 2% of controls also had low zinc level. The mean serwu zinc level of cases and controls were 1.57±0.95 and 2.37±1.06 mmol/1 respectively (p<0.01. Conclusion: From the study it is seen that low zinc value is an important cause of neonatal seizure due to primary metabolic abnormalities. So early recognition and treatment could save these babies from long term neurological sequelies.

  1. Case of Meningitis in a Neonate Caused by an Extended-Spectrum-Beta-Lactamase-Producing Strain of Hypervirulent Klebsiella pneumoniae

    Directory of Open Access Journals (Sweden)

    Khalit S. Khaertynov

    2017-08-01

    Full Text Available Klebsiella pneumoniae is one of the most important infectious agents among neonates. This pathogen has a potential to develop an increased antimicrobial resistance and virulence. The classic non-virulent strain of K. pneumoniae, producing an extended-spectrum beta-lactamases (ESBL, is associated with nosocomial infection mainly in preterm neonates. Hypervirulent K. pneumoniae strains are associated with invasive infection among previously healthy ambulatory patients, and most of them exhibit antimicrobial susceptibility. During the last few years, several cases of diseases caused by hypervirulent K. pneumoniae producing ESBL have been registered in different geographical regions of the world. However, reports of such cases in neonates are rare. Here, we reported that this pathogen can cause pyogenic meningitis in full-term neonate with poor prognosis. A previously healthy, full-term, 12-day-old neonate was admitted to the infectious diseases hospital with suspected meningitis. The clinical symptoms included loss of appetite, irritability, fever, seizures, and a bulging anterior fontanelle. The analysis of the cerebrospinal fluid confirmed the diagnosis of meningitis. Blood and cerebrospinal fluid cultures were positive for K. pneumoniae, producing ESBL. K. pneumoniae isolates were resistant to aminopenicillins, 3rd generation cephalosporins but were sensitive to imipenem and meropenem. The “string test” was positive. The study of the virulence factors of K. pneumoniae by PCR revealed the presence of the rmpA gene. A combination of K. pneumoniae virulence and drug resistance complicated by cerebral oedema led to the death of the neonate. We concluded that both the risk of developing severe forms of infection and the outcome of the disease due to K. pneumonia are associated with the phenotypic features of the pathogen such as its antibiotic susceptibility and virulence factors. Emergence of the ESBL-producing strain of hypervirulent K

  2. Hugsy : a comforting solution for preterm neonates designed to enhance parent-child bonding

    NARCIS (Netherlands)

    Claes, S.; Guerra, M.G.; Du, J.; Smits, L.M.; Kommers, D.; Oetomo, S.B.

    2017-01-01

    Premature neonates frequently need to spend several weeks or months in a Neonatal Intensive Care Unit (NICU). These neonates will experience a significant amount of pain, stress and discomfort during their hospital stay due to various medical interventions they will receive ranging from feeding to

  3. Specialist teams for neonatal transport to neonatal intensive care units for prevention of morbidity and mortality.

    Science.gov (United States)

    Chang, Alvin S M; Berry, Andrew; Jones, Lisa J; Sivasangari, Subramaniam

    2015-10-28

    Maternal antenatal transfers provide better neonatal outcomes. However, there will inevitably be some infants who require acute transport to a neonatal intensive care unit (NICU). Because of this, many institutions develop services to provide neonatal transport by specially trained health personnel. However, few studies report on relevant clinical outcomes in infants requiring transport to NICU. To determine the effects of specialist transport teams compared with non-specialist transport teams on the risk of neonatal mortality and morbidity among high-risk newborn infants requiring transport to neonatal intensive care. We used the standard search strategy of the Cochrane Neonatal Review Group to search the Cochrane Central Register of Controlled Trials (CENTRAL 2015, Issue 7), MEDLINE (1966 to 31 July 2015), EMBASE (1980 to 31 July 2015), CINAHL (1982 to 31 July 2015), conference proceedings, and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. randomised, quasi-randomised or cluster randomised controlled trials. neonates requiring transport to a neonatal intensive care unit. transport by a specialist team compared to a non-specialist team. any of the following outcomes - death; adverse events during transport leading to respiratory compromise; and condition on admission to the neonatal intensive care unit. The methodological quality of the trials was assessed using the information provided in the studies and by personal communication with the author. Data on relevant outcomes were extracted and the effect size estimated and reported as risk ratio (RR), risk difference (RD), number needed to treat for an additional beneficial outcome (NNTB) or number needed to treat for an additional harmful outcome (NNTH) and mean difference (MD) for continuous outcomes. Data from cluster randomised trials were not combined for analysis. One trial met the inclusion criteria of this review but was considered ineligible owing to

  4. Exposure assessment of neonates in israel to x-ray radiation during hospitalization at neonatal intensive care unit

    International Nuclear Information System (INIS)

    Datz, H.

    2005-03-01

    Nowadays nearly 10% of all births in western countries are premature. In the last decade, there has been an increase of 45% in the number of neonates that were born in Israel. At the same time, the survival of neonates, especially those with very low birth weight, VLBW, (less than 1,500 gr), has increased dramatically. Diagnostic radiology plays an important role in the assessment and treatment of neonates requiring intensive care. During their prolonged and complex hospitalization, these infants are exposed to multiple radiographic examinations involving X-ray radiation. The extent of the examinations that the infant undergoes depends on its birth weight, gestational age and its medical problems, where most of the treatment effort is focused especially on VLBW neonates. Most of the diagnostic X-ray examinations taken during the hospitalization of neonates in the neonatal intensive care unit (NICU) consist of imaging of the respiratory and gastrointestinal systems, namely, the chest and abdomen. The imaging process is done using mobile X-ray units located at the NICUs. Due to their long hospitalization periods and complex medical condition, all neonates, and neonates with VLBW in particular, are exposed to a much higher level of diagnostic radiation, compared to normal newborns. The goal of this research was to assess the extent of the exposure of neonates in Israel to X-ray radiation during their hospitalization at the neonatal intensive care unit. Five NICUs, located at different geographical zones in Israel and treating 20% of all newborns in Israel every year, participated in this research. The research was conducted in three phases: Phase I: Collection of information on radiographic techniques and exposure parameters (e.g. kV, mAs, focus to skin distance (FSD), examination borders). 499 X-ray examinations (from 157 neonates) were evaluated for necessary and unnecessary exposure of the neonate's organs to X-ray radiation during these examinations. Phase II

  5. Is facility based neonatal care in low resource setting keeping pace ...

    African Journals Online (AJOL)

    Objectives: To identify reasons for neonatal admission and death with the aim of determining areas needing improvement. Method: A retrospective chart review was conducted on records for neonates admitted to Mulago National Referral Hospital Special Care Baby Unit (SCBU) from 1st November 2013 to 31st January ...

  6. Hemorrhage is the most common cause of neonatal mortality in patients with sacrococcygeal teratoma

    NARCIS (Netherlands)

    Kremer, Marijke E. B.; Wellens, Lianne M.; Derikx, Joep P. M.; van Baren, Robertine; Heij, Hugo A.; Wijnen, Marc H. W. A.; Wijnen, René M. H.; van der Zee, David C.; van Heurn, L. W. Ernest

    2016-01-01

    A small percentage of neonates with sacrococcygeal teratoma die shortly after birth from hemorrhagic complications. The incidence of and risk factors associated with hemorrhagic mortality are unknown. In this multicenter study we determined the incidence of early death in neonates born with SCT and

  7. Hemorrhage is the most common cause of neonatal mortality in patients with sacrococcygeal teratoma

    NARCIS (Netherlands)

    Kremer, Marijke E B; Wellens, Lianne M; Derikx, Joep P M; van Baren, Robertine; Heij, Hugo A; Wijnen, Marc H W A; Wijnen, René M H; van der Zee, David C; van Heurn, L W Ernest

    2016-01-01

    BACKGROUND: A small percentage of neonates with sacrococcygeal teratoma die shortly after birth from hemorrhagic complications. The incidence of and risk factors associated with hemorrhagic mortality are unknown. In this multicenter study we determined the incidence of early death in neonates born

  8. Supporting families in neonatal loss: relationship and faith key to comfort.

    Science.gov (United States)

    Holston, Jane Treadwell

    2015-01-01

    Around 20,000 neonatal deaths occur each year, many from congenital heart defects such as hypoplastic left heart syndrome. Nurses are on the frontline of caring for families experiencing neonatal loss. Careful spiritual and cultural assessment, attention to beliefs, focusing on relationship, and helping families create legacy can assist with grieving and making meaning out of loss.

  9. Neonatal Outcomes of Rh-Negative Pregnancies in a Tertiary Level Neonatal Intensive Care Unit: A Prospective Study

    Directory of Open Access Journals (Sweden)

    Chacham

    2016-07-01

    Full Text Available Background Rhesus incompatibility is a preventable cause for severe neonatal hyperbilirubinemia, hydrops fetalis and still births. The prevalence of the Rh-negative blood group among Indian woman varies from 2% - 10%. Despite declining the incidence of Rhesus incompatibility, due to availability of anti-D immunoglobulin, and improved antenatal care of the Rh-negative pregnant woman, it still accounts for a significant proportion of neonatal hyperbilirubinemia and neuro-morbidity. The prevalence of Rh-negative women having Rh-positive neonates is 60%. Objectives This study aimed to estimate the incidence of Rh iso-immunization and evaluate the outcomes of Rh iso-immunized neonates. Methods This prospective observational study was conducted in a tertiary level neonatal intensive care unit, Princess Esra hospital, Deccan college of medical sciences, Hyderabad, Telangana, India. Consecutive intramural and extramural neonates admitted to neonatal intensive care unit with the Rh-negative mother’s blood group and hyperbilirubinemia were enrolled. Neonates born to Rh+ve mothers were excluded. Neonatal gestational age, birth weight, age at admission, duration of phototherapy, duration of hospitalization, neonatal examination and investigations were recorded in a predesigned, pretested performa. Results A total of 90 neonates were born to Rh-negative mothers, of which 70% (63 had the Rh-positive blood group and 30% had the Rh-negative blood group. Of these 63 neonates, 48 (76.2% had hyperbilirubinemia and 43 neonates (68.3% had significant hyperbilirubinemia (total serum bilirubin > 15mg/dL. Among them, 2%, 75% and 23% were born to primi, multi and grandmutli, respectively. Also, 14.5% of the neonates were large for dates (LFD, 75% appropriate for dates (AFD and 10.5% were small for dates (SFD. Premature and SFD neonates had higher incidence of hyperbilirubinemia. Significantly higher incidence of jaundice occurred within 72 hours of life. The mean

  10. A systematic review of the burden of neonatal mortality and morbidity in the ASEAN Region.

    Science.gov (United States)

    Tran, Hoang T; Doyle, Lex W; Lee, Katherine J; Graham, Stephen M

    2012-01-01

    Neonatal morbidity and mortality are major global public health challenges representing an increasing proportion of overall under-5 child mortality, with the vast majority of neonatal deaths occurring in resource-limited settings. In the Association of Southeast Asian Nations (ASEAN) region, it is estimated that approximately 200 000 neonatal deaths occur annually with reported estimates of the neonatal mortality rate ranging from 1 to over 30 per 1000 live-births, depending on the setting. The aim of this study is to conduct a systematic review of published data on neonatal morbidity and mortality from the ASEAN region over the last 10 years. Very few published studies reporting neonatal morbidity and mortality in this region were found. Importantly, data are available from just a few countries, with an underrepresentation of the most resource-limited settings. The majority of the studies describing mortality and morbidity were retrospective surveys or focussed on a specific cause of neonatal morbidity. Studies included findings from a range of settings, from neonatal intensive care to community settings utilizing verbal autopsy. Therefore, comprehensive and prospective data are needed to inform priorities and potential interventions to improve neonatal care and reduce neonatal mortality in this region.

  11. NCHS - Infant and neonatal mortality rates: United States, 1915-2013

    Data.gov (United States)

    U.S. Department of Health & Human Services — Rates are infants (under 1 year) and neonatal (under 28 days) deaths per 1,000 live births. https://www.cdc.gov/nchs/data-visualization/mortality-trends/

  12. Føtal og neonatal alloimmun trombocytopeni er en mulig fatal tilstand

    DEFF Research Database (Denmark)

    Morling Taaning, Ellen Birkerod; Kjeldsen-Kragh, Jens; Hedegaard, Morten

    2011-01-01

    Fetal and neonatal alloimmune thrombocytopenia (FNAIT) may lead to intracranial haemorrhage (ICH) resulting in neurological damage or death. In FNAIT, transplacental maternal antibodies cause destruction of fetal platelets. Maternal immunisation occurs to fetal human platelet antigens (HPAs...

  13. Neonatal care in the home in northern rural Honduras: a qualitative study of the role of traditional birth attendants.

    Science.gov (United States)

    Sacks, Emma; Bailey, Joanne Motiño; Robles, Chayla; Low, Lisa Kane

    2013-01-01

    Traditional birth attendants (TBAs) have limited ability to reduce maternal mortality, but may be able to have a significant impact on neonatal survival. This qualitative study explores TBAs' (possessive) experience with neonatal care in a rural Honduran community. In 6 semistructured focus groups, TBAs described services they routinely provide to newborns. Using Atlas.ti, Version 6.0. (ATLAS.ti Scientific Software Development GmbH, University of Berlin), transcripts were coded by bilingual researchers and analyzed by thematic content. TBAs demonstrated limited knowledge of newborn physiology, yet were aware of many internationally recommended practices. Despite attempts to follow recommendations, all TBAs expressed difficulty due to resource constraints. TBAs were strong advocates of immediate breast-feeding and skin-to-skin care, but they did not demonstrate knowledge regarding delayed bathing and thermal care. Most TBAs stated that a sick neonate could be identified immediately at birth; thus, infections or other illnesses developed in later days may be missed. TBAs did not believe they could have averted neonatal complications or deaths that had occurred under their care. For most healthy newborns, TBAs are the primary providers until the 2-month vaccine visit at the healthcare clinic. Improved TBA training focused on infection symptomotology, physiology, and thermoregulation for newborns may increase opportunities for improved health and timely referrals to healthcare facilities.

  14. NEONATAL ABSTINENCE SYNDROME - CASE REPORT

    Directory of Open Access Journals (Sweden)

    Aleksandra Matic

    2008-01-01

    Full Text Available Neonatal abstinence syndrome (NAS refers to the constellation of signs and symptoms exhibited by a newborn of drug-abusing mother. NAS is multisystemic disorder, most frequently involving central nervous and gastrointestinal systems with irritability, high-pitched cry, hyperactive reflexes, increased muscle tone, tremors, generalized convulsions, feeding and sleeping disorders, tachycardia, tachypnea, apnea, termolability and sweating, frequent hiccups, yawning and sneezing, vomiting, diarrhea and dehydration.Intrauterine narcotic disposition can give some other adverse effects beside NAS: fetal distress, premature birth, intrauterine growth retardation, microcephaly, increased incidence of congenital anomalies (cardiac and genitourinary anomalies, cleft palate, biliar atresia. Significantly increased risks of sudden infant’s death syndrome (SIDS, abnormalities in neurocognitive and behavioral development and deficiency in motor functions have also been noticed after the long-term surveys of these children.This paper is a case report of a newborn with developed clinical signs of NAS, but it also discusses diagnostics and management of such cases

  15. Systemic fungal infections in neonates

    Directory of Open Access Journals (Sweden)

    Rao S

    2005-01-01

    Full Text Available Advances in neonatal management have led to considerable improvement in newborn survival. However, early (72hours onset systemic infections, both bacterial and fungal, remain a devastating complication and an important cause of morbidity and mortality in these babies. Most neonatal fungal infections are due to Candida species, particularly Candida albicans. The sources of candidiasis in NICU are often endogenous following colonization of the babies with fungi. About 10% of these babies get colonized in first week of life and up to 64% babies get colonized by 4 weeks of hospital stay. Disseminated candidiasis presents like bacterial sepsis and can involve multiple organs such as the kidneys, brain, eye, liver, spleen, bone, joints, meninges and heart. Confirming the diagnosis by laboratory tests is difficult and a high index of suspicion is required. The diagnosis of fungemia can be made definitely only by recovering the organism from blood or other sterile bodily fluid. Amphotericin B continues to be the mainstay of therapy for systemic fungal infections but its use is limited by the risks of nephrotoxicity and hypokalemia. Newer formulations of amphotericin B, namely the liposomal and the lipid complex forms, have recently become available and have been reported to have lesser toxicity. More recently Indian liposomal Amphotericin B derived from neutral lipids (L-Amp -LRC-1 has shown good response with less toxicity. A clinical trial with this preparation has shown to be safe and efficacious in neonatal fungal infections. Compared to other liposomal preparations, L-Amp-LRC-1 is effective at lower dose and is less expensive drug for the treatment of neonatal candidiasis.

  16. Mortality due to noncommunicable diseases in Brazil, 1990 to 2015, according to estimates from the Global Burden of Disease study

    Directory of Open Access Journals (Sweden)

    Deborah Carvalho Malta

    Full Text Available ABSTRACT CONTEXT AND OBJECTIVE: Noncommunicable diseases (NCDs are the leading health problem globally and generate high numbers of premature deaths and loss of quality of life. The aim here was to describe the major groups of causes of death due to NCDs and the ranking of the leading causes of premature death between 1990 and 2015, according to the Global Burden of Disease (GBD 2015 study estimates for Brazil. DESIGN AND SETTING: Cross-sectional study covering Brazil and its 27 federal states. METHODS: This was a descriptive study on rates of mortality due to NCDs, with corrections for garbage codes and underreporting of deaths. RESULTS: This study shows the epidemiological transition in Brazil between 1990 and 2015, with increasing proportional mortality due to NCDs, followed by violence, and decreasing mortality due to communicable, maternal and neonatal causes within the global burden of diseases. NCDs had the highest mortality rates over the whole period, but with reductions in cardiovascular diseases, chronic respiratory diseases and cancer. Diabetes increased over this period. NCDs were the leading causes of premature death (30 to 69 years: ischemic heart diseases and cerebrovascular diseases, followed by interpersonal violence, traffic injuries and HIV/AIDS. CONCLUSION: The decline in mortality due to NCDs confirms that improvements in disease control have been achieved in Brazil. Nonetheless, the high mortality due to violence is a warning sign. Through maintaining the current decline in NCDs, Brazil should meet the target of 25% reduction proposed by the World Health Organization by 2025.

  17. Intrapartum-related neonatal encephalopathy incidence and impairment at regional and global levels for 2010 with trends from 1990

    Science.gov (United States)

    Lee, Anne CC; Kozuki, Naoko; Blencowe, Hannah; Vos, Theo; Bahalim, Adil; Darmstadt, Gary L.; Niermeyer, Susan; Ellis, Matthew; Robertson, Nicola J.; Cousens, Simon; Lawn, Joy E.

    2013-01-01

    Background: Intrapartum hypoxic events (“birth asphyxia”) may result in stillbirth, neonatal or postneonatal mortality, and impairment. Systematic morbidity estimates for the burden of impairment outcomes are currently limited. Neonatal encephalopathy (NE) following an intrapartum hypoxic event is a strong predictor of long-term impairment. Methods: Linear regression modeling was conducted on data identified through systematic reviews to estimate NE incidence and time trends for 184 countries. Meta-analyses were undertaken to estimate the risk of NE by sex of the newborn, neonatal case fatality rate, and impairment risk. A compartmental model estimated postneonatal survivors of NE, depending on access to care, and then the proportion of survivors with impairment. Separate modeling for the Global Burden of Disease 2010 (GBD2010) study estimated disability adjusted life years (DALYs), years of life with disability (YLDs), and years of life lost (YLLs) attributed to intrapartum-related events. Results: In 2010, 1.15 million babies (uncertainty range: 0.89–1.60 million; 8.5 cases per 1,000 live births) were estimated to have developed NE associated with intrapartum events, with 96% born in low- and middle-income countries, as compared with 1.60 million in 1990 (11.7 cases per 1,000 live births). An estimated 287,000 (181,000–440,000) neonates with NE died in 2010; 233,000 (163,000–342,000) survived with moderate or severe neurodevelopmental impairment; and 181,000 (82,000–319,000) had mild impairment. In GBD2010, intrapartum-related conditions comprised 50.2 million DALYs (2.4% of total) and 6.1 million YLDs. Conclusion: Intrapartum-related conditions are a large global burden, mostly due to high mortality in low-income countries. Universal coverage of obstetric care and neonatal resuscitation would prevent most of these deaths and disabilities. Rates of impairment are highest in middle-income countries where neonatal intensive care was more recently

  18. Surviving death

    DEFF Research Database (Denmark)

    Gerstroem, Anna

    2013-01-01

    such phases. The aim of this paper is to explore how an organization’s identity is re-constructed after organizational death. Based on interviews with members of a bankrupted bank who narrate their bankruptcy experiences, the paper explores how legacy organizational identity is constructed after...... organizational death. The paper shows how members draw on their legacy organizational identity to justify their past interpretations and responses to the intensifying bankruptcy threats. Members refer to their firm belief in the bank’s solid and robust identity claim when they explain how they disregarded...

  19. Later rather than sooner: the impact of clinical management on timing and modes of death in the last decade.

    Science.gov (United States)

    Dupont-Thibodeau, Amélie; Langevin, Rosalie; Janvier, Annie

    2014-11-01

    Technological and clinical advances have reduced neonatal deaths, and this study explored how the mode and timing of neonatal deaths has changed in a tertiary neonatal intensive care unit (NICU) over 10 years. We carried out a retrospective chart review on NICU deaths in 2000-2002 and 2007-2010, categorising deaths and compared the timing, cause and mode of death in the two cohorts. We analysed 204 neonatal deaths and found that the average age at death doubled from 9.71 days in 2000-2002 to 18.8 days (p = 0.014) in 2007-2010 and that the number of deaths in the first 48 h of life fell from 52% to 29% (p < 0.001). Mode of death and ethical decision-making was similar. In both cohorts, 26% of patients who died had a do not resuscitate order and 9% of the 151 patients without an order died while receiving cardiopulmonary resuscitation. Most neonates received medication to keep them comfortable and their use was similar in both cohorts. Changes in neonatal management have led to a reduction in early deaths and an increase in age at death. The impact of later deaths on families and healthcare providers deserves further research. ©2014 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  20. Birth order, gestational age, and risk of delivery related perinatal death in twins: retrospective cohort study

    Science.gov (United States)

    Smith, Gordon C S; Pell, Jill P; Dobbie, Richard

    2002-01-01

    Objective To determine whether twins born second are at increased risk of perinatal death because of complications during labour and delivery. Design Retrospective cohort study. Setting Scotland, 1992 and 1997. Participants All twin births at or after 24 weeks' gestation, excluding twin pairs in which either twin died before labour or delivery or died during or after labour and delivery because of congenital abnormality, non-immune hydrops, or twin to twin transfusion syndrome. Main outcome measure Delivery related perinatal deaths (deaths during labour or the neonatal period). Results Overall, delivery related perinatal deaths were recorded for 23 first twins only and 23 second twins only of 1438 twin pairs born before 36 weeks (preterm) by means other than planned caesarean section (P>0.99). No deaths of first twins and nine deaths of second twins (P=0.004) were recorded among the 2436 twin pairs born at or after 36 weeks (term). Discordance between first and second twins differed significantly in preterm and term births (P=0.007). Seven of nine deaths of second twins at term were due to anoxia during the birth (2.9 (95% confidence interval 1.2 to 5.9) per 1000); five of these deaths were associated with mechanical problems with the second delivery following vaginal delivery of the first twin. No deaths were recorded among 454 second twins delivered at term by planned caesarean section. Conclusions Second twins born at term are at higher risk than first twins of death due to complications of delivery. Previous studies may not have shown an increased risk because of inadequate categorisation of deaths, lack of statistical power, inappropriate analyses, and pooling of data about preterm births and term births. What is already known on this topicIt is difficult to assess the wellbeing of second twins during labourDeliveries of second twins are at increased risk of mechanical problems, such as cord prolapse and malpresentation, after vaginal delivery of first twins

  1. Maternal Super Obesity and Neonatal Morbidity after Term Cesarean Delivery.

    Science.gov (United States)

    Smid, Marcela C; Vladutiu, Catherine J; Dotters-Katz, Sarah K; Manuck, Tracy A; Boggess, Kim A; Stamilio, David M

    2016-10-01

    Objective To estimate the association between maternal super obesity (body mass index [BMI] ≥ 50 kg/m(2)) and neonatal morbidity among neonates born via cesarean delivery (CD). Methods Retrospective cohort of singleton neonates delivered via CD ≥ 37 weeks in the Maternal-Fetal Medicine Unit Cesarean Registry. Maternal BMI at delivery was stratified as 18.5 to 29.9 kg/m(2), 30 to 39.9 kg/m(2), 40 to 49.9 kg/m(2), and ≥ 50 kg/m(2). Primary outcomes included acute (5-minute Apgar score neonatal injury, and/or transient tachypnea of the newborn) and severe (grade 3 or 4 intraventricular hemorrhage, necrotizing enterocolitis, seizure, respiratory distress syndrome, hypoxic ischemic encephalopathy, meconium aspiration, ventilator support ≥ 2 days, sepsis and/or neonatal death) neonatal morbidity. Odds of neonatal morbidity were estimated for each BMI category adjusting for clinical and operative characteristics. Results Of 41,262 maternal-neonatal dyads, 36% of women were nonobese, 49% had BMI of 30 to 39.9 kg/m(2), 12% had BMI of 40 to 49.9 kg/m(2), and 3% were super obese. Compared with nonobese women, super obese women had twofold odds of acute (5 vs. 10%; adjusted odds ratio [aOR]: 1.81, 95% confidence interval [CI]: 1.59-2.73) and severe (3 vs. 6%; aOR: 2.08; 95% CI: 1.59-2.73) neonatal morbidity. Conclusion Among term infants delivered via CD, maternal super obesity is associated with increased risk of neonatal morbidity. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  2. "Spectacular Death"

    DEFF Research Database (Denmark)

    Jacobsen, Michael Hviid

    2016-01-01

    be labelled ‘spectacular death’ in which death, dying and mourning have increasingly become spectacles. Moreover, the author proposes that what is currently happening in contemporary Western society can be interpreted as an expression of a ‘partial re-reversal’ of ‘forbidden death’ to some...

  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. A “wear and tear” hypothesis to explain Sudden Infant Death Syndrome (SIDS

    Directory of Open Access Journals (Sweden)

    Eran Elhaik

    2016-10-01

    Full Text Available Sudden Infant Death Syndrome (SIDS is the leading cause of death in USA infants under one year of age accounting for approximately 2,700 deaths per year. Although formally SIDS dates back at least 2,000 years and was even mentioned in the Hebrew Bible (Kings 3:19 its etiology remains unexplained prompting the CDC to initiate a sudden unexpected infant death case registry in 2010. Due to their total dependence, the ability of the infant to allostatically regulate stressors and stress responses shaped by genetic and environmental factors is severely constrained. We propose that SIDS is the result of cumulative painful, stressful, or traumatic exposures that begin in utero and tax neonatal regulatory systems incompatible with allostasis. We also identify several putative biochemical mechanisms involved in SIDS. We argue that the important characteristics of SIDS, namely male predominance (60:40, the significantly different SIDS rate in USA Hispanics (80% lower compared to whites, 50% of cases occurring between 7.6 and 17.6 weeks after birth with only 10% after 24.7 weeks, and seasonal variation with most cases occurring during winter, are all associated with common environmental stressors, such as neonatal circumcision and seasonal illnesses. We predict that neonatal circumcision is associated with hypersensitive to pain and decreased heart rate variability which increase the risk for SIDS. We also predict that neonatal male circumcision will account for the SIDS gender bias and that cultures that practice high male circumcision rates, like USA whites, will have higher SIDS rates compared to cultures with lower circumcision rates. SIDS rates will also be higher in USA states where Medicaid covers circumcision and lower among cultures that do not practice neonatal circumcision and/or cannot afford to pay for circumcision. We last predict that winter-born premature infants who are circumcised will be at higher risk of SIDS compared to infants who

  5. A "Wear and Tear" Hypothesis to Explain Sudden Infant Death Syndrome.

    Science.gov (United States)

    Elhaik, Eran

    2016-01-01

    Sudden infant death syndrome (SIDS) is the leading cause of death among USA infants under 1 year of age accounting for ~2,700 deaths per year. Although formally SIDS dates back at least 2,000 years and was even mentioned in the Hebrew Bible (Kings 3:19), its etiology remains unexplained prompting the CDC to initiate a sudden unexpected infant death case registry in 2010. Due to their total dependence, the ability of the infant to allostatically regulate stressors and stress responses shaped by genetic and environmental factors is severely constrained. We propose that SIDS is the result of cumulative painful, stressful, or traumatic exposures that begin in utero and tax neonatal regulatory systems incompatible with allostasis. We also identify several putative biochemical mechanisms involved in SIDS. We argue that the important characteristics of SIDS, namely male predominance (60:40), the significantly different SIDS rate among USA Hispanics (80% lower) compared to whites, 50% of cases occurring between 7.6 and 17.6 weeks after birth with only 10% after 24.7 weeks, and seasonal variation with most cases occurring during winter, are all associated with common environmental stressors, such as neonatal circumcision and seasonal illnesses. We predict that neonatal circumcision is associated with hypersensitivity to pain and decreased heart rate variability, which increase the risk for SIDS. We also predict that neonatal male circumcision will account for the SIDS gender bias and that groups that practice high male circumcision rates, such as USA whites, will have higher SIDS rates compared to groups with lower circumcision rates. SIDS rates will also be higher in USA states where Medicaid covers circumcision and lower among people that do not practice neonatal circumcision and/or cannot afford to pay for circumcision. We last predict that winter-born premature infants who are circumcised will be at higher risk of SIDS compared to infants who experienced fewer

  6. Quantitative head ultrasound measurements to determine thresholds for preterm neonates requiring interventional therapies following intraventricular hemorrhage

    Science.gov (United States)

    Kishimoto, Jessica; Fenster, Aaron; Salehi, Fateme; Romano, Walter; Lee, David S. C.; de Ribaupierre, Sandrine

    2016-04-01

    Dilation of the cerebral ventricles is a common condition in preterm neonates with intraventricular hemorrhage (IVH). This post hemorrhagic ventricle dilation (PHVD) can lead to lifelong neurological impairment through ischemic injury due to increased intracranial pressure and without treatment, can lead to death. Clinically, 2D ultrasound (US) through the fontanelles ('soft spots') of the patients are serially acquired to monitor the progression of the ventricle dilation. These images are used to determine when interventional therapies such as needle aspiration of the built up cerebrospinal fluid (CSF) ('ventricle tap', VT) might be indicated for a patient; however, quantitative measurements of the growth of the ventricles are often not performed. There is no consensus on when a neonate with PHVD should have an intervention and often interventions are performed after the potential for brain damage is quite high. Previously we have developed and validated a 3D US system to monitor the progression of ventricle volumes (VV) in IVH patients. We will describe the potential utility of quantitative 2D and 3D US to monitor and manage PHVD in neonates. Specifically, we will look to determine image-based measurement thresholds for patients who will require VT in comparison to patients with PHVD who resolve without intervention. Additionally, since many patients who have an initial VT will require subsequent interventions, we look at the potential for US to determine which PHVD patients will require additional VT after the initial one has been performed.

  7. Role of massage therapy on reduction of neonatal hyperbilirubinemia in term and preterm neonates: a review of clinical trials.

    Science.gov (United States)

    Garg, Bhawan Deep; Kabra, Nandkishor S; Balasubramanian, Haribalakrishna

    2017-09-13

    Neonatal hyperbilirubinemia (NNH) is one of the leading causes of admissions in nursery throughout the world. It affects approximately 2.4-15% of neonates during the first 2 weeks of life. To evaluate the role of massage therapy for reduction of NNH in both term and preterm neonates. The literature search was done for various randomized control trials (RCTs) by searching the Cochrane Library, PubMed, and EMBASE. This review included total of 10 RCTs (two in preterm neonates and eight in term neonates) that fulfilled inclusion criteria. In most of the trials, Field massage was given. Six out of eight trials reported reduction in bilirubin levels in term neonates. However, only one trial (out of two) reported significant reduction in bilirubin levels in preterm neonates. Both trials in preterm neonates and most of the trials in term neonates (five trials) reported increased stool frequencies. Role of massage therapy in the management of NNH is supported by the current evidence. However, due to limitations of the trials, current evidences are not sufficient to use massage therapy for the management of NNH in routine practice.

  8. Efficacy of zinc sulfate in reducing unconjugated hyperbilirubinemia in neonates

    Directory of Open Access Journals (Sweden)

    Somayyeh Hashemian

    2014-09-01

    Full Text Available Hyperbilirubinemia is a common disease and unconjugated hyperbilirubinemia has been seen mainly in neonates. Severe form of unconjugated hyperbilirubinemia may cause kernicterus and even death. Conventional treatment for severe unconjugated hyperbilirubinemia consists of phototherapy and exchange transfusion that have several known disadvantages; specially exchange transfusion is associated with a significant morbidity and even mortality. These harmful effects indicate the need to develop alternative pharmacological treatment strategies for unconjugated hyperbilirubinemia. One of these pharmacological agents is zinc salts. Zinc has been shown to lower the bilirubin levels by inhibition of the enterohepatic cycling of unconjugated bilirubin. Oral zinc has been shown to reduce serum unconjugated bilirubin in animals, adolescents and low birth weight neonates. However, studies in healthy term neonates given oral zinc showed no reduction in hyperbilirubinemia based on daily measurement. In order to improve the accuracy, hyperbilirubinemia may be determined based on measurements every hour. More studies are needed to know the effect of zinc in neonatal jaundice.

  9. Rebound hyperbilirubinaemia in neonates admitted to Mofid ...

    African Journals Online (AJOL)

    term neonates without a positive Coombs test were included, and only 1 patient was readmitted with rebound hyperbilirubinaemia. (this was thought to be due to breastmilk jaundice). Our ndings are therefore similar to those of Del Vecchio et al.,[8] who reported that 1 in 48 newborns required readmission for phototherapy.

  10. Neonatal Staphylococcus lugdunensis urinary tract infection.

    Science.gov (United States)

    Hayakawa, Itaru; Hataya, Hiroshi; Yamanouchi, Hanako; Sakakibara, Hiroshi; Terakawa, Toshiro

    2015-08-01

    Staphylococcus lugdunensis is a known pathogen of infective endocarditis, but not of urinary tract infection. We report a previously healthy neonate without congenital anomalies of the kidney and urinary tract who developed urinary tract infection due to Staphylococcus lugdunensis, illustrating that Staphylococcus lugdunensis can cause urinary tract infection even in those with no urinary tract complications. © 2015 Japan Pediatric Society.

  11. Correction of Neonatal Hypovolemia

    Directory of Open Access Journals (Sweden)

    V. V. Moskalev

    2007-01-01

    Full Text Available Objective: to evaluate the efficiency of hydroxyethyl starch solution (6% refortane, Berlin-Chemie versus fresh frozen plasma used to correct neonatal hypovolemia.Materials and methods. In 12 neonatal infants with hypoco-agulation, hypovolemia was corrected with fresh frozen plasma (10 ml/kg body weight. In 13 neonates, it was corrected with 6% refortane infusion in a dose of 10 ml/kg. Doppler echocardiography was used to study central hemodynamic parameters and Doppler study was employed to examine regional blood flow in the anterior cerebral and renal arteries.Results. Infusion of 6% refortane and fresh frozen plasma at a rate of 10 ml/hour during an hour was found to normalize the parameters of central hemodynamics and regional blood flow.Conclusion. Comparative analysis of the findings suggests that 6% refortane is the drug of choice in correcting neonatal hypovolemia. Fresh frozen plasma should be infused in hemostatic disorders. 

  12. Neonatal abstinence syndrome

    Science.gov (United States)

    ... in a newborn who was exposed to addictive opiate drugs while in the mother’s womb. Causes Neonatal ... Increased muscle tone Irritability Poor feeding Rapid breathing Seizures Sleep problems Slow weight gain Stuffy nose, sneezing ...

  13. Neonatal pain management

    Directory of Open Access Journals (Sweden)

    Tarun Bhalla

    2014-01-01

    Full Text Available The past 2-3 decades have seen dramatic changes in the approach to pain management in the neonate. These practices started with refuting previously held misconceptions regarding nociception in preterm infants. Although neonates were initially thought to have limited response to painful stimuli, it was demonstrated that the developmental immaturity of the central nervous system makes the neonate more likely to feel pain. It was further demonstrated that untreated pain can have long-lasting physiologic and neurodevelopmental consequences. These concerns have resulted in a significant emphasis on improving and optimizing the techniques of analgesia for neonates and infants. The following article will review techniques for pain assessment, prevention, and treatment in this population with a specific focus on acute pain related to medical and surgical conditions.

  14. Risk factors of neonatal mortality and child mortality in Bangladesh.

    Science.gov (United States)

    Maniruzzaman, Md; Suri, Harman S; Kumar, Nishith; Abedin, Md Menhazul; Rahman, Md Jahanur; El-Baz, Ayman; Bhoot, Makrand; Teji, Jagjit S; Suri, Jasjit S

    2018-06-01

    Child and neonatal mortality is a serious problem in Bangladesh. The main objective of this study was to determine the most significant socio-economic factors (covariates) between the years 2011 and 2014 that influences on neonatal and child mortality and to further suggest the plausible policy proposals. We modeled the neonatal and child mortality as categorical dependent variable (alive vs death of the child) while 16 covariates are used as independent variables using χ 2 statistic and multiple logistic regression (MLR) based on maximum likelihood estimate. Using the MLR, for neonatal mortality, diarrhea showed the highest positive coefficient (β = 1.130; P  economic conditions for neonatal mortality. For child mortality, birth order between 2-6 years and 7 and above years showed the highest positive coefficients (β = 1.042; P  economic conditions for child mortality. This study allows policy makers to make appropriate decisions to reduce neonatal and child mortality in Bangladesh. In 2014, mother's age and father's education were also still significant covariates for child mortality. This study allows policy makers to make appropriate decisions to reduce neonatal and child mortality in Bangladesh.

  15. Foetal and neonatal thyroid disorders.

    Science.gov (United States)

    Radetti, G; Zavallone, A; Gentili, L; Beck-Peccoz, P; Bona, G

    2002-10-01

    recently identified are represented by TSH receptor mutations leading to constitutively activated TSH receptor. Infants born to mothers with Graves' history may develop neonatal thyrotoxicosis. Foetal/neonatal disease is due to transplacental thyrotrophin receptor stimulating antibodies (TRAb) passage. It's extremely important recognizing and treating Graves' disease in mothers as soon as possible, because a thyrotoxic state may have adverse effects on the outcome of pregnancy and both on the foetus and newborn. Thyrotoxic foetuses may develop goitre, tachycardia, hydrops associated with heart failure, growth retardation, craniosynostosis, increased foetal motility and accelerated bone maturation. Neonatal Graves' disease tends to resolve spontaneously within 3-12 weeks as maternal thyroid stimulating immunoglobulins are cleared from the circulation but subsequent development may be impaired by perceptual motor difficulties. Hashimoto's thyroiditis is a very common autoimmune thyroid disease. In presence of maternal Hashimoto's thyroiditis, there are usually no consequences on foetal thyroid, even if antiTPO and antiTg antibodies can be found in the newborn due to transplacental passage. However there are some literature reports describing foetal and neonatal hyperthyroidism in the affected mothers' offspring.

  16. Apparently conclusive meta-analyses may be inconclusive--Trial sequential analysis adjustment of random error risk due to repetitive testing of accumulating data in apparently conclusive neonatal meta-analyses

    DEFF Research Database (Denmark)

    Brok, Jesper; Thorlund, Kristian; Wetterslev, Jørn

    2008-01-01

    BACKGROUND: Random error may cause misleading evidence in meta-analyses. The required number of participants in a meta-analysis (i.e. information size) should be at least as large as an adequately powered single trial. Trial sequential analysis (TSA) may reduce risk of random errors due to repeti......BACKGROUND: Random error may cause misleading evidence in meta-analyses. The required number of participants in a meta-analysis (i.e. information size) should be at least as large as an adequately powered single trial. Trial sequential analysis (TSA) may reduce risk of random errors due...

  17. Neonatal marfan syndrome: report of two cases.

    Science.gov (United States)

    Ghandi, Yazdan; Zanjani, Keyhan S; Mazhari-Mousavi, Seyed-Eshagh; Parvaneh, Nima

    2013-02-01

    Neonatal Marfan syndrome is a rare and severe phenotype of this disease. A poor prognosis is anticipated due to the high probability of congestive heart failure, and mitral and tricuspid regurgitations with suboptimal response to medical therapy and difficulties in surgical management at an early age. We present two consecutive patients with this disease who are the first reported cases from Iran to the best of our knowledge. Unfortunately both of them died shortly after diagnosis. Neonatal Marfan syndrome is reported from Iran and has a poor prognosis like the patients reported from elsewhere.

  18. Staphylococcal bullous impetigo in a neonate.

    Science.gov (United States)

    Duggal, Shalini Dewan; Bharara, Tanisha; Jena, Pragnya Paramita; Kumar, Avinash; Sharma, Abha; Gur, Renu; Chaudhary, Sanjay

    2016-07-16

    An otherwise healthy, full-term neonate presented at day 15 of life to the pediatric emergency with generalized papulo-pustular rash for 2 d. This was finally diagnosed as bullous impetigo caused by Staphylococcus aureus (S. aureus). The skin lesions decreased significantly after starting antibiotic therapy and drainage of blister fluid. There was no recurrence of the lesions on follow-up. This case of generalized pustular eruption due to S. aureus in a neonate is reported, as it poses a diagnostic dilemma and can have serious consequences if left untreated.

  19. Rates of Very Preterm Birth in Europe and Neonatal Mortality Rates

    DEFF Research Database (Denmark)

    Field, David John; Draper, Elizabeth S; Fenton, Alan

    2008-01-01

    OBJECTIVE: To estimate the influence of variation in the rate of very preterm delivery on the reported rate of neonatal death in ten European regions. DESIGN: Comparison of 10 separate geographically defined European populations, from nine European countries, over a one year period (seven months......) a standardised rate of very preterm delivery and b) the existing death rate for babies born at this gestation in the individual region. This produced much greater homogeneity in terms of neonatal mortality. CONCLUSIONS: Variation in the rate of very preterm delivery has a major influence on reported neonatal...

  20. Pregnancy, Obstetric and Neonatal Outcomes in HIV Positive ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    Keywords: Pregnancy, delivery, HIV, neonate, adverse outcome. Introduction. HIV-1 infection has remained a major public health challenge in sub-Saharan Africa, accounting ... practice have greatly reduced both maternal deaths .... 2010 we reverted back to triple ARV .... between the two groups in the rates of obstetric.

  1. Neonatal hypothermia in sub-Saharan Africa: A review

    African Journals Online (AJOL)

    2012-04-05

    Apr 5, 2012 ... Nigerian Journal of Clinical Practice • Apr-Jun 2013 • Vol 16 • Issue 2 ... it is estimated that 17 million newborns develop hypothermia ... Transfer of radiant energy by radiation from the body ..... in the evaluation of critically ill patients for brain death. ... use of the condition in neonatal encephalopathies and.

  2. Neonatal asphyxia: A study of 210 cases

    Directory of Open Access Journals (Sweden)

    Hülya Üzel

    2012-06-01

    Full Text Available Objectives: Perinatal asphyxia remains an importantcause of neonatal morbidity and mortality. The aim of thisstudy was to investigate antenatal, natal, and postnatalrisk factors of neonatal asphyxia, relationship with knownrisk factors and stage of Sarnat and Sarnat scores, theeffect of risk factors on hospital discharge and survival forneonates with perinatal asphyxia.Materials and methods: In this study, we retrospectivelyanalyzed the hospital records of 210 patients diagnosedas perinatal asphyxia. The patients’ demographic characteristics,antepartum, intrapartum, and postpartum riskfactors and Sarnat and Sarnat clinical staging criteria ofnewborns were analyzed.Results: The risk factors for asphyxia were detectedantepartum period in 67.7% of newborns, intrapartum in91% and potpartum in of 29.5% of neonates. When caseswere examined according to the studied years, perinatalasphyxia ratio was the most frequent in 2007 as 28.1%.With a decline over the years, frequency dropped to %21in 2010. The number of patients with stage 3 and mortalityrate were significantly decreased over the years (p<0.05.Conclusions: Less preventable intrapartum causes ofbirth asphyxia are seen more frequently. Early detectionof risk factors together with appropriate prenatal, nataland postnatal care provision, reduced emergency caesareansections and will decrease considerably decreasefrequency of perinatal asphyxia. We think that followingup neonates who needed intensive care in neonatal unitssufficiently equipped will decrease complications due toasphyxia. J Clin Exp Invest 2012; 3(2: 194-198

  3. 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.

  4. Neonatal intestinal obstruction in Benin, Nigeria

    Directory of Open Access Journals (Sweden)

    Osifo Osarumwense

    2009-01-01

    Full Text Available Background: Intestinal obstruction is a life threatening condition in the newborn, with attendant high mortality rate especially in underserved subregion. This study reports the aetiology, presentation, and outcome of intestinal obstruction management in neonates. Materials and Methods: A prospective study of neonatal intestinal obstruction at the University of Benin Teaching Hospital, Benin, Nigeria, between January 2006-June 2008. Data were collated on a structured proforma and analysed for age, sex, weight, presentation, type/date of gestation/delivery, aetiology, clinical presentation, associated anomaly, treatment, and outcome. Results: There were 71 neonates, 52 were males and 19 were females (2.7:1. Their age range was between 12 hours and 28 days (mean, 7.9 ± 2.7 days and they weighed between 1.8 and 5.2 kg (average, 3.2 kg. The causes of intestinal obstruction were: Anorectal anomaly, 28 (39.4%; Hirschsprung′s disease, 8 (11.3%′ prematurity, 3 (4.2%; meconeum plug, 2 (2.8%; malrotation, 6 (8.5%; intestinal atresia, 8 (11.3%; necrotising enterocolitis (NEC, 4 (5.6%; obstructed hernia, 4 (5.6%; and spontaneous gut perforation, 3 (4.2%. Also, 27 (38% children had colostomy, 24 (33.8% had laparotomy, 9 (12.8% had anoplasty, while 11 (15.4% were managed nonoperatively. A total of 41 (57.7% neonates required incubator, 26 (36.6% needed total parenteral nutrition, while 15 (21.1% require d paediatric ventilator. Financial constraint, late presentation, presence of multiple anomalies, aspiration, sepsis, gut perforation, and bowel gangrene were the main contributors to death. Neonates with lower obstructions had a better outcome compared to those having upper intestinal obstruction ( P < 0.0001. Conclusion: Outcomes of intestinal obstruction are still poor in our setting; late presentation, financial constraints, poor parental motivation and lack of basic facilities were the major determinants of mortality.

  5. [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.

  6. Impact of cesarean section in a private health service in Brazil: indications and neonatal morbidity and mortality rates.

    Science.gov (United States)

    Almeida, M A; Araujo Júnior, E; Camano, L; Peixoto, A B; Martins, W P; Mattar, R

    2018-01-01

    To evaluate the incidence of, indications of, and maternal and neonatal morbidity and mortality rates in cesarean sections in a private health service in Brazil. Retrospective and observational study. Private health service in Vitória, Espírito Santo, Brazil. The patients were interviewed using a structured questionnaire to determine maternal age, gestational age at the time of delivery, number of previous deliveries, type of delivery performed, duration of labor, indications for cesarean delivery, point at which cesarean section was performed, physician responsible for delivery, and maternal morbidity, fetal morbidity, and fetal mortality rates. A descriptive analysis of the data was conducted. Students t-test was performed to compare quantitative variables, and Fishers exact test was performed for categorical variables. A total of 584 patients were evaluated. Of these, 91.8% (536/584) had cesarean sections, while only 8.2% (48/584) had vaginal deliveries. There were no reports of forceps-assisted vaginal deliveries. In 87.49% of the deliveries, the number of gestational weeks was more than 37. In terms of indications for performing cesarean section, 48.5% were for maternal causes, 30.41% were for fetal causes, and 17.17% were elective. Maternal re-hospitalization due to puerperal complications was necessary in 10.42% of the vaginal deliveries and in 0.93% of the cesarean deliveries (pcesarean section. Of the newborns with complications at birth, 40.59% (41/101) had to be admitted to the neonatal intensive care unit. There were no cases of maternal death. There were seven cases of fetal/neonatal death. We observed that the vast majority of deliveries in the private sector are performed by cesarean section, without labor, and by the patients obstetrician. We found no serious maternal complications or increased neonatal morbidity rates associated with cesarean section.

  7. The BRACELET Study: surveys of mortality in UK neonatal and paediatric intensive care trials

    Directory of Open Access Journals (Sweden)

    Platt Martin

    2010-05-01

    Full Text Available Abstract Background The subject of death and bereavement in the context of randomised controlled trials in neonatal or paediatric intensive care is under-researched. The objectives of this phase of the Bereavement and RAndomised ControlLEd Trials (BRACELET Study were to determine trial activity in UK neonatal and paediatric intensive care (2002-06; numbers of deaths before hospital discharge; and variation in mortality across intensive care units and trials and to determine whether bereavement support policies were available within trials. These are essential prerequisites to considering the implications of future policies and practice subsequent to bereavement following a child's enrolment in a trial. Methods The units survey involved neonatal units providing level 2 or 3 care, and paediatric units providing level II care or above; the trials survey involved trials where allocation was randomized and interventions were delivered to intensive care patients, or to parents but designed to affect patient outcomes. Results Information was available from 191/220 (87% neonatal units (149 level 2 or 3 care; and 28/32 (88% paediatric units. 90/177 (51% eligible responding units participated in one or more trial (76 neonatal, 14 paediatric and 54 neonatal units and 6 paediatric units witnessed at least one death. 50 trials were identified (36 neonatal, 14 paediatric. 3,137 babies were enrolled in neonatal trials, 210 children in paediatric trials. Deaths ranged 0-278 (median [IQR interquartile range] 2 [1, 14.5] per neonatal trial, 0-4 (median [IQR] 1 [0, 2.5] per paediatric trial. 534 (16% participants died post-enrolment: 522 (17% in neonatal trials, 12 (6% in paediatric trials. Trial participants ranged 1-236 (median [IQR] 21.5 [8, 39.8] per neonatal unit, 1-53 (median [IQR] 11.5 [2.3, 33.8] per paediatric unit. Deaths ranged 0-37 (median [IQR] 3.5 [0.3, 8.8] per neonatal unit, 0-7 (median [IQR] 0.5 [0, 1.8] per paediatric unit. Three trials had a

  8. Malnutrition related deaths.

    Science.gov (United States)

    Sparre-Sørensen, Maja; Kristensen, Gustav N

    2016-10-01

    Studies have shown that malnutrition increases the risk of morbidity, mortality, the length of hospital stay, and costs in the elderly population. Approximately one third of all patients admitted to geriatric wards in Denmark are malnourished according to the Danish Geriatric database. The aim of this study is to describe and examine the sudden increase in deaths due to malnutrition in the elderly population in Denmark from 1999 and, similarly, the sudden decline in malnutrition related deaths in 2007. A descriptive epidemiologic study was performed. All Danes listed in the national death registry who died from malnutrition in the period from 1994 to 2012 are included. The number of deaths from malnutrition increased significantly during the period from 1999 to 2007, especially in the age group 70 years and over. Additionally, we document a surprising similarity between the development in excess mortality from malnutrition in the five Danish regions during the same period. During the period 1999-2007 malnutrition was the direct cause of 340 extra deaths, and probably ten times more registered under other diseases. This development in excess mortality runs parallel in all five Danish regions over time. Copyright © 2016 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

  9. Irish neonatal mortality statistics for 2004 and over the past 17 years: how do we compare internationally?

    LENUS (Irish Health Repository)

    Fleming, P

    2012-02-01

    In the past 17 years neonatal mortality survey has provided important data on the trends in deaths of all live born infants born in Southern Ireland who are greater than 500 g birth weight and who die within the first 28 days of life. The aims of this study were to report neonatal mortality data for Southern Ireland for 2004, to examine trends in neonatal mortality over the past 17 years and compare Irish Neonatal Mortality rates to other countries around the world. The neonatal mortality rate for 2004 was 2.9\\/1000 with a corrected NMR of 1.9\\/1000. The response rate to the survey was 100%. Prematurity is now the leading cause of neonatal mortality representing a change from previous years. Deaths related to asphyxia have remained largely unchanged. When compared to international figures Ireland compares favourably to other countries around the world.

  10. Health insurance coverage, neonatal mortality and caesarean section deliveries: an analysis of vital registration data in Colombia.

    Science.gov (United States)

    Houweling, Tanja A J; Arroyave, Ivan; Burdorf, Alex; Avendano, Mauricio

    2017-05-01

    Low-income and middle-income countries have introduced different health insurance schemes over the past decades, but whether different schemes are associated with different neonatal outcomes is yet unknown. We examined the association between the health insurance coverage scheme and neonatal mortality in Colombia. We used Colombian national vital registration data, including all live births (2 506 920) and neonatal deaths (17 712) between 2008 and 2011. We used Poisson regression models to examine the association between health insurance coverage and the neonatal mortality rate (NMR), distinguishing between women insured via the contributory scheme (40% of births, financed through payroll and employer's contributions), government subsidised insurance (47%) and the uninsured (11%). NMR was lower among babies born to mothers in the contributory scheme (6.13/1000) than in the subsidised scheme (7.69/1000) or the uninsured (8.38/1000). Controlling for socioeconomic and demographic factors, NMRs remained higher for those in the subsidised scheme (OR 1.09, 95% CI 1.05 to 1.14) and the uninsured (OR 1.16, 95% CI 1.10 to 1.23) compared to those in the contributory scheme. These differences increased in models that additionally controlled for caesarean section (C-section) delivery. This increase was due to the higher fraction of C-section deliveries among women in the contributory scheme (49%, compared to 34% for the subsidised scheme and 28% for the uninsured). Health insurance through the contributory system is associated with lower neonatal mortality than insurance through the subsidised system or lack of insurance. Universal health insurance may not be sufficient to close the gap in newborn mortality between socioeconomic groups. 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/.

  11. Transient neonatal diabetes or neonatal hyperglycaemia: A case ...

    African Journals Online (AJOL)

    Transient neonatal diabetes and neonatal hyperglycaemia both present in the neonatal period with features of hyperglycaemia, dehydration and weight loss. Differentiating these conditions clinically is difficult. We describe the case of a 13 day old female whom we managed recently who could have had either condition.

  12. Maternal haemoglobin and short-term neonatal outcome in preterm neonates.

    Directory of Open Access Journals (Sweden)

    Elodie Savajols

    Full Text Available To determine whether there is a significant association between maternal haemoglobin measured before delivery and short-term neonatal outcome in very preterm neonates.We included prospectively all live births occurring from 25 to 32+6 weeks of gestation in a tertiary care centre between January 1(st 2009 and December 31(st 2011. Outborn infants and infants presenting with lethal malformations were excluded. Three hundred and thirty-nine mothers and 409 infants met the inclusion criteria. For each mother-infant pair a prospective record of epidemiologic data was performed and maternal haemoglobin concentration recorded within 24 hours before delivery was retrospectively researched. Maternal haemoglobin was divided into quartiles with the second and the third one regarded as reference as they were composed of normal haemoglobin values. Short-term outcome was defined as poor in case of death during hospital stay and/or grades III/IV intraventricular haemorrhage and/or periventricular leukomalacia and/or necessity of ventriculoperitoneal shunt.The global rate of poor short-term neonatal outcome was 11.4% and was significantly associated with low maternal haemoglobin values. This association remained significant after adjustment for antenatal corticosteroids therapy, gestational age, parity, mechanism of preterm birth, mode of delivery and birth weight (aOR = 2.97 CI 95% [1.36-6.47]. There was no relation between short-term neonatal outcome and high maternal haemoglobin concentration values.We show that low maternal haemoglobin concentration at delivery is an independent risk factor for poor short-term neonatal outcome in very preterm neonates. This study is one of the first to show such an association within the preterm population.

  13. 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.

  14. Evaluation of Neonates with Ventriculitis

    Directory of Open Access Journals (Sweden)

    Ferda Ozlu

    2013-08-01

    Full Text Available Backgroud: Neonatal meningitis and ventriculitis still remain a problem with high mortality in spite of systemic and intraventricular antibiotics. Ventriculitis due to repeated taps is a serious problem of posthemorragic hydrocephalus in preterm infants. Methods: In this study, we evaluated 16 infants with ventriculitis followed at Cukurova University Faculty of Medicine Neonatal Intensive Care Unit between January 1999-December 2004. Results: Mean gestational week was 33± 5 (25-40 weeks and mean birth weight was 2096 ± 912 (980-3500 grams. Venticulitis was diagnosed at 38 ± 22 days. Eleven of the infants had intraventricular hemorrhage and 15 had hydrocephalus, 5 of whom had congenital hydrocephalus. Drainage of CSF was performed by taps in 13 infants. Gram negative microorganisms (Klebsiella pneumonia, Pseudomonas aeruginosa were predominating in cultures. Both intravenous and intraventricular antibiotic treatment was performed according to the cerebrospinal fluid cultures. Vancomycine and amicasine as intraventricular therapy were performed for 28 ±17 days. Cerebrospinal fluid protein levels increased significantly at 8 infant during intraventricular therapy. Mean cerebrospinal fluid protein at the begining of intraventricular treatment was 624.1± 429.1 (109-1330 mg/dl while on 14th day of treatment it was 993.7± 582.2 (89-1750 mg/dl. Seven of the infants were ventriculoperitoneal shunted 6 of them were reinfected. Seven of the infants were died during treatment, 1 infant with ventriculoperitoneal shunt was treated and 8 infants were discharged during treatment because of parents’ refusal of therapy. Conclusion: Despite the new treatment regimens, the ventriculitis still remains a problem because of nonstandardized practice in neonatal care. [Cukurova Med J 2013; 38(4.000: 553-558

  15. The value of neonatal autopsy.

    LENUS (Irish Health Repository)

    Hickey, Leah

    2012-01-01

    Neonatal autopsy rates were in decline internationally at the end of the last century. Our objective was to assess the current value of neonatal autopsy in providing additional information to families and healthcare professionals.

  16. Infection control in neonatal intensive care unit : from a certified nurse in infection control's point of view

    OpenAIRE

    坂木, 晴世

    2007-01-01

    Neonates, especially those in neonatal intensive care units (NICU), are at high risk for infection. And nosocomial infections are responsible for almost 50% of the deaths that occur beyond 2 weeks of age. Advances in neonatal intensive care have resulted in survival of more low birth weight and sick infants. On the other hand, infection control measures in NICU are hard to say that we established. Therefore it is often that infection control measure in NICU of our country is taken in original...

  17. 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,...

  18. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980-2016: a systematic analysis for the Global Burden of Disease Study 2016.

    Science.gov (United States)

    2017-09-16

    in 25 countries rated in the highest category (5 stars), while 48, 30, 21, and 44 countries were rated at each of the succeeding data quality levels. Vital registration or verbal autopsy data were not available in 27 countries, resulting in the assignment of a zero value for data quality. Deaths from non-communicable diseases (NCDs) represented 72·3% (95% uncertainty interval [UI] 71·2-73·2) of deaths in 2016 with 19·3% (18·5-20·4) of deaths in that year occurring from communicable, maternal, neonatal, and nutritional (CMNN) diseases and a further 8·43% (8·00-8·67) from injuries. Although age-standardised rates of death from NCDs decreased globally between 2006 and 2016, total numbers of these deaths increased; both numbers and age-standardised rates of death from CMNN causes decreased in the decade 2006-16-age-standardised rates of deaths from injuries decreased but total numbers varied little. In 2016, the three leading global causes of death in children under-5 were lower respiratory infections, neonatal preterm birth complications, and neonatal encephalopathy due to birth asphyxia and trauma, combined resulting in 1·80 million deaths (95% UI 1·59 million to 1·89 million). Between 1990 and 2016, a profound shift toward deaths at older ages occurred with a 178% (95% UI 176-181) increase in deaths in ages 90-94 years and a 210% (208-212) increase in deaths older than age 95 years. The ten leading causes by rates of age-standardised YLL significantly decreased from 2006 to 2016 (median annualised rate of change was a decrease of 2·89%); the median annualised rate of change for all other causes was lower (a decrease of 1·59%) during the same interval. Globally, the five leading causes of total YLLs in 2016 were cardiovascular diseases; diarrhoea, lower respiratory infections, and other common infectious diseases; neoplasms; neonatal disorders; and HIV/AIDS and tuberculosis. At a finer level of disaggregation within cause groupings, the ten leading causes

  19. Neonatal varicella pneumonia, surfactant replacement therapy

    Directory of Open Access Journals (Sweden)

    Mousa Ahmadpour-kacho

    2015-12-01

    Full Text Available Background: Chickenpox is a very contagious viral disease that caused by varicella-zoster virus, which appears in the first week of life secondary to transplacental transmission of infection from the affected mother. When mother catches the disease five days before and up to two days after the delivery, the chance of varicella in neonate in first week of life is 17%. A generalized papulovesicular lesion is the most common clinical feature. Respiratory involvement may lead to giant cell pneumonia and respiratory failure. The mortality rate is up to 30% in the case of no treatment, often due to pneumonia. Treatment includes hospitalization, isolation and administration of intravenous acyclovir. The aim of this case report is to introduce the exogenous surfactant replacement therapy after intubation and mechanical ventilation for respiratory failure in neonatal chickenpox pneumonia and respiratory distress. Case Presentation: A seven-day-old neonate boy was admitted to the Neonatal Intensive Care Unit at Amirkola Children’s Hospital, Babol, north of Iran, with generalized papulovesicular lesions and respiratory distress. His mother has had a history of Varicella 4 days before delivery. He was isolated and given supportive care, intravenous acyclovir and antibiotics. On the second day, he was intubated and connected to mechanical ventilator due to severe pneumonia and respiratory failure. Because of sever pulmonary involvement evidenced by Chest X-Ray and high ventilators set-up requirement, intratracheal surfactant was administered in two doses separated by 12 hours. He was discharged after 14 days without any complication with good general condition. Conclusion: Exogenous surfactant replacement therapy can be useful as an adjunctive therapy for the treatment of respiratory failure due to neonatal chickenpox.

  20. Intraoperative fluid therapy in neonates

    African Journals Online (AJOL)

    Differences from adults and children in physiology and anatomy of neonates inform our ... is based on energy expenditure indexed to bodyweight.2 Energy ... fragile and poorly keratinised.5 ... neonates means that very conservative fluid regimes in neonates ..... I make an estimation of insensible loss from the skin, viscera,.

  1. Continuing with "…a heavy heart" - consequences of maternal death in rural Kenya.

    Science.gov (United States)

    Pande, Rohini; Ogwang, Sheila; Karuga, Robinson; Rajan, Radha; Kes, Aslihan; Odhiambo, Frank O; Laserson, Kayla; Schaffer, Kathleen

    2015-05-06

    This study analyzes the consequences of maternal death to households in Western Kenya, specifically, neonatal and infant survival, childcare and schooling, disruption of daily household activities, the emotional burden on household members, and coping mechanisms. The study is a combination of qualitative analysis with matched and unmatched quantitative analysis using surveillance and survey data. Between September 2011 and March 2013 all households in the study area with a maternal death were surveyed. Data were collected on the demographic characteristics of the deceased woman; household socio-economic status; a history of the pregnancy that led to the death; schooling experiences of surviving school-age children; and disruption to household functioning due to the maternal death. These data were supplemented by in-depth and focus group discussions. Quantitative data on neonatal and infant survival from a demographic surveillance system in the study area were also used. Descriptive and bivariate analyses were conducted with the quantitative data, and qualitative data were analyzed through text analysis using NVivo. More than three-quarters of deceased women performed most household tasks when healthy. After the maternal death, the responsibility for these tasks fell primarily on the deceased's husbands, mothers, and mothers-in-law. Two-thirds of the individuals from households that suffered a maternal death had to shift into another household. Most children had to move away, mostly to their grandmother's home. About 37% of live births to women who died of maternal causes survived till age 1 year, compared to 65% of live births to a matched sample of women who died of non-maternal causes and 93% of live births to surviving women. Older, surviving children missed school or did not have enough time for schoolwork, because of increased housework or because the loss of household income due to the maternal death meant school fees could not be paid. Respondents expressed

  2. Ultrasonography of Neonatal Cholestasis

    Energy Technology Data Exchange (ETDEWEB)

    Cheon, Jung Eun [Seoul National University Hospital, Seoul (Korea, Republic of)

    2012-06-15

    Ultrasonography (US) is as an important tool for differentiation of obstructive and non-obstructive causes of jaundice in infants and children. Beyond two weeks of age, extrahepatic biliary atresia and neonatal hepatitis are the two most common causes of persistent neonatal jaundice: differentiation of extrahepatic biliary atresia, which requires early surgical intervention, is very important. Meticulous analysis should focus on size and configuration of the gallbladder and anatomical changes of the portahepatis. In order to narrow the differential diagnosis, combined approaches using hepatic scintigraphy, MR cholangiography, and, at times, percutaneous liver biopsy are necessary. US is useful for demonstrating choledochal cyst, bile plug syndrome, and spontaneous perforation of the extrahepatic bile duct

  3. Rings in the neonate.

    LENUS (Irish Health Repository)

    Hackett, C B

    2011-02-01

    Neonatal lupus erythematosus (NLE) is an uncommon disease of the neonate. It is believed to be caused by the transplacental passage of maternal autoantibodies to the ribonucleoproteins (Ro\\/SSA, La\\/SSB or rarely U RNP) as these are almost invariably present in NLE sera. The most common clinical manifestations include cutaneous lupus lesions and congenital complete heart block. Hepatobiliary and haematologic abnormalities are reported less frequently. We describe a patient with cutaneous NLE to illustrate and raise awareness of the characteristic annular eruption of this condition. We also emphasize the need for thorough investigation for concomitant organ involvement and for maternal education regarding risk in future pregnancies.

  4. Sudden Death in Young People--Heart Problems Often Blamed

    Science.gov (United States)

    Sudden death in young people: Heart problems often blamed Sudden death in young people is rare, but those at ... causes and treatments. By Mayo Clinic Staff Sudden death in people younger than 35, often due to ...

  5. Glutamine Synthetase Deficiency in Murine Astrocytes Results in Neonatal Death

    NARCIS (Netherlands)

    He, Youji; Hakvoort, Theodorus B. M.; Vermeulen, Jacqueline L. M.; Labruyère, Wilhelmina T.; de Waart, D. Rudi; van der Hel, W. Saskia; Ruijter, Jan M.; Uylings, Harry B. M.; Lamers, Wouter H.

    2010-01-01

    Glutamine synthetase (GS) is a key enzyme in the "glutamine-glutamate cycle" between astrocytes and neurons, but its function in vivo was thus far tested only pharmacologically. Crossing GS(fl/lacZ) or GS(fl/f)l mice with hGFAP-Cre mice resulted in prenatal excision of the GS(fl) allele in

  6. Incidence of congenital heart disease among neonates in a neonatal unit of a tertiary care hospital

    International Nuclear Information System (INIS)

    Hussain, S.; Sabir, M.U.

    2014-01-01

    Objectives: To determine the incidence and pattern of various congenital heart disease in a neonatal unit of a tertiary care hospital. Methods: The prospective study was carried out in the neonatal unit of Combined Military Hospital, Rawalpindi, from September 2008 to August 2011. All 5800 neonates admitted with gestational age of >28 weeks irrespective of birthweight were included in the study. Neonatologist/Paediatrician carried out the neonatal examination during the first 12 hours of life. Neonates suspected of having congenital heart disease were further evaluated by pulse oxymetry, X-ray chest and echocardiography to ascertain final diagnosis and type of lesion. Data was collected on a predesigned proforma containing information regarding gender, mode of delivery, gestational age, weight at birth, family history, and associated malformations. SPSS 16 was used for statistical analysis. Results: Of the 5800 neonates, 87 (1.5%) were found to have congenital heart disease with an incidence of 15/1000. There was a male preponderance. Most common lesion was ventricular septal defect 27(31.3%), followed by atrial septal defect 20 (22.9%), patent ductus arteriosus 13 (14.94%), tetralogy of fallot 06 (6.89%), transposition of great arteries 04 (4.59%), Pulmonary stenosis 05 (5.79%) and 03(3.44%) had atrioventricular canal defects. Conclusion: Congenital heart disease is a common congenital anomaly. Its incidence varies from centre to centre due to different factors like nature of the sample, method of detection and early examination by a neonatologist/paediatrician. In this study a higher incidence is reported because it was carried out in a tertiary care unit, which is a referral hospital and all the neonates admitted in the unit were included in the study. (author)

  7. Neonatal nutrition and metabolism

    National Research Council Canada - National Science Library

    Thureen, Patti J; Hay, William W

    2006-01-01

    ..., the volume highlights the important longterm effects of fetal and neonatal growth on health in later life. In addition, there are very practical chapters on methods and techniques for assessing nutritional status, body composition, and evaluating metabolic function. Written by an authoritative, international team of cont...

  8. Approach to neonatal sepsis

    Directory of Open Access Journals (Sweden)

    Shankar Narayan

    2015-01-01

    The treatment includes supportive care along with administration of appropriate antibiotics. Adjuvant treatment includes IVIG, GCSF, exchange transfusion and pentoxifylline administration. This paper aims to present an algorithmic approach to neonatal sepsis to expedite the diagnosis along with providing appropriate and adequate treatment.

  9. Non-accidental dettol poisoning in a 3 day old neonate : a rare form ...

    African Journals Online (AJOL)

    In Nigeria, Dettol® Antiseptic Solution poisoning is an uncommon occurrence in all age groups. In a registered child specialist clinic in Kano, a three – day old neonate presented with clinical features believed initially to be due to neonatal seizures and sepsis, but which turned out to be due to non-accidental dettol® ...

  10. [Maternal death: unequal risks].

    Science.gov (United States)

    Defossez, A C; Fassin, D

    1989-01-01

    Nearly 99% of maternal deaths in the world each year occur in developing countries. New efforts have recently been undertaken to combat maternal mortality through research and action. The medical causes of such deaths are coming to be better understood, but the social mechanisms remain poorly grasped. Maternal mortality rates in developing countries are difficult to interpret because they tend to exclude all deaths not occurring in health care facilities. The countries of Europe and North America have an average maternal mortality rate of 30/100,000 live births, representing about 6000 deaths each year. The developing countries of Asia, Africa, and Latin America have rates of 270-640/100,000, representing some 492,000 deaths annually. For a true comparison of the risks of maternal mortality in different countries, the risk itself and the average number of children per woman must both be considered. A Nigerian woman has 375 times greater risk of maternal death than a Swedish woman, but since she has about 4 times more children, her lifetime risk of maternal death is over 1500 times greater than that of the Swedish woman. The principal medical causes of maternal death are known: hemorrhages due to placenta previa or retroplacental hematoma, mechanical dystocias responsible for uterine rupture, toxemia with eclampsia, septicemia, and malaria. The exact weight of abortion in maternal mortality is not known but is probably large. The possible measures for improving such rates are of 3 types: control of fertility to avoid early, late, or closely spaced pregnancies; effective medical surveillance of the pregnancy to reduce the risk of malaria, toxemia, and hemorrhage, and delivery in an obstetrical facility, especially for high-risk pregnancies. Differential access to high quality health care explains much of the difference between mortality rates in urban and rural, wealthy and impoverished areas of the same country. The social determinants of high maternal mortality

  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. Death Attitudes and Changes in Existential Outlook in Parents of Vulnerable Newborns.

    Science.gov (United States)

    Barr, Peter

    2015-01-01

    This study is an Actor-Partner Interdependence Model analysis of the relation of death attitudes with changes in outlook in 59 parent couples of neonatal intensive care newborns. Death attitudes effects with changes in outlook were mostly intrapersonal and they mainly occurred in fathers, though between gender differences were not usually significant. Death avoidance and neutral death acquiescence were positive predictors of positive changes in outlook, and fear of death and neutral death acquiescence were respective positive and inverse predictors of negative changes. Multidimensional measures of death attitudes and personal change should be used when studying these domains of psychological functioning.

  13. Neonatal Marfan Syndrome: Report of a Case with an Inherited Splicing Mutation outside the Neonatal Domain.

    Science.gov (United States)

    Le Gloan, Laurianne; Hauet, Quentin; David, Albert; Hanna, Nadine; Arfeuille, Chloé; Arnaud, Pauline; Boileau, Catherine; Romefort, Bénédicte; Benbrik, Nadir; Gournay, Véronique; Joram, Nicolas; Baron, Olivier; Isidor, Bertrand

    2016-02-01

    We report a child and her mother affected by Marfan syndrome. The child presented with a phenotype of neonatal Marfan syndrome, revealed by acute and refractory heart failure, finally leading to death within the first 4 months of life. Her mother had a common clinical presentation. Genetic analysis revealed an inherited FBN1 mutation. This intronic mutation (c.6163+3_6163+6del), undescribed to date, leads to exon 49 skipping, corresponding to in-frame deletion of 42 amino acids (p.Ile2014_Asp2055del). FBN1 next-generation sequencing did not show any argument for mosaicism. Association in the same family of severe neonatal and classical Marfan syndrome illustrates the intrafamilial phenotype variability.

  14. An MR-compatible neonatal incubator.

    Science.gov (United States)

    Paley, M N J; Hart, A R; Lait, M; Griffiths, P D

    2012-07-01

    To develop a neonatal MR-compatible incubator for transporting babies between a neonatal intensive care unit and an MRI unit that is within the same hospital but geographically separate. The system was strapped to a standard MR-compatible patient trolley, which provides space for resuscitation outside the incubator. A constant-temperature exothermic heat pad was used to maintain temperature together with a logging fluoro-optic temperature monitor and alarm system. The system has been designed to accommodate standard knee-sized coils from the major MR manufacturers. The original incubator was constructed from carbon fibre, but this required modification to prevent radiofrequency shading artefacts due to the conducting properties of the carbon fibre. A high-tensile polyester material was used, which combined light weight with high impact strength. The system could be moved onto the patient bed with the coils and infant in place by one technologist. Studies in eight neonatal patients produced high quality 1.5 T MR images with low motion artefacts. The incubator should also be compatible with imaging in 3 T MR systems, although further work is required to establish this. Images were acquired using both rapid and high-resolution sequences, including three-dimensional volumes, proton spectra and diffusion weighting. The incubator provides a safe, quiet environment for neonates during transport and imaging, at low cost.

  15. Ethical challenges in neonatal intensive care nursing.

    Science.gov (United States)

    Strandås, Maria; Fredriksen, Sven-Tore D

    2015-12-01

    Neonatal nurses report a great deal of ethical challenges in their everyday work. Seemingly trivial everyday choices nurses make are no more value-neutral than life-and-death choices. Everyday ethical challenges should also be recognized as ethical dilemmas in clinical practice. The purpose of this study is to investigate which types of ethical challenges neonatal nurses experience in their day-to-day care for critically ill newborns. Data were collected through semi-structured qualitative in-depth interviews. Phenomenological-hermeneutic analysis was applied to interpret the data. Six nurses from neonatal intensive care units at two Norwegian hospitals were interviewed on-site. The study is designed to comply with Ethical Guidelines for Nursing Research in the Nordic Countries and the Helsinki declaration. Findings suggest that nurses experience a diverse range of everyday ethical challenges related to challenging interactions with parents and colleagues, emotional strain, protecting the vulnerable infant, finding the balance between sensitivity and authority, ensuring continuity of treatment, and miscommunication and professional disagreement. A major finding in this study is how different agents involved in caring for the newborn experience their realities differently. When these realities collide, ethical challenges arise. Findings suggest that acting in the best interests of the child becomes more difficult in situations involving many agents with different perceptions of reality. The study presents new aspects which increases knowledge and understanding of the reality of nursing in a neonatal intensive care unit, while also demanding increased research in this field of care. © The Author(s) 2014.

  16. Neonatal follow-up program: Where do we stand?

    Science.gov (United States)

    2012-01-01

    Neonatal follow-up program (NFP) is becoming the corner stone of standard, high quality care provided to newborns at risk of future neuorodevelopmental delay. Most of the recognized neonatal intensive care units in the developed countries are adopting NFP as part of their mandatory care for the best long term outcome of high risk infants, especially very low birth weight (VLBW) infants. Unfortunately, in the developing and in underdeveloped countries, such early detection and intervention programs are rarely existing, mainly because of the lack of awareness of and exposure to such programs in spite of the increasing numbers of surviving sick newborns due to advancement in neonatal care in these countries. This is a review article to explore the Neonatal follow-up programs looking at historical development, benefts and aims, and standard requirements for successful program development that can be adopted in our countries. In conclusion, proper Neonatal follow-up programs are needed to improve neonatal outcome. Therefore all professionals working in the feld of neonatal care in developing countries should cooperate to create such programs for early detection and hence early intervention for any adverse long term outcome in high-risk newborn infants PMID:27493326

  17. The effects of risk factors on the improvement of hypothermia neonatal using fuzzy transition

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    Fatemeh Salmani

    2016-04-01

    Full Text Available Background and aim: Neonatal hypothermia is a major risk factor for mortality after delivery. This study aims to identify the risk factors associated with transition in hypothermia state with new definition of hypothermia states.Methods:  Four hundred and seventy nine (479 neonates hospitalized in NICU of Valiasr in Tehran, Iran in 2005 participated in this study. The rectal temperature of neonatal was measured immediately after delivery and every 30 min afterwards, until neonates became normal.Results: The mean weight of neonatal was 2580±882.9 g and mean of delivery room temperature was 29.2±1.45 °C. Most of the neonatal were mild hypothermia. There were significant associations between weight of neonatal, cardiopulmonary resuscitation (CPR and Apgar score with hypothermia state (P<0.05.  Death of neonatal was related to hypothermia state.Conclusion: The findings of this study indicated that a major risk factor for hypothermia was low weight of neonatal.

  18. MR determination of neonatal spinal canal depth.

    Science.gov (United States)

    Arthurs, Owen; Thayyil, Sudhin; Wade, Angie; Chong, W K Kling; Sebire, Neil J; Taylor, Andrew M

    2012-08-01

    Lumbar punctures (LPs) are frequently performed in neonates and often result in traumatic haemorrhagic taps. Knowledge of the distance from the skin to the middle of the spinal canal (mid-spinal canal depth - MSCD) may reduce the incidence of traumatic taps, but there is little data in extremely premature or low birth weight neonates. Here, we determined the spinal canal depth at post-mortem in perinatal deaths using magnetic resonance imaging (MRI). Spinal canal depth was measured in 78 post-mortem foetuses and perinatal cases (mean gestation 26 weeks; mean weight 1.04kg) at the L3/L4 inter-vertebral space at post-mortem MRI. Both anterior (ASCD) and posterior (PSCD) spinal canal depth were measured; MSCD was calculated and modelled against weight and gestational age. ASCD and PSCD (mm) correlated significantly with weight and gestational age (all r>0.8). A simple linear model MSCD (mm)=3×Weight (kg)+5 was the best fit, identifying an SCD value within the correct range for 87.2% (68/78) (95% CI (78.0, 92.9%)) cases. Gestational age did not add significantly to the predictive value of the model. There is a significant correlation between MSCD and body weight at post-mortem MRI in foetuses and perinatal deaths. If this association holds in preterm neonates, use of the formula MSCD (mm)=3×Weight (kg)+5 could result in fewer traumatic LPs in this population. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  19. MR determination of neonatal spinal canal depth

    Energy Technology Data Exchange (ETDEWEB)

    Arthurs, Owen, E-mail: owenarthurs@uk2.net [Centre for Cardiovascular MR, Great Ormond Street Hospital for Children, London WC1N 3JH (United Kingdom); Thayyil, Sudhin, E-mail: s.thayyil@ucl.ac.uk [Academic Neonatology, Institute for Women' s Health, London WC1E 6AU (United Kingdom); Wade, Angie, E-mail: a.wade@ucl.ac.uk [Centre for Paediatric Epidemiology and Biostatistics, UCL Institute of Child Health, London (United Kingdom); Chong, W.K., E-mail: Kling.Chong@gosh.nhs.uk [Paediatric Neuroradiology, Great Ormond Street Hospital for Children, London (United Kingdom); Sebire, Neil J., E-mail: Neil.Sebire@gosh.nhs.uk [Histopathology, Great Ormond Street Hospital for Children, London WC1E 6AU (United Kingdom); Taylor, Andrew M., E-mail: a.taylor76@ucl.ac.uk [Centre for Cardiovascular MR, Cardiorespiratory Unit, Great Ormond Street Hospital for Children and UCL Institute of Cardiovascular Science, London WC1E 6AU (United Kingdom)

    2012-08-15

    Objectives: Lumbar punctures (LPs) are frequently performed in neonates and often result in traumatic haemorrhagic taps. Knowledge of the distance from the skin to the middle of the spinal canal (mid-spinal canal depth - MSCD) may reduce the incidence of traumatic taps, but there is little data in extremely premature or low birth weight neonates. Here, we determined the spinal canal depth at post-mortem in perinatal deaths using magnetic resonance imaging (MRI). Patients and methods: Spinal canal depth was measured in 78 post-mortem foetuses and perinatal cases (mean gestation 26 weeks; mean weight 1.04 kg) at the L3/L4 inter-vertebral space at post-mortem MRI. Both anterior (ASCD) and posterior (PSCD) spinal canal depth were measured; MSCD was calculated and modelled against weight and gestational age. Results: ASCD and PSCD (mm) correlated significantly with weight and gestational age (all r > 0.8). A simple linear model MSCD (mm) = 3 Multiplication-Sign Weight (kg) + 5 was the best fit, identifying an SCD value within the correct range for 87.2% (68/78) (95% CI (78.0, 92.9%)) cases. Gestational age did not add significantly to the predictive value of the model. Conclusion: There is a significant correlation between MSCD and body weight at post-mortem MRI in foetuses and perinatal deaths. If this association holds in preterm neonates, use of the formula MSCD (mm) = 3 Multiplication-Sign Weight (kg) + 5 could result in fewer traumatic LPs in this population.

  20. [Employment during pregnancy and neonatal morbidity].

    Science.gov (United States)

    Fricker, H S; Bruppacher, R

    1984-01-01

    Neonatal morbidity was higher among the babies of 521 women who were gainfully employed during pregnancy compared to those of 475 non working women of the same area (Aarau, Switzerland). The difference was lower (6%) in the part time employed than in those working full time (11%.) It was almost entirely due to the higher number of primiparae and of smokers among those women who were working during pregnancy.

  1. NEONATAL NERVE PALSIES: A CONTEMPORARY OBSTETRIC PERSPECTIVE

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    Daren J. Roberts

    2014-05-01

    Full Text Available Background:Birth trauma and its often incorrect inference of iatrogenic causation has led to unfortunate implications for the affected child, the parents, the obstetrician and the midwife due to unwarranted medico-legal attention in our current litigious society.A more discerning evaluation of neonatal nerve palsies following labour and delivery has led to a better understanding of their aetiology with potentially more appropriate outcomes for all parties involved.

  2. 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.

  3. ASPEK KEHAMILAN DAN PERSALINAN PADA KEMATIAN NEONATAL AKIBAT ASFIKSIA LAHIR SEBELUM DAN SETELAH INTERVENSI MANAJEMEN ASFIKSIA DI KABUPATEN CIREBON

    Directory of Open Access Journals (Sweden)

    Dwi Hapsari Tjandrarini

    2012-11-01

    Full Text Available Birth asphyxia is one of the mayor causes of neonatal death in Indonesia. Management resuscitation training for village midwives in Cirebon district has successfully decreased the neonatal mortality rate caused by asphyxia. The purpose of this study is to get information about the relation between neonatal death caused by asphyxia and post asphyxia management training intervention for village midwives in Cirebon district. Total sample number was 215 death cases for baseline survey and 264 death cases for evaluation survey. Verbal autopsy method has been applied with the same population that is mothers who had neonatal death history before and after the training for the village midwives about the asphyxia newborn baby management intervention. Villages were chosen by using stratified random sampling. Data analysis using bivariate, to find out the relation between independent variable (newborn death babies cause by asphyxia and dependent variable (mother's characteristic, pregnant history, ANC, delivery process, birth attendant, various preventions done by birth attendant to make the newborn babies healthy. Bivariate analysis result showed that the factors related to the decrease of neonatal death caused by asphyxia in relation with intervention of post asphyxia training management was preventive efforts by birth attendant to make the newborn babies healthy. The effort made were make clearing the airway, drying the baby, rubbing the baby's backbones, swaddling the baby, putting the baby on the mother breast, warming the baby, except for the baby put into the incubator and given oxygen. Those prevention efforts that had been done by professional birth attendant should be maintained to decrease the neonatal death caused by asphyxia. Keywords: Neonatal death, asphyxia management, pregnancy

  4. Geographic distribution of risk of death due to homicide in Puerto Rico, 2001-2010 Distribución geográfica del riesgo de muerte por homicidio en Puerto Rico, 2001-2010

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    Diego E. Zavala-Zegarra

    2012-11-01

    Full Text Available OBJECTIVE: To raise awareness of the impact of homicides in Puerto Rico based on the findings of the spatial and temporal distribution of homicides and the use of firearms, by age and gender, using reports of interpersonal violent deaths from the Institute of Forensic Science (IFS headquartered in San Juan, Puerto Rico. METHODS: This was a descriptive study of all homicide incidents in Puerto Rico reported by the IFS for the period 2001-2010. For each of the 8 542 cases, data analyzed included age, sex, municipality of incident, date of death, and mechanism. Crude sex- and age-specific mortality rates for Puerto Rico and for each municipality per year and for the 10-year period were calculated. Cumulative rate and cumulative risks were estimated and defined as lifetime risk. The relative distribution of cumulative rates for each municipality was categorized into quartiles of highest to lowest risk and displayed as a map. RESULTS: The risk of homicide death among males is 13 times greater than among females. The highest rates were observed among males 20-24 years of age (198.4 homicides per 100 000. In any given year, firearms were used in at least 80% of homicides. The average lifetime risk of homicide death for males is 1 in 34. CONCLUSIONS: Young adult males with access to firearms are at greatest risk of homicide in Puerto Rico. Also, highly urbanized municipalities are at highest risk; however, certain non-urban municipalities along the coast also have a very high homicide risk. Top priorities should be applying the WHO "ecological model" for violent injury prevention and establishing a surveillance system that will assist in identifying the role that socioeconomics, illegal firearms trade, and drug trafficking are playing.OBJETIVO: Concientizar sobre la repercusión de los homicidios en Puerto Rico con base en los resultados de la distribución espacial y temporal de los homicidios y el uso de las armas de fuego, según la edad y el sexo, a

  5. Collection of trace evidence of explosive residues from the skin in a death due to a disguised letter bomb. The synergy between confocal laser scanning microscope and inductively coupled plasma atomic emission spectrometer analyses.

    Science.gov (United States)

    Turillazzi, Emanuela; Monaci, Fabrizio; Neri, Margherita; Pomara, Cristoforo; Riezzo, Irene; Baroni, Davide; Fineschi, Vittorio

    2010-04-15

    In most deaths caused by explosive, the victim's body becomes a depot for fragments of explosive materials, so contributing to the collection of trace evidence which may provide clues about the specific type of device used with explosion. Improvised explosive devices are used which contain "homemade" explosives rather than high explosives because of the relative ease with which such components can be procured. Many methods such as chromatography-mass spectrometry, scanning electron microscopy, stereomicroscopy, capillary electrophoresis are available for use in the identification of explosive residues on objects and bomb fragments. Identification and reconstruction of the distribution of explosive residues on the decedent's body may give additional hints in assessing the position of the victim in relation to the device. Traditionally these residues are retrieved by swabbing the body and clothing during the early phase, at autopsy. Gas chromatography-mass spectrometry and other analytical methods may be used to analyze the material swabbed from the victim body. The histological examination of explosive residues on skin samples collected during the autopsy may reveal significant details. The information about type, quantity and particularly about anatomical distribution of explosive residues obtained utilizing confocal laser scanning microscope (CLSM) together with inductively coupled plasma atomic emission spectrometer (ICP-AES), may provide very significant evidence in the clarification and reconstruction of the explosive-related events. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

  6. Neonatal bacteriemia isolates and their antibiotic resistance pattern in neonatal insensitive care unit (NICU at Beasat Hospital, Sanandaj, Iran.

    Directory of Open Access Journals (Sweden)

    Parvin Mohammadi

    2014-05-01

    Full Text Available Bacteremia continues to result in significant morbidity and mortality, particularly among neonates. There is scarce data on neonatal bacteremia in among Iranian neonates. In this study, we determined neonatal bacteremia isolates and their antibiotic resistance pattern in neonatal insensitive care unit at Beasat hospital, Sanandaj, Iran. During one year, all neonates admitted to the NICU were evaluated. Staphylococcal isolates were subjected to determine the prevalence of MRS and mecA gene. A total of 355 blood cultures from suspected cases of sepsis were processed, of which 27 (7.6% were positive for bacterial growth. Of the 27 isolates, 20 (74% were Staphylococcus spp as the leading cause of bacteremia. The incidence of Gram negative bacteria was 04 (14.8%. The isolated bacteria were resistant to commonly used antibiotics. Maximum resistance among Staphylococcus spp was against Penicillin, and Ampicillin. In our study, the isolated bacteria were 7.5 % Vancomycin and Ciprofloxacin sensitive. Oxacillin disk diffusion and PCR screened 35% and 30% mec a positive Staphylococcus spp. The spectrum of neonatal bacteremia as seen in NICU at Beasat hospital confirmed the importance of pathogens such as Staphylococcus spp. Penicillin, Ampicillin and Cotrimoxazol resistance was high in theses isolates with high mecA gene carriage, probably due to antibiotic selection.

  7. Due diligence

    International Nuclear Information System (INIS)

    Sanghera, G.S.

    1999-01-01

    The Occupational Health and Safety (OHS) Act requires that every employer shall ensure the health and safety of workers in the workplace. Issues regarding the practices at workplaces and how they should reflect the standards of due diligence were discussed. Due diligence was described as being the need for employers to identify hazards in the workplace and to take active steps to prevent workers from potentially dangerous incidents. The paper discussed various aspects of due diligence including policy, training, procedures, measurement and enforcement. The consequences of contravening the OHS Act were also described

  8. [Prenatal diagnosis at 25 weeks gestation and neonatal management of a vallecular cyst].

    Science.gov (United States)

    Cuillier, F; Testud, R; Samperiz, S; Fossati, P

    2002-11-01

    Due to the anatomical location, vallecular cyst is a rare but well-recognized cause of upper airway obstruction and death in newborn. This cyst can be accurately diagnosed by echography in utero and by MR imaging. Prenatal diagnosis allows for early consultation with surgical specialist, so that the time and place of the delivery can be addressed for neonatal preoperative planning. We report the first prenatal diagnosis of a vallecular cyst at 25 weeks of gestation. At birth, the cyst was drained and then marsupialized. We believed that, in cases of oropharyngeal tumors discovered in utero, elective delivery should be realised in a tertiary referral center in which emergency ventilation and tracheostomy are possible.

  9. 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.

  10. Risk of hearing loss in small for gestational age neonates

    Directory of Open Access Journals (Sweden)

    Melani Rakhmi Mantu

    2011-02-01

    Full Text Available Background Small for gestational age (SGA neonates often have intrauterine growth restriction due to placental insufficiency and chronic hypoxia. These conditions may cause developmental impairment, psychosocial disabilities, or metabolic dysfunction in later life. Previous studies have shown greater incidence of speech and language disabilities, learning impairment, and neuromotor dysfunction in term SGA infants compared to term appropriate for gestational age (AGA infants. Objective To compare hearing loss in SGA and AGA neonates using otoocoustic emission (OAE tests and to study correlations between maternal risk factors and hearing loss in SGA neonates. Methods A cross-sectional study was performed in St. Borromeus Hospital, Limijati Hospital, and Melinda Hospital in Bandung from February to May 2010. Study subjects consisted of full-term neonates born in these three hospitals. A retrospective medical record review was performed for this study. Statistical analysis was done by multivariable logistic-regression. Results There was a total of 4279 subjects in our study, including 100 SGA neonates and 4179 AGA neonates. We observed a greater percentage of OAE 'refer' (indicating abnormal OAE results in the SGA group compared to the AGA group (P<0.001, Z=13.247. For suhjects with OAE 'refer' results, we also analyzed the correlation to the following maternal risk factors: smoking, hypertension, diabetes mellitus and asthma. We also found significant differences between  those with and without each of the four maternal risk factors studied (P< 0.001. By using multivariant analysis to compare SGA and AGA neonates, we found the odds ratio (OR to he 4.34 (95% CI 2.52 to 7.49, P=0.001, meaning the SGA group had a 4.34 times higher risk of hearing loss than the AGA group. Conclusion SGA neonates had a higher risk of hearing loss than AGA neonates. In addition, maternal smoking, hypertension, diabetes mellitus and asthma significantly correlated to

  11. Radiological evaluation of surgical emergencies in neonate

    International Nuclear Information System (INIS)

    Suh, C. O.; Oh, K. K.; Park, C. Y.

    1980-01-01

    Most pathologic conditions requiring emergent operation in neonate are congenital anomalies and delayed diagnosis and associated anomaly are important factors which have contributed to the high mortality rate of congenital anomalies. To prevent this delay, early recognition of the danger signals, adequate roentagenologic examination and accurate diagnosis should be made. Furthermore radiologists should be aware of developing mechanism, clinical manifestations and roentgenographic findings of those neonatal emergencies. 135 cases of neonatal emergencies were analyzed at this point of view, which verified by surgery and pathologic examination at Yonsei University College of Medicine, Severance Hospital since 1968. Embryology and characteristic roentgenographic pictures of each disease were discussed. The conclusions are as follows; 1. Most cases (110/135) presented intestinal obstruction. Imperforate anus (29 cases) was most common disease which followed by infantile hypertrophic pyloric stenosis (25 cases), small bowel atresia and stenosis (18 cases), congenital megacolon (15 cases) and esophageal atresia (14 cases). 2. Clinical Type and time of occurrence of symptoms and signs were so characteristic that these were helpful for differential diagnosis. 3. In infantile hypertrophic pyloric stenosis, confirmative diagnosis could be made in plain abdominal film, when 'Caterpillar sign' was seen. 4. When small bowel obstruction was suspected in plain abdominal film, barium enema examination was more helpful than upper G-I study. When microcolon was found, lower small bowel obstruction was highly suggested. 5. Diagnosis of midgut malrotation was possible in larger cases (4/7). Upper G-I examination was more valuable than barium enema study, because duodenal obstruction due to Ladd's band was common problem in neonate. 6. In neonatal period, diagnosis of aganglionosis could be made with the finding of barium stasis on 24-48 hours delay film, even though no demonstration of

  12. Neonatal outcomes in fetuses with cardiac anomalies and the impact of delivery route.

    Science.gov (United States)

    Parikh, Laura I; Grantz, Katherine L; Iqbal, Sara N; Huang, Chun-Chih; Landy, Helain J; Fries, Melissa H; Reddy, Uma M

    2017-10-01

    Congenital fetal cardiac anomalies compromise the most common group of fetal structural anomalies. Several previous reports analyzed all types of fetal cardiac anomalies together without individualized neonatal morbidity outcomes based on cardiac defect. Mode of delivery in cases of fetal cardiac anomalies varies greatly as optimal mode of delivery in these complex cases is unknown. We sought to determine rates of neonatal outcomes for fetal cardiac anomalies and examine the role of attempted route of delivery on neonatal morbidity. Gravidas with fetal cardiac anomalies and delivery >34 weeks, excluding stillbirths and aneuploidies (n = 2166 neonates, n = 2701 cardiac anomalies), were analyzed from the Consortium on Safe Labor, a retrospective cohort study of electronic medical records. Cardiac anomalies were determined using International Classification of Diseases, Ninth Revision codes and organized based on morphology. Neonates were assigned to each cardiac anomaly classification based on the most severe cardiac defect present. Neonatal outcomes were determined for each fetal cardiac anomaly. Composite neonatal morbidity (serious respiratory morbidity, sepsis, birth trauma, hypoxic ischemic encephalopathy, and neonatal death) was compared between attempted vaginal delivery and planned cesarean delivery for prenatal and postnatal diagnosis. We used multivariate logistic regression to calculate adjusted odds ratio for composite neonatal morbidity controlling for race, parity, body mass index, insurance, gestational age, maternal disease, single or multiple anomalies, and maternal drug use. Most cardiac anomalies were diagnosed postnatally except hypoplastic left heart syndrome, which had a higher prenatal than postnatal detection rate. Neonatal death occurred in 8.4% of 107 neonates with conotruncal defects. Serious respiratory morbidity occurred in 54.2% of 83 neonates with left ventricular outflow tract defects. Overall, 76.3% of pregnancies with fetal

  13. Aetiology of community-acquired neonatal sepsis in low- and middle-income countries

    Directory of Open Access Journals (Sweden)

    Donald Waters

    2011-12-01

    Full Text Available 99% of the approximate 1 million annual neonatal deaths from life-threatening invasive bacterial infections occur in developing countries, at least 50% of which are from home births or community settings. Data concerning aetiology of sepsis in these settings are necessary to inform targeted therapy and devise management guidelines. This review describes and analyses the bacterial aetiology of community-acquired neonatal sepsis in developing countries.

  14. Predicting Factors of INSURE Failure in Low Birth Weight Neonates with RDS; A Logistic Regression Model

    OpenAIRE

    Bita Najafian; Aminsaburi Aminsaburi; Seyyed Hassan Fakhraei; Abolfazl afjeh; Fatemeh Eghbal; Reza Noroozian

    2015-01-01

    Background:Respiratory Distress syndrome is the most common respiratory disease in premature neonate and the most important cause of death among them. We aimed to investigate factors to predict successful or failure of INSURE method as a therapeutic method of RDS. Methods:In a cohort study,45 neonates with diagnosed RDS and birth weight lower than 1500g were included and they underwent INSURE followed by NCPAP(Nasal Continuous Positive Airway Pressure). The patients were divided into failu...

  15. Congenital hypothyroidism in neonates

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    Aneela Anjum

    2014-01-01

    Full Text Available Context: Congenital hypothyroidism (CH is one of the most common preventable causes of mental retardation in children and it occurs in approximately 1:2,000-1:4,000 newborns. Aims and Objectives: The aim of this study is to determine the frequency of CH in neonates. Settings and Design: This cross-sectional study was conducted in neonatal units of the Department of Pediatrics Unit-I, King Edward Medical University/Mayo Hospital, Lahore and Lady Willington Hospital Lahore in 6 months (January-June 2011. Materials and Methods: Sample was collected by non-probability purposive sampling. After consent, 550 newborn were registered for the study. Demographic data and relevant history was recorded. After aseptic measures, 2-3 ml venous blood analyzed for thyroid-stimulating hormone (TSH level by immunoradiometric assay. Treatment was started according to the individual merit as per protocol. Statistical Analysis Used: Data was analyzed by SPSS 17 and Chi-square test was applied to find out the association of CH with different variables. Results: The study population consisted of 550 newborns. Among 550 newborns, 4 (0.8% newborns had elevated TSH level. CH had statistically significant association with mother′s hypothyroidism (P value 0.000 and mother′s drug intake during the pregnancy period (P value 0.013. Conclusion: CH is 0.8% in neonates. It has statistically significant association with mother′s hypothyroidism and mother′s drug intake during pregnancy.

  16. The Change of Perinatal Mortality Over Three Decades in a Reference Centre in the Aegean Region: Neonatal Mortality has decreased but Foetal Mortality Remains Unchanged

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    Nilgün Kültürsay

    2017-12-01

    Full Text Available Background: Perinatal, foetal and neonatal mortality statistics are important to show the development of a health care system in a country. However, in our country there are very few national and regional data about the changing pattern of perinatal neonatal mortality along with the development of new technologies in this area. Aims: Evaluation of the changes in mortality rates and the causes of perinatal and neonatal deaths within years in a perinatal reference centre which serves a high-risk population. Study Design: Cross-sectional retrospective study. Methods: The perinatal, neonatal and foetal mortality rates in the years 1979-1980 (1st time point and 1988-1989 (2nd time point were compared with the year 2008 (3rd time point. The causes of mortality were assessed by Wigglesworth classification and death reports. The neonatal mortality in the neonatal intensive care unit was also calculated. Results: Foetal mortality rates were 44/1000, 31.4/1000 and 41.75/1000 births, perinatal mortality rates were 35.6/1000, 18.8/1000 and 9/1000 births, and neonatal mortality rates were 35.6/1000, 18.8/1000 and 9/1000 live births for the three study time points, respectively. The mortality rate in neonatal intensive care unit decreased consistently from 33%, to 22.6% and 10%, respectively, together with decreasing neonatal mortality rates. The causes of perinatal deaths were foetal death 85%, immaturity 4%, and lethal congenital malformations 8% according to Wigglesworth classification in 2008, showing the high impact of foetal deaths on this high perinatal mortality rate. Infectious causes of neonatal deaths decreased but congenital anomalies increased in the last decades. Conclusion: Although neonatal mortality rate decreased significantly; foetal mortality rate has stayed unchanged since the late eighties. In order to decrease foetal and perinatal mortality rates more efficiently, reducing consanguineous marriages and providing better antenatal care for

  17. Treating Hypotension in Preterm Neonates With Vasoactive Medications

    Directory of Open Access Journals (Sweden)

    Chloe Joynt

    2018-04-01

    Full Text Available Preterm neonates often have hypotension which may be due to various etiologies. While it is controversial to define hypotension in preterm neonates, various vasoactive medications are commonly used to provide the cardiovascular support to improve the blood pressure, cardiac output, or to treat shock. However, the literature on the systemic and regional hemodynamic effects of these antihypotensive medications in neonates is deficient and incomplete, and cautious translation of findings from other clinical populations and animal studies is required. Based on a literature search on published reports, meta-analytic reviews, and selected abstracts, this review discusses the current available information on pharmacologic actions, clinical effects, and side effects of commonly used antihypotensive medications including dopamine, dobutamine, epinephrine, norepinephrine, vasopressin, and milrinone in preterm neonates.

  18. Telemedicine in Neonatal Home Care

    DEFF Research Database (Denmark)

    Holm, Kristina Garne; Brødsgaard, Anne; Zachariassen, Gitte

    2016-01-01

    participatory design and qualitative methods. Data were collected from observational studies, individual interviews, and focus group interviews. Two neonatal units participated. One unit was experienced in providing neonatal home care with home visits, and the other planned to offer neonatal home care......BACKGROUND: For the majority of preterm infants, the last weeks of hospital admission mainly concerns tube feeding and establishment of breastfeeding. Neonatal home care (NH) was developed to allow infants to remain at home for tube feeding and establishment of breastfeeding with regular home...... visits from neonatal nurses. For hospitals covering large regions, home visits may be challenging, time consuming, and expensive and alternative approaches must be explored. OBJECTIVE: To identify parental needs when wanting to provide neonatal home care supported by telemedicine. METHODS: The study used...

  19. Antenatal corticosteroids trial in preterm births to increase neonatal survival in developing countries: study protocol.

    Science.gov (United States)

    Althabe, Fernando; Belizán, José M; Mazzoni, Agustina; Berrueta, Mabel; Hemingway-Foday, Jay; Koso-Thomas, Marion; McClure, Elizabeth; Chomba, Elwyn; Garces, Ana; Goudar, Shivaprasad; Kodkany, Bhalchandra; Saleem, Sarah; Pasha, Omrana; Patel, Archana; Esamai, Fabian; Carlo, Waldemar A; Krebs, Nancy F; Derman, Richard J; Goldenberg, Robert L; Hibberd, Patricia; Liechty, Edward A; Wright, Linda L; Bergel, Eduardo F; Jobe, Alan H; Buekens, Pierre

    2012-09-19

    Preterm birth is a major cause of neonatal mortality, responsible for 28% of neonatal deaths overall. The administration of antenatal corticosteroids to women at high risk of preterm birth is a powerful perinatal intervention to reduce neonatal mortality in resource rich environments. The effect of antenatal steroids to reduce mortality and morbidity among preterm infants in hospital settings in developed countries with high utilization is well established, yet they are not routinely used in developing countries. The impact of increasing antenatal steroid use in hospital or community settings with low utilization rates and high infant mortality among premature infants due to lack of specialized services has not been well researched. There is currently no clear evidence about the safety of antenatal corticosteroid use for community-level births. We hypothesize that a multi country, two-arm, parallel cluster randomized controlled trial to evaluate whether a multifaceted intervention to increase the use of antenatal corticosteroids, including components to improve the identification of pregnancies at high risk of preterm birth and providing and facilitating the appropriate use of steroids, will reduce neonatal mortality at 28 days of life in preterm newborns, compared with the standard delivery of care in selected populations of six countries. 102 clusters in Argentina, Guatemala, Kenya, India, Pakistan, and Zambia will be randomized, and around 60,000 women and newborns will be enrolled. Kits containing vials of dexamethasone, syringes, gloves, and instructions for administration will be distributed. Improving the identification of women at high risk of preterm birth will be done by (1) diffusing recommendations for antenatal corticosteroids use to health providers, (2) training health providers on identification of women at high risk of preterm birth, (3) providing reminders to health providers on the use of the kits, and (4) using a color-coded tape to measure

  20. Antenatal corticosteroids trial in preterm births to increase neonatal survival in developing countries: study protocol

    Directory of Open Access Journals (Sweden)

    Althabe Fernando

    2012-09-01

    Full Text Available Abstract Background Preterm birth is a major cause of neonatal mortality, responsible for 28% of neonatal deaths overall. The administration of antenatal corticosteroids to women at high risk of preterm birth is a powerful perinatal intervention to reduce neonatal mortality in resource rich environments. The effect of antenatal steroids to reduce mortality and morbidity among preterm infants in hospital settings in developed countries with high utilization is well established, yet they are not routinely used in developing countries. The impact of increasing antenatal steroid use in hospital or community settings with low utilization rates and high infant mortality among premature infants due to lack of specialized services has not been well researched. There is currently no clear evidence about the safety of antenatal corticosteroid use for community-level births. Methods We hypothesize that a multi country, two-arm, parallel cluster randomized controlled trial to evaluate whether a multifaceted intervention to increase the use of antenatal corticosteroids, including components to improve the identification of pregnancies at high risk of preterm birth and providing and facilitating the appropriate use of steroids, will reduce neonatal mortality at 28 days of life in preterm newborns, compared with the standard delivery of care in selected populations of six countries. 102 clusters in Argentina, Guatemala, Kenya, India, Pakistan, and Zambia will be randomized, and around 60,000 women and newborns will be enrolled. Kits containing vials of dexamethasone, syringes, gloves, and instructions for administration will be distributed. Improving the identification of women at high risk of preterm birth will be done by (1 diffusing recommendations for antenatal corticosteroids use to health providers, (2 training health providers on identification of women at high risk of preterm birth, (3 providing reminders to health providers on the use of the kits, and

  1. Fetal/Neonatal Alloimmune Thrombocytopenia: Pathogenesis, Diagnostics and Prevention.

    Science.gov (United States)

    Brojer, Ewa; Husebekk, Anne; Dębska, Marzena; Uhrynowska, Małgorzata; Guz, Katarzyna; Orzińska, Agnieszka; Dębski, Romuald; Maślanka, Krystyna

    2016-08-01

    Fetal/neonatal alloimmune thrombocytopenia (FNAIT) is a relatively rare condition (1/1000-1/2000) that was granted orphan status by the European Medicines Agency in 2011. Clinical consequences of FNAIT, however, may be severe. A thrombocytopenic fetus or new-born is at risk of intracranial hemorrhage that may result in lifelong disability or death. Preventing such bleeding is thus vital and requires a solution. Anti-HPA1a antibodies are the most frequent cause of FNAIT in Caucasians. Its pathogenesis is similar to hemolytic disease of the newborn (HDN) due to anti-RhD antibodies, but is characterized by platelet destruction and is more often observed in the first pregnancy. In 75 % of these women, alloimmunization by HPA-1a antigens, however, occurs at delivery, which enables development of antibody-mediated immune suppression to prevent maternal immunization. As for HDN, the recurrence rate of FNAIT is high. For advancing diagnostic efforts and treatment, it is thereby crucial to understand the pathogenesis of FNAIT, including cellular immunity involvement. This review presents the current knowledge on FNAIT. Also described is a program for HPA-1a screening in identifying HPA-1a negative pregnant women at risk of immunization. This program is now performed at the Institute of Hematology and Transfusion Medicine in cooperation with the Department of Obstetrics and Gynecology of the Medical Centre of Postgraduate Education in Warsaw as well as the UiT The Arctic University of Norway.

  2. Neonatal mortality in New Zealand sea lions (Phocarctos hookeri) at Sandy Bay, Enderby Island, Auckland Islands from 1998 to 2005.

    Science.gov (United States)

    Castinel, A; Duignan, P J; Pomroy, W E; López-Villalobos, N; Gibbs, N J; Chilvers, B L; Wilkinson, I S

    2007-07-01

    As part of a health survey of New Zealand sea lions (Phocarctos hookeri) on Enderby Island, Auckland Islands (50 degrees 30'S, 166 degrees 17'E), neonatal mortality was closely monitored at the Sandy Bay colony for seven consecutive years. Throughout the breeding seasons 1998-99 to 2004-05, more than 400 postmortem examinations were performed on pups found dead at this site. The primary causes of death were categorized as trauma (35%), bacterial infections (24%), hookworm infection (13%), starvation (13%), and stillbirth (4%). For most pups, more than one diagnosis was recorded. Every year, two distinct peaks of trauma were observed: the first associated with mature bulls fighting within the harem and the second with subadult males abducting pups. In 2001-02 and 2002-03, epidemics caused by Klebsiella pneumoniae increased mortality by three times the mean in nonepidemic years (10.2%). The increased mortality was attributed directly to acute suppurative infection due to the bacterium and also to an increase in traumatic deaths of debilitated pups. Parasitic infection with the hookworm Uncinaria spp. was a common finding in all pups older than three weeks of age and debilitation by the parasite may have contributed to increased susceptibility to other pathogens such as Klebsiella sp. or Salmonella sp. This study provides valuable quantitative data on the natural causes of neonatal mortality in New Zealand sea lions that can be used in demographic models for management of threatened species.

  3. Neonatal intensive care in a Karen refugee camp: a 4 year descriptive study.

    Directory of Open Access Journals (Sweden)

    Claudia Turner

    Full Text Available A third of all deaths in children aged <5 years occur in the neonatal period. Neonatal intensive care is often considered too complex and expensive to be implemented in resource poor settings. Consequently the reductions that have been made in infant mortality in the poorest countries have not been made in the neonatal period. This manuscript describes the activities surrounding the introduction of special care baby unit (SCBU in a refugee setting and the resulting population impact.A SCBU was developed in Maela refugee camp on the Thailand-Myanmar border. This unit comprised of a dedicated area, basic equipment, drugs and staff training. Training was built around neonatal guidelines, comprising six clinical steps: recognition, resuscitation, examination, supportive medical care, specialised medical care, and counselling of parents with sick newborns.From January 2008 until December 2011, 952 infants were admitted to SCBU. The main admission diagnoses were early onset neonatal sepsis, jaundice and prematurity. Early prematurity (<34 weeks carried the highest risk of mortality (OR 9.5, 95% CI 5.4-16.5, p<0.001. There was a significant decrease in mortality from 19.3% (2008 to 4.8% (2011 among the infants admitted for prematurity (p=0.03. The neonatal mortality in Maela camp as a whole declined by 51% from 21.8 to 10.7 deaths per 1000 live births over the corresponding period (p=0.04. Staff expressed more confidence in their ability to take care of neonates and there was a more positive attitude towards premature infants.Neonatal mortality can be reduced in a resource poor setting by introduction of a simple low cost unit specialising in care of sick neonates and run by local health workers following adequate training. Training in recognition and provision of simple interventions at a high standard can increase staff confidence and reduce fatalistic attitudes towards premature neonates.

  4. Neonatal outcome after fetal anemia managed by intrauterine transfusion.

    Science.gov (United States)

    Garabedian, C; Rakza, T; Thomas, D; Wibaut, B; Vaast, P; Subtil, D; Houfflin-Debarge, V

    2015-11-01

    In-utero transfusion is now well under control and improves the survival of foetuses monitored for fetal anemia with a survival rate of more than 80 %. The aim was to evaluate short-term neonatal outcome after fetal severe anemia managed by intrauterine transfusions. We did a retrospective study of all neonates born after management of severe fetal anemia (n = 93) between January 1999 and January 2013 in our regional center. The two main causes of anemia were maternal red blood cell alloimmunization (N = 81, 87 %) and Parvovirus B19 infection (N = 10, 10.8 %). In the alloimmunization group, phototherapy was implemented in 85.2 % of cases with a maximum level of bilirubin of 114.4 ± 60.7 (mg/dl). Transfusion and exchange transfusion were, respectively, required in 51.9 % and in 34.6 % of cases. One neonate presented a convulsive episode, and we observed three neonatal deaths. In the parvovirus group, none of the child had anemia at birth and no management was necessary. Contemporary management of Rhesus disease is associated with encouraging neonatal outcomes. In case of Parvovirus infection, no specific management is necessary at. But, in all cases of fetal anemia, children should be followed up with particular attention to neurologic development. • In-utero transfusion is now well under control and improves the survival of fetuses monitored for fetal anemia. • Limited studies are available on the effect of IUT on postnatal outcome in infants with a history of fetal anemia. What is New: • Contemporary management of severe Rhesus disease is associated with encouraging neonatal outcomes. • The majority of infants can be managed with phototherapy and a limited number of top-up transfusions and exchange transfusions. In case of Parvovirus infection, the short-term neonatal outcome is excellent.

  5. Implementation of Bubble CPAP in a Rural Ugandan Neonatal ICU.

    Science.gov (United States)

    McAdams, Ryan M; Hedstrom, Anna B; DiBlasi, Robert M; Mant, Jill E; Nyonyintono, James; Otai, Christine D; Lester, Debbie A; Batra, Maneesh

    2015-03-01

    Respiratory distress is a leading cause of neonatal death in low-income and middle-income countries. CPAP is a simple and effective respiratory support modality used to support neonates with respiratory failure and can be used in low-income and middle-income countries. The goal of this study was to describe implementation of the Silverman-Andersen respiratory severity score (RSS) and bubble CPAP in a rural Ugandan neonatal NICU. We sought to determine whether physicians and nurses in a low-income/middle-income setting would assign similar RSS in neonates after an initial training period and over time. We describe the process of training NICU staff to use the RSS to assist in decision making regarding initiation, titration, and termination of bubble CPAP for neonates with respiratory distress. Characteristics of all neonates with respiratory failure treated with bubble CPAP in a rural Ugandan NICU from January to June 2012 are provided. Nineteen NICU staff members (4 doctors and 15 nurses) received RSS training. After this, the Spearman correlation coefficient for respiratory severity scoring between doctor and nurse was 0.73. Twenty-one infants, all CPAP, with 17 infants starting on the day of birth. The majority of infants (16/21, 76%) were preterm, 10 (48%) were CPAP, 5.2 ± 2.3 after 2-4 h of CPAP, 4.9 ± 2.7 after 12-24 h of CPAP, and 3.5 ± 1.9 before CPAP was discontinued. Duration of treatment with CPAP averaged 79 ± 43 h. Approximately half (11/21, 52%) of infants treated with CPAP survived to discharge. Implementing bubble CPAP in a low-income/middle-income setting is feasible. The RSS may be a simple and useful tool for monitoring a neonate's respiratory status and for guiding CPAP management. Copyright © 2015 by Daedalus Enterprises.

  6. Maternal and neonatal complications in term breech delivered vaginally

    International Nuclear Information System (INIS)

    Jadoon, S.; Jadoon, S.M.K.; Shah, R.

    2008-01-01

    To evaluate the maternal and neonatal complications in terms of genital tract trauma to mother, perinatal mortality. Apgar score at 5 minutes and neonatal trauma in all singleton term breech cases delivered vaginally. A 100 consecutive patients with singleton breech presentation, whether booked or unbooked, were admitted and delivered vaginally in hospital during the study period. They were studied for maternal and neonatal complications. Maternal complication included any genital tract trauma during delivery while neonatal complications were perinatal mortality, low Apgar score (less than eight at 5 minutes) and birth trauma. There were a total 3977 deliveries during this study period, 145 breech presentation (incidence 3.6%). Out of those, 100 were included in the study. All were unbooked cases, 87% were multigravida while 13% were primigravida. An Apgar score of eight was recorded in 87% babies while 10% had an Apgar score of less than eight after 5 minutes. There were 3 still births and one neonatal death. Aggregated perinatal mortality rate was 40/1000 live births. Only one baby had birth trauma (Erbs paralysis) during vaginal breech delivery. Ninety seven (97%) mothers had no complications while only 3 (3%) had complications. Out of these, one had cervical tear and 2 had vaginal tears. Offering a trial of vaginal breech delivery to strictly selected and well-counselled patients remains an appropriate option without compromising perinatal and maternal outcome. It also decreases the rate of operative delivery for this malpresentation. (author)

  7. Neonatal euthanasia is unsupportable: the Groningen protocol should be abandoned.

    Science.gov (United States)

    Kon, Alexander A

    2007-01-01

    The growing support for voluntary active euthanasia (VAE) is evident in the recently approved Dutch Law on Termination of Life on Request. Indeed, the debate over legalized VAE has increased in European countries, the United States, and many other nations over the last several years. The proponents of VAE argue that when a patient judges that the burdens of living outweigh the benefits, euthanasia can be justified. If some adults suffer to such an extent that VAE is justified, then one may conclude that some children suffer to this extent as well. In an attempt to alleviate the suffering of extremely ill neonates, the University Medical Center Groningen developed a protocol for neonatal euthanasia. In this article, I first present the ethical justifications for VAE and discuss how these arguments relate to euthanizing ill neonates. I then argue that, even if one accepts the justification for VAE in adults, neonatal euthanasia cannot be supported, primarily because physicians and parents can never accurately assess the suffering of children. I argue that without the testament of the patient herself as to the nature and magnitude of her suffering, physicians can never accurately weigh the benefits and burdens of a child's life, and therefore any such system would condemn to death some children whose suffering is not unbearable. I conclude that because the primary duty of physicians is to never harm their patients, neonatal euthanasia cannot be supported.

  8. The Impact of Twin Birth on Early Neonatal Outcomes.

    Science.gov (United States)

    Fumagalli, Monica; Schiavolin, Paola; Bassi, Laura; Groppo, Michela; Uccella, Sara; De Carli, Agnese; Passera, Sofia; Sirgiovanni, Ida; Dessimone, Francesca; Consonni, Dario; Acaia, Barbara; Ramenghi, Luca Antonio; Mosca, Fabio

    2016-01-01

    This study aims to describe the impact of twin birth, chorionicity, intertwin birth weight (BW) discordance and birth order on neonatal outcomes. We performed a hospital-based retrospective study on 2,170 twins (6.4% of all live births) and 2,217 singletons inborn 2007 to 2011. Data on neonatal characteristics, morbidities, and mortality were collected and compared. Univariate and multiple (adjusted for gestational age [GA] and gender) linear random intercept regression models were used. Overall, 62.3% of twins were born premature. At multiple regression, twins were similar to singletons for neonatal morbidities, but they were more likely to have lower BW and to be born by cesarean delivery. Monochorionic twins had lower GA and BW compared with dichorionic ones and were more likely to develop respiratory distress syndrome (odds ratio [OR], 1.7), hypoglycemia (OR, 3.3), need for transfusion, (OR, 3.4) but not brain abnormalities. Moderate and severe BW discordance were associated with longer length of stay and increased risk for morbidities but not for death. Birth order had no effects. Prematurity was the most common outcome in twins and accounted for the apparently increased risk in morbidities. Monochorionicity was confirmed as risk factor for lower GA and neonatal morbidities. BW discordance may play a role in developing neonatal complications and needs to be further investigated. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  9. Neonatal cystic fibrosis screening test

    Science.gov (United States)

    Cystic fibrosis screening - neonatal; Immunoreactive trypsinogen; IRT test; CF - screening ... Cystic fibrosis is a disease passed down through families. CF causes thick, sticky mucus to build up in ...

  10. Contextual determinants of neonatal mortality using two analysis methods, Rio Grande do Sul, Brazil.

    Science.gov (United States)

    Zanini, Roselaine Ruviaro; Moraes, Anaelena Bragança de; Giugliani, Elsa Regina Justo; Riboldi, João

    2011-02-01

    To analyze neonatal mortality determinants using multilevel logistic regression and classic hierarchical models. Cohort study including 138,407 live births with birth certificates and 1,134 neonatal deaths recorded in 2003, in the state of Rio Grande do Sul, Southern Brazil. The Information System on Live Births and mortality records were linked for gathering information on individual-level exposures. Sociodemographic data and information on the pregnancy, childbirth care and characteristics of the children at birth were collected. The associated factors were estimated and compared by traditional and multilevel logistic regression analysis. The neonatal mortality rate was 8.19 deaths per 1,000 live births. Low birth weight, 1- and 5-minute Apgar score below eight, congenital malformation, pre-term birth and previous fetal loss were associated with neonatal death in the traditional model. Elective cesarean section had a protective effect. Previous fetal loss did not remain significant in the multilevel model, but the inclusion of a contextual variable (poverty rate) showed that 15% of neonatal mortality variation can be explained by varying poverty rates in the microregions. The use of multilevel models showed a small effect of contextual determinants on the neonatal mortality rate. There was found a positive association with the poverty rate in the general model, and the proportion of households with water supply among preterm newborns.

  11. Clinical practice: neonatal resuscitation. A Dutch consensus

    NARCIS (Netherlands)

    van den Dungen, F.A.M.; van Veenendaal, M.B.; Mulder, A.L.M.

    2010-01-01

    The updated Dutch guidelines on Neonatal Resuscitation assimilate the latest evidence in neonatal resuscitation. Important changes with regard to the 2004 guidelines and controversial issues concerning neonatal resuscitation are reviewed, and recommendations for daily practice are provided and

  12. Determinants and causes of neonatal mortality in Jimma Zone, Southwest Ethiopia: a multilevel analysis of prospective follow up study.

    Directory of Open Access Journals (Sweden)

    Gurmesa Tura Debelew

    Full Text Available BACKGROUND: Ethiopia is among the countries with the highest neonatal mortality with the rate of 37 deaths per 1000 live births. In spite of many efforts by the government and other partners, non-significant decline has been achieved in the last 15 years. Thus, identifying the determinants and causes are very crucial for policy and program improvement. However, studies are scarce in the country in general and in Jimma zone in particular. OBJECTIVE: To identify the determinants and causes of neonatal mortality in Jimma Zone, Southwest Ethiopia. METHODS: A prospective follow-up study was conducted among 3463 neonates from September 2012 to December 2013. The data were collected by interviewer-administered structured questionnaire and analyzed by SPSS V.20.0 and STATA 13. Verbal autopsies were conducted to identify causes of neonatal death. Mixed-effects multilevel logistic regression model was used to identify determinants of neonatal mortality. RESULTS: The status of neonatal mortality rate was 35.5 (95%CI: 28.3, 42.6 per 1000 live births. Though significant variation existed between clusters in relation to neonatal mortality, cluster-level variables were found to have non-significant effect on neonatal mortality. Individual-level variables such as birth order, frequency of antenatal care use, delivery place, gestation age at birth, premature rupture of membrane, complication during labor, twin births, size of neonate at birth and neonatal care practice were identified as determinants of neonatal mortality. Birth asphyxia (47.5%, neonatal infections (34.3% and prematurity (11.1% were the three leading causes of neonatal mortality accounting for 93%. CONCLUSIONS: This study revealed high status of neonatal mortality in the study area. Higher-level variables had less importance in determining neonatal mortality. Individual level variables related to care during pregnancy, intra-partum complications and care, neonatal conditions and the immediate

  13. Symptomatic aneurysm of ductus arteriosus in neonates

    International Nuclear Information System (INIS)

    Koneti, Nageswara R; Kanchi, Vasudevan; Kandraju, Hemasree; Jaishankar, S

    2011-01-01

    Four neonates presented within 24 hours of birth with stridor, respiratory distress and a weak cry. Clinical examination of the cardiovascular system revealed no abnormality. The transthoracic echocardiogram showed large aneurysm of ductus arteriosus at the aortic isthmus, tapering to a small tortuous channel at the site of pulmonary artery insertion. Computerized tomography scan performed in two of the neonates demonstrated considerable compression of adjacent thoracic structures. One required surgical excision due to persistence of symptoms. Serial echocardiograms in the remaining three babies showed transition through various stages of resolution over a period of 6 weeks to 3 months, resulting in the obliteration of the aneurysm. All babies are doing well during the follow-up

  14. Symptomatic aneurysm of ductus arteriosus in neonates

    Directory of Open Access Journals (Sweden)

    Nageswara R Koneti

    2011-01-01

    Full Text Available Four neonates presented within 24 hours of birth with stridor, respiratory distress and a weak cry. Clinical examination of the cardiovascular system revealed no abnormality. The transthoracic echocardiogram showed large aneurysm of ductus arteriosus at the aortic isthmus, tapering to a small tortuous channel at the site of pulmonary artery insertion. Computerized tomography scan performed in two of the neonates demonstrated considerable compression of adjacent thoracic structures. One required surgical excision due to persistence of symptoms. Serial echocardiograms in the remaining three babies showed transition through various stages of resolution over a period of 6 weeks to 3 months, resulting in the obliteration of the aneurysm. All babies are doing well during the follow-up.

  15. Mortalidade neonatal em Taubaté: um estudo caso-controle Neonatal mortality in Taubaté, São Paulo, Brazil: a case-control study

    Directory of Open Access Journals (Sweden)

    Ruth Sampaio Paulucci

    2007-12-01

    Full Text Available OBJETIVO: Identificar e quantificar os fatores de risco para óbito neonatal em Taubaté, São Paulo. MÉTODOS: Trata-se de estudo caso-controle com dados de nascidos vivos e de óbitos neonatais de Taubaté, em 2003, obtidos da Secretaria Estadual da Saúde de São Paulo. Os casos (óbitos neonatais e os controles (recém-nascidos nos mesmos dias daqueles que faleceram foram reunidos num banco por meio da técnica de linkage. As variáveis independentes foram: variáveis sociodemográficas e assistenciais (idade e escolaridade maternas, paridade, consultas no pré-natal, tipo de parto e relato de natimorto e variáveis biológicas (peso ao nascer, idade gestacional, escore de Apgar, presença de defeito congênito e sexo. Utilizou-se a regressão logística para identificar e quantificar os efeitos destas variáveis em relação ao óbito neonatal pelo programa SPSS 10.0. Foram introduzidas no modelo as variáveis que apresentaram pOBJECTIVE: To identify and to estimate the risk factors associated to neonatal mortality in Taubaté, São Paulo, Brazil. METHODS: This case-control study enrolled live births in the city of Taubaté during 2003. Live birth data and death records were obtained from São Paulo Health Department. Neonatal deaths were cases and babies born alive in the same day of cases were the controls. A single data file was created by linkage approach. Dependent variable was neonatal death. Independent variables were those related to socio-demographic characteristics and prenatal care (maternal age, years in school, parity, previous stillbirths, prenatal care, as well as the biological ones (birthweight, gender, gestational age, congenital defects and Apgar score. Logistic regression was used to identify and to estimate the risk factors associated to neonatal death. The variables with p<0.20 were introduced in the model and maintained if p<0.05, by SPSS 10.0. RESULTS: 392newborns with 34 neonatal deaths were studied. There were 198

  16. Volume and leak measurements during neonatal CPAP in neonates

    OpenAIRE

    Fischer, Hendrik S.

    2011-01-01

    As yet, little is known about the effects of air leakages during CPAP in newborns. The present doctoral dissertation investigates tidal volume and leak measurements during nasal continuous positive airway pressure in neonates using a commercial ventilatory device. Investigations include in vitro studies, modelling and computer simulation as well as a clinical randomized cross-over trial in neonates.

  17. Neonatal adrenal hemorrhage presenting as late onset neonatal jaundice

    OpenAIRE

    Qureshi, Umar Amin; Ahmad, Nisar; Rasool, Akhter; Choh, Suhail

    2009-01-01

    Clinical manifestations of adrenal hemorrhage vary depending on the degree and rate of hemorrhage, as well as the amount of adrenal cortex compromised by hemorrhage. We report here a case of neonatal adrenal hemorrhage that presented with late onset neonatal jaundice. The cause of adrenal hemorrhage was birth asphyxia.

  18. 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...

  19. Outbreak of Acinetobacter baumannii in a neonatal intensive care unit: antimicrobial susceptibility and genotyping analysis.

    Science.gov (United States)

    Touati, Arabella; Achour, Wafa; Cherif, Ahmed; Hmida, Hayet Ben; Afif, Firas Bou; Jabnoun, Sami; Khrouf, Naima; Hassen, Assia Ben

    2009-06-01

    We describe an outbreak of nosocomial respiratory infection caused by multi-drug resistant Acinetobacter baumannii in a neonatal intensive care unit (NICU) in Tunis and our investigation to determine the source. Between May 2006 and February 2007, 31 infants hospitalized in the NICU of the Centre of Maternity and Neonatology of La Rabta in Tunis developed A. baumannii pneumonia. A case (infected infant) was defined as any patient hospitalized in the NICU during the outbreak period, with clinical signs of pneumonia and isolation of A. baumannii from tracheal aspirate. Ten rectal swabs and 98 environmental specimens were collected for the epidemiological investigation. Thirty-nine A. baumannii isolates were collected: 31 clinical strains from tracheal aspirates (>10(3) colony-forming units [CFU]/mL), 3 environmental strains from incubators, and 5 from rectal swab. For the genotyping method, we used pulsed-field gel electrophoresis using ApaI restriction endonuclease. Thirty-one neonates developed multiple drug-resistant A. baumannii-associated pneumonia with 10 deaths due to A. baumannii infection, 48.4% had very low birth weight (neonates were premature. The mean age at the beginning of symptoms was 6.9 days. A. baumannii isolates were resistant to all beta-lactams. Resistance rates to other antibiotics were, respectively, 94.9% for gentamicin, 87.2% for cotrimoxazole, 41% for netilmicin, and 5.1% for tobramycin. All the isolates were susceptible to colistin. Pulsed-field gel electrophoresis analysis of outbreak-isolates indicated the presence of only one clone (A) containing nine subtypes genetically related to the outbreak strain. The clonal diffusion of A. baumannii strains in an NICU was confirmed by molecular method. Control measures were reinforced to contain the outbreak.

  20. Post-neonatal drop in alveolar SP-A expression

    DEFF Research Database (Denmark)

    Stray-Pedersen, Arne; Vege, Ashild; Stray-Pedersen, Asbjorg

    2008-01-01

    BACKGROUND: Surfactant protein A (SP-A) is synthesized in the lung and is a part of the innate immune system. The aim of this study was to evaluate the expression of SP-A in lung tissue from fetuses, infants, children and adults with special regard to sudden infant death syndrome (SIDS). METHODS......: A total of 160 cases were studied; 19 fetuses and neonates, 59 SIDS and 49 explained infant deaths below 1 year of age, 19 toddlers and 14 adults. Immunohistochemical detection of SP-A using monoclonal antibodies was performed by microscopy of lung tissue specimens collected at autopsy. A scoring system...

  1. Community-Based Cause of Death Study Linked to Maternal and ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    While Ethiopia has successfully reduced under-five childhood mortality, there have been slower gains in reducing neonatal (newborn) and maternal mortality rates. About 220,000 children and mothers die every year in Ethiopia. For most, the causes of death are unknown as fewer than 30% of Ethiopia's births and deaths ...

  2. In EXOG-depleted cardiomyocytes cell death is marked by a decreased mitochondrial reserve capacity of the electron transport chain

    NARCIS (Netherlands)

    Tigchelaar, Wardit; De Jong, Anne Margreet; van Gilst, Wiek H.; De Boer, Rudolf A.; Sillje, Herman H. W.

    Depletion ofmitochondrial endo/exonuclease G-like (EXOG) in cultured neonatal cardiomyocytes stimulates mitochondrial oxygen consumption rate (OCR) and induces hypertrophy via reactive oxygen species (ROS). Here, we show that neurohormonal stress triggers cell death in endo/exonuclease

  3. Reference intervals of citrated-native whole blood thromboelastography in premature neonates.

    Science.gov (United States)

    Motta, Mario; Guaragni, Brunetta; Pezzotti, Elena; Rodriguez-Perez, Carmen; Chirico, Gaetano

    2017-12-01

    Bleeding due to acquired coagulation disorders is a common complication in premature neonates. In this clinical setting, standard coagulation laboratory tests might be unsuitable to investigate the hemostatic function as they reflect the concentration of pro-coagulant proteins but not of anti-coagulant proteins. Thromboelastography (TEG), providing a more complete assessment of hemostasis, may be able to overcome some of these limitations. Unfortunately, experience on the use of TEG in premature neonates is very limited and, in particular in this population, reference ranges of TEG parameters have not been yet evaluated. To evaluate TEG in preterm neonates, and to assess their reference ranges. One hundred and eighteen preterm neonates were analyzed for TEG in a retrospective cohort study. Double-sided 95% reference intervals were calculated using a bootstrap method after Box-Cox transformation. TEG parameters were compared between early-preterm and moderate-/late-preterm neonates and between bleeding and non-bleeding preterm neonates. Comparing early-preterm with moderate-/late-preterm neonates, TEG parameters were not statistically different, except for fibrinolysis which was significantly higher in early preterm neonates. Platelet count significantly correlated with α angle and MA parameters. Bleeding and non-bleeding neonates had similar TEG values. These results reinforce the concept that in stable preterm neonates, in spite of lower concentration of pro- and anti-coagulants proteins, the hemostasis is normally balanced and well functioning. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Factors associated with mortality in a neonatal intensive care unit

    Directory of Open Access Journals (Sweden)

    Flávia Emília Cavalcante Valença Fernandes

    2017-05-01

    Full Text Available Aims: To describe the factors associated with mortality of newborns hospitalized in a Neonatal Intensive Care Unit in the period from 2012 to 2015. Methods: This was a descriptive, quantitative study of secondary data, correlated with the causes of death and hospitalization according to classification by ICD-10.  The categorical variables were presented in absolute and relative frequencies, with measurements of central tendency and dispersion. Evaluation of the factors associated with neonatal death was made by the logit model of analysis with correction of robust errors by the statistical program Stata 12.0, considering values of p<0.05 and interval of confidence of 95%.  Results: Of the 563 newborns, 58.6% were of the male sex; 89.0% were early newborns, 73.0% were premature. 181 newborns died (32.3%. The main causes of hospitalization were: difficulties during birth, conditions of birth and immaturity (45.0%, pathologies associated with the respiratory system (21.1%, congenital malformations (9.7%. The main causes of death were: septicemia of the NB (40.4%, respiratory discomfort of the NB (22.4%. The significant associations for mortality were the use of ventilatory supports: Mechanical Ventilation (p=0.001, Hallo (p=0.000, CPAP (p=0.000, VNI (p=0.005. Conclusions: The major risk factors for neonatal mortality were associated with septicemia and use of mechanical ventilation.

  5. SUBSTANTIATION OF THE PRIORITIES OF NATIONAL ACTION PLAN TO END PREVENTABLE DEATHS OF NEWBORNS WITHIN THE GLOBAL STRATEGY OF THE UN «EVERY WOMAN EVERY CHILD»

    OpenAIRE

    Znamenska, T. K.; Shun’ko, E.; Kovaliova, O.; Pohylko, V.; Mavropulo, T.

    2016-01-01

    To substantiate the priorities of the national action plan to end the preventable deaths of newborns in Ukraine. Spend a content analysis of the UN advisory basis, the Council of Europe in the field of health and WHO to terminate preventable neonatal deaths, as well as the analysis of the database «MATRIX - BABIES» and unified forms of regional neonatologists statements for 2014.The main priorities of the National Plan of Action for cessation of preventable neonatal deaths are: adequate finan...

  6. Brain death and related issues

    International Nuclear Information System (INIS)

    Akhtar, M.; Mushtaq, S.; Jamil, K.; Ahmed, S.

    2003-01-01

    Concerns about the erroneous diagnosis of death and premature burial have been expressed from times immemorial. Patients with brain stem death have absolutely no chance of recovery. Brain death is considered at par with death in most of the countries. General public in most parts of the world shows reluctance to acce